It’s Complementary Archives

Winter 2008 – Medical field recognizes and places value in Complementary and Alternative Medicine.

Cancer patients utilize many types of complementary and alternative medicine (CAM) to help deal with their disease. That usage is now formally recognized by three federal agencies with the appointment of the first recipient of a new fellowship in medical oncology and CAM.

Scott Miller, M.D., of Iowa, is the first recipient of the new fellowship, jointly sponsored by the National Center for Complementary and Alternative Medicine (NCCAM), the National Cancer Institute (NCI), the NIH Clinical Center and the U.S. Food and Drug Administration (FDA). The three-year fellowship is designed to help new researchers gain expertise in CAM and cancer research, policy and regulatory affairs and clinical investigation.

“This fellowship provides physicians the opportunity to study CAM approaches in oncology,” explained Patrick Mansky, M.D., director of NCCAM‘s Complementary and Integrative Medicine Consult Service at the NIH Clinical Center.” Dr. Miller brings an excellent degree of training and experience to this position.” Dr. Miller‘s training included experience at a clinic that focused on cancer patients and CAM. According to Dr. Miller, a major challenge in patient care came from “unsafe duplication. Some clinic patients were using multiple products, up to 15 or 20 at once,” he said. “Also, some preparations such as “tonics‘ have multiple ingredients. I recall one patient who was taking a group of combination products; five contained selenium that, when added together, exceeded the recommended levels.”

In order to avoid such situations, Dr. Miller said the clinicians at the clinic reviewed all of a patient‘s products, attempted to produce a rational strategy, if possible, and tried to avoid such duplications. Another challenge they faced was the fact that some herbs, such as St. John‘s Wort, can interfere with chemotherapy.

Among his responsibilities during his fellowship, Dr. Miller will learn about the use of CAM in cancer pain, symptom management and rehabilitation; learn about clinical trials methodology and design and carry out an original research project; learn about regulatory issues pertinent to the use of CAM therapies, especially botanicals, through a rotation at the FDA; and perform patient evaluations and patient care as part of a team.