In the early years of my career as an oncologist, I’m learning that you really remember the patients you can’t save. Those with essentially curable cancers who refused the right treatment stand out the most.
One of those is a patient I’ll call Ruth. She was only 30 when she was diagnosed with breast cancer, as I learned later from her medical history. It was localized to her left breast and contained within the relatively small tumor; there were no signs it had spread to other parts of her body. With the right treatment, Ruth had about a 75 percent chance of staying free of breast cancer for the rest of her life.
The “right treatment,” though, wasn’t going to be easy. Ruth would need to have surgery to remove the tumor followed by several months of chemotherapy, which would cause fatigue, nausea, and hair loss. Then it would be on to several weeks of radiation, which can cause fatigue, skin irritation, and scarring of the lungs. The path would be arduous, but it offered Ruth the best chance for a cure.
Instead, she chose an alternative medicine approach with a doctor in Mexico. I never learned exactly what it entailed, but it generally consisted of getting intravenous infusions of vitamins, including vitamin C, once a week. Drinking juices and other beverages with berry and plant extracts — all with supposed anti-cancer and healing properties — was also part of the treatment. Everything was “natural” and wholesome. After several months, she returned home to Chicago. Her breast felt fine and she thought the treatment had been successful.
A year later, Ruth found herself tiring easily. She had little appetite and was rapidly losing weight. She was also having trouble thinking and remembering things. She came to the emergency room when she lost strength and balance in her legs to the point that she couldn’t walk. An MRI showed that her breast cancer had spread to the lining of the brain and entire spinal cord. A spinal tap showed that the fluid that cushioned Ruth’s brain and spinal cord was filled with breast cancer cells.
I met Ruth when she was first admitted to the hospital. By then, she couldn’t articulate where in Mexico she had received her treatment, or what exactly it was, because her memory was fading and she was increasingly confused. She had no family and refused to call her friends for support.
I explained that her breast cancer had spread widely and that she had a few weeks or months to live. We could give her a high dose of a chemotherapy drug called methotrexate to try to improve her balance, leg strength, and mental clarity, but beyond keeping her comfortable there was little else we could do. This time, Ruth agreed to chemotherapy, though it was far too late. Despite the treatment, she became more confused and her weakness worsened. She lost the ability to speak or swallow any food or water. Four days later, Ruth slipped into a coma and died alone in a hospital room. She was only 31.
It is human nature to believe that anything that is “all natural” is intrinsically good. That line of thought can lead people astray. The truth is, cancer is all natural. While some are caused by smoking or chemical exposures, most of them are sporadic, meaning they aren’t caused by any lifestyle factor, food, or chemical exposure. Cholesterol, a major cause of heart attacks and strokes, is natural and even necessary — the body requires it to build cell membranes and the protective covering around nerves. HIV, Ebola, and Zika are all caused by naturally occurring viruses.
Ruth, with her belief in so-called natural healing, thought nothing of stepping onto an airplane weighing thousands of pounds and flying at 30,000 feet from Chicago to Mexico. What could be more unnatural?
Absolute and exclusive belief in natural alternative medicine to cure cancer has devastating consequences. A study out this month in the Journal of the National Cancer Institute looked at 281 patients with non-metastatic breast, lung, colorectal, and prostate cancers who chose to be treated exclusively with an alternative approach, and compared their survival with patients who received conventional cancer treatment. Overall, those in the alternative medicine group were 2.5 times more likely to die. Those with lung cancer were nearly 2.2 times more likely to die, and those with colorectal cancer were 4.5 times more likely. Women with breast cancer fared the worst — with a 5.7 times higher death rate among those who chose only alternative therapies. Several other studies have shown similar outcomes, especially for breast cancer.
People with cancer are easy targets for naturopathic scams because they can be desperate for hope and extensively research their treatment options. “Natural” treatments with few side effects appear irresistible when compared to surgery, chemotherapy, and radiation. But it is almost impossible for most people to know beforehand that these natural remedies won’t do anything for their cancer. If the cancer returns, they are more likely to blame the cancer rather than the ineffective natural remedies they received.
There’s no doubt that alternative medicine can play important roles in cancer care. Techniques such as acupuncture, yoga, meditation, and others can greatly improve cancer-related fatigue, pain, mental health, and quality of life when they are added to standard cancer therapy.
Some doctors reject alternative medicine completely, alienating patients like Ruth in the process. The unfortunate thing is that she didn’t have to choose between alternative and traditional medicine. They can be complementary approaches, not exclusive ones. She could have taken vitamin C tablets, drank berry extract beverages, and participated in yoga or meditation classes during chemotherapy or radiation therapy regimens.
Making a decision about treating cancer shouldn’t be based solely on a natural versus unnatural algorithm. We should focus on making choices that realistically have the best chance to help us. Sometimes, the “unnatural” option is the best one.
Suneel D. Kamath, M.D., is a hematology/oncology fellow at Northwestern Memorial Hospital in Chicago.