As the interest and value of “natural” remedies has increased, so has the use of complementary therapies.1 Complementary therapies include dietary supplements, mind-body strategies, body manipulation, acupuncture, and alternative medicine systems used in conjunction with conventional cancer treatments (e.g., chemotherapy, radiation therapy, hormonal therapies, targeted therapies, and immunotherapies). Although there are few studies on this topic, overall, adjunctive use of these therapeutic approaches does not appear to prolong or shorten survival, and data are mixed regarding whether they improve or reduce quality of the patient’s life.2-4
Alternative medicine is generally defined as unproven treatments intended to replace conventional methods. anticancer therapies. Studies on alternative medicines against cancer are even more limited than those on complementary medicines in oncology.5 However, several recently published studies suggest that replacing conventional cancer treatment with alternative treatments is associated with shorter survival.
Alternative medicine as a treatment for cancer
A retrospective study of 280 patients with non-metastatic breast, lung, colorectal, or prostate cancer who replaced conventional therapy with alternative treatments and 560 matched patients who received conventional therapy evaluated survival outcomes over a median follow-up period of 66 months.5
Overall, patients who used alternative treatments had a significantly shorter 5-year survival, 55%, compared with 78% in patients who received conventional treatment (hazard ratio (HR), 2.21; 95% CI, 1.72-2.83; log-rank P.
<.001).
Analyzed separately, survival was significantly shorter for patients with breast, lung, and cancer. colorectal cancer, but not in people with prostate cancer. The authors concluded that the lack of significance for prostate cancer patients was because the majority of patients in the sample (75%) had low-to-intermediate risk disease, which is often taken in charge under observation. Additionally, prostate cancer generally has a slow natural progression, and the follow-up time in this study was too short to detect differences.
The study found that predictors of alternative medicine use were higher socioeconomic status, low comorbidity score, stage II/III disease, breast or lung cancer, and having reside in an Intermountain West or Pacific region.
Another similar retrospective study included 1.9 million patients with non-metastatic breast, lung, colorectal, or prostate cancer; of which 258 patients received complementary medicine in addition to conventional cancer treatment.6
Although these patients received conventional treatment, more refused surgery, chemotherapy, radiotherapy, and hormonal therapy than patients who received only conventional treatments.
Additionally, patients who used complementary medicines had a 5-year shorter overall survival than those who did not receive any complementary therapy (82% versus 87%; P. <0.001), and it was associated with increased mortality (HR, 2.08; 95% CI, 1.50-2.90). However, when adjusted for refusal or delay of treatment, this association was no longer significant, suggesting that the increased risk of death is not necessarily due to the use of complementary medicine itself, but to the refusal or delay of conventional treatment.
However, for patients who received complementary medications and also continued their conventional treatments, there was no difference in mortality rates compared to patients receiving conventional chemotherapy alone. This suggests that patients who started but then refused other conventional treatments were those with higher mortality rates.
