Abstract
The popularity of complementary and alternative medicine (CAM) has increased tremendously in recent years. Thus, it is imperative to distinguish between alternative therapies that can be dangerous and complementary therapies that are primarily palliative and augment conventional treatment. Memorial Sloan-Kettering Cancer Center's Integrative Medicine Service offers complementary therapies to patients in an attempt to improve quality of life and provide symptom management. In addition to clinical services, it also provides education to health care professionals and the public and performs clinical and laboratory research on complementary modalities and the antitumor properties of botanicals. If CAM is to be accepted by mainstream medicine, research must be done using standard research methodologies.
The Popularity of complementary and alternative medicine (CAM) has impacted every element of health care in the United States and all medical specialties, including pain and palliative care. This is evident on many levels. Within the government, action reflects public interest in and the concomitant growth of support for CAM. Ten years ago, the National Institutes of Health created an Office of Alternative Medicine. In 1998 this office was elevated to the National Center for Complementary and Alternative Medicine (NCCAM). Its budget has increased tenfold since its creation.1
On the academic front, many medical and nursing schools in North America now offer elective courses in CAM, and the number of research articles about complementary medicine in major medical journals has consistently increased. The economic impact also has been significant. In the year 2000, the American public spent over $10 billion on herbs and related CAM products alone. Research2 show that visits to CAM providers increased 47.3 percent from 1990 and 1997, exceeding total visits to all primary care physicians in that time period. There also has been an increase in the use of CAM therapies in conventional health care institutions. Between 1998 and 1999, the number of community hospitals in the United States offering complementary modalities increased to more then 11 percent.2