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Alternative and Complementary Therapies: Popular but Potentially Dangerous?


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Feb. 24, 2000 (Washington) -- When she practiced in Texas, some of the patients who came to Vivian von Gruenigen, MD, took shark cartilage and charcoal enemas. When she relocated to Ohio, the favorites switched to green tea and vitamin supplements.

Then one of her patients, a 46-year-old woman with cervical cancer, developed a mysterious fever and chills nine days after she started radiation therapy. She was hospitalized for four days.

While von Gruenigen, a gynecological oncologist, sat at her patient's bedside, the woman's story tumbled out. She'd been drinking "super-tonic," an unappetizing and seemingly noxious elixir concocted of tea chaparral, apple cider vinegar, horseradish root, hot peppers, garlic, ginger, radish, onion -- and vodka. But that wasn't all. She'd also taken wheat grass juice, red clover, and something called Fen LB.

"I had a patient overdose on botanicals," von Gruenigen tells WebMD, still sounding flabbergasted some time after the incident. It was then that von Gruenigen knew she had to take action. What were her patients consuming that she didn't know about, and what possible danger were they exposing themselves to? Were they possibly counteracting the effects of other standard therapies they were getting?

Von Gruenigen vowed to find out which alternative and complementary medicines her patients were using, but instead she went a step further -- surveying 452 patients seen by herself and her colleagues. The results, presented at the Society of Gynecological Oncologists meeting earlier this month, showed that 56% of typical gynecology patients were using such supplements or engaging in practices considered therapeutically unproven for their particular diagnoses.

The most common were nutritional supplements (20%), followed by prayer, exercise, megavitamins, and green tea. Among her cancer patients, the rate was even higher.

But though the patients might have felt comfortable taking such supplements or engaging in these practices, they usually didn't tell their physician. In the gynecology group, approximately one-fourth told their physician, while about 40% in the cancer group shared such information.

"This is why it is so important [for physicians] to be asking patients what they are using," says von Gruenigen, also an assistant professor in the College of Medicine at Northeastern Ohio School of Medicine in Akron. Physicians also have a responsibility to help patients sort out which therapies might be harmful.

"Physicians should get on the web and research every product their patients are using. As patient advocates, you don't want them throwing away their money, per se. And when they are getting chemo or radiation, it is not recommended that they have any alternative therapies."

Von Gruenigen also asked the cancer patients how much they estimated spending for such activities during the course of their illness; they reported spending between $35 and $3,000 -- an average of $711. Only about 18% was covered by insurance.

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