Complementary & Alternative Medicine Integrative Therapies: By: Melanie Santos RNIII, BSN, OCN, CMSRN Salinas Valley Memorial Healthcare System Five Branches University Student : March 2019 WHAT IS CAM? Complementary Medicine: Used along with standard medical treatments Example using acupuncture to help with side effects of hospice and palliative care treatment Integrative Medicine: A total approach to care that involves the patient s mind, body, and spirit. It combines standard medicine with the CAM practices that have shown the most promise. Example learning to use relaxation as a way to reduce stress during chemotherapy 1
MANY CHOICES You have many choices to make before, during, and after your hospice and palliative care treatment. One choice you may be thinking about is complementary and alternative medicine. We call this CAM for short. People with may use CAM to: Cope with side effects of treatment Nausea Pain Fatigue Ease their anxiety surrounding cancer treatment and related stress Feel that they are doing something more to help them with their own care 2
A 2008 Scholarly Article found on NCBI Clinical research on acupuncture in cancer care is a new and challenging field in oncology. The results of clinical research will continue to provide us with clinically relevant answers for patients and oncologists. The evidence currently available has suggested that acupuncture is a safe and effective therapy to manage cancer and treatment related symptoms, while giving patients the ability to actively participate in their own care plan. Types of CAM We are learning more about CAM therapies every day, but there is still more to learn. Consumers may use the terms: Natural Holistic Home remedy Eastern medicine Experts use five categories to describe CAM 3
Mind-Body Medicines: Hypnosis A state of relaxed and focused attention in which the patient concentrates on a certain feeling, idea, or suggestion to aid in combating pain Imagery Imagining scenes, pictures, or experiences to help the body deal with or live with pain Based on the belief that your mind is able to affect your body Mind-Body Medicines: Based on the belief that your mind is able to affect your body Yoga Systems of stretches and poses, with special attention given to breathing Creative outlets Art Music Dance 4
Biologically Based Practices This type of CAM uses things found in nature including dietary supplements and herbal products. Vitamins Herbs Foods Special diets It is common for people at end of life to have questions about different foods to eat that wil help them feel better or manage their ailments. Manipulative and Body- Based Practices Massage Manipulation of tissues with hands (Tuina in TCM) or special tools like guasha Chiropractic care A type of manipulation of the joints and skeletal system Reflexology Using pressure points in the hands or feet to affect other parts of the body 5
Energy Medicine Energy medicine involves the belief that the body has energy fields that can be used for alleviating discomfort. Therapists use pressure or move the body by placing their hands in or through these fields. Tai Chi Involves slow, gentle movements with a focus on the breath and concentration Reiki Balancing energy either from a distance or by placing hands on or near the patient Therapeutic Touch Moving hands over energy fields of the body Whole Medical Systems Health systems and beliefs that have evolved over time in different cultures and parts of the world Ayurvedic medicine A system from India emphasizing balance among body, mind, and spirit Homeopathy Uses very small doses of substances to trigger the body to help with the discomfort Naturopathic medicine Uses different methods that help the body deal with any discomfort Chinese medicine combining different herbs or forming a formula indicated for patient s presentation 6
TRADITIONAL CHINESE MEDICINE Based on the view that health is a balance in the body Chinese Medicine of two forces called yin and yang. Traditional Chinese medicine has been widely applied for endof life care in China Includes a variety of interventions such as Herbal medicine Acupoint stimulation Diet therapy Massage TCM five element music therapy Qigong 7
What is Acupuncture? It is one of the oldest healing practices originated from China for thousands of years A procedure introduced to the United States in 1971 Involves a thin, metallic needle penetration through the skin Involves stimulation of anatomical points More Research Highlighting the Benefits of Acupuncture Variety of research studies indicate useful for managing nausea and vomiting caused by opioids or palliative treatments Causes a hemodynamic response Other attributed benefits Low back pain Bladder pain Easing bladder pain with urination Lowers blood pressure Reduces angina (with herbs) Clears acne Helps with depression, stress, and more 8
Chinese Herbal Medicine These are natural plants with medicinal benefits Prepared through oral decoction, mouth rinse, nasal feeding, topical Uses seeds, roots, leaves, branches or flowers Ginger Effective in relieving nausea Ginkgo biloba Treats circulation and thins the blood Echinacea May improve immunity Limited Research. Taking herbal medicine should be discussed with the Oncologist/physician prior to usage. What is Qigong? Qigong is an ancient Chinese health care system that integrates Physical postures Breathing techniques Focused attention The word Qigong is made up of two Chinese words Qi (chee) means life force or vital energy that flows through all things in the universe Gong (gung) means accomplishment or skill cultivated through steady practice Together qigong means cultivating energy practiced for health maintenance and increasing vitality 9
Practice of Qigong Vary from Tai Chi soft internal styles Kung Fu external, vigorous style Easily adapted Physically challenged All age groups Reduce stress Build stamina Increase vitality pain management Enhance the immune system Improves body systems Cardiovascular Respiratory Circulatory Lymphatic Digestive Research about the benefits of Qigong Reduces hypertension Reduces incidence of falling in the aged Currently being studied for fatigue in breast cancer patients Quality of Life, fatigue, mood disturbance, and inflammation 10
Talk with Your Doctor Before You Use CAM Some may fear that their doctor won t understand or approve the use of CAM Doctors know that people want to take an active part in their care and are often willing to work with them Make sure all aspects of your cancer care work together What Questions Should I Ask my Doctor? What types of CAM might: Help me cope, reduce my stress, and feel better? Help me feel less tired? Help me deal with cancer symptoms, such as pain, or side effects of treatment, such as nausea If I decide to try CAM therapy: Will it interfere with my treatment or medicines? Can you help me understand these articles I found about CAM? Can you suggest a CAM practitioner for me to talk to? Will you work with my CAM practitioner? 11
A Natural Product Does Not Mean a Safe Product Here are some important facts about dietary supplements such as herbs and vitamins: They may affect how well other medicines work in your body Herbal supplements can act like drugs in your body Vitamins can take strong action in your body Choose Practitioners with Care CAM practitioners are people who have special training. Choosing one should be done with the same care as choosing a doctor. Things to remember when choosing a practitioner: Ask your doctor or nurse to suggest someone or speak with someone who knows about CAM Others who may help you find a practitioner Contact CAM professional organizations Ask about each practitioner s training and experience Do they have a license to practice in California? Call your health care plan to see if this therapy is covered 12
References Boules, Dimitri. A Common Patient Question: How Does Acupuncture Work." Acupuncture Today, April 2018, www.acupuncturetoday.com/digital/index.php?i=722&a_id=33459&pn=13& r=t&page=13. Web. 20 Mar 2018. Bonucci, Massimo et al. Integrated Cancer Treatment in the Course of Metastatic Pancreatic Cancer: Complete Resolution in 2 Cases. Sage Journals, February 2018, www. journals.sagepub.com/doi/full/10.1177/1534735418755479#articlecitationd ownloadcontainer. Web. 15 Mar 2018 Evidence Based Complementary and Alternative Medicine Volume 2016 (2016), Article ID 1720239, 13 pages www.dx.doi.org/10.1155/2016/1720239 Lu, Weidong et al. The Value of Acupuncture in Cancer Care. Hematology/oncology clinics of North America 22.4 (2008): 631 viii. PMC. www.ncbi.nlm.nih.gov/pmc/articles/pmc2642987/ Web. 15Mar. 2018. The wise build bridges, the fools build barriers WHICH ONES ARE YOU? 13