Complementary and alternative medicine in the palliative care of cancer patients

Patients with advanced cancer often seek complementary and alternative medicine as holistic treatment. Reflecting the relevance of the topic, a German expert group developed recommendations for counseling cancer patients on complementary medicine (CAM) issues. Going beyond these recommendations, we have now developed recommendations focusing on the palliative treatment setting. In selected cases CAM can be used in addition to scientifically founded treatment. These recommendations are based on general ethical principles and a specific evaluation of data following a literature search. There is little knowledge on the risks of CAM (side effects and interactions are mostly unknown). Especially alternative treatments which promise a "cure" even in cases of advanced cancer entail the danger for patients and physicians to evade the actual situation of a fatal disease. The concept to follow must be an honest and thorough counseling of patients and their families which will enable them to make a self-determined choice of treatment. Necessary treatments should not be delayed or omitted.