Over the past two decades there has been a growing acceptance of 'integrative oncology', also known as complementary and alternative medicine (CAM), in cancer care and research at academic medical centres and medical schools. Proponents of integrative oncology argue that it is based in science and provides the 'best of both worlds' by combining science-based treatments and 'holistic' medicine. However, a close examination of the methodologies indicates that, from a standpoint of basic science, the vast majority of 'integrative' treatments are supported by little, if any, scientific evidence. What are the consequences of this integration? Is there any harm? Are there any potential benefits?
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The author thanks S. Novella for helpful discussions regarding issues relevant to this manuscript, and in particular K. Atwood IV for introducing the author to the concept of science-based medicine.
The corresponding author is the chair of the board of directors of the Society for Science-Based Medicine (www.sfsbm.org), an organization dedicated to promoting a strong scientific basis for medicine, and the managing editor of the Science-Based Medicine weblog (www.sciencebasedmedicine.org).
- Bayesian statistics
A method based on Bayes' theorem for calculating the degree to which new data changes the probability that the hypothesis being tested is true.
A liquid developed by James V. Sheridan and promoted as a treatment for cancer since the 1930s, containing chemicals such as inositol, sodium sulphite, catechol, and others. There is no evidence it has anticancer activity.
- Declaration of Helsinki
A statement of ethical principles for medical research involving human subjects developed by the World Medical Association. It stipulates, “Medical research involving human subjects must conform to generally accepted scientific principles, be based on a thorough knowledge of the scientific literature, other relevant sources of information, and adequate laboratory and, as appropriate, animal experimentation”.
- German New Medicine
A system of medicine created by German physician Ryke Geerd Hamer that attributes cancer to an unresolved psychic conflict, evidence of which can be seen on computed tomography scans of the brain. Resolving this conflict, according to Hamer, allows the body to 'heal itself' of cancer.
- Gerson protocol
An alternative cancer treatment involving extreme dietary modifications, including large doses of supplements, as well as coffee enemas.
Mandelonitrile-beta-glucuronoside, a modified form of the natural substance amygdalin, which is found in almonds and the pits of apricots. There is no evidence it has anticancer activity, and its use can result in cyanide poisoning.
- Natural products
Medicines from natural plant or animal sources that are used as either extracts or purified active components.
- Pre-test probability
Under Bayesian statistics, pre-test probability is the estimated probability that a hypothesis being tested is true prior to executing the study and analysing new data.
- Tongue diagnosis
In traditional Chinese medicine, a system of diagnosis that maps various organs to specific areas on the tongue, much like reflexology maps specific organs to locations on the soles of the feet and palms of the hands.
- Traditional Chinese medicine
An ancient system of medicine based on the Taoist belief that everything is interconnected. It includes herbal medicine, acupuncture and tongue diagnosis, and attributes causes of disease to imbalances in the 'six qi'.
A concept that living creatures are fundamentally different from non-living objects because they possess a non-physical element that gives them life, referred to as 'qi' (traditional Chinese medicine), prana (Ayurveda), and the 'vital force' (naturopathy and homeopathy).
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Gorski, D. Integrative oncology: really the best of both worlds?. Nat Rev Cancer 14, 692–700 (2014). https://doi.org/10.1038/nrc3822