An ongoing series highlighting complementary therapies, adapted from The Complete Guide to Complementary Therapies in Cancer Care By Barrie R. Cassileth, MS, PhD
Complementary therapies are noninvasive, non-pharmacologic adjuncts to mainstream treatment. They improve patients’ strength and control of the physical and emotional symptoms associated with cancer and other illnesses. They provide self-help guidance to enhance body and soul at times when one feels vulnerable and life seems out of control. Complementary therapies are used as adjuncts to mainstream care of cancer and other illnesses, not as substitutes. They improve physical and emotional function and manage stress and symptoms of aging, regardless of health status. Complementary therapies are rational, evidence-based practices delivered or taught by trained practitioners. They include mind-body practices such as meditation and self-hypnosis; massage therapies; nutritional counseling; physical fitness, including programs such as aerobic exercise, qigong, tai chi, yoga, and many other practices; music therapy; and acupuncture.
Naturopathic medicine is an approach to healing practiced by naturopathic doctors (NDs), who diagnose illness with the same techniques used by conventional physicians. They treat illness with natural methods, however, generally avoiding pharmaceutical drugs and other products of modern medicine.
Naturopathy was organized in the late nineteenth century. By the early 1900s, there were more than 20 schools of naturopathic medicine in the United States, and naturopathic conventions in the 1920s often attracted more than 10,000 practitioners.
Most schools of naturopathy became defunct by the 1940s, however, when standards of quality were introduced, bringing increased scrutiny to medicine and the licensing of medical schools. Interest in naturopathy waned shortly thereafter. Today, however, naturopathy is among the many forms of alternative and complementary medicine enjoying a resurgence of interest.
What Is Naturopathic Medicine?
Naturopathic medicine, positioned as a low-cost, more gentle alternative to conventional care, combines modern knowledge of the body and disease with a variety of healing methods not used in mainstream medicine. The naturopathic approach to disease includes the many natural methods geared to strengthen the body’s own healing ability. Treatment avoids drugs and surgery. Although naturopaths are not MDs, they do perform minor surgical procedures.
Unlike many alternative systems of care, naturopathic medicine does not have its own view of human physiology, function, and disease apart from that held by conventional medicine. Rather than rely on concepts such as the body types of Ayurvedic medicine or the vital life-force concept of traditional Chinese medicine, naturopaths study conventional anatomy and other medical sciences. They use X-rays, order laboratory tests, and apply physical examination techniques as do conventional physicians.
Naturopathy and conventional medicine differ, however, in emphasis and treatment. Naturopathy is not associated with a unique healing technology. Rather it uses a collection of natural treatment modalities:
- Homeopathy is a system of medicine involving the use of very small amounts of a symptom-causing substance to treat the condition that produces similar symptoms.
- Traditional Chinese medicine applies techniques developed in ancient China to treat disease.
- Acupuncture involves the insertion of needles in specific points on the body to cure or treat disease.
- Hydrotherapy, or spa therapy, prescribes rest treatment at spas.
- Physical medicine includes a system of manipulating the bones and the spine in a way that is similar to chiropractic and osteopathic manipulation. Physical forces such as electricity, heat, and sound also are applied to treat patients, as are various massage and exercise techniques.
- Botanical medicine involves the use of whole plants and herbs as medicines, a practice with a long tradition in many cultures. Naturopathic physicians believe that botanical medicines are superior to synthetic drugs in some instances. They also claim that botanical medicines are safer, have fewer side effects, and are less costly.
- Nutritional therapies ensure that each patient follows the optimum diet for his or her health and lifestyle. Healthful, nutritionally balanced diets are prescribed. Advocates point to increasing evidence about the role of nutrition in disease and the extensive training in nutrition received by naturopathic doctors compared with conventional physicians.
- Counseling, or behavioral medicine, is an important component of naturopathy, and practitioners emphasize the role played by mental and emotional health in disease. Naturopathic physicians are trained in counseling, biofeedback, stress reduction, and other means of helping improve mental and therefore overall health.
Some naturopathic physicians obtain further training in one or more of these techniques and specialize in treating patients with these methods. Naturopathic doctors may also apply other alternative or unproven techniques, such as ozone therapy for patients with cancer or AIDS.
How Are Naturopathic Doctors Trained?
Naturopathic physicians attend a four-year academic program at a naturopathic medical school after completing a four-year undergraduate college degree. Acceptance requirements for naturopathic medical school are similar to those for mainstream medical schools, including a college degree and the completion of courses in physics, biology, and chemistry.
The first two years of naturopathic medical school include conventional medical science courses, such as anatomy, physiology, and pathology. The last two years are devoted to the specific techniques of naturopathic treatment discussed previously and to seeing patients, primarily in outpatient (nonhospital) environments, under the supervision of fully trained and experienced naturopathic practitioners.
While both conventional and naturopathic physicians undergo four years of training, conventional physicians must also serve a minimum of three years of residency after medical school before they may practice even the most basic medical care. Naturopathic physicians who pass certifying exams offered by the Council on Naturopathic Medical Education are licensed and may begin practice directly after completing their four-year program.
What Practitioers Say It Does
Naturopaths view naturopathic medicine as an alternative to conventional primary care, claiming to treat the entire range of illness, from self-limiting and minor problems to diseases like AIDS and cancer. Naturopaths do not, however, provide emergency care, and they do not perform major surgery, referring patients to conventional specialists as necessary. Some naturopathic physicians do practice natural childbirth in home or birth center settings.
Proponents stress that naturopathic therapy has fewer side effects and lower costs than conventional medicine. Some of these differences, however, may be due to the fact that naturopaths refer patients with complicated cases and those requiring major treatment to conventional practitioners. For example, naturopaths do not attend problematic births, referring such cases to hospital-based obstetricians.
Beliefs on Which Naturopathy Is Based
The overarching goal of naturopathy is to enlist the natural healing power of the body to fight disease. Some naturopaths equate this healing power with the “vital force” idea that underlies the traditional healing systems of several ancient cultures. There are other principles as well:
- Uncovering and treating the cause of disease instead of merely alleviating symptoms
- Avoiding drugs and surgery in favor of natural methods
- Emphasizing treatment of the whole person, based on a detailed examination of the patient’s lifestyle, environment, and medical history that can influence well-being
- Emphasizing preventive medicine
Patients are taught to adopt healthful diets and lifestyles in an effort to ward off the development of illness. To this end naturopathic doctors are seen as teachers who educate patients about their own bodies and the best ways to maintain health.
Naturopathy’s beliefs and methods stem from case-history observations, medical records, practitioners’ experience in treating patients, clinical nutritional data, and therapies long popular in Europe, Asia, and India.
Research Evidence to Date
Naturopathic medicine uses several specific techniques that vary in their effectiveness or ability to influence health. Some naturopathic approaches, such as homeopathy, may be of little value. Others are documented and known to be effective. Examples include the importance of diet in modifying the risk of severe illnesses such as heart disease and cancer and the use of acupuncture to reduce pain and to assist withdrawal from addiction. Researchers at the University of Minnesota Medical School examined naturopathic treatments and found some supporting scientific evidence in their favor but noted the need for definitive clinical trials.
Naturopathic medicine is an excellent example of how the nature of proof can differ between conventional and alternative physicians. Most techniques used by naturopathic physicians have long traditions, and practitioners cite these traditions as evidence of effectiveness. In contrast, conventional medicine requires validation of therapies with objective proof, such as clinical trials.
What It Can Do for You
Because naturopathy uses many different techniques, it is necessary to examine them individually, just as conventional medical therapy would be evaluated. Most naturopathic remedies are considered harmless by conventional practitioners, but more study is needed before naturopathic therapies can be said to reverse disease. Naturopathic treatments generally can be helpful against minor illnesses, but using naturopathic instead of conventional therapy for major illnesses or serious conditions is not wise.
Where to Get It
There are seven accredited naturopathic medical schools in North America: Bastyr University in Seattle; Boucher Institute of Naturopathic Medicine in Vancouver, Canada; Canadian College of Naturopathic Medicine in Toronto, Canada; National College of Natural Medicine in Portland, Oregon; National University of Health Sciences in Chicago, Illinois; Southwest College of Naturopathic Medicine in Phoenix, Arizona; and the University of Bridgeport in Bridgeport, Connecticut. All of these can be accessed on the Internet.
Many insurance companies in the United States and Canada cover naturopathic care. Some companies offer subscribers a choice between naturopathic and conventional services. These programs use naturopaths as primary care doctors who maintain responsibility for patients’ overall care and typically refer patients to mainstream medical specialists as necessary.
The American Association of Naturopathic Physicians and the Canadian Association of Naturopathic Doctors provide information about naturopathic training as well as lists of licensed naturopathic practitioners.
To read the full “Naturopathic Medicine” chapter and more about complementary therapies, purchase The Complete Guide to Complementary Therapies in Cancer Care: Essential Information for Patients, Survivors, and Health Professionals online at The Cancer Care Store (cancercarestore.com).
Adapted with permission from The Complete Guide to Complementary Therapies in Cancer Care: Essential Information for Patients, Survivors, and Health Professionals by Barrie R. Cassileth. Copyright © 2011 World Scientific Publishing Co. Pte. Ltd.
Licensure for Naturopaths
As of this writing, about two dozen US states and Canadian provinces license naturopathic doctors. Accreditation is provided by the American Association of Naturopathic Physicians (AANP), naturopathy’s national professional organization.
The AANP strongly recommends that patients verify their naturopathic physician’s certification with the AANP. The AANP warns that some practitioners who advertise themselves as naturopathic doctors obtained degrees from unaccredited schools or through the mail rather than at accredited institutions. Most US states do not license naturopaths, but many doctors practice naturopathy without licenses and in states that do not offer licensure.