Complementary, Alternative, & Integrative Medicine

Defining CAM

There are many definitions of complementary and alternative medicine (CAM), and these definitions change over time. The most commonly used definition came from the U.S. National Institutes of Health’s National Center for Complementary and Complementary Medicine (NCCAM, now the National Center for Complementary and Integrative Health, NCCIM). While not used by the NCCIM, the definition is very helpful for a broad understanding of this class of medical care and therapies.

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—that is, medicine as practiced by holders of M.D. (medical doctor) degrees and their allied health professionals, such as physical therapists, psychologists, and registered nurses.”

An important distinction exists between complementary medicine and alternative medicine. Complementary medicine is used together with conventional medicine, whereas alternative medicine is used in place of conventional medicine. Research has shown that only approximately 3 – 6%
of cancer patients use CAM as an alternative to conventional care. CAMEO’s focus is on complementary rather than alternative medicine. 

Integrative medicine
is a term that refers to combining, “treatments from conventional medicine and CAM for which there is some high-quality evidence
of safety and effectiveness.” (NCCIH)

Classification of CAM Therapies

CAM includes a wide variety of therapies and practices. The U.S. National Institutes of Health’s National Center for Complementary and
Integrative Health (NCCIH) groups CAM into five main categories:

Mind-Body Medicine

Mind-body therapies affect the mind’s ability to influence physiological functions as well as to improve feelings of well-being. Mind-body medicine encompasses a number of therapies, including meditation, biofeedback, hypnosis, guided imagery, visualization, relaxation therapy, art and music therapy. Increasingly, these therapies are being offered within conventional cancer care settings because of recent evidence that these therapies can enhance the quality of life of cancer patients.

Biological-based Practices

Biological-based practices include natural health products, such as vitamins, minerals and herbs. Natural health products create perhaps the most controversy of all CAM therapies due to the potential for side effects and interactions between these products and pharmaceutical drugs. Many people associate a “natural product” with being a safe product without the risks associated with pharmaceutical drugs. This is not the case. Evidence has demonstrated that natural health products can cause significant side effects, particularly when not used in appropriate doses and circumstances. However, there is also beginning evidence that shows a positive role of some natural health products in the prevention and treatment of cancer. More research is needed to understand the nature of these positive effects. Due to concerns that natural health products may interfere with the mechanism of action of chemotherapy and radiation, patients are generally advised to avoid taking natural health products during active cancer treatments.

Manipulative and Body-based Practices

Manipulative and body-based practices include a large group of therapies such as chiropractic and massage therapy as well as many other manual therapies. In particular, massage has become a popular therapy that is increasingly recognized by both health professionals and patients as a beneficial addition to conventional cancer treatment to reduce anxiety, depression, pain, and fatigue. There is some concern about the use of massage for cancer patients regarding the intensity of the pressure applied and the area where the massage is given (tumor sites, recent surgery). Similarly, chiropractic care should be used with caution by individuals with metastatic disease that may involve the spinal region.

Energy Medicine

Energy therapies are a group of CAM therapies that focus on influencing human energy fields and include such therapies as reiki, therapeutic touch, healing touch, magnet therapy and qi gong. Underlying many of these energy therapies is the belief that treatment is needed to either “balance” energy in the body or to relieve blockages of energy. Some energy therapies, such as therapeutic touch and healing touch, have a long tradition of being part of conventional health professions’ scope of practice (i.e., nursing) and have been offered within cancer care settings in recent years. Clinical trials of the effectiveness of energy therapies in cancer populations, however, are in the early stages and further research is needed.One exception in terms of the body of evidence supporting the effectiveness of a CAM energy therapy is acupuncture, which has been found to be helpful in treating some symptoms associated with cancer treatment, including chemotherapy-related nausea and vomiting. Although serious side effects of acupuncture are rare, cancer patients who are immunocompromised (i.e., immune system is impaired) due to conventional cancer treatments need to ensure extra care is taken and strict clean needle techniques are used during acupuncture treatments.

Whole Medical Systems

NCCAM also includes a category called whole medical systems that are based on complete systems of theory and practice and involve a range of modalities. In North America, these whole medical systems include First Nations traditional healing, naturopathy, traditional Chinese medicine, and Ayurveda.


This information is not intended to be a basis for clinical recommendations or an endorsement of these CAM therapies. Any changes in your health management plan should be discussed with your health care provider.