Alternative and Complementary Therapies: Popular but Potentially Dangerous?
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
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.