Using alternative medicine - linked to lower survival rate

cp418

https://www.sciencedaily.com/releases/2017/08/1708...

Using alternative medicine only for cancer linked to lower survival rate

Patients who choose to receive alternative therapy as treatment for curable cancers instead of conventional cancer treatment have a higher risk of death, according to researchers.

Patients who choose to receive alternative therapy as treatment for curable cancers instead of conventional cancer treatment have a higher risk of death, according to researchers from the Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center at Yale School of Medicine and Yale Cancer Center. The findings were reported online by the Journal of the National Cancer Institute.

pupmom

Makes sense to me. Thanks for posting.

Momine

Well, that would be a given, I would think.

Momto8

I'm having great success with alternative treatment with low dose IPT therapy! No surgery, no radiation and no evidence of original disease.

pupmom

Momto8, what's your diagnosis, beyond having bc? That makes a LOT of difference, and you have not included it in your profile.

Edit: Actually I don't even know if you ever had breast cancer! Can you please clarify?

Momine

Momto8, IPT is still chemo, even if it is a yet unproved way to use chemo.

dtad

Hi everyone..IMO the study is vague and over generalized. It doesn't state what cancers and what alternative medicine. It seems like a no brainer that if the question is presented that way the conclusion would be that way

Momine

Dtad, fair point. However, are you aware of any particular cancers that are known to respond to alternative treatments?

pupmom

I think those cancers arise from psychosomatic illness.

http://www.telegraph.co.uk/news/health/11635758/Ps

The mind is a powerful thing!

BarredOwl

Re: ". . . the study is vague and over generalized. It doesn't state what cancers . . ."

The feature posted by cp418 linked to the underlying abstract ("Journal Reference"), which does state what type of cancers were included:

"We identified 281 patients with nonmetastatic breast, prostate, lung, or colorectal cancer who chose [alternative medicine] AM, administered as sole anticancer treatment among patients who did not receive conventional cancer treatment (CCT), defined as chemotherapy, radiotherapy, surgery, and/or hormone therapy."

The specific alternative therapies relied upon do not appear to have been recorded in the database.

I was able to access the full-text of the article here.

[Edit: Link to main page with free pdf: https://academic.oup.com/jnci/article/110/1/djx145/4064136/Use-of-Alternative-Medicine-for-Cancer-and-Its]

"It is important to note that complementary and integrative medicine are not the same as AM as defined in our study (13)."

There are limitations to retrospective, observational studies, yet other designs are not feasible due to ethical constraints. Regarding non-metastatic breast cancer, they concluded:

"Patients who initially chose AM for treatment of curable cancer in lieu of CCT were rare and had statistically significantly worse survival. After controlling for sociodemographic and clinical factors, the magnitude of difference was largest for breast cancer because women who used AM as initial treatment without CCT had more than a fivefold increased risk of death."

Additional studies are cited in the bibliography.

BarredOwl

Momine

Pupmom, what do you mean by that? Which cancers and what kind of psychosomatic illness?

pupmom

Momine, I meant those who suffer from hypochondria and/or Munchausen's Syndrome.

dtad

Barredowl...thanks for the clarification. Apparently I didn't read the whole thing. My bad!

Momine

Pupmom, I am just trying to understand, do you believe that cancer is caused by hypochondria/Munchhausen?

pupmom

No, Momine, I don't believe that. I was just implying that some people wrongly believe they have cancer because of psychological disorders.

MTwoman

and then those people (who pupmom mentions above) get "cured" by these alternative (only) treatments

pupmom

MTwoman, you nailed it.

Kicks

Well said pupmom and MTwoman.

It also needs to be remembered that in addition to those with mental issues, there are also those who have agendas to promote their theories financially. Anyone else remember the Laetril scandals back in the '60's and those who were harmed? I do unfortunately.

Momine

Pupmom, ok, thanks, I was confused Another thing I have come across several times is a patient, who has actually received standard medical treatment, at least in part, but ascribes his/her health to XYZ alternative therapy. Chris Wark of "Chris Beat cancer" is a good example of this. Similar is the patient who goes on about how she either "refused" chemo or how she chose to do XYZ alternative instead of chemo. Then when you drill down a bit, it turns out the patient was never a candidate for chemo in the first place.

That said, I think there is a lot of room for evolving the use of existing medications, like, for example, the IPT therapy mentioned further up. I also saw a thing recently that using COX-2 inhibitors and a beta blocker in connection with BC surgery may lower mets risk.

We do have a couple of brave souls here, who have gone completely alternative and are doing well. I would love for doctors to investigate such cases more carefully, because there could be some important insights to be gained.

And, finally, we need that cure, preferable one that does not involve crippling treatment.

pupmom

No problem, Momine. I was trying to be cryptic, but went too far with that, lol.

In medicine, a thing exists called spontaneous remission, whereby people get better for no known reason. It's obviously very rare, but cases do exist.

As you said what we really must have is a cure.

MTwoman

Right. When you are doing a study that is based in scientific methods, you can't just study the people who indicate that they did really well on an alternative therapy. You could do a case study on them, to relate that info, make hypotheses based on differences you find in that person and test them out.

But an actual study, that advances knowledge about which treatments work for whom and that is generalizable, requires rigor. Random sampling (not those that already benefitted), prospective study (not after the fact), carefully constructed methods that narrowly focus on the identified intervention, taking into consideration confounding factors and blinding (double blinding is best, when no one knows which 'arm' receives what) are part of appropriate scientific method. Parts of that get harder with a disease like bc, as you don't want to provide an intervention (to study/test) that may be less effective than the standard of care and then randomly assign someone to that test arm.

(edited for spelling)

pupmom

MTwoman, wish I could "like" your post!

MTwoman

ChiSandy

What BarredOwl said— I just read that same study, as it came in my inbox via DG Cardiology Alerts (my DH signed up using my e-mail addy because he hadn’t started using e-mail yet).

Pupmom, ailments (and symptoms) that turn out to be psychosomatic are those related to the nervous and cardiovascular system. Three mechanisms are at play—inflammation and the release of cortisol and vagus nerve response, either separately or intertwined; both these mechanisms are heavily influenced by physical and emotional stress. Irritable bowel, GERD in a patient w/o hiatal hernia, panic attack (can mimic esophagitis, gallstone pain and even heart attack); headache not caused by infection, allergy, injury, tumor or anatomical defect; cardiac arrhythmia; asthma attacks (in a diagnosed individual); neuromuscular symptoms that mimic those of actual organic NM diseases like MS, MG, even ALS or Parkinson’s. Stress induces cortisol release—which in turn causes release of both adrenaline (the “fight-or-flight” hormone essential for primitive humans’ survival during physical danger) and inflammatory cytokines. Inflammatory cytokines might even cause a hitherto sessile arteriosclerotic plaque to become friable, break off, and cause an ischemic MI or stroke. They are useful, however, in fighting infection (which action is part of the immune response).

Some oncologists (and nutritionists at cancer centers) have posited that inflammatory cytokines—while useful during chemo or rads, the object of which is tissue damage—result in oxidative damage due to free radicals; and therefore lower the body’s ability to rebound after completing active adjuvant therapy, resist infection, tolerate helpful medications; and might even make a patient more susceptible to recurrence—not because of changes to the tumor cells but the weakening of the “host,” aka the body. But even they acknowledge there is no evidence that cytokines have any effect on existing tumor cell proliferation, nor genetic mutation in normal or cancer cells.

And MTWoman, you nailed it: it is considered medically unethical to knowingly assign a patient to a known-ineffective treatment arm in a study regarding a life-altering-or-threatening disease without full disclosure to and consent from that patient; and once that patient knows what they’re receiving, that might influence their perception and thus reporting of their symptoms.

(There is a phenomenon known as the “no-cebo effect:” when a patient knows—whether or not in a study—they are receiving a drug with known side effects, they may report experiencing some of those side effects even when there is no physiological evidence upon examination & testing. This happens most often in the case of statins—many patients ascribe muscle pain to the rare but deadly rhabdomyolysis that statins can cause, but blood tests and muscle biopsy reveal no damage whatsoever; the muscle pain is often psychosomatic or due to pre-existing physical “de-conditioned” status).

That’s why double-blind prospective studies of alternative medicine alone vs. complementary medicine vs. conventional treatment alone are unconscionable and impossible. So all reliable evidence that is available is either epidemiological or otherwise retrospective (and to some extent statistical).

Momine

MTwoman, all true. However, with such a huge (unfortunately) patient population as we have in BC, I do think some unconventional investigations (not studies in the classic, medical sense) might yield some useful insights. Susan Love's foundation, for example, is trying to do something along these lines, however imperfect the approach may be.

I would also, for example, be really interested in a detailed follow-up study of specific BC groups, meaning patients who have received standard of care. We still don't understand how it is that someone with a 3C DX manages to truck on for a full lifespan sometimes, nor why someone with a 1A DX suddenly presents with mets 8 years out.

Heidihill

Genomic signatures might have more prognostic value. Clinical risk may not be the same as genomic risk. So people who have had success with alternative only may have been genomically low-risk, or changed their epigenetics somehow to reduce risk.