Firstly, we wholeheartedly support and
encourage practices that can help you, the patient or caregiver, to improve your
fitness and general health. Notably, wise changes in
diet and exercise can
help you to achieve this and is associated with improved survival.
This topic is mainly about the types of medicines or practices that may be
prescribed or promoted to treat lymphoma and disease-related symptoms.
We believe that the word "medicine" should
be reserved for interventions that have proven to be effective in clinical trials.
Without standards for medical claims (or what we call medicine) we'd have
millions of choices but no basis for making an informed choice.
CAM stands for
Complementary and Alternative "medicine." CAM is an umbrella term for practices that are not generally
given by mainstream medical doctors. Here we
describe CAM practices along with medical practices used to treat disease and
These are practices that are sometimes
a part of mainstream medical care,
such as to help improve general health or to help to relieve symptoms.
Yoga for pain or
stress relief is an example. Exercise to help manage fatigue is
another. Such activities are sometimes called integrativemedicinewhen used by medical doctors.
theory-based practices that
are used to replace mainstream medical care. The promotions of
alternative cancer practices are typically based onimplausible
scientific theories (pseudoscience), testimonials
and conspiracy theories.
Alternative practices can have low to significant direct risks to
the patient. Tragic outcomes can result from delaying proven
therapies. These can also be expensive - draining families of
their life savings despite having no basis for the claims that are
Note: 3 in 5 adults will have a diagnosis of cancer. All
people (even persons with a strong intelligence and excellence in
their fields) are vulnerable to claims about non-toxic alternative
cures. Steve Jobs, for example, unwisely chose alternative
practices at a time when he had a real chance to effectively treat
his cancer. Doctors, regulators, scientists also get cancer.
There is no conspiracy to suppress cures from you or their loved
These are medical practices
that are based on scientific discovery that have been proven
by clinical testing to provide clinical benefit - defined as
living a longer life or by improving quality of life.
These pre-defined (prospective) tests of the treatments
(clinical trials) are carried out
in patients who have the disease. The results are reviewed by
peers and independent regulatory agencies. In the assessment
the improvement in the condition (benefit) must outweigh the risks
and side effects of the practice.
The prospective design of
clinical trials helps to measure the rate of outcomes, such as
response rate, and also the expected duration of response, side effects,
and survival - for others. Such as 30/100 responses. A key principles of
evidence-based medicine is to evaluate a treatment in ways that
predict the results for others. Such as:
* Use of study design of sufficient size
and uniform eligibility
* Pre-specifying the intervention
(prospective design): the patient population, the number of
participants (the denominator), how and when the outcomes will be
measured, and the result that warrants approval
* Reproducibility of the outcomes by other groups (verification)
Note: Some medical conditions are difficult
to treat effectively even with evidence-based medicines.
In some cases the goal of
treatment can shift to best supportive care or palliative care -
where the intent is to improve quality of life and to manage
Best practice can be controversial, such when standard approaches
that have side effects are not expected to help to control the
disease and its symptoms. In such cases, no treatment can be
wise, or the consideration of clinical trials that are testing
therapies that may work in other ways.
Clinical trials - investigational interventions
These are tests of study
drugs or other interventions that have not proven to be effective or
better than a standard approach to treating a medical condition.
To be approved for testing in humans, the investigational practice must
be based on plausible science and carried out with careful oversight to
minimize risks to the study participants - starting with finding the
optimal safe dose.
Note: without clinical
trials there can be no reliable advances in the practice of medicine to
treat disease. PAL urges patients to consider clinical trials
routinely -- ideally with the help of an independent specialist in the
field to help you to determine if a study might be appropriate for your
unique clinical circumstance.
See Trial Talk
for a list of lymphoma specialists you might consult about trials as
part of a second opinion.
These are changes to life style that
may reduce the risk of developing some
kinds of disease.
Most everyone agrees that preventive practices (adopting a healthful diet,
increasing our exercise, cessation of smoking) are keys to better
decreasing the incidence of many diseases, and lowering medical costs.
Some obvious targets of such efforts would be the tobacco and food
industries, but also public education.
Anonymous & Confidential
4-question CAM SURVEY
for lymphoma survivors or caregivers
To can better meet needs when we understand the community we serve - details
After you complete the survey you
will see a list of what you selected.
When you return to this
form, you are done.
a) You are
survivor, OR caregiver (providing
input for another)
b) Gender of person diagnosed:
c) Age at diagnosis:
d) Approximate time since diagnosis:
e) Grade of lymphoma (choose one):
Complementary and Alternative Medicine (CAM):
medicine - non-mainstream substitutes for treatment
complementary medicine - practices used to improve quality of life,
such as yoga
believe that herbs, supplements, and other life style practices
CAN directly change
the course of the disease
(Yes, Likely, Don't know, Unlikely, No)
You consider testimonials
(experiences related by individuals) to be reliable
evidence of the merits of CAM practices.
(Yes, Not sure, No)
You feel that there could be a conspiracy in the medical establishment to undermine
the credibility of CAM practices for cancers.
(Yes, Not sure, No)
Click Submit to complete the
survey. Thank you for participating!
Medical experts speaking out against Unproven Therapies for
Spontaneous Remission and the Placebo Effect,
Stephen Barrett, M.D.
Recovery from illness, whether it follows self-medication,
treatment by a scientific practitioner, or treatment by an
unscientific practitioner, may lead individuals to conclude that
the treatment received was the cause of the return to good health.
Respectful Insolence by Surgeon/ Scientist Orac
"A statement of fact cannot be insolent." The
miscellaneous ramblings of a surgeon/scientist on medicine, quackery,
science, pseudoscience, history, and pseudohistory (and anything else that
"Patients who don’t understand the difference
between informationbased on theory, anecdote, historical
analysis, or double-blindplacebo controlled studies are making
ill-informed decisions,believing alternative therapies are safer
or more effectivewhen they are not. Even patients who presume
that alternativetherapies are ineffective may use them. Why?
When faced witha life-threatening disease requiring highly toxic
treatmentswith no guarantees, or when dying because there are no
effectiveconventional treatments, it takes guts to reject
something orsomeone claiming to be able to save you, just in
case you mightbe wrong."
... "modern medicine's integrity is being eroded by New
Age mysticism, cult-like schemes, ideologies, and classical quackery, all
known as "alternative medicine." Using obscure language and
misleading claims, they promote changes that would propel medicine back five
centuries or more. They would supplant objectivity and reason with myths,
feelings, hunches and sophistry.
NCCAM is being presented as a scientific
vehicle to study alternative medicine's anomalous methods. But NCCAM
actually promotes the movement by assuming that false and implausible claims
are legitimate things to study."
Debunking cancer myths: An interview with a Mayo Clinic specialist mayoclinic.com/
Medical myths not only mislead but also may hamper proper treatment.
Find out why these common cancer myths are wrong. Highly recommended
"NCAHF is a private nonprofit, voluntary
health agency that focuses upon health misinformation, fraud, and quackery
as public health problems. Our positions are based upon the principles of
science that underlie consumer protection law. We advocate: (a) adequate
disclosure in labeling and other warranties to enable consumers to make
truly informed choices; (b) premarketing proof of safety and effectiveness
for products and services claimed to prevent, alleviate, or cure any health
problem; and, (c) accountability for those who violate the law."
Caring (Really) for Patients Who Use Alternative Therapies
for Cancer jco.org
"The reasons why people seek alternative therapies
for cancerare broad. Many seek out alternative therapy when
options forconventional therapy have been exhausted. There is
also therecognition that, for some tumor systems, conventional
therapyis of limited effectiveness and that the side effects of
chemotherapy,surgery, and radiation are feared. For some tumor
systems, noconventional therapy exists and the standard therapy
is participationin phase I or phase II trials. Many patients
perceive that theconventional approach is emotionally or
spiritually empty andprovides neither comfort nor solace."
Medlexicon: Fasting May Boost Chemo By Weakening Cancer
“The study shows that five out of eight cancer types in mice
[also\ responded to fasting alone: it slowed the growth and spread
and of tumors.” (showing the limitation of animal
COMPLEMENTARY AND ALTERNATIVE
THERAPIES FOR CANCER PATIENTS
A Cancer Patient’s Guide to Complementary and Alternative Medicine
Heather L. Morein University of California San Diego School of
Independent Study Project, April 2002 (Large 168 pg document)
Use of Complementary/Integrative Nutritional Therapies During
Cancer Treatment: Implications in Clinical Practice -
2002 H. Lee Moffitt Cancer Center and Research Institute, Inc.