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Complementary and Alternative Therapies
Complementary and Alternative Therapies
Author: Ayda G. Nambayan, DSN, RN, St. Jude Children’s Research Hospital
Content Reviewed by: Emma deVilla, MA, RN, Nursing Instructor, Capital Health System
School of Nursing, Trenton, New Jersey
Cure4Kids Release Date: 6 June 2006
In Document 9 of Module 4, complementary and alternative medicine (CAM) is referred to as
the broad and complex combination of interventions that are not part of the conventional
treatment for cancer. Complementary therapies are commonly used by patients not to treat their
cancer but to enhance their quality of life by reducing side effects of treatment, enabling selfcare, and enhancing well-being. Patients who use complementary therapies report increased
feelings of control over their disease and self-management. In contrast to complementary
therapies, alternative therapies are often used in desperation and reflect patients’ fear and their
sense of hopelessness and helplessness.
Research has shown that many children and adolescents with cancer are receiving CAM while
they are being treated for cancer, despite the fact that the effectiveness of CAM has not been
proven. Further, results of particular studies suggest that although the reasons for using
complementary therapies differ from the reasons for using alternative therapies, these
unconventional treatments provide patients and families a sense of control over their disease and
a sense of hope.
The parents’ need to “do everything possible” for their child is a strong motivation for the use of
CAM. Parents and patients use CAM (A – 1) to ease pain and relieve side effects caused by
treatment or the disease itself. Whereas some forms of CAM may be advantageous (A – 2) in the
treatment of pediatric cancer, others may be deleterious (A – 3), particularly if used in place of
allopathic treatment.
Patients cannot be and should not be denied the freedom of choice. Because the use of CAM is
often disregarded by health care providers, parents and patients may feel uncomfortable
discussing the issue of CAM and/or disclosing their use of CAM with the physicians and nurses.
Good rapport and open communication between health care providers and parents and patients
are essential components of the treatment process. Failure to keep the lines of communication
open and reveal all aspects of the treatment to health professionals may result in negative
consequences for the patients.
Not only do parents need to disclose their thoughts on CAM use to their health care providers,
but also the physicians and nurses need to be receptive of the wishes of their patients and parents
and understand their motivations for wanting to use CAM. Providing unbiased information about
CAM to the parents and patients is a way to foster open communication and trust.
Module 7 – Document 28
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Complementary and Alternative Therapies
Nursing Roles
Nurses have an obligation to ensure that the patients and families receive the information
necessary to make an informed choice related to the use of CAM. If patients are using CAM,
nurses have the responsibility to monitor them for the effects of this type of treatment.
Nurses have the obligation to educate the patients and families about the use of CAM. Even
complementary therapies that may be beneficial in relieving symptoms in many patients may be
deleterious to others. For example, massage is considered to be soothing and generally helpful in
relieving pain; however, massage may cause pathologic fractures in patients who have bone
metastasis.
Nurses must also support patients and families in their choice of CAM and provide them with
adequate information so they can make informed decisions. Further, nurses should monitor each
patient’s use of CAM and educate parents and patients about potential side effects.
Module 7 – Document 28
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Complementary and Alternative Therapies
Helpful Web Links
American Cancer Society
http://www.cancer.org/docroot/ETO/ETO_5.asp
National Institutes of Health
Botanica Dietary Supplements
http://ods.od.nih.gov/factsheets/BotanicalBackground.asp
University of Texas MD Anderson Cancer Center
CancerWise
Pet Therapy
http://www.cancerwise.org/may_2005/display.cfm?id=75d680ee-3586-4130a324fed565828e87&color=blue&method=displayfull&color=blue
CancerGuide: Alternative and Complementary Therapies
http://www.cancerguide.org/alternative.html
BC Cancer Agency
Evaluating Alternative and Complementary Therapies
http://www.bccancer.bc.ca/PPI/UnconventionalTherapies/EvaluatingAlternativeComplementaryTherapyInformation.ht
m
Quackwatch
http://www.quackwatch.org/00AboutQuackwatch/altseek.html
HealthGoods
http://www.healthgoods.com/education/health_information/Alternative_Therapies/pharmacological_biologi
cal.htm
Module 7 – Document 28
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Complementary and Alternative Therapies
APPENDIX
A – 1 Unconventional Therapies Used by Pediatric Patients with Cancer (N = 75)
Therapies Used
Any use
Diet changes
Nutritional supplements
n
63
35
27
%
84
47
36
Herbal agents
20
27
Other oral therapies
5
7
Touch therapies
Bioenergetic therapies
12
6
16
8
Mind-body therapies
20
27
Topical therapies
13
17
Other non-oral therapies
Detoxification
Hydrotherapy
1
1
2
1
1
3
Aromatherapy
Comprehensive systems
1
2
1
3
Other
6
8
Examples
--Macrobiotic diet
Ensure,
megavitamins, shark
cartilage
Echinacea, St. John’s
wort
Megavitamins,
minerals
Reiki, massage,
Magnet therapy,
antineoplastons
Support groups,
hypnotherapy,
Tibetan yoga
Heat, ointments,
salves, acupuncture,
acupressure
Music, relaxation
Coffee enemas
Warm baths,
compresses
Candles
Psychotherapy,
relaxation
Adapted from
Kelly KM, Jacobson JS, Kennedy DD, Braudt SM, Mallick M, Weiner MA. Use of unconventional therapies by children with
cancer at an urban medical center. J Pediatr Hematol Oncol. 2000 Sep-Oct;22(5):412-6
Abstract:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11037851&query_hl=3&
itool=pubmed_docsum
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Module 7 – Document 28
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Complementary and Alternative Therapies
A – 2 Advantageous Therapies Often Used to Complement Conventional Treatments



Psychotherapy, counseling, relaxation.
These therapies are available in many cancer treatment centers and are now often viewed
as part of conventional support for many patients.
Massage, aromatherapy, reflexology, acupuncture, visualization, hypnotherapy.
Pet therapy. Pet therapy is the use of trained animals such as cats and dogs to visit with
patients. The pets provide comfort for patients and can be used in different therapeutic
ways: for example, repeatedly stroking or brushing a pet’s fur can serve as a
strengthening exercise for patients with brain tumors, mobility can be improved by
walking with a dog, and memory can be improved if the patient memorizes pets’ names.
Research shows that visiting with animals can accomplish the following:
 Reduce stress-induced symptoms,
 Help patients feel less lonely or depressed,
 Provide a welcome distraction from pain and illness,
 Bring out the person’s nurturing instincts,
 Make people feel safe and unconditionally accepted.
Some of these therapies are available in cancer treatment centers or hospices, but they are not
usually part of conventional support. When animals are used as part of therapy, caution
should be taken if patients are immunocompromised as pets may be a source of infectious
pathogens.
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A – 3 Deleterious and Dubious Therapies That May Be Used by Patients with Cancer
Use of the following therapies needs to be closely monitored or discouraged.



Specific dietary regimens, unconventional medicines, megavitamin therapy.
These therapies should be approached with caution and discussed with the physician,
because they may be harmful.
Herbal therapies. It has been claimed that echinacea can boost the immune system, that
St. John’s wort is effective against depression and that melatonin can cure insomnia;
however, there is no sound scientific evidence to support these claims. Similar evidence
is lacking for chaparral tea, which has been described as an analgesic, an expectorant, an
emetic, a diuretic and an anti-inflammatory substance. Essiac tea, which is thought to
contain burdock, Indian rhubarb, sorrel, slippery elm and, possibly, additional ingredients
is claimed to have antitumor effects.
Immunoaugmentive therapies. This type of therapy is also known as cellular therapy,
live-cell therapy, cellular suspensions, glandular therapy, fresh-cell therapy, siccacell
therapy, embryonic-cell therapy and organotherapy. For this type of therapy, tissue is
obtained from animal embryos, fetuses or organs and is processed in a variety of ways.
The product is injected into the patient or taken orally.
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Module 7 – Document 28
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Complementary and Alternative Therapies
Acknowledgments
Author: Ayda G. Nambayan, DSN, RN, St. Jude Children’s Research Hospital
Content Reviewed by: Emma deVilla, MA, RN, Nursing Instructor, Capital Health System
School of Nursing, Trenton, New Jersey
Edited by: Julia Cay Jones, PhD, ELS, Freelance Biomedical Editor, Memphis, TN
Cure4Kids Release Date: 6 June 2006
Cure4Kids.org
International Outreach Program
St. Jude Children's Research Hospital
332 N. Lauderdale St.
Memphis, TN 38105-2794
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Module 7 – Document 28
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