Many pediatric patients with cancer are using complementary and alternative medical practices (CAM) during their treatment for childhood cancer. Although surveys in the 1970s and 1980s showed CAM was used less than 20% of the time, more recent surveys show that 31-84% of children with cancer are using CAM therapies. The factors associated with CAM use among children with cancer vary. They include:
- General parental attitudes towards health care
- A desire “to try everything possible”
- Poor prognosis of the cancer
- Prior use of CAM therapies
- Higher parental education
- Older age
- Religiosity
The rationale for using CAM therapies among families who have a child with cancer also vary. Most families do not turn to CAM for primary treatment over standard treatment regimens. However, because of the intense nature of cancer treatment, many families choose to use CAM resources to assist with the side effects of treatment.
As with conventional therapy, CAM therapies are not risk-free. The majority of these adverse reactions have been associated with the use of herbs. These were most frequently due to contamination. Herbs and other biologically based CAM therapies are marketed as dietary supplements in the United States, and therefore are not subject to the same Food and Drug Administration (FDA) regulations that apply to conventional drugs.
The major concern among pediatric oncologists is the potential for interactions among biologically based therapies and conventional chemotherapy and radiation therapy. No actual herb-drug interactions have been reported in humans undergoing cancer treatment, so the potential for interactions is still regarded as theoretical. It is known that some agents may interfere with the metabolism of certain chemotherapeutic agents. The use of some herbs during chemotherapy may lead to sub-therapeutic (reduced) chemotherapy levels that might ultimately impact a patient's outcome.
Kara Kelly, MD, Columbia Presbyterian College of Physicians and Surgeons
Reviewed June 2008