CAM-Cancer’s position paper on terminology

Written by CAM-Cancer Executive Committee and Editors and the CAM-Cancer Consortium.
Updated February 9, 2016

In CAM-Cancer, we have a problem that we discuss regularly but cannot resolve easily: our name. We know that many people are unhappy about the term ‘CAM’, complementary and alternative medicine, and we too feel that it is far from ideal. But what is the ideal term? Let’s have a brief look at the options.

‘Alternative medicine’ was probably the first term for this field that was not derogatory. Before it came into common use, some people called it ‘fringe medicine’, quackery or worse. At first sight, ‘alternative’ seemed therefore a reasonable solution to refer to therapies that offered alternative options to treatment. On reflection, however, it turned out to be quite wrong and potentially misleading: the modalities in question are most often used complementary to (i.e. together with or alongside) conventional medicine, not as an alternative (i.e. instead of conventional medicine). The term “complementary medicine” therefore seemed to be a better descriptive term for what was actually being practiced by patients. The conventional medicine community mostly sees the term as appropriate, and it has gained wide support. These “complementary medicine” practices can either be practiced separate from conventional health care, or they can be offered within the conventional health care system. In the latter situation the combination of conventional and complementary practices can be called “integrative medicine”, or “integrative health”.  Proponents of this “integrated” model are divided into two different lines of thinking: Some see integrative medicine or health as a different way of approaching a patient’s health problems, claiming a broader and more “holistic” care. The treatment can, if deemed to be appropriate, include “complementary medicine” practices. The other line of thought sees “integrative medicine” as a technical combination of conventional and complementary treatment approaches. While the advocates of the treatments in question seemed satisfied, critics expressed their doubts. They argued that integrating “complementary medicine” therapies into routine care would render it not more but less efficient.

We at CAM-cancer are well aware of these and most other arguments around terminology. In 2002, when our initiative started, we opted for the term CAM, simply because we thought it is as good an option as any of the others. Re-discussing this choice, we regularly feel more or less the same way. Whether offered inside or outside conventional health care these treatments are still complementary to conventional medicine.

Since we are looking at CAM specifically in the context of cancer, we even believe that using the term CAM, which refers to both alternative and complementary approaches, has certain advantages. On the one hand, there are many treatments that are currently being promoted as an alternative cure for cancer. We feel strongly that we have to inform the public of the evidence on ‘alternative cancer cures’ by providing objective summaries of the evidence which invariably show that they do not cure cancer. On the other hand, there are some forms of CAM which might be helpful in cancer palliation or supportive therapy, and we hope to inform the public about these treatments on a evidence-based basis. CAM covers both these aspects well, and we thus have decided to keep our name unchanged.

CAM-Cancer Executive Committee and Editors, CAM-Cancer Consortium. Complementary or alternative or integrative/integrated? CAM-Cancer’s position paper on terminology [online document]. February 9, 2016.