What about Diet, Dietary Supplements and Complementary and Alternative Medicine?

Many people diagnosed with cancer are interested in learning about how to help themselves through dietary changes, vitamins, supplements, and complementary/alternative medicine (CAM). Many patients or relatives of patients look into these to make sure they have covered all possible options to ensure the best possible outcome. Complementary medicine refers to treatments used in addition to conventional medicine. Alternative medicine is used instead of conventional treatment. Another term you may encounter is integrative medicine, which refers to bringing together the best of conventional and complementary medicine to optimize the care of patients.

An important difference between traditional “western” medicine and CAM, is that in conventional medicine, new drugs and medical devices are available to patients only after extensive, formal research has been conducted. Many practitioners of CAM claim health benefits or “cures” that have not been proven through a rigorous research process. This is especially true for many dietary supplements, which are not sold as drugs, and therefore are completely unregulated as to their safety and any benefits claimed.

But some complementary approaches can enhance comfort, control symptoms or side effects, or help patients maintain their general health and quality of life. Increasingly, physicians and surgeons who care for cancer patients are learning about the potential benefits of an integrative approach. As CAM is more routinely evaluated using accepted research methodology, it will become easier for physicians to help their patients evaluate the potential benefits and risks. We encourage patients who are considering the use of CAM to discuss it with their doctors. We know of no evidence that alternative medicine can achieve outcomes that are better than or even as good as those of conventional medicine.

A number of major cancer centers throughout the United States have developed CAM programs and web sites. Some centers provide only advice and referrals, but others provide CAM services to patients on site. In addition, the National Institutes of Health National Center for Complementary and Alternative Medicine (http://nccam.nih.gov/) and the National Cancer Institute’s Office of Cancer Complementary and Alternative Medicine (http://www.cancer.gov/cam/) offer helpful information.

Among the types of CAM that many patients consider are the following:

Mind-body approaches, such as meditation, hypnosis, or yoga
Biologically based approaches, which include:
- Dietary changes or adoption of special diets, such as the macrobiotic diet or the Pritikin diet
- Nutritional or vitamin supplements, including antioxidant supplements
- Herbs, either as pa`rt of the diet or as supplements
Manipulation of the body, via massage, chiropractic, reflexology, etc.
Energy or vibrational therapies, such as Qi gong, or Reiki
Whole medical systems, usually based on the traditional medicine of ethnic groups, such as Traditional Chinese Medicine or Ayurveda (the traditional philosophical and medical system of India)

Concerns with CAM:

It is normal for patients with cancer to seek comfort, security, and the best possible treatment for their cancer. A common, but overly simplistic, belief is that conventional cancer treatments are toxic and that CAM is safe because it is natural. The conventional cancer treatments in use today have shown benefits in clinical trials; that is, patients who receive the treatments had better outcomes than patients who did not. All chemotherapy drugs require approval by the Food and Drug Administration (FDA) in the United States, and the European Medicine Evaluation Agency (EMEA) in the European Union. The only scientifically acceptable way to discover whether a treatment has benefits and/or side effects, is to study it in a formal clinical trial that has undergone extensive peer scientific and ethical review. Not all "natural" substances are safe; as everyone knows, toadstools are natural and quite lethal.

To date, very few clinical trials have been conducted with CAM therapies in patients with hepatobiliary cancer. Even the best treatments can be abused and may therefore cause harm. For example, some patients may feel so much better as a result of apparently harmless approaches, such as meditation or imagery, that they become euphoric and think that they no longer need conventional treatment. It is important for patients and their families to keep their perspective and to use common sense. If they do, CAM can make an important contribution to their well-being.

To help you research companies that received warning letters from the FDA for selling fake cancer cures online:

www.fda.gov.cder/news/fakecancercuresWL.htm

http://www.liverdisease.com/harmfulherbs_hepatitis.html

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What about Diet, Dietary Supplements and Complementary and Alternative Medicine?