Aug. 17, 2000 - Visits to chiropractors and acupuncturists, and the use of vitamins, herbal remedies, and massage, are becoming increasingly important options to breast cancer patients, according to a new survey.
But the survey's researchers stress that such complementary and alternative medicine should remain just that, an option, and should not be used at the expense of conventional treatment. Apparently, many women in the survey felt the same way.
"Our interviews ... show that no one refused conventional therapy, and that the women are most likely to seek complementary therapies after they have concluded conventional therapy," lead researcher Heather Boon, PhD, tells WebMD. Boon is assistant professor in the department of health administration at the University of Toronto.
The study, which appears in the July issue of the Journal of Clinical Oncology, found that two-thirds of the 411 breast cancer patients who answered a questionnaire used some sort of complementary or alternative medicine during or after their conventional treatment. The reasons most often cited were to assist the body's natural forces to heal, to boost the immune system, to enhance quality of life, to assist other treatments, and to relieve symptoms of their illness and treatment.
Only about half the patients said they discussed such treatment with their doctors, and researchers believe more communication between patients and physicians is needed. Alternative therapies can often be helpful, but some are at best ineffective, and at worst dangerous.
"Clinicians really need to start talking with patients and asking them in a nonjudgmental way about these therapies while they are taking routine histories," Boon says. "The biggest concern when it comes to alternative therapies is the possibility of negative interactions between conventional medications and oral alternative medicines. Physicians need to know when their patients are taking these so [they] can monitor [it]."
According to the survey, patients' choices of alternative therapies, in order of preference, were: vitamins and minerals, herbal remedies, green tea, diet, essiac (an herbal tea), body work, meditation, and shark cartilage.
In order of popularity, patients most often visited these types of alternative practitioners: chiropractors, herbalists, acupuncturists, naturopathic practitioners, reflexologists, touch therapists, homeopathic practitioners, physicians offering complementary and alternative therapies, faith healers, and others.
In an editorial accompanying the study, Harold J. Burstein, MD, PhD, of Brigham and Women's Hospital in Boston, summarizes the reasons complementary and alternative medicine has enjoyed increasing popularity. The list is long. He writes that an expanding health consciousness, a thriving marketplace, the easing of regulations on dietary supplements, the burst of information available through mass media and the Internet, a growing social acceptance, and last, but not least, a disillusionment with conventional medicine all play a part.
Doctors should consider consumer interest in complementary and alternative medicine "a challenge to be better doctors ... an opportunity to ... [focus] on the genuine needs of cancer patients that neither surgery nor radiation nor chemotherapy can satisfy," Burstein writes. "[Seeking alternative treatment is] often not about cancer treatment but about feeling better and about having greater control over one's destiny."
The Ontario study further documents "the communication gap that separates patient practices from physician awareness," Burstein adds. "Oncologists might be surprised to find just how common [the use of alternative therapy] is, because we tend to not ask about it."
Anne Wallace, MD, a surgical oncologist and director of the Breast Care Unit at the University of California, San Diego, agrees.
"I'd encourage patients to discuss these things with their doctors and feel comfortable in doing so," she tells WebMD. "If your doctor gives you a funny look when you mention [alternative therapies], maybe it's not because he or she disapproves of what you're doing, but because he or she is learning about these things, too. In the next decade, we will probably learn a lot about complementary and alternative medicine."
Wallace also advises patients seeking alternative therapies to go to reputable health centers and practitioners, and to remember that many herbs are actually drugs that can interact with other medications.