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Complementary and Alternative Medicine in Cancer Treatment: 

Questions and Answers 

1. What is complementary and alternative medicine?

 

Complementary and alternative medicine (CAM), as defined by the National 

Center for Complementary and Alternative Medicine (NCCAM), is a group of 

diverse medical and health care systems, practices, and products that are not 

presently considered to be part of conventional medicine. Complementary 

medicine is used together with conventional medicine. Alternative medicine is 

used in place of conventional 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 physical therapists, 

psychologists, and registered nurses. Other terms for conventional medicine 

include allopathy; Western, mainstream, orthodox, and regular medicine; and 

biomedicine. Some conventional medical practitioners are also practitioners of 

CAM. 

Key Points 

• Complementary and alternative medicine (CAM) is a group of diverse medical and 

health care systems, practices, and products that are not presently considered to be 

part of conventional medicine (see Question 1). 

• It is important that the same scientific evaluation that is used to assess conventional 

approaches be used to evaluate CAM therapies (see Question 3). 

• The National Cancer Institute and the National Center for Complementary and 

Alternative Medicine are sponsoring or cosponsoring various clinical trials 

(research studies) to study CAM therapies for cancer (see Question 5). 

• It is important that patients inform all of their health care providers about any 

therapies they are currently using or considering. This is to help ensure a safe and 

coordinated course of care (see Question 7). 
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This fact sheet answers some frequently asked questions about the use of CAM 

therapies among the general public, and about how CAM approaches are 

evaluated, and suggests sources for further information.

2. Are complementary and alternative therapies widely used?

The results of studies of CAM use have been inconsistent. One large-scale study 

published in the November 11, 1998, issue of the Journal of the American 

Medical Association found that CAM use among the general public increased 

from 33.8 percent in 1990 to 42.1 percent in 1997. However, an analysis of data 

from the 1999 National Health Interview Survey indicated that only 28.9 percent 

of U.S. adults (age 18 and over) had used at least one CAM therapy in the past 

year. These results were published in the journal Medical Care in 2002. 

Several surveys of CAM use by cancer patients have been conducted with small 

numbers of patients. One study published in the February 2000 issue of the 

journal Cancer reported that 37 percent of 46 patients with prostate cancer used 

one or more CAM therapies as part of their cancer treatment. These therapies 

included herbal remedies, vitamins, and special diets. 

A larger study of CAM use in patients with different types of cancer was 

published in the July 2000 issue of the Journal of Clinical Oncology. This study 

found that 69 percent of 453 cancer patients had used at least one CAM therapy as 

part of their cancer treatment. 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? 

 

 It is important that the same rigorous scientific evaluation used to assess 

conventional approaches be used to evaluate CAM therapies. The National 

Cancer Institute (NCI) and NCCAM are funding a number of clinical trials 

(research studies) at medical centers to evaluate CAM therapies for cancer. 

Conventional approaches to cancer treatment have generally been studied for 

safety and effectiveness through a rigorous scientific process that includes clinical 

trials with large numbers of patients. Less is known about the safety and 

effectiveness of complementary and alternative methods. Some CAM therapies 

have undergone rigorous evaluation. A small number of CAM therapies 

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. According to 

a panel of experts at a National Institutes of Health (NIH) Consensus Conference 

in November 1997, acupuncture has been found to be effective in the 

management of chemotherapy-associated nausea and vomiting and in controlling 
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pain associated with surgery. In contrast, some approaches, such as the use of 

laetrile, have been studied and found ineffective or potentially harmful. 

4. What is the Best Case Series Program?

 

The Best Case Series Program, which was started by the NCI in 1991, is one way 

CAM approaches that are being used in practice are being evaluated. The 

program is overseen by the NCI’s Office of Cancer Complementary and 

Alternative Medicine (OCCAM). Health care professionals who offer CAM 

services submit their patients’ medical records and related materials to OCCAM. 

OCCAM conducts a critical review of the materials and develops follow-up 

research strategies for approaches that have therapeutic potential. 

5. Are the NCI and NCCAM sponsoring clinical trials in complementary and 

alternative medicine?

The NCI and NCCAM are currently sponsoring or cosponsoring various 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. Current trials include the following: 

• Acupuncture to reduce the symptoms of advanced colorectal cancer 

• Combination chemotherapy plus radiation therapy with or without shark 

cartilage in the treatment of patients who have non-small cell lung cancer that 

cannot be removed by surgery 

• Hyperbaric oxygen therapy with laryngectomy patients (people who have had 

an operation to remove all or part of the larynx (voice box)) 

• Massage therapy for cancer-related fatigue 

• Chemotherapy compared with pancreatic enzyme therapy plus specialized diet 

for the treatment of pancreatic cancer 

• Mistletoe extract and chemotherapy for the treatment of solid tumors 

Patients who are interested in taking part in these or any clinical trials should talk 

with their doctor. 

 

The NCI, NCCAM, and OCCAM clinical trials databases offer patients, family 

members, and health professionals information about research studies that use 

CAM. Clinical trials can be found by searching: 

• The NCI’s PDQ® Clinical Trials Database—The PDQ Clinical Trials 

database can be searched at http://www.cancer.gov/clinicaltrials/ using such 

criteria as cancer type, type of trial, geographic region, trial sponsorship, 

and/or drug name. This information is also available by calling the NCI’s 

Cancer Information Service (see below). 
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• The NCCAM Clinical Trials Web page—Clinical trials can be searched by 

type of treatment or disease at http://nccam.nih.gov/clinicaltrials/ on the 

Internet. 

• The OCCAM Clinical Trials Web page—Links are provided to the NCI’s 

clinical trials databases at http://www.cancer.gov/cam/clinicaltrials_intro.html 

on the Internet. 

6. What should patients do when using or considering complementary and 

alternative therapies? 

Cancer patients using or considering complementary or alternative therapy should 

discuss this decision with their doctor or nurse, as they would any therapeutic 

approach. Some complementary and alternative therapies may interfere with 

standard treatment or may be harmful when used with conventional treatment. It 

is also a good idea to become informed 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 Question 8. 

7. When considering complementary and alternative therapies, 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 side effects can be expected? 

• 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 and practitioners is available 

from NCCAM (see below). 

8. What Federal agencies can provide more information about CAM therapies?

Patients, their families, and their health care providers can learn about CAM 

therapies from the following Government agencies and resources: 

NCCAM is the Federal Government’s lead agency for scientific research on 

CAM. NCCAM is dedicated to exploring complementary and alternative healing 

practices in the context of rigorous science, training CAM researchers, and 

disseminating authoritative information to the public and professionals. 

The NCCAM Clearinghouse provides information on NCCAM and on CAM, 

including fact sheets, other publications, and searches of Federal databases of 

scientific and medical literature. Publications include: 
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• “Are You Considering Using Complementary and Alternative Medicine 

(CAM)?” (http://nccam.nih.gov/health/decisions) 

• “Selecting a Complementary and Alternative Medicine Practitioner” 

(http://nccam.nih.gov/health/practitioner) 

• “Consumer Financial Issues in Complementary and Alternative Medicine” 

(http://nccam.nih.gov/health/financial/index.htm) 

The Clearinghouse does not provide medical advice, treatment recommendations, 

or referrals to practitioners. 

NCCAM Clearinghouse 

Post Office Box 7923 

Gaithersburg, MD 20898–7923 

Toll-free in the United States: 1–888–644–6226 

International: 301–519–3153 

Callers with TTY equipment: 1–866–464–3615 

Fax: 1–866–464–3616 

Fax-on-Demand service: 1–888–644–6226 

E-mail: info@nccam.nih.gov 

Web site: http://nccam.nih.gov 

The NCI’s Office of Cancer Complementary and Alternative Medicine

(OCCAM) coordinates the activities of the NCI in the area of complementary and 

alternative medicine. OCCAM supports CAM cancer research and provides 

information about cancer-related CAM to health providers and the general public 

via http://www.cancer.gov/cam on the Internet. 

NCI’s PDQ, a comprehensive cancer information database, contains peerreviewed summaries of the latest information about the use of CAM in the 

treatment of cancer. Each summary contains background information about the 

specific treatment, a brief history of its development, information about relevant 

research studies, and a glossary of scientific and medical terms. CAM summaries 

can be accessed at http://www.cancer.gov/cancerinfo/pdq/cam on the Internet. 

The Food and Drug Administration (FDA) regulates drugs and medical devices 

to ensure that they are safe and effective. This agency provides a number of 

publications for consumers, including information about dietary supplements. 

Food and Drug Administration 

5600 Fishers Lane 

Rockville, MD 20857 

Telephone: 1–888–463–6332 (toll-free) 

Web site: http://www.fda.gov/ 

FDA’s Dietary Supplements Web page: 

http://www.cfsan.fda.gov/~dms/supplmnt.html 
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The Federal Trade Commission (FTC) enforces consumer protection laws and 

offers publications to guide consumers. The FTC also collects information about 

fraudulent claims. 

 Consumer Response Center 

Federal Trade Commission 

600 Pennsylvania Avenue, NW. H–130 

 Washington, DC 20580 

 Telephone: 1–877–382–4357 (1–877–FTC–HELP) (toll-free) 

Callers with TTY equipment: 202–326–2502 

Web site: http://www.ftc.gov 

CAM on PubMed®, a database accessible via the Internet, was developed jointly 

by NCCAM and the NIH National Library of Medicine (NLM). It contains 

bibliographic citations (from 1966 to the present) for articles in scientifically 

based, peer-reviewed journals on CAM. These citations are a subset of the 

NLM’s PubMed system, which contains over 11 million journal citations from the 

MEDLINE® database and additional life science journals important to health 

researchers, practitioners, and consumers. CAM on PubMed also displays links to 

many publisher Web sites, which may offer the full text of articles. To access 

CAM on PubMed, go to http://nccam.nih.gov/camonpubmed/ on the Internet. 

MedlinePlus®, a tool provided by the NLM, is a searchable database of health 

information. The Drug, Supplements, and Herbal Information section has 

extensive information about dietary and herbal supplements, as well as drugs. 

This resource is available at 

http://www.nlm.nih.gov/medlineplus/druginformation.html on the Internet. 

References 

 

Bennett M, Lengacher C. Use of complementary therapies in a rural cancer population. 

Oncology Nursing Forum 1999; 26(8):1287–1294. 

Cassileth BR, Chapman CC. Alternative and complementary cancer therapies. Cancer

1996; 77(6):1026–1034. 

Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the 

United States, 1990-1997: Results of a follow-up national survey. Journal of the 

American Medical Association 1998; 280(18):1569–1575. 

Kao GD, Devine P. Use of complementary health practices by prostate carcinoma 

patients undergoing radiation therapy. Cancer 2000; 88(3):615–619. 
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Nelson W. Alternative cancer treatments. Highlights in Oncology Practice 1998; 

15(4):85–93. 

Ni H, Simile C, Hardy AM. Utilization of complementary and alternative medicine by 

United States adults: Results from the 1999 national health interview survey. Medical 

Care 2002; 40(4):353–358. 

Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE. 

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, Bauer L, Curt G, et al. Use of complementary medicine by adult patients 

participating in cancer clinical trials. Oncology Nursing Forum 2000; 27(4):623–630. 

White JD. Complementary, alternative, and unproven methods of cancer treatment. In: 

DeVita VT Jr., Hellman S, Rosenberg SA, editors. Cancer: Principles and Practice of 

Oncology. Vol. 1 and 2. 6th ed. Philadelphia: Lippincott Williams and Wilkins, 2001. 

# # # 

Related Resources

Publications (available at http://www.cancer.gov/publications) 

• Thinking About Complementary and Alternative Medicine—A Guide for 

People With Cancer 

National Cancer Institute (NCI) Resources

Cancer Information Service (toll-free)

 Telephone: 1–800–4–CANCER (1–800–422–6237) 

 TTY: 1–800–332–8615 

Online 

NCI’s Web site: http://www.cancer.gov 

LiveHelp, NCI’s live online assistance: 

https://cissecure.nci.nih.gov/livehelp/welcome.asp

This fact sheet was reviewed on 1/17/06