COMPLEMENTARY & ALTERNATIVE

THERAPIES (CAT) FOR TYPICAL

CANCER TREATMENTS

WHAT ARE COMPLEMENTARY &

ALTERNATIVE TREATMENTS
(CAT)?
Complementary & Alternative Therapies, or CAT is any practice that
is put forward as having the healing effects of Western medicine, but
does not originate from evidence gathered using the scientific method.
It is not part of biomedicine, or is contradicted by scientific evidence or
established science.
These treatments include folk healers, herbal medicines like medicinal
marijuana, Reiki Therapy and guided imagery amongst many others.
Alternative therapies can be substitutes for pharmacological treatments.
However, when the two are used together it is important to confirm that
the combination of therapies is safe.

DATA
In 2002, a study conducted by
the National Health Interview
Survey (NHIS) revealed that
55% of adults believed that use
of CAM would support health
when used in combination with
conventional medical
treatments

A study done by the University

of Pennsylvania (n = 316)
revealed:
Overall mean age: 58 years
Women
comprised
2/3rd
(64.6%) of the participants.
Caucasians
made
up
76.9%; African Americans,
17.7%,
Asians,
2.5%,
Hispanic individuals, 1.9%,
and Other,1.0%.
61.3% reported CAM use.

ETHNIC HEALERS

Across many countries there are groups who believe in ethnic healers that
use traditional remedies in order to cure diseases.
These Native healers dedicate their lives to their work, administering
remedies for the healing of mental, physical, emotional and spiritual
illnesses.
Ethnic healers may act in the roles of chaplains, medical doctors and
psychotherapists.
During the healing ceremonies most healers use prayers, holy water,
pictures of Biblical figures, etc.

ETHNIC HEALERS ACROSS THE

GLOBE
Latin America and Spain utilize Curanderos and
Curanderas (literally translating to healer).
In numerous parts of Asia Ying and Yang beliefs are used
for healing. The idea of Ying and Yang represents balance.
A more modern representation of this would be
homeostasis.
In India Shamans (sometimes called Anki Sharmas) are
folk healers that can be summoned to use astrology and
traditional prayer to heal numerous types of ailments.
Shamans are said to represent joy, comfort and
happiness.

WHAT ARE THEY USING?

Some ethnic healers use simple concoctions of water, plants, herbs,
incents, mud and other natural resources to create their remedies.
Since it is believed by many cultures that illness may come from sin,
curses, or a lesson from God, religious borrowings may be used alongside
the natural elements.

VIDEO
https://www.youtube.com/watch?v=8_dE9h5eWyo
2:20

HERBAL REMEDIES

HERBAL REMEDIES
Herbs and other plant-based products are one of the oldest and commonly used forms of medicine
worldwide
Western Systems Single herbs (E.g. Echinacea, St. Johns wort)
Traditional Chinese Medicine (TCM) herbal formulas are a major component of TCM, dating back
approximately 2,500 years
Japanese Kampo
Shamans and other folk healers

Plant-based therapies may contain:

Raw herbs
Whole/cut plants
Isolated plant parts (stem, leaves, flowers, roots, etc.)
Processed juices
Resins
Oil

Produced as a powder, liquid, pills, or a topical cream/gel

HERBAL REMEDIES
In the U.S., herbal remedies are sold as dietary supplements
For the purpose of stimulating, maintaining, supporting, regulating, and
promoting health
NOT a treatment for a disease process

Not regulated by the FDA

POPULAR HERBAL REMEDIES ESSIAC

Originally created by a Native
healer in Canada, but popularized
by Canadian nurse Rene M. Caisse
Herbal tea burdock, turkey
rhubarb, sorrel, and slippery elm
Research of the National Cancer
Institute found no anticancer effect.
Essiac was found to stimulate the
growth of human breast cancer
cells

MUSHROOM DERIVED COMPOUNDS PSK

Japan
Polysaccharide kureha (PSK) an
extract from Coriolus verisicolor
Trials of PSK extract in
chemotherapy/radiotherapy
revealed superior survival in
patients with esophageal &
gastric cancer

SHO-SAIKO-TO (XIAO-CHAI-HU-TANG)
Traditional Asian medicine (Japanese
Kampo, TCM)
Used in liver disease
Found to have antiproliferative
effects on various cancers such as
hepatoma

260 patient trial

In 5 years, there was a 1/3 reduction
of incidence of hepatocellular
carcinoma & 40% reduction of
deaths

 High prevalence of herbal remedy use among cancer patients, especially

breast cancer
Reasons for use:

Improve quality of life (QOL)

Aid conventional medical treatment for cancer
Prevent their cancer recurrence
Extend their lifespan

 Herbs used:

Bee pollen
Licorice root
Black cohosh
Mother wort
Blue cohosh
Nux vomica
Chaste berries
Progesterone topical (vitex
agnus cactii)
Progesterone cream (wild
Mexican yam)

Chickweed tincture
Pulsatilla
Dong quai (tong Kwai)
Royal jelly
Echinacea (49%)
Sage tea
Evening primrose oil
Sarsaparilla
false unicorn
Sepia
Garlic
St. Johns Wort

Ginko biloba
(32%)
Valeriana
Ginseng
Wild yam root
Herbal tea
(35%)
Shark cartilage
Lachesis

NURSING CONSIDERATIONS
Patient Advocacy

It is important to include questions about alternative therapies in the initial patient interview!
Dont ask, dont tell ~69% of CAM-using patients dont volunteer this information

Patient Teaching

Drug Interactions

Herb-herb
Herb-drug

Adverse reactions - St. Johns wort (P450 inducer)

Toxicity

Patient Safety

Prepared the right way, right indication, right amount, right duration, and appropriate monitoring

MEDICAL MARIJUANA
Medical marijuanarefers to using the
whole unprocessed marijuana plant or
its basic extracts to treat a disease or
symptom
Scientific study of the chemicals in
marijuana, called cannabinoids, has led
to two FDA-approved medications that
contain cannabinoid chemicals in pill
form
The two main cannabinoids from the
marijuana plant that are of medical
interest are THC and CBD

WHY SHOULD WE
LEGALIZE?
For many seriously ill people, medical marijuana is the only medicine that
relieves their pain and suffering
Medical marijuana treats symptoms of a patients medical condition,
without causing weakening side effects
Medical marijuana has been shown to alleviate symptoms of a huge
variety of serious medical conditions including but not limited to :
cancer
AIDS
glaucoma

WHY SHOULD WE LEGALIZE?

CONTINUED.

THC increases appetite and reduces nausea

THC may also decrease pain, inflammation (swelling and redness), and
muscle control problems

VIDEO

http://www.webmd.com/painmanagement/video/medical-marijuana-2016

REIKI THERAPY FOR CANCER

PATIENTS

WHAT IS REIKI THERAPY AND

WHERE DID IT COME FROM?
What is Reiki?
Reiki is a gentle, non-invasive practice believed to
stimulate a persons own healing response via placement
of light touch on or slightly above the participants body.
Where did Reiki originate from?
- Reiki was found in the early 20th century by Makao Usui,
a Japanese Buddhist and spiritual healer. It came to the
clinical setting in the 1930s.

REIKI TREATMENT FOR CANCER

PATIENTS
Sessions last anywhere from 10 to 30 minutes
Free of charge to patients receiving cancer treatment, and time
permitting, to their care givers. Staff members can also request to get
Reiki therapy.
Reiki therapy is provided during chemotherapy treatment, before or
after radiation oncology/proton beam therapy, or at the hospital
during inpatient stays.
The Reiki practitioner performs personalized hand placements tailored
to the patients preferences, time constraints, and ease to touch.
Practitioners will offer 3-5 basic hand positions on the head, torso,
arms, legs and feet.

PATIENT AND STAFF EDUCATION

Printed educational materials are distributed
at different locations where Reiki is performed
to allow patients to know about the presence
and potential benefits of this program.
Verbal education is given to nursing staff,
social workers, Reiki volunteers and other
clinicians.

REIKI THERAPY STUDY

A study was created by the Integrative Oncology Program at the
Abramson Cancer Center at the University of Pennsylvania. Data was
collected from participants who received Reiki sessions between
February 1st, 2010 to October 27th, 2010. Using the Distress Thermometer
(DT) as the survey instrument, this assessed emotional distress as well
as anxiety and depression among patients with cancer. Patients were
asked How stressed have you been during the past week including
today on a scale of 0 to 10? The study expanded the tool assessing
anxiety, pain, depression, and fatigue.
Immediately after Reiki therapy, participants again would complete the
DT assessment and were asked to rate the following statements from 0
(not at all) to 4(very much):
I liked the Reiki session
I would recommend Reiki to others
I plan to continue using Reiki
The Reiki session was helpful to me
To decrease bias, participants completed the surveys after the Reiki
practitioner exited the room, and the nurses would collect the surveys.

DATA ANALYSIS FOR REIKI

THERAPY
After analyzing 213 cancer
patients who volunteered in the
reiki study, its was found that:
50% decrease in self-reported
distress (from 3.80 to 1.55),
anxiety (4.05 to 1.44),
depression(from 2.54 to 1.10),
pain (from 2.58 to 1.21), and
fatigue (from 4.80 to 2.30).
176 (82.6%) participants stated
that they liked Reiki, 157 (73.7 %)
participants plan to continue Reiki
therapy, and 175 (82.2 %) would
recommend Reiki to others.

GUIDED IMAGERY

WHAT IS GUIDED IMAGERY?

Guided imagery meditation is a gentle but powerful technique that focuses and
directs the imagination in proactive, positive ways.

GUIDED IMAGERY
Directed thoughts that guide your imagination towards a relaxed state
It is based on the concept that the body and mind are connected
Uses all of your senses
Anyone can do it!

BENEFITS OF GUIDED IMAGERY

Reduces blood pressure
Lowers cholesterol
Heighten short- term immune cell
activity
Lessens headache & pain
Accelerates weight loss
Reduces anxiety
It has been shown, again and again, to
reduce the aversive effects of
chemotherapy & radiation, especially
nausea, depression, soreness, and
fatigue

WHY DO WE PRACTICE GUIDED

IMAGERY?
Promote relaxation
Reach goals such as loosing weight or cessation of smoking
Manage pain
Promote healing

VIDEO
https://www.youtube.com/watch?v=kyQAKcWYtsk

NCLEX POP QUIZ!!

ANSWER

NCLEX POP QUIZ!!

ANSWER

NCLEX POP QUIZ!!

A client with cancer has been advised by the physician that he should have
chemotherapy. The client is concerned about chemotherapy and wants to take
herbal treatments instead. The nurses best response to the client is which of the
following?

1. You are making a mistake and placing your life in jeopardy.

2. Herbal treatments are not approved by the Food and Drug Administration (FDA).
3. Herbal treatments have not been researched with cancer.
4. Tell me about your concerns with chemotherapy.

ANSWER
4. Tell me about your concerns with chemotherapy.
4. Asking the client to speak about his concerns encourages open
discussion. Telling the client that he is making a mistake is judgmental of
the clients wishes and eliminates opportunities
for the client to explore the situation and discuss various treatment
options. Saying that herbal treatments have not been approved by the
FDA or that they have not been researched is irrelevant, places a value
judgment on the clients wishes, and provides no opportunity for
discussion.

NCLEX POP QUIZ!!

The nurse is presenting a lecture on herbs to a group in the community. Which
guidelines should the nurse discuss with the group? Select all that apply.
1. Do not take herbs if you are pregnant or attempting to get pregnant.
2. Administer smaller amounts of herbs to babies and young children.
3. Store the herbal remedy in a cool, dry, dark place.
4. Advise against belief in unsubstantiated claims of miracle cures.
5. Think of herbs as medicinesmore is not necessarily better.

ANSWERS
1, 3, 4, 5
1. This is a guideline for prudent use of herbs.
2. According to guidelines for prudent use of herbs, babies and young
children should not be given any types of herbs.
3. Herbs exposed to sunlight and heat may lose potency.
4. This is a guideline for prudent use of herbs.
5. This is a guideline that both consumers and health-care
providers must be aware of when using herbal therapy.

NCLEX POP QUIZ!!

ANSWER

NCLEX POP QUIZ!!

The client with cancer is not eating and has lost 15 lbs in the last month. The
health-care provider has prescribed the cannabinoid dronabinol (Marinol).
Which statement indicates the client needs more teaching concerning this
medication?

1. This medication will help stimulate my appetite.

2. It is not uncommon to get drowsy when taking this medication.
3. This is marijuana and I do not want to get addicted to it.
4. I should chew sugarless gum when taking this medication.

ANSWER
Answer: 3. This is marijuana and I do not want to get
addicted to it.
1. This medication is prescribed to help stimulate the clients appetite;
therefore, the client does not need more teaching.
2. A side effect of this medication is drowsiness; therefore, the client does
not need more teaching.
3. Cannabinoid, the active ingredient in marijuana, is frequently
abused as an illegal drug, but it is not addicting.
4. A side effect of this medication is a dry mouth, so chewing sugarless
gum indicates the client understands the medication teaching.

NCLEX POP QUIZ!!

The nurse clarifies that the difference between complementary therapy
and alternative therapy is that complementary therapy:
a. Must be administered by a medical doctor.
b. Is administered with conventional therapy.
c. Replaces conventional therapy.
d. Is administered to a group of patients at the same time.

ANSWER
ANS: B
Complementary therapy is administered with conventional therapy, such
as reiki therapy with chemotherapy for cancer patients.

NCLEX POP QUIZ!!

The nurse outlines what as the advantage(s) of alternative health care?
Select all that apply.
a. Offering more patient control of health care.
b. Offering a variety of health care advisors.
c. Keeping patients from having to make decisions.
d. Using natural products rather than chemical.
e. Incorporating cultural beliefs and practices.

ANSWERS
ANS: A, B, D, E
Alternative health care actually promotes the patient's decision making in
care.

NCLEX POP QUIZ!!

Which of the following has been known to achieve benefits for clients with
cancer through the use of the mind to visualize a positive physiologic
effect?
A) Hypnosis
B) Imagery
C) Biofeedback
D) Humor

ANSWER
B) Imagery
Rationale: Imagery is a physiologic technique that uses the mind to
visualize a positive physiologic effect. When using imagery, clients
conjure up mental images of their body waging and winning a battle with
the disease process. Hypnosis a therapeutic intervention that facilitates
physiologic change though the power of suggestion. Humor would not
appropriate in this situation. Biofeedback is a technique in which a person
voluntarily controls one or more physiologic functions.

NCLEX POP QUIZ!!

The mind and body are connected in the provision of care. This statement
describes what?
A) Homeopathic care
B) Holistic care
C) Altruistic care
D) Allopathic care

ANSWER
B) Holistic care
Rationale: Holistic interventions focus on the interrelated needs of body,
mind, emotions, and spirit.