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12. Complementary therapies

We will try to answer some of the most common questions people with breast cancer ask about the use of complementary therapies, and explains some of the therapies in a little more detail.

Please remember that there is no reliable scientific evidence to show that any of the therapies listed can either cure breast cancer or control it. Having said that, many people find that using them helps them to improve their ‘quality of life’, that is their physical, emotional, spiritual and psychological well-being.

There has been limited research into the effectiveness of most complementary therapies. Conventional medicine relies on clinical trials to find out if a treatment works and the ‘gold standard’ of these is a randomized trial, where one treatment is compared to another – or no treatment at all.

Because of the lack of this type of research it is impossible to say whether a specific therapy may benefit people with breast cancer.

Many support groups or support centers offer complementary therapies. Sometimes therapies are free or you may be asked for a donation according to what you can afford. Other centers charge a fee. If you see a private therapist, check their fees beforehand as well as their qualifications.

What are complementary therapies?

Complementary therapies are, as the name suggests, treatments or therapies that may complement or supplement the ‘conventional’ medical treatments already described before. You might find one or more of these therapies useful in reducing the amount of stress you feel, or in helping you to relax during or after your treatment.

They are also sometimes referred to as ‘supportive’ therapies. Many complementary therapies require you to take an active part, so you feel you are doing something to help yourself. For some people, using one or more complementary therapies gives them a sense of taking control, as it is a part of their treatment which they have chosen to use rather than had prescribed for them.

What’s the difference between complementary therapies and alternative therapies?

Complementary therapies used to be called alternative therapies. This implied that they should be used instead of ‘conventional’ medical treatments.

The change in name reflects a change in attitude: they are now seen as additional, rather than separate, options. Some people do still refer to alternative therapies when they mean using therapies instead of using conventional medicine. In this course we are not advocating this approach. Sometimes alternative therapies are called ‘unproven’ therapies.

This means that no formal research has been published to show their effectiveness, and this is why health professionals often suggest people avoid them during their cancer treatment.

Can I use alternative or complementary therapies instead of having hospital treatment?

Yes, if you wish to but you should discuss the pros and cons fully with your surgeon, oncologist and breast care nurse. This is an important decision and, as stated at the beginning there is no reliable evidence that any alternative or complementary therapy can cure or control breast cancer.

Are there many complementary therapies to choose from?

Dozens! But those that may be particularly helpful for people who have breast cancer are described in this course.

Do complementary therapies work?

That’s a question that doesn’t have a direct answer. Some people swear by one method. Others try one or more therapies during and after they have had surgery, radiotherapy or chemotherapy. Not everyone will find that they benefit from using complementary therapies, but for many people the option to at least try is all-important.

It is perhaps worth mentioning that not everyone wants to use complementary therapies. No one should be pushed into trying something they are not sure about just because a relative or friend is convinced it would be helpful.

How could these therapies help me?

Many complementary therapies take an holistic approach. This means that you are seen as a whole person in terms of your physical body, your mind and your spirit. Many conventional doctors and nurses also try to take a holistic approach. Physical symptoms you might be experiencing from your cancer or your treatment are taken into account together with your feelings and emotions.

So it’s not simply a question having treatment given to a particular part of you. Rather, it involves letting a practitioner know how you are feeling in a broader sense, in order that you can work together to face the cancer and any treatment and side effects you might experience.

The therapies are unlikely to completely remove the side effects of some treatments, but you might find they reduce those you do have.

Therapies which focus on your emotional and psychological wellbeing may be aimed at stimulating your immune system by helping you to relax and so reduce any stress or tension you might have.

These therapies give you a central role in your own treatment and can encourage a positive outlook. Feeling you are doing something to help yourself can give you a tremendous boost.

Will my doctor refuse to treat me if I use complementary therapies?

No doctor should refuse to treat a person who wishes to use complementary therapies alongside hospital treatment, as long as the therapies used are not likely to interfere with the hospital treatment or to make any side effects worse.

The majority of cancer specialists now accept that many of their patients use therapies that aim to provide emotional and psychological support. They may, however, be less keen on other therapies. If you find this to be so you should ask why, in case there are valid medical reasons against your choice.

If I decide to use a particular complementary therapy, do I still have to go back to the doctor for regular check-ups?

Yes, regular check-ups are important, as without them your progress cannot be properly monitored. So you should continue going to see whoever is in charge of your aftercare – either the doctor at the hospital follow-up clinic or your family doctor.

 How do I choose a therapy that’s right for me?

Choosing between therapies can be very difficult. You could:

• Talk to others who have used them;

• Contact some of the existent organizations for information;

• Visit centers where different therapies are practiced;

• Read books about them.

Then try one or more that you find appealing.

Does the kind of breast cancer I have make a difference to the therapy I choose?

It should be considered, as some therapies might not be helpful in certain cases. For example, some herbal remedies might not be prescribed if your breast cancer is hormone receptor positive.

You should tell the therapist what type of breast cancer you have and what other treatment you are having or have had, even if it is some time ago.

A fully qualified and experienced therapist will take an extensive history of your breast cancer, and any other medical conditions, before developing a therapy plan for you. It may be that the therapy you are interested in is not suitable for you because of a possible interaction with your treatment. It is also very important you tell your therapist what medicines you are taking.

If you are still having treatment or regular check-ups at a hospital, you might also want to ask the opinion of one of the health professionals there.

Does my hospital treatment affect my choice of complementary therapy?

Yes, it does. Some hospital treatments cause side effects that might be made worse if a particular therapy is being used at the same time. For example, if you are having chemotherapy treatment that causes you to be feel sick or to vomit, the hospital staff might suggest a type of diet you should eat to try to reduce this side effect.

It’s not a good idea to introduce a completely new complementary diet at this time. If you are having radiotherapy, massage to the area being treated is not a good idea during the weeks of treatment, and for a few weeks afterwards, because of the sensitivity of your skin.

However, you could have massage to another part of your body.

How do I know if a therapist would be suitable to work with me?

A qualified therapist shouldn’t take you on as a client without first knowing all the relevant facts about you. If you are not asked directly you should tell the therapist about your breast cancer and any treatment you have had. If she then feels that the therapy might be unsuitable for you, it is unlikely that they will suggest you start to work with them.

A good therapist should advise you against a therapy that might adversely affect your breast cancer or ‘conventional’ treatment.

Do all therapists have recognized qualifications?

Many types of complementary therapy require therapists to belong to national or professional associations, specific for different therapies.

Each association should be concerned with training, qualifications, and/or accreditation schemes, and they should not permit any member to practice if they have not satisfied some specific criteria or are not suitably qualified.

In addition, the professional associations supporting most of the therapies listed in this chapter require their members to undertake continuing professional development courses to update their knowledge and skills in order to remain registered.

So it is essential to check that the person you are planning to see has reached a recognized standard, for example a diploma or degree in their therapy.

Simply having a certificate on the wall is not always a guarantee of expertise. For example, a person can claim to be a counselor even if they have only completed a one-term or one-year course.

They might have a certificate, but they would not be eligible to be a full member of the major national association, like the British Association for Counseling and Psychotherapy.

This body has strict codes of conduct and guide - lines for members and would be able to tell you if the person you are thinking of seeing is indeed a current member. Before you choose a therapy you should check out these facts by contacting the relevant association as well as asking the therapist.

Other questions to ask include whether the therapist has insurance, for example. Professional associations we go to list later. By asking questions and checking up you should be able to avoid the charlatans as well as ensuring that you find a trained therapist.

What types of training do complementary therapists have to have?

Training for therapists ranges from short courses to diplomas or degrees. Many therapists are doctors, nurses, physiotherapists, radiographers or other health professionals who have undertaken extra training in a particular therapy.

Some therapists will have only completed a recognized qualification in their specific field and others are teachers of techniques such as meditation and yoga based on ancient philosophies.

You should always check what qualifications a therapist has, whether they are registered with a national organization or association and also what experience they have of working with people with cancer.

Are these complementary therapies expensive?

Not many therapies are available on the National Public Health Centers those that are may only be available in larger cancer centers.

Many therapies involve a course of treatment lasting for several sessions and this could prove costly if you see a private therapist. Before you decide to embark on a course of treatment, you should ask exactly how many times you will be expected to attend, how often and how much it will cost.

Your breast care nurse may know of local – or national – support organizations which provide therapies in return for a small fee or donation, as mentioned in the introduction of our text.

Do complementary therapies take up much time?

Some do and some don’t. Once you have learned how to use relaxation techniques you may find you can take a few minutes out relaxing whenever you like. On the other hand, counseling may require you to travel to the counselor, have the session and travel back again, perhaps at a regular time each week for a number of weeks.

What if I don’t have the willpower to keep using a particular therapy?

Many people worry that if they start to use a therapy they will have to continue for a long time, and some of the therapies mentioned do require a lot of willpower. But if you don’t want to carry on, for whatever reason, it is important that you stop, or you will be left feeling tied to something that started out as a matter of choice.

If I start a therapy and then give up, won’t I feel I’ve failed and let everyone down?

Just as choosing to use a particular therapy should be your own decision, so stopping is up to you, too. It isn’t a question of failing, rather it is a question of having tried something that isn’t right for you or that has been useful but no longer feels that way. No one else has the right to tell you to continue when you don’t want to.

Sometimes people stop using a therapy because it is too expensive or because they can no longer give the time necessary. It can be very hard to reach such a decision without feeling guilty about stopping, particularly if relatives or friends had been eager for you to take up the therapy in the first place. Yet, once again, the decision belongs to you and no one should attach blame or be angry about your choice.

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