Researchers identify factors associated with choosing alternative treatment for cancer and compare survival outcomes with conventional cancer treatment.
Some patients with cancer choose to use methods of alternative treatment for cancer rather than conventional cancer treatment. However, the effectiveness of alternative medicine is still unknown as research on the topic is limited in part due to lack of data and partly due to patient hesitancy to disclose alternative treatments to their medical providers.
As recently discussed in the British Medical Journal, researchers have attempted to address this knowledge gap, using data from a national database with the goal of identifying factors associated with alternative treatment selection and comparing the survival outcomes to conventional cancer treatment.
The American study was recently published by JNCI: Journal of the National Cancer Institute. Conducted at the Yale School of Medicine, researchers identified patients from the US National Cancer Database from 2004 to 2013 with breast, prostate, lung, or colorectal cancer—the four most prevalent types—who chose to be solely treated with alternative medicine therapies.
The patients included in the study were those who chose an alternative treatment for cancer and did not receive chemotherapy, radiotherapy, surgery, and/or hormone therapy. Researchers did not include patients diagnosed with metastatic disease, stage IV disease according to the American Joint Commission on Cancer (AJCC) system, or in receipt of upfront palliative treatment. Scientists also excluded those with unknown treatment status and/or demographic and clinical factors.
The survival rates of the 281 selected patients who chose the alternative medicine route were compared with 560 conventional treatment patients, matched for demographic and clinical factors. After statistic analyses were completed, the results showed that, overall, patients who pursued alternative treatment for cancer had markedly worse five-year survival rates than those who underwent conventional therapy. Even after controlling for clinical and demographic factors, choosing alternative medicine over traditional treatment was an independent predictor of an increased risk of death.
Of course, the increased risk varied according to the type of cancer. Breast cancer patients who chose the alternative medicine route yielded the greatest increase—a staggering fivefold—in the risk of death. Those with lung cancer experienced the lowest with a more than twofold increase in risk. There was no significant difference observed for those with prostate cancer, which may have been due to the naturally slowly progressing nature of the disease. The results also showed several trends consistent with prior research in patients who opted for alternative medicine: younger age, breast cancer, higher education and income, Pacific region, and more advanced stage of cancer.
The researchers remind us, however, to note that complementary and integrative medicine is different from alternative medicine, as defined by their study. While complementary and integrative medicine includes a wide range of treatments that complement conventional medicine, alternative medicine usually consists of unproven therapies and techniques which are used in place of conventional treatment.
Some limitations of this study include its observational nature as well as other limitations of the data such as unmeasured confounders or selection bias that could impact survival. However, because patients receiving alternative medicine were most probably younger, more affluent, more well-educated, and less burdened with comorbidities, the researchers say that these would not likely account for the observed survival differences.
In all, the study found that patients who opted for alternative treatment for cancer instead of conventional treatment were at a greater risk of death. The researchers stress that improved communication needs to occur between patients and their medical providers and that further research must be done to assess the safety and effectiveness of certain alternative medicine treatments. This will ensure better outcomes and quality of life for cancer patients.
Written by Rebecca Yu
McCarthy, M. (2017). Cancer patients who opt for alternative treatment at greater risk of death, study finds. BMJ. 358:j4006 doi: 10.1136/bmj.j4006
Johnson, S. B., Park, H. S., Gross, C. P., & Yu, J. B. (2018). Use of Alternative Medicine for Cancer and Its Impact on Survival. JNCI: Journal of the National Cancer Institute, 110(1).