Wearing a colorful lei and arguing for an ethnically attuned approach to alternative medicine in cancer care and treatment, Hawaiian native Dr. Joanne Itano discussed the virtues of everything from naturopathy to yoga in her presentation at the 16th International Conference on Cancer Nursing in Atlanta.

Itano, a professor at the University of Hawaii, walked her audience through the many alternatives of complementary and alternative medicine (CAM), focusing particular attention on Hawaiian alternative approaches used in cancer treatment. CAM comes in many shapes and sizes, says Itano—therapeutic massage, chiropractic, meditation, hypnosis, art therapy, support groups, macrobiotics, vegetarianism, and antioxidants, to name just a few. Citing a CDC National Health Statistics Report that showed significant increases in deep breathing, meditation, massage, and yoga among adults and children in the U.S. population at large, Itano said that patients rely on CAM for a wide variety of reasons, including dissatisfaction with ineffective therapies and the side effects of cancer medicines, as well as poor communication between doctor and patient, insufficient time with health care professionals, and the high cost of conventional therapies.

Itano reports that in Hawaii, 36% of cancer patients use CAM therapies (a number in line with the national average), with religious or spiritual therapies, herbal medicine, and lifestyle changes dominating the list.

Among Hawaiians, Itano reported significant ethnic differences in preferences for CAM. Caucasions are more likely to use vitamins, support groups, and homeopathy. Chinese Hawaiians are drawn to herbal therapies, and Native Hawaiians find comfort in religious healing, prayer, vitamins, massage and bodywork.

Some Native Hawaiians seek out Ho’olomilomi, a kind of spiritual massage, to relieve pain and side effects of cancer treatment. Delivered by a therapist who is “aligned with divine energy,” the massage “keeps the heart and mind clear for the spirit to move through them as a conduit for healing energy.”