Der Onkologe

, Volume 14, Issue 1, pp 73–80 | Cite as

Komplementäre und alternative Medizin bei Tumorpatienten

Ein Dilemma in der modernen Onkologie
Übersichten

Zusammenfassung

Zahlreiche Studien zeigen, dass die Mehrzahl aller Tumorpatienten, die einer schulmedizinischen Tumortherapie zugewiesen wurden, auch irgendeine Form komplementärer und alternativer Medizin nutzt. Daher ist der onkologisch tätige Arzt gezwungen bzw. fast schon verpflichtet, sich mit komplementären und alternativen Therapiemethoden auch im Rahmen moderner und multimodaler Therapiekonzepte auseinanderzusetzen.

Oft suchen die Krebspatienten, die komplementäre und alternative Therapieverfahren anwenden, Unterstützung bei Heilpraktikern oder anderen naturheilkundlich oder komplementärmedizinisch Tätigen, aber immer öfter auch bei ihrem behandelnden Onkologen. Daher gilt es, eine gemeinsame Basis und Lösungen von Problemen zu finden, die die Bedürfnisse des Patienten erfüllen. Häufig besteht der Wunsch bei den betroffenen Krebspatienten und ihren Familien nach einer individualisierten Therapie, die unter anderem die Nebenwirkungen klassischer onkologischer Methoden abfedern soll. Hierbei wird die Palette der traditionellen Medizin aus anderen Kulturkreisen ebenso nach Therapieansätzen beleuchtet wie eine Vielzahl obskurer Behandlungen. Auch wenn die komplemetäre und alternative Medizin bei den meisten Patienten generell den guten Ruf einer sanften Medizin genießt, ist dieser nicht ohne weiteres berechtigt. Nebenwirkungen sind in vielfältiger Weise möglich und es besteht grundsätzlich ein Risiko für nachteilige Interaktionen. Ebenso ist die finanzielle Belastung durch alternative Therapien nicht zu unterschätzen.

Schlüsselwörter

Alternative Therapieverfahren Heilpraktiker Onkologe Nebenwirkungen Interaktionen 

Complementary and alternative medicine in tumor patients

A dilemma in modern oncology

Abstract

Numerous studies indicate that most tumor patients referred for conventional tumor therapy also use some form of complementary and alternative medicine (CAM). This forces – or even obliges – the doctor working in the field of oncology to grapple with the methods of CAM even within the framework of modern and multimodal therapy designs.

Cancer patients who use CAM techniques often look to alternative therapists or others working with natural or complementary methods of healing for support, but with increasing frequency they are also hoping for such support from their treating oncologists. It is therefore important to find a common basis and common solutions to problems that will meet the patients’ needs. Cancer patients themselves and their families often feel the need of an individually tailored treatment designed to lessen the impact of the side-effects of the methods traditionally used in oncology. Both the full range of techniques offered by traditional medicine in other cultural groups and a myriad of obscure treatments are examined for possible treatment approaches. Even though CAM generally enjoys a reputation for ‘soft’ medicine among most patients, this is not necessarily justified. Many kinds of side-effects are possible, and there is definitely a risk of harmful interactions. Nor should the financial burden imposed by alternative therapies be underestimated.

Keywords

Complementary methods Alternative therapist Oncologist Side-effects Interactions 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Literatur

  1. 1.
    Arras HE, Bierter W (1989) Welche Zukunft haben wir? Christoph-Merian, BaselGoogle Scholar
  2. 2.
    Asher BF, Seidman M, Snyderman C (2001) Complementary and alternative medicine in otolaryngology. Laryngoscope 111: 1383–1389PubMedCrossRefGoogle Scholar
  3. 3.
    Astin JA(1998) Why patients use alternative medicine: results of a national study. JAMA 279: 1548–1553PubMedCrossRefGoogle Scholar
  4. 4.
    Astin JA, Reilly C, Perkins C, Child WL (2006) Breast cancer patients‘ perspectives on and use of complementary and alternative medicine: a study by the Susan G. Komen Breast Cancer Foundation. J Soc Integr Oncol 4: 157–169PubMedCrossRefGoogle Scholar
  5. 5.
    Beuth J (2007) Evidenzbasierte Komplementäronkologie. Onkologe 13: 534–542CrossRefGoogle Scholar
  6. 6.
    Boon H, Stewart M, Kennard MA et al. (2000) Use of complementary/alternative medicine by breast cancer survivors in Ontario: prevalence and perceptions. J Clin Oncol 18: 2515–2521PubMedGoogle Scholar
  7. 7.
    Bruns F, Steinmann D, Micke O (2007) Spiritualität in der Onkologie. Onkologe 13: 490–498CrossRefGoogle Scholar
  8. 8.
    Bruns F, Glatzel M, Schönekaes K et al. (2006) Complementary and alternative medicine experience in radiation oncology patients: first results of a multi-center approach. Trace Elem Electrolytes 23: 318–326Google Scholar
  9. 9.
    Büntzel J, Sayer B, Büntzel H, Müller C (2007) Unkonventionelle Behandlungsansätze in der Palliativmedizin. Onkologe 13: 509–519CrossRefGoogle Scholar
  10. 10.
    Büntzel J, Mücke R, Schäfer U, Micke O (2006) Use of complementary and alternative medicine (CAM) in head and neck cancer – is it really limited? Laryngoscope 116: 506–507Google Scholar
  11. 11.
    Burstein HJ, Gelber S, Guadagnoli E, Weeks JC (1999) Use of alternative medicine by women with early-stage breast cancer. N Engl J Med 340: 1733–1739PubMedCrossRefGoogle Scholar
  12. 12.
    Burstein HJ (2000) Discussing complementary therapies with cancer patients: what should we be talking about? J Clin Oncol 18: 2501–2504PubMedGoogle Scholar
  13. 13.
    Cheng B, Hung CT, Chiu W (2002) Herbal medicine and anaesthesia. Hong Kong Med J 8: 123–130PubMedGoogle Scholar
  14. 14.
    Corbin L (2005) Safety and efficacy of massage therapy for patients with cancer. Cancer Control 12: 158–164PubMedGoogle Scholar
  15. 15.
    Drew AK, Bensoussan A, Whyte IM et al. (2002) Chinese herbal medicine toxicology database: monograph on Radix Sophorae Flavescentis, „ku shen“. J Toxicol 40: 173–176Google Scholar
  16. 16.
    Drew AK, Whyte IM, Bensoussan A et al. (2002a) Chinese herbal medicine toxicology database: monograph on Herba Asari, „xi xin“. J Toxicol 40: 169–172Google Scholar
  17. 17.
    Dudenredaktion (Hrsg) (2006) Duden 07. Das Herkunftswörterbuch. 4. überarb. Aufl. Bibliographisches Institut, MannheimGoogle Scholar
  18. 18.
    Eisenberg DM, Davis RB, Ettner SL et al. (1998) Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 280: 1569–1575PubMedCrossRefGoogle Scholar
  19. 19.
    Eisenberg DM, Kessler RC, Foster C et al. (1993) Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 328: 246–252PubMedCrossRefGoogle Scholar
  20. 20.
    Ernst E (2000) ‚Alternative cancer cures’: looking for common ground. Lancet Oncol 1: 54–55PubMedCrossRefGoogle Scholar
  21. 21.
    Ernst E (2001) Alternative cancer cures. Br J Cancer 85: 781–782PubMedCrossRefGoogle Scholar
  22. 22.
    Ernst E (2001a) Intangible risks of complementary and alternative medicine. J Clin Oncol 19: 2365–2366PubMedGoogle Scholar
  23. 23.
    Ernst E (2002) „Alternative“ medicine and science – like fire and water? Wien Klin Wochenschr 114: 655–656PubMedGoogle Scholar
  24. 24.
    Fernandez CV, Stutzer CA, MacWilliam L, Fryer C (1998) Alternative and complementary therapy use in pediatric oncology patients in British Columbia: prevalence and reasons for use and nonuse. J Clin Oncol 16: 1279–1286PubMedGoogle Scholar
  25. 25.
    Fugh-Berman A (2000) Herb-drug interactions. Lancet 355: 134–138PubMedCrossRefGoogle Scholar
  26. 26.
    Gertz MA, Bauer BA (2001) Caring (really) for patients who use alternative therapies for cancer. J Clin Oncol 19: 4346–4349PubMedGoogle Scholar
  27. 27.
    Greenhalgh T, Hurwitz B (2005) Narrative-based Medicine – Sprechende Medizin. Hans Huber, BernGoogle Scholar
  28. 28.
    Grothey A, Duppe J, Hasenburg A, Voigtmann R (1998) [Use of alternative medicine in oncology patients]. Dtsch Med Wochenschr 123: 923–929PubMedGoogle Scholar
  29. 29.
    Izzo AA, Ernst E (2001) Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs 61: 2163–2175PubMedCrossRefGoogle Scholar
  30. 30.
    Lampe H, Jun X, Micke O, Bodenstein H (2007) Traditionelle Chinesische Medizin in der Onkologie. Onkologe 13: 499–508CrossRefGoogle Scholar
  31. 31.
    Lewith GT (2000) Complementary and alternative medicine: an educational, attitudinal and research challenge. Med J Aust 172: 102–103PubMedGoogle Scholar
  32. 32.
    Lissoni P, Barni S, Ardizzoa A (1994) A randomized study with pineal hormone melatonin versus supportive care alone in patients with brain metastases due to solid neoplasms. Cancer 73: 699–701PubMedCrossRefGoogle Scholar
  33. 33.
    Markman M (2001) Interactions between academic oncology and alternative/complementary/integrative medicine: complex but necessary. J Clin Oncol 19: 52S–53SPubMedGoogle Scholar
  34. 34.
    Markman M (2002) Safety issues in using complementary and alternative medicine. J Clin Oncol 20: 39S–41SPubMedCrossRefGoogle Scholar
  35. 35.
    Marquard O (1981) Ende des Schicksals? Einige Bemerkungen über die Unvermeidlichkeit des Unverfügbaren. In: ders., Abschied vom Prinzipiellen. Philosophische Studien. Reclams Universal-Bibliothek, Stuttgart, S 67–90Google Scholar
  36. 36.
    McGinnis LS (1991) Alternative therapies, 1990. An overview. Cancer 67: 1788–1792PubMedGoogle Scholar
  37. 37.
    Metz JM (2000) „Alternative medicine“ and the cancer patient: an overview. Med Pediatr Oncol 34: 20–26PubMedCrossRefGoogle Scholar
  38. 38.
    Micke O, Mucke R, Schonekaes K, Buntzel J (2003) Complementary and alternative medicine in radiotherapy patients–more harm than expected? In regard to D’Amico et al..: self-administration of untested medical therapy for treatment of prostate cancer can lead to clinically significant adverse events. IJROBP 2002; 54: 1311–1313. Int J Radiat Oncol Biol Phys 57: 1197–1198PubMedGoogle Scholar
  39. 39.
    Micke O, Haverkamp U (2004) High Tech versus sanfte Medizin – (K)ein Widerspruch. 5. Wiesbadener Strahlentherapiesymposium: High Tech versus sanfte Medizin. Wiesbaden 2004Google Scholar
  40. 40.
    Micke O, Büntzel J, Glatzel M et al. (2007) Komplementäre und alternative Therapieverfahren bei Tumorpatienten: Vitamine für „ein besseres Gefühl“ Im Focus Onkologie 1–2: 65–69Google Scholar
  41. 41.
    Micke O, Büntzel J, Höffken K (2007a) Was wollen Tumorpatienten? Onkologe 13: 475–476CrossRefGoogle Scholar
  42. 42.
    Münstedt K (2005) Ratgeber unkonventionelle Krebstherapien. 2. Aufl. Ecomed, LandsbergGoogle Scholar
  43. 43.
    Münstedt K, Brüggmann D, Jungi WF (2007) Naturheilkunde und Komplementärmedizin in der Tumortherapie. Gefahren, Aufklärungsbedarf und Qualitätssicherung. Onkologe 13: 528–533CrossRefGoogle Scholar
  44. 44.
    Paltiel O, Avitzour M, Peretz T et al. (2001) Determinants of the use of complementary therapies by patients with cancer. J Clin Oncol 19: 2439–2448PubMedGoogle Scholar
  45. 45.
    Patterson RE, Neuhouser ML, Hedderson MM et al. (2002) Types of alternative medicine used by patients with breast, colon, or prostate cancer: predictors, motives, and costs. J Altern Complement Med 8: 477–485PubMedCrossRefGoogle Scholar
  46. 46.
    Richardson MA, Sanders T, Palmer JL et al. (2000) Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol 18: 2505–2514PubMedGoogle Scholar
  47. 47.
    Risberg T, Lund E, Wist E (1995) Use of non-proven therapies. Differences in attitudes between Norwegian patients with non-malignant disease and patients suffering from cancer. Acta Oncol 34: 893–898PubMedCrossRefGoogle Scholar
  48. 48.
    Rosenthal DS, Dean-Clower E (2005) Integrative medicine in hematology/oncology: benefits, ethical considerations, and controversies. Hematology (Am Soc Hematol Educ Program) 491–497Google Scholar
  49. 49.
    Ryan M, Ratcliffe J, Tucker J (1997) Using willingness to pay to value alternative models of antenatal care. Soc Sci Med 44: 371–380PubMedCrossRefGoogle Scholar
  50. 50.
    Schönekaes K, Micke O, Mücke R et al. (2003) [Use of complementary/alternative therapy methods by patients with breast cancer]. Forsch Komplementarmed Klass Naturheilkd 10: 304–308PubMedCrossRefGoogle Scholar
  51. 51.
    Shen J, Andersen R, Albert PS et al. (2002) Use of complementary/alternative therapies by women with advanced-stage breast cancer. BMC Complement Altern Med 2: 8PubMedCrossRefGoogle Scholar
  52. 52.
    Shumay DM, Maskarinec G, Gotay CC et al. (2002) Determinants of the degree of complementary and alternative medicine use among patients with cancer. J Altern Complement Med 8: 661–671PubMedCrossRefGoogle Scholar
  53. 53.
    SKAK (Schweizerische Studiengruppe für Komplementäre und Alternative Methoden bei Krebs) (2006) Ukrain. Dokumentation Nr. 06/08. Krebsliga Schweiz, BernGoogle Scholar
  54. 54.
    Slifman NR, Obermeyer WR, Aloi BK et al. (1998) Contamination of botanical dietary supplements by Digitalis lanata. N Engl J Med 339: 806–811PubMedCrossRefGoogle Scholar
  55. 55.
    Snodgrass SR (19992) Vitamin neurotoxicity. Mol Neurobiol 6: 41–73CrossRefGoogle Scholar
  56. 56.
    Söllner W, Zingg-Schir M, Rumpold G, Fritsch P (1997) Attitude toward alternative therapy, compliance with standard treatment, and need for emotional support in patients with melanoma. Arch Dermatol 133: 316–321PubMedCrossRefGoogle Scholar
  57. 57.
    Söllner W, Maislinger S, DeVries A et al. (2000) Use of complementary and alternative medicine by cancer patients is not associated with perceived distress or poor compliance with standard treatment but with active coping behavior: a survey. Cancer 89: 873–880PubMedCrossRefGoogle Scholar
  58. 58.
    Söllner W, Maislinger S, Kappauf H (2003) How to improve communication between physicians and cancer patients about use of complementary and alternative medicine? Psychooncology 12: 203–204PubMedCrossRefGoogle Scholar
  59. 59.
    Sparber A, Bauer L, Curt G et al. (2000) Use of complementary medicine by adult patients participating in cancer clinical trials. Oncol Nurs Forum 27: 623–630PubMedGoogle Scholar
  60. 60.
    Spengler O (1931) Der Mensch und die Technik. Beitrag zu einer Philosophie des Lebens. Beck, MünchenGoogle Scholar
  61. 61.
    Stern S (2007) Die Kämpferin: Porträt Karin Kraft. Kma 7: 64–67Google Scholar
  62. 62.
    Tibballs G (1997) Titanic. Der Mythos des „unsinkbaren“ Luxusliners. Gondrom, BindlachGoogle Scholar
  63. 63.
    Tucker GM (2002) Policy on alternative therapies. Am J Health Syst Pharm 59: 198PubMedGoogle Scholar
  64. 64.
    Verhoef MJ, Balneaves LG, Boon HS, Vroegindewey A (2005) Reasons for and characteristics associated with complementary and alternative medicine use among adult cancer patients: a systematic review. Integr Cancer Ther 4: 274–286PubMedCrossRefGoogle Scholar
  65. 65.
    White AR, Ernst E (2000) Economic analysis of complementary medicine: a systematic review. Complement Ther Med 8: 111–118PubMedCrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  1. 1.Klinik für Strahlentherapie und RadioonkologieFranziskus HospitalBielefeldDeutschland
  2. 2.Klinik für HNO-Erkrankungen, Kopf-Hals-ChirurgieSüdharz-Krankenhaus NordhausenNordhausenDeutschland

Personalised recommendations