rently considered to be part of conventional medicine (NCCAM, 2002). The use of CAM is very common among the general population. In 2002 an estimated 62 percent of adults used some form of CAM therapy during the past year when the definition of CAM therapy included prayer specifically for health reasons (Barnes et al., 2004). When prayer was excluded from the definition, 36 percent of adults used some form of CAM therapy during the past year.

Individuals with cancer frequently use CAM products with the belief that their use will arrest their disease, alleviate symptoms, promote well-being, and increase their sense of control over their health (Burstein, 2000; Richardson et al., 2000; Antman et al., 2001). Common categories of CAM therapies used by cancer survivors include dietary modification and supplementation, herbal products and other biological agents, acupuncture, massage, exercise, and psychological and mind-body therapies (Weiger et al., 2002). In their review of the effectiveness and safety of such products, Weiger and colleagues found several CAM therapies that offer potential benefits for patients with cancer. For CAM therapies intended for palliation of symptoms associated with cancer or side effects of conventional treatment, the authors advised physicians to consider recommending and monitoring massage for anxiety or pain, moderate exercise, and psychological and mind-body therapies (e.g., support groups, relaxation training, imagery). Other CAM therapies, however, may be ineffective, and many present risks to cancer survivors (e.g., phytoestrogens for breast cancer survivors taking tamoxifen). The authors recommend that physicians communicate openly with patients about CAM use. Recent studies suggest, however, that many cancer patients do not discuss their use of CAM with their physicians (Lee et al., 2000; Navo et al., 2004). Such discussions are especially important given the association in some studies between the use of CAM and greater psychosocial distress (Burstein et al., 1999; DiGianni et al., 2002).

Cancer survivors can obtain comprehensive information about CAM from the American Cancer Society’s Guide to Complementary and Alternative Cancer Methods (ACS, 2000) and from the NCI’s Office of Cancer Complementary and Alternative Medicine (NCI and NCCAM, 2004).

Summary

Clinical encounters with cancer survivors provide “teachable moments” for health prevention and promotion (Demark-Wahnefried et al., 2005; Ganz, 2005). The adoption of healthy lifestyle behaviors provides an opportunity for cancer survivors to assume control of some aspects of their health and improve outcomes from cancer and other chronic illnesses. There are opportunities to intervene to help cancer survivors quit smoking, exer-



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