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Alternative cancer therapies linked to reduced survival
Cancer patients who use alternative therapies may be more likely to shun conventional treatments and risk their chances of survival, research suggests.
A study of 1,290 patients in the US found people who received such therapies often refused life-saving care such as chemotherapy or surgery.
Fewer of them survived five years after starting treatment compared to those on standard care, researchers found.
Experts urged patients not to ditch proven cancer medicines.
Tell that to Steve Jobs.
Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable Cancers (open, DOI: 10.1001/jamaoncol.2018.2487) (DX)
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Alternative Therapies for Cancer Patients Reduce Survival Rates
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Goto, n.:
A programming tool that exists to allow structured programmers
to complain about unstructured programmers.
-- Ray Simard
(Score: 4, Informative) by MostCynical on Sunday July 22 2018, @10:28AM (4 children)
musical version:
https://www.youtube.com/watch%3Fv%3DHhGuXCuDb1U [youtube.com]
"I guess once you start doubting, there's no end to it." -Batou, Ghost in the Shell: Stand Alone Complex
(Score: 2) by JoeMerchant on Sunday July 22 2018, @12:58PM (2 children)
Exactly.
There's two relevant dimensions to these statistics: median survival rate (which is what TFA refers to), and confidence interval, which I suspect TFA is neglecting.
If there ever comes a day where I am diagnosed with a well known cancer with a well known treatment with a well known median survival rate of 17%, 95% CI +/- 5%, and a new experimental treatment with a handful of cases, basically unknown survival rate (because 5 years hasn't passed since patient 1), but a rational explanation why this treatment might be much better for me - I think I would try the experimental treatment rather than play Russian Roulette with 5/6 chambers full.
Even if the median survival rate of the new treatment is only 10% for the entire experimental group, they may be able to tease apart risk factors for sub-populations in that group and going forward identify sub-populations with expected survival rates much better than the traditional treatment. Early days you may not be easily classified as to whether or not the new treatment is beneficial for your case, but later on those sub-populations who it works better for can benefit and those that it is not indicated for hopefully will have other investigational avenues as options to the 5/6 chance of death offered by the "best available" treatment.
🌻🌻 [google.com]
(Score: 1, Informative) by Anonymous Coward on Sunday July 22 2018, @07:33PM (1 child)
I thought similar until I did medical research and realized that almost all these numbers are BS in someway. At best, they all refer to some really specific situation thats not you. At worst, its just whatever numbers met a threshold for a grad student to get published and thus move on.
(Score: 2) by JoeMerchant on Sunday July 22 2018, @09:30PM
All too true, however - in oncology, there are riduculously high numbers of tracked and documented, some treatments go back 50+ years (including radiation and chemo), so they actually do have some scientific basis for the numbers.
On the other hand, I had (still have a bit of) a schwannoma which the first MD mostly extracted before he identified/classified it. It grew back to about 30% of its previous size, I had moved 1000 miles away and so went to visit another MD who cheerfully informed me that "I want to get that whole thing out, soon as possible, it can spread turning into a string of beads, I have an opening in surgery next Tuesday you can schedule as you leave...." Umm... pass? I did a quick Google search and, indeed, in the first page there was a reference to a Japanese man who had a schwannoma on a nerve between his ribs and it did indeed present as a string of beads. However, no other reference to schwannoma out of the dozens I checked referenced a string of beads presentation, and even searches for schwannoma string of beads only turned up the one reference at the time - though I see a few more today, but the overwhelming body of reference was much less: big and scary, schedule surgery for extraction immediately and much more: if it is not a problem presently, wait and see. A few years later I visited another MD and that was her first advice, and now 15+ years later it would seem that she and I were correct: surgery not required.
🌻🌻 [google.com]
(Score: 2) by JoeMerchant on Sunday July 22 2018, @01:48PM
By the way, Minchin's rant is awesome, and I agree with 99% of what he says, and disagree with 90% of what he has Storm say (discrepancy mostly because he doesn't let Storm talk much), but - cherry picking some points of disagreement:
Proponents of Science often do take their Science on what amounts to Faith, and when pressed on the point, much like practitioners of Faith they simply scream "SCIENCE!!!" louder rather than actually examining what they are asserting. Bad science doesn't go around labeling itself as such, but there is an awful lot of it out there that is little different from faith, and in until the majority of the public can discern bad science from good, Storm's point that science is little different from faith rings true for the majority which cannot.
The final argument about "I get to live twice as long" is radically oversimplifying a complex assertion. In absolute terms, some people in the deep past also managed to live to 100+ years of age, statistically we're doing much better now, but the spread still runs from infant mortality through 100+ years. Another point is the extremely long lived people of today in places like Okinawa and the mountains [chicagotribune.com] or even faithful practitioners of the Mediterranean diet. It's not the pinnacles of modern science that's giving them their longer lives. It's not magic, either, but science is clearly still playing catch-up - what has been happening more or less naturally in those cases is still outperforming the best modern science has to offer the rest of the world in terms of longevity.
Rather than post a third reply, I'll waffle back to the cancer treatment statistic for a moment and also throw in the dimension of quality of life - if there's a traditional treatment with a 60% survival rate but a really shitty quality of life for 2 years during treatment and followup (and perhaps even accelerated mortality for the losers), or an alternative with a 45% survival rate and minimal impact on quality of life during treatment, which would do you choose? (Assuming similar confidence intervals for both...) Steve Jobs is a popular target for his cancer treatment choices, but I believe he opted for the higher quality of life option first - lost the gamble, but it may have still been a very rational gamble to take.
🌻🌻 [google.com]
(Score: 2, Interesting) by Anonymous Coward on Sunday July 22 2018, @02:43PM (3 children)
Rant on
My wife and I were flabbergasted by an old oncologist who proposed treatment schedule was the pinnacle of 1995. He scheduled chimio before surgery to reduce a small tumor that the oncologist surgeon told us he was able to operate and choosed chemo instead of hormo therapy when the cancer was 100% hormonopositive... Going back to the surgeon we were able to get another oncologist that confirmed that the correct treatment schedule was surgery, hormono, depending on the pathology result chemo and depending on the surgeon observation radiotherapy...
The old oncologist schedule was backward with regards to everything that was published after 2010. When were done with her breast cancer we will a formal complaint with the medical board... and maybe have her dossier analyzed by a medical lawyer.
Rant off
(Score: 4, Insightful) by JoeMerchant on Sunday July 22 2018, @03:04PM (2 children)
Conservatism is the norm in oncology. That your oncologist was only 8 years out of date is probably better than average.
🌻🌻 [google.com]
(Score: 0) by Anonymous Coward on Monday July 23 2018, @01:46AM (1 child)
Thanks you just saved me some lawyer fee. But I am not sure if I should be reassured or worried by your statement!!
But we still will fill a formal complaint, with the board as this cost nothing but time fillings a lot of forms...
(Score: 2) by JoeMerchant on Monday July 23 2018, @01:20PM
Just because it is the norm does not mean that it is good, right, or even acceptable.
If you love the idea of suing your doctor, consult a lawyer or two there are probably some who would take the case, I doubt you'd find any to do this on contingency, but I'm not super-experienced in ambulance chasing and/or malpractice (I think there's a lot of overlap.)
DO complain to the board - it might even get them to kick their M.D.s and encourage them to do some real continuing education instead of just going to conferences and playing hole-in-one tournaments to win a new car: literally, I was at a conference with 50,000 MD's "in attendance," they had a talk by then Surgeon General C. Everett Coop - less than 100 MDs attended, more of them were out at the golf tee trying to sink a hole in one to win a Cadillac. The paper presentations and other continuing education events were similarly ultra-thinly attended, but I do believe many of those golf playing MDs managed to wrangle some CE credit for attending the conference.
Not all conferences are like that, I regularly attended another for several years with attendance in the 10-12,000 range, and that one at least had mobs of semi-interested docs and nurses at the paper presentations, and full auditoriums for the talks, even if they did also have (well attended) celebrity appearances by such luminaries as Loni Anderson.
🌻🌻 [google.com]
(Score: 2) by HiThere on Sunday July 22 2018, @05:25PM (1 child)
It's their life, damn it. If they want to choose a treatment that's less likely to cure them and more likely to leave them dead, that's their right. They should be told the official expert opinion, but it's their life. And sometimes the experts are wrong.
Also, sometimes there's no "good treatment" available. And it that case it can make lots of sense to play the long shots.
OTOH, asking their insurance to cover it is a separate question, and one I'm conflicted about.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2) by JoeMerchant on Sunday July 22 2018, @09:44PM
Even more to the point: what's the quality of life impact of the various treatment choices? Signing up for a year of certain misery for a 5% better chance of survival isn't really good odds when you've got less than 20 years to live no matter what.
🌻🌻 [google.com]
(Score: 1, Insightful) by Anonymous Coward on Sunday July 22 2018, @06:52PM (1 child)
Quite likely, those who expected to survive on standard care were not inclined to use alternative therapies. And vice versa.
(Score: 2) by darkfeline on Tuesday July 24 2018, @03:52AM
Even so, those who were not expected to survive would probably have had a better chance had they stuck to medical science over prayer under a different name, e.g., 0.1% chance of survival vs 0.0001%
Join the SDF Public Access UNIX System today!
(Score: 0) by Anonymous Coward on Sunday July 22 2018, @07:51PM
So patients with certain types of cancer who are getting no hope from their "conventional therapy" (ie poison we hope kills the cancer before your organs shut down) results seek out other options. The ones that tell their hospital about it die sooner than those who get encouraging results early on from the conventional therapy. They dont mention this possibility from what I can see in the paper.
(Score: 0) by Anonymous Coward on Sunday July 22 2018, @09:28PM (7 children)
My stepdad has prostrate cancer. It was diagnosed early while he was still quite healthy - he lived a life of sports and good food. However, from the beginning, he refused chemo, even though he got told the expert opinion not just by the docs, but also by his sister in law (my aunt) who's a nurse working in palliative care. She has seen lots of cancer patients through to the end and provided not just her experience, but also graphic details of what's gonna happen when left untreated properly.
He's a stubborn naturalist type and doesn't "believe" in the "school of conventional medicine", sticking with an alternative practitioner he's gone to for most of his adult life - which worked up till now because apart from some small ailments, he was always as vital as a horse.
A year since diagnosis, hormone therapy slowed down the cancer, but he's been living with a bladder catheter ever since. But despite this and growing pains he refuses to let go of his belief in alternative medicine. It's pretty agonizing to have to watch, unable to do anything.
How would you try to convince someone like this that his lifelong "observation" of "alternative medicine works" is wrong and that he should not place his faith in it if he wants to live?
(Score: 2) by JoeMerchant on Sunday July 22 2018, @09:47PM (1 child)
First: most men die with prostate cancer, not of prostate cancer.
It sounds like your dad has a bad case, there are some very targeted therapies (thermal ablation comes to mind, there are others), which can dramatically reduce the symptoms with very little collateral damage.
Of course, with our cat, she just hates the vet, so we have decided that rather than making her periodically miserable dragging her to the vet for regular checkups, we'll let her take her chances with the world of disease and health problems. She turns 14 this year.
🌻🌻 [google.com]
(Score: 0) by Anonymous Coward on Monday July 23 2018, @06:50AM
Had the same situation with my cat. She did not like the change in scenery and overriding her will at all. When I got her back home, she would remind me how much she hated the place. She wasn't the same loving animal I had, now she was scared, untrusting, considered me a threat, and would tense up into very obvious unease whenever I picked her up.
I, like you, could not bear to force her to go through this again. Rather take my chances, and let her live in peace... even if it meant getting sick and dying in peace.
Thankfully, the law around here considers a cat to be a wild animal, and does not have to have tracking chips implanted into them or licensed. If she were a dog, I'd have no choice... too many snoops make it their business to pry into my business... they see my animal as a guaranteed moneymaker as long as they keep law in place to guarantee I have to jump through hoops for licensing.
(Score: 2) by Grishnakh on Monday July 23 2018, @03:41AM (3 children)
There's nothing you can do. This stuff is a religion. My ex-wife believes in this stuff too; it's one of the reasons we divorced. There's just no point in talking about alternative vs. conventional medicine with these people; you can't change their mind, just like you can't change the mind of a devout religious person about their religion of choice.
(Score: 0) by Anonymous Coward on Monday July 23 2018, @04:47AM
http://amishamerica.com/do-amish-visit-doctors/ [amishamerica.com]
https://www.ncbi.nlm.nih.gov/pubmed/11503162 [nih.gov]
(Score: 0) by Anonymous Coward on Monday July 23 2018, @05:06AM (1 child)
More: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0051560 [plos.org]
https://www.bmj.com/content/353/bmj.i2139 [bmj.com]
Amazing how they never suspect its some aspect of their "healthcare" thats reducing lifespan. I wonder if bloodletters were just as smug.
(Score: 3, Insightful) by All Your Lawn Are Belong To Us on Monday July 23 2018, @05:45PM
I wonder if bloodletters had journals detailing their mortality rates? Well, no I don't.
What you're actually seeing in those articles you cited is medical science and healthcare, in case you'd missed that.
This sig for rent.
(Score: 2) by All Your Lawn Are Belong To Us on Monday July 23 2018, @05:39PM
First, recognize that it is that person's choice and you might be wrong yourself. Alternative therapies do work for many things, and can also be very complementary to an allopathic regimen as well. The real sin is in forcing treatment against somebody's will, of either type. You're not talking forcing here, just convincing, just showing that there are worse alternative that have in fact been done in medical history. And in that first recognition also realize that you most likely will not convince him of anything - be prepared that he will continue to disagree with you.
Aside from that, you can - in love - ask why the person doesn't believe that conventional treatment may help. Or if they, for your sake, would see an oncologist to get information - not necessarily treatment. (Finding the right oncologist or physician is a key here, as many will just want to treat with their knowledge and not address whether their treatment is "right" for the patient.) You can point out your feelings that you believe that seeking conventional treatment (or conventional treatment alongside the alternative) has a better chance at having your stepdad in your life for longer, and that you want him to have the best chance for recovery.
And then let him decide.
(And this isn't just academic. I have a relative whom I love dearly in exactly the same situation, except that she is now considering surgery after having tried natural methods. And yes, I find that it breaks my heart that she didn't agree to this a year ago because usually the prognosis only gets worse the longer you wait. But I had to do the same above.)
This sig for rent.