As the interest and value of “natural” remedies increases, 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, hormone therapies, targeted therapies and immunotherapies). Although there are few studies on this topic, overall, the complementary use of these therapeutic approaches does not appear to prolong or shorten survival, and the data is mixed as to whether they improve or reduce the quality life of patients.2-4
Alternative medicine is generally defined as unproven treatments intended to replace conventional cancer therapies. Studies on alternative medicine in oncology are even more limited than those on complementary medicine in oncology.5 Yet several recently published studies suggest that substituting conventional cancer treatment for alternative treatments is associated with shorter survival.
Alternative medicine as a cancer treatment
A retrospective study of 280 patients with non-metastatic breast, lung, colorectal or prostate cancer who switched from conventional treatment to alternative treatments and 560 matched patients who received conventional treatment evaluated survival outcomes on a median follow-up of 66 months.5
Overall, patients who used alternative treatments had a significantly shorter 5-year survival of 55% versus 78% in patients who received conventional treatment (relative risk [HR], 2.21; 95% CI, 1.72-2.83; log rank P
Analyzed separately, survival was significantly shorter for patients with breast, lung and colorectal cancer, but not for those with prostate cancer. The authors concluded that the lack of significance for patients with prostate cancer was due to the fact that the majority of patients in the sample (75%) had low to intermediate risk disease, which is often supported by observation. Additionally, prostate cancer generally has a slow natural progression and the follow-up time in this study was too short to detect any 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 residence in a region of Intermountain West or Pacific.
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 therapy, more refused surgery, chemotherapy, radiotherapy and hormone therapy than patients who received only conventional treatments.
Additionally, patients who used complementary medicines had a shorter 5-year overall survival than those who did not receive complementary therapies (82% vs. 87%; P
However, for patients who received complementary medicine 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 death rates.