I

n 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.

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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.

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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.

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  • In these days cancer is 100% curable provided it is diagnosed in early stages and treated under the oncologists. I am a cancer survivor. I was diagnosed throats cancer in 2012. I was diagnosed at DMC Ludhiana and treated at MohandaiCancers Hospital Ludhiana. Now I am following 6 monthly check ups.

  • I think any medical intervention must be from Evidence Based Medicine. To be alone may have played an important role to choice “natural cancer treatment”. It rises a question: “Could a good psychologic support have resulted in different treatment choice?”

  • What strikes me most about this blog is the description of ‘Ruth’s’ last few days before her death. No family and not wanting to inform friend’s of her condition. Dying alone in a hospital at the young age of 31. So very sad.

  • Indeed it is heart breaking when people choose an exclusively alternative treatment strategy as a rule. I see this among patients all the time and it frustrates me to no end.

    Just as heart breaking, or perhaps even more so, are the stories of patients who putting all their faith in those who should deserve it, their board certified oncologist, who at the recommendation of their oncologist refuse “gold standard” integrative treatments (gold-standard conventional + gold-standard unconventional) that when “done right” overwhelmingly demonstrate superior survival on a consistent basis. It’s just as heart breaking to see peer reviewed articles publish studies (one was published just last month) in respected journals reviewing integrative treatments under the guise of them being gold-standard when they were not … not even reaching the sad status of tarnished-gold, brass, or just pig-iron standard.

    The prejudice among those practitioners who get most of their learning from the water cooler and cherry picked articles the the one I just mentioned is understandable, especially when backed by recollections of patients refusing conventional care with the inane belief that reflexology and prayer alone will save them.

    But all conventional treatments started out unconventional and if given the chance. The lack of that chance compounded with profound prejudice is the biggest problem today as “EBM standards” as screwed up as they are have made the costs so great for FDA approval, that only outrageously expensive proprietary treatments have the financial backing (due to the profit motive) to push themselves through the process.

    We will see just how wrong convention can be when the recently initiated Sepsis treatment (celebrated by Dr. Paul E Marik) at the NIH demonstrates without any doubt that intravenous vitamin C (so dismissively maligned in this article) cures sepsis … something that proponents have been saying for 2 dozen years.

    In short: Not all “alternative medicine” is the same (the good stuff becomes conventional, eventually), and and all-or-nothing approach is bad whether your exclusivity is with respect to conventional or unconventional medicine. The good practitioner looks at the protocols tested and reads the little details in the report (like soft-drinks given during intravenous vitamin C, or selecting only patients that conventional medicine gave up upon – sheesh) and whom can distinguish between a gold-standard protocol and a tarnished-standard good for little more than TP.

  • You don’t have to fly to Mexico for these “treatments.”

    Some “Registered Naturopathic Doctors” in Colorado offer IV vitamin C and mistletoe extract for cancer.

    There’s really no end to the nonsense naturopaths offer the public, including homeopathics for rattlesnake bite, and having kids wear wet, frozen underwear and socks instead of a flu shot. Their major textbook instructs them in how to diagnose and treat according to the Four Humors — blood, phlegm, yellow bile and black bile. Yes, this is the ancient practice that includes bleeding to treat a fever (which killed our first president).

    How on earth have naturopaths, who commonly refer to themselves as “physicians,” convinced legislators to legitimize them through toothless regulation?

  • Well and good but you are forgetting to say that studies show that 70% of cancer deaths are of patients diagnosed early with potentially curable cancer.
    Most patients with breast cancer are given paclitaxel which has been proved to promote metastases !
    I had all traditional treatment including paclitaxel ( little i knew) with early curable cancer . Just to find myself with advanced stage 4 cancer. Which was not natural progression, it was promoted by the very drugs i took….to save my life!
    We need to combine both natural n pharmacological if we were to achieve better outcomes. Patients who choose integrative practices are isolated and awfully treated by drs as if they were stupid hippies!

    • Well said, Soraya. Purists are almost always willing fools, regardless which approach they take. The wise man takes the best from what’s available, and makes available the best that is just out of reach, and uses whatever he can to do the best he can. Only a fool makes snap judgement through mere association. Would be that more practitioners were wiser by a magnitude of order.

  • What is the cancer journal relation to big pharma?
    Chemo and radiation don’t have great success either many times and cause suffering and mutations leading to more cancer. Either way not always miraculous, but oncos telling patients to eat crap during weight loss feeds the cancer. How much nutrition training did you get in med school? Why don’t we focus on prevention and epigenetics?

    • Rachel said:

      “Chemo and radiation don’t have great success either many times and cause suffering and mutations leading to more cancer.”

      Why do you say that?

  • I wonder which corporation paid for this travesty of journalism. Would statnews please let us know the name of the corporation that gave the grant, aid, contribution or adverting funds that supported this?

    • This article was written by a physician who has no conflicts of interest. His work was not supported by any corporation or advertising. In case you missed it, this article is part of STAT’s First Opinion section.

      Pat Skerrett
      Editor, First Opinion

    • I so sick of whackos, with degrees or not, insisting that any of us who are involved in cancer research and education are merely shills for big pharma and are lining our pockets with money, having no intention of helping people. It’s false, bizarre, and insulting. This was a well-written article that hopefully educates people. Even some “doctors” apparently need the info.

    • I agree with the suggestion that those who do articles like this are not shills … not at least intentionally so. The article is exactly what a typical conventional practitioner should be expected to feel and believe given the environment in which they swim. And I mean swim. The indoctrination and dogma and constant barrage of poorly done studies to support the status quo is so incessant, and the priesthood in which practitioners are rock-stars and patients are cattle who deserve every impudent remark … it is so extreme that it is nearly impossible for many practitioners to even conceive the possibility that they live in a microcosmic bubble.

      The reality is that studies (example: PMC3677204) have shown that 34% of cancer patients use CAM, but only 7% end up telling their practitioner. In short: Doctors Don’t Know What Their Patients Are Doing To Cure Cancer. They only remember the bull headed ones who foolishly refused conventional care (whom *some* practitioners use as a test case even for integrative approaches, which is just plain stupid) … failing to realize that half of their patients are using CAM and they don’t even know who they are.

      Here’s the thing … most all CAM is at worst a distraction that costs more money (but on average far less than conventional care). Even amygdalin which creates cyanide when exposed to stomach acid … no studies other than statistically insignificant (we’re talking EBM, let’s use the ruler equally, okay?) case studies showing decreased survival (and lets not forget the infamous report where researcher Ralph Moss was fired for revealing that the study was intentionally botched so amygdalin wouldn’t demonstrate significant efficacy). But I digress.

      Dr. Kamath is a good doctor who does a very respectable job with what he can with the training with which he has been inundated. His opinions are authentic and are just what one would expect who’s lived in an exclusionist society based on screwy EMB standards which resulting costs disallow serious research into the treatments he has been raised to impugn: non-proprietary treatments, which he calls “alternative” (neglecting to admit that intregrative / adjuctive therapies might have any value).

      The good thing is that he is a vestige of the old guard. I’m part of a movement with JoinTheDASH.org, and we’re promoting 25 initiatives that will eventually put an end to this insidious situation. It may take dozens of year … but in the end truth will out. I think it will come about by their own greed too … healthcare bankrupting the nation (pharma is the #3 costliest industry … #1 is food dring, #2 is oil). The solution is not political. It’s scientific and statistics-twisting types which are plentiful on “STATNEWS” will one day be seen as idiots who were so intent on running pvals that they never looked at the crap on which those pvals were based.

    • Typo in last comment. It’s actually 43% who *do* use CAM. Only 7% of patients tell their doctor about it. The other 36% do it secretly out of fear because they’ll be treated as if they’re the fool who relies exclusively on CAM. With good reason. I’ve seen it happen more than I care to admit.

    • One can neither feed cancers nor starve them. If the body does not have enough “sugars” to meet demand then it merely synthesizes them. If you have excess you eliminate or store them.
      This article is poor journalism and even worst science. Merely sensationalism.

    • Steve Jobs did indeed opt for an “alternative” unproven approach to treating his cancer before eventually turning to actual medicine. Arguably the delay killed him.
      Dr. Lasker, this is clearly labelled as an opinion piece, and I must disagree that it is in any way sensationalism. The study it references from The Journal of the National Cancer Institute is clear about the different outcomes for treating cancers with science-based medicine vs. unproven “alternative” approaches. Is that “poor science”? Because is seems to me to confirm the obvious.

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