CAM in Nursing: Evidence, Risks, and Realities

group project CAM Nursing

Complementary and Alternative Medicine in Nursing

---

Photo by Fotos on Unsplash

• Alternative Medicine Definition
• Placebo Effect and Natural Course
• Risks and Outcomes
• Alternative Cancer Treatments
• Terminology of Alternative Medicine

1

Alternative Medicine

Definition and Characteristics

---

Photo by Arturo Esparza on Unsplash

> Alternative medicine refers to practices that aim to achieve the healing effects of medicine, but that by definition lack biological plausibility, testability, repeatability, or supporting evidence of effectiveness.

— Wikipedia

• Such practices are not part of evidence-based medicine.
• Frequently used terms for relevant practices are New Age medicine, pseudo-medicine, unorthodox medicine, holistic medicine, fringe medicine, and unconventional medicine, with little distinction from quackery.
• Unlike modern medicine, which employs the scientific method to test plausible therapies by way of responsible and ethical clinical trials, producing repeatable evidence of either effect or of no effect, alternative therapies reside outside of mainstream medicine.
• alternative therapies ... rely on testimonials, anecdotes, religion, tradition, superstition, belief in supernatural "energies", pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources.

• Some alternative practices are based on theories that contradict the established science of how the human body works; others appeal to the supernatural or superstitions to explain their effect or lack thereof.
• In others, the practice has plausibility but lacks a positive risk–benefit outcome probability.
• Research into alternative therapies often fails to follow proper research protocols (such as placebo-controlled trials, blind experiments and calculation of prior probability), providing invalid results.
• History has shown that if a method is proven to work, it eventually ceases to be alternative and becomes mainstream medicine.

2

Placebo Effect and Risks

Perceived Effects and Dangers

---

Photo by Cory Mogk on Unsplash

Perceived Effects Much of the perceived effect of an alternative practice arises from a belief that it will be effective, the placebo effect, or from the treated condition resolving on its own (the natural course of disease). This is further exacerbated by the tendency to turn to alternative therapies upon the failure of medicine, at which point the condition will be at its worst and most likely to spontaneously improve.

Worse Outcomes and Harm In the absence of this bias, especially for diseases that are not expected to get better by themselves such as cancer or HIV infection, multiple studies have shown significantly worse outcomes if patients turn to alternative therapies. While this may be because these patients avoid effective treatment, some alternative therapies are actively harmful (such as cyanide poisoning from amygdalin, or the intentional ingestion of hydrogen peroxide) or actively interfere with effective treatments.

• The alternative medicine sector is a highly profitable industry with a strong lobby, and faces far less regulation over the use and marketing of unproven treatments.
• Complementary medicine (CM), complementary and alternative medicine (CAM), functional medicine (FM), integrated medicine or integrative medicine (IM), and holistic medicine attempt to combine alternative practices with those of mainstream medicine.
• Traditional medicine practices become "alternative" when used outside their original settings and without proper scientific explanation and evidence.
• Alternative methods are often marketed as more "natural" or "holistic" than methods offered by medical science, that is sometimes derogatorily called "Big Pharma" by supporters of alternative medicine.
• Billions of dollars have been spent studying alternative medicine, with few or no positive results and many methods thoroughly disproven.

3

Alternative Cancer Treatments

Safety and Efficacy Concerns

---

Photo by Trnava University on Unsplash

> Alternative cancer treatment describes any cancer treatment or practice that is not part of the conventional standard of cancer care. These include special diets and exercises, chemicals, herbs, devices, and manual procedures.

— Wikipedia

• Most alternative cancer treatments do not have high-quality evidence supporting their use and many have been described as fundamentally pseudoscientific.
• Concerns have been raised about the safety of some purported treatments, and some have been found unsafe in clinical trials. Despite this, many untested and disproven treatments are used around the world.
• Alternative cancer treatments are typically contrasted with experimental cancer treatments – science-based treatment methods – and complementary treatments, which are non-invasive practices used in combination with conventional treatment.
• All approved chemotherapy medications were considered experimental treatments before completing safety and efficacy testing.

• 32.9%: US cancer patients died within 5 years
• 2.5x: More likely to die within 5 years

• Most alternative cancer treatments have not been tested in proper clinical trials.
• Among studies that have been published, the quality is often poor.
• A 2006 review of 196 clinical trials that studied unconventional cancer treatments found a lack of early-phase testing, little rationale for dosing regimens, and poor statistical analyses.
• These treatments have appeared and vanished throughout history.

4

Terminology of Alternative Medicine

Rebrandings and Descriptions

---

Photo by Yury Nam on Unsplash

> Alternative medicine is a term often used to describe medical practices where are untested or untestable. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), functional medicine, and holistic medicine are among many rebrandings of the same phenomenon.

— Wikipedia

Alternative medicine lacks biological plausibility, evidence, and poses risks; prioritize evidence-based practices in nursing.

Thank you for your attention

---

Photo by Galt Museum & Archives on Unsplash