unit 14

Question 1

What are some of the reasons cancer patients turn to CAM therapies?

Answer 1

Conventional cancer treatment is painful and debilitating, and is often unsuccessful. It is not surprising, therefore, that many cancer patients seek CAM therapies in an attempt to improve their quality of life and prolong their life. This is especially the case with patients who have been told that their disease is untreatable.

Question 2

What are the two groups of CAM therapies for cancer?

Answer 2

Alternative therapies: goal is to achieve an anti-cancer action. Therapies include diet and nutrition, pharmacological and biological treatments, and herbal medicines

Complementary therapies: Used to support the patient while they undergo conventional medical treatment. Include music therapy, massage therapy, and mind-body techniques

Dividing line between the two is fuzzy

Question 3

What does the research say overall about diets for cancer treatments?

Answer 3

There has been a great deal of speculation that various dietary regimens or dietary supplements may be of value in the treatment of cancer. However, no dietary intervention has ever been proven to cure cancer, though some diets have had a positive effect on the quality of life of a person with cancer.

Question 4

describe the macrobiotic diet in regards to cancer

Answer 4

Traditional oriental concepts of yin and yang are the basis of this diet. It is mainly vegetarian with a large content of whole grain cereals. It may also have a high content of vegetables and soybean products. There is no good evidence that the diet is of any value for persons with cancer.

Unless carefully formulated, the diet is lacking in key nutrients and be potentially harmful for cancer patients

Question 5

Describe gerson therapy, a diet for cancer

Answer 5

The therapy has several features that resemble naturopathy. An important component is coffee enemas which are intended to remove “toxins” from the body. The patient is placed on a low-fat diet with fruit and vegetable juices given hourly. The patient is also given numerous other medicines and dietary supplements, including thyroid treatment and potassium supplements, while salt is restricted.

Question 6

Is megadoses of vitamin C good for cancer patients?

Answer 6

no. There is no evidence that suggests it helps cancer patients

Question 7

describe antineoplastons therapy

Answer 7

The treatment consists of peptides, amino acids, and other simple organic substances that are said to promote the body’s natural defenses against cancer. The therapy has been attacked numerous times by the FDA and medical researchers on the grounds that there is an absence of any supporting evidence

Question 8

Describe sark cartilage therapy

Answer 8

Some years ago a book was published with the title “Sharks don’t get Cancer.” This resulted in shark cartilage becoming a popular treatment of cancer.

The promotion of crude shark cartilage extracts as a cure for cancer has contributed to at least two significant negative outcomes: a dramatic decline in shark populations and a diversion of patients from effective cancer treatments. Scientific evidence to date supports neither the efficacy of crude cartilage extracts nor the ability of effective components to reach and eradicate cancer cells.

Question 9

Describe laetrile therapy

Answer 9

Laetrile is a substance found in the seeds of particular fruits and nuts. It produces cyanide when broken down in the body. It has been claimed that the cyanide selectively poisons cancer cells but no supporting evidence has been produced. Often purported by clinics in mexico

Question 10

describe Di Bella Multitherapy

Answer 10

This is a multi-drug, custom made, medical treatment

The drug cocktail consists of several main ingredients: the hormone drugs somatostatin and melatonin, and a mixture of vitamins A, D, and E. Di Bella claims it is effective in blocking, if not curing, most cancers. Extensive trials done by an Italian Study Group found that the treatment was of little or no benefit

As a result, in 1998, the federal government sent four Canadian doctors to Italy to investigate the treatment. In their report, they recommended that Canada not introduce the treatment or subject it to clinical trials as it is scientifically unfounded

Question 11

Describe the position of herbal medicines for cancer treatments

Answer 11

Most herbal medicines are of unproven value (Miller et al., 2008). However, we need to bear in mind that many of today’s drugs were originally used as herbal treatments. It is therefore quite possible that some herbal treatments may be of therapeutic value for cancer.

Question 12

Describe hoxsey treatment for cancer

Answer 12

The preparation is a mixture of herbs and other substances. One of the herbs is pokeweed root, which is poisonous and can be fatal. The treatment has never been properly tested.

Question 13

Describe essiac herbal treatment

Answer 13

This is a herbal mixture, apparently of Native American origin.

Used by a nurse in 1922 where she set up a clinic in ontario to treat patients

Overall, the evidence is weak that this therapy is effective

Question 14

describe mistletoe herbal therapy

Answer 14

An extract of mistletoe, known as iscador, has been used as a cancer treatment for decades. Much research has been carried out into this treatment, often with positive results on survival and quality of life

A point stressed by the investigators who reviewed this subject is that definitive conclusions cannot be made as many of the studies were of poor methodological quality.

Question 15

he most commonly used foods or supplements taken for symptoms associated with Breast cancer were…

Answer 15

green tea, vitamins C and E, flaxseed, and specialty foods/diets. Each was used by about 10 to 13 per cent of the women. Lesser numbers used essiac and shark cartilage.

Question 16

The most commonly used types of CAM for symptoms associated with breast cancer were, in decreasing order,

Answer 16

massage therapy (10 per cent), nutrition, reiki, naturopathy, homeopathy, and therapeutic touch (3.6 per cent).

Question 17

How many women with breast cancer use CAM?

Answer 17

more than 80 percent of all women with breast cancer report using CAM (41 percent in a specific attempt to manage their breast cancer)

Question 18

CAM therapies are available from a variety of sources. A survey of naturopaths in the USA and Canada found that the CAM therapies most commonly used by these practitioners were

Answer 18

dietary counselling (94%), herbal medicines (88%), antioxidants (84%), and supplemental nutrition (84%).

Question 19

The most common specific treatments for cancer were

Answer 19

vitamin C (39%), coenzyme Q10 (34%), and Hoxsey formula (29%)

Question 20

Alternative cancer therapies can carry a high degree of risk. . Why?

Answer 20

This is because patients may use ineffective CAM therapies rather than an effective conventional treatment. A study of breast cancer patients who refused or delayed standard treatments in favour of alternative therapies concluded that there was a higher likelihood of disease progression and increased risk of recurrence and death

Question 21

Ernst and colleagues (2007) reviewed the research evidence supporting various CAM therapies. The therapies can be divided into two clear groups. Describe the findings for these two groups

Answer 21

Research has been mostly negative for therapies where herbs or diet supplements are given. These are mostly alternatives therapies. However, some positive findings have been reported for gingko, ginseng, and coenzyme Q10. By contrast, there is quite good evidence showing the value of several types of complementary therapies that provide comfort for the patient. These include aromatherapy/massage, music therapy, relaxation, and spiritual healing. These latter findings are similar to the conclusions reached in another review, namely that the CAM therapies that have the strongest benefit for effectively and safely reducing physical and emotional symptoms are massage therapy, music, and mind-body therapies

Question 22

It is likely that a patient’s belief in the efficacy of treatment can

Answer 22

relieve pain, anxiety, and other functional disorders that accompany cancer.

Question 23

How are mind-body techniques claimed to help cancer?

Answer 23

it has often been claimed that these types of therapy provide benefits that go much beyond the area of physical and emotional symptoms and that they can influence the course of the cancer. Bernie Siegel and Deepak Chopra are two well-known authors who have asserted that changing mental state can affect the course of cancer. In best-selling books aimed at the general public these authors make claims such as that patients can control the course of cancer using thoughts. This whole area is highly controversial and nothing has been firmly established.

Question 24

Why do many patients use alternative therapies that lack credible supporting evidence?

Answer 24

Insight into this came from a study in which interviews were carried out on 60 breast cancer patients who used CAM therapies

The investigators observed that key factors in the decision to reject potentially life-prolonging conventional therapy were negative first experiences with “uncaring, insensitive, and unnecessarily harsh” oncologists, fear of side effects, and belief in the efficacy of alternative therapies.

Patients who rejected conventional treatment tend to believe that chemotherapy and radiotherapy are risky and not beneficial. Moreover, they often believe that they can cure themselves from cancer with simple methods like raw fruits, vegetables, and supplements. These findings are not really surprising as the message from CAM therapists is frequently a good deal more positive (and dishonest) than that given by oncologists.

Question 25

The study also suggested how oncologists could make patients more receptive to the best treatment options

Answer 25

The breast cancer patients stated that a compassionate approach to cancer care, educating patients about their options, and allowing them time to come to terms with their diagnosis before starting treatment might have led them to better treatment choices.

Question 26

What are two features for claims that say they help to cure cancer?

Answer 26

First, they are based on an unproven theory regarding the cause of cancer and how it can be effectively treated.

Second, the clinical evidence showing that the treatment actually works is of low methodological quality.

What we often see is a series of cases where the claim is made that many patients had a partial, or even total, remission of the cancer. For multiple reasons such evidence can be highly misleading.

With some of the treatments discussed here, no RCTs have ever been carried out. In other cases, RCTs have generated negative findings, thereby contradicting the earlier, (apparently) very positive findings. However, there are a few instances where RCTs have given apparently positive results. Most often, such RCTs have included only a small number of patients and have been short term. Much hesitation is therefore required before taking the results at face value: confirmation is required, especially from larger studies with longer follow-up.

Question 27

What are the costs associated with CAM therapies for cancer when examining more known types of therapies

Answer 27

This revealed that CAM therapies cost no more than one per cent of the cost of conventional treatment. However, these patients were using CAM therapies that have a modest cost, such as chiropractic, massage therapy, and acupuncture.

Question 28

What are the costs associated with CAM therapies when examining clinics that specialize in it?

Answer 28

Reference was made earlier to a cancer treatment based on antineoplastons. There is no credible evidence that it is effective. Nevertheless, according to some reports, patients may be charged around $300,000 for treatment

Question 29

What are three facts to consider for alternate therapies for Cancer?

Answer 29

Although purveyors of alternative therapies often make grandiose claims, the hard evidence to support such claims is meagre at best. Indeed, no convincing evidence has as yet emerged from RCTs that any alternative therapy can significantly improve the odds of survival.

In many cases, persons who supply alternative therapies profit from the enterprise.

Persons who advocate alternative therapies often rationalize the treatment based on unscientific arguments.

Question 30

Which therapies provide good indication of effectiveness for CAM therapies intended for alleviating physical and emotional symptoms

Answer 30

Examples include massage therapy, music, and mind-body therapies.

Question 31

Which cancer treatment diet uses the traditional concepts of yin and yang and has a list of foods to avoid which includes foods with a cooling or freezing effect?

Answer 31

macrobiotic diet

Question 32

Which alternative cancer therapy includes large amounts of vegetables?

Answer 32

macrobiotic and gerson therapy

Question 33

Which alternative cancer therapy claims that the treatment kills cancer cells by poisoning them with cyanide?

Answer 33

laetrile

Question 34

Which alternative cancer therapy claims that peptide fractions slow or reverse tumour growth?

Answer 34

antineoplastons

Question 35

Discuss the features that typically characterize most types of alternative cancer therapies.

Answer 35

Most alternative cancer therapies offer grandiose claims such as the ability to cure cancer, are very expensive, and are based on unscientific arguments.

Question 36

Discuss the factors that account for the large numbers of cancer patients who use alternative cancer therapies.

Answer 36

The public is dissatisfied with the technologic and impersonal nature of some features of modern medicine. Alternative practitioners are often viewed as more caring, as treating the whole person and providing more emotionally satisfying, communicative relationships. Factors such as inadequate pain management often motivate patients to seek more effective and less toxic alternatives to conventional options. A major factor is a diagnosis of “incurable” cancer, which can lead to a state of desperation.