Presented as an alternative to conventional medical treatment, the multibillion-dollar field of complementary and alternative medicine yields remarkably bad outcomes for cancer patients. While promising clinical trials have earned some practitioners of complementary medicine, like acupuncture, a greater degree of acceptance by the medical community in recent years, many patients in the United States, whether out of financial insecurity or mistrust of medicine, are pursuing complementary medicine instead of conventional medicine, rather than as a complement to conventional medicine. A new study in JAMA Oncology suggests that this trend has deadly consequences for cancer patients.
In a paper published Thursday, a team of researchers at Yale School of Medicine present evidence that cancer patients who receive complementary medicine — like supplements, traditional Chinese medicine, homeopathy, naturopathy, yoga, acupuncture, massage, and meditation — are more likely to refuse conventional cancer treatments, including chemotherapy, radiation therapy, surgery, and hormone therapy. By looking back over the medical records of 1.9 million patients who were diagnosed with nonmetastatic breast, prostate, lung, or colorectal cancer between January 1, 2004, and December 31, 2013, the study’s authors found that patients who received complementary medicine had double the risk of death compared to patients who did not use complementary medicine.
“Patients who used complementary medicine had a worse survival,” James B. Yu, M.D., an associate professor of therapeutic radiology and one of the authors on the paper, tells Inverse. He’s careful to point out, though, that this lower survival rate is not necessarily because of the therapies themselves, but because these patients were more likely to refuse conventional cancer treatment. “If patients who underwent complementary medicine did not refuse recommended cancer treatment, they had the same survival as patients who did not undergo complementary medicine.”
The study’s authors say there are a few different factors motivating cancer patients to forgo proven medicine in favor of complementary therapies, including spiritual beliefs, as well as the marketing and popularity of natural healing.
“Patients also want to feel like they are active participants in their care,” Skyler Johnson, M.D., a therapeutic radiology resident and the first author on the study, tells Inverse. “Our clinical experience also suggests some distrust in certain aspects of conventional cancer care, a fear of conventional cancer treatment side-effects and a desire to have more natural treatment options.”
This isn’t to say that complementary therapies don’t do anything. Many patients report that complementary therapies like yoga can help them deal with the pain and other side effects of cancer and cancer treatment. But the data from this new study suggests that some patients think such therapies are enough all on their own.
Nonetheless, the researchers get why people end up taking that route.
“Cancer and cancer treatment is scary. I understand the very human desire to wonder whether there is a better way, a more ‘natural’ or ‘magical’ way,” Yu says. “It is our job as physicians and caregivers to help patients in their cancer journey and encourage and educate them to undergo proven therapy. Complementary medicine may play a role in that if it helps them undergo recommended medical treatment, but it can lead to worse outcomes if it is used as an excuse to forgo curative treatment.”
Yu and Johnson hope their work, which shows a dramatic increase in risk of death when patients refuse conventional cancer treatment, will encourage people not to pursue only complementary medicine.
“I hope that this information will reach cancer patients and providers and provide them with further information that they can use to have respectful, science-based discussions on the methods that will most likely meet the patient’s goals of care,” says Johnson.
Yu also points out that, since complementary medicine is often used to improve patients’ quality of life, he encourages them to pursue it as long as it doesn’t interfere with their actual cancer treatment. He points out, though, that sometimes there are things apart from complementary medicine that patients can use to deal with the stress and difficulty of receiving cancer treatments. In those cases, he recommends against complementary therapy and tells patients to do what makes life feel more worth living.
“If there is something they’d rather spend the money on — a dinner with a loved one, an experience that will bring them closer to a loved one — a gift to themselves or to a family member,” he says, “I tell them to spend it on that other tangible thing that will provide them a greater human connection and improve their lives in a tangible way.”