Complementary and alternative medicine are umbrella terms generally used to describe any method that is not considered standard practice to diagnose or treat illness or disease. Although often used together, it is important to distinguish between the two methods. Complementary medicine is used in addition to conventional medicine. Alternative medicine is used instead of conventional medicine. These two very different medical approaches are often grouped under a single heading – complementary and alternative medicine (CAM).
Various complementary therapies have been touted for their role in cancer prevention, treatment and the reduction of symptoms and side effects. In some cases, the benefits of complementary medicine may have been demonstrated, to one degree or another, in clinical tests. Therapies that are considered alternative to conventional medicine have not been tested in scientific studies. They are not supported by any objective scientific evidence.
In both complementary and alternative medicine, patients should be aware that the U.S. Food and Drug Administration (FDA) does not regulate or ensure the safety of many CAM-related products.
It is vital for patients to consult their physician before adding CAM to their treatment regimen. In some cases, these therapies may reduce their ability to fight cancer, by interfering with or delaying conventional, proven treatments.
The National Center for Complementary and Alternative Medicine (NCCAM) has established five complementary and alternative medicine categories. They are alternative medical systems, mind-body interventions, biologically-based therapies, manipulative and body-based methods, and energy therapies.
About complementary and alternative medicine
Complementary and alternative medicine (CAM) refers to a broad group of healthcare products, practices and systems that are not considered a part of conventional medicine. Although the two are often grouped under a single heading, complementary and alternative medicine are quite different from one another. Complementary medicine is intended to support conventional medicine, whereas alternative medicine is designed to replace accepted practices.
Unlike conventional treatment, which typically focuses on killing cancer cells, the goal of complementary medicine (also called complementary therapy) is to promote overall health and well-being. Many complementary therapies can help patients effectively manage symptoms and improve their quality of life. Benefits of these techniques and supplements may include:
- Decreased pain and discomfort
- Reduced nausea
- Increased muscle strength
- Decreased depression, stress and anxiety
Alternative medicine (also called alternative therapy) is used instead of conventional cancer treatment. Cancer patients should exercise caution when deciding whether to replace treatments with alternative methods. Although patients may hear about promising therapies from friends, family members and other well-intentioned individuals, most alternative treatments have not been studied to establish their safety and effectiveness. Patients who decide to use alternative therapies may, in fact, reduce their ability to fight cancer by replacing or delaying conventional cancer treatment. Patients should also be aware that the U.S. Food and Drug Administration (FDA) does not regulate or ensure the safety of many CAM products.
The American Cancer Society uses the following terms to describe treatments. Understanding these terms can help a patient know which therapies may or may not be safe and effective. Patients should always discuss any treatments they are considering with their physician:
- Proven. Treatments that are evidence-based. Proven treatments are tested in accordance with strict guidelines and deemed to be safe and effective by the FDA.
- Research or investigational. Treatments that are being investigated in a clinical trial. Before a treatment is approved by the FDA, it must be studied and tested in laboratory test tubes, animals and a subset of human beings. Treatments deemed safe and effective by the FDA become part of conventional or mainstream medicine.
- Integrative. Treatments that combine proven or conventional medicines and/or techniques with complementary methods.
- Unproven or untested. Treatments that have little scientific basis or are being studied. Sufficient scientific evidence is not available to support the use of unproven treatments.
- Quackery. This term refers to unsubstantiated methods that falsely claim to cure, diagnose or prevent certain cancers. These methods are typically based on patient testimonials rather than valid scientific evidence.
Some patients choose CAM because they have difficulty tolerating conventional cancer treatments, which include surgery, radiation therapy, chemotherapy and biological therapy. Other reasons for turning to complementary and alternative methods may include:
- Relief of pain
- Relief of side effects
- Desire to improve immune system function
- Distrust of mainstream medicine
- Pressure from family or friends
- Exhaustion of all possible conventional treatments
Patients should always consult their physician before making treatment changes or beginning a new treatment regimen. When speaking to their physician about CAM, patients may want to consider the following recommendations:
- Bring a friend or family member to the appointment. It may help to have another person present to hear what is discussed and to ask appropriate questions.
- Write down a list of questions to ask the physician. This helps ensure that patients do not forget to address important issues, such as whether all conventional treatment options have been exhausted or whether complementary treatments will interfere with conventional treatment.
- Write down the answers to all questions or ask the physician’s permission to record the conversation. Even if information does not seem useful at the time, it may be helpful in the future.
- Have the physician clarify any statements that are confusing.
Patients debating the merits of CAM should consider the following:
- What claims have been made about the treatment in question? Is it supposed to reduce the side effects of conventional medication, cure the cancer, etc.?
- What are the credentials of the treatment’s advocates? Are they cancer experts who have been published in reliable medical journals? Patients should beware of so-called “experts” who do not provide their credentials.
- How is the treatment promoted? Is it described in credible scientific journals or only mentioned on television, radio or Internet advertisements? Are the specialists associated with tratment compensated for their endorsements?
- How much does the treatment cost? Will it be covered by insurance (as is the case with some complementary methods)? Is the treatment available only in certain countries?
- Is the treatment widely used in the healthcare community or is it limited in its scope?
- Will the treatment replace conventional methods? If so, will it affect the patient’s chances for recovery?
Patients can find answers for many of these questions by speaking with their physician and researching specific treatments on government and other reliable Internet sites and/or their local library.
Types and differences of CAM
The National Center for Complementary and Alternative Medicine (NCCAM) has established five categories of complementary and alternative medicine (CAM). They are: alternative medical systems, mind-body interventions, biologically-based therapies, manipulative and body-based methods, and energy therapies.
Alternative medical systems
Alternative medical systems are based on complete theoretical and practical medical systems. Many alternative medical systems evolved before and apart from conventional Western medicine. Examples of alternative medical systems include:
- Naturopathic medicine. Based on the belief in the body’s healing power.
- Homeopathic medicine. Treatment of symptoms with diluted medicines.
- Ayurveda. A South Asian holistic system.
- Traditional Chinese medicine.
Mind-body interventions rely on various techniques to enhance the mind’s ability to affect bodily symptoms and function. Examples of mind-body interventions include:
- Prayer and spirituality
- Mental healing
- Art therapy
- Music therapy
- Dance therapy
Biologically-based therapies are composed of natural substances, such as foods, herbs and vitamins. They should not be confused with biological therapy, which uses drugs to boost the immune system. Examples of biologically-based therapies include:
- Special diets
- Herbal products
- Vitamins and minerals
- Dietary supplements
Manipulative and body-based methods
Manipulative and body-based methods are based on movement and/or manipulation of one or more body parts. Examples include:
- Chiropractic manipulation
Energy therapies involve the use of fields of energy. The two types of energy therapies include:
- Biofield therapies. These are designed to affect fields of energy that supposedly surround and penetrate the body. The existence of these energy fields has not been scientifically established. Some kinds of energy therapy involve manipulation of these alleged biofields by applying pressure and/or placing the hands inside or through the fields. Examples of biofield therapies include Reiki, therapeutic touch and qi gong.
- Bioelectromagnetic-based therapies. These use electromagnetic fields, such as magnetic fields, pulsed fields, direct-current fields or alternating current fields, in an unconventional manner.
Safety issues with CAM
There is much confusion regarding the safety of certain complementary and alternative medicines (CAMs). Many patients believe the terms “natural” and “safe” are synonymous when, in fact, the safety of many so-called natural CAM products depends on a variety of factors, including:
- The individual. No two people respond to treatment the same way. A patient’s response to CAM treatment depends on factors such as general health and how the therapy is used.
- The ingredients in the product.
- The source of those ingredients.
- The manufacturing process (e.g., how well the product’s manufacturer avoids contamination).
- The training, experience and skill of the practitioner (when applicable).
Adverse effects of CAM have not been well studied. However, some studies indicate that use of CAM therapies can worsen a patient’s quality of life by increasing depression and cancer symptoms. Other possible risks of CAM include:
- Antioxidant interference with radiation therapy or chemotherapy. Antioxidants are nutrients that protect the body against the tissue damage that results from normal metabolism. Because this tissue damage is linked to increased cancer risk, the use of vitamins and herbs containing antioxidants has been proposed for treating cancer. There is concern in the medical community that use of antioxidants may interfere with radiation therapy or chemotherapy. However, recent research suggests that antioxidants may provide nutritional benefits without the risk of interfering with external beam radiation. Further study is needed to better understand the relationship between antioxidants and conventional cancer treatments.
- Drug interactions. There are limited published data regarding the potential interactions between prescription drugs and CAM products, such as herbs and vitamins. Therefore, physicians typically recommend that chemotherapy patients avoid using these high-dose agents, unless scientific studies confirm that significant interactions will not occur. St. John’s wort (Hypericum perforatum), a treatment for depression, is associated with many well-documented drug interactions, including interference with the effectiveness of some forms of chemotherapy. Other herbs of concern include hops (Humulus lupulin) and bloodroot (Sanguinaria canadensis). Cancer patients should notify their physician before introducing herbs or vitamins to their treatment regimen and should be supervised when using the products.
- Bleeding. Many CAM supplements and herbs can increase the risk of bleeding in patients. For example, multiple case studies have found that use of Ginkgo biloba is associated with significant bleeding, and isolated case reports noted bleeding with use of garlic (Allium sativum) and saw palmetto (Sarenoa repens). Cancer patients should notify their physician before adding supplements and herbs to their treatment regimen.
- Liver damage. Multiple supplements and herbs can cause hepatotoxicity, damage or destruction of the liver. Therefore, patients should exercise caution when combining certain CAMs with other hepatotoxic agents.
- Phytoestrogens. These plant-based compounds are found in many popular herbs, such as soy (Glycine max), red clover (Trifolium pratense) and black cohosh (Cimicifuga racemosa). The effectiveness of phytoestrogens in treating hormone-sensitive cancers (e.g., breast cancer) is unclear and controversial. Therefore, these agents should be used cautiously in this population.
- Standardization. Standardization of CAMs is impossible to achieve because the preparation of supplements and herbs is not regulated by the U.S. Food and Drug Administration (FDA) to the same degree as approved drugs. Supplements do not have to meet the manufacturing standards established for drugs.
There are hundreds of complementary and alternative medicines (CAMs) that are touted by advocates for their supposed role in cancer prevention, treatment and the reduction of symptoms and side effects. Some of the complementary and alternative methods that have been promoted as ways of preventing cancer include:
- Lycopene. Dietary lycopene is present in tomatoes and tomato-based products, pink grapefruit, watermelon, apricots, rose hips, guava and palm oil. Lycopene is believed to have antioxidant properties, which were thought to reduce cancer risk. However, further research is needed because the original data is now in question.
- Selenium. This trace mineral is found in water and soil as well as some foods. Selenium is also believed to have antioxidant properties. Researchers are investigating the relationship between selenium and cancer prevention. Lycopene and selenium may help lower the risk of prostate cancer, according to the American Cancer Society (ACS).
- Vitamins A, C and E and beta carotene. Vitamin A is believed to have antioxidant properties. However, clinical trials do not support the use of this vitamin in cancer prevention because it has not demonstrated cancer-fighting properties and may increase lung cancer risk in patients with a predisposition to the disease. Additionally, regular intake of large doses of vitamin A is discouraged because hypervitaminosis (excess accumulation of vitamins in the body) may occur. Supplements of vitamin A may increase the risk of prostate cancer, according to the ACS. Research by the National Cancer Institute (NCI) has linked supplements of beta carotene, a precursor of vitamin A, to an increased risk of lung cancer in heavy smokers.
There is limited clinical research regarding the relationship between vitamin C and cancer. However, the dangers of taking large doses of the vitamin, such as reduced platelet aggregation, may outweigh any potential benefits.
Vitamin E also has antioxidant properties. However, recent studies suggest possible cardiac toxicity with supplements of vitamin E. The NCI does not make recommendations on dietary supplements but advises reducing the risk of cancer with a low-fat diet high in vegetables, fruits and whole grains.
Vitamin B6 may reduce the risk of colon cancer in women. Studies have shown that women with reduced levels of vitamin B6 in their diet may have a greater risk of developing cancerous polyps in the colon.
Recent research has suggested that men who take more than the recommended dose of vitamins on a regular basis may increase their risk of a certain form of prostate cancer. Researchers found that men who took mroe than seven multivitamins per week had a 30 percent greater risk of developing aggressive prostate cancer. Additional studies are necessary to further evaluate the findings.
- Green tea. Green tea comes from the dried leaves of a shrub called Camellia sinensis. Some animal and laboratory research suggests that components of green tea may possess antioxidant and antiangiogenic (preventing the formation of blood vessels) properties. Many lab studies in animals have shown that green tea has some effect on cancer cells, but human studies are more complex. After reviewing studies, the U.S. Food and Drug Administration (FDA) concluded that green tea probably does not help prevent breast, prostate or any other type of cancer. The FDA believes that evidence from these studies does not support the claims of cancer prevention with green tea. Further studies were recommended to substantiate the claims.
- Other therapies. Many additional agents are used in efforts to prevent cancer, such as aloe, cranberry, grape seed extract, milk thistle, omega-3 fatty acids/fish oil and others. There are conflicting studies about the effectiveness of these products and patients are urged to speak with their physician before beginning these or any other CAM therapies.
- Spices. A number of spices have been studied for well-being, particularly in the area of cancer prevention. Turmeric, a yellow spice commonly used in Indian cooking, has been linked to a reduction in the risk of breast cancer. Research has shown that curcumin, an active compound in turmeric, may be an antioxidant that helps prevent tumors for forming. Several studies conducted by the U.S. Department of Defense’s Breast Cancer Research Program suggest that people who eat diets rich in turmeric have lower rates of breast, prostate, lung and colon cancer.
Rosemary, another common spice, has been studied as a means to reduce the cancer-causing compounds created during the cooking process. Researchers found that when they added antioxidants extracted from rosemary to ground beef, the cooked food contained smaller amounts of heterocyclic amines (HCAs), a carcinogenic compound.
Other spices or ingredients have been show to kill or slow cancer cells in limited laboratory settings or animal studies. These include the use of ginger on ovarian cancer cells and the use of capsaicin (an ingredient in chili peppers) on pancreatic cancer cells in mice. Additional research is necessary to support the claims of spices and their role in cancer prevention and treatment.
The following complementary and alternative methods have been used to treat cancer and attempt to prevent secondary cancers:
- Mistletoe extracts (Viscum album). This semiparasitic plant has been used to treat human ailments for centuries. Extracts of mistletoe have stimulated the immune system and eliminated cancer cells in the laboratory. For people with cancer, mistletoe extract is not taken orally but injected in or near a tumor. Mistletoe injections are among the most common unconventional cancer treatments in Europe. In the United States, mistletoe injections are not approved by the FDA and are only available in clinical trials.
- Antineoplastons. In the late 1970s, a researcher observed that a group of compounds called antineoplastons was missing in the urine of cancer patients. Early studies involving treating cancer with antineoplastons were canceled before completion. Therefore, the efficacy of this treatment is unknown. However, clinical trials are currently investigating the effects of antineoplastons on various cancers, according to the NCI.
- Shark and cow cartilage and AE-941. Use of shark and bovine cartilage as a CAM began decades ago and became popular among cancer patients in the 1980s. However, preparations of cartilage are not standardized, and product testing has found large amounts of water that act as filler. Few studies of cartilage cancer trials have been published in scientific journals, according to the NCI. A shark cartilage derivative called AE-941 has shown some promise in cancer treatment and is being studied in a clinical trial.
- Sea vegetables. These seaweed and algae compounds are believed to have immune-stimulating and/or anticancer properties and are marketed in the United States as dietary supplements. In some lab and animal studies, certain algae compounds were found to slow the growth of cancer cells. These studies have not been conducted in humans. In addition, studies of large groups of people who regularly eat seafood and algae show they have lower rates of breast cancer than those who eat more meat. Additional clinical studies regarding the relationship between sea vegetables and cancer are being conducted throughout the world.
- Newcastle disease virus (NDV). This avian (bird) virus, which also affects humans, replicates much better in human cancer cells than in healthy human cells. NDV-based anticancer therapy was beneficial in some clinical studies. However, the studies had incomplete reports and poor design.
- Milk thistle. This herbal plant has been used to treat liver and biliary disorders for more than 2,000 years. One of its active substances, silymarin, is believed to function as an antioxidant, inhibit the growth of cancer cell lines and increase the effectiveness of certain chemotherapy medications. However, no clinical trials have been published to support the use of milk thistle in cancer treatment. Milk thistle is marketed as a dietary supplement in the United States. As with other antioxidants, milk thistle is not recommended for patients who are receiving chemotherapy or radiation therapy. These supplements have the potential to interfere with the cancer-killing effectiveness of these treatments.
- 714-X. The primary ingredient of 714-X is naturally derived camphor (a compound obtained from the leaves or wood of the camphor tree) that is chemically altered by the addition of a nitrogen atom. This CAM supposedly stabilizes the patient’s immune system and restores the immune system’s ability to ward off cancer. No study of 714-X has been published in a reliable scientific journal. Therefore, the safety and efficacy of this CAM has not been determined. Use of 714-X in the United States has not been approved.
- Essiac herbal combination tea. This combination herbal tea was developed in Canada in the 1920s and is marketed worldwide as a dietary supplement. Supposed benefits of Essiac include increased immunity, reduction in tumor size and pain relief, among others. However, no reliable Essiac research has been published.
- Soy (Glycine max). There is much controversy regarding the use of soy in cancer treatment. Researchers believe that certain components in soy may contribute to reducing cancer risk. Laboratory, animal and population studies have suggested that soy may lower the risk of developing breast, prostate and colon cancers. However, these findings have yet to be shown in clinical trials. Human studies sponsored by the National Cancer Institute are currently underway to examine the use of isoflavones as prevention and treatment agents for breast and prostate cancer.
No reliable research substantiates that soy or isoflavones are effective in treating cancer. Furthermore, the use of soy supplements in breast cancer patients remains uncertain. Some studies suggest they may work as anti-estrogen agents and reduce cancer growth. Others suggest that the estrogen properties in soy may actually cause cancers to grow faster. Due to this conflict, many oncologists recommend that women with estrogen-sensitive breast tumors should avoid large amounts of soy in their diet. Additional randomized clinical trials are necessary to further understand the role of soy and cancer prevention and treatment.
- Cancell/Entelev. Also known as Jim’s Juice, Sheridan’s Formula, Crocinic Acid and many other names, this liquid compound has been distributed as a cancer treatment since the late 1930s. No study of Cancell has been reported, and use of this CAM is not approved in the United States and its distribution is prohibited.
- Maitake mushroom extract (Grifola frondosa). Maitake mushroom extract is a Japanese food and medicine, which has become popular among American, European and Asian cancer patients. There is little scientific evidence to support the effectiveness of this CAM, which allegedly modifies immune function and shrinks or prevents tumors. Because this CAM has a long dietary history in Japan, it is probably safe in low doses. However, animal research indicates that possible adverse effects may include hypoglycemia (low blood sugar) and hypotension (low blood pressure). Clinical studies are being conducted with beta-glycan, a component of mushrooms, to evaluate its effect on cancer cell growth and its ability to increase the effectiveness of cancer treatments.
- Shiitake mushroom extract (Letinula edodes). Shiitake mushroom extract is also a Japanese food and medicine. Preclinical evidence indicates that use of this CAM may increase cellular immunity and inhibit the growth of tumors. Certain components of the extract may help reduce the side effects of cancer treatment. Animal studies and at least one clinical trial have found that shiitake mushromm compounds may be effective against advanced recurrent stomach cancer and colorectal cancer. However, further human clinical studies are needed to determine the effectiveness of the compounds in cancer treatment and prevention. Multiple published reports indicate that allergic reactions, such as rash and photodermatitis, occurred after contact or ingestion of shiitake mushroom extract.
- Hoxsey formula. A man named John Hoxsey developed the original Hoxsey formula in the mid-1800s. Today’s Hoxsey formula is an herbal mixture that can be used in a variety of ways (e.g., taken by mouth, applied to the skin, etc.). The formula is individualized for each patient, according to medical history and cancer type. Ingredients typically include potassium iodide, licorice, red clover and others. No reliable research supports the effectiveness of this CAM.
- Hydrazine sulfate. This industrial chemical has been studied as a treatment for cancer and its symptoms, such as wasting (cachexia). Hydrazine sulfate purportedly limits a tumor’s ability to obtain blood sugar (glucose). However, the chemical has been shown to increase the risk of breast, liver and lung tumors in laboratory animals, which suggests that it is carcinogenic. Hydrazine sulfate has not demonstrated anticancer activity in clinical trials, and data regarding its effect on cachexia are not conclusive. Although this chemical is marketed in the United States as a dietary supplement, the Food and Drug Administration (FDA) has not approved its use for cancer treatment outside of clinical trials.
- Gerson therapy and coffee enemas. Gerson therapy was developed by Max Gerson in the 1930s as a treatment for migraine headaches. It involves adhering to a strict diet, drinking 13 glasses of fruit and vegetable juice a day, taking vitamins and receiving coffee enemas. These elements supposedly detoxify the body. Data regarding the effectiveness of Gerson therapy is unavailable. Gerson therapy can be dangerous and is not approved for cancer treatment in the United States.
- Laetrile. This alternative therapy is found in the pits of nuts and fruits. Cyanide is believed to be the primary purported anticancer component of this treatment. The alleged benefit of laetrile is tumor regression. However the cancer-fighting abilities of this treatment have not been proven. The NCI has concluded after studying the compound that laetrile is not effective in fighting cancer. Adverse effects of laetrile are numerous and may include cyanide toxicity, headache, nausea, vomiting and others. Laetrile is not approved by the FDA and is not available for use in the United States.
- Immuno-augmentative therapy (IAT). This therapy involves daily injections of human blood products. IAT was designed in the 1970s to attack cancer cells and stimulate the immune system. Its use was halted in the 1980s when the safety of all human blood products was called into question after the human immunodeficiency virus (HIV) was identified and its transmission through blood verified. A ban prohibiting people from bringing this CAM into the United States was issued in July 1986.
- Chaparral tea. This tea is derived from a shrub that grows in the desert regions of Mexico and the southwestern United States. Benefits, which supposedly include tumor regression, are unproven. Numerous adverse effects have been documented, including liver failure and cirrhosis, kidney damage, kidney cancer, nausea, vomiting, diarrhea, abdominal cramps, rash and fever. Some preliminary rsearch has suggested that one component of chaparral tea, known as NDGA, may help make certain anti-cancer drugs more effective. However, additional lab and animal studies are needed to evaluate its potential role in cancer treatment. The FDA has cautioned againsted internal use of chaparral tea because of its toxic side effects.
- Other therapies. Many additional agents are used as potential cancer treatments, including aloe, barley, flaxseed, ginseng, passion flower and others. The effectiveness of these treatments has not been established. Patients are urged to speak with their physician before beginning these or any other CAM therapies.
Complementary and alternative therapies may also be used to relieve the symptoms and side effects of cancer and its treatments. No effective CAMs have been found for chemotherapy toxicity or wasting (cachexia). However, many CAM treatments address the following:
- Nausea and vomiting. Initial evidence supports the use of ginger (Zingiber officinale) and certain forms of acupuncture and accupressure to manage nausea and vomiting associated with chemotherapy. Other CAM approaches including black tea (Camellia sinensis), peppermint (Mentha x piperita) and valerian (Valeriana officinalis) require further study.
- Constipation. Physicians often recommend natural derivatives, such as oral senna and aloe vera for patients who are constipated.
- Well-being. Researchers have evaluated the effects of numerous therapies on quality of life, general well-being and symptoms, such as pain.
- Adverse effects of radiotherapy. Many CAMs have been used to treat nonspecific symptoms of radiation therapy, including milk thistle, ozone therapy (which adds oxygen to the blood), Reiki (healing touch) and others.
The sales of vitamins, herbal products and dietary supplements have increased dramatically in the United States during the past decade. However, physicians, pharmacists and other healthcare professionals have voiced concern about the public’s knowledge of the products and potential adverse side effects and interactions. Studies have indicated that two-thirds of the people who use herbal supplements do not use them in accordance to scientific guidelines. Further studies are necessary to gain more clinical information about CAM and to educate consumers about their benefits and risks.
Questions for your doctor about CAM
Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their condition. Patients may wish to ask their doctor ore healthcare professional the following questions about complementary and alternative medicine (CAM):
- Which types of CAM may be best suited for my condition?
- Which vitamins or supplements may help me?
- What CAM has been show to be effective for my cancer?
- What CAM may interfere with my cancer treatments?
- Which types of CAM can help me with the side effects of cancer treatment?
- Will acupuncture or acupressure treatments help me?
- Can I use CAM with traditional medicines?
- What foods or diet guidelines may help with my cancer?
- What foods or supplements should I avoid?
- Can any CAM help prevent my cancer from returning?
- How do I know if the CAM I am using is safe?
- Do you recommend any CAM for your patients with cancer?
- Can you refer me to any CAM specialists?
- Where can I go for additional information on CAM?