Complementary cancer therapies

Definition

Alternative and complementary therapies refer to treatments outside the mainstream of Western scientific medicine. They cover a wide variety of approaches, ranging from the medical systems of other cultures to special diets or medications, spiritual practices, herbal remedies, and external energy sources. As a general rule, complementary is used to refer to treatments that are offered alongside mainstream methods of cancer therapy to relieve the patient's discomfort or contribute to his or her overall sense of well-being. Other terms that are sometimes used for complementary therapies are adjunctive, which means helping or assisting, and supportive. Complementary or supportive treatments are not considered cures for cancer. When they are given together with mainstream cancer treatments, the combination is called integrative therapy.

The word alternative refers to treatments used instead of mainstream cancer treatments in an attempt to cure cancer. Some alternative treatments have not yet been tested by scientific researchers while others have been tested and shown not to work. If alternative remedies are used instead of proven cancer treatments, they may harm the patient by allowing the cancer to grow and reducing the chances of curing it by standard therapies. Treatments that are still being tested on animals or humans are called research or investigational therapies. In the United States, medications or other methods of treatment must be approved by the Food and Drug Administration (FDA) before they can be considered standard treatments for cancer. In 1991, Congress established the Office of Alternative Medicine as part of the National Institutes of Health. It includes the National Center for Complementary and Alternative Medicine, or NCCAM. As of October 2000, NCCAM supports 15 specialized research centers that study the safety and effectiveness of various complementary and alternative medicine (CAM) treatments for cancer.

Description

Today there are over two hundred complementary/alternative substances and treatment methods that have been given to cancer patients. They can be grouped for purposes of discussion into ten major categories.

Biologic

Biologic treatments are drugs or other medical products that are derived naturally from plants, animals, or the human body itself. They are thought to help the body fight cancer by restoring its biochemical balance.

Many biologic treatments have already been tested by researchers. They vary widely in their effectiveness:

• Antineoplaston therapy. Antineoplastons, which are extracted from blood serum and urine, are short-chain amino acids that supposedly reprogram the DNA of cancer cells so that the cells reproduce normally instead of uncontrollably. The FDA and National Cancer Institute (NCI) have permitted clinical trials of antineoplas-tons in cancer patients. However, the clinical trials were closed in 1995 because of small enrollment numbers in the trials and lack of consensus about how to recruit more patients for the trials. Because of the small numbers in the trials, the NCI draws no conclusions about the effectiveness of antineoplastons. Antineoplaston therapy can be used with standard chemotherapy .
• 714X. 714X is a treatment consisting of three 21-day rounds of injections of camphor and organic salts directly into the lymphatic system. It is based on a theory that cancer cells use up large amounts of nitrogen and secrete a poisonous K-cofactor that paralyzes the immune system so that nitrogen can be drawn from healthy cells. Since the camphor in 714X contains nitrogen, the cancer cells do not have to secrete the K-cofactor, which in turn allows the immune system to recover.
• Cancell/Entelev. Cancell/Entelev is a liquid marketed as a treatment for cancer as well as AIDS, epilepsy, lupus, and other diseases. It is also sold as Cantron, Sheridan's Formula, Jim's Juice, and Crocinic Acid. Cancell is a mixture of 12 common chemicals—including nitric acid and sulfuric acid—none of which are known to be effective against cancer. The NCI tested Cancell four times between 1978 and 1991; no benefit to this therapy could be demonstrated, and the NCI decided not to study it further.
• Hydrazine sulfate. Hydrazine sulfate is a chemical that has been used to treat the loss of appetite (anorexia ) and wasting away of body tissue (cachexia) that occur in late-stage cancer; it has not been promoted as a cure for cancer. It is available in the United States as a dietary supplement. Hydrazine sulfate has been studied by the Russian government as well as the NCI, but test results are not conclusive. As of 2001, no clinical trials of hydrazine sulfate are being conducted in the United States.
• Laetrile. Laetrile, which is also known as amygdalin or vitamin B₁₇, is a chemical found in fruit pits, lima beans, sorghum, and clover; it contains sugar and produces cyanide. The cyanide is considered to be the primary anti-cancer agent in laetrile. Laetrile has been used by itself to treat cancer and as part of metabolic therapy, but it has not shown any anti-cancer effectiveness in NCI clinical trials. It is not approved for use in the United States but is available in Mexico. When taken by mouth, laetrile can produce side effects resembling the symptoms of cyanide poisoning.
• Hydrogen peroxide therapy. Hydrogen peroxide has been used in the United States and Japan since the 1960s as an adjunctive treatment to radiation therapy . The hydrogen peroxide is diluted in water and injected directly into the patient's arteries. Some researchers think that hydrogen peroxide helps to shrink tumors by making them more sensitive to radiation.

Metabolic therapies

Metabolic therapies combine enzyme treatments, diets, and nutritional supplements with herbal medicines or special formulas. They are based on the belief that cancer results from many factors acting together, and that it should be treated by strengthening the entire body, not just by removing the tumor.

Most of these therapies are considered questionable by mainstream physicians:

• Kelley/Gonzalez therapy. Kelley/Gonzalez therapy focuses on cancer of the pancreas. Its practitioners regard cancer as resulting from inadequate levels of pancreatic enzymes, which help the body to digest protein. Kelley/Gonzalez therapy includes a diet tailored to each individual, nutritional supplements, digestive aids, enzyme supplements, and colonic irrigation. It is the most promising of the metabolic therapies. As of 2001, the NCI is conducting clinical trials of Kelley/Gonzalez therapy at Columbia University.
• Gerson therapy. Gerson therapy combines a low-salt vegan diet with large quantities of fruit and vegetable juices, as well as three or four coffee enemas each day to detoxify the body. It is based on the notion that cancer patients have too much sodium in their bodies and not enough potassium. Gerson therapy is not recommended as an alternative to conventional treatment for cancer.
• Issel's whole-body therapy. This form of metabolic therapy originated in Germany. It includes psychotherapy, oxygen therapy, and the removal of amalgam dental fillings (which contain small amounts of mercury) as well as a special diet.
• Revici therapy. Revici therapy is based on the belief that cancer is associated with imbalances in the body's tissue-building and tissue-breakdown processes. These imbalances are treated with intravenous injections of lipids (fatty or waxy organic substances) containing oxygen, copper, calcium, and selenium.

Immune enhancement therapies

Immune enhancement therapies are based on the theory that cancers in humans result from a weakened immune system.

Therapies in this category are not recommended as alternatives to conventional cancer treatment:

• Immuno-augmentative therapy (IAT). IAT is based on the theory that cancer results from an imbalance among four blood protein components, called the tumor antibody, the tumor complement, the blocking protein, and the deblocking protein. Treatment consists of injecting various amounts of these components to restore the proper balance.
• Livingston therapy. Livingston therapy uses a raw-food vegetarian diet combined with nutritional supplements and vaccines to restore the patient's immune system. It is based on a theory that cancer is caused by a bacterium called progenitor cryptocides, found in eggs, milk, poultry, and beef products.

Bodywork/movement therapies

Doctors often recommend bodywork and movement therapies as adjunctive treatments for cancer because they benefit patients emotionally as well as physically. The exercise involved in dance therapy, yoga, and t'ai chi helps to preserve muscle tone and joint flexibility. Therapeutic massage can relieve muscle soreness resulting from emotional stress.

Some common forms of body work and movement therapy include:

• Acupuncture and acupressure. Acupuncture is a basic form of treatment in traditional Chinese medicine. It involves the insertion of very thin steel needles into points on the body associated with the flow of vital energy. In acupressure, the energy points are stimulated by finger pressure. These forms of treatment are often combined with massage.
• Chiropractic. A chiropractor treats the patient's nervous system by manipulating or adjusting the segments of the spinal column. Some people find that chiropractic relieves back pain. As of 2001, one of the NCCAM's 15 research centers is specializing in studies of chiropractic.
• Yoga. Yoga is a good form of low-impact exercise for releasing stress and tension. Its stretches and poses can be modified to fit the needs or limitations of individual patients. Cancer patients who have had surgery should consult their doctor before starting a yoga program.
• T'ai chi. T'ai chi is a Chinese system of meditative exercise that involves a series of slow circular or stretching movements. Many patients find it relaxing and calming. In clinical settings, control groups practicing t'ai chi showed improvements in symptoms and signs such as strength, appetite, weight gain, stamina, and bowel function, hence increasing the ability for self-cure. In addition, t'ai chi and related practices are simple to learn and produce no side effects.
• Therapeutic massage. Therapeutic massage is often recommended as a complementary treatment to mainstream cancer therapy, but should not be given near the area of any recent surgery.
• Dance therapy. Dance therapy allows patients to release strong emotions as well as exercising their joints and muscles.

Diets and digestive treatments

These forms of treatment are based on the belief that the human digestive tract stores or produces toxic substances and should be cleansed periodically by special foods, fasting, or washing out the lower bowel.

Dietary therapies vary in their usefulness as complementary cancer treatments:

• Vegan diets. Vegan diets are vegetarian diets that omit eggs and dairy products as well as meat. They are thought to offer some protection against cancer, because the milk as well as the tissues of animals raised for meat may contain carcinogenic (cancer-causing) chemicals. In addition, the high fiber content of vegan diets appears to lower the risk of colon cancer.
• Fasting and juice therapies. These therapies are a major part of naturopathic treatment. Naturopaths maintain that the body can devote more of its energy to healing itself when it does not have to digest high-fat, high-calorie foods. In addition, they regard fasting as a way to help the body rid itself of toxic wastes.
• Macrobiotics. Macrobiotic diets originated in Japan, and classify foods according to the Eastern distinction between yin and yang rather than Western nutritional categories. These diets emphasize brown rice, fruits and vegetables eaten in season, and cooking over a flame rather than using electricity. Although macrobiotic diets have been credited with preventing or curing cancer, no scientific studies have verified these claims.
• Colonic irrigation. This is a treatment method that circulates warm water through the patient's large intestine to remove feces and toxic substances from the walls of the colon. It has been recommended by some alternative therapists for AIDS-related cancers.

Herbal therapies and food supplements

Herbal treatments are historically important because of their role in the development of a number of standard medications. Complementary herbal treatments are presently used to relieve the side effects of mainstream cancer therapy, such as peppermint tea for nausea or ginger for diarrhea . Patients should, however, consult a health professional before taking any herbal preparation by mouth to make sure that the herb (s) will not interact with prescription medications. Fragrant herbs (rosemary, lemongrass, mint, etc.) can be added to massage oils or bath water for aromatherapy.

Other herbal therapies and dietary supplements have been advertised as cures for cancer:

• Hoxsey formulas. The Hoxsey formulas are herbal remedies for external as well as internal use. The external Hoxsey formula contains bloodroot, which was used by some Native Americans to treat cancer. The internal formula is a mixture of red clover, buckthorn, burdock, licorice root, and several other herbs. The American Cancer Society placed the Hoxsey formulas on its list of unproven methods in 1968.
• Cartilage. Both bovine (cow) and shark cartilage are available in the United States as dietary supplements. Shark cartilage is presently being studied as a cancer treatment in clinical trials approved by the FDA. It appears to slow down or stop the formation of new blood vessels (angiogenesis) in tumors in animals. As of 2001, however, it is not clear that shark cartilage is an effective anti-cancer treatment in humans.
• Coenzyme Q₁₀. Coenzyme Q₁₀, also known as vitamin Q₁₀, ubiquinone, or ubidecarenone, is a compound that occurs naturally in the human body. It appears to help cells produce energy and to stimulate the immune system. Coenzyme Q₁₀ has not been investigated widely as a treatment for cancer in humans as of 2001, but it has been reported to lengthen the survival of cancer patients. It is sold in the United States as a dietary supplement.
• Mistletoe. Mistletoe (Viscum album ) is a parasitic plant that has been shown to kill cancer cells in laboratory tests and stimulate the immune system. Although the leaves and berries are toxic to humans, mistletoe extracts are available over the counter in Europe and Asia. There is no clinical evidence that mistletoe is an effective treatment for human cancer, and mistletoe extracts have not been approved for sale in the United States.
• Pau d'arco. Pau d'arco comes from a tree in the South American rainforest. The bark is dried and used to brew a medicinal tea. Pau d'arco was investigated by the NCI for possible anti-tumor effectiveness, but the study concluded in 1974 that a dose strong enough to shrink tumors in humans would have toxic side effects. In small doses, however, pau d'arco tea does appear to stimulate the immune system. It can be purchased in the United States in health food stores.
• Essiac tea. Essiac is a mixture of herbs including bur-dock, slippery elm inner bark, sheep sorrel, Turkish rhubarb, watercress, red clover, and kelp. Promoters of Essiac claim that the tea strengthens the immune system, relieves pain, increases appetite, reduces tumor size, and extends survival. Some also claim that it cleanses the blood, promotes cell repair, restores energy levels, and detoxifies the body. Despite testimonials, there is no scientific evidence to support the use of this mixture for cancer treatment. NCI studies of Essiac in 1983 found no anticancer activity. However, serious side effects from these herbs are rare, and patients may benefit psychologically from the treatment.

External energy therapies

Treatments in this category are based on the belief that there are forms of energy in the universe that can be tapped for purposes of human healing. These energies, which are sometimes called "subtle energies, " are thought to be present in mineral formations, plants, the earth's magnetic field, the spectrum of visible light, interpersonal contact, and certain structures or energy fields within the human body itself. Most practitioners of external energy therapies do not ask cancer patients to avoid or give up conventional treatment methods.

The most common forms of external energy therapies include:

• Crystal/gemstone healing. Crystal or gemstone healing is based on the theory that the human body is surrounded by an invisible energy field, or aura, and that the color or crystal structure of a gemstone or mineral can transmit healing energy to the body through the aura.
• Shamanism. Shamanism is the belief that certain persons (shamans) have unusual spiritual powers that can be used for healing. The shaman (who may be a woman in some traditions) acts as an intermediary between the patient and supernatural beings or powers. Native American healers are one type of shaman.
• Bach flower remedies. The 38 Bach flower remedies are tinctures of wildflowers discovered by an English homeopath in the 1920s. They are said to assist physical healing by clearing up negative emotional states or conditions.
• Light/color therapy. Light or color treatment combines the physical effects of the different wavelengths in visible light with the psychological or symbolic meanings attached to specific colors. The practitioner may suggest wearing or visualizing certain colors, or shine colored lights on specific energy points on the patient's body.
• Reiki. Reiki is a holistic approach based on Eastern concepts of universal life energy in which the practitioner holds her or his hands in symbolic patterns over the affected part of the patient's body. It is not a form of massage. Reiki can be used for self-healing as well as treating someone else.
• Therapeutic touch. Therapeutic touch resembles Reiki in that the practitioner is thought to transmit universal energy or "life force" to the patient. Instead of touching the patient directly, however, the practitioner passes his or her hands over the patient's energy field, two to four inches above the body.

Mind-and spirituality-based approaches

Mind-based or spirituality-based approaches draw on the mental and spiritual dimensions of human beings to treat the physical side effects of cancer treatment. They are related to the belief that all dimensions of a person's being should be involved in cancer treatment, and that the mind and spirit can affect or influence physical processes.

These approaches are frequently recommended by health professionals as complementary treatments that allow patients to regain a sense of personal effectiveness and active participation in their lives:

• Prayer. Prayer has been shown in over a hundred reputable double-blind clinical studies to have positive effects on anxiety, high blood pressure, headaches, heart disease, and wounds. As of 2001, NCCAM is conducting a study of the effects of prayer on breast cancer in African-American women.
• Meditation. Meditation is helpful in relieving stress, pain, and other side effects of cancer treatment. There are several different approaches to meditation, such as using a mantra (a sacred word or phrase), chanting, focusing on a visual image, or focusing on one's breath.
• Biofeedback. Biofeedback is a method of learning to modify certain body functions (temperature, heart rate, etc.) related to relaxation with the help of electronic monitors. Eventually, the patient can learn to control his or her relaxation responses without feedback from the machine.
• Hypnosis. Hypnosis is often recommended to lower anxiety and relieve pain. Patients can be hypnotized by a therapist or taught to hypnotize themselves. Hypnosis and biofeedback have both been shown to ease chemotherapy-related nausea and anticipatory nausea (queasiness caused by psychological triggers, such as the sight of the chemotherapy room or smell of treatment chemicals).
• Imagery and visualization. Patients are asked to picture or create an inner image that symbolizes their resistance to cancer. They might visualize their medications as a fire burning up their cancer cells, or their white blood cells as soldiers fighting the enemy.

Sensory-based therapies

Treatments in this category are often used in integrative treatment plans. They are given to help cancer patients cope with the side effects of radiation or chemotherapy, to provide positive sensory experiences, and to improve overall quality of life.

Sensory-based treatments include:

• Aromatherapy. Aromatherapy is the use of fragrances—usually the essential oils of flowers and other plant parts—to relax cancer patients or lift their spirits. The fragrant oils are used to scent oil for massage or added to bath water.
• Art therapy. Art therapy allows cancer patients to express their feelings through their creations and to find satisfaction in learning new skills or techniques. Art therapy may include painting, sculpture, making pottery, quilting, metalwork, print making, photography, or other activities.
• Journaling. Keeping a journal can aid a patient's psychological well being by providing an emotional and creative outlet. Journaling also offers an arena in which patients can sort out thoughts and concerns about their disease.
• Music therapy. Music therapy can be used to help patients relax, release feelings of sadness or anger, or participate in a group activity. It can involve making music as well as listening to it.
• Pet therapy. Pet therapy is the use of trained animals (usually cats, small dogs, birds, or rabbits) in hospital settings to provide comfort and companionship to cancer patients. Petting and talking to the animals has been shown to benefit patients psychologically and physically.

Traditional approaches

Some of the therapies in this category developed outside the European medical tradition, while the last two developed in the West during the eighteenth and nineteenth centuries:

• Native American medicine. Specific beliefs about the causes of disease vary among the five hundred tribes of Native Americans. In general, however, Native American medicine emphasizes the importance of people living in beauty, harmony, and peace with one another and with their environment. Native American healing rituals are most often used as complementary treatments within integrative treatment plans.
• Ayurveda. Ayurveda is the traditional medical system of India. It emphasizes identifying a person's physical and psychological constitution as part of the healing process. Treatments include dietary recommendations and herbal or mineral remedies.
• Traditional Chinese medicine (TCM). TCM includes five major forms of treatment: diet, exercise, acupuncture, massage, and traditional herbal remedies. It regards human health as resulting from balancing the various vital energies within the human body and keeping the body in harmony with its external environment. As of 2001, the Center for Cancer Complementary Medicine at Johns Hopkins is conducting two studies of Chinese herbal remedies.
• Homeopathy. Homeopathy is a system of treating disease with extremely small doses of substances that would produce symptoms in a healthy person similar to those of the disease being treated. For example, a homeopathic practitioner might give a feverish patient belladonna, which can cause fever in a healthy person.
• Naturopathy. Naturopathy is an approach to healing that rejects surgery and synthetic drugs. Naturopaths recommend vitamin supplements, natural herbal remedies, diets, and fasting to assist the body's natural healing processes.

Special concerns

Because complementary and alternative therapies vary so widely in their underlying assumptions, their claims to effectiveness, their licensing standards for practitioners, and the materials and equipment involved in their use, patients should talk to their doctor before beginning any complementary or alternative form of treatment. Patients should also investigate said treatments and the practitioner's level of experience in this area.

Surgery

Cancer patients who have had recent surgery should consult their doctor before starting yoga, t'ai chi, or any other form of movement therapy. In addition, Swedish massage and certain forms of deep tissue massage are not suitable for patients who have not fully recovered from surgery.

Clinical trials

Patients who are interested in a specific complementary or alternative therapy may wish to participate in a study of that treatment. Information about CAM trials can be obtained from the NCI's CancerNet at <http://www.cancernet.nci.nih.gov/cam>.

Fraudulent treatments

False claims about a treatment, such as stating that it cures or prevents cancer when it is known to be useless, are sometimes referred to as "quackery." Several groups and organizations can help patients evaluate questionable therapies.

Treatment decisions

Patients considering CAM therapies should ask their doctor:

• What does the treatment claim to do? Cure cancer? Increase the effectiveness of standard treatments? Or relieve symptoms or side effects?
• How is the practitioner licensed or credentialed? For example, there are licensing boards in most states for massage therapists, acupuncturists, practitioners of Chinese medicine, yoga instructors, and homeopaths.
• Is the treatment based on specific theories about the causes of cancer? How are these theories regarded by mainstream health professionals?
• Is the treatment associated with specific types of cancer, such as cancers of the digestive tract or the nervous system?
• Does the treatment have any restrictions or side effects of its own?
• Is the treatment recommended for other diseases or conditions, or only for cancer?
• How is the treatment advertised or promoted? In medical journals, mainstream health publications, the mass media, or only in "New Age" or special-interest magazines?

Patients should look for "red flags" that may indicate that a treatment is fraudulent:

• The treatment is unusually expensive.
• It is based on unproven or discredited theories.
• It claims to be a "secret" offered by only a few providers.
• Patients must go outside the United States or Canada for the treatment.
• Patients are told not to use standard cancer treatments.
• The treatment lacks any connection to reputable licensing bodies, medical schools, research institutions, or cancer organizations.

Resources

BOOKS

Altman, Nathaniel. Oxygen Healing Therapies for Optimum Health and Vitality. Rochester, VT: Healing Arts Press, 1995.

American Cancer Society. The American Cancer Society's Guide to Complementary and Alternative Cancer Methods. New York: American Cancer Society, 2000.

Borysenko, Joan, Ph.D.. Minding the Body, Mending the Mind. Reading, MA: Addison-Wesley Publishing Co., Inc., 1987. Dr. Borysenko has worked as a cancer researcher at Tufts Medical School as well as Director of the Mind/Body Clinic at Harvard University.

The Burton Goldberg Group. Alternative Medicine: The Definitive Guide. Fife, WA: Future Medicine Publishing, Inc., 1995.

Cassileth, Barrie R., Ph.D.. "Questionable and Unproven Cancer Therapies." In Cancer Therapy. Dollinger, Malin, MD, Ernest H. Rosenbaum, MD, and Greg Cable, eds. Kansas City, MO: Andrews and McMeel, 1994.

Chiazzari, Suzy. "Healing with Color." In The Complete Book of Color: Using Color for Lifestyle, Health, and Well-Being. Boston: Element Books Ltd., 1998.

Collinge, William, Ph.D.. Subtle Energy: Awakening to the Unseen Forces in Our Lives. New York: Warner Books, 1998.

Dass, Ram. Journey of Awakening: A Meditator's Guidebook. New York: Bantam Books, 1978. An excellent brief guide to the different methods of meditation in all the major religious traditions, as well as an introduction to the practice itself.

Dossey, Larry, MD. Healing Words: The Power of Prayer and the Practice of Medicine. New York: HarperCollins, 1993. Dr. Dossey is affiliated with the NIH's Office of Alternative Medicine.

Feuerstein, Georg, and Stephan Bodian. Living Yoga: A Comprehensive Guide for Daily Life. New York: Jeremy P. Tarcher/Perigee Books, 1993.

Kabat-Zinn, Jon. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Dell Publishing, 1990. The author is the director of the Stress Reduction Clinic at the University of Massachusetts Medical Center.

Mehl-Madrona, Lewis, M.D. Coyote Medicine: Lessons from Native American Healing. New York: Fireside, 1997.

Melody. Love Is in the Earth—A Kaleidoscope of Crystals, 2nd ed. Wheat Ridge, CO: Earth-Love Publishing House, 1997.

Murray, Michael, ND, and Joseph Pizzorno, ND. Encyclopedia of Natural Medicine. Rocklin, CA: Prima Publishing, 1991. Parts I and II explain the theories and principles of naturopathy.

National Cancer Institute of the National Institutes of Health. Chemotherapy and You: A Guide to Self-Help During Cancer Treatment. NIH Publication #99-1136. Can be downloaded from <http://cancernet.nci.nih.gov>.

Price, Shirley. Practical Aromatherapy. London: Thorsons, 1994.

Reid, Daniel P. Chinese Herbal Medicine. Boston: Shambhala, 1993.

Stein, Diane. Essential Reiki: A Complete Guide to an Ancient Healing Art. Freedom, CA: The Crossing Press Inc., 1997.

Stein, Diane. All Women Are Healers: A Comprehensive Guide to Natural Healing. Freedom, CA: The Crossing Press Inc., 1996. Includes chapters on the Bach flower remedies, acupressure, homeopathy, gemstone therapy, herbal treatments, and vitamin therapy.

Svoboda, Robert, and Arnie Lade. Tao and Dharma: Chinese Medicine and Ayurveda. Twin Lakes, WI: Lotus Press, 1995.

Vithoulkas, George. Homeopathy: Medicine of the New Man. New York: Simon & Schuster, 1992.

ORGANIZATIONS

American Academy of Medical Acupuncture. (800) 521-2262.

American Association of Naturopathic Physicians. 601 Valley St., Suite 105, Seattle, WA 98109. (206) 298-0126. Fax: (206) 298-0129. <http://www.naturopathic.org>.

American Botanical Council. <http://www.herbalgram.org>.

American Cancer Society (ACS). 1599 Clifton Road, NE, Atlanta, GA 30329. (404) 320-3333 or (800) ACS-2345. Fax: (404) 329-7530. <http://www.cancer.org>.

American Foundation of Traditional Chinese Medicine (AFTCM). 505 Beach Street, San Francisco, CA 94133. (415) 776-0502. Fax: (415) 392-7003. E-mail: aftcm@earthlink.net.

American Herbal Products Association. 8484 Georgia Ave., Suite 370, Silver Spring, MD 20910. (301) 588-1174. <http://www.ahpa.org>.

American Indian Science and Engineering Society (AISES).5661 Airport Blvd., Boulder, CO 80301-2339. (303) 939-0023. Fax: (303) 939-8150. E-mail: aisehq@spot.colorado.edu. <http://www.colorado.edu/aises>.

Consumer Reports Health Letter. P.O. Box 52145, Boulder, CO80321.

Delta Society (pet therapy). <http://www.deltasociety.org>.

National Cancer Institute, Office of Cancer Communications.31 Center Drive, MSC 2580, Bethesda, MD 20892-2580. (800) 4-CANCER. TTY: (800) 332-8615. Email: cancer-mail@cips.nci.nih.gov. <http://www.nci.nih.gov>.

National Center for Homeopathy (NCH). 801 North Fairfax St., Suite 306, Alexandria, VA 22314. (703) 548-7790. Fax: (703) 548-7792.

National Certification Board for Therapeutic Massage and Bodywork. 8201 Greensboro Drive, Suite 300, McLean, VA 22102. (703) 610-9015.

National Council Against Health Fraud. P.O. Box 1276, Loma Linda, CA 92354.

NIH National Center for Complementary and Alternative Medicine (NCCAM) Clearinghouse. P. O. Box 8218, Silver Spring, MD 20907-8218. TTY/TDY: (888) 644-6226. Fax: (301) 495-4957. <http://www.nccam.nih.gov>.

NIH Office of Dietary Supplements. Building 31, Room 1B25, 31 Center Drive, MSC 2086. Bethesda, MD 20892-2086. (301) 435-2920. Fax: (301) 480-1845. Web site: http://odp.od.nih.gov/ods.

Office of Cancer Complementary & Alternative Medicine of the National Cancer Institute (OCCAM). Email: ncioccam1-r@mail.nih.gov. <http://www.occam.nci.nih.gov>.

Quackwatch. <http://www.quackwatch.com>.

OTHER

Cancer Supportive Care Programs. 21 June 2001 <http://www.cancersupportivecare.com>. Provides information about pain control, nutrition, and other aspects of supportive care for cancer patients.

The Wellness Community. 21 June 2001 <http://www.wellnesscommunity.org>. Offers support groups, stress reduction workshops, exercise programs, social events, and nutritional counseling for cancer patients and their families.

Rebecca J. Frey, Ph.D.

KEY TERMS

Adjunctive

—Any form of therapy that is considered to help or assist a patient's primary treatment.

Alternative

—A form of treatment outside mainstream medicine that is used as a cure instead of standard treatments.

Angiogenesis

—The formation of blood vessels. Shark cartilage is undergoing tests on its effects on angiogenesis in tumors.

Anorexia

—Loss of appetite. Anorexia is a common side effect of chemotherapy.

Aura

—The field of subtle energy that surrounds the human body, according to external energy therapists.

Biologics

—Drugs or other medical products made from biological sources.

Cachexia

—The wasting away of body tissue.

Complementary

—Any form of treatment outside the mainstream that is not considered a cure but is given to ease symptoms or contribute to general well-being.

Detoxification

—Ridding the body of digestive wastes considered toxic through fasting, drinking large quantities of juice, or colonic irrigation.

Holistic

—Any approach to health care that emphasizes the patient's total well-being, including psychological and spiritual as well as physical aspects.

Integrative

—An approach to cancer treatment that combines mainstream therapies with one or more complementary therapies.

Investigational

—A drug or therapy that is approved for use in clinical trials but not for regular treatment of patients.

Mantra

—A sacred word or phrase, used in some forms of meditation to deepen the meditative state.

Quackery

—A fraudulent form of treatment or therapy.

Vegan

—A vegetarian who omits all animal products, including eggs and milk, from their diet.