COMMENTARY

Correcting Patients' Understanding of Alternative Cancer Therapies

Gerald Chodak, MD

Disclosures

November 27, 2018

Hello. I am Dr Gerald Chodak for Medscape. Today's topic is the use of alternative therapies in people with cancer. [Alternative therapies] include herbs, vitamins, and supplements, which contribute to a multi-billion-dollar industry. The American Society of Clinical Oncology conducted a survey in 2017 and repeated it again this year.[1,2]

The patients or individuals who completed this survey are part of a databank of people who have agreed to do online surveys, so caution is needed in how we interpret these results. Nevertheless, they got responses from about 5000 individuals, including 40% who had cancer themselves, a family member with cancer, or who were involved in the care of someone with cancer. The results are interesting in the following ways.

First, the majority felt that they were most concerned about dying or suffering from cancer going forward, and 96% believed that doctors helped them avoid unnecessary therapies. Even so, a surprising 40% of the group felt that these alternative therapies could cure cancer without using conventional therapies. Overall, 75% felt that there was a role for alternative therapies in combination with conventional therapies.

Interestingly, the results varied depending on age. Younger people aged between 18 and 37 were much more likely to believe that there is a benefit [with the use of alternative therapies] compared with older people. Only 21% of people over age 72 believed that these agents could cure cancer without conventional therapies. An important observation is that only 15% say they talk to their doctors about the role or the use of these alternative therapies.

I think there are some important take-home messages, realizing that this is not a randomized survey. First, I believe that doctors need to be much more proactive in communicating with patients and finding out whether they are using alternative therapies. [This is important] not only for patients with cancer but also for patients who are on any medications.

Individuals need to be informed that there are potential problems [with the use of alternative therapies]. Number one is that there are few studies that have demonstrated significant benefit in people with cancer. Also, studies have shown that many of these alternative therapies have contaminations or do not contain exactly what is on the label, so dosages may be incorrect.

Because there is an absence of good trials, we do not know how these agents will interact with conventional medications. Alternative therapies could increase the toxicity or they could lessen the efficacy. This information needs to be conveyed to patients more proactively.

It is interesting that many people have these attitudes regarding alternative therapies, and it is surprising to see that they are more common in younger people. Nevertheless, going forward, I think we have an opportunity and a need to better communicate with our patients. I look forward to your comments. Thank you.

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