Patients who choose to receive alternative therapy as the treatment for curable cancers, instead of conventional cancer treatment, have a higher risk of death, according to Yale research.
The researchers were from the Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Centre at Yale School of Medicine and Yale Cancer Centre.
There is increasing interest by patients and families in pursuing alternative medicine as opposed to conventional cancer treatment. This trend has created a difficult situation for patients and providers. Although it is widely believed that conventional cancer treatment will provide the greatest chance at cure, there is limited research evaluating the effectiveness of alternative medicine for cancer.
While many cancer patients use alternative therapy in addition to conventional cancer treatments, little is known about patients who use alternative therapy as their only approach to treating their cancer.
“We became interested in this topic after seeing too many patients present in our clinics with advanced cancers that were treated with ineffective and unproven alternative therapies alone,” said the study’s senior author, Dr James B Yu, associate professor of therapeutic radiology at Yale Cancer Centre.
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.”
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.
Skyler B Johnson, Henry S Park, Cary P Gross, James B Yu
[link url="https://news.yale.edu/2017/08/10/using-only-alternative-medicine-cancer-linked-lower-survival-rate"]Yale University material[/link]
[link url="https://academic.oup.com/jnci/article-abstract/110/1/djx145/4064136/Use-of-Alternative-Medicine-for-Cancer-and-Its?redirectedFrom=fulltext"]Journal of the National Cancer Institute abstract[/link]