You may have heard the terms "alternative" or "complementary" used to refer to methods of diagnosing, preventing, or treating cancer and wondered exactly what they meant. How can you know if these approaches are safe and if they are likely to help you? The definitions below can help you sort out what these terms mean.

American Cancer Society Operational Statement on Complementary and Alternative Methods of Cancer Management

Guidelines for Using Complementary and Alternative Methods

How to Know What Is Safe: Choosing and Using Dietary Supplements

What Terms Are Used to Describe Cancer Treatment?

Proven treatment refers to evidence-based, or mainstream medical treatments that have been tested following a strict set of guidelines and found to be safe and effective. The results of such studies have been published in peer reviewed journals-that is, journals reviewed by other doctors or scientists in the field. The treatments used in mainstream medicine have been approved by the Food and Drug Administration.

Research or investigational treatments are therapies being studied in a clinical trial. Clinical trials are research projects that determine whether a new treatment is effective and safe for patients. Before a drug or other treatment can be used regularly to treat patients, it is studied and tested carefully, first in laboratory test tubes, and then in animals. After these studies are completed and the therapy is found safe and promising, it is tested to see if it helps patients. After careful testing with patients shows that the drug or other treatment is safe and effective, the Food and Drug Administration may approve it for regular use. Only then does the treatment become part of the standard, mainstream collection of proven therapies used to treat disease in human beings.

Complementary refers to supportive methods that are used to complement, or add to, mainstream treatments. Examples might include meditation to reduce stress, peppermint tea for nausea, and acupuncture for chronic back pain. Complementary methods are not given to cure disease, rather they may help control symptoms and improve well-being. Some of the methods, such as massage therapy, yoga, and meditation, that are categorized as complementary have actually been referred to as supportive care in the past.

Integrative therapy is a term that refers to the combined offering of evidence-based mainstream and complementary therapies.

The term unproven or untested can be confusing because it is sometimes used to refer to treatments with little basis in scientific fact, while it may also refer to treatments or tests that are under investigation. Adequate scientific evidence is not available to support its use.

Alternative refers to treatments that are promoted as cancer cures. They are unproven because they have not been scientifically tested, or were tested and found to be ineffective. If used instead of evidence-based treatment, the patient may suffer, either from lack of helpful treatment or because the alternative treatment is actually harmful.

Quackery refers to the promotion of methods that claim to prevent, diagnose, or cure cancers that are known to be false, or which are unproven. These methods are based on the use of patient testimonials as evidence of its efficacy and safety. Often the treatment is claimed to be effective in other diseases as well as cancer.

Can I Safely Use an Alternative or Complementary Cancer Treatment?

Many people with cancer use one or more kinds of alternative or complementary therapies. Often they are reluctant to tell their doctors about their decision. The best approach is to look carefully at your choices. Talk to your doctor about any method you are considering. There are many complementary methods you can safely use along with standard mainstream treatment to help relieve symptoms or side effects, to ease pain, and to help you enjoy life more. Here is a partial list of some complementary methods that some people have found helpful when used along with medical treatment:

Some Helpful Complementary Approaches

• aromatherapy
• art therapy
• biofeedback
• massage therapy
• meditation
• music therapy
• prayer, spiritual practices
• t’ai chi
• yoga

But if you are thinking about using any other method instead of evidence-based medical treatment, look first at the questions below.

Questions to Ask About Alternative and Complementary Therapies

• What claims are made for the treatment: to cure the cancer or to enable the evidence-based treatment to work better? to relieve symptoms or side effects?
• What are the credentials of those supporting the treatment? Are they recognized experts in cancer treatment? Have they published their findings in trustworthy journals?
• How is the method promoted? Is it promoted only in the mass media (books, magazines, TV and radio talk shows) rather than in scientific journals?
• What are the costs of the therapy?
• Is the method widely available for use within the health-care community, or is it controlled with access to its use limited?
• If used in place of standard therapies or clinical trials, will the ensuing delay affect any chances for cure or advance the cancer stage?

Use the checklist below to spot those approaches that might be open to question. If you are not sure, talk to your doctor or nurse before moving ahead.

• Is the treatment based on an unproven theory?
• Does the treatment promise a cure for all cancers?
• Are you told not to use conventional medical treatment?
• Is the treatment or drug a "secret" that only certain providers can give?
• Does the treatment require you to travel to another country?
• Do the promoters attack the medical/scientific establishment?

There is a great deal of interest today in complementary and alternative therapies. Mass communication, especially the Internet, makes it possible for people to share ideas and information very quickly. But too often information on the Internet is written by promoters of useless treatments. We recommend the resources available at the Memorial Sloan-Kettering Cancer Center Integrative Medicine Web site, particularly the section called Herbs, Botanicals & Other Products.