This is the second study published in the last year looking at outcomes of cancer patients using alternative medicine, showing a negative effect on survival. The same author, Skylar Johnson, was the lead author on both studies. Last year’s study looked at using alternative treatments instead of standard therapy, and the newly published study looks at patients who used at least one standard therapy.

In the current study, just published in JAMA Oncology, the researchers followed a cohort of 258 cancer patients who used alternative medicine, and 1032 matched patients who did not. They found:

Patients who chose CM did not have a longer delay to initiation of CCT but had higher refusal rates of surgery (7.0% [18 of 258] vs 0.1% [1 of 1031]; P < .001), chemotherapy (34.1% [88 of 258] vs 3.2% [33 of 1032]; P < .001), radiotherapy (53.0% [106 of 200] vs 2.3% [16 of 711]; P < .001), and hormone therapy (33.7% [87 of 258] vs 2.8% [29 of 1032]; P < .001). Use of CM was associated with poorer 5-year overall survival compared with no CM (82.2% [95% CI, 76.0%-87.0%] vs 86.6% [95% CI, 84.0%-88.9%]; P = .001) and was independently associated with greater risk of death (hazard ratio, 2.08; 95% CI, 1.50-2.90) in a multivariate model that did not include treatment delay or refusal.

All that means that cancer patients who used alternative medicine in addition to at least some standard therapy were more likely to refuse chemotherapy, radiation, or surgery. As a result patients using CM (complementary medicine, in the jargon chosen for the study) had a 5-year survival that dropped from 86.6% to 82.2%. This represents twice the risk of dying over this time.

The authors also point out that this difference was likely an underestimate of the negative effects of using CM, because the CM cohort were younger and healthier at baseline. So it is likely that using alternative medicine to treat your cancer more than doubles your risk of dying over the next five years.

This also supports other data which suggests patients are not largely turning to alternative medicine out of desperation because their cancer is incurable. It is people who tend to be young, female, healthier, and with more disposable income that are doing so. This is a cultural phenomenon.

These study results also suggest that it is the delay in standard treatment that is causing the worse outcomes. When delay or refusal of standard care is taken into consideration, the higher death rate becomes nonsignificant. This means that direct harm from the alternative treatments themselves is not a major factor.

These data also suggest that alternative cancer treatments don’t work. Despite the hyped claims of proponents, the only apparent affect of using alternative treatments instead of mainstream treatments is that you lose the benefits of the mainstream treatments. If alternative treatments worked they should compensate for the delay or lack in standard treatment. And of course, people often choose alternative treatments because they think they are more effective – when clearly they are not.

Further, despite the fact that the authors call alternative treatments “complementary” in their study, patients are clearly relying on them as an alternative. This is the primary risk that science-based advocates warn about, and no one should fall for the marketing claim that such treatments are complementary, or can be “integrated” into mainstream medicine. They have always been a risky alternative.

In the BBC write up for this study they write:

Martin Ledwick, Cancer Research UK’s head information nurse, said complementary therapies might help improve wellbeing or quality of life for some patients.

Actually there is no scientific evidence that they do. First, this is a fake category. There isn’t really any such thing as “complementary therapies” as a real category. This is just everything that isn’t science-based. The only blanket statement that you can make about them is that there is no evidence that they work. (If there were, they would just be medicine.)

This is also the dangerous foot in the door. Those people marketing fake treatments for cancer have learned to use this marketing tactic – saying that their treatment are not meant to replace standard therapy, just complement them. And they don’t improve outcome, they just improve quality of life. They make the softest claim they can, as a way to skirt the need for actual evidence, or even a plausible rationale.

But in the real world this is a deception. In the end, if you are a proponent of magical therapy, you are a proponent of magical therapy. If you are convinced that it works somehow, because placebo effects gave the illusion of feeling a little better, that clearly will convince some patients that they can rely on such magical treatments. Maybe they don’t need to deal with the side effects of chemotherapy, those vitamins and that coffee enema will do.

The “complementary quality of life” treatments are just a Trojan horse for dangerous nonsense. This is the risk of abandoning a consistent science-based approach to medicine. People rely on nonsense, and they die.

The fact that the people who rely the most on magical treatments are the ones with the best prognosis at the start just magnifies the tragedy. Every cancer doctor can tell you stories of young otherwise healthy mothers, with highly treatable cancers, who opt for alternative treatments, lured by the siren song of “natural” treatments that will cure them without side effects. In the end they become another statistic, ravaged by their cancer until it is too late.

Further keep in mind that in this study all the CM subjects had to have used at least one standard therapy. Only 7% refused surgery, and for most solid tumors surgery is the most effective single component of treatment. Chemotherapy and radiation therapy are adjunctive, mainly used to prevent recurrence. And still refusing these therapies doubled the chance of death.

This study also does not capture patients who refuse all standard therapy in favor of alternative treatments. That was the focus of the study the same authors published last year, and unsurprisingly the risk of dying was even higher than in the current study:

Overall, the hazard ratio (HR) for death was 2.5 (95% confidence interval [CI] 1.88 to 3.27); 5.68 for breast cancer (CI 3.22 to 10.04); 2.17 for lung cancer (CI 1.42 to 3.32); and 4.57 for colorectal cancer (CI 1.66 to 12.61).

For breast cancer women were almost 6 times as likely to die if they relied on alternative treatments rather than conventional care.

If “alternative medicine” were a drug or procedure, and we now had this level of data showing a significantly increased risk of death, it would be abandoned with haste. This kind of data, however, has had almost no effect on alternative practitioners, whose defining characteristic is that they are immune to evidence. This is why we need to educate the public about the risks of relying on unconventional treatments, and to be skeptical of the hype and false claims.