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CAM and Older Patients

Posted 9/2/2015

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  This report from the Journal of Geriatric Oncology was surprising to me. It suggests a high use of CAM (complementary and alternative therapies) by older patients who are undergoing active cancer treatment. I have not read the full study, and the summaries don't include information about the ages of the participants. Therefore, I don't know if we are talking about people in their mid to late 60s or mid to late 80s. Does that change things? Does it matter?

  What always matters is that many/most patients are not fully forthcoming to their oncologists about other things they are doing. As I have repetitively said, it is vitally important to tell your doctor about all other medications you are taking; there may be negative interactions between some vitamins or supplements and chemo drugs or radiation. It is really foolish to agree to intense cancer treatments and then do something that may sabotage them.

  Mostly what this study does is force me to examine my assumptions about older people. Again, we don't know how old is "older" in this case. But I somehow had not expected that many elderly people (in my head, I am thinking late 70s and up) were fans of supplements or acupuncture or therapeutic massage. I am wondering if this has something to do with money--the very high cost of some new cancer treatments and high deductibles or co-pays that may be difficult for people on fixed incomes. Maybe they think that a high dose of Vit A, or whatever, is cheaper. Again, this study does not say much about what they were doing, but it does interest me. And proves, once again, that it is usually a mistake to assume that I know much of anything!

  Here is the start and a link to read more of the Eureka Science report:

High use of alternative medicine in senior oncology patients

(PHILADELPHIA) -- Alternative medicines are widely thought to be at least harmless and very often helpful for a wide range of discomforts and illnesses. However, although they're marketed as "natural," they often contain active ingredients that can react chemically and biologically with other therapies. Researchers performed a comprehensive review of all of the medications taken by senior oncology patients and found that as 26 percent were using complementary or alternative medicines (CAM), in a report published August 12th, in the Journal of Geriatric Oncology.
"Currently, few oncologists are aware of the alternative medicines their patients take," says Ginah Nightingale, PharmD, an Assistant Professor in the Jefferson College of Pharmacy at Thomas Jefferson University. "Patients often fail to disclose the CAMs they take because they think they are safe, natural, nontoxic and not relevant to their cancer care, because they think their doctor will disapprove, or because the doctor doesn't specifically ask."
There are a number of CAMs that are known to interfere with certain cancer treatments. For example, St. John's wart can make some cancer therapy less effective, according to the National Institutes of Health. Others can interfere with anesthesia during surgery for cancer. But not all interactions have been studied. Because CAMs fall under the category of health supplements, they are not regulated by the Food and Drug Administration (FDA), which means that dose and potency (and therefore reaction in the body) can vary widely between products, and between patients.


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