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Introduction

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The term 'complementary therapy' in cancer care is an amorphous one and has historically been identified with many different aspects of care, from nutritional supplements through to exercise, with many forms of intervention such as massage coming under the same umbrella. This, combined with the fact that until relatively recently the majority of such treatments were performed by non-healthcare professionals, has made it notoriously difficult to collate strong evidence of safety and efficacy for the myriad therapies available, and for clinicians to make informed choices as to whether to support such practice in relation to their own patients. To make the situation even more complex, until recently complementary therapies were always tied in with 'alternative' therapies: when patients chose not to continue with conventional medicine but instead try alternative routes to health. There are several therapies (e.g. nutrition, such as the Gerson diet, or herbal medicine) that can be used as a complement or alternative to conventional care. In order to make complementary therapies more acceptable in mainstream care, institutions have developed a variety of different terminologies to try and better express how therapies can support the care of the cancer patient, such as integrative therapies, complementary medicine and holistic therapies.

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Many cancer centres and units either provide or have access to complementary therapies for their patients as a supportive measure to help relieve stress and facilitate a better quality of life during treatment. These are usually free and often charity-funded for NHS patients. The evolution of such services has occurred despite a lack of high-quality, peer-reviewed data and continues to develop, becoming almost an expectation, because of patient demand and staff observation of the perceived benefits. Cancer Research UK, for example, has a page on its website providing information for patients on how they can access therapies.

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For clarity, this chapter is a reflection on the potential benefits of incorporating complementary therapies into mainstream healthcare for patients with cancer and their families. It is beyond the remit of this chapter to explore all complementary therapies offered in the cancer care setting; therefore, the focus is to show a spread of therapies used for different indications and suggest their potential for integration.

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Acupuncture

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Acupuncture is a complementary therapy with one of the largest evidence bases in oncology and related fields. A study by Molassiotis et al.1 showed it to be a promising management technique for cancer-related fatigue, which is a significant cause of morbidity in this patient population. One of the challenges with acupuncture is the necessity for a series of weekly treatments (individual protocols may vary), with the usual course being 6 weeks and often with maintenance 'top-ups' to sustain symptomatic improvement. This can lead to issues around funding and additional visits. However, in the Molassiotis et al. study,1 self-needling was successfully taught to participants and may provide a practical solution to long-term symptom control. In ...

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