One of the problems for clinicians has been that – while there's a lot of information out there about complementary and alternative therapies – there is relatively little data, or mixed results, from human clinical trials...the kind of information that physicians are accustomed to using as a basis for recommendations. Why ask if someone is using herbs if you don't know what relevance it might have?
Unfortunately, much of the information available is not reliable. According to our experts, many of the claims made in magazines, web sites and mail campaigns are extravagant... and in some cases actually fraudulent, an issue before the Federal Trade Commission now. So, health care providers need to be aware of that and help direct patients to credible resources.
Fortunately, there are a growing number of credible information resources. The NIH has a CAM section now, as do PubMed and Medline.
M. D. Anderson shares evidence-based information with faculty and staff, as well as the public on its website called Complementary & Integrative Medicine Education Resources – CIMER. The purpose of the website is to collect and review information, and to share that with providers and patients as it becomes available.
S. Tomasovic, PhD:
We needed to create an environment in the institution where that kind of communication could happen and where our physicians could become more knowledgeable about how to talk to patients about that ... more knowledgeable about what things they might be doing... the patients might be doing that could potentially interact in a harmful way or even in a positive way with the treatments that we were giving in the institution. So our educational programs and the CIMER website and the communications skills that we're trying to deliver are all centered around providing a more holistic approach to patient care in the institution and making sure that we understand and have good communication about what else they're doing in their lives that could support what we're doing here at M. D. Anderson in patient care or that potentially might interfere with that.
L. Cohen, PhD:
We're at a whole new phase in medicine where patients are becoming extremely empowered. Physicians want to empower patients, and we've learned from patients in many surveys over the past five years that a lot of patients are engaging in different complementary modalities, and even a survey done at M. D. Anderson showed that if you exclude spirituality and psychotherapy... just include physical movement, herbal products, that close to 70% of patients combine some type of complementary modality with their traditional treatment, so what we're going to be doing and feel strongly is we have to move forward in this new and emerging field...
S. Tomasovic, PhD:
Our experts look at the literature that's out there and try to analyze that and summarize that and bring it together in a collated and understandable form so that medical professionals primarily can go to the website and find out what is that latest information on a particular agent and the possibilities that it may be helpful, of no particular concern, or harmful in combination with therapies or by itself.
The CIMER website can be accessed from M. D. Anderson's homepage. It contains scientific reviews of studies, and links to other credible sites.
There are other important resources for physicians who have patients who are interested in complementary therapies. They are pharmacologists, dieticians and other health care professionals within M. D. Anderson knowledgeable about herbals and supplements and how they interact with the medications that are prescribed...
Nicki Lowenstein, MS, RD, LD, CNSD:
It's probably the very most important thing that physicians communicate about these complementary therapies with patients... and that physicians that aren't real comfortable with all the complementary therapies make referrals to, say, Clinical Nutrition or the Place...of wellness to people who can steer them in the right direction, because, while it's not chemotherapy, a little relaxation therapy goes a long way with a lot of these patients. And, again, while it's not radiation therapy, having some ideas about what the side effects of the radiation are going to be so that the patients have the tools to circumvent them can go a long way to improving their quality of life during treatment.
©2007 The University of Texas M. D. Anderson Cancer Center
1515 Holcombe Blvd, Houston, TX 77030
1-800-392-1611 (USA) / 1-713-792-6161