Acupuncture is the practice of inserting thin needles into specific body points to improve health and well-being. It originated in China more than 2,000 years ago. American practices of acupuncture use medical traditions from China, Japan, Korea and other countries. In the United States, the best-known type involves putting hair-thin, metallic needles in your skin.
Research has shown that acupuncture reduces nausea and vomiting after surgery and chemotherapy. It can also relieve pain. Researchers don't fully understand how acupuncture works. It might aid the activity of your body's pain-killing chemicals. It also might affect how you release chemicals that regulate blood pressure and flow.
Cancer and Complementary and Alternative Medicine
Key Points
 | Complementary and
alternative medicine (CAM) is a group of diverse medical and health care
systems, practices, and products that are not part of conventional medicine. |
| The same scientific
evaluation that is used to assess conventional cancer treatments should be
used to assess CAM therapies. |
| The National Center for
Complementary and Alternative Medicine (NCCAM) is sponsoring a number of
clinical trials (research studies in people) to study CAM therapies for
cancer. |
| To ensure a safe and coordinated course of care, people with cancer should inform their health care providers about any CAM therapy that they are currently using or considering. |
1. What is complementary and alternative medicine?
Complementary and alternative medicine is a group of diverse medical and health care systems, practices, and products that are not part of conventional (standard) medicine. Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals, such as nurses, physical therapists, and dietitians.
| Complementary medicine is used along with conventional medicine. |
| Alternative medicine is used instead of conventional medicine. |
| Integrative medicine combines standard medicine with CAM practices that have been shown to be effective. |
This fact sheet answers some frequently asked questions about the use of CAM therapies and the way that CAM approaches are evaluated, and suggests resources for further information (see "For More Information").
2. Is CAM widely used?
According to the most recent comprehensive survey on Americans' use of CAM, 36 percent of U.S. adults are using some form of CAM. When megavitamin therapy and prayer for health reasons are included in the definition of CAM, that percentage rises to 62 percent. These results are based on the 2002 National Health Interview Survey, which was supported by NCCAM and the National Center for Health Statistics (part of the Centers for Disease Control and Prevention). The survey found that rates of CAM use are especially high among patients with serious illnesses such as cancer.
Several smaller studies of CAM use by cancer patients have been conducted. A study of CAM use in patients with cancer in the July 2000 issue of the Journal of Clinical Oncology found that 69 percent of 453 cancer patients had used at least one CAM therapy as part of their cancer treatment. A study published in the December 2004 issue of the Journal of Clinical Oncology reported that 88 percent of 102 people with cancer who were enrolled in phase I clinical trials (research studies in people) at the Mayo Comprehensive Cancer Center had used at least one CAM therapy. Of those, 93 percent had used supplements (such as vitamins or minerals), 53 percent had used nonsupplement forms of CAM (such as prayer/spiritual practices or chiropractic care), and almost 47 percent had used both.
A review article in the March 2005 issue of the Southern Medical Journal reported that cancer patients take supplements to reduce side effects and organ toxicity, to protect and stimulate their immune systems, or to prevent further cancers or recurrences. Patients frequently see using supplements as a way to take control over their health and increase their quality of life.
Additional information about CAM use among cancer patients can be found in a review article published in Seminars in Oncology in December 2002.
3. How are CAM approaches evaluated?
The same rigorous scientific evaluation used to assess conventional cancer treatments should be used for CAM therapies. NCCAM is funding a number of clinical trials to evaluate CAM therapies for cancer.
Conventional cancer treatments are studied for safety and effectiveness through a rigorous scientific process that includes laboratory research and clinical trials with large numbers of patients. Less is known about the safety and effectiveness of complementary and alternative methods to treat cancer, although some CAM therapies have undergone rigorous evaluation.
A small number of CAM therapies, which were originally considered to be purely alternative approaches, are finding a place in cancer treatment--not as cures, but as complementary therapies that may help patients feel better and recover faster. One example is acupuncture. In 1997, a panel of experts at the National Institutes of Health (NIH) Consensus Conference found acupuncture to be effective in managing chemotherapy-associated nausea and vomiting and in controlling pain associated with surgery. In contrast, some approaches, such as the use of laetrile, have been studied and found ineffective or potentially harmful.
4. Is NCCAM sponsoring clinical trials on CAM for cancer?
NCCAM is sponsoring a number of clinical trials to study complementary and alternative treatments for cancer. Some of these trials study the effects of complementary approaches used in addition to conventional treatments, while others compare alternative therapies with conventional treatments. Recent trials include the following:
| Acupuncture to relieve neck and shoulder pain following surgery for head or neck cancer |
| Ginger as a treatment for nausea and vomiting caused by chemotherapy |
| Massage for the treatment of cancer pain |
| Mistletoe extract combined with chemotherapy for the treatment of solid tumors |
Patients who are interested in taking part in these or any other clinical trials should talk with their health care provider.
Patients, family members, and health professionals can use the following Web resources to find out about CAM clinical trials:
| The
NCCAM
Clinical Trials Web page. Describes current
clinical trials for cancer and other health conditions. Information on
clinical trials is also available through the NCCAM Clearinghouse (see "For
More Information"). |
| The National Cancer Institute (NCI) PDQ Clinical Trials Database. Includes studies of CAM and conventional medicine for cancer. This information is also available through NCI's Cancer Information Service (see "For More Information" for contact information). |
5. What should patients do when using or considering CAM therapies?
Cancer patients who are using or considering CAM should discuss this decision with their health care provider, as they would any therapy. Some complementary and alternative therapies may interfere with standard treatment or may be harmful when used along with standard treatment. The booklet "Thinking About Complementary and Alternative Medicine: A Guide for People with Cancer" discusses choices that people face in making decisions about cancer treatment and includes suggestions on how to talk with health care providers about these choices (see "For More Information").
As with any medicine or treatment, it is a good idea to learn about the therapy, including whether the results of scientific studies support the claims that are made for it. Some resources for this information are provided in the "For More Information" section.
6. When considering CAM, what questions should patients ask their health care providers?
| What benefits can be expected from this therapy? |
| What are the risks associated with this therapy? |
| Do the known benefits outweigh the risks? |
| What are the potential side effects? |
| Will the therapy interfere with conventional treatment? |
| Is this therapy part of a clinical trial? If so, who is sponsoring the trial? |
| Will the therapy be covered by health insurance? |
Further information on evaluating CAM therapies, selecting practitioners, and considering financial issues for CAM treatment is available from NCCAM (see "For More Information").
References
Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States, 2002. CDC Advance Data Report #343. 2004.
Dy GK, Bekele L, Hanson LJ, et al. Complementary and alternative medicine use by patients enrolled onto phase I clinical trials. Journal of Clinical Oncology. 2004;22(23):4810-4815.
Frenkel M, Ben-Arye E, Baldwin C, et al. Approach to communicating with patients about the use of nutritional supplements in cancer care. Southern Medical Journal. 2005;98(3):289-294.
National Cancer Institute. PDQ Cancer Information Summary: Laetrile/Amygdalin. National Cancer Institute Web site. Accessed on August 11, 2005.
National Institutes of Health. Acupuncture: NIH Consensus Statement. National Institutes of Health Office of Disease Prevention Web site. Accessed on August 30, 2005.
Richardson MA, Sanders T, Palmer JL, et al. Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. Journal of Clinical Oncology. 2000;18(13):2505-2514.
Richardson MA, Straus SE. Complementary and alternative medicine: opportunities and challenges for cancer management and research. Seminars in Oncology. 2002;29(6):531-545.
Sparber A, Wooton JC. Surveys of complementary and alternative medicine: Part II. Use of alternative and complementary cancer therapies. Journal of Alternative and Complementary Medicine. 2001;7(3):281-287.
For More Information
NCCAM Clearinghouse
The NCCAM Clearinghouse provides information on CAM and on NCCAM, including publications and results of searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners. Publications include:
Toll-free in the U.S.:
1-888-644-6226
TTY (for deaf and hard-of-hearing callers): 1-866-464-3615
Web site:
nccam.nih.gov
E-mail:
info@nccam.nih.gov
National Cancer Institute's Cancer Information Service
The National Cancer Institute (NCI) is the lead Federal Government agency for cancer research. NCI's Cancer Information Service can provide answers to questions about cancer, help with quitting smoking, informational materials, and help in using the NCI Web site.
Toll-free in the U.S.:
1-800-4-CANCER (1-800-422-6237)
Web site:
www.cancer.gov
E-mail:
cancer.gov_staff@mail.nih.gov
PubMed
A service of the National Library of Medicine (NLM), PubMed contains publication information and (in most cases) abstracts of articles from medical journals. CAM on PubMed, developed jointly by NCCAM and NLM, is a subset of NLM's PubMed system and focuses on the topic of CAM.
Web site:
www.ncbi.nlm.nih.gov/entrez
CAM on PubMed:
www.nlm.nih.gov/nccam/camonpubmed.html
This publication is not copyrighted and is in the public domain. Duplication is encouraged.
|
NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy in this information is not an endorsement by NCCAM. |
NCCAM
Publication No.
D286
September 2005
What is
Chiropractic?
Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic care is used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.
Doctors of Chiropractic – often referred to as chiropractors or chiropractic physicians – practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling.
The most common therapeutic procedure performed by doctors of chiropractic is known as “spinal manipulation,” also called “chiropractic adjustment.” The purpose of manipulation is to restore joint mobility by manually applying a controlled force into joints that have become hypomobile – or restricted in their movement – as a result of a tissue injury. Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function for the sufferer. Manipulation, or adjustment of the affected joint and tissues, restores mobility, thereby alleviating pain and muscle tightness, and allowing tissues to heal.
Chiropractic adjustment rarely causes discomfort. However, patients may sometimes experience mild soreness or aching following treatment (as with some forms of exercise) that usually resolves within 12 to 48 hours.
In many cases, such as lower back pain, chiropractic care may be the primary method of treatment. When other medical conditions exist, chiropractic care may complement or support medical treatment by relieving the musculoskeletal aspects associated with the condition.
Doctors of chiropractic may assess patients through clinical examination, laboratory testing, diagnostic imaging and other diagnostic interventions to determine when chiropractic treatment is appropriate or when it is not appropriate. Chiropractors will readily refer patients to the appropriate health care provider when chiropractic care is not suitable for the patient’s condition, or the condition warrants co-management in conjunction with other members of the health care team.
Herbal Medicine
An herb is a plant or plant part used for its scent, flavor or therapeutic properties. Herbal medicine products are dietary supplements that people take to improve their health. Many herbs have been used for a long time for claimed health benefits. They are sold as tablets, capsules, powders, teas, extracts and fresh or dried plants. However, some can cause health problems, some are not effective and some may interact with other drugs you are taking.
To use an herbal product as safely as possible
| Consult your doctor first |
| Do not take a bigger dose than the label recommends |
| Take it under the guidance of a trained medical professional |
| Be especially cautious if you are pregnant or nursing |
National Center for Complementary and Alternative Medicine
Dietary supplements are vitamins, minerals, herbs and other substances meant to improve your diet. They can come as pills, capsules, powders and liquids. Supplements do not have to go through the testing that drugs do.
Some supplements can play an important role in health. For example, pregnant women can take the vitamin folic acid to prevent certain birth defects in their babies. Taking supplements can also be a type of complementary or alternative medicine (CAM).
To take a supplement as safely as possible
National Center for Complementary and Alternative Medicine