There are many ways of categorizing complementary therapies. The National Center for Complementary and Alternative Medicine at the National Institutes of Health lists five categories of therapies for investigation and research. They are:
Now, while it may not be a huge concern to healthcare providers that patients engage in yoga or meditation as part of their health practices, more and more patients are also using herbal and other biologic therapies. In fact, the NIH has recommended those as a major focus for research, because of their potential for harm... or at least unknown effects.
Laura Michaud, PharmD:
There are a lot of interactions that can occur. I think a lot of people believe these products are natural...therefore they're safe, and I think more than anything natural can often mean that they're not as safe, because we don't know what's in them a lot of times. The other things that can occur...patients who are on particularly chemotherapy but even hormone therapy for particular disease states, or any kind of medication for other diseases, any type of herb, supplement, even vitamins or minerals can potentially interact with those drugs. Some of the main interactions that we see with chemotherapy are things that could negate the effects of the chemotherapy on the cancer cells. There are particular classes of chemotherapy that are dependent on the production of free radicals in the body in order for them to act on cancer cells. If you take a lot of high dose antioxidants, that could negate that effect by preventing the production of those free radicals and the damage that they could incur on cancer cells... so that's one of the biggest problems that we encounter with a lot of products out there today.
The other issues can also be interactions through liver metabolism, or excretion by the kidneys that can be changed or altered by particular drugs or herbs or vitamins or anything of that nature that the patient might be ingesting as well, and those could alter toxicity as well as efficacy of any types of chemotherapy or cancer treatments in general.
As I spoke with experts, I learned that it's not only supplements and herbs... that it's wise to be aware that complex dietary regimens and foods are also important...
Nicki Lowenstein, MS, RD, LD, CNSD:
A lot of patients, when they're diagnosed with cancer, automatically stop everything that they think that they're doing that's unhealthy. They'll stop with caffeine. They'll stop with fat. They'll stop with sugar. They'll eat lots more fruits and vegetables. In some cases this is a good thing. In many cases, however, they need those nutrients. They need those extra calories, and some of those foods are very quick and easy to eat, and they need something that doesn't fatigue them to prepare.
So, sometimes when you go all the way to the other end, you are actually lacking key nutrients that you were getting before. So it is helpful before any patient makes any big change in their diet, and if the patient's discussing this with their doctor, it's a good thing for them to know that those referrals can be made really early on, and we can help them to implement those diet changes in a healthy way and in a safe way that is complementary to their treatment and is not necessarily going to interfere with it.
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