Topics in Integrative, Alternative, and Complementary Therapies (PDQ®)

NCI PDQ Summaries for Patients

Botanicals/Herbal Products
Mind-Body Therapies
Nutritional Therapies
Pharmacologic Treatments
About This PDQ Summary
General CAM Information
Evaluation of CAM Therapies
Questions to Ask Your Health Care Provider About CAM
To Learn More About CAM

Integrative TherapiesIntegrative, Alternative, and Complementary Therapies


Complementary and alternative medicine (CAM) includes many different kinds of therapies, botanicals, and dietary supplements. Complementary medicine is treatment that is used along with standard treatments but is not considered standard. Alternative medicine is treatment that is used instead of standard treatments. In general, less research has been done for CAM than for standard treatments. Integrative therapy is medical care that combines standard care with CAM practices.

The 2007 National Health Interview Survey reported that about 4 out of 10 adults use a CAM therapy. Natural products and deep breathing exercises were the most common. One large survey reported on the use of complementary therapies in cancer survivors. The therapies used most often were prayer and spiritual practice, relaxation, faith and spiritual healing, and nutritional supplements and vitamins.

CAM therapies are used often to treat children with cancer, both inside and outside of clinical trials. CAM therapies have been used to treat side effects caused by cancer or cancer treatment. Cancer patients sometimes choose alternative medicine over standard treatment; however, alternative medicine does not work as well as standard medicine to treat cancer. In Asian countries, traditional Chinese medical therapies are often used along with standard therapy.

One study showed that when cancer patients and their doctors talked about CAM therapy, it was most often brought up by the patient. Both the patient and the doctor were more satisfied with the visit when they talked about CAM therapy.

This cancer information summary gives a brief description of integrative, alternative, and complementary therapies found in PDQ Cancer Information Summaries or Fact Sheets from the National Cancer Institute (NCI). Links are included to take you to the specific PDQ summary or NCI Fact Sheet for more information about each topic. See NCI's Office of Cancer Complementary and Alternative Medicine for links to other resources.


Acupuncture is a part of traditional Chinese medicine used in China and other Asian countries for thousands of years. In patients with cancer, acupuncture is usually used to relieve symptoms, treat side effects of therapy, such as pain, nausea and vomiting, and improve quality of life.

Botanicals/Herbal Products

Black Cohosh

Black cohosh is a North American perennial herb. A substance found in the root of this plant has been used to treat a number of medical conditions. Black cohosh has been studied to relieve hot flashes. However, randomized, placebo-controlled clinical trials using this herb have found that black cohosh doesn't work any better than a placebo (inactive substance) in relieving hot flashes.

Cannabis and Cannabinoids (also known as marijuana)

Cannabis is a plant from Central Asia that is grown in many parts of the world today. In the United States, it is a controlled substance and is classified as a Schedule I agent (a drug with increased potential for abuse and no known medical use). The Cannabis plant makes a resin that contains active chemicals called cannabinoids. Cannabinoids cause drug-like effects throughout the body, including the central nervous system and the immune system. Possible benefits of medicinal Cannabis for people living with cancer include control of nausea and vomiting, increasing appetite, relieving pain, and improving sleep.

Essiac/Flor Essence

Essiac and Flor Essence are herbal tea mixtures originally developed in Canada. They are sold worldwide as dietary supplements. Supporters of Essiac and Flor Essence say that these products can help detoxify the body, make the immune system stronger, and fight cancer. There is no evidence in clinical trials that Essiac or Flor Essence can help treat patients with cancer.


Flaxseed comes from the flax plant. It is a rich source of omega-3 fatty acid, fiber, and compounds called lignans. It is being studied in the prevention of several types of cancer. Flaxseed has also been studied for its effect on hot flashes.


Ginger is a root that is used in cooking and in some cultures to treat medical conditions such as nausea. It can be used fresh, dried and powdered, or as a juice or oil. Ginger has been studied for the relief of nausea and vomiting in cancer patients.


Ginseng is an herb that is used to treat fatigue. It may be taken in capsules of ground ginseng root. Studies of ginseng have been done in patients either during or after their treatment for cancer. Patients who were given ginseng had less fatigue than patients who were given a placebo (inactive substance).

  • See the Intervention section in the PDQ health professional summary on Fatigue for more information.


L-carnitine is a dietary supplement that is thought to be helpful in treating fatigue related to cancer. L-carnitine helps the body make energy and lowers inflammation that may be linked to fatigue.


See the Cannabis and Cannabinoids section in this summary.

Medicinal Mushrooms

Medicinal mushrooms have been used for hundreds of years, mainly in Asian countries, to treat infections. More recently, medicinal mushrooms have also been used to treat lung diseases and cancer.

Milk Thistle

Milk thistle is a plant whose fruits have been used for more than 2,000 years as a treatment for liver and bile duct disorders. The active substance in milk thistle is silymarin. Milk thistle has been studied in the treatment of side effects caused from cancer and cancer treatment.

  • See the PDQ patient summary on Milk Thistle for more information.

Mistletoe Extracts

Mistletoe is a plant used commonly in Europe, where different extracts are made and sold as injectable prescription drugs. The FDA has not approved mistletoe as a treatment for cancer or any other medical condition.


PC-SPES is a patented mixture of eight herbs. PC-SPES was taken off the market because some batches had prescription medicines in them. The manufacturer is no longer in business and PC-SPES is no longer being made.

  • See the PDQ patient summary on PC-SPES for more information.

St. John's Wort

St. John's wort (Hypericum perforatum) is an herbal product sold as an over-the-counter treatment for depression. St. John's wort has not been proven to be better than standard antidepressant medicines. Studies have been done to compare St. John's wort with antidepressants, placebo (inactive) medicines, or both, and have shown mixed results.

Be sure to talk with your doctor before taking St. John's wort. It may change the way some of your other medicines work, including anticancer medicines. Also, there are no standards for companies that make St. John's wort, so the amount of active ingredient may be different in each brand.

Selected Vegetables/Sun's Soup

“Selected Vegetables” and “Sun’s Soup” are different mixtures of vegetables and herbs that have been studied as treatments for cancer. Dried and frozen forms of Selected Vegetables are sold in the United States as dietary supplements. The vegetables and herbs in Selected Vegetables/Sun’s Soup are thought to have substances that block the growth of cancer cells and/or help the body's immune system kill cancer cells. There is very little evidence that Selected Vegetables/Sun’s Soup is useful as a treatment for cancer and no randomized or controlled clinical trials have been done.

Mind-Body Therapies

Aromatherapy and Essential Oils

Aromatherapy is the use of essential oils from plants (flowers, herbs, or trees) as therapy to improve physical, emotional, and spiritual well-being. Patients with cancer use aromatherapy mainly as supportive care to improve their quality of life, such as lowering stress and anxiety. Aromatherapy may be used with other complementary treatments, such as massage and acupuncture, as well as with standard treatment.

Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is a type of psychotherapy that helps patients change their behavior by changing the way they think and feel about certain things. CBT may help treat many side effects of cancer and cancer treatment.

CBT has been studied for insomnia.

  • See the Management section in the PDQ health professional summary on Sleep Disorders for information about CBT use for insomnia.

Relaxation therapy and imagery have been used to treat anticipatory nausea and vomiting.

CBT may be helpful for depression in patients with cancer. Most counseling or talk therapy programs for depression are offered in both individual and small-group settings.

CBT may be used to treat post-traumatic stress disorder symptoms in patients with cancer. The treatment can focus on solving problems, teaching coping skills, and providing a supportive setting for the patient.


Hypnosis is a trance-like state that allows a person to be more aware and focused and more open to suggestion. Under hypnosis, the person can concentrate more clearly on a specific thought, feeling, or sensation without becoming distracted.


Qigong is a form of traditional Chinese medicine that combines movement, meditation, and controlled breathing. Its purpose is to enhance the vital energy or life force that keeps a person’s spiritual, emotional, mental, and physical health in balance. Some clinical trials have shown that qigong may improve their quality of life and fatigue related to cancer.

  • See the Exercise section in the PDQ patient summary on Fatigue for more information about how qigong is being studied in fatigue related to cancer.


Studies have shown that religious and spiritual values are important to most Americans. Many patients with cancer rely on spiritual or religious beliefs and practices to help them cope with their disease. For healthcare providers, spiritual or religious well-being are sometimes viewed as an aspect of complementary and alternative medicine.

Tai Chi

Tai chi is a form of traditional Chinese mind-body exercise and meditation that uses slow sets of body movements and controlled breathing. Tai chi is done to improve balance, flexibility, muscle strength, and overall health. Some clinical trials have shown that tai chi may improve their quality of life and fatigue related to cancer.

  • See the Exercise section in the PDQ patient summary on Fatigue for more information about how tai chi is being studied in fatigue related to cancer.


Yoga is an ancient system of practices used to balance the mind and body through movement, meditation (focusing thoughts), and control of breathing and emotions. Yoga is being studied as a way to relieve stress and improve sleep in cancer patients. One study showed that breast cancer survivors who took part in a yoga program had lower levels of fatigue and inflammation (swelling).

Nutritional Therapies

Antioxidants and Cancer Prevention

Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals. Free radical damage may lead to cancer. Examples of antioxidants include beta-carotene, lycopene, vitamins C, E, and A, and other substances.

There has been some concern about whether antioxidants may make chemotherapy and radiation therapy less effective.

Coenzyme Q10

Coenzyme Q10 is made by the body. Coenzyme Q10 helps cells produce energy and acts as an antioxidant. Studies show that coenzyme Q10 may protect the heart from damage caused by certain chemotherapy drugs.

Dietary Supplements

Many studies suggest that the use of complementary and alternative medicine is common among many cancer patients, and the use of vitamins, supplements, and specific foods is frequently reported by patients with prostate cancer.

Gerson Therapy

The Gerson therapy is used by some practitioners to treat cancer, based on changes in diet and nutrient intake. An organic vegetarian diet plus nutritional and biological supplements, pancreatic enzymes, and coffee or other types of enemas are all part of the Gerson therapy. Few clinical studies of the Gerson therapy have been published.


Glutamine is an amino acid that is important for the health of gastrointestinal (GI) mucosal cells. These cells are often damaged by chemotherapy and radiation therapy. This causes mucositis (inflammation of the lining of the digestive system, often seen as mouth sores) and diarrhea. This can lead to treatment delays, small doses, and may severely affect quality of life. Some studies suggest that oral glutamine can reduce mucositis and diarrhea by helping mucosal cells and the entire GI tract heal faster.

Gonzalez Regimen

The Gonzalez regimen is a cancer treatment that is tailored by the practitioner for each patient and is available only to the patients of its developer. It involves taking certain pancreatic enzymes thought to have anticancer activity. The regimen also includes specific diets, vitamin and mineral supplements, extracts of animal organs, and coffee enemas.


Lycopene is a carotenoid (a natural pigment made by plants). It is found in a number of fruits and vegetables, including apricots, guava, and watermelon. The main source of lycopene in the American diet is tomato-based products. Lycopene is thought to have antioxidant activity. Lycopene has been studied for its role in chronic diseases, including cardiovascular disease and cancer.


Melatonin is a hormone made by the pineal gland during the hours of darkness. It plays a major role in the sleep-wake cycle. Clinical studies in renal, breast, colon, lung, and brain cancer suggest that melatonin may make chemotherapy and radiation therapy more effective; however randomized, blinded trials are needed to study these results.

Modified Citrus Pectin (MCP)

Citrus pectin is found in the peel and pulp of citrus fruits such as oranges, grapefruit, lemons, and limes. Citrus pectin can be modified so that it can be digested and absorbed by the body. Modified citrus pectin (MCP) may have effects on cancer growth and metastasis. Some research suggests that MCP may protect against different types of cancer, including colon, lung, and prostate cancer.


The pomegranate (Punica granatum L.) plant is native to Asia and grown in many parts of the world. Different parts of the pomegranate fruit have bioactive compounds that may support good health, including antioxidants found in the peel. Certain pomegranate extracts have been shown in laboratory studies to slow the growth and spread of prostate cancer cells and to cause cell death.


Probiotics are live microorganisms used as dietary supplements to help with digestion and normal bowel function. A bacterium found in yogurt called Lactobacillus acidophilus is the most common probiotic. The use of probiotics may be recommended in conditions related to diarrhea and other gastrointestinal problems, such as gut-barrier dysfunction and inflammation.


Selenium is a trace mineral (a nutrient that is essential to humans in tiny amounts). Selenium is found in certain proteins that are active in many body functions, including reproduction and immunity. Selenium is being studied for its role in cancer.


Soy comes from a plant native to Asia that grows beans that are used in many food products. Soy foods, such as soy milk, miso, tofu, and soy flour, contain phytochemicals that may have health benefits. Isoflavones are the most widely studied compounds in soy. Soy is being studied for the prevention of cancer, hot flashes during menopause, and osteoporosis (loss of bone density).


Tea comes from the plant Camellia sinensis. Tea contains polyphenol compounds including catechins, which are antioxidants that help protect cells from damage caused by free radicals.

Some studies suggest that green tea may help protect against cardiovascular disease. There is also evidence that green tea may protect against different types of cancer.

Vitamin C, High-Dose

Vitamin C (ascorbic acid) is a nutrient that humans must get from food or supplements since it cannot be made in the body. Vitamin C is an antioxidant and helps prevent oxidative stress. It also works with enzymes to play a key role in making collagen. High-dose vitamin C has been studied as a treatment for cancer patients.

Vitamin D

Vitamin D is a nutrient involved in a number of functions that are necessary for good health. Skin exposed to sunshine can make Vitamin D. It can also be consumed in the diet, but very few foods naturally contain vitamin D. These foods include fatty fish, fish liver oil, and eggs.

Vitamin E

Vitamin E is a nutrient that the body needs in small amounts to stay healthy and work the way it should. It is fat-soluble (can dissolve in fats and oils) and is found in seeds, nuts, leafy green vegetables, and vegetable oils. Vitamin E boosts the immune system and helps keep blood clots from forming. It also helps prevent cell damage caused by free radicals (unstable molecules in the body). Vitamin E is being studied in the prevention and treatment of some types of cancer. It is a type of antioxidant.

Pharmacologic Treatments


714-X is a chemical compound that contains camphor, which is a natural substance that comes from the wood and bark of the camphor tree. Nitrogen, water, and salts are added to camphor to make 714-X. It is claimed that 714-X protects the immune system and helps the body fight cancer. No peer-reviewed studies of 714-X have been published to show that it is safe or effective in treating cancer.

  • See the PDQ patient summary on 714-X for more information.


Antineoplastons are drugs made of chemical compounds that occur naturally in the urine and blood. It has been claimed that antineoplaston therapy can be used to stop certain cancer cells from dividing, while healthy cells are not affected.


Cancell/Cantron/Protocel is a liquid that has been made in different forms since the late 1930s. It is also known by the names Sheridan’s Formula, Jim’s Juice, JS-114, JS-101, 126-F, and the "Cancell-like" products Cantron and Protocel. The exact ingredients of Cancell/Cantron/Protocel are not known and it is not effective in treating any type of cancer.

Cartilage (Bovine and Shark)

Bovine (cow) cartilage and shark cartilage have been studied as treatments for cancer and other medical conditions for more than 30 years. Substances that keep the body from making the new blood vessels that a tumor needs to grow have been found in bovine cartilage and shark cartilage. However, these substances have not been shown to affect the growth of normal cells or tumor cells.

Hydrazine Sulfate

Hydrazine sulfate is a chemical that has been studied as a treatment for cancer and as a treatment for cachexia (body wasting) that can develop with this disease. It has been claimed that hydrazine sulfate limits the ability of tumors to take in glucose, which is a type of sugar that tumor cells need to grow.


Laetrile is another name for the chemical amygdalin, which is found in the pits of many fruits and in many plants. Cyanide is thought to be the active anticancer ingredient of laetrile. Laetrile has shown little anticancer activity in animal studies and no anticancer activity in clinical trials in humans.

Newcastle Disease Virus (NDV)

Newcastle Disease Virus (NDV) is usually thought to be an avian (bird) virus, but it also infects humans. It causes a potentially fatal, noncancerous disease (Newcastle disease) in birds, but causes only minor illness in humans. NDV appears to copy itself much better in human cancer cells than in most normal human cells and is being studied for anticancer effects.

About This PDQ Summary

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

Purpose of This Summary

This PDQ cancer information summary has current information about the complementary and alternative therapies found in other PDQ summaries and NCI Fact Sheets. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Clinical trials are listed in PDQ and can be found online at NCI's website. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).

Permission to Use This Summary

PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

The best way to cite this PDQ summary is:

PDQ® Integrative, Alternative, and Complementary Therapies Editorial Board. PDQ Topics in Integrative, Alternative, and Complementary Therapies. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: Accessed <MM/DD/YYYY>. [PMID: 26389508]

Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 2,000 scientific images.


The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on on the Managing Cancer Care page.

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General CAM Information

Complementary and alternative medicine (CAM)—also called integrative medicine—includes a broad range of healing philosophies, approaches, and therapies. A therapy is generally called complementary when it is used in addition to conventional treatments; it is often called alternative when it is used instead of conventional treatment. (Conventional treatments are those that are widely accepted and practiced by the mainstream medical community.) Depending on how they are used, some therapies can be considered either complementary or alternative. Complementary and alternative therapies are used in an effort to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease.

Unlike conventional treatments for cancer, complementary and alternative therapies are often not covered by insurance companies. Patients should check with their insurance provider to find out about coverage for complementary and alternative therapies.

Cancer patients considering complementary and alternative therapies should discuss this decision with their doctor, nurse, or pharmacist as they would any type of treatment. Some complementary and alternative therapies may affect their standard treatment or may be harmful when used with conventional treatment.

Evaluation of CAM Therapies

It is important that the same scientific methods used to test conventional therapies are used to test CAM therapies. The National Cancer Institute and the National Center for Complementary and Integrative Health (NCCIH) are sponsoring a number of clinical trials (research studies) at medical centers to test CAM therapies for use in cancer.

Conventional approaches to cancer treatment have generally been studied for safety and effectiveness through a scientific process that includes clinical trials with large numbers of patients. Less is known about the safety and effectiveness of complementary and alternative methods. Few CAM therapies have been tested using demanding scientific methods. A small number of CAM therapies that were thought to be purely alternative approaches are now being used in cancer treatment—not as cures, but as complementary therapies that may help patients feel better and recover faster. One example is acupuncture. According to a panel of experts at a National Institutes of Health (NIH) meeting in November 1997, acupuncture has been found to help control nausea and vomiting caused by chemotherapy and pain related to surgery. However, some approaches, such as the use of laetrile, have been studied and found not to work and to possibly cause harm.

The NCI Best Case Series Program which was started in 1991, is one way CAM approaches that are being used in practice are being studied. The program is overseen by the NCI’s Office of Cancer Complementary and Alternative Medicine (OCCAM). Health care professionals who offer alternative cancer therapies submit their patients’ medical records and related materials to OCCAM. OCCAM carefully reviews these materials to see if any seem worth further research.

Questions to Ask Your Health Care Provider About CAM

When considering complementary and alternative therapies, patients should ask their health care provider the following questions:

  • What side effects can be expected?
  • What are the risks related to this therapy?
  • What benefits can be expected from this therapy?
  • Do the known benefits outweigh the risks?
  • Will the therapy affect conventional treatment?
  • Is this therapy part of a clinical trial?
  • If so, who is the sponsor of the trial?
  • Will the therapy be covered by health insurance?

To Learn More About CAM

National Center for Complementary and Integrative Health (NCCIH)

The National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH) facilitates research and evaluation of complementary and alternative practices, and provides information about a variety of approaches to health professionals and the public.

  • NCCIH Clearinghouse
  • Post Office Box 7923 Gaithersburg, MD 20898–7923
  • Telephone: 1-888-644-6226 (toll free)
  • TTY (for deaf and hard of hearing callers): 1-866-464-3615
  • E-mail:
  • Website:

CAM on PubMed

NCCIH and the NIH National Library of Medicine (NLM) jointly developed CAM on PubMed, a free and easy-to-use search tool for finding CAM-related journal citations. As a subset of the NLM's PubMed bibliographic database, CAM on PubMed features more than 230,000 references and abstracts for CAM-related articles from scientific journals. This database also provides links to the websites of over 1,800 journals, allowing users to view full-text articles. (A subscription or other fee may be required to access full-text articles.)

Office of Cancer Complementary and Alternative Medicine

The NCI Office of Cancer Complementary and Alternative Medicine (OCCAM) coordinates the activities of the NCI in the area of complementary and alternative medicine (CAM). OCCAM supports CAM cancer research and provides information about cancer-related CAM to health providers and the general public via the NCI website.

National Cancer Institute (NCI) Cancer Information Service

U.S. residents may call the NCI Cancer Information Service toll free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 am to 8:00 pm. A trained Cancer Information Specialist is available to answer your questions.

Food and Drug Administration

The Food and Drug Administration (FDA) regulates drugs and medical devices to ensure that they are safe and effective.

  • Food and Drug Administration
  • 10903 New Hampshire Avenue
  • Silver Spring, MD 20993
  • Telephone: 1-888-463-6332 (toll free)
  • Website:

Federal Trade Commission

The Federal Trade Commission (FTC) enforces consumer protection laws. Publications available from the FTC include:

  • Who Cares: Sources of Information About Health Care Products and Services
  • Fraudulent Health Claims: Don’t Be Fooled
  • Consumer Response Center
  • Federal Trade Commission
  • 600 Pennsylvania Avenue, NW
  • Washington, DC 20580
  • Telephone: 1-877-FTC-HELP (1-877-382-4357) (toll free)
  • TTY (for deaf and hard of hearing callers): 202-326-2502
  • Website:
Date last modified: 2018-04-04