Complementary and conventional cancer care: the integration of two cultures.

There is now increasing evidence that many cancer patients are seeking unorthodox forms of support and treatment. These range from measures to enhance the quality of life, such as counselling and relaxation therapy, through to alternative cancer remedies, such as extreme diets with detoxification by coffee enemas. Much of complementary care is provided outside the hospital setting, often without the knowledge of the health care professionals involved in a patient's treatment. The Bristol Cancer Help Centre was founded in 1980 to provide an alternative approach to cancer treatment. It became the leading British centre for such therapies, although, from its outset, it had an uneasy relationship with conventional medicine. Some clinicians were highly critical of its perceived methods even though very few actually visited the centre to examine the evolving programmes of care offered. In 1988, a group of oncologists from Hammersmith Hospital visited the Bristol Centre. A joint development programme was conceived in which the lessons from Bristol were integrated into a busy academic oncology unit prior to the design and construction of a new cancer centre. Many problems emerged in trying to merge the two cultures, one driven by technology, the other by human need. Several other oncology units are adopting complementary strategies within their services. Here we describe our joint experience and outline the Hammersmith supportive care model currently in use.