The Problem with Complimentary Medicine

Disturbing research from Yale oncologists last week: cancer patients who used Complimentary Medicine have double the risk of death than patients who don't. The study is called "Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable Cancers," and it appears in JAMA Oncology.

There's a lot to talk about here. It's an emotional issue for a lot of cancer patients. And it has some important lessons for Follicular Lymphoma patients.

First, we need to understand what Complimentary Medicine is, and what it isn't. (I'm going to call Complimentary Medicine "CM" from here, because I'm a horrible typist, believe it or not, and it's a lot to type.)

CM is often lumped in with Alternative Medicine, and together they are known as CAM (Complimentary and Alternative Medicine). They're different. Alternative Medicine, as the name says, tries to find an alternative to conventional medicine. CM, on the other hand, tries to find ways to compliment, or work with, conventional medicine.

So, in terms of cancer, conventional medicine would include things like surgery, radiation, chemotherapy, immunotherapy -- the things that your oncologist is probably recommending, and that have been studied in clinical trials and approved by the FDA or other regulatory bodies.

Alternative Medicine is stuff that hasn't been approved. It might be studied, but not in clinical trials (at least, not any that are reported anywhere). Alternative Medicine includes a lot of things that people have suggested to me, or that I've seen discussed in Lymphoma groups online. Things like the juice of berries that cost lots of money, or herbs, or whatever they do in clinics that are run by people who don't have medical licenses anymore. When someone tells me about one of these treatments, they usually tell me about a friend of a friend who was cured by it (but not someone they actually met), or they say "studies have shown that this works," but they can't actually show me a study.

CM is a little different. It's sometimes called Integrative Medicine, and the idea is that it's used with conventional medicine. It includes things like supplements, traditional Chinese medicine, yoga, acupuncture, massage, and meditation. The idea is not to replace chemo or immunotherapy, but to use both together. So while someone is going through chemo, they may try natural supplements to help with nausea (rather than a prescription medicine), or do yoga to help build strength, or meditation to help with emotional side effects.

But CM is meant to be complimentary -- used with conventional medicines, not instead of them.

And that's where the problem comes in.

The JAMA Oncology study looked back at he records of almost 2 million cancer patients with one of 5 different cancers (none of them had blood cancer). They found that patients who used CM were more likely than those who didn't use CM to refuse surgery, chemo, radiation, and hormone therapy (all conventional treatments). The CM users also had a lower Overall Survival after 5 years.

That's disturbing.


CM becomes an alternative, rather than a compliment.

It's a fine line, and probably easy to cross. We all know what chemo and radiation and surgery and other treatments do -- they all have side effects, short-term and long-term. We've all heard the horror stories about people who had problems with those side effects (and some of us have lived through them). And we'd all love to think there are treatments that can help us without the side effects.

And when we hear about a friend of a friend who found that kind of treatment, or something that "studies have shown" is a possibility, we are tempted to jump at it.

Things that are "natural" are better, right?

Sure. However -- arsenic is natural, too. But I'm not taking that to cure my cancer.

I get it. We all want that magic formula. But as much as I rely on Hope to get me through some days, I know it's not going to extend my life. Not without Rituxan.

Personally, I think CM is an OK thing. The research hospital I go to has an Integrative Medicine Office. They offer classes on meditation and Tai Chi, and they will consult with cancer patients on which supplements are most appropriate for them. They are also very clear about two things -- first, the services they offer are "evidence-based" (there has been research done that shows that it can help patients, especially with Quality if Life), and second, the services are not meant to replace conventional therapy.

Honestly, if their Tai Chi classes were more conveniently scheduled, I would take one. But I wouldn't expect it to shrink my nodes.

So I hope the message I want to get across is clear -- CM can be a good thing. But you still need chemo, immunotherapy, and other conventional therapies that have been tested and approved. It's literally a matter of life or death.

That said, two more important things to keep in mind.

First, the study suggests that one reason why some people turn to CM is because of financial reasons. In other words, they don't have the money for chemo or other conventional treatment, so they hope something cheaper will help. It's an important point -- these patients aren't really making a choice between CM and conventional treatments. They're doing what they can to stay alive. They have no choice. This is sad to read. I wish I had a solution, other than to encourage them talk to the oncologist and see what kind of financial help might be available for them.

Second, Follicular Lymphoma patients in particular have to be really careful about CM, and giving it too much credit. Our disease is a funny one. Often, it gets worse, but other times it gets worse and then better. I just experienced this myself -- a lymph node popped up near my hip in March, and by the time I saw the doctor last week, it was shrinking again. "They do that," the oncologist said.

But it would be easy for me to think that the node shrank because of something I did, rather than it just doing it on its own. My wife's walking partner has been away for a while, so I've been walking with her once or twice a day instead. That's my only major lifestyle change I can think of in the last couple of months. I could easily make the connection -- more walking led to my shrinking node. Do-it-yourself Complimentary Medicine.

Of course, the walking is very unlikely to be the cause of the node shrinking. No more than any other CM would be. It would be tempting for some people to substitute a diet change, or a supplement, or an exercise routine for the walking, and think "I don't need chemo -- I can just do X instead."

Resist that temptation, FLers.

Walking with my wife has been wonderful in many other ways. It starts the day off with some exercise. It gives us a chance to talk -- to dream about our plans to travel, so gloat over how great our kids (usually) are, to work through stuff that's bothering us. It's CM at its best -- good for an overall better Quality of Life.

But a walk in the neighborhood won't cure cancer.

Do what makes you feel good. But remember -- no magic formulas.