The Risk of Alternative Cancer Treatments
AVOIDING EVIDENCE-BASED TREATMENTS IN FAVOR OF UNTESTED ONES CAN CONTRIBUTE TO HIGHER DEATH RATES, A YALE STUDY FOUND.
A diagnosis of cancer, even an early-stage, highly curable cancer, can prompt some people to feel as if they’ve suddenly lost control of their future and that they must do whatever they can to regain it.
They may seek guidance from the internet, friends and acquaintances, some of whom may be quick to relate tales of miraculous cures from alternative remedies that claim to spare patients the challenges of established cancer treatments like surgery, radiation and chemotherapy.
One web-based group, Integrative Cancer Answers, states that as many as 83% of cancer patients choose to use one or more forms of alternative medicine, ranging from acupuncture and herbs to vitamins and yoga, most often in conjunction with therapies clinically proven to be effective.
However, a small but significant number of cancer patients reject the treatments offered by mainstream oncologists and seek instead alternative remedies that may sound wonderful to a layperson but lack the support of scientifically valid research. Their reasons range from wanting to feel empowered by making their own treatment decisions to avoiding toxic side effects by selecting remedies they consider harmless.
But are they really harmless? When remedies that have been proved beneficial are replaced by those supported primarily by wishful thinking, anecdotes and sloppy science (if any science), the result can be a death sentence that could have been avoided.
In a recent study by researchers at the Yale School of Medicine of 281 patients with potentially curable cancers of the breast, lung, colon-rectum or prostate that had not yet spread beyond their site of origin, the use of alternative medicine in lieu of conventional cancer treatments resulted in an overall death rate two and a half times higher than the rate experienced by patients getting standard therapies.
Among women with breast cancer, choosing alternative remedies resulted in a nearly sixfold increase in the chance of dying during an average follow-up period of five and a half years. For patients with colon or rectal cancer who chose alternative treatments, the death rate was four and a half times higher. And for those with lung cancer, the rate was twice as high.
Only men with prostate cancer who rejected standard treatments experienced no difference in the risk of death during the follow-up period, a result, the researchers suggested, that most likely reflects the typical slow growth of prostate cancer. The findings were published in the Journal of the National Cancer Institute.
The research team, led by Dr. Skyler B. Johnson, a therapeutic radiologist, emphasized a very important point: Alternative medicine, which the authors defined as “an unproven therapy that was given in place of conventional treatment,” is not the same as complementary or integrative treatments, which are used as additions, or complements, to standard cancer care.
Too often, when “alternative medicine” is used instead of standard medical treatments, it delays the use of remedies known to be effective and gives an early curable cancer time to grow, spread and ultimately become lethal.
In a related report in JAMA Oncology, Johnson’s team wrote that the higher death rate associated with the alternative treatments used by patients in their study was likely to have been “mediated by the refusal of conventional cancer treatment.”
“Complementary medicine,” on the other hand, carries fewer risks, since it is used along with standard remedies, most often to lessen treatment side effects and enhance feelings of well-being, if chosen properly, complementary therapies should not interfere with the benefits of established treatments.
“Integrative medicine” refers to a combined approach of medically established remedies with one or more practices used in complementary and alternative medicine, or CAM, that have been shown to be safe and effective. It, too, need not impede the effectiveness of standard cancer treatments.
However, not every alternative treatment that patients latch onto is safe. Some may interfere with the effectiveness of established remedies or cause adverse reactions when combined with them. This is most likely to happen when patients use them without first discussing their intention with the doctor overseeing their cancer treatment.
In an advisory to patients on talking to one’s doctor about alternative and complementary medicine, the American Cancer Society acknowledges that “many doctors may not know about the use, risks and potential benefits of these unconventional treatments.” Still, the organization urges patients to let their doctors know they are considering a complementary remedy, “to make sure it won’t interfere with” their regular medical treatment.
Patients are urged to make a complete list of all dietary supplements they are taking or plan to take and let their doctors know about them. Doctors can help patients identify products that are fraudulent or dangerous.
It is likely, the society notes, that there are “mainstream methods for treating the side effects or symptoms” associated with cancer and its established treatments that the doctor can recommend.
Most important, the organization says: “Don’t delay or skip regular treatment without warning. If you’re thinking about stopping or not taking mainstream treatment, please talk to your doctor about this.”
All the same, the cancer society maintains that treatment decisions ultimately are up to the patient. “Even though you may be giving up the only proven treatment for your cancer, this is still your choice to make,” the society’s advisory states.
Assuming that you will use an alternative method as a complement to, not a substitute for, conventional treatment, the Mayo Clinic suggests 10 options that are safe and “may help you cope with signs and symptoms caused by cancer and cancer treatments such as anxiety, fatigue, nausea and vomiting, pain, difficulty sleeping, and stress."
— Acupuncture can help relieve nausea and pain, the clinic states.
— Aromatherapy may also help relieve nausea, pain and stress, but patients are cautioned against using large amounts of lavender oil and tea tree oil on their skin.
— Exercise can relieve fatigue and stress and improve sleep.
— Hypnosis may control pain and reduce stress.
— Massage can relieve pain and may also reduce anxiety, fatigue and stress, although it may not be safe for patients with low blood counts.
— Meditation can relieve anxiety and stress.
— Music therapy has been shown to relieve pain and control nausea and vomiting.
— Relaxation techniques like progressive muscle relaxation can improve sleep and relieve anxiety and fatigue.
— Tai chi, as long as movements that cause pain are avoided, can relieve stress and improve strength and balance.
— Yoga also may reduce stress and fatigue and improve sleep.
This article originally appeared in The New York Times.
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