Herbs, Massage or Hypnosis?

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Cancer Patients Get Advice

Every day, cancer patients walk into their doctors’ offices and neglect to mention the other treatment they are pursuing on the side: the herbal supplements, the hypnosis, the trip to the acupuncturist.

Many of the report’s recommendations on prevention and treatment jibe with more widely known guidelines from other medical groups such as the American Society of Clinical Oncology and the American Cancer Society. But these groups haven’t offered guidelines for complementary therapies.

Half of all Americans have used complementary and alternative therapies, according to a federal survey. And cancer patients are especially likely to do so, according to Barrie Cassileth, chief of integrative medicine at Memorial Sloan-Kettering Cancer Center and lead author of the complementary-therapy guidelines.

The aim was to offer useful guidance for doctors and patients on which therapies may be helpful and which may not.

“Doctors aren’t comfortable discussing these subjects with their patients,” says Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, who wasn’t involved in the guidelines.

Among the recommendations, the ACCP report notes that some herbal supplements may interfere with chemotherapy or radiation. But other therapies, such as acupuncture, may help some patients deal with pain and other symptoms.

The report also makes clear that any benefits of these therapies are limited to treating the often debilitating effects of cancer and cancer treatment, and not the disease itself. So patients shouldn’t forgo standard treatment in favor of alternative therapies. But guidelines may apply beyond lung cancer, because many symptoms are common to many kinds of cancer, says Dr. Cassileth.

Among the alternative therapies that are recommended, acupuncture for pain relief was found to be helpful when drugs aren’t enough, or when the side effects of pain medications become a problem and the patient wants to reduce the dose. Acupuncture is also recommended to control nausea and vomiting associated with chemotherapy, when symptoms aren’t well controlled with drugs says, and should be treated only by a practitioner qualified to treat cancer patients.

Massage given by a therapist trained in treating cancer patients can reduce anxiety, pain, fatigue and distress, but the “application of deep or intense pressure” isn’t recommended in patients with a greater-than-normal tendency to bleed.

The guidelines generally don’t recommend the use of herbal supplements. For example, patients receiving the chemo drug pemetrexed should take vitamin B12 and folic-acid supplements. In general, supplements should be “evaluated for side effects and potential interaction with other drugs,” the researchers say.

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