Complementary and Alternative Medicine Chong, O. An integrative approach to addressing clinical issues in complementary and alternative medicine in an Outpatient Oncology Center. Clinical Journal of Oncology Nursing, 10 183—
Case 2 What is the definition and scope of CAM? The answer to this question continues to invite debate; looking to the federal government for a definition provides at least an historical perspective on the question.
CAM whole medical systems are naturopathic medicine, homeopathy, Ayurveda and traditional Chinese medicine TCM including acupuncture; these systems have evolved over centuries to millennia.
Mind-body medicine and energy medicine encompass a broad spectrum of techniques including meditation, QiGong, and hypnotherapy.
Somatic therapies include massage, craniosacral, and chiropractic. This is a fractional list of the many therapies and modalities that may reside under the general rubric of CAM. How extensively is CAM used? Subsequent, more exhaustive, surveys demonstrated that CAM use has steadily increased.
The most common presenting complaints among people seeking CAM treatment are back pain and other musculoskeletal complaints National Health Statistics Reports.
The antipathy of allopaths toward many forms of CAM persisted for much of the 20th century. However in recent decades significant progress has been made in establishing integrative medical centers at which CAM and allopathic practitioners work together to co-manage patients.
In the Seattle area each of the major hospitals now includes CAM in their curricula, houses integrated medicine clinics, and engages in collaborative research with CAM researchers.
Nationwide, this trend holds also holds. What is known about the efficacy of CAM? Research to evaluate the efficacy of CAM is ongoing. Federal funding for CAM research has increased over the past two decades, but still falls short of allocations made to other areas of inquiry.
To date, clinical trials have demonstrated some efficacy of CAM therapies in the amelioration of back pain, upper respiratory infections, and diabetes. Medicinal mushrooms are being studied in cancer patients with promising results. In vitro studies provide exciting data on the induction of apoptosis in cancer cells by botanical compounds, modulation of immune function by herbal products or mushrooms, and the mitigation of cellular oxidative stress by botanical extracts.
The Cochrane Reviews provide useful summaries of extant CAM clinical trials and all entries articulate the need for more research in the area.
There are many methodological issues that make the design of CAM research studies challenging. Following are a few of many examples. Botanical medicine derives from folk traditions in which plants, either the whole plant or isolated parts of it, are harvested and prepared according to learned wisdom.
Botanical extracts are complex mixtures of molecular constituents that are difficult to standardize and characterize, an issue further complicated by the timing of harvest, method of extraction, and growing conditions.
The western science paradigm of pharmaceutical development and testing a single molecule delivered in pure form at relatively high concentrations does not fit the realities of botanical therapies.
Whole system CAM practices treat the individual patient in a very individualized way, generally using multiple interventions simultaneously. Such an approach does not lend itself to validation by the RCT approach. Using this approach, an individual serves as their own control, and the intervention or placebo is each administered multiple times, in random order, with outcome measures taken during each phase.
Informative though they can be, these studies are laborious, expensive, and time-consuming for the subject, thus increasing attrition rates. In designing an RCT, it is often difficult to define an appropriate control group.
In acupuncture studies, for example, debate continues about what constitutes sham needling: In botanical medicine studies on compounds with a strong or recognizable taste for example, garlichow does one come up with true placebo? NCCAM addresses some of these concerns in its current statement of funding prioritiesasserting the need for pharmacokinetic studies of biologically based interventions, the optimization of dosing regimens across modalities and control groups, and the refinement and validation of outcome measures.
Additionally, studies on safety and efficacy and mechanistic studies are being encouraged. What ethical issues are associated with CAM in clinical practice?
In the context of clinical practice, the ethical issues pertain to providing optimal medical care to an individual. Any physician, allopathic or otherwise, is bound by oath to do no harm and to provide the most efficacious therapies to their patient.
The precepts of evidence-based medicine EBM and the accessibility of medical research literature provide clinicians with powerful tools to identify such therapies.
In evaluating the risk of harm and the potential benefits of any therapy, weight must be given to the amount and quality of research that has been done on the intervention, known risks and side effects of the therapy, the credential and competence of the practitioner, the seriousness of the condition being treated, and the belief system and wishes of the patient.
Given the relative dearth of research literature on many CAM therapies, the clinician must use best judgment to decide which therapies are unlikely to do harm, either directly or by reducing the effectiveness of other therapies, and which may offer some, if not great, benefit.
A CAM therapy that is neither harmful nor effective can become damaging if it precludes the patient obtaining effective treatment.
The advantage of integrative medical clinics is to take much of the guesswork out of this algorithm. Well-trained, licensed CAM providers working alongside conventional clinicians create an environment in which patient care can utilize current best practices in each discipline.
What ethical issues are associated with research in CAM? In the context of CAM research, different ethical issues arise.Background. Use of complementary and alternative medicine (CAM) is widespread among different patient populations despite the availability of evidence-based conventional medicine and lack of supporting evidence for the claims of most CAM types.
COMPLEMENTARY AND ALTERNATIVE MEDICINE 3 Abstract Complementary and alternative medicine (CAM) has been used for centuries. Common methods include chiropractic, diet, . Complementary and alternative medicine (CAM) refers to the array of therapies that extend beyond conventional Western medical treatments.
The term complementary describes treatments used in. The electronic Journal of Traditional and Complementary Medicine (eJTCM) is a quarterly open-access journal that covers the fields of traditional medicine, herbal medicine, and dietary therapy.
The Journal provides a global platform for discussion, perspectives and research on traditional and Complementary. EUROCAM Complementary and Alternative Medicine EUROCAM is a foundation uniting European organisations representing CAM patients and trained CAM health professionals, including medical doctors, veterinarians and other practitioners.
Free Essay: Complementary and Alternative Medicine (CAM) Therapies in Cancer Patients Acquiring the knowledge and understanding of how to get complementary.