MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

The integration of so-called alternative medicine (SCAM) into cancer care may reduce the adverse effects of anti-neoplastic treatment but also cause new problems and non-adherence to conventional treatment. Therefore, its net benefit is questionable.

The aim of this randomized controlled study was to investigate the impact of integrative open dialogue about SCAM  on cancer patients’ health and quality of life (QoL).

Patients undergoing curative or palliative anti-neoplastic treatment were randomly assigned to standard care (SC) plus SCAM or SC alone. A nurse specialist facilitated SCAM in one or two sessions. The primary endpoint was the
frequency of grade 3–4 adverse events (AE) eight weeks after enrollment. Secondary endpoints were the frequency of grade 1–4 AE and patient-reported QoL, psychological distress, perceived information, attitude towards and use of SCAM 12 and 24 weeks after enrollment. Survival was analyzed post-hoc.

Fifty-seven patients were randomized to SCAM and 55 to SC.  No significant differences were found in terms of AEs of cancer patients. A trend towards better QoL, improved survival, and a lower level of anxiety was found in the SCAM group.

The authors concluded that integration of SCAM into daily oncology care is feasible. IOD-CAM was not superior to SC in reducing the frequency of grade 3-4 AEs, but it did not compromise patient safety.  Implementation of  SCAM
may improve the QoL, anxiety, and emotional well-being of the patients by reducing the level of nausea, vomiting and diarrhea. Finally, SCAM potentially improves the patients’ self-care, which contributes to
increased treatment adherence and improved survival.

This is an interesting paper with a very odd conclusion. The positive trends found failed to be statistically significant. Why employ statistics only to ignore them in our interpretation of the findings?

I can well imagine that the integration of effective treatments into cancer care improves the outcome. I have no problem with this at all – except it is not called INTEGRATIVE MEDICINE but EVIDENCE-BASED MEDICINE!!! If we integrate dubious treatments into cancer care, it’s called INTEGRATIVE MEDICINE, and it’s unlikely to do any good.

In my view, this small study showed just one thing:

Integrative medicine does not reduce adverse effects in cancer patients.

 

2 Responses to Integrative medicine does not reduce adverse effects in cancer patients.

  • This is an interesting paper with a very odd conclusion. The positive trends found failed to be statistically significant. Why employ statistics only to ignore them in our interpretation of the findings?

    In my experience many doctors regard a non-significant trend in the data to be a pointer to what the study would have shown if the number of subjects had been greater. Statisticians, of course, know that this is not the case. However, you often see doctors pointing out trends in their research at scientific meetings, and everybody else nodding sagely instead of calling them out for fundamentally misunderstanding the mathematics of probability.

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