ALTERNATIVE MEDICINE INFORMATION PORTABLE
Integrative medicine is an approach to medical care that combines conventional medicine with CAM practices that have shown through science to be safe and effective. This approach often stresses the patient's preferences, and it attempts to address the mental, physical, and spiritual aspects of health.
ALTERNATIVE MEDICINE INFORMATION
Conventional medicine is a system in which health professionals who hold an M.D. (medical doctor) or D.O. (doctor of osteopathy) degree treat symptoms and diseases using drugs, radiation, or surgery. It is also practiced by other health professionals, such as nurses, pharmacists, physician assistants, and therapists. It may also be called allopathic medicine, biomedicine, Western, mainstream, or orthodox medicine. Some conventional medical care practitioners are also practitioners of CAM.
Complementary medicine is used along with standard medical treatment but is not considered by itself to be standard treatment. One example is using acupuncture to help lessen some side effects of cancer treatment. Less research has been done for most types of complementary medicine.
Alternative medicine is used instead of standard medical treatment. One example is using a special diet to treat cancer instead of cancer drugs that are prescribed by an oncologist. Less research has been done for most types of alternative medicine.
Some CAM therapies have undergone careful evaluation and have been found to be generally safe and effective. These include acupuncture, yoga, and meditation to name a few. However, there are others that do not work, may be harmful, or could interact negatively with your medicines.
NCI and the National Center for Complementary and Integrative Health (NCCIH) are currently sponsoring or cosponsoring clinical trials that test CAM treatments and therapies in people. Some study the effects of complementary approaches used in addition to conventional treatments, and some compare alternative therapies with conventional treatments. You can find a list of all cancer CAM clinical trials here.
Talk to your doctor before you start any kind of complementary or alternative medicine, even for managing side effects from standard treatment. Complementary and alternative medicines may make standard cancer treatments not work as well.
The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.
NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.
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Natural Medicines Comprehensive Database (naturalmedicinesdatabase.com). Provides the largest number of evidence-based reviews. Authors are primarily doctors of pharmacy. Includes scientific names, uses, safety, effectiveness, mechanism of action, adverse reactions, interactions, and dosage.
Natural Standard (www.naturalstandard.com). A multidisciplinary, multi-institutional initiative for review of complementary and alternative therapies. Similar process to Cochrane reviews, with an additional historic and folkloric perspective.
National Cancer Institute (NCI) Office of Cancer Complementary and Alternative Medicine (www.cancer.gov/cam). PDQ cancer information summaries specific to either patients or health-care providers. Includes background; proposed mechanisms of action; and laboratory, animal, and clinical studies.
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The widespread use of complementary and alternative medicine (CAM) is of major importance to today's health care consumers, practitioners, researchers, and policy makers. For example, look at the following statistics on CAM: 42 percent of people in the United States report that they have used at least one CAM therapy: however, less than 40 percent of those using CAM disclosed such use to a physician. In 1997, an estimated 15 million adults took prescription medications concurrently with herbal remedies or high-dose vitamins, bringing into play the possibility of negative interactions. Total visits to CAM providers exceed total visits to all primary-care physicians. Out-of-pocket costs for CAM are estimated to exceed $27 billion, which shows that CAM is now big business. Hospitals, managed care plans, and conventional practitioners are incorporating CAM therapies into their practices. Medical schools, nursing schools, and schools of pharmacy are teaching their students about CAM. Information about CAM flows freely in various media: newspapers, magazines, books, pamphlets, and the Internet. Friends talk to friends about remedies for specific problems.
Among clinicians who practice conventional medicine, there has been a marked shift over past decades from a reliance on professional experience to a greater emphasis on more rigorous quantitative evidence derived from randomized trials and systematic reviews of multiple trials. These more rigorous approaches have more recently been used in investigations of CAM. However, among the heterogeneous interventions that comprise CAM, particularly those that depend on variable practitioner approaches and the customization of interventions to individual patients, there are significant obstacles to use of the methods that have gained dominance in testing and advancing the knowledge base for conventional medical practitioners.
As the name implies, alternative medical systems is a category that extends beyond a single modality, and refers to an entire system of theory and practice that developed separately from conventional medicine. Examples of these systems include traditional Chinese medicine, ayurvedic medicine, homeopathy, and naturopathy.
A different approach to classifying CAM modalities is a descriptive taxonomy that groups therapies according to their philosophical and theoretical identities (Kaptchuk and Eisenberg, 2001). Practices are divided into two groups. The first group appeals to the general public and has become popularly known as CAM. This group includes professionalized or distinct medical systems (e.g., chiropratic, acupuncture, homeopathy), popular health reform (e.g., dietary supplement use and specialized diets), New Age healing (e.g., qi gong, Reiki, magnets), psychological interventions, and nonnormative scientific enterprises (conventional therapies used in unconventional ways or unconventional therapies used by conventionally trained medical or scientific professionals). The second group includes practices that are more relevant to specific populations, such as ethnic or religious groups (e.g., Native American traditional medicine, Puerto Rican spiritis, folk medicine, and religious healing).
This discussion of definitions shows that no clear and consistent definition of CAM exists, nor is there a recognized taxonomy to organize the field, although the one proposed by NCCAM is commonly used. Given the committee's charge and focus, for the purposes of this report, the committee has chosen to use as its working definition of CAM a modification of the definition proposed by the Panel on Definition and Description at a 1995 NIH research methodology conference (Defining and describing complementary and alternative medicine, 1997). This modified definition states that
Complementary and alternative medicine (CAM) is a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed.
The development of research centers is the main method used to pursue research. NCCAM's CAM-related research centers can be placed into several categories: Dietary Supplement Research, Developmental Centers that partner institutions where CAM is practiced and those where conventional medicine is practiced, Centers of Excellence, Centers for CAM Research, and Exploratory Program Grants for Frontier Medicine Research. The establishment of international centers for CAM research is also an initiative in development. Unlike the other centers at NIH, which invest about two-thirds of their research funding in basic research, NCCAM places the largest proportion of its resources in clinical research; the ratio of funding for clinical research to funding for basic research was 2.5:1 in FY 2003 (NCCAM, 2004).
NCCAM also participates in a variety of outreach efforts. It maintains several outlets for both the public and the research community. The NCCAM website ( ) provides detailed descriptions of its ongoing activities as well as fact sheets about CAM, information on factors related to decision making about treatments, cost and payment questions, and safety alerts and advisories. NCCAM also publishes a quarterly newsletter containing updates on new and ongoing activities of the center. NCCAM also uses lectures, town meetings, and exhibits at scientific meetings as opportunities to increase people's awareness of CAM and the center.
In addition, NCCAM has established a clearinghouse, accessible by Internet and telephone in both English and Spanish, for people seeking information about CAM. The clearinghouse does not provide medical advice but does disseminate scientifically based information on CAM. Two other activities that assist with outreach are publications in peer-reviewed scientific journals, the number of which is increasing, and the development of the CAM on PubMed subsection of the National Library of Medicine's MEDLINE database. 041b061a72