ABSTRACT
As outlined in the Introduction, the potential integration of CAM into the UK cancer services has become a key issue for the UK DoH. However, the movement toward a more rounded, and less exclusively biomedical, approach to cancer care has been slow. Although national cancer policy is increasingly advocating, albeit implicitly, ‘integrative’ and ‘patient-centred’ practice (Department of Health, 2000, 2004), a virtual stalemate in the debate about ‘evidence’ and ‘efficacy’ has prevented any real progress being made. Many biomedical clinicians and health researchers argue for the development of a biomedical-type evidence base before there is even consideration of using CAM therapies for NHS cancer patients (Ernst, 2001). ‘Unproven’ therapies, it is argued, should not be offered to patients (House of Lords, 2000) due to risks of potential harm and wasting NHS resources. However, an increasingly popular perspective amongst CAM practitioners, patient groups and some social scientists alike is that professional gate-keeping, paradigmatic incommensurability and restrictive understandings of ‘evidence’ are the real barriers to state funding of CAM for cancer patients (e.g. Borgerson, 2005; Broom and Tovey, 2007). Moreover, cancer patients themselves are increasingly choosing treatments regardless of their clinical ‘efficacy’ (e.g. Lewith et al., 2002), suggesting the pursuit of evidence-based medicine (EBM) in cancer care may have little resonance with many patients’ experiences.
