Women Who Use Complementary Medicine Techniques May Be Less Likely to Start Chemotherapy

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Complementary medicine is the term used to describe therapeutic techniques that are not part of conventional medicine (also called "regular," "standard," or "mainstream" medicine). Many complementary medicine techniques, such as acupuncture and tai chi, come from traditional Chinese medicine. Complementary therapies are used as a "complement" or addition to conventional medicine. Because complementary medicine can be combined or integrated with conventional medical treatment, it is also called "integrative medicine."

Complementary medicine includes techniques such as acupuncture, herbal medicine, massage, support groups, and yoga. Sometimes called holistic medicine, complementary medicine typically addresses how disease affects the whole person: physically, emotionally, spiritually, and socially.

A study suggests that women diagnosed with early-stage breast cancer who were prescribed chemotherapy were less likely to start chemotherapy if they used complementary medicine techniques.

The study was published online on May 12, 2016 by JAMA Oncology. Read the abstract of “Association Between Complementary and Alternative Medicine Use and Breast Cancer Chemotherapy Initiation: The Breast Cancer Quality of Care (BQUAL) Study.”

The study, called the Breast Cancer Quality of Care study, involved 685 women younger than 70 diagnosed with early-stage breast cancer from May 2006 to July 2010.

Just under half the women (306 women or 45%) were prescribed chemotherapy. For the rest of the women, chemotherapy was considered discretionary, meaning they could have the treatment if they wanted it.

The researchers interviewed the women right after they were diagnosed and asked if they used five types of complementary medicine techniques:

  • vitamins or mineral supplements
  • herbs or botanicals
  • other natural products
  • mind-body self-practice, including meditating, praying, or doing yoga or journaling on your own
  • mind-body practitioner-based practice, including attending a yoga class, getting a massage, or having acupuncture

The women were followed for 1 year. Throughout the year, the researchers asked the women if and when they had started chemotherapy.

Overall, the researchers found:

  • 598 women (87%) said they used some type of complementary medicine technique
  • 261 women (38%) said they used three or more complementary medicine techniques
  • the most common complementary medicine techniques used were dietary supplements and mind-body practices
  • 272 women (89%) who were prescribed chemotherapy started chemotherapy
  • 135 women (36%) for whom chemotherapy was discretionary started chemotherapy

Among the women who were prescribed chemotherapy:

  • women who used dietary supplements were less likely to start chemotherapy
  • women who used several types of complementary techniques were less likely to start chemotherapy

compared to women who didn’t use complementary medicine techniques.

Using mind-body practices didn’t seem to affect whether the women started chemotherapy or not.

For women whom chemotherapy was discretionary, using complementary medicine techniques didn’t seem to affect whether they started chemotherapy or not.

The results of this study are troubling. While chemotherapy does cause side effects, some of them severe, it does kill any cancer cells that may be left behind after surgery and reduces the risk of the cancer coming back.

In an accompanying editorial, Dr. Robert Zachariae, of the Department of Psychology at Aarhus University in Denmark, wrote, “To provide the best-evidence-based decision support regarding CAM [complementary and alternative medicine] use -- including whether to use CAM as a complementary or alternative treatment to adjuvant chemotherapy -- oncologists need to be actively involved in discussing CAM use with their patients. Only by acknowledging that communication about CAM use is an important part of cancer care will oncologists be able to help patients make sufficiently informed choices about CAM use.”

A Breastcancer.org study confirmed that many people don’t want to tell their cancer doctors they’re using complementary therapies. People feel that there’s not enough time during a doctor visit, or the doctor might disapprove. Many people think that their doctor didn’t study this type of medicine in school, so won’t know anything about it.

But it’s extremely important that you talk to your doctor about any and all complementary medicine techniques you’re using. While most complementary techniques can help ease pain and fatigue, some dietary supplements can interfere with the effectiveness of some anti-cancer medicines.

Here are some points that can help you talk to your doctor:

  • Do a little homework. Download information on the therapies that interest you from reputable websites, such as Breastcancer.org, the National Center for Complementary and Alternative Medicine (NCCAM), and cancer center sites. Write down your questions and bring them with you to your appointment so you don’t forget to ask about them.
  • Express your point of view. Tell your doctor that you have started to read about complementary therapies or you want to try them. Make it clear that you feel complementary medicine is an important way to help your physical and emotional symptoms, as well as your quality of life.
  • Listen to your doctor's response. Give your doctor enough time to respond to your statements. After she or he has spoken, make sure you understand the doctor's point of view.
  • Talk to the nurse about complementary therapies. Nurses may have had more training in complementary medicine. The nurse also can go over the points you have already brought up with the doctor.
  • Ask your doctor if your complementary medicine practitioner can call to discuss your combined care. Your doctor may be concerned that your complementary medicine practitioner has not worked with people who have been diagnosed with breast cancer. Or your doctor may have a question about the practitioner's credentials. A conversation between the two can help ensure you get the quality care you deserve.
  • Restate your commitment to conventional cancer treatment. It's important for your doctor to know that you are committed to continuing your chemotherapy, radiation treatments, or hormonal therapy.

For more information, visit the Breastcancer.org Complementary & Holistic Medicine pages.

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