CAM: A Terminology Requiring Relegation to the Historical Wastebasket

The authority of American science and public health policy is under siege.^1,2 Unfortunately, few would likely disagree with this observation and its many serious implications, including the rapid spread of health-related misinformation.³

One might propose a variety of responses along with strategies designed to alter the current disconcerting but also realistic trajectory of the status of these unquestionably vital societal enterprises.

A specific approach which could be implemented today would be for the broad scientific community to carefully consider the potential for personal or organizational bias within both internal (e.g., peer-reviewed publications) and more externally focused communications as well as for the subsequent interpretation of reports or pronouncements by patients, family members, and the public at large.

Consider here, the use of the term “CAM” (“complementary and alternative medicine”).Certainly, this terminology is clear, or is it?

To most I would suspect “complementary” implies “in addition to ….”, while “alternative” suggests “instead of ….”. In years past, this critical distinction probably made little difference as the implication of CAM was that its two very distinct components were invariably linked, or at least that the “complementary” component was as much a murky and potentially dangerous black box as whatever “alternative” strategies were proposed to patients with cancer and perhaps tragically undertaken.

Many, including this author,⁴ have described the realistically possibly horrendous outcomes associated with cancer clinics beyond our borders promising cures for patients where hospice and end-of-life palliative care would surely have been a far more rational and humane approach.

And it is not difficult to quantify the effect, at least statistically, for a patient who elected to forgo known beneficial anticancer therapy (surgery, radiation, systemic antineoplastic pharmaceutical agents) for a specific clinical indication. For example, the fortunately limited percentage of women (3%) over the age of 65 diagnosed with ovarian cancer who may elect to receive no conventional therapy (surgery, chemotherapy) experience a median survival of approximately 2 months.⁵

It is also relevant to clearly acknowledge that certain “complementary medicine” strategies that may be employed by individual patients in addition to standard-of-care anticancer treatments, including often unregulated supplements, may produce harmful effects.⁶ The realistic concerns associated with the issues noted above are not debatable and should not be ignored either in discussions regarding such approaches for the general cancer population or in individual patient management. 

However, much has changed in the world of “complementary” strategies employed in the management of malignant disease, including the critical use of a different term, “integrative oncology”, to describe approaches designed (and subsequently rigorously tested) to favorably impact the quality of life for patients during their cancer journey.⁷

In fact, over the approximately past decade numerous peer-reviewed publications have revealed the potential benefits of integrative oncology in clearly defined clinical settings, where the strategies may make a highly meaningful difference in an individual patient’s mental health and ability to successfully carry out activities of daily living. A partial listing of such efforts include the use of acupuncture for control of chemotherapy-induced emesis, chemotherapy-induced neuropathy, hot flashes among patients with breast cancer, and aromatase inhibitor–related joint discomfort^8-11; yoga for patients receiving thoracic radiotherapy, as a strategy to improve sleep quality in patients, and in reducing fatigue^12-14; mindfulness strategies among distressed survivors of breast cancer and in the management of fatigue^15,16; and a variety of integrative strategies for pain management.¹⁷

Unfortunately, there continue to be those within the academic oncology sphere who focus their rhetoric and criticism on “CAM”. This includes the limited percentage of individuals who elect to ignore standard effective cancer therapeutics and instead employ “alternative” approaches, often resulting in substantial shortening of survival.^18,19 Linking “alternative” with integrative oncology results in an objectively false narrative, directly or indirectly implying the negative outcomes are somehow associated with what are increasingly recognized to be quite beneficial components of patient management.

Today, there are growing challenges to the authority and objectivity of the scientific establishment. One may realistically argue that by continuing to utilize a remarkably distorted description of the discipline of integrative oncology powerful ammunition will continue to be provided to those solely focused on destructive efforts.

References

1. Siddiqui S, Whyte LS. Republican-led panel votes to hold Fauci in contempt. Wall Street Journal. August 7, 2026:A3.
2. Whyte LS. Order urges fewer childhood vaccines. Wall Street Journal. August 11, 2026:A3.
3. Pearson H. “Staggering” number of people believe unproven claims. Nature. 2026;652(8112):1101-1102. doi:10.1038/d41586-026-01285-2
4. Markman M. Medical complications of “alternative” cancer therapy. N Engl J Med. 1985;312(25):1640-1641. doi:10.1056/NEJM198506203122517
5. Lin JJ, Egorova N, Franco R, et al. Ovarian cancer treatment and survival trends among women older than 65 years of age in the United States, 1995-2008. Obstet Gynecol. 2016;127(1):81-89. doi:10.1097/AOG.0000000000001196
6. Werneke U, Earl J, Seydel C, Horn O, Crichton P, Fannon D. Potential health risks of complementary alternative medicines in cancer patients. Br J Cancer. 2004;90(2):408-413. doi:10.1038/sj.bjc.6601560
7. Witt CM, Balneaves LG, Cardoso MJ, et al. A comprehensive definition for integrative oncology. J Natl Cancer Inst Monogr. 2017;2017(52):lgx012. doi:10.1093/jncimonographs/lgx012
8. Chen J, Xu F, Zhang L, et al. Efficacy and safety of acupuncture for chemotherapy-induced nausea and vomiting: a systematic review and meta-analysis of randomized controlled trial. Front Neurol. 2026;17:1774507. doi:10.3389/fneur.2026.1774507
9. Bao T, Patil S, Chen C, et al. Effect of acupuncture vs sham procedure on chemotherapy-induced peripheral neuropathy symptoms: a randomized clinical trial. JAMA Netw Open. 2020;3(3):e200681. doi:10.1001/jamanetworkopen.2020.0681
10. Mao JJ, Bowman MA, Xie SX, et al. Electroacupuncture versus gabapentin for hot flashes among breast cancer survivors: a randomized placebo-controlled trial. J Clin Oncol. 2015;33(31):3615-3620.
11. Hershman DL, Unger JM, Greenlee H, et al. Comparison of acupuncture vs sham acupuncture or waiting list control in the treatment of aromatase inhibitor–related joint pain: a randomized clinical trial. JAMA Netw Open. 2022;5(11):e2241720. doi:10.1001/jamanetworkopen.2022.41720
12. Milbury K, Chen A, Li Y, et al. Yoga for patients undergoing thoracic radiotherapy and their family caregivers: results of a randomized controlled trial. JCO Oncol Pract. Published online April 27, 2026. doi:10.1200/OP-25-01079
13. Mustian KM, Sprod LK, Janelsins M, et al. Multicenter, randomized controlled trial of yoga for sleep quality among cancer survivors. J Clin Oncol. 2013;31(26):3233-3241.
14. Kiecolt-Glaser JK, Bennett JM, Andridge R, et al. Yoga’s impact on inflammation, mood, and fatigue in breast cancer survivors: a randomized controlled trial. J Clin Oncol. 2014;32(10):1040-1049.
15. Carlson LE, Tamagawa R, Stephen J, et al. Randomized-controlled trial of mindfulness-based cancer recovery versus supportive expressive group therapy among distressed breast cancer survivors (MINDSET): long-term follow-up results. Psychooncology. 2016;25(7):750-759.
16. Bower JE, Lacchetti C, Alici Y, et al. Management of fatigue in adult survivors of cancer: ASCO–Society for Integrative Oncology guideline update. J Clin Oncol. 2024;42(20):2456-2487.
17. Mao JJ, Ismaila N, Bao T, et al. Integrative medicine for pain management in oncology: Society for Integrative Oncology–ASCO guideline. J Clin Oncol. 2022;40(34):3998-4024.
18. Johnson SB, Park HS, Gross CP, et al. Complementary medicine, refusal of conventional therapy, and survival among patients with curable cancers. JAMA Oncol. 2018;4(10):1375-1381.
19. Ayoade OF, Caturegli G, Canavan ME, Resio BJ, Berger ER, Boffa DJ. Use of complementary and alternative medicine in the management of breast cancer. JAMA Netw Open. 2026;9(3):e260337. doi:10.1001/jamanetworkopen.2026.0337