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Alternative medicine and cancer - warnings to heed

Alternative medicine and cancer - warnings to heed

09/02/2018
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Merogenomics


Alternative cancer treatments

There is and probably always will be a war waging between the proponents of western medicine and those in the more alternative camp. This can take on many forms, from being open-minded to either approach, to complete mistrust of one or the other.

Interest in alternative medicine is certainly substantial. It is enough to be the method of choice for some when it comes to cancer treatment.

The only problem is that we don’t have much empirical data on the comparison effect between alternative medicine’s impact on cancer patients versus the conventional standard cancer treatment. In this case, the conventional medical treatments for cancer include chemotherapy, radiotherapy, surgery, and hormone therapy. So a recent publication that looked into the topic of alternative versus conventional cancer therapy was very important in helping to shed light on this issue. The primary results were somewhat startling, if not discouraging, but also yielded very interesting tidbits of information.

The study focused on the survival rate of cancer patients for the four most commonly observed cancers in the US (breast, prostate, lung, and colorectal cancers), based upon the available data in the National Cancer Database between 2004 and 2013. If patients were metastatic at the moment of diagnosis, had stage IV cancer, were placed under palliative care, or showed incomplete information in their records, they were excluded from the study.

Image article quote on most common cancer

Data was available on 280 patients whom elected to pursue an alternative medicine approach only with no access to standard medical treatment options. This data was contrasted with 560 patients who did receive conventional cancer therapy (for a total of 840 analyzed patients).

Were there big differences between the two groups? That is part of the interesting information discovered, and it might surprise you. Cancer patients that used alternative medicine were more likely to have a lower comorbidity score (predicted one-year mortality for a patient with more than one disease), have a higher cancer stage (stage II or III), and were more likely to have breast or lung cancer.

But check out the interesting demographics: alternative medicine group patients were also more likely to be younger, to be female, to have a higher socioeconomic status (higher education and income), and more likely to reside in the Intermountain West or Pacific regions.

Image article quote alternative cancer treatments

 

Cancer survival with alternative medicine

What about the survival rate? For the sake of simplicity, we will only mention the averages: the use of alternative medicine versus conventional cancer therapy was associated with the worse five-year survival rate (54.7% versus 78.3%, respectively). Another way to put it would be through hazard ratio, which compares the rate of death between the two studied populations. So if one group of people is twice as likely to die than the other, their hazard ration would be 2. If that group was ten times more likely to die, the stated hazard ratio would be 10. In this case, when ensuring that the comparison was done between individuals with equivalent clinical and sociodemographic factors, the hazard ratio for a greater risk of death was 2.5 between patients who utilized alternative medicine versus a standard treatment approach.

Image article quote on cancer survival rates

And when stratified by cancer type, the five-year survival rates for alternative medicine could be even more discouraging: 58.1% vs 86.6% for breast cancer (with a hazard ratio of 5.68), 19.9% vs 41.3% for lung cancer (with a hazard ratio of 2.17), 32.7%, vs 79.4% for colorectal cancer (with a hazard ratio of 4.57). Only prostate cancer showed no statistical differences with 86.2% five-year survival rates for alternative medicine treatments versus 91.5% for a standard medicine approach (with a hazard ratio of 1.68).

The authors’ blunt conclusion was: “cancer patients who initially chose treatment with alternative medicine without conventional cancer treatment were more likely to die.”

Blog Figure 1 Cancer morality rates

Adapted from Johnson SB et al. 2018. J Natl Cancer Inst 110(1). doi: 10.1093/jnci/djx145.

These are very serious findings because it suggests that the alternative medicine approaches are either not working as effectively in helping people on their own, or are not utilized correctly to their most effective outcome. Unfortunately, what these alternative therapies were was not stated, as that information was not available in the records analyzed. Such information is either not delivered to the doctors by the patients, or not placed in the medical records by the doctors. It would have been good to be able to stratify the impact of these approaches, as the authors do mention that some limited evidence for the effectiveness of alternative medicine exists, but no references were provided. The National Institute of Health does actually have a very informative website on complementary and alternative medicine, while the National Cancer Institute has assembled such information specifically related to cancer. Luckily, people who choose only the alternative medicine approach appear to be rare, and typically such an approach is used in conjunction with the conventional treatment methods.

In addition, the authors stressed that alternative medicine is not to be confused with complementary or integrative medicine that can be used alongside of the conventional treatments. In essence, alternative medicine is an unproven therapy according to the western standards of scientific analysis. However, the authors noted that the characteristics of the individuals who are more likely to use complementary medicine are very similar to those reaching for alternative medicine.

Image article quote on alternative medicine

Of all the other factors that were looked at, be it gender, level of education, income level, insurance type, geographical region, or the clinical stage of cancer, none of these had a significant impact on the hazard ratio with exception of stage III cancer. So only the use of alternative medicine or the presence of stage III cancer were proven to be the predictors of an increased risk of death. There was one observation that raised an eyebrow, and that was the insurance type. If comparing all of the individuals in the study based solely on their insurance, irrespective of treatment type and any other factors, those who held government insurance showed a significantly reduced hazard ratio compared to those who did not have insurance (no insurance coverage was used as a reference, with no differences observed for those with private, Medicaid, or Medicare insurances compared to no insurance coverage). The statistical significance disappeared when other factors were incorporated into the model, such as treatment type, age, cancer type, race, clinical stage, etc. Still, another good reason to consider government work?

 

Alternative approach, not alternative treatment

My take is that if you seek a different approach that is certainly not standard yet, but has an incredible amount of scientific support, then look at the use of genome sequencing. Of course it is not a treatment resource, but it can still help identify molecular information towards better treatment. In most major cancer centers, genomics is still considered experimental, and often with limited access for patients, but an enormous amount of resources are being invested in this area. You might have heard of the famous announcement by President Barack Obama of the Precision Medicine Initiative, a large scale research program to leverage the power of genome sequencing to develop better cancer prevention and treatment methods tailored to an individual. We are talking about an enormous effort that will involve the sequencing of millions of cancer patients!

Image of article quote on precision medicine initiative

Another good example was recently announcement by the Children with Cancer UK to sequence the genomes of every child with a tumour in Britain. Once again, you can’t help but appreciate the scale of these amazing initiatives.

Image of article quote on children with cancer

And there are good reasons for it. It appears that the majority of cancers develop due to random mutations, arising from such events as inaccurate DNA replication. One study pointed to such mutagenesis impact accounting for 66% of cancer development, compared to 29% arising from environmental influences, and only 5% due to hereditary reasons. You can’t blame your parents for everything! And it can be even much higher in specific cancer types. This means that even though a big chunk of cancers can be prevented by avoiding harmful environments and leading a healthy lifestyle, the confounding genetics can strike at anyone. Like a sinister death star from deep… inner space? Not that it should be an excuse for your favourite unhealthy habits.

Image of article quote on causes of cancer

Blog Figure2 Causes of cancer development

Adapted from Tomasetti C et al. 2017. Science 355(6331):1330

It appears that it generally takes two or more critical gene mutations for cancer to occur, and this genetic footprint, or mutational signature, is becoming increasing better understood. As an example, nearly a complete mutational load has been uncovered in breast cancer development through genome sequencing. In total, 93 genomic sites are known that if mutated will lead normal breast cells to change into cancer cells.

Image of article quote on cancer facts

 

Treating based on DNA

In turn, such knowledge is not left idle. It can lead to development of novel cancer treatments, provide information on appropriately matched current treatment, or even help determine if chemotherapy is a correct option or not. Remaining with the theme of breast cancer, Herceptin is one example of a drug that is used for treatment of cancer with specific mutations. One major study last year showed that combination of Herceptin with another drug was so effective, that it precluded the need for subsequent chemo treatment.

And treatment solutions personalized to specific genetic mutations are on a rapid rise thanks to the rapidly increasing knowledge of genomics. According to a report on a progress of personalized medicine published early in 2017, development of personalized medicines has increased by 62% from 2012 to 2016 alone, then totaling at 132 novel medications. In turn, the number cancer patients that exhibit such genetic mutations that could be targeted by specific drugs can range from 21% for head and neck cancer to 73% for melanoma.

If you believe that majority of us will develop cancer, then which group you might be falling into? You can see why there is so much excitement in this area to fight this epidemic. In fact, the progress of anti-cancer treatments has been so rapid, it appears that there is a problem finding enough patients for all the clinical trials taking place. As the New York Times recently reported, one of the main bottlenecks is that not enough cancer patients have an opportunity to sequence their genomes. An opportunity that can save life!

Image article quote on cancer genomics

So if you desire to try something that for the moment might still seem unconventional, we suggest considering cancer sequencing, and Merogenomics can definitely aid you with that path if needed. If reaching out for alternative medicine to treat such serious condition as cancer, check out the links provided or seek information from very reputable sources. And while much in cancer treatment certainly remains to be discovered, and some studies might never see the light of day due to lack of incentives, the development of modern medicines is very complex and medical research is often deeply misunderstood. So stay well informed and may your genetics stay healthy.

 

This article has been produced by Merogenomics Inc. and edited by Kerri Bryant. Reproduction and reuse of any portion of this content requires Merogenomics Inc. permission and source acknowledgment. It is your responsibility to obtain additional permissions from the third party owners that might be cited by Merogenomics Inc. Merogenomics Inc. disclaims any responsibility for any use you make of content owned by third parties without their permission.

 

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