Integrative Medicine: Herbs, Botanicals & Other Products: FAQs

Integrative Medicine

Do you offer alternative treatments for cancer?
Alternative treatments are those used instead of mainstream therapies. They are unproven, expensive and unsafe. We do not offer alternative medicine in this hospital.

What is complementary medicine?
Complementary medicine includes therapies that are used as adjuncts to mainstream cancer care. They are supportive measures that control symptoms, enhance well-being, and contribute to overall patient care. Their benefits are usually supported by clinical studies and they are generally inexpensive. Complementary therapies include acupuncture, massage, music, and mind-body therapies such as meditation.

Does healthcare insurance pay for Integrative Medicine therapies?
It depends on the coverage of your policy. Many insurance companies recognize the benefits and cost-effectiveness of complementary therapies and offer coverage to include them. Some hospitals provide these therapies free of charge as part of the overall inpatient care.
Spending on most complementary therapies is considered a medical expense and may also be eligible for a healthcare flexible spending account.

Dietary Supplements for Cancer Prevention

What are free radicals? Do they cause cancers?
Free radicals are chemicals that have unpaired electrons. They are present in the environment and are also generated in the body through normal metabolism. Free radicals are highly active and are thought to interact with DNA causing cell damage and cancer.

What are antioxidants?
Antioxidants are substances that can inhibit the process of oxidation associated with free radicals. Many foods and dietary supplements, such as vitamin C and pycnogenol, have antioxidant effects.

Can antioxidants be used to prevent cancers?
Some believe a diet rich in antioxidants helps prevent cancer. However, there is no conclusive evidence that antioxidant supplements can reduce cancer incidence. Moreover, high intake of certain antioxidants is associated with increased cancer risk.

Should I use a daily multivitamin to prevent cancer?
Studies of multivitamin use for cancer prevention have yielded mixed results. Most found that multivitamins have little or no effect in reducing the overall risk of cancer. And some studies suggest that multivitamin supplementation may actually increase the risk of certain cancers. But according to a recent study from the Physicians’ Health Study published in the Journal of the American Medical Association, multivitamins can lower cancer incidence in male cancer survivors. Because of variation in the populations studied and the formulations of multivitamins used, the benefits of a daily multivitamin for general cancer prevention remain unclear.

Dietary Supplements During Cancer Treatment

Are there any herbs that can be used to treat cancer?
Many chemotherapeutic drugs used in cancer treatment are derived from plants. They are developed after rigorous clinical trials for safety and efficacy. Only a few oral herbal supplements, like turmeric, and some medicinal mushrooms have been tested this way. However, even those that showed promising results in lab studies may not have the same effects in humans. In addition, the optimal dosages are often not determined. More studies are needed before they can be recommended for general use.

Can I use herbs or supplements safely during chemotherapy?
Most herbs and dietary supplements have not been studied together with chemotherapy drugs and their interactions remain unclear. Many oncologists advise their patients to avoid these products during chemotherapy.

How do herbs interact with chemotherapy drugs?
Herbs can interact with chemotherapy drugs through different mechanisms. Some herbs can interfere with the metabolism of the drugs, making them less effective. Other herbs may potentiate the adverse effects, such as bleeding, of chemotherapy drugs.

While undergoing cancer therapy, do I have to avoid spices and herbs in cooking?
Culinary herbs used in small quantities for flavoring are generally safe. However, consuming large amounts for prolonged period of time may have adverse effects. For example, there are reports of post-operative hemorrhage associated with use of garlic.

Dietary Supplements to Alleviate Side Effects of Cancer Treatment

Can I take antioxidants to prevent the side effects of cancer therapies?
There are prescription drugs that act as antioxidants to help protect against the adverse effects of cancer therapies. The precise mechanism and the side effects of these drugs have been thoroughly examined. However, very few antioxidant dietary supplements have been studied for their safety and usefulness. Current information about the use of these products is confusing. Some think they help kill cancer cells or protect healthy cells from the damage caused by chemotherapy drugs or radiation therapy. But antioxidant supplements may also make these treatments less effective. Until more is known, it is wise to avoid them during chemotherapy.

I heard some herbal formulas can be used to treat the side effects of chemotherapy. Is that true?
Herbs like Astragalus have immunomodulating effects. They have been studied in humans and have been shown to help reduce some of the adverse reactions induced by chemotherapy. However, they are not appropriate for all patients and larger clinical trials are needed to confirm their safety and efficacy.

I have peripheral neuropathy following chemotherapy. Is there a natural treatment to relieve my symptoms?
Several nutritional supplements, such as glutamine, glutathione, vitamin Bs, vitamin E and alpha-lipoic acid, have been tested as treatments for peripheral neuropathy. Early clinical trials indicate that glutamine may reduce the incidence and severity of chemotherapy-induced peripheral neuropathy. Preliminary studies show that acupuncture can reduce pain and improve nerve function and sensation, and can help relieve peripheral neuropathy associated with chemotherapy. But larger studies are needed to confirm these effects.

Are there any herbs that can help my hair grow back?
Hair loss is a common adverse effect from chemotherapy. Most patients' hair will grow back after discontinuing treatment. Currently, there is no evidence that herbs can help regrow hair.

What is good for “dry mouth”?
Many patients may experience xerostomia (dry mouth) after surgery or radiation therapy for head and neck cancer. Prescription drugs can be used to help relieve this symptom but they are often associated with other side effects. Currently, there is convincing evidence that acupuncture can be used to address this symptom safely and effectively. Patients can consult with a qualified practitioner for more information.

What are phytoestrogens?
These are herbs that have estrogen-like activities. A few popular examples include soy, red clover, flaxseed, and dong quai.

I have estrogen-receptor positive breast cancer. Can I take soy products?
The use of soy products by patients with hormone sensitive cancer remains controversial.
Animal studies show that constituents in soy may stimulate the growth of breast cancer cells and increase risk of metastasis. They can also work against tamoxifen, a drug used for estrogen-dependent breast cancer. However, epidemiological data suggest that soy foods help reduce breast cancer risk and have a positive effect on breast cancer survivors. Soy foods also have other health benefits as they are naturally rich in protein and low in fat. Until more is known, many experts agree that moderate consumption of soy foods is acceptable but concentrated soy supplements should be avoided.

Herb-drug Interactions

Do botanicals interfere with the metabolism of drugs?
Yes, many botanicals interfere with the way a drug is processed in the body: Increased metabolism of a drug reduces its concentration in the blood and may reduce its effectiveness; decreased metabolism of a drug increases its concentration in the blood and can lead to toxicity or increased side effects.

I am taking an anticoagulant drug. Why are there so many dietary restrictions?
Anticoagulant drugs, such as warfarin, have a very narrow therapeutic range. They can cause adverse effects and are prone to interact with other drugs and dietary supplements. Herbs like ginger, garlic, turmeric can interfere with anticoagulants increasing the risk of bleeding. Certain vegetables rich in vitamin K can decrease the therapeutic effects of warfarin.

How do I know if an herb or a vitamin can interact with chemotherapy drugs or other prescription drugs?
Talk to your physician or pharmacist before taking dietary supplements.

Acupuncture

How does acupuncture work?
In Traditional Chinese Medicine, acupuncture is thought to treat diseases by promoting flow of energy (Qi) in meridians that are believed to connect various organs in the body. Modern research indicates that acupuncture can modulate the secretion of neurochemicals, such as beta-endorphin and serotonin, to help relieve pain. Studies also suggest that patient-practitioner interaction plays a role in acupuncture's therapeutic effects. Research is underway to determine the mechanisms underlying acupuncture's effects.

Can acupuncture be used to treat cancer?
There is no scientific evidence to show that acupuncture can be used to treat cancer or to shrink tumors. But several studies indicate acupuncture's usefulness in alleviating symptoms associated with cancer and its treatments.

What is acupuncture good for?
Acupuncture can be used to control several symptoms associated with cancer treatment, such as pain, anxiety, nausea, dry mouth, and hot flashes. There is preliminary evidence indicating the benefits of acupuncture for neuropathy.

Is it safe to receive acupuncture during cancer treatment?
Acupuncture can be performed safely during cancer treatment. However, patients who are on anticoagulants or are susceptible to infections should use acupuncture with caution. It is important to consult with an oncology-trained acupuncturist for evaluation before beginning treatment.

Can I receive acupuncture if I have lymphedema?
Due to risk of infections, patients are often advised to avoid needles on limbs that are prone to lymphedema. This extends to the use of acupuncture needles. However, most acupuncturists use disposable needles and clean needle technique which greatly reduce the risk of infection. Furthermore, emerging data from recent studies indicate that acupuncture treatment is safe and helps reduce symptoms of lymphedema. We are currently conducting a study to confirm the safety and efficacy of acupuncture for lymphedema. Patients with lymphedema should first consult with a physician and seek treatment from trained acupuncturists.

Do I need a doctor's referral for an acupuncture treatment?
In New York and in many other states, acupuncturists are considered as independent healthcare providers. You don't need a doctor's referral to get an acupuncture treatment. However, it is important to consult with your physician for a proper diagnosis and evaluation. Your doctor and acupuncturist can work together to provide you the best care.