Alternative Therapies Worsen Breast Cancer Outcomes

By: A.D. Walling

Background
About 84 percent of patients with breast cancer use some form ofalternative or complementary therapy. The most common of these therapies aredietary modalities (27 percent of patients), spiritual healing (24 percent),herbal remedies (13 percent), physical techniques (14 percent), andpsychological methods (3 percent).

Use of complementary and alternativetherapies in patients with breast cancer is associated with younger age,higher education level, and history of chemotherapy. Despite theirwidespread use, there are no published data on cancer outcomes followingalternative or complementary therapies. Chang and colleagues studied therecords of women who refused or delayed standard therapy for breast cancerto assess the impact of treatment choices on prognosis.

The Study
Data were available on 33 patients with an average age of 53.2years. Of the six women who refused surgery, five progressed to stage IVdisease (one of whom died) and one remained at stage II during a median14-month follow-up period. Nine patients with stage I or II diseasesubstituted alternative therapy for chemotherapy or hormonal therapy. Eightof these patients remained recurrence-free during a median 22-monthfollow-up period.

Results
The authors calculated mean 10-year mortality rates for patientswho eventually used standard therapy and for patients who substitutedalternative therapy for standard therapy. For patients who delayed surgery,the 10-year relative risk of mortality associated with alternative therapywas estimated at 1.58. For those who refused chemotherapy, the relative riskwas 1.54.

Conclusion
The authors conclude that, despite the many assumptions in thestudy, the results indicate that substituting alternative therapy forstandard therapy adversely affects outcomes in patients with breast cancer.(AAFP)