Complementary and alternative medicine (CAM) includes a variety of therapeutic approaches not typically taught in conventional medical schools or used by the majority of conventionally trained physicians (Gordon and Curtin 2000). Complementary refers to modalities used to complement, that is, used in addition to conventional medicine, while alternative is usually used to describe treatments intended to replace conventional treatment (Murphy, Morris et al. 1997). Some such practices enjoy a history of research to support claims of efficacy but have not gained popularity among the majority of medical practitioners (e.g., use of acupuncture to reduce chemotherapy-induced nausea) (Dibble, Chapman et al. 2000; Mayer 2000; Shen, Wenger et al. 2000); others either lack or have unsupporting research to back claims of safety or efficacy (e.g., use of milk thistle to protect liver function during chemotherapy) (Ladas and Kelly 2003). Even so, the labeling of which modalities are complementary or alternative may shift over time as research and practice move some into conventional use and disprove others. Some practices less amenable to our current research epistemology may never move out of CAM nomenclature or perceptions (such as multi-modality system approaches, and perhaps, spirituality).
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