Evaluating complementary and alternative therapies for cancer patients

"Complementary and alternative" therapies are actually a vast collection of disparate, unrelated regimens and products, ranging from adjunctive modali ties that effectively enhance quality of life and promising antitumor herba l remedies now under investigation, to bogus therapies that claim to cure c ancer and that harm not only directly, but also indirectly by encouraging p atients to avoid or postpone effective cancer care. Complementary therapies such as music and massage, herbal teas to aid diges tion and relieve nausea, yoga, tai-chi, meditation, and the many other well -documented techniques that relieve stress and enhance well-being should be made available to patients to augment and ease the experience of cancer tr eatment and recovery. Many time-tested herbal and diet-based remedies are n ow being studied for their abilities to induce or extend remission without toxicity. At the same time, lack of government regulatory authority leaves consumers at the mercy of those who promote unproved remedies, scores of which line g rocery store and pharmacy shelves. Many of these over-the-counter products contain harmful ingredients. Herb-drug interactions, only some of which are documented, occur with frequency and are sufficiently problematic to requi re that patients stop taking herbal remedies prior to surgery (to prevent i nteractions with anesthetics and anticoagulant effects); before radiation ( due to potential for increased photosensitivity); and during courses of che motherapy (to prevent product-drug interactions). Moreover, both good infor mation and misinformation that appear in printed materials and on the Inter net appeal to better educated consumers, who are, in fact, the most likely to try complementary and alternative methods.