Oncology Society addresses complementary medicine in cancer care

Spring 2013, Living Well Magazine

Is your Oncologist open and willing to discuss complementary or alternative therapies that could provide relief from pain or nausea, add to your overall wellbeing or aid the treatment of cancer? If you’re one of the many Australians who have withheld their use of complementary, alternative or lifestyle options from their Oncologist the Clinical Oncology Society of Australia (COSA)’s position statement might be of interest to you.

A survey performed in 2010 indicates that up to 65% of Australian cancer patients use at least one form of CAM[1], with over half of these patients using CAM in conjunction with conventional therapy[2].  A study of Australian radiotherapy patients found that only 40% discussed their use of CAM with their oncologist[3].

In May 2013 the Clinical Oncological Society of Australia (COSA)* took an important step towards a more integrated approach to cancer care by releasing a position statement on the use of complementary and alternative medicine (CAM) by cancer patients.

There’s often a great deal of confusion and misuse of terms when discussing ‘CAM therapies’ and The Gawler Cancer Foundation is regularly bundled in with one category or another without understanding of the true definitions. So we thought it would be beneficial to include COSA’s definition of the four most commonly used terms.

Common Terms: 

Conventional Medicine is medicine practiced by holders of medical degrees and by qualified allied health professionals, such as pharmacists, physiotherapists, psychologists, social workers and registered nurses.

Complementary Medicine includes medicines and therapies that are not traditionally part of conventional medical practice, used together with conventional medicine to produce better health outcomes.

Alternative Medicine is medicines and therapies that are not considered part of conventional medical practice and are used in place of conventional medicine.

Integrative Medicine refers to the blending of conventional and complementary medicines with the aim of using the most appropriate, safe and evidence-based modality|(ies) available.

Where does The Gawler Cancer Foundation fit in?

As leaders in lifestyle-based practices aimed to support the body, mind, emotions and spirit contributing to the healing process, we work within an integrative medicine framework. Our work is most clearly defined as lifestyle medicine, meaning lifestyle-based practices such as moderate exercise, regular meditation, good nutrition and emotional healing. Our approach widely complements prescribed therapies however we are not complementary or alternative medicine. It would have been great to also see the increasingly used term ‘Lifestyle Medicine’ defined in COSA’s position statement as it’s good to have clarity in all areas relevant to cancer care. ‘Lifestyle Medicine’ focuses on what people diagnosed with an illness can do for themselves in addition to whatever conventional or CAM therapies are, or are not, being used.

So how does COSA’s position statement help to integrate the safe and beneficial use of CAM therapies with conventional medicine?

Firstly, they acknowledge “the study and use of complementary and alternative medicine (CAM) by cancer patients is rapidly changing in terms of both the evidence supporting particular medicines and therapies and the professional standards and accreditation of CAM providers. This uncertainty often leads to anxiety for health professionals and patients.”

COSA encourages health professionals to:

  • Focus on open discussion with their patients regarding CAM
  • Become familiar with reputable resources for CAM information
  • Discuss with patients the concept of evidence-based medicine
  • Recognise any limitations to the knowledge of CAM and seek further advice when necessary

COSA’s Guiding Principles for CAM use 

  • Patient centred care
    In clinical practice, the primary concern of a health professional is the care of their patient.
  • Shared decision-making 
    Making decisions about health care is the shared responsibility of the health professional and the patient.
  • Respect
    Providing good patient care includes recognising and respecting the patient’s right to make their own decisions about their healthcare.
  • Effective communication
    Health professionals should create an environment that encourages patients to communicate how they are managing their health, including the use of any CAM.
  • Avoiding prejudice
    A patient’s decision to use CAM should not affect the quality of medical care they receive.
  • Minimising risk
    Health professionals should apply the principles of risk minimisation and management when a patient chooses to use CAM.

As many of our program participants and members also consider/ed various CAM therapies as a part of their whole-body healthcare plan it’s good to see these guidelines support more open communication between cancer specialists, CAM providers and patients.

To further support this “COSA recommends health professionals become familiar with the CAM treatments commonly used by their patient group, including the potential benefits and risks.”

They refer readers to health professionals registered with The Australasian Integrative Medicine Association (www.aima.net.au) or integrative cancer centres for assistance.

At The Gawler Cancer Foundation we support respectful and informed communication between the different disciplines of cancer care and between doctor and patient.

The ability to make informed decisions and to create your own package of care is empowering, and the more conventional medicine understands about integrative medicine, the better able the patient is to assimilate all the practices that work for them.

“There is an urgent need for the conduct of research that clarifies the potential benefits and risks of CAM and its role in cancer care. COSA supports scientific investigation into CAM use in cancer care.” The Gawler Cancer Foundation wholeheartedly agrees.

To read the full position statement visit www.cosa.org.au

COSA is the peak national body representing multidisciplinary health professionals whose work encom- passes cancer control and care. COSA members are doctors, nurses, scientists and allied health profes- sionals involved in the clinical care of cancer patients. COSA is affili-ated with and provides medical and scientific advice to Cancer Council Australia.

1. Oh B, Butow P, Mullan B, Beale P, Pavlakis N, Rosenthal D, Clarke S. The use and perceived benefits resulting from the use of complementary and alternative medicine by cancer patients in Australia. Asia Pac J Clin Oncol. 2010; 6: 342-9

2. Klafke N, Eliott JA, Wittert GA, Olver IN. Prevalence and predictors of complementary and alternative medicine (CAM) use by men in Australian cancer outpatient services. Ann Oncol. 2012;23: 1571-8.

3. Gillett J, Lentile C, Hiscock J, Plank A, Martin JM. Complementary and alternative medicine use in radiotherapy: what are patients using? J Altern Complement Med. 2012; 18: 1014-20.