References
for chiropractic and cancer management
Warning: there is absolutely no way a
chiropractor would care for a patient with cancer without
consultation with other professionals. You need to
understand that chiropractors refer to other health
professionals. They must, in the case of cancer. They do so
at all times.
What this research urges is that CO-MANAGEMENT by a
chirorpactor can be of benefit, just as in any condition
from back pain to stomach ache. Thats is my opinion, but it
is based on rapidly advancing body of research. The tip of
the iceberg is below, and it gets more astounding every
day.
Much research now supports the use of complementary care;
in fact purely chemo-, or radio-therapy is a thing of the
past in some world centers for treatment.
1. Alternatives in Cancer Pain Treatment: The
Application of Chiropractic Care
Objectives: To review written resources disclosing reliable
facts and knowledge in chiropractic services in cancer pain
management.
Data Sources: Conventional and biomedical and complementary
and alternative medicine journals, electronic media, full
text databases, electronic resources, books in print, and
newsletters.
Conclusion: The judicial use of chiropractic services in
cancer patients appears to offer many economical and
effective strategies for reducing the pain and suffering of
cancer patients, as well as providing the potential to
improve patient health overall.
Implications for Nursing Practice: Clinicians should assess
and support the use of chiropractic services in cancer
patients. Chiropractic is one of the leading alternatives
to standard medical treatment in cancer pain management.
Evans RC, Rosner AL. Seminars in Oncology Nursing. August
2005; Vol. 21, Iss. 3, pp. 184-189.
2. Communicating Facts and Knowledge in Cancer
Complementary and Alternative Medicine
Objectives: To review written resources disclosing reliable
facts and knowledge in cancer complementary and alternative
medicine (CAM).
Data Sources: Conventional and biomedical and complementary
and alternative medicine journals, electronic media, full
text databases, electronic resources, and newsletters.
Conclusion: Sources of CAM information are numerous. The
inherent quality of this information fluctuates.
High-quality sources of cancer CAM information are
available and accessible for health care providers.
Implications for Nursing Practice: As the use of CAM
therapies becomes more commonplace in consumer health care,
it is critical that health care providers are cognizant of
available sources of high-quality CAM facts and knowledge
and possess the ability to discuss this information with
colleagues and consumers in the scientific and lay
communities.
Lee CO. Seminars in Oncology Nursing. August 2005; Vol. 21,
Iss. 3, pp. 201-214.
3. Cancer Patients In Canada Receive Chiropractic
A study published in the Journal of Clinical Oncology, July
18, 2000 shows that Ontario women diagnosed with breast
cancer in 1994 or 1995 elected to use some form of what the
study termed, "Complementary/Alternative Medicine"
including chiropractic. The study conducted at the Centre
for Studies in Family Medicine, Faculty of Medicine and
Dentistry, University of Western Ontario, randomly surveyed
women from Ontario diagnosed with breast cancer. Overall,
66.7% of the respondents reported using some form of
Alternative Medicine most often in an attempt to boost the
immune system. The most common form of what the study
classified as alternative medicine was chiropractic. In
addition, 62.0% reported use of home alternative products,
most frequently vitamins/minerals, herbal medicines, green
tea, special foods, and essiac. Interesting though was that
slightly less than half of the patients using these
procedures informed their medical doctors.
4. Patterns of alternative medicine use by cancer
patients.
Stephen D Begbie, Zoltan L Kerestes and
David R Bell. MJA 1996; 165: 540
Objective: To assess the patterns of alternative medicine
use in patients of a public hospital oncology unit, and to
compare patients' experience of alternative with
conventional medicine.
Design and setting: Self-administered questionnaire survey
of cancer patients attending specialist consulting rooms at
the Royal North Shore Hospital and the Oncology Outpatient
Clinic at Port Macquarie Base Hospital during August 1995.
Participants: 507 patients attended the clinics; 335 (66%)
returned questionnaires, of which 319 (62%) were
sufficiently complete for analysis.
Main outcome measures: Expectations of and satisfaction
with both conventional and alternative treatment, use of
alternative treatment, and patient characteristics
associated with this use.
Results: Expectations of and satisfaction with both
conventional and alternative treatment were very high.
Alternative treatments (most commonly dietary and
psychological methods) were used by 21.9% of patients.
Median annual cost of alternative therapy was $530, with
most patients reporting "value for money". Younger age and
being married were positively associated, and satisfaction
with conventional treatment was negatively associated, with
alternative medicine use; 40% of patients did not discuss
alternative medicine with their physician.
Conclusions: A significant proportion of cancer patients
use one or more forms of alternative therapy. The use of
alternative therapy may reflect on deficiencies in the
current standard of care.
5. Prevalence and Cost of Alternative Medicine in
Australia
MacLennan, A.H., Wilson, D.H., Taylor, A.W.
(1996), The Lancet, Vol. 347, pp. 569-573.
This study is the largest survey in the world literature on
the utilization of "alternative" providers. The survey
found that on an annual basis, 20 percent of the south
Australian population visited alternative medicine
practitioners. By far the most common health care providers
visited were chiropractors, by 15 percent of the
population.
6. Tired of Killer 'Cures'? It's Time, Says the
Author, to Rethink The Alternatives
By James S. Gordon MD
Special To The Washington Post
Tuesday, August 20, 2002; Page HE01
The signs and symptoms of crisis in our health care system
have become front-page news in recent weeks. Treatments
that were routine -- widely accepted by physicians and
embraced by the public -- have proven inappropriate,
possibly dangerous and wasteful.
The federally funded Women's Health Initiative appears to
have demonstrated that the hormone replacement therapy
(HRT) that was supposed to prevent heart disease in
menopausal women actually increases its likelihood. A
well-executed study on the surgical treatment of
osteoarthritis of the knee (published in the New England
Journal of Medicine) showed that a placebo group --
patients who only thought they had surgery -- actually did
as well as those who were operated on. And, a few weeks
ago, a lead article in the New York Times reported on
several major studies that show that more conventional
health care and more medical specialists do not necessarily
produce improvement in health status for both older people
and newborns.
This cluster of disturbing findings is simply the most
recent and visible manifestation of the limitations and
counterproductiveness of an approach to health that places
overwhelming emphasis on expensive and often side
effect-laden surgical and pharmacological treatments, an
approach that has largely devalued prevention, self-care
and the perspectives and techniques of the world's systems
of traditional medicine and healing.
Over the last several years we have learned that the
treatments we routinely provide are, even when
appropriately used, the fourth leading cause of death in
our country.
While we argue about whether or not prescription drugs
should be provided through Medicare, old people's medicine
cabinets are bulging with prescribed bottles that are,
according to many well-done studies, often unnecessary,
redundant and dangerous, as well as prohibitively
expensive.
In spite of tens of billions of dollars of investment in
research and treatment -- and some real improvements in the
treatment of some cancers -- more than 500,000 Americans
still die of cancer each year, and millions more who "do
well" suffer terribly from the side effects of their
treatment.
The surgeon general tells us that the percentage of obese
teenagers has doubled in the last two decades and that
these overfed and under-exercised, and often anxious and
depressed, young people are falling victim to chronic
illnesses such as diabetes, heart disease and perhaps
cancer at ever-earlier ages. Our newborns continue to die
at rates significantly higher than those in a number of
other developed countries.
Meanwhile, our health care costs, already more than twice
as much per person as those of any other developed country,
are escalating out of sight. A recent article in Health
Affairs predicted that if costs continue to escalate at
current rates, expenditures will double in 10 years.
Outside the System
Americans in unprecedented numbers are looking for relief
outside the current system. They want help with preventing
and treating the chronic illnesses that threaten, disable
and dismay them -- heart disease, chronic pain, HIV,
obesity, depression and cancer -- and from the side effects
that the state-of-the-art conventional treatments for these
illnesses often produce.
They are also looking for a more intimate relationship with
their health care providers. They want health professionals
who will respect them as partners in their care and who see
and understand them as whole people with complex lives, not
just "lesions" and lab values.
Many of these people are looking to other approaches to
healing. According to one study, published in the Journal
of the American Medical Association in 1998, 42 percent of
all Americans are using other than conventional therapies
as alternatives or complements to conventional medicine.
They are making 200 million more visits to "complementary
and alternative health care providers" -- acupuncturists,
chiropractors, massage therapists and others -- than to
primary care physicians.
The White House Commission on Complementary and Alternative
Medicine Policy, which I chaired, was created in 2000 to
assess these and other developments and to formulate
recommendations to make the benefits of complementary and
alternative medicine (CAM) and its broader, more holistic
perspective available to all Americans. The commission was
established because of enormous public and congressional
interest in CAM. The commission's work coincided with a
similar study by the World Health Organization on the
possible benefits of traditional systems of healing and of
such modern CAM approaches as large-dose vitamin
supplementation and homeopathy.
The commission recently completed a report, which the White
House is studying, that will soon be on the desks of all
members of Congress.
The commission's recommendations -- based on 20 months of
public testimony and discussion with most of the major
conventional medical, as well as CAM, organizations -- can
help to enlarge our perspective and refocus our attention.
They point to the need for a better balance between the
current research emphasis on finding "magic bullets" --
single drugs, procedures or, indeed, single alternative
therapies -- and the creation and investigation of
comprehensive therapeutic approaches that combine the best
of conventional, complementary and alternative therapies.
In place of the current emphasis on finding and using more,
and more expensive, high-tech interventions, the commission
stresses the importance of an informed public, of
self-awareness and self-care (including nutrition, exercise
and mind-body approaches) in both clinical work and health
professional education, and of the role of physicians as
teachers as well as "treaters."
Time for a Change
The commission's report is particularly relevant now, as
the results of studies that highlight health care
shortcomings accumulate.
The newspapers tell us that osteoarthritis of the knee does
not benefit from surgical intervention and does only
middling well with anti-inflammatory drugs. The commission
report offers another, nonsurgical, non-pharmacological
way. We would suggest that it's time to do a major study on
a comprehensive approach to osteoarthritis, one that
combines self-care with safe and effective remedies that
are largely free of side effects.
There is evidence, for example, that exercise, acupuncture,
yoga, massage and an inexpensive supplement, glucosamine
sulfate, are each of some help and that dietary change and
weight loss can also produce real improvement in symptoms.
More than 40 million Americans currently suffer great pain
and endure limitations of movement because of
osteoarthritis. They pay tens of billions of dollars each
year for doctors and drugs, and cost our economy tens of
billions more in lost time at work.
Why not combine these CAM therapies, together with group
support, and study this approach for cost-effectiveness as
well as for safety and effectiveness? We can do the study
with a tiny portion of the $1.5 billion we will save each
year if we refrain from unnecessary knee surgery. And if
this holistic approach proves helpful, we may find
ourselves saving tens of billions more. The commission
noted that Dean Ornish's program for reversing heart
disease, the nation's leading cause of mortality,
represents a pioneering effort to demonstrate the
effectiveness and cost-effectiveness of this kind of
comprehensive program.
In a program based on education and self-care, Ornish
teaches patients to combine significant dietary
modifications, physical exercise, yoga and stress
management in the context of a supportive group. Several
studies published in prestigious journals have demonstrated
improved physical functioning and quality of life in
Ornish's patients. The diameters of their coronary arteries
have increased and they have no longer needed coronary
bypass surgery. Meanwhile, their insurers have saved up to
$30,000 for each person enrolled in the study.
Much medical effort is lavished on ensuring that patients
"comply" with doctors' orders, whether or not these orders
are for treatments that are effective, appropriate and
cost-effective. The commission lays out a plan for the full
participation of all Americans in every aspect of their
health care -- in setting public health priorities, as well
as in deciding on, formulating and carrying out their own
therapeutic regimens.
The commission recommends that the government make it
possible for us to make these decisions wisely by making
the best information about the benefits and hazards of all
forms of health care easily available -- to ordinary people
as well as to the health professionals who serve them.
We urge as well a significant redirection of effort and
funds to the prevention of illness and the promotion of
health and wellness. Though some continue to argue about
the state of the evidence, it seems to us quite clear that
if our children learn to eat and exercise better, and learn
how to deal with stress more effectively, they will be able
to forestall much of the later suffering -- the
debilitating and life-threatening chronic illnesses -- for
which they seem to be headed.
Finally, we need to make sure that we continually keep the
broadest possible perspective on what is and is not
working, and are willing to raise questions about any
orthodoxy -- conventional or alternative -- that may
restrict our vision.
The bad news about hormone replacement therapy and current
treatments for osteoarthritis, as well as the rising human
and economic costs of our inefficient and too-often
ineffective system of health care, can, we believe, be an
opportunity. Now is the time to reassess and readdress the
shortcomings in our approach to health care as well as in
the individual interventions we use -- and to look closely
at approaches that may save us all large sums of money, as
well as untold suffering.
James S. Gordon, MD, former chair of the White House
Commission on Complementary and Alternative Medicine
Policy, is the director of the Center for Mind-Body
Medicine in Washington, a clinical professor of psychiatry
and family medicine at Georgetown Medical School and author
of "Manifesto for a New Medicine: Your Guide to Healing
Partnerships and the Wise Use of Alternative Therapies."
© 2002 The Washington Post Company
7. McLean TW, Kemper KJ.
Lifestyle, biomechanical, and bioenergetic complementary
therapies in pediatric oncology.
J Soc Integr Oncol. 2006 Fall;4(4):187-93.
After the diagnosis of cancer in a child is made, many
families complement conventional medical care with
lifestyle changes including diet, exercise, environment,
and mind-body therapies. Biomechanical, bioenergetic, and
other therapies are also sometimes sought. These include
massage, chiropractic, acupuncture/acupressure, therapeutic
touch, Reiki, homeopathy, and prayer. Some of these
complementary therapies have well-established roles in
cancer therapy for children, whereas others are
controversial and require more research.
8. Swarup AB, Barrett W, Jazieh AR. Am J Clin Oncol. 2006
Oct;29(5):468-73.
The use of complementary and alternative medicine by cancer
patients undergoing radiation therapy.
Division of General Internal Medicine, University of
Cincinnati Medical Center, Cincinnati, Ohio, USA.
OBJECTIVE: Use of complementary alternative medicine (CAM)
is widespread among patients with chronic diseases
including cancer. The purpose of our study was to examine
the pattern of alternative medicine use in patients
undergoing radiation treatment of cancer.
METHODS AND MATERIALS: A cross-sectional study was
conducted among cancer patients treated with radiation
therapy from July 2003 through July 2005 at the University
of Cincinnati. We defined CAM as the use of dietary
supplements, massage therapy, prayer, acupuncture,
chiropractic, and other novel therapies undertaken after
their diagnosis with cancer.
RESULTS: There were 152 patients that participated in the
study. Their median age was 59 (range, 21-85), 82 (54%)
were males, 108 (69%) were Caucasian. Out of 152 patients,
104 (68%) patients were users of CAM. The most common CAM
modality reported was prayer 85 (82%) and use of dietary
supplements 84 (80%). The majority of users were female and
well-educated. Among CAM users 60 (58%) had discussed its
use with their physician. Level of education, employment
status and income showed a significant correlation with the
use of CAM.
CONCLUSION: This study demonstrates that the use of
complementary alternative medicine among cancer patients
receiving radiation therapy is frequent. Given the
potential risks with some CAM therapies, physicians should
actively ask patients whether they use CAM and provide
appropriate counseling.
9. McEachrane-Gross FP, Liebschutz JM, Berlowitz D.
Use of selected complementary and alternative medicine
(CAM) treatments in veterans with cancer or chronic pain: a
cross-sectional survey.
BMC Complement Altern Med. 2006 Oct 6;6(1)
ABSTRACT: BACKGROUND: Complementary and alternative
medicine (CAM) is emerging as an important form of care in
the United States. We sought to measure the prevalence of
selected CAM use among veterans attending oncology and
chronic pain clinics and to describe the characteristics of
CAM use in this population.
METHODS: The self-administered, mail-in survey included
questions on demographics, health beliefs, medical problems
and 6 common CAM treatments (herbs, dietary supplements,
chiropractic care, massage therapy, acupuncture and
homeopathy) use. We used the chi-square test to examine
bivariate associations between our predictor variables and
CAM use.
RESULTS: Seventy-two patients (27.3%) reported CAM use
within the past 12 months. CAM use was associated with more
education (p=0.02), higher income (p=0.006), non-VA
insurance (p=0.003), additional care outside the VA
(p=0.01) and the belief that lifestyle contributes to
illness (p=0.015). The diagnosis of chronic pain versus
cancer was not associated with differential CAM
use (p=0.15). Seventy-six percent of CAM non-users reported
that they would use it if offered at the VA. CONCLUSIONS:
Use of 6 common CAM treatments among these veterans is
lower than among the general population, but still
substantial. A large majority of veterans reported interest
in using CAM modalities if they were offered at the VA. A
national assessment of veteran interest in CAM may assist
VA leaders to respond to patients needs.
10. Support Care Cancer. 2007 Jan 5; [Epub ahead of print]
Demographic, medical, and psychosocial correlates to CAM
use among survivors of colorectal cancer.
¥ Lawsin C, Duhamel K, Itzkowitz SH, Brown K, Lim H,
Thelemaque L, Jandorf L.
Department of Oncological Sciences, Mount Sinai School of
Medicine, 1425 Madison Avenue, P.O. Box 1130, New York, NY,
10029, USA, Catalina.Lawsin@mssm.edu.
GOALS OF WORK: Complementary and alternative medicines
(CAM) use among cancer patients is becoming more prevalent;
however, our understanding of factors contributing to
patients' decisions to participate in CAM is limited. This
study examined correlates of CAM use among colorectal
cancer (CRC) survivors, an understudied population that
experiences many physical and psychological difficulties.
MATERIALS AND METHODS: The sample was 191, predominantly
white, CRC survivors (mean age = 59.9 +/- 12.6) who were
members of a colon disease registry at a NYC metropolitan
hospital. Participants completed assessments of
sociodemographic characteristics, psychosocial factors
[e.g., psychological functioning, cancer specific distress,
social support (SS), quality of life (QOL)], and past CAM
use (e.g., chiropractic care, acupuncture, relaxation,
hypnosis, and homeopathy).
MAIN RESULTS: Seventy-five percent of participants reported
using at least one type of CAM; most frequently reported
was home remedies (37%). Younger (p < 0.01) or female
patients (p < 0.01) were more likely to participate in
CAM than their older male counterparts. Among psychosocial
factors, poorer perceived SS (p = 0.00), more intrusive
thoughts (p < 0.05), and poorer overall perceived QOL (p
< 0.05) were associated to CAM use. In a linear
regression model (including age, gender, SS, intrusive
thoughts, and perceived QOL), only age remained a
significant predictor of CAM use.
CONCLUSION: These findings demonstrate that CAM use is
prevalent among CRC survivors and should be assessed
routinely by providers. CAMs may serve as a relevant
adjunct to treatment among CRC patients as well as an
indication of need for additional SS, especially among
younger patients.
