Integrative oncology in palliative medicine
Patients under palliative care, facing poor prognoses and a heavy symptom burden, often seek health-care practices and agents outside of mainstream medicine. Collectively these modalities often are termed ‘complementary and alternative medicine’ (CAM), to describe a diverse group of therapies that range from unproved alternative ‘cures’ offering false hope, to adjunctive complementary therapies that provide legitimate supportive care and that comprise integrative oncology. Although complementary therapies and alternative approaches are sometimes discussed under the single umbrella of CAM, it is clinically and conceptually necessary to distinguish between complementary and ‘alternative’ because they are profoundly different, and because there are no viable ‘alternatives’ to mainstream cancer care. The acronym is an easy but incorrect and counterproductive conflation of two unrelated approaches. This chapter summarizes the state of integrative medicine and medical oncology in the current health-care system. It discusses helpful complementary therapies applicable to palliative medicine and also describes the unproven alternatives that are widely proffered to patients and families internationally.