Discussing complementary and alternative medicine (CAM) with patients and families:
Because CAM use by children with cancer is affected by a variety of factors, including parental use of CAM, demographics, stage of treatment, religious and cultural backgrounds, and social and economical factors, it is important to inquire about a wide variety of CAM use practices during routine exams upon diagnosis, through treatment, and into survivorship. Often patients do not disclose the use of CAM because they are not asked about their use or are too nervous to disclose their use to a physician. Most CAM users do not use CAM in lieu of conventional medicine but rather use CAM to manage symptoms. Therefore, it is important to probe directly about type of CAM and reason for use. A few suggested questions to begin a conversation with your patient’s parents or guardians can include:
- Do you currently use any complementary or alternative medicine for yourself, such as vitamins, herbal or plant products, massage therapy, or yoga?
- Do you currently use any complementary or alternative medicine for your child?
- Are you interested in using complementary and alternative medicine for your child during or following treatment? If so, what are you interested in using?
Selecting a CAM provider
The clinician should be aware of the professional licensure regulations, the scope of practice, and malpractice concerns of their state to understand the legal parameters of referring children with cancer to CAM providers (Cohen, 2006). Because state laws establish professional standing in order to protect the public from practitioners who do not meet recognized standards of care, in the absence of such laws, entities that provide services would be at increased risk of liability if an adverse event occurred (White House Commission on Complementary and Alternative Medicine Policy, 2006). Further consideration should be made with helping patients find a CAM provider experienced in working with cancer and with children.
For the CAM provider: Working with a child with cancer
The CAM provider should be well informed about the diagnosis and conventional treatment plan of their patient so as not to prescribe or treat with a CAM therapy or modality that may interfere with the patient’s prognosis. Specific concerns associated with CAM use among younger children and adolescents may include apprehensions around touch and body image.
Cohen, M. H. (2006). Legal and ethical issues relating to use of complementary therapies in pediatric hematology/ oncology. Journal of Pediatric Hematology/ Oncology, 28 (3), 190-193.
White House Commission on Complementary and Alternative Medicine Policy (2006). White House commission on complementary and alternative medicine policy final report 2002 (NIH Publication 03-5411) [On-line]. Retrieved November 17, 2006, from: http://www.whcCAMp.hhs.gov/
Last updated: October 13, 2009