As featured in a Cancer Research UK article, Receiving the news that you have cancer can come about as a big shock, leaving you asking hundreds of questions. It is because of this that it is essential that patients have access to the best advice, founded on accurate information so that they can make informed decisions about their treatments.
If you research online, you will find a myriad of articles relating to more easily accessible and less daunting forms of treatment when compared to the standard medical approach.
These non-medical therapies include treatments such as herbal medicines or aromatherapy, and when combined with traditional medical therapies they are known as complementary therapies.
Dr. Skyler Johnson, a radiation oncologist from Yale University in the US, says he has experienced seeing his own patients gravitate toward these types of complementary treatments to increase their chances of survival.
“There’s really no evidence that supports people’s beliefs that complementary medicine can improve survival,” says Johnson.
There’s really no evidence that supports people’s beliefs that complementary medicine can improve survival.
– Dr. Skyler Johnson, Yale University
And a new study from Johnson and his team, published in the Journal of the American Medical Association, aims to measure the impact that complementary medicine might have. The results suggest that the likelihood of dropping out of conventional medical treatments increased amongst patients that were also taking complementary medicine. And, as a result of this, they were more likely to die.
“Some medical professionals, ourselves included, though when a patient comes in and says they want to try a complementary medicine instead of a conventional cancer treatment we could convince them to do both,” says Johnson. “It seems like a good compromise, and we thought they’d still do just fine.”
But unfortunately, there’s no evidence to support these assumptions. “That’s why we felt it was important to do this study.”
The study involved picking out patients who had been diagnosed with the four most common types of cancer (breast, lung, prostate and bowel cancer) and were deemed treatable by traditional cancer treatments.
They then selected all the patients whose records said they’d chosen to have a complementary treatment with at least one additional conventional cancer treatment such as surgery, radiotherapy or chemotherapy.
The selected people were then matched with others in the sample who hadn’t received additional treatments but shared similar factors, like cancer type, cancer stage, and age.
“These are the features that impact survival,” says Johnson. “It meant we could eliminate these confounding factors that would otherwise impact the results.”
After analyzing the data, it appeared that both groups started their recommended conventional treatment at a similar time. But those who chose to use complementary therapies were more likely to opt out of additional medical treatment further down the line. The team then compared the overall survival of the two groups.
“The results say that cancer patients who chose to use complementary medicines in addition to conventional cancer treatment were at an increased risk of death,” says Johnson. “The results say that cancer patients who chose to use complementary medicines in addition to conventional cancer treatment were at an increased risk of death.” – Dr. Skyler Johnson, Yale University
Crucially, they found that the risk of death was even higher for the people who thought they could use complementary treatments to replace part of the treatment recommended by their doctor.
“Most people are combining complementary treatments with conventional cancer treatments thinking that it was the best of both worlds,” says Johnson.
The concern is that patients engaged in complementary therapies are more likely to forgo the complete conventional medical therapies as they tend to pick and choose complementary treatments, especially with regards to chemotherapy.
“From the data, it looks like most patients in the complementary medicine group had surgery but were more likely to turn down radiotherapy and chemotherapy.” It just showed that in general, these patients didn’t do as well as their matched counterparts. But it wasn’t able to determine why.
Patients in the complementary medicine group were more likely to be of a younger demographic than those who opted not to have complementary medicine.
“One of the very nuanced and interesting parts of this study is that this young female group, who in general have a lower cancer risk and a better chance of survival if they do develop cancer, were more likely to use complementary medicines.”
Interestingly, the study showed taking these additional treatments didn’t impact their survival. “However, in theory, if complementary medicine were to boost survival, then this group taking complementary medicine should be doing better than those who aren’t.”
Some important factors have to be considered, even though this study suggests a link between the use of non-medical cancer treatments and a lower chance of survival.
First, the study relied on people telling their doctors if as patients, they had received additional non-medical treatment. “The reality is that patients aren’t always telling their doctors the decisions they’re making and what they’re doing,” says Johnson. So it is not a stretch to consider that many of these patients may be taking complementary therapies outside of their doctors’ knowledge.
Secondly, the spectrum of classification for complementary medicines and treatments is broad. In this particular study, it defined a complementary medicine as “an unproven cancer treatment administered by non-medical personnel,”
Lastly, the use of complementary medicine is typically not recorded, the number of people who the team could be sure used additional treatments was small. A more accurate picture is needed by comparing a more significant sample.
Johnson has stated that he cannot infer as to why people decided to use these additional treatments. “This study quantifies for us who’s doing what and how often they are doing it and what is the results of those decisions.”
“I think in the future we’ll need to tease out some of the behavioural aspects of this,” Johnson says.
It is essential that patients considering complementary therapies do not see them as an alternative to conventional treatments that have been shown through clinical trials to make a real difference to survival. -Martin Ledwick, Cancer Research UK
“It is important that patients considering complementary therapies do not see them as an alternative to conventional treatments that have been shown through clinical trials to make a real difference to survival,” says Ledwick.
“In this study people with potentially treatable cancers who delayed or refused conventional treatments while they tried complementary approaches had a greater risk of dying.” He says it’s essential that people are now made aware of this.
Johnson’s next step is to figure out what information people value and make that information readily available and consumable so that people can make more informed decisions. Ledwick concurs that patients need more support to understand what the expectations from
conventional treatments are and to be aware of “the significant risk of substituting these with unproven therapies.”
Patients have the right to make their own decisions about treatment, but they need the right information to make better ones. This study sheds some light on the issue. Please note, the contents of this article do not necessarily represent the official position of the PSMO. If you have any health concerns, please consult your general physician. For any cancer-related concerns and to ensure the best possible advice, please speak to a Cancer Expert. If you would like to reach out to the PSMO, please contact us here or search for your closest
PSMO doctor here.