Alternative vs Complementary vs Integrative Medicine: Why it’s Important to Know the Difference

YogiAnatomyAdmin | August 30, 2018 |

Rehabilitation professionals are accustomed to providing interventions that don’t cure diseases and many conditions. Rather, we provide interventions that help people improve their functional status and quality of life. We, along with our patients and clients know full well that we are not curing them of cancer, HIV, arthritis, lupus, etc.  Nevertheless, modalities such as electrical stimulation, biofeedback, diaphragmatic breathing, plants, meditation, manual therapy, yoga and of course exercise are known to either reduce pain, improve mobility, enhance sleep and/or enhance mood. These are all important considerations for living ones’ life as fully as possible despite the diagnosis of a chronic or terminal disease or condition. As long as there are conditions and diseases that have no cure, people will be seek remedies and interventions that help them functional as optimally as possible.

Enter the New York Times article, Alternative Cancer Treatments May Be Bad for Your Health with the subtitle, People who used herbs, acupuncture and other complementary treatments tended to die earlier than those who didn’t. On the surface, this seems to be an alarming and outrageous statement, and indeed it is.

Let’s start dissecting the title and subtitle by understanding “alternative” and  “complementary”. The National Center for Complementary and Integrative Health (NCCIH) explains that these terms mean very different things. If a non-mainstream practice, (i.e., an intervention that doesn’t have scientific evidence or approval) is used in place of conventional medicine, it’s deemed “alternative”. We know these as any number of treatments that have no published articles on their safety and efficacy, require cash payments, and promise a cure. 

A non-mainstream practice that’s used together with conventional medicine is considered “complementary”.  The NCCIH uses the term “integrative health” when complementary health approaches such as natural products, yoga, meditation, deep breathing, etc. are incorporated into mainstream health care. In fact, the NCCIH is helping to fund research on integrative approaches for symptom management in patients with cancer and survivors. Their funded studies have suggested that:

  • people with cancer who receive integrative therapies while in the hospital have less pain and anxiety
  • massage therapy may lead to short-term improvements in pain and mood in patients with advanced cancer
  • yoga may relieve persistent fatigue that some women experience after breast cancer treatment

 

Now let’s come back to the NYT article, which is based on the paper published in JAMA Oncology. It appears the definition of “complementary” was confounded with “alternative”, meaning that people who chose to refuse conventional medicine were mixed in with the people who chose an integrative health approach of combining complementary therapies with conventional treatment. 

What also challenges the merits and conclusions of the paper is that complementary medicine was defined as “other-unproven: cancer treatments administered by non-medical personnel”. Certainly this is not inclusive of all the modalities applied in an evidence-informed manner licensed rehabilitation professionals who are helping patients navigate through pain, fatigue, depression, physical impairments and activity limitations. 

And finally, a flag should be raised over the fact that the JAMA Oncology article reported on 258 patients in the complementary therapy group while there were 1,901,557 people in the conventional cancer treatment group. This breakdown of groups makes no sense when multiple surveys have found that just under 50% to 88% of people with cancer use complementary approaches. That would mean that there should have been anywhere from 836,000 to 1.6 million people in the complementary therapy group.

So what should we take away from this? 

#1 Don’t believe the headlines.

#2 Read and critically appraise the primary source of information, in this case the article in JAMA Oncology, not the New York Times.

#3 Language and words are important. Know what terms mean!

#4 People are living longer with chronic diseases and conditions that have no cure and the interventions we provide as rehabilitation professionals, yoga therapists, psychologist, mental health counselors, nurses, etc. can have powerful and positive effects on our patients and clients.

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