Cosa Discussion Paper 2007

Information about complementary and alternative therapies.
[phpBB Debug] PHP Warning: in file [ROOT]/vendor/twig/twig/lib/Twig/Extension/Core.php on line 1266: count(): Parameter must be an array or an object that implements Countable
User avatar
Cyndie
Enlightened one
Enlightened one
Posts: 585
Joined: Mon Oct 08, 2007 10:56 pm
Contact:

Cosa Discussion Paper 2007

Postby Cyndie » Tue Mar 04, 2008 8:04 pm

Setting an Australian Research Agenda in Complementary Therapies

Background
Although viewed with scepticism by the medical and scientific community, the last two decades have seen an unprecedented growth in the use of complementary and alternative medicines (CAM) in the management of a large number of medical conditions, including cancer. This document uses the definition used by the National Centre for Complementary and Alternative Medicine (NCCAM), as the one more commonly used in the CAM literature.1

“CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.... The list of what is considered to be CAM changes continually, as those therapies that are proven to be safe and effective become adopted into conventional health care and as new approaches to health care emerge.

Complementary medicine is used together with conventional medicine. An example of a complementary therapy is using aromatherapy … to help lessen a patient's discomfort following surgery.
Alternative medicine is used in place of conventional medicine. An example of an alternative therapy is using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a conventional doctor”.1

Unlike complementary therapies, which are adjuncts to mainstream cancer care, alternative therapies are typically promoted as stand-alone treatments, or alternatives to chemotherapy,
surgery, etc for treating cancer; this is problematic in the care of cancer patients, where delays in instituting treatment can reduce the possibility of a cure or remission.2

Although the complementary and alternative therapies are different, the acronym of CAM is commonly used in the literature, although this “acronymic convenience” may unwittingly validate the use of alternative medicine as alternatives to recognised medical treatment. 2-4

General levels of CAM use and costs of treatment
A population-based survey in South Australia found that in 2000, 52% of the population used at least one non-medically prescribed medicine and that 23% visited at least one complementary healthcare practitioner.8 A cost extrapolation of the expenditure on CAM in Australia for 2000 suggested that AUD 2.3 billion were spent on CAM, representing approximately 4 times the public contribution to the Pharmaceutical Benefits Scheme.8 The annual retail turnover of complementary medicine alone in Australia in 2003 was estimated at 800 million AUD, with an additional 20% of the national output being exported.9

The costs to consumers for CAM treatments can be significant, with an Australian survey estimating a median annual cost of 530 AUD.10

Reasons for CAM use by cancer patients
CAM use is common among cancer patients, with recent US surveys indicating that anywhere from 9 to 91% of cancer patients used some form of CAM therapy at some point during the course of their disease.11. Reasons for CAM use included effective symptom relief,12 seeking an improved quality of life,12-14 congruence own values and beliefs,15 a desire to do as much as possible to fight cancer,15-18 concerns about the toxicity of conventional therapies,15, 19 or expectations it would boost the immune system or destroy the cancer cells. 13, 20, 21.

Integrating CAM into the continuum of cancer care
As some complementary therapies are proven safe and effective, they may become integrated into mainstream care, in a holistic approach to cancer care termed integrative medicine,2, 6although the level of integration and the quality of services offered vary greatly in different countries and among individual cancer centres.2

In North America, the response to an increased patient interest in CAM has been accompanied by the development of research and clinical programs in integrative medicine in many major cancer centres.24 Their efforts, coupled with the creation of NCCAM at the National Health Institute, have made significant contributions towards a greater appreciation of the role CAM could play in integrated patient management. This also resulted in more dialogue between unconventional and conventional treatment providers and created opportunities for collaboration in exploring the potential of novel treatments and facilitating their more rigorous evaluation.11

Establishing research priorities in complementary therapies

A collaborative approach to establish common research goals has been emphasized by the creation of Australian National Institute of Complementary Medicine (NICM) and the inclusion of complementary medicine in the overall health and medical research strategic plan of the National Health and Medical Research Council (NHMRC).

NICM’s mission is to “build the capacity of complementary medicine research across Australia, effectively connecting complementary medicine researchers and professionals with the broader research community, industry and other stakeholders to provide strategic focus and foster excellence in research”

The focus of NICM research is foremost research into complementary medicine products, with a focus on botanicals and pharmacological and biological treatments. In August this year, NICM conducted a mapping exercise for establishing research priorities in complementary therapies. Some research priorities identified by participants in the research forum included:
• Quantifying the contribution complementary therapies make to addressing national health priority areas
• Enhancing research in the safety/ effectiveness of complementary treatments
• Evaluating the contribution technological advances make to advancing CM research (e.g. NMR spectroscopy to evaluate herbal medicine effects)
• Focusing research activities to therapies amenable to scientific enquiry
• Developing research capacity where local expertise and opportunities already exist
• Supporting research with potential to attract additional funding/ support from the private sector.

A brief poll of representatives of consumer based cancer organisations identified the following key issues for consumers affected by cancer and their representative organisations:
• Supporting research in the safety/ balance of benefits and harms associated with the use of different treatment modalities
• Prioritising research into therapies commonly used by cancer patients
• Research with potential to contribute most to improved cancer outcomes
• Supporting relevant health services research for CM use by cancer patients
• Research modalities of integrating promising treatment modalities into standard cancer care


References:
1. http://nccam.nih.gov/health/whatiscam/. NCCAM, 2005. (Accessed August 18, 2007)
2. Cassileth BR, Deng G. Complementary and alternative therapies for cancer. Oncologist 2004;9(1):80-9.
3. Cassileth BR. Alternative and complementary medicine. Separating the wheat from the chaff. Cancer 1999;86(10):1900-2.
4. Cassileth BR. 'Complementary' or 'alternative'? It makes a difference in cancer care. Complement Ther Med 1999;7(1):35-7.
5. Ernst E. The current position of complementary/alternative medicine in cancer. Eur J Cancer 2003;39(16):2273-7.
6. Cassileth B, Deng G, Vickers A, Yeung S. Integrative oncology: complementary therapies in cancer care. In: Decker, ed. Integrative oncology. Hamilton ON: BC; 2005.
7. Cassileth B, Vickers A. Complementary and Alternative Cancer Therapies. In: Holland JFFI, E, ed. Cancer Medicine. 6th ed. Hamilton: B.C. Decker Inc.; 2003.
8. MacLennan AH, Wilson DH, Taylor AW. The escalating cost and prevalence of alternative medicine. Prev Med 2002;35(2):166-73.
9. Expert Committee on Complementary Medicines in the Health System. Complementary Medicines in the Australian Health System. Report to the Parliamentary Secretary to the Minister for Health and Ageing. Canberra: Commonwalth of Australia; 2003 September 2003.
10. Begbie SD, Kerestes ZL, Bell DR. Patterns of alternative medicine use by cancer patients. Med J Aust 1996;165(10):545-8.
11. White JD. The National Cancer Institute's perspective and agenda for promoting awareness and research on alternative therapies for cancer. J Altern Complement Med 2002;8(5):545-50.
12. Kimby CK, Launso L, Henningsen I, Langgaard H. Choice of unconventional treatment by patients with cancer. J Altern Complement Med 2003;9(4):549-61.
13. Chrystal K, Allan S, Forgeson G, Isaacs R. The use of complementary/alternative medicine by cancer patients in a New Zealand regional cancer treatment centre. N Z Med J 2003;116(1168):U296.
14. Molassiotis A, Fernadez-Ortega P, Pud D, et al. Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol 2005;16(4):655-63.
15. Singh H, Maskarinec G, Shumay DM. Understanding the motivation for conventional and complementary/alternative medicine use among men with prostate cancer. Integr Cancer Ther 2005;4(2):187-94.
16. Algier LA, Hanoglu Z, Ozden G, Kara F. The use of complementary and alternative (non-conventional) medicine in cancer patients in Turkey. Eur J Oncol Nurs 2005;9(2):138-46.
17. van der Weg F, Streuli RA. Use of alternative medicine by patients with cancer in a rural area of Switzerland. Swiss Med Wkly 2003;133(15-16):233-40.
18. Liu JM, Chu HC, Chin YH, et al. Cross sectional study of use of alternative medicines in Chinese cancer patients. Jpn J Clin Oncol 1997;27(1):37-41.
19. Menniti-Ippolito F, Gargiulo L, Bologna E, Forcella E, Raschetti R. Use of unconventional medicine in Italy: a nation-wide survey. Eur J Clin Pharmacol 2002;58(1):61-4.
20. Downer SM, Cody MM, McCluskey P, et al. Pursuit and practice of complementary therapies by cancer patients receiving conventional treatment. Bmj 1994;309(6947):86-9.
21. Shen J, Andersen R, Albert PS, et al. Use of complementary/alternative therapies by women with advanced-stage breast cancer. BMC Complement Altern Med 2002;2:8.
22. Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. Jama 1998;280(18):1569-75.
23. Kao GD, Devine P. Use of complementary health practices by prostate carcinoma patients undergoing radiation therapy. Cancer 2000;88(3):615-9.
24. Cassileth B, Deng G, Vickers A, Yeung KS. PDQ Integrative oncology. Complementary therapies in cancer care. Hamilton, London: BC Decker Inc; 20
Cyndie
Living every day!!!!

[phpBB Debug] PHP Warning: in file [ROOT]/vendor/twig/twig/lib/Twig/Extension/Core.php on line 1266: count(): Parameter must be an array or an object that implements Countable
[phpBB Debug] PHP Warning: in file [ROOT]/vendor/twig/twig/lib/Twig/Extension/Core.php on line 1266: count(): Parameter must be an array or an object that implements Countable
[phpBB Debug] PHP Warning: in file [ROOT]/vendor/twig/twig/lib/Twig/Extension/Core.php on line 1266: count(): Parameter must be an array or an object that implements Countable

Return to “CAMs”

Who is online

Users browsing this forum: No registered users and 1 guest