and Alternative Medicine. in Cancer Care. To The ediTor: complementary and alternative medicine (CAM) use among cancer patients under …
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LETTERS TO THE EDITORS
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Complementary and Alternative Medicine in Cancer Care
To The ediTor: In the May 2008 issue, I read with interest the article by Lafferty et al regarding complementary and alternative medicine CAM use among cancer patients under mandatory insurance coverage1 It is unfortunate that the authors did not have access to data regarding CAM sought by terminally ill patients that was outside insurance coverage; the article raises an important issue about the ethics of offering certain CAM therapies When I was a medical student a number of years ago, I rotated through the clinic of a well-known alternative practitioner who offered week-long programs for the terminally ill that included herbal oil massages, foods thought to contain salubrious amounts of the Ayurvedic humors vata, pitta, and kapha, and meditation The program was oriented more toward cure from Ayurvedic practice than palliation, I found Although there are undoubtedly many benefits to be derived from
such engagement in spiritual endeavors, these programs cost many, many thousands of dollars, of which insurance covered zero, and seemed to be populated by those whom conventional medicine had failed–those willing to spend anything in desperate, final, and ultimately futile hope of a miraculous cure for their cancer The practitioner has become a very, very rich man The terminally ill are a vulnerable population and more likely to be willing to spend money on unproven therapies because of their desperation Managed care must be judicious in its coverage of CAM therapies, carefully evaluating the costs, potential benefits for the patients, and risks in light of this desperation Additionally, managed care organizations that do offer CAM have a responsibility to educate their patients on the actual evidence that exists for benefiting the patient, and brokering reasonable expectations about healing, cure, and palliation
Christopher N Mills, MD, MPH Department of Emergency Medicine George
Washington University Washington, DC
Funding: None reported Author Disclosure: The author reports no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article Address correspondence to: Christopher N Mills, MD, MPH, Department of Emergency Medicine, George Washington University, 2150 Pennsylvania Ave, NW-Ste 28-417, Washington, DC 20037 E-mail: cnmills@yahoocom
Managed care must be judicious in its coverage of CAM therapies, carefully evaluating the costs, potential benefits for the patients, and risks in light of this desperation
reference
1 Lafferty We, Tyree PT, devlin SM, Andersen Mr, diehr PK Complementary and alternative medicine provider use and expenditures by cancer treatment phase Am J Manag Care 2008;145:326-334 n
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SEPTEMBER 2008
