Use of So-Called Alternative Medicine in the Management of Breast Cancer

Innovations in both the surgical and medical management of breast cancer over the past few decades have led to reductions in treatment-related morbidity and increases in overall survival. Despite these advancements in surgery, chemotherapy, radiation, endocrine therapy, and immunotherapy, a subset of patients continues to choose so-called alternative medicine (SCAM). The objective of this study was to describe the association of SCAM with survival in patients with breast cancer.

This cohort study analyzed data from the National Cancer Database on female patients diagnosed with breast cancer from 2011 through 2021. Survival time was compared among patients who received conventional treatment, conventional treatment plus SCAM, and SCAM only. Data were analyzed from May 2025 to December 2025.

The primary outcome was 5-year survival. Unadjusted 5-year survival was assessed by Kaplan-Meier analysis, and adjusted survival was assessed with a Cox proportional hazards model controlled for age, race and ethnicity, Charlson Comorbidity index, insurance type, facility type, region, year of diagnosis, cancer stage, and income.

Of 2 169 202 female patients with breast cancer identified, 2 157 219 (median [IQR] age, 62 [52-71] years) were included in the sample. A total of 2 106 665 patients (97.6%) received conventional therapy.

• 273 (<0.1%) received SCAM alone,
• 568 (<0.1%) received a combination of SCAM and coventional therapies,
• 49 713 (2.3%) received no treatment.

Compared with patients treated with conventional therapies, those treated with SCAM alone (adjusted hazard ratio [AHR], 3.67; 95% CI, 3.03-4.44; P < .001) or no treatment (AHR, 3.53; 95% CI, 3.48-3.58; P < .001) had the highest risks for mortality. Patients who received a combination of conventional therapies and SCAM were less likely to receive endocrine therapy (eg, 40.7% vs 65.2% in stage II; P < .001) and radiation (59.5% vs 36.6% in stage II; P < .001) compared with patients treated exclusively with conventional therapies. Receipt of a combination of conventional therapies and SCAM was associated with a higher mortality compared with being treated exclusively with conventional therapy (AHR, 1.45; 95% CI, 1.22-1.72; P < .001).

The authors concluded that, in this cohort study of data from female patients with breast cancer included in the NCDB, the use of SCAM instead of conventional therapies was uncommon but was associated with a reduction in survival time. Further study is warranted.

The full text of this study is worth reading. It shows clearly that patients who use SCAM – even as an additional therapy – tend to skip some live-saving treatments. Why? Possibly because SCAM therapists persuade them that this is a good idea. I have personally seen this happening several times. It means that the SCAM might well be harmless, but the SCAM therapist is not!

The list of investigations showing that SCAM is a risk factor for cancer patients undergoing oncological treatments is growing. The message for patients is important and clear: stay away from SCAM while receiving curative treatment. Later on, during the supportive or palliative phase of care, some forms of SCAM might be helpful for improving cancer patients’ quality of life. For people with a keen interest in this area, I recommend reading my book which attempts to define which forms of SCAM might be beneficial for cancer patients at what stage of the recovery.