One-third of cancer patients use complementary and alternative medicine
A stunning one-third of
people with a cancer diagnosis use complementary and alternative medicines such
as meditation, yoga, acupuncture, herbal medicine, and supplements. UT
Southwestern Medical Center's Dr. Nina Sanford made the discovery that's now
drawing renewed attention to habits she said cancer patients must disclose
during treatment. Dr. Sanford is an Assistant Professor of Radiation Oncology
who specializes in and treats cancers of the gastrointestinal tract.
Herbal supplements
were the most common alternative medicine and chiropractic, or osteopathic
manipulation, was the second most common, according to Dr. Sanford's analysis
of data from the Centers for Disease Control and Prevention's National Health
Interview Survey. Her findings were published in the journal JAMA Oncology.
"Younger patients
are more likely to use complementary and alternative medicines and women were
more likely to, but I would have thought more people would tell their
doctors," Dr. Sanford said, referring to the finding that 29 percent of
people who use complementary and alternative medicine did not tell their
physicians. Many survey respondents said they did not say anything because
their doctors did not ask, or they did not think their doctors needed to know.
Dr. Sanford and other
cancer specialists agree this is concerning, especially in the case of herbal
supplements.
"You don't know
what's in them," Dr. Sanford said. "Some of these supplements are
kind of a mishmash of different things. Unless we know what's in them, I would
recommend patients avoid using them during radiation because there's likely not
data on certain supplements, which could interfere with treatment. With radiation
specifically, there is concern that very high levels of antioxidants could make
radiation less effective."
Dr. David Gerber, a
lung cancer specialist and a Professor of Internal Medicine and Population and
Data Sciences at UTSW, said physicians need to know if their patients use
herbal supplements because they can completely throw off traditional cancer
treatments.
"They may
interact with the medicines we're giving them, and through that interaction it
could alter the level of the medicine in the patient," he said. "If
the levels get too high, then toxicities increase, and if the levels get too
low, the efficacy would drop."
Nancy Myers wanted to
use supplements during her 2015-2017 cancer treatments, but she ran it by her
doctors first.
"I would ask the
physician, 'Could I?' and everyone said, 'No, we don't know how that interacts
with your conventional medicine,' so I respected that," the 47-year-old
mother of four said. Only after treatment did she start taking turmeric,
omega-3, vitamin D, and vitamin B6. "I have plenty of
friends in this cancer journey who I've met who take supplements. A lady I met
recently takes 75 supplements a day. It takes her two hours to package her
supplements every week," she said.
Ms. Myers said every
person in her cancer support group uses some kind of alternative medicine. In
addition to supplements, she practices meditation and yoga with guidance from a
smartphone app.
"It's what we can
control. We can't control the whole cancer," she said. "It helps
because it takes your mind off just thinking about it."
She said she knows of
some people with cancer who use only alternative medicine - and no traditional
medical treatments. Dr. Sanford said this is a dangerous approach that could be
fatal. The most famous case of this was Apple founder Steve Jobs, who
reportedly used special diets, acupuncture, and other alternatives after
receiving a diagnosis of pancreatic cancer. He turned to traditional medicine
late in his battle with cancer and died in 2011.
While doctors are highly
cautious about the use of herbs and other supplements during treatment, they
are much more open to meditation and yoga as practices that can help patients
cope with the shock of a cancer diagnosis and the stress of chemotherapy,
radiation, and surgery.
"We strongly
advise patients to stay active and engage in exercise during treatment,"
Dr. Sanford said. "A common side effect of radiation is fatigue. I let the
patients know that the patients who feel the most fatigue are the ones who are
the most sedentary and that those who are doing exercise are the ones who
frequently have the most energy."
Belindy Sarembock, 53,
of Dallas, said she practiced yoga during her treatments for breast cancer. She
started the classes with skepticism and quickly became convinced of the
benefits.
"I was one who
would have laughed at yoga before breast cancer, but now it just helps me so
much," she said. "It's just so relaxing, I just feel so good after I
leave. It's just so peaceful. For your body, I can't think of anything better
than that."
She said she had
neuropathy or nerve damage from chemotherapy, and yoga almost immediately took
the pain away.
"I couldn't get
onto my toes. After the second time of going to yoga, I was able to go onto my
toes," she said. "I wish I would have known about the yoga earlier.
It was just such a benefit and helped me so much. I highly recommend it to
anyone."
Nina N Sanford, David
J Sher, Chul Ahn, Ayal A Aizer, Brandon A Mahal.
Prevalence and Nondisclosure of Complementary and Alternative Medicine Use in
Patients With Cancer and Cancer Survivors in the United States.
JAMA Oncol. 2019. doi: 10.1001/jamaoncol.2019.0349.
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