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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 Page 1 of 6 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 Page 2 of 6 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 Page 3 of 6 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 Go Back Module 7 – Document 28 Page 4 of 6 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. Go Back 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. Go Back Module 7 – Document 28 Page 5 of 6 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 You may duplicate and redistribute this content in its entirety for educational purposes provided that the content is made available free of charge. This content may not be modified or sold. You can assist us in the development of additional free educational materials by sending us information about how and when you show this content and how many people view it. Send all comments and questions to [email protected]. © St. Jude Children's Research Hospital, 2006 Last printed 6/30/2017 12:24:00 AM Last Updated: 6 June 2006; AS X:\HO\IO Edu Grp\Projects\NURSING COURSE\NCEnglish\Edited\Module 7\M7 Final Revisions\NEM07D28V10.doc Module 7 – Document 28 Page 6 of 6