There are very few good and thorough clinical studies on the use and the long-term effectiveness or efficacy of alternative forms of medicine in the treatment of cancer (let alone the treatment of prostate cancer specifically).
A group of researchers at Yale School of Medicine (see Johnson et al.) have now reported data on a cohort of 281 patients who were initially diagnosed with non-metastatic breast, prostate, lung, or colorectal cancer and who elected to be treated exclusively with alternative forms of medicine. In other words, these individuals decided to have no conventional form of cancer treatment at all (i.e., no surgery, no radiation therapy, no hormonal therapy, and no chemotherapy).
The authors compared the outcomes of each of 280 of these 281 patients to patients with comparable types of cancer, age, and related characteristics (i.e., another 560 patients altogether), all of whom did receive conventional types of cancer therapy.
Here are the key findings reported by the authors:
- The following were associated with an increased likelihood of electing treatment exclusively with alternative medicine:
- Having either breast or lung cancer
- Having a higher than average socioeconomic status
- Living in the Pacific or Intermountain West regions of the USA
- Diagnosis with AJCC Stage II or III disease
- Having a low comorbidity score
- Compared to the patients treated with conventional forms of therapy, the patients who elected to be treated with alternative medicine had a significantly greater risk of death
- Overall (hazard ratio [HR] = 2.50
- Among the subgroup with breast cancer (HR = 5.68)
- Among the subgroup with lung cancer (HR = 2.17)
- Among the subgroup with colorectal cancer (HR = 4.57)
The authors conclude that
Although rare, [alternative medicine] utilization for curable cancer without any [conventional cancer therapy] is associated with greater risk of death.
Now The “New” Prostate Cancer InfoLink is of the very firm opinion that, for non-communicable diseases (and all forms of cancer in and of themselves are believed to be non-communicable), every patient has an absolute right to make his or her decision about how he or she wants to be treated — however odd or unusual that decision might be. (Communicable diseases that can lead to the infection of others are a different category of illness and different “rules” can reasonably be applied.)
We assume, based solely on the data in the abstract of this paper, that there was no statistically significant difference in the risk of death for the men with prostate cancer in this study. We don’t find this to be in the slightest bit surprising, given that the study probably only included about 70 prostate cancer patients, all of whom had been diagnosed with localized or perhaps locally progressive prostate cancer. It would probably take 200 to 500 such prostate cancer patients to show a difference.
We would also note that this study doesn’t comment on the use or the efficacy of alternative forms of medical care in combination with conventional forms of cancer therapy, so whether there are potential overall survival benefits to such strategies is unknown.
Filed under: Diagnosis, Living with Prostate Cancer, Management, Risk, Treatment | Tagged: alternative, death, medicine, risk, utilization |
THE "NEW" PROSTATE CANCER INFOLINK 
When I read this, I immediately wanted to know how long the follow-up period of this study was, and over what time period the estimated survival was. This info was not given in the abstract, so I dug into the paper to find out.
My mind was boggled by the heavy use of statistics, but what I did learn was: (1) The median follow-up for the whole group was 66 months. (2) There were 72 prostate cancer patients who were treated exclusively with alternative medicine, for whom the calculated 5-year survival was 82.6%, versus 91.5% for the matched controls treated by conventional therapy. Given the small size of the data set, this difference was not considered significant.
The study is based on the category “other-unproven cancer treatments administered by non-medical personnel” in the US National Cancer Database. It is unknown what kind of treatments are grouped in this category. At least no treatment provided by a doctor. I think a retrospective study based on 72 cases is of little value. However, it was reported in several press articles.
Here is another article discussing this study.
An extreme of presumptuousness is to tell someone else what they should do in the form of medical treatment. I have explained prostate cancer and active surveillance to several men. One of them proceeded to tell me that I should abandon all that and resort to some homeopathic method. This individual does not even believe in getting PSA tests. I’ve informed guys about active surveillance but tell them whether it is right for them or not is very much an individualized decision.