This document discusses complementary and alternative medicine (CAM) therapies for cancer patients. It defines CAM as non-pharmacological interventions focused on well-being, healing, or symptom management, often used alongside conventional treatment. Some common CAM therapies discussed include massage, acupuncture, meditation, guided imagery, aromatherapy, humor, prayer, spirituality, and herbal remedies. The document provides an overview of the top CAM therapies cancer patients find helpful, potential benefits of various therapies, and signs that a treatment may be unsafe or ineffective. It aims to educate nurses on discussing CAM options sensitively and monitoring potential drug interactions when patients use both conventional and alternative treatments.

1. Non-Pharmacologic
Interventions in Cancer
Complementary and Alternative Medicine (CAM)
Jeff Marc Bliss Billedo, SN
Hematology Unit
Tawam John Hopkins Hospital

2. Objectives
 Define Complementary and Alternative
Therapy.
 Identify nurses roles and responsibilities
involving Complementary and
Alternative Medicine (CAM) use.
 Understand the reasons why clients use
CAM and know which ones help them.
 Familiarize and understand the different
CAM.

3. Complementary and Alternative
Medicine
 Interventions that are supportive in nature and focused
on increasing well-being, healing, or management of
symptoms.
 Most often used in conjunction with conventional medical
treatment.
 May be categorized as those that focus on the following:
1. The mind, body and spirit connection.
2. Manual and energy healing and physical touch
techniques, including manipulation, movement, or
touching the body and energy fields.

4. The 2007 National Health Interview Survey (NHIS),
which included a comprehensive survey of CAM use
by Americans, showed that approximately 38 percent
of adults use CAM.
National Center for Complementary and Alternative
Medicine (NCCAM)

5. NCCAM's Role
NCCAM's mission is to define, through rigorous scientific
investigation, the usefulness and safety of complementary and
alternative medicine interventions and their roles in improving
health and health care. NCCAM achieves its mission through basic,
translational ("bench-to-bedside"), and clinical research; research
capacity building and training; and education and
outreach programs.
National Institutes of Health established NCCAM.
Purposes:
Fund studies evaluating effectiveness of C.A.M.
Advance health professional knowledge re: C.A.M.
Serve as a clearinghouse for information about these therapies
NIH and NCCAM

6. Complementary Therapy
 Is used along with standard or mainstream medical
treatment/ conventional medicine. Some may help
relieve certain symptoms of cancer, relieve side effects
of cancer treatment, or improve a patients sense of well-
being.
Alternative Therapy
 Is used instead of mainstream treatment. They are
either unproven because they have not been
scientifically tested, or they have been disapproved.
Integrative Therapy
 Is a term often used to describe the combined use of
proven mainstream treatments and complementary
methods.

8. QUACKERY and
FRAUD
 WHAT MAKES COMPLEMENTARY
or ALTERNATIVE Therapies
harder to evaluate?
1. The treatments are assumed to
be safe
2. Some treatments are assumed
to be effective
3. The expectation effect
4. Good research studies take time
QUACKERY- refers to
the promotion of
methods that claim to
prevent, diagnose, or
cure cancer s that are
not known to be false,
or which are unproven
and most likely false.
FRAUD- goes a step
beyond quackery. In
this case, treatments
are advertised
deceptively by people
whose main intent is to
make money.

9. Nurses must:
1. Be non-judgmental despite personal opinions.
2. Build rapport by showing client respect – if not, he may
be afraid to tell about CAM use
3. Understand that CAM can be beneficial, when used
correctly.
4. Be aware that CAM can be dangerous if it interacts or
interferes with conventional treatment.
5. Be willing to teach the public about the positive and
negative information regarding CAM.
6. Be aware that use of CAM is popular and increasing and
must be included in the history & physical assessment.
7. Know that herbals in particular, can have significant
effect on prescription drugs and body functions.

10. Reasons given by clients for
using CAM.
 Helps to cope more
effectively with stress.
 Decreases discomforts of
treatment.
 Gives increased sense of
control.
 Improves quality of life.
 Relieves symptoms (e.g.
pain, nausea, fatigue,
insomnia).

11. Complementary and Alternative Medicine
Therapies Identified as Helpful by Clients
with Cancer
Therapy Helpful * Number
Self-help groups 100% 7
Spiritual 94% 34
Imagery 86% 8
Massage 80% 5
Exercise 67% 12
Lifestyle diet 60% 5
Relaxation 50% 22
Herbal/Botanical 20% 5
Sparber A et al: Use of Complementary medicine by adult patients participating in
cancer clinical trials, Oncology Nurs Forum 27(4):628, 2000
*Percentage reflects answers given as helpful/very helpful.

12. Types of CAM
non
pharmacologic
interventions
1. Systems of
Health Care
2. Mind-body
therapies
3. Manipulative
and body-
based
therapies
4. Biologically
based
therapies
5. Energy
therapies

13. Types of CAM :Non-
Pharmacologic Interventions
Mind-Body-Spirit
techniques
Imagery,Meditation,Yoga,Aromatherapy,
Hypnosis, Humor,Spirituality
Manipulative and Body
based therapies
Massage,Reflexology,Chiropratic,Osteopa
thy
Manual or energy healing
techniques
Acupressure,Acupuncture,Healing and
Therapeutic touch
Biologically based
approaches
Diet,Herbals,Vitamins
Energy therapies Reiki,Magnets,Qi gong
Alternative medical
systems
Ayurveda,Naturopathy,Homeopathy,TCM

14. Prayer and
Spirituality
•Spirituality is generally described
as an awareness of something
greater than the individual self. It is
often expressed through religion
and/or prayer, but there are many
other paths of spiritual pursuit and
expression.
•Prayer is the most Widely Used
CAM in U.S.
(NCCAM, 2004)
•Prayer
•For Self
•For Others
•Healing Prayer Services
•Prayer Groups

15. Meditation
• Stress relief/ reduce
anxiety
• Relaxation
• Reduced levels of lactic
acid
• Decreased oxygen
consumption
• Slowed heart rate
• Decreased blood
pressure
• Improved function of
immune system
• Reduce pain
Hypnosis
• An artificially induced
alteration of
consciousness
characterized by
increased suggestibility
and receptivity to
direction.
• It has been used to
reduce anxiety, nausea,
vomiting and pain and to
promote healing.

16. Guided Imagery
• Distraction when
confronting pain, discomfort
or fear
• Making decisions and
altering behavior
• Caution: not recommended
for emotionally unstable or
cognitively impaired client
• Reduction of nausea &
vomiting and pain.
• Decreasing anxiety
• Promoting comfort during
cancer treatment
Music
 Considered a universal
language and is used in
combination with many
approaches to enhance
relaxation.
 Studies support
effectiveness of music as a
non pharmacologic method
of pain reduction by
stimulating the release of
endorphins.

17. Massage
• Within few minutes of
massage, most people
experience reduced blood
pressure, reduced heart
rate, endorphin release,
slower, deeper, more
effective breathing and
reduction of muscular
tension.
• Some studies suggests that
it can decrease stress,
anxiety, depression, and
pain.
Reflexology
• A form of foot massage
designed to harmonize body
functions.
• Based on the concept that
the whole person is
interconnected and that
imbalance in one part of the
body is reflected in changes
else where.

18. Acupressure
• Is based on the eastern
concept that Qi, or energy,
flows through the body in
defined pathways called
meridians.
• This energy can be blocked
or stuck and pressing on
specific points along the
meridians or channels
through which Qi is thought
to flow can improve the flow
and relieve imbalance.
Acupuncture
• Treatments involve leaving
thin, sterile acupuncture
needles in the skin for 20
minutes.
• It is a technique in which
very thin needles are put
into the body to treat a
number of symptoms.
• It may help with mild pain
and some types of nausea.

19. Aromatherapy
 Lavender – promotes relaxation &
sleep
 Peppermint – stimulation,
concentration
 Sandalwood – ease depression
 Chamomile – relaxation
 Lemon – promotes sleep/ tx for
insomnia and/or digestive disorders
•Is the use of
fragrant substances
called essential oils
that are distilled
from plants to alter
mood or improve
symptoms such as:
•Stress , nausea
and anxiety
•Muscular and
rheumatic pains
•Digestive disorders
•Can be used for
sense of smell, but
also as
compresses, baths
or topical

20. Humor
•Ability to see the humor in
situations in life is a valuable
health asset and can be
cultivated even during serious
illness such as cancer.
•Laughing relaxes the nervous
system, and the diaphragm
moves up and down vigorously,
emptying the lungs more
completely than usual.

21. Signs of treatments
to avoid
1. Does the treatment promise for a
cure for all cancers?
2. Are you told not to use
recommended or standard
medical treatment?
3. Does the treatment claim to offer
benefits, but no side effects?
4. Is the treatment or drug only
offered by one person or clinic?
5. Do the promoters use terms like
“scientific breakthrough”, “miracle
cure”, “secret ingredient” or
“ancient remedy”?
6. Are you offered personal stories
of amazing results but no actual
scientific evidence?
7. Do the promoters attack the
medical or scientific community?

22. References:
• Itano, J.K., Taoka, K. N. (2005). Core Curriculum for
Oncology Nursing
•http://www.mdanderson.org/patient-and-cancer-
information/cancer-information/cancer-topics/cancer-
treatment/complementary-medicine/index.htm
•http://www.cancer.org/treatment/treatmentsandside
effects/complementaryandalternativemedicine/comp
lementary-and-alternative-methods-for-cancer-
management
•http://www.nccam.nih.gov/health/whatiscam
•http://www.pubmed.com