This is the second study published in the last year looking at outcomes of cancer patients using alternative medicine, showing a negative effect on survival. The same author, Skylar Johnson, was the lead author on both studies. Last year’s study looked at using alternative treatments instead of standard therapy, and the newly published study looks at patients who used at least one standard therapy.
In the current study, just published in JAMA Oncology, the researchers followed a cohort of 258 cancer patients who used alternative medicine, and 1032 matched patients who did not. They found:
Patients who chose CM did not have a longer delay to initiation of CCT but had higher refusal rates of surgery (7.0% [18 of 258] vs 0.1% [1 of 1031]; P < .001), chemotherapy (34.1% [88 of 258] vs 3.2% [33 of 1032]; P < .001), radiotherapy (53.0% [106 of 200] vs 2.3% [16 of 711]; P < .001), and hormone therapy (33.7% [87 of 258] vs 2.8% [29 of 1032]; P < .001). Use of CM was associated with poorer 5-year overall survival compared with no CM (82.2% [95% CI, 76.0%-87.0%] vs 86.6% [95% CI, 84.0%-88.9%]; P = .001) and was independently associated with greater risk of death (hazard ratio, 2.08; 95% CI, 1.50-2.90) in a multivariate model that did not include treatment delay or refusal.
All that means that cancer patients who used alternative medicine in addition to at least some standard therapy were more likely to refuse chemotherapy, radiation, or surgery. As a result patients using CM (complementary medicine, in the jargon chosen for the study) had a 5-year survival that dropped from 86.6% to 82.2%. This represents twice the risk of dying over this time.
The authors also point out that this difference was likely an underestimate of the negative effects of using CM, because the CM cohort were younger and healthier at baseline. So it is likely that using alternative medicine to treat your cancer more than doubles your risk of dying over the next five years.
Complementary, alternative and other such remedies all have a role to play in medical care. However, it is important to have all of the facts about a disease before just using one approach. Steven Jobs used alternative treatment for his pancreatic cancer, when he probably should have gone with tried therapies first. It is a great “back-up” but it is not a substitute.
I disagree with the premise that “alternative practices do not stand up to rigorous scientific scrutiny.” What makes a treatment “alternative” is NOT that it does not stand up to scientific scrutiny but that it is not taught in medical schools. Medical schools nearly exclusively teach about pharmaceuticals and surgery. What they teach is unduly influenced by pharmaceutical companies that are threatened by alternatives. It is a myth that the standard treatments of conventional western medicine have “rigorous scientific scrutiny.”
According to this study from the Archives of Internal Medicine, only 14% of the recommendations of the Infectious Disease Society of America had strong evidence from RCTs. Quoting Larry Dossey, M.D.:
The British Medical Journal recently undertook an general analysis of common medical treatments to determine which are supported by sufficient reliable evidence. They evaluated around 2,500 treatments, and the results were as follows: 13 percent were found to be beneficial 23 percent were likely to be beneficial Eight percent were as likely to be harmful as beneficial. Six percent were unlikely to be beneficial. Four percent were likely to be harmful or ineffective. This left the largest category, 46 percent, as unknown in their effectiveness. In other words, when you take your sick child to the hospital or clinic, there is only a 36 percent chance that he will receive a treatment that has been scientifically demonstrated to be either beneficial or likely to be beneficial. This is remarkably similar to the results Dr. Brian Berman found in his analysis of completed Cochrane reviews of conventional medical practices. There, 38 percent of treatments were positive and 62 percent were negative or showed “no evidence of effect.”
There is a surprisingly large amount of scientific evidence, including many high-quality randomized controlled trials that support the safety and efficacy of nutritional and herbal medicine.