Thursday 15 April 2010

What is the Prevalence of Complementary and Alternative Medicine for Children with Cancer in India?

A collection of health care systems, practices and products which does not fall within conventional medicine is called Complementary and Alternative Medicine (CAM). When it is used as an adjunct to conventional medicine it is called Complementary, and when used as a substitute, it is called Alternative. Included among these are homeopathy, ayurveda, yoga, acupuncture, herbal remedies, nutritional-based therapies and others.

The use of CAM is particularly prevalent in those with cancer. Reasons for use include hope for therapeutic benefit, reduced risk as well as alleviation of adverse-effects. In a recently published systematic review (Ref - Bishop et al, Pediatrics, April 2010) the overall prevalence of CAM was 6% to 91%. Use of individual therapies were 2% to 48% for herbal remedies, 3% to 47% for nutritional interventions, 3% to 30% for faith healing and 1% to 17% for homeopathy. Notably, 23 of the 28 studies in the systematic review were from North America and Europe, and none of the studies were from India. By doing a literature search on Pubmed I was unable to identify any studies which could give me the information of CAM in this context in India.

CAM is associated with children with cancer in India in a multitude of ways. Prior to accurate diagnosis and appropriate treatment, children with cancer in India often have been receiving some form of treatment from CAM practitioners. This leads to a delay in presentation which then contributes to a higher stage, more intense treatment and poorer outcomes. Then during treatment with chemotherapy and radiotherapy, these children often take some form of complementary therapy to reduce the adverse effects. Lack of adequate supportive care and good, honest communication lead families to expend valuable energy and resources in the pursuit of CAM. Finally, when treatment is refused or abandoned (not an uncommon outcome in India) parents try to find answers with CAM practitioners. There is a need to study and better understand CAM use in children with cancer in India.


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