Complementary and Alternative Medicine (CAM) is defined by the Cochrane collaboration as:" a broad domain of healing resources that encompasses all health system, modalities, and practices and their accompanying theories and beliefs, other than intrinsic to the politically dominant health systems of a particular society or culture in a given historical period" [4
]. However, the National Centre for Complementary and Alternative Medicine (NCCAM 2006) in America defines CAM as "a group of diverse medical and health care systems, practices and products that are not presently considered to be part of conventional medicine" [5
]. The definition given by Cochrane emphasises healing resources together with its beliefs and theories, while NCCAM talks about systems, practices and products outside conventional medicine. A more recent definition of CAM adapted by the Cochrane School of Complementary medicine is: " diagnosis, treatment and/or prevention which complements main stream medicine by contributing to a common whole, by satisfying a demand not met by orthodox methods or by diversifying the conceptual framework of medicine". Ernst and Cassileth favour this definition because it sees CAM as "complementary" to conventional medicine [1
]. The World Health Organisation (WHO) defines CAM as: "A comprehensive term used to refer to both traditional medical systems such as traditional Chinese medicine, Indian ayurverda, Arabic unani medicine, and to various forms of indigenous medicine" [6
The term Complementary and Alternative Medicine (CAM) is an umbrella term covering both 'complementary therapies' and 'alternative medicines'. Though the phrases are sometimes used synonymously, differences exist between the two. The phrase 'complementary therapy' is defined by cancerBacup as "treatments which are given alongside the conventional cancer treatments" [7
]. This means it is there to complement the main conventional therapies such as radiotherapy, surgery, hormone treatment and chemotherapy in the case of cancer patients. The phrase 'Alternative medicine' is described as "practices used instead of standard medical treatment" [8
]. However, the definition of "Alternative medicine" outlined by World Health Organisation (WHO) encompasses all forms of healthcare provision, which usually lie outside the official health sector. This definition makes no distinction between the terms "Alternative" and "Complementary". Therefore, in the case of cancer management, anything that falls outside radiotherapy, surgery, hormone therapy and chemotherapy could be considered as Alternative medicine. Because of the meaning attached to the phrase "Alternative therapy", most people prefer to use the term "complementary" instead, although the term is still used to differentiate natural medicine from modern medicine [9
]. Nonetheless, the term "Alternative medicine" is popular and much preferred in the United States, as most people still believe that it can sometimes replace conventional medicine in cases where conventional medicine has not lived to expectations [10
Defining what complementary and alternative medicine (CAM) is, has not been without difficulties. One such problem lies in the fact that there is no clear-cut definition of CAM. What is considered as complementary in the UK is in fact conventional in another country. For instance, Lewith explains that herbal medicine and acupuncture are practiced as Complementary therapy in UK and USA whereas they are considered as part of the main conventional medicine in China [11
According to CancerBacup, CAM can be divided into three different categories. These are psychological and self-help therapies, which help patients, deal with the emotional and psychological aspects of their illness like stress, anxiety and depression. Among these therapies are counselling, relaxation, healing, visualisation, meditation and art therapy and hypnotherapy. The second group of complementary therapies are considered as physical therapies. These therapies use the sense of touch as the main tool and among them are aromatherapy, acupuncture, massage, reflexology and shiatsu. The last group of complementary therapies are those classified as unconventional medicine or drugs, and includes Homeopathy, Herbal medicine, Essiac, and Bach flower remedies.
However, Montbriand in his study on the overview of complementary therapies chosen by cancer patients had a different grouping for complementary therapies, and described the three types of CAM as psychological, physical and spiritual [12
]. The psychological therapies involve some kind of distraction strategies to take the mind of patients off the illness with a positive attitude towards life and finally cure. The physical therapies include herbal tea treatment, injection of thyme enzyme for the enhancement of the immune system, diet alteration and megavitamins. Spiritual therapies involve prayer and healing, for example.
It has been argued that Complementary and Alternative Medicine emphasises the healing of both body and mind. According to Herzberg "While scientific medicine focuses on cures of diseases, complementary medicine is concerned with helping us to heal ourselves" [9
] Similarly Fulder, considers that complementary therapy emphasises the restoration of health rather than the removal of sickness [10
]. Tschudin, points out that attitude is one of the fundamental differences between complementary therapies and orthodox medicine [13
]. While orthodox or conventional medicine views symptoms as hostile and treats them accordingly, Tschudin considers that complementary therapies "use a symptom of illness which a person presents merely as a tool, guide or instructor, to discover more basic imbalances in the person's body, mind or spirit".