Posted On: 16/08/2017
"Cancer patients who use alternative medicine more than twice as likely to die," is the stark message from The Independent. Researchers found that people who chose alternative medicine instead of conventional cancer treatments were much less likely to survive for at least five years.
Overall, 78% of people having conventional treatment for cancer survived at least five years, compared to only 55% of people having alternative treatment alone. The difference was biggest for breast cancer, where people who chose alternative therapies were more than five times as likely to die within five years as those who chose conventional treatments.
Because this is an observational study, we don't know if other factors might have affected people's survival chances, as well as treatment choice. However, treatment choice seems the most likely explanation.
There are reports that some people find complementary treatments of benefit during cancer treatments. For example, some people have said thatÃ‚Â acupuncture helped them cope better with the side effects of chemotherapy.
But importantly, the emphasis is very much on the "complementary" and not on the "alternative". Ignoring medical advice on the treatment choices that potentially offer the most benefit couldÃ‚Â prove fatal.
The study was carried out by researchers from Yale School of Medicine. No funding information was provided. Two of the four researchers had received previous grants from companies involved in conventional cancer treatments, and one received research funding from the organisation 21st Century Oncology.
The study was published in theÃ‚Â peer-reviewed Journal of the National Cancer Institute as a "brief communication", meaning not all the study data was published. Some additional data is published online.
Most of the UK media ran reasonably accurate and balanced stories. Several Ã¢â‚¬â€œ notably the Mail Online and The Sun Ã¢â‚¬â€œ speculated on the types of alternative therapy people might have been using.
For example, the Mail said: "Breast cancer patients are 5.68 times more at risk if they opt for homeopathy." However, the researchers did not record the alternative therapies used, so we don't know whether homeopathy was one of them.
The Mail also refers to "herbs, botanicals, diets or energy crystals." While these are sometimes promoted as alternative treatments for cancer, again, we don't know which of them were used by people in this study.
This was an observational case control study. This means researchers identified people with cancer who chose to use alternative therapies (cases) and compared their outcomes with those of people with cancer who chose conventional treatments (controls).
The controls were matched as far as possible with each case based on age, sex, demographics and type of cancer. Observational studies can show trends and links between factors (in this case between type of treatment and length of survival after cancer diagnosis) but cannot prove that one causes the other.
Researchers used data from the US National Cancer Database to identify patients with breast, lung, colorectal or prostate cancer, who opted not to receive conventional cancer therapies, but were recorded as having had "other-unproven cancer treatments administered by non-medical personnel."
These patients were matched with two patients with the same type of cancer, who were similar in other ways, but had opted for conventional treatment. Researchers then looked to see how many people lived for at least five years, comparing those who chose alternative therapies with those who chose conventional cancer treatments.
Researchers only included people who had cancer that had not yet spread from the initial site. This type of cancer is usually treatable by conventional treatments They also excluded people with stage 4 (advanced) cancer, those whose treatment was intended to be palliative rather than curative, and people whose treatment was unknown.
Researchers found 281 people who matched the criteria and who had opted for alternative therapy only. Of these, 280 were matched to 560 people with the same cancer, who chose conventional cancer treatments.
To minimise the effect of confounding factors researchers matched people in the study using these criteria:
In addition, when calculating relative chances of surviving five years, the researchers adjusted their figures to account for the effects of medical and demographic factors.
Researchers found that people choosing alternative therapies were more likely to be younger, female, have fewer other ailments, a higher cancer stage, a higher income and education level.
Taking all types of cancer together:
The type of cancer made a difference, though. This is probably because some cancers can kill quickly without treatment, and treatment is very effective. We can see this in the breast cancer results:
However, for prostate cancer, it made little difference whether people opted for conventional treatment (91.5% lived for at least five years) or alternative treatment (86.2% lived for at least five years).
This is probably because prostate cancer usually grows very slowly in the early stages so few people die.
For the first five to 10 years, there's little difference in those who have conventional treatments and those who have their prostate cancer monitored, with no treatment unless it starts to grow. So, you would not expect to see a difference in a five year study.
The researchers said: "We found that cancer patients who initially chose treatment with alternative medicine without conventional cancer treatment were more likely to die."
They added: "Improved communication between patients and caregivers, and greater scrutiny of use of alternative medicine for initial treatment of cancer is needed."
The results and conclusions of this study are clear: people who choose conventional treatments for cancer (such as surgery, radiotherapy, chemotherapy and hormone treatments) are likely to live longer than those who choose alternative medicine only.
It's rare for people to choose to ignore conventional treatment completely when faced with a cancer diagnosis. More often, people choose to add complementary therapies to their conventional cancer treatment. This study doesn't apply to people combining conventional and complementary therapies.
There are some limitations to the study to be aware of:
People who are diagnosed with cancer and want the best chance of surviving should choose conventional cancer therapies. These give the best chance of helping people with cancer to live longer lives.
Complementary therapies such as acupuncture and tai chi may help some people but they should never take the place of potentially life-saving treatments such as chemotherapy, surgery and radiotherapy.
Cancer patients who use alternative medicine more than twice as likely to die. The Independent, August 15 2017
Cancer patients who shun chemo for alternative therapies Ã¢â‚¬Ëœare TWICE as likely to dieÃ¢â‚¬â„¢. The Sun, August 15 2017
Cancer warning: THIS treatment option could double your risk of dying. Daily Express, August 15 2017
Johnson SB, Park HS, Gross CP, Yu JB. Use of Alternative Medicine for Cancer and Its Impact on Survival. Journal of the National Cancer Institute. Published online August 10 2017