Shark cartilage in the water: One size does not fit all

doi:10.1136/bmj.39051.728738.3A

BMJ 2006;333:1221-1222 (9 December), doi:10.1136/bmj.39051.728738.3A

Letters

Shark cartilage in the water

One size does not fit all

The first 150 words of the full text of this article appear below.

I agree with many of Waxman's points, but onesize does not fit all.¹ The efficacy and potential physicalharm of someone self administering coffee enemas is differentfrom that of someone receiving aromatherapy for improvementof general wellbeing. A distinction needs to be made between"complementary" and "alternative'' therapies. The psychologicaland spiritual domains are as important to many patients as theirobjective response to treatments.

Rather than being a "battle," for many patientstheir experience of cancer treatment is a helplessly passiveone. Accessing complementary therapies can be an empoweringexperience regardless of the anticipated benefits. If 80% ofpatients are seeking out additional or alternative therapies,we need to equip ourselves with a knowledge and evidence basefrom which to advise patients. The websites often warn patientsthat doctors will disparage the use of their product, and wehave a responsibility not to push our patients towards . . . [Full text of this article]

Simon I R Noble, senior lecturer in palliative medicine

¹ Cardiff University and Royal Gwent Hospital NP20 2UB simon.noble@gwent.wales.nhs.uk