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Home > Patients & Visitors > Health Library > Topics in Integrative, Alternative, and Complementary Therapies (PDQ®): Integrative, alternative, and complementary therapies - Patient Information [NCI]
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
Complementary and alternative medicine (CAM) includes a wide variety of therapies, botanicals, nutritional products, and practices. Integrative therapy combines standard care with CAM practices. The 2007 National Health Interview Survey reported that about 4 out of 10 adults use a CAM therapy, naming natural products and deep breathing exercises as the most commonly used treatments.
One large survey reported on the use of complementary therapies in cancer survivors. The therapies used most often were prayer and spiritual practice, relaxation, faith and spiritual healing, and nutritional supplements and vitamins. CAM therapies are used often by children with cancer, both in and outside clinical trials. CAM therapies have been used to manage side effects caused by cancer or cancer treatment.
This cancer information summary gives a brief description of integrative, alternative, and complementary therapies found in PDQ Cancer Information Summaries or Fact Sheets from the National Cancer Institute (NCI). Links are included to take you to the specific PDQ summary or NCI Fact Sheet for more information about each topic. See NCI's Office of Cancer Complementary and Alternative Medicine for links to other resources.
Acupuncture is a part of traditional Chinese medicine used in China and other Asian countries for thousands of years. In patients with cancer, acupuncture is usually used to relieve symptoms, treat side effects of therapy, and improve quality of life. It may help the immune system work better, control nausea and vomiting caused by chemotherapy, and relieve cancer pain. Acupuncture may treat weight loss, anxiety, depression, insomnia, poor appetite, and gastrointestinal symptoms (constipation and diarrhea).
Black cohosh is a North American perennial herb. A substance found in the root of this plant has been used in some cultures to treat a number of medical conditions. Black cohosh has been studied to relieve hot flashes. However, randomized, placebo-controlled clinical trials using this herb have found that black cohosh is no better than a placebo in relieving hot flashes.
Cannabisand Cannabinoids (also known as marijuana)
Cannabis is a plant from Central Asia that is grown in many parts of the world today. In the United States, it is a controlled substance and is classified as a Schedule I agent (a drug with increased potential for abuse and no known medical use). The Cannabis plant makes a resin that contains active chemicals called cannabinoids. Cannabinoids cause drug-like effects throughout the body, including the central nervous system and the immune system. Possible benefits of medicinal Cannabis for people living with cancer include control of nausea and vomiting, increasing appetite, relieving pain, and improving sleep.
Essiac and Flor Essence are herbal tea mixtures originally developed in Canada. They are marketed worldwide as dietary supplements. Supporters of Essiac and Flor Essence say that these products can help detoxify the body, make the immune system stronger, and fight cancer. There is no evidence in clinical trials that Essiac or Flor Essence can be effective in treating patients with cancer.
Flaxseed comes from the flax plant. It is a rich source of omega-3 fatty acid, fiber, and a compound called lignin. It is being studied in the prevention of several types of cancer. Flaxseed has also been studied for its effect on hot flashes.
Ginger is an herb that is used in cooking and in some cultures to treat medical conditions such as nausea. It can be used fresh, dried and powdered, or as a juice or oil. Ginger has been studied for the relief of nausea and vomiting in cancer patients.
Ginseng is an herb that is used to treat fatigue. It may be taken in capsules of ground ginseng root. Studies of ginseng have been done in patients either during or after their treatment for cancer. Patients who were given ginseng had less fatigue than patients who were given a placebo (inactive substance).
L-carnitine is a dietary supplement that is thought to be helpful in treating fatigue related to cancer. L-carnitine helps the body make energy and lowers inflammation that may be linked to fatigue.
See the Cannabis and Cannabinoids section in this summary.
Milk thistle is a plant whose fruit and seeds have been used for more than 2,000 years as a treatment for liver and bile duct disorders. The active substance in milk thistle is silymarin. Laboratory studies show that silymarin stimulates repair of liver tissue and acts as an antioxidant that protects against cell damage. It slows the growth of certain types of cancer cells and may make some types of chemotherapy less toxic and more effective.
Mistletoe is a semiparasitic plant that has been used since ancient times to treat many ailments. It is used commonly in Europe, where a variety of different extracts are made and marketed as injectable prescription drugs. The FDA does not allow these injectable drugs to be sold in the United States and they are not approved as a treatment for patients with cancer.
PC-SPES is a patented mixture of eight herbs. Each herb used in PC-SPES has been reported to have anti-inflammatory, antioxidant, or anticancer properties. PC-SPES was taken off the market because some batches were found to contain prescription medicines in addition to the herbs. The manufacturer is no longer in business and PC-SPES is no longer being made.
St. John's wort
St. John's wort (Hypericum perforatum) is an herbal product sold as an over-the-counter treatment for depression. St. John's wort has not been proven to be better than standard antidepressant medicines. Many studies have been done to compare St. John's wort with antidepressants, placebo (inactive) medicines, or both, and have shown mixed results.
Be sure to talk with your doctor before taking St. John's wort. It may change the way some of your other medicines work, including anticancer medicines. Also, there are no standards for companies that make St. John's wort, so the amount of active ingredient may be different in each brand.
Selected Vegetables/Sun's Soup
"Selected Vegetables" and "Sun's Soup" are different mixtures of vegetables and herbs that have been studied as treatments for cancer. Dried and frozen forms of Selected Vegetables are sold in the United States as dietary supplements. The vegetables and herbs in Selected Vegetables/Sun's Soup are thought to have substances that block the growth of cancer cells and/or help the body's immune system kill cancer cells. There is limited evidence that Selected Vegetables/Sun's Soup is useful as a treatment for cancer and no randomized or controlled clinical trials have been done.
Aromatherapy and Essential Oils
Aromatherapy is the use of essential oils from plants (flowers, herbs, or trees) as therapy to improve physical, emotional, and spiritual well-being. Patients with cancer use aromatherapy mainly as supportive care to improve their quality of life, such as lowering stress and anxiety. Aromatherapy may be combined with other complementary treatments (e.g., massage and acupuncture) as well as with standard treatment.
Cognitive-Behavioral Therapy (CBT)
Cognitive-behavioral therapy (CBT) is a type of psychotherapy that helps patients change their behavior by changing the way they think and feel about certain things. CBT may be helpful in treating many side effects of cancer and cancer treatment.
Thinking and behavioral interventions focus on positive thoughts and images instead of negative thoughts and behaviors. Patients may gain a sense of control and develop coping skills to deal with the disease and its symptoms. These interventions also show promise for the treatment of insomnia in patients with cancer.
Relaxation and imagery techniques may be used for short periods of pain or discomfort (e.g., during procedures). Quick, simple techniques are useful when the patient has trouble concentrating due to severe pain, anxiety, fatigue, or nausea.
CBT for may be helpful for depression in patients with cancer. Most counseling or talk therapy programs for depression are offered in both individual and small-group settings. CBT may also help decrease a cancer patient's fatigue by working on cancer-related factors that make fatigue worse.
CBT may be used to treat post-traumatic stress disorder symptoms in patients with cancer. The treatment can focus on solving problems, teaching coping skills, and providing a supportive setting for the patient.
Hypnosis is a trance-like state that allows a person to be more aware and focused and more open to suggestion. Under hypnosis, the person can concentrate more clearly on a specific thought, feeling, or sensation without becoming distracted.
Manual Lymphedema Therapy
Manual lymphedema therapy is a massage that helps move lymph fluid out of a swollen arm or leg into healthy lymph nodes where it can drain.
Qigong is a form of traditional Chinese medicine that combines movement, meditation, and controlled breathing. Its purpose is to enhance the vital energy or life force that keeps a person's spiritual, emotional, mental, and physical health in balance. Some clinical trials, mostly in small numbers of patients with cancer, have shown that qigong may improve their quality of life and cancer-related fatigue.
Studies have shown that religious and spiritual values are important to most Americans. Many patients with cancer rely on spiritual or religious beliefs and practices to help them cope with their disease. For healthcare providers, spiritual or religious well-being are sometimes viewed as an aspect of complementary and alternative medicine.
Tai chi is a form of traditional Chinese mind-body exercise and meditation that uses slow sets of body movements and controlled breathing. Tai chi is done to improve balance, flexibility, muscle strength, and overall health. Some clinical trials, mostly in small numbers of patients with cancer, have shown that tai chi may improve their quality of life and cancer-related fatigue.
Yoga is an ancient system of practices used to balance the mind and body through exercise, meditation (focusing thoughts), and control of breathing and emotions. Yoga is being studied as a way to relieve stress and treat sleep problems in cancer patients.
Antioxidants and Cancer Prevention
Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals. Free radical damage may lead to cancer. Examples of antioxidants include beta-carotene, lycopene, vitamins C, E, and A, and other substances.
There has been some concern about whether antioxidants may make chemotherapy and radiation therapy less effective.
Coenzyme Q10 is made naturally by the human body. Coenzyme Q10 helps cells produce energy and acts as an antioxidant. Studies show that coenzyme Q10 may boost the immune system and protect the heart from damage caused by certain chemotherapy drugs. No report of a randomized clinical trial using coenzyme Q10 as a treatment for cancer has been published in a peer-reviewed scientific journal.
Many studies suggest that the use of complementary and alternative medicine is common among prostate cancer patients, and the use of vitamins, supplements, and specific foods is frequently reported by these patients.
The Gerson therapy is used by some practitioners as a treatment for cancer based on changes in diet and nutrient intake. An organic vegetarian diet plus nutritional and biological supplements, pancreatic enzymes, and coffee or other types of enemas are the main features of the Gerson therapy. Few clinical studies of the Gerson therapy have been published.
The Gonzalez regimen is a cancer treatment that is tailored by the practitioner for each patient and is currently available only to the patients of its developer. It involves taking certain pancreatic enzymes thought to have anticancer activity. The regimen also includes specific diets, vitamin and mineral supplements, extracts of animal organs, and coffee enemas.
Lycopene is a carotenoid (a natural pigment made by plants). It is found in a number of fruits and vegetables, including apricots, guava, and watermelon. The main source of lycopene in the American diet is tomato-based products. Lycopene is thought to have antioxidant activity. Lycopene has been studied for its role in chronic diseases, including cardiovascular disease and cancer.
Melatonin is a hormone made by the pineal gland during the hours of darkness. It plays a major role in the sleep-wake cycle. Clinical studies in renal, breast, colon, lung, and brain cancer suggest that melatonin may make chemotherapy and radiation therapy more effective; however randomized, blinded trials are needed to study these results.
Modified Citrus Pectin
Citrus pectin is found in the peel and pulp of citrus fruits such as oranges, grapefruit, lemons, and limes. Citrus pectin can be modified with high pH and heat so that it can be digested and absorbed by the body. Modified citrus pectin (MCP) may have effects on cancer growth and metastasis. Some research suggests that MCP may be protective against various types of cancer, including colon, lung, and prostate cancer.
The pomegranate (Punica granatum L.) is native to Asia and grown in many parts of the world. Different parts of the pomegranate fruit have bioactive compounds that may support good health, including antioxidants found in the peel. Certain pomegranate extracts have been shown in laboratory studies to slow the growth and spread of prostate cancer cells and to cause cell death.
Probiotics are live microorganisms used as a dietary supplement to help with digestion and normal bowel function. A bacterium found in yogurt called Lactobacillus acidophilus is the most common probiotic. The use of probiotics may be recommended in conditions related to diarrhea, gut-barrier dysfunction, and inflammatory response.
Selenium is a trace mineral (a nutrient that is essential to humans in tiny amounts). Selenium is found in certain proteins that are active in many body functions, including reproduction and immunity. Selenium is being studied for its role in cancer.
Soy is from a plant native to Asia that grows beans used in many food products. Soy foods (e.g., soy milk, miso, tofu, and soy flour) contain phytochemicals that may have health benefits. Isoflavones are the most widely researched compounds in soy. Soy is being studied for the prevention of cancer, hot flashes during menopause, and osteoporosis (loss of bone density).
Tea has long been thought to have health benefits, and many believe it can help lower the risk of cancer. Tea contains polyphenol compounds including catechins, which are antioxidants that help protect cells from damage caused by free radicals.
Some studies suggest that green tea may have a protective effect against cardiovascular disease. There is also evidence that green tea may protect against various forms of cancer.
Vitamin C, High-Dose
Vitamin C (ascorbic acid) is a nutrient that humans must get from food or supplements since it cannot be made in the body. Vitamin C is an antioxidant and helps prevent oxidative stress. It also works with enzymes to play a key role in making collagen. High-dose vitamin C has been studied as a treatment for cancer patients.
Vitamin D is a nutrient involved in a number of functions that are essential for good health. Skin exposed to sunshine can make Vitamin D. It can also be consumed in the diet, but very few foods naturally contain vitamin D. These foods include fatty fish, fish liver oil, and eggs.
Vitamin E is a nutrient that the body needs in small amounts to stay healthy and work the way it should. It is fat-soluble (can dissolve in fats and oils) and is found in seeds, nuts, leafy green vegetables, and vegetable oils. Vitamin E boosts the immune system and helps keep blood clots from forming. It also helps prevent cell damage caused by free radicals (unstable molecules in the body). Vitamin E is being studied in the prevention and treatment of some types of cancer. It is a type of antioxidant.
714-X is a chemical compound that contains camphor, a natural substance that comes from the wood and bark of the camphor tree. Nitrogen, water, and salts are added to camphor to make 714-X. It is claimed that 714-X protects the immune system and helps the body fight cancer. No peer-reviewed studies of 714-X has been published to show that it is safe or effective in treating cancer.
Antineoplastons are drugs made of chemical compounds that are naturally present in the urine and blood. It has been claimed that antineoplaston therapy can be used to stop certain cancer cells from dividing, while healthy cells are not affected.
Cancell/Cantron/Protocel is a liquid that has been made in different forms since the late 1930s. It is also known by the names Sheridan's Formula, Jim's Juice, JS-114, JS-101, 126-F, and the "Cancell-like" products Cantron and Protocel. The exact ingredients of Cancell/Cantron/Protocel are not known and it is not effective in treating any type of cancer.
Cartilage (Bovine and Shark)
Bovine (cow) cartilage and shark cartilage have been studied as treatments for people with cancer and other medical conditions for more than 30 years. Substances that prevent the body from making the new blood vessels that a tumor needs to grow have been found in bovine cartilage and shark cartilage. However, these substances have not shown an effect on the growth of normal cells or tumor cells.
Hydrazine sulfate is a chemical that has been studied as a treatment for cancer and as a treatment for body wasting (i.e., cachexia) that can develop with this disease. It has been claimed that hydrazine sulfate limits the ability of tumors to take in glucose, which is a type of sugar that tumor cells need to grow.
Laetrile is another name for the chemical amygdalin, which is found in the pits of many fruits and in numerous plants. Cyanide is thought to be the active anticancer ingredient of laetrile. Laetrile has shown little anticancer activity in animal studies and no anticancer activity in human clinical trials.
Newcastle Disease Virus (NDV)
Newcastle Disease Virus (NDV) is usually thought to be an avian (bird) virus, but it also infects humans. It causes a potentially fatal, noncancerous disease (Newcastle disease) in birds, but causes only minor illness in humans. NDV appears to copy itself much better in human cancer cells than in most normal human cells and may have anticancer effects.
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about the complementary and alternative therapies found in other PDQ summaries and NCI Fact Sheets. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials are listed in PDQ and can be found online at NCI's website. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary]."
The best way to cite this PDQ summary is:
PDQ® Integrative, Alternative, and Complementary Therapies Editorial Board. PDQ Topics in Integrative, Alternative, and Complementary Therapies. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: http://www.cancer.gov/about-cancer/treatment/cam/patient/cam-topics-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389508]
Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 2,000 scientific images.
The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.
More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website's E-mail Us.
Complementary and alternative medicine (CAM)—also referred to as integrative medicine—includes a broad range of healing philosophies, approaches, and therapies. A therapy is generally called complementary when it is used in addition to conventional treatments; it is often called alternative when it is used instead of conventional treatment. (Conventional treatments are those that are widely accepted and practiced by the mainstream medical community.) Depending on how they are used, some therapies can be considered either complementary or alternative. Complementary and alternative therapies are used in an effort to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease.
Unlike conventional treatments for cancer, complementary and alternative therapies are often not covered by insurance companies. Patients should check with their insurance provider to find out about coverage for complementary and alternative therapies.
Cancer patients considering complementary and alternative therapies should discuss this decision with their doctor, nurse, or pharmacist as they would any therapeutic approach, because some complementary and alternative therapies may interfere with their standard treatment or may be harmful when used with conventional treatment.
It is important that the same rigorous scientific evaluation used to assess conventional approaches be used to evaluate CAM therapies. The National Cancer Institute and the National Center for Complementary and Integrative Health (NCCIH) are sponsoring a number of clinical trials (research studies) at medical centers to evaluate CAM therapies for cancer.
Conventional approaches to cancer treatment have generally been studied for safety and effectiveness through a rigorous scientific process that includes clinical trials with large numbers of patients. Less is known about the safety and effectiveness of complementary and alternative methods. Few CAM therapies have undergone rigorous evaluation. A small number of CAM therapies originally considered to be purely alternative approaches are finding a place in cancer treatment—not as cures, but as complementary therapies that may help patients feel better and recover faster. One example is acupuncture. According to a panel of experts at a National Institutes of Health (NIH) in November 1997, acupuncture has been found to be effective in the management of chemotherapy-associated nausea and vomiting and in controlling pain associated with surgery. In contrast, some approaches, such as the use of laetrile, have been studied and found ineffective or potentially harmful.
The NCI Best Case Series Program which was started in 1991, is one way CAM approaches that are being used in practice are being investigated. The program is overseen by the NCI's Office of Cancer Complementary and Alternative Medicine (OCCAM). Health care professionals who offer alternative cancer therapies submit their patients' medical records and related materials to OCCAM. OCCAM conducts a critical review of the materials and develops follow-up research strategies for approaches deemed to warrant NCI-initiated research.
When considering complementary and alternative therapies, patients should ask their health care provider the following questions:
National Center for Complementary and Integrative Health (NCCIH)
The National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH) facilitates research and evaluation of complementary and alternative practices, and provides information about a variety of approaches to health professionals and the public.
CAM on PubMed
NCCIH and the NIH National Library of Medicine (NLM) jointly developed CAM on PubMed, a free and easy-to-use search tool for finding CAM-related journal citations. As a subset of the NLM's PubMed bibliographic database, CAM on PubMed features more than 230,000 references and abstracts for CAM-related articles from scientific journals. This database also provides links to the websites of over 1,800 journals, allowing users to view full-text articles. (A subscription or other fee may be required to access full-text articles.)
Office of Cancer Complementary and Alternative Medicine
The NCI Office of Cancer Complementary and Alternative Medicine (OCCAM) coordinates the activities of the NCI in the area of complementary and alternative medicine (CAM). OCCAM supports CAM cancer research and provides information about cancer-related CAM to health providers and the general public via the NCI website.
National Cancer Institute (NCI) Cancer Information Service
U.S. residents may call the NCI Cancer Information Service toll free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 am to 8:00 pm. A trained Cancer Information Specialist is available to answer your questions.
Food and Drug Administration
The Food and Drug Administration (FDA) regulates drugs and medical devices to ensure that they are safe and effective.
Federal Trade Commission
The Federal Trade Commission (FTC) enforces consumer protection laws. Publications available from the FTC include:
Last Revised: 2016-04-08
If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.
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