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J Natl Cancer Inst Monogr. 2017 Nov 1;2017(52). doi: 10.1093/jncimonographs/lgx014.

Traditional and Complementary Medicine in Pediatric Oncology and Low-Middle Income Countries: Recommendations from the International Society of Pediatric Oncology (SIOP), T&CM Collaborative.

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Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY; Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY; Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada; Department of Pediatric Oncology, Tata Memorial Hospital, Mumbai, India; Department of Pediatrics and Child Health, Tygerberg Childrens' Hospital, University of Stellenbosch, Stellenbosch, South Africa; Pediatric Hematology-Oncology Department, Manuel de Jesus Rivera La Mascota, Children's Hospital, Managua, Nicaragua; Hemato-Oncology Service, Unidad Nacional de Oncologia Pediatrica, Guatemala City, Guatemala; Medical School Francisco Marroquín University, Guatemala City, Guatemala; Banso Baptist Hospital, Kumbo, Cameroon.


Significant strides have been made in the treatment of childhood cancer. Improvements in survival have led to increased attention toward supportive care indications; including the use of traditional and complementary medicine (T&CM). The use of T&CM among children and adolescents with cancer is well documented in both high-income countries (HICs) and low-middle income countries (LMICs). A higher incidence of the use of T&CM has been reported among children undergoing treatment in LMICs, which has elevated concerns related to drug interactions, adherence to therapy, and treatment-related toxicities. These observations have underscored the need for effective models of integrative care that are culturally sensitive yet sustainable in an LMIC setting. We present considerations inclusive of the clinical care, educational opportunities, governmental policy, and research priorities necessary for the development of models of integrative care for pediatric cancer units in an LMIC setting.

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