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Complementary and alternative medicine (CAM) is popular among patients with cancer and often is used in conjunction with conventional medicine, mostly without the knowledge or guidance of healthcare professionals. The popularity of CAM has brought into sharp focus clinical issues such as the lack of disclosure and concern about interactions among dietary supplements, prescribed medications, and diseases. Those clinical issues underscore the need for a coordinated approach to integrate CAM therapies safely into conventional medicine. This article describes how an integrative CAM program in an outpatient oncology center addresses some of the clinical issues. The CAM program uses a nurse specialist to interface between CAM and conventional medicine. An interesting aspect of the CAM program is the provision of patient consultation and the creation of an individualized complementary therapies plan.Use of complementary and alternative medicine (CAM) among the general population, and patients diagnosed \vith cancer in particular, has increased steadily since the 1980s. Many of the therapies are used in conjunction with conventional medicine; consequently, several challenging clinical issues have surfaced that must be addressed. The issues include the lack of disclosure of CAM use by patients to their providers (Eisenberg et al., 1998; Yates et al., 2005), concerns about safety and efficacy surrounding CAM therapies (Henderson & Donatelle, 2004), and lack of knowledge about CAM on the part of patients and healthcare providers (HCPs) (Kreitzer, Mitten, Harris, & Shandeling, 2002; Rosenbaum, Nisly, Ferguson, & Kligman, 2002).In response to these challenges, an outpatient oncology center created an institutional committee of physicians, nurses, and other providers to investigate how best to meet the demands for CAM and to address these clinical issues. The outcome was the development of a CAM program that gained the full support of administrators, physicians, nurses, and social workers. The goal of the CAM program is to integrate complementary therapies into conventional medicine practice. In a newly developed role, a nurse specialist (NS) who is knowledgeable in CAM and conventional medicine was assigned to further develop and manage the CAM program. The ability of the NS to navigate between CAM and conventional medicine facilitates integration and bridges the gap between patients, other providers, and CAM practitioners. A special feature of the CAM program is the provision of an individualized patient consultation by the NS. This approach is unique because the consultation provides a forum for patient education about CAM, the beginning of an invaluable therapeutic relationship, and the creation of an individualized complementary therapies plan (CTP).Defining Complementary and Alternative MedicineIn 2005, the Institute of Medicine (IOM) offered a composite definition of CAM.Complementary and alternative medicine (CAM) is a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed (p. 19).This definition takes key elements in the field of CAM into consideration, such as differing healthcare practices, beliefs, and theories; patients' perspective of perceived health benefits; and the recognition that the boundaries between the different systems are fluid and have the potential for change. Several classifications of CAM exist. The National Center for Complementary and Alternative Medicine (2005) suggested five categories: (a) alternative medical systems such as traditional Chinese medicine, (b) mind-body interventions such as meditation, (c) biologically based therapies such as herbs, food, and vitamins, (d) manipulative and body-based therapies such as massage, and (e) energy therapies such as Reiki.Complementary and Alternative Medicine Use by Adults With CancerThe prevalence of CAM use in the general population gradually increased from 1990-2004, a trend that is captured collectively in several large national studies (Barnes, Powell-Griner, McFann, & Nahin, 2004; Eisenberg et al., 1993, 1998; Ni, Simile, & Hardy, 2002). Estimated CAM use by patients with cancer in a systematic review of 26 published studies in 13 countries showed an average prevalence of 31% and a range of 7%-64% percent (Ernst & Cassileth, 1998). This is consistent with the different studies undertaken in the United States that documented usage ranging from 28% (Burstein, Gelber, Guadagnoli, & Weeks, 1999) to 91% (Henderson & Donatelle, 2004; Yates et al., 2005).The demography of CAM users remains consistent over time. A