Complementary and Alternative Medicine: A Japanese Perspective

The use of complementary and alternative medicine (CAM) is increasing rapidly.The World Health Organization (WHO) classifies 65-80% of the world's health care services as 'traditional medicine' (1).Therefore, from the viewpoint of the population ratio, more people use CAM than modern western medicine.Although much attention has been focused on CAM not only from physicians but also basic medical researchers, scientific evidence for most CAM is still sparse.Emergence of CAM as a new current of medicine depends on whether or not precise scientific evidence can be accumulated.Why has CAM become so popular among 'consumers'?I think that the following factors are responsible:• CAM is easy to understand and familiar• CAM is non-invasive, with few side effects • CAM helps improve quality of life (QOL) or activity of daily life (ADL) • CAM helps one to maintain one's own health • Western modern medicine does not fully correspond to the patients' demands • the trend towards a more holistic medical approach • ballooning medical expenses In this overview, I will describe and discuss the current status of CAM in Japan.The situation in Japan should be of much interest, since Japan is unique as a country in which highly advanced modern Western medicine coexists with traditional Asian medicine. Classification of CAMCAM, as defined by The National Center for Complementary and Alternative Medicine (NCCAM) in the USA, is a group of diverse medical and health care systems, practices and products that are not presently considered to be part of conventional Western medicine.NCCAM classifies CAM therapies into five categories, or domains (Table 1).In Japan, part of anti-aging medicine (growth hormone treatment, etc), lifestyle drugs (remedies for alopecia, obesity, impotence, etc) and 'environmental medicine' are considered to be included in CAM treatment.For example, developing a functional food which absorbs dioxins and promotes discharge into facilities, or developing a filter to trap the free radicals of automobile exhaust gas or cigarette smoke, etc, are included in the category of 'environmental medicine'.The CAM domain in Japan also encompasses some forms of advanced medical treatments, which are not yet widely carried out, such as immunotherapy for cancer using tumor specific antigens, etc. In-vitro fertilization and embryo transfer (IVF/ET), one of the most advanced medical technologies, was regarded as CAM at the very beginning.Now, however, IVF/ET is widely used in conventional hospitals, so it can be said that some CAM modalities have been taken into conventional medical treatment.So, in Japan CAM has some connotations of 'frontier' medicine.Unlike Western countries, in Japan, part of Kampo medicine (Japanese herbal medicine) and acupuncture are covered by public health insurance.Therefore, Japanese practitioners of Kampo and acupuncture would object to their inclusion in CAM and would rather regard themselves as belonging to the Advance