Introduction

Complementary and alternative medicine (CAM) has become a high-profile issue in the last two decades, and in the context of cancer care it is both prominent and controversial. Use of CAM by cancer patients in the United Kingdom (UK) is considerable and calls for increased public provision are frequent. Research continues to illustrate high levels of individual patient usage (e.g. Ernst and Cassileth, 1998; Fouladbakhsh et al., 2005; Lewith et al., 2002; Rees et al., 2000; J. Scott et al., 2005) and there exists a substantial divide between public preference for therapeutic alternatives and National Health Service (NHS) provision. CAM, at least in a limited form, is now considered a fairly standard element of palliative care in the UK, with a recent report emphasising the integral nature of CAM to end-of-life care (Tavares, 2003). Whilst broad shifts towards integration have been evident in the treatment of more advanced disease, hospital-based cancer services have shown less propensity to accept non-biomedical options and, as such, are coming under increased political and public pressure to move beyond a purely biomedical-type service provision (Broom and Tovey, 2007). However, despite considerable advocacy on the part of political lobby groups, grassroots patient support networks and the volunteer sector, hospital-based oncology services currently provide very little in the way of non-biomedical therapeutics, and even in palliative care contexts CAM services are limited in scope and lack formalised financial backing from the NHS.