Cancer Patients’ Use of Complementary Therapies
Hester Hill Schnipper, LICSW, OSW-C Program Manager Emeritus, Oncology, Social Work
AUGUST 12, 2021
Let’s start with a clarification: complementary therapies are used in addition or alongside of conventional western medical care, while alternative therapies are used instead of the standard treatments. There is limited or no medical/scientific evidence to support the use of some complementary therapies and many alternative ones. You may also have heard the expression CAMs; that means complementary and alternative medicines.
73% of women with breast cancer reported using at least one kind of CAM therapy while their doctors estimated that only 43% did so.
Examples of complementary therapies are acupuncture, traditional Chinese medicine, homoeopathy and naturopathy. Examples of alternative medicines are large doses of vitamins or supplements in place of other prescribed medications, colonic irrigation and special diets or herbs described as preventing or curing disease. Many Americans use CAM therapies for many reasons, usually adding them to conventional treatments. Recent surveys have shown that about one third of Americans use one or another CAM modality.
What about cancer patients? A large percentage of cancer patients and survivors use or have used some type of complementary or alternative medicine. Their goals include relieving pain, nausea, and other symptoms and side effects as well as directly hoping to treat the cancer. A recent survey released at last month’s American Society of Clinical Oncology (ASCO) meetings showed a shocking disconnect between patient use and their doctors’ estimates of that use. For example, 73% of women with breast cancer reported using at least one kind of CAM therapy while their doctors estimated that only 43% did so. Some studies have shown as many as 90% of cancer patients use CAM treatments, but most studies report closer to 50% use.
There are many articles and books that describe the positive effects of cancer patients using CAM therapies along with prescribed chemotherapy or radiation treatments. There are also papers that describe negative effects, but the reasons for the dangers are not usually made clear. The simple explanation is that possible interactions between cancer drugs, radiation, immunotherapy or other kinds of cancer treatments and CAM therapies have not been studied or understood. Most people would hesitate if they realized that taking large doses of vitamins or supplements could interfere with the benefit of their treatment. Directly stated: why would you choose to put yourself through chemo and simultaneously do something that might make the chemo less effective? On the other side, reports of positive outcomes suggest a strong need for more research, but specifics are not supplied.
It is very important that patients are honest with their doctors about their CAM use. All cancer providers support patients doing everything they can to help themselves but worry about all the unknowns. The recent survey underscores the low disclosure rate and the need for better communication. Patients may feel that their doctors will disapprove of their choices, and many physicians are less than fully knowledgeable about some CAM therapies. Patients are more likely to get their information about these treatments from family, friends or the popular press. Most doctors strongly feel that they need to know what other treatments their patients are considering or using. This is likely generally true, but especially so for cancer doctors who worry about possible harm. One study found that 80% of cancer providers feel that interactions between herbal treatments or supplements and cancer treatments are problematic. Interestingly, only 15% could elaborate about those concerns. The information and the communication gaps are huge.
Most cancer clinicians are completely comfortable with any CAM treatments that don’t involve ingesting anything. Specifically, there are few if any worries about acupuncture, Reiki or Chi Gong, but lots of worries about supplements and herbs. There is a lot of room for options here; for example, some research has suggested some anti-cancer value for green tea, and that seems safe. The worries are more directed at herbs and teas and supplements that have not been examined and are unknown.
The important message here is that is important for patients and their doctors to discuss this issue. There are many things to discuss during a medical appointment, and this may seem less pressing than some other things, but it is vital that your doctor is aware of any CAM treatments that you are using.