Introduction

Complementary and alternative medicine (CAM) or integrated therapies range from drug-like interventions with single herbs to complex herbal formulas, high dose vitamins and supplements, mind–body–spiritual interventions, physical approaches, energy-based therapies, and multifaceted treatment regimens. The lack of standardized products, the complexity of multiple regimens, and individualized treatments pose challenges to evaluation by researchers. Despite the lack of evidence to support efficacy, many patients with advanced cancer seek these approaches. As interest in CAM therapies continues to rise with growing public concerns about appropriate end-of-life care, this chapter presents a rationale for discussing CAM with patients and exploring the potential role of these therapies in conventional oncology care.

Palliative care has been described as “ … care that takes place in a context where … cure is no longer possible and disease modification provides diminishing returns.” The goal of palliative care is to provide for any unmet physical, psychosocial, and spiritual needs of terminally ill patients and their families. The most important concerns expressed by hospice patients are the existential, spiritual, familial, physical, and emotional aspects of illness; however, these concerns have rarely been the focus of care at the end of life., When cure is not an option, maintaining quality of life and controlling symptoms are more appropriate than potentially distressing treatments associated with limited improvement but physical and emotional suffering. Social and cultural forces are demanding a more holistic approach to convey empathy and compassion and support the dignity and quality of life in the final days.