A Natural Product Does Not Mean a Safe Product

by National Cancer Institute

(Page 2 of 2)

Here are some important facts about dietary supplements such as herbs and vitamins:

They may affect how well other medicines work in your body.

Herbs and some plant-based products may keep medicines from doing what they are supposed to do. These medicines can be ones your doctor prescribes for you, or even ones you buy off the shelf at the store.

For example, the herb St. John's wort, which some people with cancer use for depression, may cause certain anticancer drugs not to work as well as they should.

Herbal supplements can act like drugs in your body.

They may be harmful when taken by themselves, with other substances, or in large doses. For example, some studies have shown that kava, an herb that has been used to help with stress and anxiety, may cause liver damage.

Vitamins can also take strong action in your body.

For example, high doses of vitamins, even vitamin C, may affect how chemotherapy and radiation work. Too much of any vitamin is not safe--even in a healthy person.

Tell your doctor if you are taking any dietary supplements, no matter how safe you think they are. This is very important. Even though there are ads or claims that something has been used for years, they do not prove that it is safe or effective. It is still important to be careful.

Supplements do not have to be approved by the Federal Government before being sold to the public. Also, a prescription is not needed to buy them. Therefore, it's up to consumers to decide what is best for them.

Choose Practitioners with Care

CAM practitioners are people who have training in the therapies listed on pages 2-6. Choosing one should be done with the same care as choosing a doctor. Here are some things to remember when choosing a practitioner:

• Ask your doctor or nurse to suggest someone or speak with someone who knows about CAM.

• Ask whether someone at your cancer center or doctor's office can help you find a CAM practitioner. There may be a social worker or physical therapist who can help you.

• Ask whether your hospital keeps lists of centers or has staff who can suggest people.

• Contact CAM professional organizations to get names of practitioners who are certified. This means that they have proper training in their field.

• Contact local health and wellness organizations.

• Ask about each practitioner's training and experience.

• Ask whether the practitioner has a license to practice in your state. If you want to confirm the answer, ask what organization gives out the licenses. Then, you may choose to follow up with a phone call.

• Call your health care plan to see if it covers this therapy.

What general questions should I ask the CAM practitioner?

• What types of CAM do you practice?
• What are your training and qualifications?
• Do you see other patients with my type of cancer?
• Will you work with my doctor?

What questions about the therapy should I ask the CAM practitioner?

• How can this help me?
• Do you know of studies that prove it helps?
• What are the risks and side effects?
• Will this interfere with my cancer treatment?
• How long will I be on the therapy?
• What will it cost?
• Do you have information that I can read about it?
• Are there any reasons why I should not use it?

Other Questions To Ask Yourself

• Do I feel comfortable with this person?
• Do I like how the office looks and feels?
• Do I like the staff?
• Does this person support standard cancer treatments?
• How far am I willing to travel for treatment?
• Is it easy to get an appointment?
• Are the hours good for me?
• Will insurance cover the cost of CAM?

Call your health plan or insurer to see whether they cover CAM therapies. Many are not covered.

Getting Information from Trusted Sources

Government Agencies

There is a lot of information on CAM, so it's important to go to sources you can trust. Good places to start are the government agencies listed in the back of this booklet. They offer lots of information about CAM that might be helpful to you. They may also know of universities or hospitals that have CAM resources.

Be careful of products advertised by people or companies that:

• Make claims that they have a "cure";
• Do not give specific information about how well their product works;
• Make claims only about positive results that have few side effects;
• Say they have clinical studies, but provide no proof or copies of the studies.

Just remember, if it sounds too good to be true, it probably is.

Web Sites

Patients and families have been able to find answers to many of their questions about CAM on the Internet. Many Web sites are good resources for CAM information. However, some may be unreliable or misleading.

Questions to ask about a Web site:

• Who runs and pays for the site?
• Does it list any credentials?
• Does it represent an organization that is well-known and respected?
• What is the purpose of the site, and who is it for?
• Is the site selling or promoting something?
• Where does the information come from?
• Is the information based on facts or only on someone's feelings or opinions?
• How is the information chosen? Is there a review board or is the content reviewed by experts?
• How current is the information?
• Does the site tell when it was last updated?
• How does the site choose which other sites to link you to?

Books

A number of books have been written about different CAM therapies. Some books are better than others and contain trustworthy content, while others do not.

If you go to the library, ask the staff for suggestions. Or if you live near a college or university, there may be a medical library available. Local bookstores may also have people on staff who can help you.

It's important to know that information is always changing and that new research results are reported every day. Be aware that if a book is written by only one person, you may only be getting that one person's view.

Questions to ask:

• Is the author an expert on this subject?
• Do you know anyone else who has read the book?
• Has the book been reviewed by other experts?
• Was it published in the past 5 years?
• Does the book offer different points of view, or does it seem to hold one opinion?
• Has the author researched the topic in full?
• Are the references listed in the back?

Magazine Articles

If you want to look for articles you can trust, ask your librarian to help you look for medical journals, books, and other research that has been done by experts.

Articles in popular magazines are usually not written by experts. Rather, the authors speak with experts, gather information, and then write the article. If claims about CAM are made in magazine articles, remember:

• The authors may not have expert knowledge in this area;
• They may not say where they found their information;
• The articles have not been reviewed by experts;
• The publisher may have ties to advertisers or other organizations. Therefore, the article may be one-sided.

When you read these articles, you can use the same process that the magazine writer uses:

• Speak with experts;
• Ask lots of questions;
• Then decide if the therapy is right for you.

About the Author

www.nci.nih.gov
The National Cancer Institute's research programs are extensive and contain many innovative initiatives. I invite you to explore our Web site to find out more about the exciting work being conducted here at NCI and by NCI-supported scientists throughout the country.