Frequently Asked Questions about Complementary Therapies

What are complementary and alternative therapies?

Complementary and alternative therapies are a group of diverse medical and healthcare systems, practices and products that are used to diagnose, treat and/ or prevent illness, although the effectiveness and exact mechanism of such treatments may not have been scientifically proven. Complementary therapies are taken in conjunction with conventional treatments, while alternative therapies are used instead of conventional treatments.

They include:

Nutritional and dietary approaches: supplements, Gerson diet, macrobiotic diet, coenzyme Q10, omega-3 fish oils, sharks cartilage, biological products;
Herbal supplements: ginseng, black cohosh, red clover
Mind-body therapies: imagery, psychotherapy, meditation, spiritual healing, prayer, hypnosis;
Manipulative & body based therapies: acupuncture, massage, reflexology; chiropractic;
Traditional whole medicine systems: naturopathy, homeopathy, ayurveda, traditional Chinese medicine; and
Energy Medicine: reiki, therapeutic touch, qi qong.

(Incorporating definitions from the Therapeutic Goods Administration, 2005 and adapted from the National Centre for Complementary and Alternate Medicine, 2005).

Why has the Cancer Institute NSW decided to look at the use of complementary therapies by people with cancer?

Complementary therapies are supportive approaches that can improve well-being and quality of life for people with cancer. Their use is increasing in Australia with many people with cancer using complementary therapies on a regular basis. Health professionals are increasingly seeing some of these therapies as useful, particularly their potential for dealing with side effects of treatments and the emotional wellbeing of patients. Some hospitals are offering some of these therapies as part of the care pathway for people being treated for cancer.

There is a significant lack of research dealing with many of these complementary therapies.1) While much research is being undertaken, a cohesive and coordinated approach is required to ensure consumers receive independent information about therapies and high quality products and services.

An important premise is the respect for patient choice in meeting their medical needs. However, it is important to advise patients about the realistic expectations of benefit and risk in using complementary therapies. Patients invest much money and hope in complementary therapies and the Cancer Institute NSW will help ensure these investments are not in vain.

What is the Cancer Institute NSW doing in the area of complementary therapies?

The Cancer Institute NSW has established a Complementary Therapies Committee as part of the NSW Oncology Group (NSWOG). The Committee members include complementary therapists, researchers, conventional health professionals and community representatives.

A Complementary Therapies Access Review was conducted in 2005 to investigate the complementary therapies that are currently offered to people with cancer in NSW Area Health Services The Review will inform the future of the Cancer Institute NSW’s Complementary Therapies Program. Click here to download a Fact Sheet about the Review .

A number of links to information on complementary therapies used by people with cancer have been included on our website to help inform people with cancer and their health professionals in their decision to use these therapies. While there has not been a systematic evaluation of all the material contained in these sites they are considered to be reliable and appropriate resources for obtaining information to help people make choices

How widespread is the use of complementary therapies in cancer?

Complementary therapy use by the Australian general population is increasing from up to 52.1% in a South Australian population 2) which was similar to a survey of Australian hospital patients which found 53% of people had used in the past 5 years, were using or intended to use complementary therapies 3) . Around 40% of cancer services and hospitals refer patients to private providers of massage, acupuncture, yoga, chiropractic therapy, reflexology, aromatherapy, Reiki, naturopathy and more.

One-third of cancer services and hospitals also offer meditation directly, 60% offer relaxation and 90% offer counselling.

International studies have shown that the proportion of people with cancer who choose to use complementary therapies may be as high as 83.3% in some populations.5) 6)

What are the most popular complementary therapies used by people with cancer in Australia?

In an Australian study of people with cancer, relaxation (58%), diet (57%), vitamins (53%), positive imagery (44%) and faith healing (30%) were the five most popular therapies. A smaller proportion of people used naturopathy, immune therapy, homoeopathy and acupuncture.

In one Australian study, seventy patients of the 319 assessed (22%) indicated they were using complementary therapies. The most common therapies chosen were dietary and psychological, followed by herbs. Seventy-five per cent of patients tried more than one therapy.7) These trends remain prevalent among cancer patients today.

In International studies religious and spiritual practices tend to be the most commonly reported (80.5%) 6). Healing (65% 8) ), nutritional and supplemental therapies (62.2%) 6) and physical movement (59.2%) 6) were the next commonly reported. When religious and spiritual practices were excluded similar results were found in studies from in the US and UK 6,7.

What is known about the benefits of complementary therapies for cancer?

Many patients report positive effects from complementary therapies and this is supported by their heavy financial investment in them. Clinical trials need to be undertaken on a range of therapies for people with cancer. In Australian cancer patients 4) the most frequently given reasons for their use of therapies were a preference for natural therapy and seeing the complementary therapies as another source of hope. Many people find these therapies provide improvement in their quality of life.

Several surveys have been conducted assessing the use of complementary therapies by people with cancer. Research over the last decade shows that of the people who survive cancer:

25% found acupuncture helpful;
31% found hypnotherapy helpful; and
69% found meditation, relaxation or visual imagery helpful.

And of the palliative cancer patients:

58% found acupuncture helpful;
46% found hypnotherapy helpful; and
82% found meditation, relaxation or visual imagery helpful.

What are the potential dangers?

It is important for cancer patients using or considering complementary therapies to discuss this decision with their doctor or nurse, as they would any therapeutic approach. Some complementary therapies may interfere with standard treatment (rending them less effective) or may be harmful when used with conventional treatment. It is also a good idea to become informed about the therapy, including whether the results of scientific studies support the claims that are made for it. There are many web-based resources that can provide information and also a national independent medicines information line ( Medicines Line - 1300 888 763 ). DO NOT STOP TREATMENT OR ALTER THE TREATMENT PLAN DEVELOPED BY YOUR DOCTOR WITHOUT DISCUSSING YOUR DECISION FIRST.

Should complementary therapies form a part of cancer care?

Reviews will be conducted by the Cancer Institute NSW to help answer these questions. This will allow patient choice and needs to be respected, using all the available evidence.

References :

1) Chatwin J & Tovey P. Complementary and alternative medicine ( CAM), cancer and group-based action: a critical review of the literature. European Journal of Cancer Care2004; 13: 3: 210–218

2) Rao A. Supporting Australians with cancer: a critical review of complementary therapies in oncology. Cancer Forum: The Cancer Council Australia. 2004; 28(2):88-91.

3) Snape L. Personal Communication Nov 2004.

4) Begbie SD , Kerestes ZL, Bell DR. Patterns of alternative medicine use by cancer patients. MJA 1996;165:545-48.

5) Verdoef MJ, Hildsen RJ, O’Beirne M. Complementary therapies and cancer care: an overview. Patient Education and Counseling. 1999;38:93-100.

6) Richardson MA , Sanders T, Palmer JL, Greisinger A, Singletary SE. Complementary/Alternative medicine use in a comprehensive cancer centre and the implications for oncology. Journal of Clinical Oncology 2000;18(13):2505-14.

7) Begbie SD, Kerestes ZL, Bell DR. Patterns of alternative medicine use by cancer patients. Med J Aust 1996; 165: 545–548

8) Downer SM, Cody MM, McCluskey P, Wilson PD, Arnott SJ, Lister TA, Slevin ML. Pursuit and practice of complementary therapies by cancer patients receiving conventional treatment. BMJ 1994;309:86-89.