The notion of an alternative cancer cure is, as I have pointed out ad nauseam, a contradiction in terms (I am sure this sentence will prompt protests; so please, do send me links to reliable studies that prove it to be incorrect). It suggests that oncologists are a somewhat sadistically deranged group of professionals who would reject a promising therapy simply because it originates not from within the mainstream of medicine. Yet, some proponents of so-called alternative medicine (SCAM) claim that, even though there might be not a single SCAM that cures cancer, the use of a tailor-made mixture of several SCAMs could be beneficial, particularly if employed in addition to conventional cancer treatments. In fact, ‘integrated oncologists’ often claim that employing a package of diverse SCAMs will prolong the live of cancer patients.
But are they correct?
In this post, I will investigate by discussing the few studies that have tested this hypothesis.
In 2003, a Norwegian study examined the association between SCAM-use and cancer survival. Survival data were obtained with a follow-up of 8 years for 515 cancer patients. A total of 112 patients had used SCAM. In total, 350 patients died during the follow-up period. Death rates were higher in SCAM-users (79%) than in those who did not use SCAM (65%). The hazard ratio of death for SCAM-use compared with no use was 1.30. The authors of this paper concluded that the use of SCAM seems to predict a shorter survival from cancer.
In 2013, Korean researchers evaluated whether SCAM-use influenced the survival and health-related quality of life (HRQOL) of terminal cancer patients. They prospectively studied a cohort of 481 cancer patients. During a follow-up of 164 person-years, 466 patients died. Compared with non-users, SCAM-users did not survive longer. The use of mind-body interventions or prayer was even associated with significantly worse survival. SCAM 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 SCAM did not provide any definite survival benefit, CAM users reported clinically significant worse HRQOLs.
A 2017 study from Malaysia evaluated whether the use of SCAM among newly diagnosed breast cancer patients was associated with delays in presentation, diagnosis or treatment of breast cancer. A total of 340 newly diagnosed patients were included in this study. The prevalence of SCAM use was 46.5%. The use of SCAM was associated with delays in presentation, diagnosis and treatment of breast cancer. The authors concluded that the use of SCAM was significantly associated with delay in presentation and resolution of diagnosis.
A 2017 US study was aimed at determining whether SCAM use impacts on the prognosis of breast cancer patients. A total of 707 patients with stage I-IIIA breast cancer completed a 30-month post-diagnosis interview including questions on SCAM use. During the observation period, 70 breast cancer-specific deaths and 149 total deaths were reported, and 60.2 % of participants reported SCAM use post-diagnosis. No associations were observed between SCAM use and breast cancer-specific or total mortality. The authors concluded that SCAM use was not associated with breast cancer-specific mortality or total mortality.
Another 2018 study from the US investigated SCAM use and its impact on survival. The researchers included 281 patients with nonmetastatic breast, prostate, lung, or colorectal cancer who chose SCAM, administered as sole anticancer treatment. The results show that SCAM use was independently associated with greater risk of death compared with conventional cancer therapy (CCT). The authors concluded that SCAM utilization for curable cancer without any CCT is associated with greater risk of death.
The same group of researchers compared overall survival of patients with cancer receiving CCT with or without SCAM. They used the National Cancer Database on 1 901 815 patients from 1500 Commission on Cancer-accredited centres across the US who were diagnosed with non-metastatic breast, prostate, lung, or colorectal cancer between January, 2004, and December, 2013. Patients were matched on age, clinical group stage, comorbidity, insurance type, race/ethnicity, year of diagnosis, and cancer type. The entire cohort comprised 1 901 815 patients with cancer, 258 patients in the SCAM group and 1 901 557 patients in the control group. The results of this study showed that patients who received SCAM were more likely to refuse additional CCT, and had a higher risk of death. The results suggest that mortality risk associated with SCAM was mediated by the refusal of CCT.
Collectively, these studies do not demonstrate that SCAM use leads to a better prognosis of cancer patients. On the contrary, several investigations have suggested the opposite effect. There are several possibilities to explain why SCAM use shortens the life of cancer patients:
- Some of the therapies in question might have a direct adverse effect on cancer progression, for instance, by being toxic or by interacting with conventional cancer drugs.
- Patients who choose to use SCAM might be more ill that those who do not employ it. The Malaysian study3 quoted above suggests that this is a possibility. In several studies, however, this factor has been taken into account and is therefore an unlikely explanation.
- Patients who opt for SCAM might take conventional cancer treatments less seriously or even shun them completely. The last two of the above-cited studies seem to suggest that this is the most likely explanation.
Whatever the explanation, the fact is that SCAM, in whatever shape or form, does not improve the natural history of cancer… That is unless you can show me convincing evidence to the contrary.
 Risberg T, Vickers A, Bremnes RM, Wist EA, Kaasa S, Cassileth BR. Does use of alternative medicine predict survival from cancer? Eur J Cancer. 2003 Feb;39(3):372-7. doi: 10.1016/s0959-8049(02)00701-3. PMID: 12565991.
 Yun YH, Lee MK, Park SM, Kim YA, Lee WJ, Lee KS, Choi JS, Jung KH, Do YR, Kim SY, Heo DS, Kim HT, Park SR. Effect of complementary and alternative medicine on the survival and health-related quality of life among terminally ill cancer patients: a prospective cohort study. Ann Oncol. 2013 Feb;24(2):489-494. doi: 10.1093/annonc/mds469. Epub 2012 Oct 30. PMID: 23110809.
 Mohd Mujar NM, Dahlui M, Emran NA, Abdul Hadi I, Wai YY, Arulanantham S, Hooi CC, Mohd Taib NA. Complementary and alternative medicine (CAM) use and delays in presentation and diagnosis of breast cancer patients in public hospitals in Malaysia. PLoS One. 2017 Apr 27;12(4):e0176394. doi: 10.1371/journal.pone.0176394. PMID: 28448541; PMCID: PMC5407802.
 Neuhouser ML, Smith AW, George SM, Gibson JT, Baumgartner KB, Baumgartner R, Duggan C, Bernstein L, McTiernan A, Ballard R. Use of complementary and alternative medicine and breast cancer survival in the Health, Eating, Activity, and Lifestyle Study. Breast Cancer Res Treat. 2016 Dec;160(3):539-546. doi: 10.1007/s10549-016-4010-x. Epub 2016 Oct 21. PMID: 27766453; PMCID: PMC5558457.
 Johnson SB, Park HS, Gross CP, Yu JB. Use of Alternative Medicine for Cancer and Its Impact on Survival. J Natl Cancer Inst. 2018 Jan 1;110(1). doi: 10.1093/jnci/djx145. PMID: 28922780.
 Johnson SB, Park HS, Gross CP, Yu JB. Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable Cancers. JAMA Oncol. 2018 Oct 1;4(10):1375-1381. doi: 10.1001/jamaoncol.2018.2487. PMID: 30027204; PMCID: PMC6233773.