MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

This press-release caught my eye today. It relates to an article that does not seem to be available yet (at least when I looked it was not on Medline). As it is highly relevant to issues that we have repeatedly discussed on this blog, let me quote the important sections of the press-release instead:

To investigate alternative medicine use and its impact on survival compared to conventional cancer treatment, the researchers studied 840 patients with breast, prostate, lung, and colorectal cancer in the National Cancer Database (NCDB) — a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The NCDB represents approximately 70% of newly diagnosed cancers nationwide. Researchers compared 280 patients who chose alternative medicine to 560 patients who had received conventional cancer treatment.

The researchers studied patients diagnosed from 2004 to 2013. By collecting the outcomes of patients who received alternative medicine instead of chemotherapy, surgery, and/or radiation, they found a greater risk of death. This finding persisted for patients with breast, lung, and colorectal cancer. The researchers concluded that patients who chose treatment with alternative medicine were more likely to die and urged for greater scrutiny of the use of alternative medicine for the initial treatment of cancer.

We now have evidence to suggest that using alternative medicine in place of proven cancer therapies results in worse survival,” said lead author Dr. Skyler Johnson. “It is our hope that this information can be used by patients and physicians when discussing the impact of cancer treatment decisions on survival.”

Dr. Cary Gross, co-author of the study, called for further research, adding, “It’s important to note that when it comes to alternative cancer therapies, there is just so little known — patients are making decisions in the dark. We need to understand more about which treatments are effective — whether we’re talking about a new type of immunotherapy or a high-dose vitamin — and which ones aren’t, so that patients can make informed decisions.”

END OF QUOTE

Regular readers of my blog will not be surprised; we have discussed similar findings before:

Korean researchers evaluated whether complementary/alternative medicine (CAM) -use influenced the survival and health-related quality of life (HRQOL) of terminal cancer patients. From July 2005 to October 2006, they prospectively studied a cohort study of 481 cancer patients. During a follow-up of 163.8 person-years, they identified 466 deceased patients. Their multivariate analyses of these data showed that, compared with non-users, CAM-users did not have better survival. Using mind-body interventions or prayer was even associated with significantly worse survival. CAM users reported significantly worse cognitive functioning and more fatigue than nonusers. In sub-group analyses, users of alternative medical treatments, prayer, vitamin supplements, mushrooms, or rice and cereal reported significantly worse HRQOL. The authors conclude that “CAM did not provide any definite survival benefit, CAM users reported clinically significant worse HRQOLs.”

A Norwegian study examined the association between CAM-use and cancer survival. Survival data were obtained with a follow-up of 8 years for 515 cancer patients. A total of 112 patients used CAM. During the follow-up period, 350 patients died. Death rates were higher in CAM-users (79%) than in those who did not use CAM (65%). The hazard ratio of death for CAM-use compared with no use was 1.30. The authors of this paper concluded that “use of CAM seems to predict a shorter survival from cancer.”

This study from the US was aimed at determining whether CAM use impacts on the prognosis of breast cancer patients. Health Eating, Activity, and Lifestyle (HEAL) Study participants (n = 707) were diagnosed with stage I-IIIA breast cancer. Participants completed a 30-month post-diagnosis interview including questions on CAM use (natural products such as dietary and botanical supplements, alternative health practices, and alternative medical systems), weight, physical activity, and comorbidities. Outcomes were breast cancer-specific and total mortality, which were ascertained from the Surveillance Epidemiology and End Results registries in Western Washington, Los Angeles County, and New Mexico. Cox proportional hazards regression models were fit to data to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for mortality. Models were adjusted for potential confounding by socio-demographic, health, and cancer-related factors. Among the 707 participants, 70 breast cancer-specific deaths and 149 total deaths were reported. 60.2 % of participants reported CAM use post-diagnosis. The most common CAM were natural products (51 %) including plant-based estrogenic supplements (42 %). Manipulative and body-based practices and alternative medical systems were used by 27 and 13 % of participants, respectively. No associations were observed between CAM use and breast cancer-specific (HR 1.04, 95 % CI 0.61-1.76) or total mortality (HR 0.91, 95 % CI 0.63-1.29). The authors concluded that CAM use was not associated with breast cancer-specific mortality or total mortality. Randomized controlled trials may be needed to definitively test whether there is harm or benefit from the types of CAM assessed in HEAL in relation to mortality outcomes in breast cancer survivors.

MY CONCLUSION:

Some forms of CAM might be effective in supportive or palliative care of cancer patients. However, if it is used or recommended as a cancer therapy, our alarm bells should start ringing.

 

PS

I just found the new article; here is its abstract:

There is limited available information on patterns of utilization and efficacy of alternative medicine (AM) for patients with cancer. We identified 281 patients with nonmetastatic breast, prostate, lung, or colorectal cancer who chose AM, administered as sole anticancer treatment among patients who did not receive conventional cancer treatment (CCT), defined as chemotherapy, radiotherapy, surgery, and/or hormone therapy. Independent covariates on multivariable logistic regression associated with increased likelihood of AM use included breast or lung cancer, higher socioeconomic status, Intermountain West or Pacific location, stage II or III disease, and low comorbidity score. Following 2:1 matching (CCT = 560 patients and AM = 280 patients) on Cox proportional hazards regression, AM use was independently associated with greater risk of death compared with CCT overall (hazard ratio [HR] = 2.50, 95% confidence interval [CI] = 1.88 to 3.27) and in subgroups with breast (HR = 5.68, 95% CI = 3.22 to 10.04), lung (HR = 2.17, 95% CI = 1.42 to 3.32), and colorectal cancer (HR = 4.57, 95% CI = 1.66 to 12.61). Although rare, AM utilization for curable cancer without any CCT is associated with greater risk of death.

7 Responses to Use of alternative medicine hastens death of cancer patients

  • Hi Edzard,
    I never died as predicted, but it was not because of aromatherapy oil. In fact I had a scan in April which was clear. Just to recap I was given 22 months in August 2013 with chemotherapy. I stoped chemo after a few cycles because it obviously had not worked in 2011 as I was now stage 4 with metastasis, they said I might only live six months if I stopped chemo. I read in the medical literature no one had lived four years and yet I have, because I did not follow the evidence as advised, having experimented and self medicated with cannabis oil. Yes I am what you would call am “anecdote” what amazes me, is no one is trying to figure out why I have done so well, they prefer to do research which confirms their bias. The only difference between the treatment I had in 2011 and 2013, is that I took cannabis oil instead of chemotherapy.

    It appears to me the reason they dont investigate my case or write it up as a “case study”, is because it questions everything you and the medical establishment believe. No doubt I will die one day and it will probably be from cancer, I have had so much radiation, from scans and treatment, but not only have I lived four years, I am cancer free after 4 years and no one can explain why or wants to find out?? Its not as black and white as you would have your readers believe.

    • 1) I am VERY glad to hear all this!
      2) “It appears to me the reason they dont investigate my case or write it up as a “case study”, is because it questions everything you and the medical establishment believe.” this is not true; I question my belief all the time, and if I were your oncologist, I probably would publish a case-report and might research cannabis oil. perhaps you self-medicated cannabis oil which would make it difficult for your oncologist to write it up [we did xy, and then this happened, and the patient claimed he had done this but we have no documentation…etc. – do you see what I mean?]
      why don’t you write it up yourself and publish it? if you want, I try to help you.
      3) I never see myself as seeing things black or white, never!

  • It seems that many ‘non-critical’ based thinkers who belive they have had an “alternative-caused experience/result” immediately begin an incriminating indictment of ‘critical based’ thinkers, As if critical thinking and demand-for-proof motivation were somehow at root for scientific shortcomings.
    If I was to criticize acupuncturists or naturopaths for not giving ample consideration to some ‘Scientology techniques’ which eliminated an opioid addiction (or cured cancer) their collective bullshit meters might probably go red-line….since everyone has a standard to which they find TOO far fetched.
    It seems to me scoffing at science-based methods, irrespective of whether there may be some corruption or covert fiduciary considerations (we are after all motivated by and in need of compensation past mere spiritual satisfaction) just seems intellectually immature (how much latitude is given the Catholic Church or charities that have proven malfeasance?). Someone will die from a lightning strike today and someone will win the lottery….and someone with a “fatal” disease will survive….but science and medicine are still the ONLY place real shelter from the slings and arrows of life exist.

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