Survivorship. Barrie Cassileth
at comprehensive cancer centers have the experience to confirm your diagnosis specifically and to ensure that it is accurate and complete. They can then prescribe an appropriate treatment plan based on the latest scientific evidence.
If surgery or other needed treatment is especially complex, you may prefer to have it at the comprehensive center with a team that specializes in your particular type and location of disease. Some advanced diagnostic and treatment facilities are available only at the major cancer centers. When you have a confirmed diagnosis and a treatment plan, you can decide to complete the treatment at the comprehensive cancer center or return home with your treatment prescription to receive your treatment locally. Your local oncologist will always be able to contact and correspond with his or her counterpart at the comprehensive center. If need be, you can always return to the comprehensive center for follow-up consultation tests and advice as needed.
Serious potential problems will be avoided by seeing experts at a comprehensive center right after a tentative diagnosis. It will avoid such worst-case scenarios as receiving an incorrect or insufficient diagnosis or suboptimal treatment, avoiding time delays when time is of the essence.
What about Complementary and “Alternative” Medicine?
The good news is that, thanks to the latest medical advances, millions of cancer patients—the great majority—live for many years after being diagnosed. But the conventional, evidence-based care delivered by oncologists that has made this possible is sometimes lacking in other aspects of care. While conventional care in the hospital setting can be extraordinarily successful at treating the tumor, it can also feel very impersonal. Cancer patients’ physical and emotional symptoms may fall through the cracks. Where conventional therapies such as chemotherapy and radiation treat the tumor, adjunctive complementary (integrative) therapies treat physical and emotional symptoms. At least some adjunctive complementary therapies are available in virtually all major cancer centers, as well as in many community hospitals.
Cynthia, age 36 with advanced-stage gynecologic cancer, commenting on massage therapy
“Knowing I can count on a massage and on this kind of bodywork has made a huge difference. It’s hard to describe what being touched is like during this time, but everything has been so frightening—the diagnosis, the chemo, the pain, the side effects. I am so unbelievably anxious—and your touch helps me so much.”
Complementary therapies do not treat the cancer itself. Instead, they effectively control physical and emotional symptoms and promote general health and well-being. Such therapies include meditation, self-hypnosis, yoga, acupuncture treatment, music therapy, massage therapy, healthy diets, exercise, and more. It is worth repeating that complementary therapies should never be used instead of conventional cancer care. Rather, they are important adjuncts to use along with proper cancer care. Many highly promoted remedies are falsely touted to cancer patients as “miracle cures,” but the old adage about sounding too good to be true applies here. (We’ll discuss this much more in the next section.)
Unfortunately, dissatisfied with the treatment options available to them and looking to take control of their own health and healing, some cancer patients turn instead to a variety of unconventional therapists for “alternative cancer treatments.” These include naturopathy, ayurveda, herbalism, homeopathy, special diets, expensive bogus approaches such as oxygen therapy, bioelectromagnetism, and numerous others.
No “alternative” treatments have been shown through research to cure or treat cancer.
It is important to realize that no “alternative” treatments have been shown through research to cure or treat cancer, despite promoter claims to the contrary. These bogus “alternative” treatments must be separated from complementary therapies, which are evidence based and used to control symptoms and enhance well-being. Respected complementary therapies are detailed in parts 2 and 3.
Our goal in this book is to provide you with clear, objective, and easy-to-use information and resources to help you take advantage of the most useful and scientifically validated complementary modalities, while avoiding those that are unproven or potentially harmful. Information—including much misinformation—abounds on these topics. We hope this book will help light the way as you explore your options.
What Integrative Medicine Is … and Isn’t
Integrative medicine takes advantage of complementary therapies such as acupuncture, massage, meditation, guided imagery and self-hypnosis, and yoga. The field especially emphasizes the crucial importance of good nutrition and physical activity. Always along with, not instead of conventional cancer care, integrative medicine incorporates these and other modalities to manage symptoms that may occur during and remain after completion of cancer treatment. Integrative therapies reduce both short- and long-term side effects, such as pain and anxiety. They can relieve stress, promote general well-being, and, in some cases, reduce the risk of cancer recurrence.
According to the Consortium of Academic Health Centers for Integrative Medicine, there are yet other integrative medicine benefits: it “reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals, and disciplines to achieve optimal health and healing.”
Jimmy, 45-years old, under treatment for diffuse large B-cell lymphoma
“This hasn’t been the easiest time, but one thing I’ve really appreciated about having to be in the hospital was the acupuncture, massage, music, and mind-body sessions. They’ve really helped this all be less awful.”
The Important Difference between Complementary and Alternative Medicine
In the realm of integrative medicine or integrative oncology, terminology can be very confusing. “Complementary” and “alternative” are sometimes used synonymously, and the acronym “CAM” (complementary and alternative medicine) perpetuates the problem. However, here is a better set of terms used by integrative medicine specialists and increasingly by others: “Alternative medicine” is understood to mean treatments promoted for use instead of conventional cancer therapy. “Complementary therapies” are treatments used in conjunction with conventional care.
“Alternative” medicine encompasses a broad array of unconventional treatment modalities that are generally either unproven or were disproved in scientific studies. Examples are listed in the appendix at the end of the book. “Complementary” therapies, on the other hand, are rational and scientifically validated for symptom control use along with mainstream cancer care.
Some modalities that have an appropriate complementary usage may be considered by some for use in treating cancer instead, making that use “alternative” instead of complementary. An example is the use of acupuncture for symptom control (a very helpful complementary therapy), but use of acupuncture to treat cancer would be a useless “alternative” treatment as illustrated in the Steve Jobs cautionary tale that follows. Alternative techniques are to be avoided. They can be dangerous as well as useless.
Acupuncture, massage therapy, and music therapy, among other modalities, have been shown to be safe and effective as complementary treatments for managing pain, nausea, stress, and many other symptoms, and for supporting overall patient well-being. Their growing use in mainstream cancer settings is known as “integrative oncology.”
Important Distinction
Be wary of any claim that a non-mainstream technique (something other than surgery, chemotherapy, radiation therapy, etc.) can treat or cure cancer. Be wary even when such approaches use the term “integrative.” Whether such claims are products of wishful thinking or malicious scams, they are not supported by scientific research. Second, remember that complementary (also called integrative) therapies, by definition, must be used in conjunction with or following the conclusion of,