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Complementary and Alternative Therapies for Cancer Patients APPENDIX A: NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE CLASSIFICATION OF ALTERNATIVE THERAPIES The National Center for Complementary and Alternative Medicine (NCCAM), a division of the National Institutes of Health (NIH) designed a classification system to assist in organizing the different therapeutic approaches in complementary and alternative medicine (CAM). CAM has been divided into five major categories. Within each category, medical practices will be designated CAM, behavioral medicine or overlapping therapies. CAM encompasses practices that are not considered standard therapies. Behavioral medicine practices fall mainly within the domain of conventional medicine. Overlapping practices can be either CAM or behavioral medicine, depending on their application. Within each category, relevant examples will be listed. Not all of the therapies listed have been tested for efficacy in cancer treatment. These therapies are included so that there is a comprehensive reference list to refer to if needed. Therapies in bold print have been reviewed in this manual. Many therapies reviewed in this manual were chosen based on popularity with patient populations nationally as supported by the National Cancer Institute and the American Cancer Foundation. Therapies that have been or continue to be researched by the NCCAM have also been selected. Additionally, in an effort to focus on a San Diego-based patient population, several San Diego-based oncologists were asked to list complementary and alternative therapies their patients asked questions of or incorporated into their cancer care. Other reviewed therapies were included due to the proximity of treatment centers in Southern California and Tijuana, Mexico. If questions arise regarding therapies not reviewed in this manual, please contact your local comprehensive cancer center or the National Cancer Institute. I. Mind-Body Interventions The role of emotions in recovery and the ability of the mind to influence physical functions are the basis for mind-body approaches to cancer therapy. Because some patterns of emotions and behavior can lead to alterations in body biochemistry and immune system function, changing unhealthy patterns of emotions and behavior may positively affect the body. This category includes psychotherapy, support groups, guided imagery or visualization, music and art therapy and hypnosis. Mind-body medicine is divided into four subcategories:
1. Mind-Body
Systems 2. Mind-Body
Methods CAM_________________________________________ Behavioral Medicine_____________________________ Overlapping____________________________________ 3. Religion and Spirituality These approaches involve nonbehavioral aspects of spirituality and religion and their relationship with biological function. CAM__________________________________________ 4. Social and Contextual Areas This subcategory includes therapies based in social, cultural, symbolic and contextual interventions not covered in other areas. CAM___________________________________________ Overlapping_____________________________________ II. Energy TherapiesIn energy medicine, the human body is viewed as a complex of interacting energy fields that help regulate the body. Energy fields originating within the body are known as biofields. Energy fields from other sources are called electromagnectic fields. Biofield therapies are intended to affect the energy fields that are within and surround the human body. These therapies include Qi gong, Reiki and Therapeutic Touch. Bioelectromagnetics refers to the unconventional use of electromagnetic fields for medical purposes. Practitioners of bioelectromagnetics believe that disease may result if these energy fields become unbalanced. Therefore, healers try to rebalance the energy fields and restore the well-being of the body. • Electromagnetic
Therapy • Qi gong III. Alternative Medical Systems There are several distinct systems of alternative practice that encompass many different therapeutic theories and methods. These include folk therapies, Chinese Medicine, Ayurveda, Homeopathy and Naturopathy. 1. Acupuncture and Oriental Medicine
• Acupotomy
•
Herbal Formulas 2. Traditional Indigenous Systems
• Ayurvedic
Medicine •
Practices Psychic Surgery 3. Unconventional Western Systems CAM__________________________________________________________ 4. Naturopathy IV. Biologic-Based Therapies This category includes dietary interventions, single nutrient supplements and biological-based products intended to treat cancer. 1. Diet and Nutrition - Diet is now recognized as playing a major role in lowering the risk of some types of cancer. Some CAM practitioners believe that nutritional therapies can also slow, stop or reverse the development of an established cancer or even slow or prevent recurrence. However, well-designed studies have not been conducted to test those beliefs. This category includes dietary approaches and special diets. • Asian
• High Fiber 2. Single Nutrients • Amino Acids
• Medium Chain Fatty Acids 3. Herbal Medicine - The use of herbs in medicine is ancient in its origins. Herbal therapies employ plant and plant products from hundreds of different medical traditions. This category often overlaps with the pharmacologic and biologic therapies. Single Herbal Remedy• Aloe Vera
• Garlic 4. Products - These treatments include biochemical agents, vaccines, blood products and synthetic chemicals not yet accepted by the medical community. In contrast to conventional medicines, these alternative agents are marketed as containing unique, largely non-toxic mixtures to control or combat cancer. • Antineoplastons
• Hydrogen Peroxide V. Manual Healing Medicine Touch and manipulation with the hands have been considered a therapeutic instrument for much of the history of medicine, dating back to instructions by Hippocrates about therapeutic massage.[2] Other fields include chiropractic and osteopathic manipulation. Manual Healing Medicine is divided into three subcategories 1. Chiropractic Medicine 2. Massage
and Body Work 3. Unconventional Physical Therapies • Alternative Nostril
Breathing • Colonics
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