Keep CAM out of Australian cancer care

Keep CAM out of Australian cancer care

According to an article just published in the Asia-Pacific Journal of Oncology, only a few Australian hospitals integrate "complementary and alternative medicine" into their oncology treatment programs. Australians should consider themselves lucky. Here in the U.S., incorporation of pseudoscience into hospitals and academic medical centers appears epidemic. We even have a Society of Integrative Oncology that counts naturopaths among its members.

Regrettably, the authors of "Integration of complementary and alternative medicine into cancer-specific supportive care programs in Australia: A scoping study" don't realize their good fortune. Quite the opposite. They want to

"systematically integrate cancer-specific supportive care such as CAM into Australian cancer services."

This advocacy arises from a survey undertaken by the authors of Australian hospitals offering adult oncology services (n=124). The survey found that 53% of the hospitals offer no established referral pathway for cancer-specific supportive care services of any kind, CAM or otherwise. The remainder either offered referrals to external support services or had their own internal supportive care programs. Of the 35 hospitals with internal systems, about two-thirds offered cancer patients some type of CAM services, as well as "mainstream" services, like diet, exercise and nutrition, while the remaining one-third offered only the latter, no CAM included.

The authors deserve kudos for at least recognizing that diet, exercise and nutrition are "mainstream." They did not, as too often happens in the U.S., try to rebrand these as "CAM" or "integrative." They also provide the valuable knowledge that over half of Australian hospitals with adult oncology treatment do not provide any sort of supportive services, a situation that certainly deserves redress.

The mainstream cancer supportive care services, according to the authors, were provided by cancer-specific allied care professionals, the Cancer Council or other rehabilitation programs run by different departments offering a "wide range of cancer-specific services on a regular basis and have practitioners specialized in cancer."

Curiously, however, it is not this model of mainstream supportive care, run by allied health professionals with specialized training in cancer, that the authors champion. Rather, it is

"[i]dentifying barriers and factors influencing the structure of care delivery can facilitate the appropriate use of CAM. Ultimately, evaluation of cancer-specific SCPs in hospital settings enables the identification of appropriate integrative oncology models that may best meet patients' needs."

And what are these CAM services lauded by the authors? According to a chart in their article, the following are being "integrated" into supportive oncology care:

Reflexology

Acupuncture

Bowen technique

Kinesiology

Feldenkrais

Pilates

Massage

Tai chi

Reiki

Pranic healing

Healing touch

Acuenergetics

Medical qigong

Yoga

Cranialsacral therapy

The authors seem unaware that their own government recently reviewed a number of these therapies (those identified in boldface type) and found them lacking in evidence of safety, effectiveness and cost-effectiveness. Nor do they acknowledge the lack of evidence supporting the others, like reiki, pranic healing, qigong, and healing touch, which are based on highly implausible concepts of an immeasurable "energy" flowing from the practitioner to the patient. Acupuncture, similarly based on a prescientific belief in an incorporeal "life force," doesn't work, for anything. "Acuenergetics" is simply a newer fabrication based on this same elusive "energy." Cranialsacral therapy, like acupuncture, relies on the existence of a physiological phenomenon that doesn't exist.

"CAM" is, by definition, unproven. Proven treatments are called "medicine," no matter their original source. I am at a loss to understand why the authors would want to incorporate pseudoscience into cancer supportive care. They offer no explanation. Australians should stick with mainstream cancer supportive care and expand its access to other hospitals, not subject sick people to worthless treatments. 

Points of Interest 10/20/2016
Points of Interest 10/28/2016

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