Don't know if the following is of any help. I'm not exactly an advanced user and am normally the one asking for help.
I looked up an old cam follower tutorial I've got, after seeing this thread.
The cam in that tutorial was basically made with an elipse, and the follower can be made tangent to the ellipse.
However, most cams are not an ellipse so I tried making a custom cam shape from circles, ellipses, etc, then clipping to leave the finished cam shape.
Problem with that is I could not make a tangent constraint to the entire periphery of the cam lobe. Only certain "sections" of the periphery would select.
So then I tried to make a cam from a spline, and just like with an elipse, I could constrain a circle (follower) to the full cam periphery.
As per the tutorial, I rotated the cam with "Precise Placement" and the follower moved up and down, maintaining tangency to the cam.
Of course this requires you design the cam from a spline.
Tutorial attached and a screenshot of the "spline cam" and follower I did as a test.