o the many profound changes we now face in health care, alternative T and complementary medicine must be added as a major factor. This increasingly popular and accepted field has an impact on every facet of the health care system and all specialties of medicine, including oncology. Unorthodox or alternative medicine is no longer a collection of covert activities. On the contrary, the contemporary version is wide open, made available to the general public through every known means of communication, including, importantly, the Internet.
Moreover, alternative therapies in the United States do not exist in a vacuum. This is very much an international phenomenon. Unconventional therapies abound in Canada, Europe, Australia, and Asia. Elsewhere they tend to be called "complementary" therapies, because they are used typically to supplement mainstream medicine or to calm the symptoms of terminal illness with noninvasive treatments that carry minimal or no side effects.
Quackery represents a small portion of today's alternative and complementary medicine and is overshadowed by the magnitude of the more commonly used adjunctive therapies. It appears that most people who use unconventional therapies do so for relief of self-limiting or minor problems, to enhance emotional and physical well-being, or as an integral feature of a wellness-oriented life style. The situation in cancer medicine seems analogous, with most cancer patients using alternatives as complementary techniques to help control symptoms. Smaller numbers of patients adopt alternative cancer treatments in lieu of mainstream therapies.
The majority of physicians who practice alternative medicine are family practitioners or psychiatrists; very few oncologists do so. Most oncologists are not familiar with the alternative and complementary therapies used by many of their patients. Therefore, this article describes alternative and complementary therapies, their rationale and methods. Little in the way of evaluation can be presented, because very few alternative therapies have been studied with acceptable methodologies, if at all, hence their categorization as "alternative" or "unproven.