The use of complementary and alternative medicines (CAM) by cancer patients is substantial. CAM are defined as methods that are not part of standard medical treatment (as described by evidence-based clinical practice guidelines, consensus statements or common medical practice) and are either used instead of (alternatively) or in addition (complementary) to a standard cancer treatment (See also our position paper on terminology, in our Special Topics section).
These methods represent a great variety ranging from chemically well-defined molecules or other substances and mixtures from plant or animal origin to non-material methods like mind-body therapies, spiritual healing or psychosocial procedures.
The reasons why cancer patients use CAM are complex. Some patients hope to cure the disease or support their body in the fight against the disease. Others hope to reduce the side effects of conventional cancer treatments or are generally disappointed with their conventional treatment. The desire to explore all treatment possibilities and/or to take control and have an active input into their treatment is another factor. At a psychosocial level, patients are facing fears about death and are searching for support and hope.
The challenge for oncologists is to give an objective and responsible answer to this type of demand. An informative dialogue should therefore be offered on all questions and needs of patients and their relatives. (See also the article How to communicate effectively about complementary, integrative and integrative medicine, in our Special Topics section).
The patient autonomy should be respected but the oncologist has to discuss and negotiate a realistic and safe treatment plan with their patients. Oncologists also need to be aware of their patients’ use of CAM and should ask them patients about it directly, as many of them do not report their CAM use to their regular health provider. Doctors need objective and independent information on CAM methods, especially on safety issues like adverse effects and possible interactions, as well as a critical appraisal of medical evidence. This space should not be left empty and therefore available to misinformation or any form of quackery.
Cancer patients and the public are flooded with information about CAM. Rumours, the media, and the internet spread accurate and inaccurate information at accelerating rates. It is critical that both, patients and physicians, have access to reliable evidence-based information. Today there are many scattered resources available resulting in redundancies and sometimes outdated publications. By bringing leading CAM and cancer experts together, the CAM-Cancer project seeks to present an authoritative information resource supported by CAM and/ or cancer groups.
The project was originally funded by the European Commission within the framework of the "Quality of Life and Management of Living Resources" program during its set-up phase in October 2002 - September 2005.
Aims and outcomes of the original project
The aims of the original CAM-Cancer project were:
- to prepare and disseminate suitable evidence-based information for health professionals in order to assist them in informing their patients
- to build an international authoritative network around CAM in cancer led by a panel of experts in CAM research and/or in cancer care with privileged contacts to cancer organizations.
The project had a number of key outcomes:
- CAM summaries
The main outcome of the original project was the production of a number of peer-reviewed, up-to-date summaries of the existing scientific information on CAM modalities in cancer. Priority was given to modalities that are widely used or are associated with risks. The summaries synthesize facts on CAM and provide clear statements to health professionals. Documentation with regards to efficacy/ effectiveness and safety issues as well as CAM background, promoter claims, description of treatment methods, and biologic mechanisms were gathered and presented in a clear and easily accessible format.
- Network development
Another outcome was the establishment of an international, authoritative network of key stakeholders with an interest in CAM. This resulted in the establishment of the CAM-Cancer Collaboration.
In September 2007, the National Research Center for Complementary and Alternative Medicine (NAFKAM) took over the responsibility to continue the CAM-Cancer project, by hosting, maintaining and developing the web site and its summaries, along with managing the CAM-Cancer Collaboration.