Chapter 16: Integrative Oncology

INTRODUCTION

In discussing the legal issues pertaining to integrative and alternative healing methods in oncology, with a focus on the liability concerns of medical practitioners in this field, there are a number of matters to consider. First, the nature of alternative therapies used in oncologic treatment must be considered, with particular reference to the reasons for which cancer patients choose them and how they are used and whether these therapies are combined with conventional cancer treatments or used on their own. These alternative treatments must also be investigated; there are specific claimed benefits for each treatment, and these have been medically proven to a greater or lesser degree. In particular, it is necessary to distinguish alternative treatments from experimental treatments and to discuss the legislation pertaining to the provision of these on the market, as well as the potential medical liability of treating physicians. The reasons motivating cancer patients to choose to be treated with these alternative treatments will also be discussed, including discussion of whether treating oncologists oversee the administration of these treatments or whether patients choose to undergo alternative treatment without the endorsement of their treating physician. In addition to these issues, there are also concerns pertaining to consent that must be considered. These matters are complicated and interlinked, and ultimately, the primary aim of oncologists is to treat their patients to the best of their ability and comply with the law. Thus, this chapter seeks to clarify the aforementioned issues.

ONCOLOGY TREATMENT AND ALTERNATIVE THERAPIES

The use of complementary and alternative medicine (CAM) has become increasingly popular among patients diagnosed with cancer over the course of the past two decades.¹

Although these therapies can be effective, they often have a number of toxic side effects that are unpleasant for patients, especially when they are already dealing with a serious and life-threatening illness.¹ Patients may use CAM therapies to cope with the toxic effects of conventional treatments such as radiation or chemotherapy.²

Furthermore, in comparison to the perceived toxicity of conventional medicine, CAMs are often perceived by many cancer patients to be natural and thus more beneficial. However, proof of the benefits of these treatments is lacking.³

There are wide variety of CAMs, and the term is used primarily to refer to substances and treatments that are considered to be “outside of the American medical mainstream” and that oncologists do not generally recommend.⁴ It is necessary to distinguish between alternative and complementary treatments or medicines; alternative treatments are ones that are used in place of conventional medicine, whereas complementary treatments are used in addition to conventional medicine.⁴ Research has found that as cancer patients find themselves being forced to deal with the long-term effects of the disease and the toxicity of conventional treatments, they become more likely to use CAMs.⁴ There are a large number of ...