We've said that many cancer patients are using some form of CAM... one of the misconceptions about CAM use is that it's mostly folk medicine found in specific ethnic cultures... not so, it appears. So, who are they and what are they using?
Eva Singletary, MD:
In our survey that we did of patients in our outpatient clinics at M. D. Anderson, what we found was the type of person who would most likely use alternative medicine was not who you thought it was going to be. The patients tended to be well-educated. They could have either early or advanced cancer, and they were well informed about their treatment options.
Joan Engbretson, DrPH:
According to most of the surveys that are done, the heaviest users of what we call the complementary therapies, or the alternative and complementary therapies, whatever term was used actually are the well educated, middle class, Caucasian, main stream people, and that was a big shock, because they also a probably the heaviest users of biomedicine ... of the professional sector.
We've all read about patients who pursue alternative paths instead of conventional treatment for cancer.... But most are simply seeking additions to their treatment. And sometimes the therapies sought are not necessarily biologic therapies, but other modalities that are important adjuncts because they help patients cope with their illness and treatments. Many of those therapies can be found at M. D. Anderson's Place...of wellness, where persons touched by cancer... patients, their family members, caregivers, whoever's in their support system, may engage in programs that complement medical care. They may also get referrals for other complementary therapies.
Nicki Lowenstein, MS, RD, LD, CNSD:
When you hear complementary therapies, people tend to think of traditional Chinese medicine or acupuncture or herbs and things like that, but it also encompasses stress management techniques, meditation, better diets in terms of not necessarily macrobiotic and things like that, but better diets, better intake, looking at the types of foods people eat to give them more energy.
Laura Baynham Fletcher, MA, LPC:
We do have nutrition classes, of course; that is a huge area that patients and families members alike want to know about, not just the what are good things to eat while we are in chemotherapy, but they want to know about immune boosting types of things. They want to know about how to protein pack smoothies, because the patient may not be able to eat as well. They may get a recipe and get to taste that, and try it out. But more importantly, than the group sessions is getting that individual consult.
That's something that we feel real strongly about, because they come in, they want the information. But they really want to know, "This bag of herbs that I've been taking -- is it OK to still take them?" And this provides a beautiful opportunity for them in a safe way to say I am taking these things and help me to understand better if I should or shouldn't be taking them.
W. Baile, MD:
...many patients go there because of problems of feeling demoralized or wanting to do something in addition to their front line cancer treatment, and they'll participate in yoga and exercise and art therapy and tai chi and music therapy, and for those patients, being with other individuals who are more or less in the same boat as they are, and also using some of the therapies that are available... movement therapy, expressive therapies, can really boost their spirits, so perhaps those are more appropriate than antidepressants or anxiolytics for those patients. But we still have to do the controlled studies to really prove that.
Laura Baynham Fletcher , MA, LPC:
Our yoga program is always full, many times with a waiting list. The tai chi program... any of the relaxation, guided imagery, self hypnosis types of sessions, because they not only learn about what these modalities came from, what they may be focused on, whether that be some symptom management or strictly relaxation kind of overall well being, but they're going to get to engage in that practice there with that facilitator and be able to go back home or back to their inpatient room, etc., and engage in that activity going forward. So they're skill based. It gives them a tool when they walk out the door.
Many experts we spoke to emphasized the fact that we should not assume that a patient's CAM use is medically inconsequential or trivial, even if it's in the spiritual or mind-body categories... that these things impact conventional treatment by sustaining patients through it.
While there may be no definitive data to show that yoga or group therapy increases survival, there are everyday anecdotes here at the Place...of wellness from patients who say it was these things that enabled them to continue with their chemotherapy, for example... and that without them they would have discontinued their cancer treatment.
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