CANCER patients and their doctors have long engaged in a version of dont ask, dont tell: Patients dont tell their doctors they are sampling alternative treatments as an adjunct to conventional therapy, and most doctors never ask.
The publication recently by Harvard Medical School researchers of an extensive review of the safety and effectiveness of more than a dozen of the most commonly used alternative treatments may prompt conversation that would benefit both parties and help prevent harmful interactions.
Many alternative treatments, especially nutritional supplements, interact negatively with chemotherapy or radiation, noted Wendy A. Weiger, lead author of the study, which appears in the Dec 3 issue of the Annals of Internal Medicine.
Weiger and her colleagues at Harvards Osher Institute spent three years reviewing more than 400 published studies of therapies ranging from acupuncture, megavitamins, shark cartilage and macrobiotic diets. The researchers goal was to consider the impact of alternative treatments on both disease progression and survival, as well as relief from the symptoms of cancer or treatments for it. The authors did not examine the role of alternative treatments in preventing cancer.
Only one form of treatment so-called mind-body therapies, such as relaxation training, yoga, support groups or similar interventions that ease the psychological stress of living with cancer was found to be beneficial; it was recommended by the authors without reservation.
Seven treatments, including moderate exercise, soy supplementation for prostate cancer and acupuncture for chemotherapy-related nausea and vomiting, were given a qualified endorsement and were characterised as reasonably recommended, but the evidence of their benefit was not as strong as for mind-body therapies.
Nine other treatments, including high-dose vitamin A or vitamin C and St Johns wort, a supplement used as an antidepressant, should be avoided by some or all cancer patients, according to the report. High doses of vitamin A were found to be dangerous for all cancer patients, while St Johns wort can interact negatively with chemotherapy.
We didnt identify any magic bullets, Weiger said, adding that she was surprised at how few treatments could be recommended without reservation based on existing scientific evidence. The field (of alternative medicine research) is still in its infancy. LAT-WP
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