Las Vegas Review-Journal

Alternativ­e cancer treatments have risks

- By Jane E. Brody New York Times News Service

Adiagnosis of cancer, even an early-stage, highly curable cancer, can prompt some people to feel as if they’ve suddenly lost control of their future and that they must do whatever they can to regain it.

They may seek guidance from the internet, friends and acquaintan­ces, some of whom may be quick to relate tales of miraculous cures from alternativ­e remedies that claim to spare patients the challenges of establishe­d cancer treatments like surgery, radiation and chemothera­py.

One web-based group, Integrativ­e Cancer Answers, states that as many as 83 percent of cancer patients choose to use one or more forms of alternativ­e medicine, ranging from acupunctur­e and herbs to vitamins and yoga, most often in conjunctio­n with therapies clinically proven to be effective.

However, a small but significan­t number of cancer patients reject the treatments offered by mainstream oncologist­s and seek instead alternativ­e remedies that lack the support of scientific­ally valid research. Their reasons range from wanting to feel empowered by making their own treatment decisions to avoiding toxic side effects by selecting remedies they consider harmless.

But are they really harmless? When remedies that have been proved beneficial are replaced by those supported primarily by wishful thinking, anecdotes and sloppy science (if any science), the result can be a death sentence.

In a recent study by researcher­s at the Yale School of Medicine of 281 patients with potentiall­y curable cancers of the breast, lung, colon-rectum or prostate that had not yet spread beyond their site of origin, the use of alternativ­e medicine in lieu of convention­al cancer treatments resulted in an overall death rate 2 1/2 times higher than the rate experience­d by patients getting standard therapies.

Among women with breast cancer, choosing alternativ­e remedies resulted in a nearly sixfold increase in the chance of dying during an average follow-up period of 5 1/2 years. For patients with colon or rectal cancer who chose alternativ­e treatments, the death rate was 4 1/2 times higher. And for those with lung cancer, the rate was twice as high.

Only men with prostate cancer who rejected standard treatments experience­d no difference in the risk of death during the follow-up period, a result, the researcher­s suggested, that most likely reflects the typical slow growth of prostate cancer. The findings were published in the Journal of the National Cancer Institute.

The research team, led by Dr. Skyler Johnson, a therapeuti­c radiologis­t, emphasized an important point: Alternativ­e medicine, which the authors defined as “an unproven therapy that was given in place of convention­al treatment,” is not the same as complement­ary or integrativ­e treatments, which are used as additions, or complement­s, to standard cancer care.

Too often, when “alternativ­e medicine” is used instead of standard medical treatments, it delays the use of remedies known to be effective and gives an early curable cancer time to become lethal.

In a related report in JAMA Oncology, Johnson’s team wrote that the higher death rate associated with the alternativ­e treatments used by patients in their study was likely to have been “mediated by the refusal of convention­al cancer treatment.”

“Complement­ary medicine,” on the other hand, carries fewer risks, since it is used along with standard remedies, most often to lessen side effects and enhance feelings of well-being. If chosen properly, complement­ary therapies should not interfere with the benefits of establishe­d treatments.

“Integrativ­e medicine” refers to a combined approach of medically establishe­d remedies with one or more practices used in complement­ary and alternativ­e medicine known to be safe and effective.

However, not every alternativ­e treatment that patients latch onto is safe. Some may interfere with the effectiven­ess of establishe­d remedies or cause adverse reactions when combined with them. This is most likely to happen when patients use them without first discussing their intention with their doctor.

The American Cancer Society acknowledg­es that “many doctors may not know about the use, risks, and potential benefits of these unconventi­onal treatments.” Still, the organizati­on urges patients to let their doctors know they are considerin­g a complement­ary remedy, “to make sure it won’t interfere with” their regular medical treatment.

Patients are urged to make a list of all dietary supplement­s they are taking or plan to take and let their doctors know about them. Doctors can help patients identify products that are fraudulent or dangerous.

It is likely, the society notes, that there are “mainstream methods for treating the side effects or symptoms” associated with cancer and its establishe­d treatments that the doctor can recommend.

Most important, the organizati­on says: “Don’t delay or skip regular treatment without warning. If you’re thinking about stopping or not taking mainstream treatment, please talk to your doctor about this.”

All the same, the cancer society maintains that treatment decisions ultimately are up to the patient. “Even though you may be giving up the only proven treatment for your cancer, this is still your choice to make,” the society’s advisory states.

Assuming that you will use an alternativ­e method as a complement to, not a substitute for, convention­al treatment, the Mayo Clinic suggests 10 options that are safe and “may help you cope with signs and symptoms caused by cancer and cancer treatments such as anxiety, fatigue, nausea and vomiting, pain, difficulty sleeping, and stress.”

Acupunctur­e can help relieve nausea and pain, the clinic states.

Aromathera­py may also help relieve nausea, pain and stress, but patients are cautioned against using large amounts of lavender oil and tea tree oil on their skin.

Exercise can relieve fatigue and stress and improve sleep.

Hypnosis may control pain and reduce stress.

Massage can relieve pain and may also reduce anxiety, fatigue and stress, although it may not be safe for patients with low blood counts.

Meditation can relieve anxiety and stress.

Music therapy has been shown to relieve pain and control nausea and vomiting.

Relaxation techniques like progressiv­e muscle relaxation can improve sleep and relieve anxiety and fatigue.

Tai chi can relieve stress and improve strength and balance.

Yoga also may reduce stress and fatigue and improve sleep.

 ?? EDEL RODRIGUEZ / THE NEW YORK TIMES ?? Not every alternativ­e treatment that patients latch onto is safe. Some may interfere with the effectiven­ess of establishe­d remedies or cause adverse reactions when combined with them.
EDEL RODRIGUEZ / THE NEW YORK TIMES Not every alternativ­e treatment that patients latch onto is safe. Some may interfere with the effectiven­ess of establishe­d remedies or cause adverse reactions when combined with them.

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