Rules of Thumb for Incorporating Alternative Therapies into Cancer Care

David J. Kerr, CBE, MD, DSc, FRCP, FMedSci


October 26, 2017

Hello. I am David Kerr, professor of cancer medicine at University of Oxford in Oxford, England. I have just returned from a remarkable week in China. I am a visiting professor at a couple of Chinese universities in Xiamen and at the Second Military University in Shanghai. I am popping back and forth to China a lot just now. It is an extraordinary and incredible country that shows what, within a socialized healthcare system, can be done in terms of top-down reforms. But that is a talk for another day.

I am an honorary clinician at these hospitals and thus get to see patients. The very interesting balance between the practice of conventional Western medicine and the admixture of traditional Chinese medicine always fascinates me. Traditional Chinese medicine depends on the blend of herbs and various other medicines; it is all about the balance of life.

There is a very formal, traditional training in the delivery of this Chinese medicine. We plan to conduct conventional clinical trials to learn whether, when we combine Western approaches with traditional Chinese medicine, we see benefits in terms of better symptom control during chemotherapy, particularly if it improves fatigue and perhaps even improves efficacy. We will see what the trials tell us.

This experience has made me think about the advice we give to patients who want to access some form of alternative medicine. I am not saying that traditional Chinese medicine is weird or wacky—far from it. It is a 1000-year-old tradition with a number of extraordinary practitioners. Thinking more generally, I believe that it is a very reasonable thing for patients to do.

Patients may want to access diverse healing approaches through various sources of alternative therapies: homeopathic medicines, the power of prayer—who knows what these may be. I believe that anything we can do to empower patients to feel that they can take charge of their own disease is helpful. This gives them something that they can actively do for themselves rather than being passive participants in the management of their cancer.

Three 'Rules' for Choosing Alternative Therapies

I have three rules of thumb when choosing among these treatments. First, the therapy should not cost an exorbitant amount of money. Sad to say, there are charlatans out there who take advantage of the vulnerable. If they can squeeze additional money out of those who are desperate, they will. It should not cost an arm and a leg.

Second, it should not hurt. It should not have so many side effects or be so uncomfortable that it reduces quality of life, causes pain, or whatever it might be. Coffee enemas, for example, are unproven, uncomfortable, and no good.

Third, the therapy should not get in the way of the other, conventional therapies. That is a consideration because some herbal remedies may inhibit certain enzymes involved in the metabolism of our drugs. There also may be the possibility of other interactions.

If our patients can satisfy these broad, semi-arbitrary rules of thumb, I believe that we, as traditional healers and practitioners of modern molecular Western medicine, should be prepared to support our patients if they are keen to explore these different types of medicine.

Thanks for listening, as always. We would be very interested in your ideas about how we, as keepers of the Western medical philosophy—"guardians of the flame"—can support our patients in this area. Perhaps in the future, I will speak more formally about traditional Chinese medicine, because it is utterly extraordinary and definitely worth exploring within the constructs of a conventional clinical trial pathway.

Thank you for listening. I would be very keen to read any of your comments. For the time being, Medscapers, ahoy!


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