Cancer patients who use complementary medicine have higher risk

Cancer patients who use complementary medicine have a higher risk of dying because they are more likely to forego key parts of their conventional treatment, a new study warns.

In recent years there has been a boom in the rate of patients using ‘complementary medicine’ – such as vitamin D supplements, cannabis oil, and acupuncture – alongside their traditional chemotherapy, radiotherapy or surgery.

Unlike people who practice ‘alternative therapy’ (using only non-traditional treatments), complementary medicine patients use these methods as an added boost.

However, research by Yale University shows most people with treatable cancers who try these complementary methods tend to forego at least one component of the conventional treatment that their doctor recommends.

Unequivocally, those who did drop part or all of their treatment in favor of complementary medicine had a higher risk of death. 

Lead author of the study Dr Cary Gross told the findings show that doctors, who may turn their nose up at non-traditional treatments, need to be open about discussing such things with their patients, who may be desperate for something to alleviate the pain of cancer but are forced to weigh up the pros and cons on their own.

The use of CBD oil (file image pictured) has become ubiquitous in recent years since more than half of the US has legalized medical marijuana. Vitamins, probiotics, and plant-based diets have also taken off as popular approaches to control various types of cancers

‘I think for some patients, [complementary therapy] is a very reasoned and informed choice; they understand the risks and benefits and they have elected to go that route,’ Dr Gross, of Yale Cancer Center, said.

‘However, I’m concerned that there’s a larger group that may not have been well informed and they may have been misinformed about the benefits. If you look at what’s out there on the web, there is a myriad of claims about what these treatments can do. 

‘Physicians’ lack of comfort discussing these alternative therapies, and lack of knowledge about them, perpetuates the feeling among patients that they cannot discuss it with their doctor for fear of feeling belittled or ignorant. Too many think that doctors are just working for Big Pharmaceutical companies and are more focused about profits than their comfort.

‘We need to work out why these things help cancer patients feel better, and to be open to discussing that.’

Dr Gross said the study idea came from casual discussions between the team members, colleagues at Yale Cancer Center who all work in various fields – from primary care (like Gross) to radiotherapy. 

‘The overarching concern that we have all been sharing with one another is that we have all had experiences speaking to patients with cancer who have said they are going to forego traditional treatment in favor of something else,’ he explained. 

‘For example, a breast cancer patient for whom radiation was recommended to reduce recurrence to the breast would say “I’m just going to get acupuncture instead”.’

Dr Gross insists he, personally, is not opposed to patients incorporating non-traditional therapies into their lives to ease the pain of cancer or in the hope that it will aid their treatment. 

However, he said he realized that neither he nor any of his colleagues could answer the burning question: is it helpful, harmful, or futile?  

‘Past research into why patients use non-medical complementary treatments has shown the majority of cancer patients who use complementary medicines believe their use will result in improved survival,’ said the study’s senior author, James Yu, MD, associate professor of therapeutic radiology at Yale Cancer Center. 

‘We became interested in this topic after we reviewed the literature, and found that there was scant evidence to support this belief.’

The study was an attempt to inject some clarity into the murky field of research on complementary medicines, which fall outside the remit of medicines prescribed by a qualified doctor. 

The use of CBD oil, for example, has become ubiquitous in recent years, particularly since more than half of the US has legalized medical marijuana. Vitamins, probiotics, and plant-based diets have also taken off as popular approaches to control various types of cancers.

However, few studies have looked at how patients use these medicines – whether as an extra boost or a replacement – and whether it proves effective for them.  

The team looked at 10 years of data on 1,290 patients in the National Cancer Database (which accounts for 70 percent of US cancers) who had breast, prostate, lung, or colorectal cancer.

Among them, they found that 258 had used complementary medicine, compared to 1,032 who had not, between 2003 and 2014.

They found that even those who’d had one form of conventional cancer treatment had a higher risk of death if they’d used complementary medicine too. 

The reason for that, they said, appeared to be that those patients were more likely to reject follow-up conventional treatment.    

‘The fact that complementary medicine use is associated with higher refusal of proven cancer treatments as well as increased risk of death should give providers and patients pause,’ said lead author Skyler Johnson, MD, chief resident in radiation oncology at Yale School of Medicine. 

‘Unfortunately, there is a great deal of confusion about the role of complementary therapies. 

‘Although they may be used to support patients experiencing symptoms from cancer treatment, it looks as though they are either being marketed or understood to be effective cancer treatments.’

Dr Gross said the findings should be seen as an invitation to conduct more studies that focus on patients’ real concerns to avoid patients turning to Dr Google over their own physician. 

‘Research that focuses on the patient rather than the cancer is grossly under-funded,’ he said. 

‘Why is it that people who get complementary medicine are more likely to refuse traditional therapy? Maybe it reflects a lack of faith in traditional medicine, and a lack of options for treatments that ease the pain of cancer.

‘The critical next step is to conduct research that answers questions patients have so they can discuss it with their physician.’