Alternative Cancer Therapies: Beneath the Radar

October 21, 2005

Although nearly half of cancer patients undergoing chemotherapy or radiation treatment also use complementary or alternative medical therapy (CAM), 75% of them do not tell their oncologist, and such omissions may compromise treatment, according to a study presented 16 October 2005 at the American Society for Therapeutic Radiology and Oncology's 47th Annual Meeting in Denver.

The data also showed that use of CAM is uneven across therapeutic groups: Patients receiving only chemotherapy are almost twice as likely to use CAM (65%), compared with people receiving only radiation (35%), according to a report in ScienceDaily.com on 18 October.

Lack of communication with doctors is a major issue. Only just more than one-third (36%) of respondents said their doctors provided an important source of information about CAMs.

"This study shows the significant lack of communication between patients and their doctors about the use of complementary and alternative medicines, like vitamins and herbs," said Neha Vapiwala, MD, lead author of the study and a radiation oncologist at the University of Pennsylvania in Philadelphia, according to ScienceDaily.com. "It's important for doctors to know about their patients' CAM use and to understand patients' reasons for using it, so that they can better tailor and optimize treatment regimens and improve patient quality of life during radiation and/or chemotherapy."

Researchers conducted a survey of 273 patients at Philadelphia cancer clinics, including 142 patients receiving radiation therapy for either prostate or breast cancer, and 131 patients on chemotherapy.

"When we give patients radiation therapy, we want the radiation to create free radicals that destroy tumor cells," Dr. Vapiwala said during a poster presentation, according to a report in MedPage Today. "But herbal medications such as saw palmetto and St. John's Wort contain antioxidants [that neutralize free radicals] that may prevent what we want the radiation to accomplish."

According to Dr. Vapiwala, patients undergoing radiation therapy are advised to stop taking all CAMs, except for a daily standard vitamin pill. Specifically, they are asked to stop taking high doses of vitamins. "We really don't know what these products do to our patients undergoing radiation, so we think the best answer-until they are thoroughly studied-is not to use them," Vapiwala said, according to MedPage Today.

Who Uses CAMs and Why

According to the survey, respondents use non-prescription CAM products because they are a cost-effective cancer-treatment method. Patients used two products on average, with vitamins, herbal supplements and botanical supplements the most popular.

Patients who used CAMs tended to have a higher educational level, which may reflect higher income to purchase the supplement, and access to the Internet and other publications, according to Dr. Vapiwala.

Risks Associated with CAMs

Knowing why patients take CAMs and which ones they are taking is important for doctors to know, according to Dr. Vapiwala, as it helps doctors to tailor treatment regimens and improve patients' quality of life. Moreover, "a one-time question is not enough," she said, advising that doctors query patients about CAM usage throughout treatment.

"This is a problem most of us don't know how to deal with," said Gregory Swanson, MD, an associate professor of radiation oncology and urology at the University of Texas at San Antonio, according to MedPage Today. "You name a product, and some of our patients have taken it."

Use of CAMs is not benign, said Swanson, noting that cancer patients of his have taken fatal doses of Vitamin A, believing that high doses would help to fight their cancer.

"There may be something out there that works," he said, noting that drugs such as Taxol (paclitaxel) are derived from tree-bark. "But f For many of these products, we just don't know how they may interfere with treatment. I have advised my patients not to take these medicines for that reason."

Sources:
ASTRO: Cancer Patients Using Alternative Medicine Keep Oncologists in Dark, MedPage Today, 17 October 2005.
Cancer Patients Hide Their Use Of Complementary And Alternative Treatments From Their Doctors, ScienceDaily.com, 18 October 2005.
Initiation of complementary and Alternative Medical Therapies by Cancer Patients During Radiation Therapy, American Society for Therapeutic Radiology and Oncology 47th annual meeting, Abstract #2374.

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