Complementary and Alternative Medicine

“Integrative health care” includes both conventional treatments and complementary approaches. Conventional treatment refers to mainstream Western medicine. Complementary approaches are practices used alongside conventional treatment. These approaches may include:^1,2

• Mind-body practices – yoga, meditation and relaxation techniques, massage, chiropractic manipulation, acupuncture, hypnotherapy
• Natural products – herbs, vitamins, minerals, probiotics, other dietary supplements
• Traditional healing practices and alternative medical systems – traditional Chinese medicine (TCM), Ayurvedic medicine, homeopathy, and naturopathy

Some people use the term alternative medicine to describe these practices. Alternative medicine is when non-mainstream treatments are used in place of conventional medicine.^1,2

Home remedies are also a form of alternative medicine, but it is important to understand the associated risks.¹

Who uses complementary practices? And why?

People choose complementary practices for many reasons. Some people use them to relieve symptoms of cancer treatment. Others find that they reduce stress related to treatment or procedures. Many complementary approaches can be used safely by most people.^1,2

What are the benefits of complementary practices?

Many complementary practices are safe to use with conventional treatment. These practices may control symptoms. They may improve quality of life. For example:³

• Acupuncture may relieve mild pain or nausea and reduce stress and anxiety.
• Aromatherapy can relieve mild pain and nausea. It can also be relaxing.
• Massage therapy may decrease fatigue, anxiety, nausea, and pain.
• Meditation may help you be relaxed and calm during stressful procedures or treatments. It has been shown to potentially reduce blood pressure and symptoms of anxiety and depression.
• Reiki is an energy therapy that may reduce anxiety and improve well-being.
• Hypnotherapy may reduce vomiting, pain, and fatigue.
• Spirituality and prayer may help with better coping, improved health, reduced anxiety, and depression.

What are the risks of complementary practices?

Most complementary practices are safe to use. But when it comes to dietary supplements, such as herbs, vitamins and minerals, and probiotics, many of these interactions are not well studied or understood.¹

Supplements are not regulated by the US Food and Drug Administration (FDA) the same way other drugs are. This means that no outside agency is required to confirm the ingredients or suggested dose.⁴

For example, a fish oil supplement may have more or less fish oil than listed on the label. A supplement may also contain ingredients that are not labeled correctly or at all. This can be dangerous. It can lead to taking too much or taking unwanted ingredients.⁴

The FDA created good manufacturing practices (GMPs) to help this situation. GMPs are guidelines for companies to follow when making supplements. But the FDA may not regularly inspect all facilities making supplements in the United States.⁴

Many more supplements are sold than are adequately tested. Your doctor can help you decide if a supplement is safe.⁴

Alternative practices can be dangerous if they delay effective treatment. Delaying effective treatment for skin cancer can lead to worse outcomes. One risk of using a possibly ineffective therapy is that it gives the cancer time to grow. Melanoma is the most likely to invade and spread (metastasize) if it is not treated early. Aggressive squamous cell carcinoma and basal cell carcinoma are less common. However, metastatic non-melanoma skin cancer can be hard to treat.

Should I talk with my doctor about complementary medicine?

Friends and family are often the main source of information about complementary medicine. Your doctor may not discuss these approaches, and you may be reluctant to bring them up. Although it may be hard to start the discussion, there are good reasons to have this conversation:^3,5

• You probably have researched the alternative treatment and learned what other respected sources have to say about it. Asking for your doctor’s thoughts is part of your own research about this treatment. This discussion is part of developing a treatment plan that both you and your doctor can agree upon.
• Dietary supplements can have harmful interactions with conventional medicines. To avoid harmful effects, patients should review all medicines (prescription and over-the-counter), herbal supplements, and vitamins they are taking, or are considering taking, with their doctor or pharmacist.
• By discussing your concerns with your doctor, you may learn that there are mainstream ways to manage bothersome side effects or symptoms.

Please talk with your doctor if you are thinking of stopping or delaying conventional treatment. Ultimately, the choice to start or continue treatment is yours. However, together with your doctor, you may be able to modify treatment to make it more acceptable. You may learn that there are different treatment options with proven benefits.⁵