WHAT IS COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM)?
Complementary and Alternative Medicine (CAM) is defined as a medical system, practice or product that is not usually thought of as standard care. Standard medical care is care that is based on scientific evidence. For thyroid cancer, standard care includes surgery, radioactive iodine and thyroid hormone suppression therapy. For patients with other thyroid diseases, standard care may include thyroid hormone suppression or supplementation.
The National Institutes of Health National Center for Complementary and Alternative Medicine (NIH NCCAM) defines complementary medicine as being used along with standard medical treatments, and alternative medicine as being used in place of standard medical treatments. Integrative medicine is a comprehensive approach to care that includes a patients’ mind body and spirit; this combines standard medicine with CAM practices.
TYPES OF COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM)
The NIH NCCAM uses five categories to describe the different types of CAM. It would be difficult to create a comprehensive list, but some examples are described below:
These are based on a belief that the mind is able to affect your body. Examples include:
These include things most often found in nature, and includes dietary supplements and herbal products. Examples include:
- Special diets
A note about Biologically-Based Practices. It’s common for patients with thyroid cancer or thyroid disease to be recommended to practice a special diet that avoids foods that contain iodine. In fact, use of iodine either in liquid form or as a supplement is not recommended. It’s also common for patients to be told to take Vitamin D or calcium supplementation. In one sense, physicians who treat patients with thyroid disease are therefore recommending a few highly selected biologically based practices. While these practices can be helpful, it’s important to note that there is no one special diet or vitamin that has been proven to eliminate cancer or remove thyroid disease. Because of these special reasons, it’s important to talk with the doctor managing your treatment about any special diets or supplements you are thinking about using.
MANIPULATIVE AND BODY-BASED PRACTICES
These are based on working with the body and are thought to have underlying benefits for the mind as well. Examples include:
Energy medicine invokes the belief that the body has energy fields that can be manipulated for healing and wellness. Examples include:
- Tai Chi
WHOLE MEDICAL SYSTEMS
These systems include beliefs and approaches to healing and wellness that come from all of the world and from many cultures. Examples include:
- Chinese medicine
- Ayurvedic medicine
REASONS PATIENTS WITH THYROID CANCER/THYROID DISEASE CHOOSE CAM
There are few studies that have looked at why patients with thyroid disease choose CAM. Some of the reasons they state are to:
- Help cope with the side effects of medication and treatments including fatigue, dry mouth, weight gain and mental “fogginess”
- Ease the stress and anxiety of medication and treatments, or the worries about having a lifelong diagnosis
- Feel that this could help with their care
- Try to treat or cure their disease
A diagnosis of thyroid cancer or thyroid disease can be stressful or worrisome. Some patients who are newly diagnosed may want to add to their physician’s recommendations or even avoid allopathic treatment entirely. It’s natural to want to be well and to think about what else you can do to improve your health. There is a lot of information available, and new approaches for treating thyroid cancer and thyroid disease are always being tested. It can be hard to tell the difference between what is “standard” care and what is “complementary and alternative” medicine. This brochure is intended to help you understand what to consider as you make these choices. The most important message is to talk with your doctor about what you are already using and before you try anything new.
TALK WITH YOUR DOCTOR BEFORE YOU USE CAM, AND IF YOU ARE ALREADY USING CAM
Some patients are afraid their doctor won’t understand or approve of the use of CAM; some physicians may not understand or approve of this in their patients. But physicians know that their patients want to take an active role in their treatment. We want the best for our patients and would prefer an open line of communication. Talking with your physician about CAM is particularly important because we want to ensure that your treatment works well, and some CAM that may seem safe could potentially interfere with your treatment.
QUESTIONS TO ASK YOUR DOCTOR ABOUT CAM:
Do you know what types of CAM might help me deal with the side effects of treatment?
Will CAM interfere with my treatment or medicines?
Can you help me understand what I have read/ heard about CAM?
A “NATURAL” PRODUCT DOES NOT MEAN A “SAFE” PRODUCT
Supplements do not have to be approved by the federal government before being sold to the public, and a prescription is not needed to buy them. The same is true for most CAM practices. There are ads and claims that a certain product has been used for years, or that they are effective in fighting cancer; these claims do not prove that these approaches are safe or effective. Some of these therapies can cost thousands of dollars. It’s important for you as a consumer to decide what is best for you, but you should be careful. Tell your physician if you are using any form of CAM, no matter how safe you think it is. Here are some facts about biological products you may find surprising:
- Herbs and other products may interfere with how well other medicines work in your body.
- Supplements and cleanses can act like drugs in your body.
- Vitamins can have strong activity in your body.
- Taking more of a good vitamin is not necessarily better.
CHOOSE PRACTITIONERS WITH CARE
CAM practitioners are people who should have training and experience in CAM treatment. You should choose one as carefully and thoughtfully as you choose your physician. Be careful of products advertised that claim they have a “cure” but do not give specific information about how well their product works or claim they have only positive results without side effects. Here are some approaches to remember when finding a practitioner:
- Ask your physician if they can suggest a CAM practitioner
- Ask whether someone in your cancer or treatment center can recommend a CAM practitioner
- Ask whether your hospital has a center for integrative medicine or has staff who practice this
- Contact the CAM professional organization to ensure that your practitioner is certified. This means that they have proper training in their field as judged by national experts. A comprehensive list of certifying organizations is beyond the scope of this brochure; as an example, massage therapists may have certification through the American Massage Therapy Foundation and acupuncturists through NCCAOM (the National Certification Commission for Acupuncture and Oriental Medicine).
WHERE CAN I GET MORE INFORMATION AND HOW CAN I TRUST IT?
There is a lot of information about CAM and it’s difficult to know who to trust. Good places to start are listed to the right. Here are some key questions to ask as you evaluate CAM information:
- Who benefits from the information given? If the site is selling or promoting something, even indirectly, this will tell you that the information is likely to be unreliable. A review board, expert review and a well-known and respected organization are important for reliability.
- Where does the information itself come from? Is the author of the site themselves an expert, and are their references listed and from credible sources? Do they have the credentials to be able to critically evaluate claims and the data underlying them? Anecdotal evidence (based on stories from a handful of people) or qualitative evidence (based on feelings about the treatment) is not considered to be substantial scientific data to support claims of benefit.
- How current is the information? Information on CAM and on standard treatment changes quickly.
- Does the information take into account my specific condition? Patients with thyroid cancer and thyroid disease have special needs that not all CAM practitioners fully understand. It’s important to know this and to make sure you ask lots of questions and talk with your doctor before using CAM.