Survivorship. Barrie Cassileth
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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, not instead of, conventional care. Complementary therapies, helpful as they can be, are not in themselves curative. However, when used along with mainstream care, they can help you weather both the disease and any negative side effects of cancer and its treatments as well.
Steve Jobs—A Cautionary Tale
The story of Steve Jobs’ battle with pancreatic cancer, as told by his biographer Walter Issacson, provides a cautionary tale in the use of “alternative” medicine. Employees and friends of the iconic Apple CEO joked that he generated a “reality-distortion field,” allowing him to make up rules as he went along and to create products and even whole new product categories without any prior evidence that people would want them. Many would argue that this was Jobs’ unique brand of brilliance, and few would deny that it served him well in business. But unfortunately, when it comes to cancer or any similar disease, wishful thinking isn’t enough.
Jobs was diagnosed with pancreatic cancer in 2003 after a CT scan to look for kidney stones showed a “shadow” on his pancreas. Although pancreatic cancer is one of the most deadly malignancies, Jobs’ particular type (a neuroendocrine islet tumor) was slow growing and treatable, with a relatively good prognosis. Nevertheless, he opted not to have surgery and sought to treat his disease through diet and other alternative means. He eventually agreed to the surgery nine months later when doctors found that the cancer had spread. Jobs underwent a liver transplant and sought out experimental treatments, but ultimately died on Oct. 5, 2011, at age 56.
Of course, we cannot know for sure what would have been. Perhaps, despite the favorable odds, mainstream treatment may not have been able to save him or extend his life. But turning to surgery earlier and using complementary medicine as an adjunct to, rather than a replacement for, conventional care likely would have given him a better chance.
In the absence of certainty about the best way forward, following the medical evidence—albeit incomplete and constantly evolving—is usually the safest option. Also remember that preventing disease is not the same as curing it. Eating well, exercising regularly, and so on can indeed help decrease the risk of cancer and other diseases, but they can’t be expected to cure disease on their own.
Knowledge Is Power, but Consider the Source
An enormous amount of information about integrative medicine can be found in printed sources and online. But again, a word of caution—some of this information is high quality and scientifically validated, and some is not. Some is downright ugly, as there are many scam artists out there promoting bogus remedies and cures.
At present, a simple Google search for “alternative cancer” produces close to 62 million hits! Two examples of sites that rank highly in that search and should be avoided—Cancer-Tutor.com and Alternative-Cancer.net—are representative examples of the numerous sites that provide and/or sell “advice” on a range of therapies purported to cure cancer without mainstream treatment. On the other hand, there are useful sites that debunk false information, such as QuackWatch.org, and others that provide good information on complementary treatments, their risks, and their benefits. (A list of reliable information sources can be found in the resources section at the end of the book.)
The problem of quackery has been recorded since the seventeenth century. Some quacks are true charlatans with purely financial motives, while others are believers in what they preach. Both, however, promote unproven or disproved alternative therapies as cures for disease. And, unfortunately, there is no shortage of patients willing to embark on these questionable and often very expensive treatment plans. Desperate patients and their loved ones are inclined to believe in miracles—particularly when facing serious or untreatable illnesses.
“The Quack,” oil on canvas by Jan Steen (1626–1679).
The truth is that unproven approaches are dangerous to patients. Even when the therapy itself does not harm, people too often choose to shun conventional treatment entirely and replace it with an alternative treatment that does nothing to diminish their disease. Public education can help, along with knowledgeable doctors who are familiar