Richer, younger, smarter cancer patients choose alternative medicine

People who choose to get alternative treatments for cancer tend to have everything else going for them – being happier, younger, wealthier, and more educated. 

Yet those who try to treat curable cancers with alternative medicines – including crystals and homeopathy – are 5.68 times more likely to die than people who get traditional treatments.

The alternative medicine business is booming in the US, where it is worth $34 billion, even though only a third of its ‘treatments’ have been tested.

But more highly-educated people may be sabotaging themselves by believing that they are smart enough to spot a real success story over snake oil instead of trusting doctors. 

Survival rates for patients with curable cancers were significantly worse for those who got alternative treatments (solid) than for those who had traditional ones (dashed)

Dr Skyler Johnson, lead author of a study on cancer survival times and alternative medicine, found out that his wife had been diagnosed with a late stage lymphoma while he was in medical school.

The first thing the couple did was to ignore all of the advice that Dr Johnson gives his patients: they went online.

‘There was so much misinformation there, and it was hard for me to sift through it, and I thought, “if I have some medical training, and good education, then how hard is it for someone who doesn’t to tell what’s real?”‘ he says. 

The more ‘worldly’the person, the better educated ones are trying to figure out what they can do for their cancer and start researching far a field. It kind of makes sense

Dr James Yu, study author and radiologist

‘So I totally empathize with the patients who do that after getting a diagnosis from doctors who don’t really speak their language as well as they should so [the patients] go to the internet,’ says Dr Johnson, who is now a radiology resident at Yale University. 

In fact, he and Dr James Yu, director of the school’s prostate and genitourinary cancer radiotherapy program, both theorize that being more educated may make people like Dr Johnson more likely to go looking for alternative therapies because they fancy themselves competent to choose a good one.

There is a kind of ‘mirror effect,’ Dr Yu says. 

‘The more “worldly” the person, the better educated ones are trying to figure out what they can do for their cancer and start researching far a field,’ he says. ‘It kind of makes sense.’ 

But, Dr Yu warns, ‘that’s a trap.’

Lung cancer patients that only did alternative treatments have far worse five-year survival times than those who had traditional treatments 

Lung cancer patients that only did alternative treatments have far worse five-year survival times than those who had traditional treatments 

Survival for people who treated bowel cancer in non-traditional ways fell off steeply after about 40 months 

Survival for people who treated bowel cancer in non-traditional ways fell off steeply after about 40 months 

He added: ‘Steve Jobs is an example of somebody who initially pursued non-medical therapy [to treat his pancreatic cancer] and subsequently got traditional therapy. 

‘But at that stage, you are allowing your cancer to grow, which will make it worse than if you pursued appropriate therapy in the first place,’ he says. 

Steve Jobs reportedly tried alternative medicines to treat his pancreatic cancer before his death in 2011

Steve Jobs reportedly tried alternative medicines to treat his pancreatic cancer before his death in 2011

In spite of both his eventual traditional treatments and attempts at alternative – including rumored dietary measures – Jobs succumbed to cancer in 2011.

Though they never resorted to traditional medicine, alternative medicine patients whose data Dr Yu and Dr Johnson analyzed faced the same fate: they were more than twice as likely to die within five years of their diagnoses than those who got traditional treatments.

In their study, Dr Yu and Dr Johnson looked at survival rates for people who had been diagnosed with breast, prostate and bowel cancers. 

The odds that someone with more than a high school level of education would get an alternative treatment for one of those cancer were higher for those who were less educated.

‘Maybe these people have just enough education to think that they may know better [than their doctors] but in reality they might not,’ says Dr Johnson.  

Higher degrees of education and higher incomes often go hand-in-hand, as was true in their study. 

More disposable income also means that these patients can afford to pay out-of-pocket for alternative treatments not covered by their insurance. 

 Maybe these people have just enough education to think that they may know better [than their doctors] but in reality they might not

Dr Skyler Johnson, study author and radiology resident

‘We know that complementary and alternative medicine is a growing, multi-billion-dollar industry, and one where patients pay more out of pocket [for treatment] than they pay doctors,’ says Dr Johnson. 

The industry has done nothing but grow in recent years, and Grand View Research even projected that it will be worth nearly $200 billion globally by 2025.

Its rise in popularity, Dr Johnson suggests, is driven in part by clever and ubiquitous online marketing campaigns, including tempting stories of seemingly miraculous recovery. 

But, in reality, these alternative ‘medicines’ – which may include anything from special diets to cannabis oil and acupuncture – have not been properly studied as cancer treatments. 

‘In many cases, it would be unethical to randomize a patient [in a trial] between a proven therapy and quackery,’ says Dr Yu. 

‘So it’s difficult to disprove the quackery because you don’t want to give it to someone fighting cancer because it won’t work,’ he adds.   

Patients have reported that therapies like acupuncture and massage have helped to assuage the unpleasant side effects of proven cancer therapies, and doctors typically take no issue with this. 

But desperation and fear – both of death and of these side effects – evidently drive some to try these therapies instead of traditional ones. 

Prostate cancer survival rates were fairly high overall, but were still lower for alternative medicine patients

Prostate cancer survival rates were fairly high overall, but were still lower for alternative medicine patients

Breast cancer patients that forewent proven treatment deteriorated quickly 

Breast cancer patients that forewent proven treatment deteriorated quickly 

Dr Johnson and Dr Yu’s study backs that notion up. They found that people in later stages of their cancers were more likely to forego traditional treatment. 

‘When faced with a treatment that can be difficult and you can be scared and try to think that there’s a treatment out there that has the benefit and not the side effects,’ says Dr Yu. 

‘It’s human nature to deny reality,’ he adds. 

The reality is that there are countless unproven treatments being showcased online, and the differences between real science and ‘quackery.’ 

So Dr Johnson decided to make the CRAP test for crap science. 

His clever evaluation method uses scores for four factors to determine whether information about alternative ‘medicines’ can be trusted: conspiracies or claims too good to be true, requests for money, anecdotes, and publisher credentials.  

 It’s human nature to deny reality

Dr Johnson knows, from his own experience with his wife, that after a cancer diagnosis, ‘your first instinct is going to be to go home and look for things, and most can’t be trusted.’ 

He advises his patients to use the CRAP factors during their own information gathering, ‘but I don’t say “don’t go to that website,” because if my doctor said that that’s probably the first thing I’d do.’ 

The pair of doctors acknowledge that, even if they are placebo effects, many patients may simply feel better if they seek and use alternative treatments, and that’s alright, so long as they do it in coordination with proven treatments.

‘We as physicians need to do a better job of understanding that patients want to participate in their therapy,’ says Dr Yu.

‘We need to listen to them so we can help to persuade them to do traditional therapies with complementary alternative therapies,’ and not forego proven, potentially life-saving treatments. 

DR SKYLER JOHNSON’S TEST FOR SPOTTING ‘CRAP’ SCIENCE 

When his wife was diagnosed with cancer while radiologist Dr Skyler Johnson was in medical school, even he struggled to wade through the wealth of misinformation he found online.   

So Dr Johnson decided to make the ‘CRAP’ test for crap science. 

His clever evaluation method uses scores for four factors to determine whether information about alternative ‘medicines’ can be trusted: conspiracies or claims too good to be true, requests for money, anecdotes, and publisher credentials.  

Dr Johnson knows, from his own experience with his wife, that after a cancer diagnosis, ‘your first instinct is going to be to go home and look for things, and most can’t be trusted.’ 

He advises his patients to use the CRAP factors during their own information gathering, ‘but I don’t say “don’t go to that website,” because if my doctor said that that’s probably the first thing I’d do.



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