Outcomes: CAM vs, Standard
First, I am writing this Friday evening, the second entry of the day, because I will be traveling much of the day tomorrow. Not that any of you likely care about when my fingers are flying over the keys, but, since I normally keep to a routine, I always like to explain myself when it is different. Going to Maine, our little house, for the week of the 4th and can't wait.
This is a preview from the World Journal of Surgical Oncology; the final article, in PDF form, is not yet available. This is really important and seems to be the first (or one of the few) studies comparing the outcomes/the survival of women who refuse standard western medicine in favor of complementary/alternative treatments vs. those who opt for the usual western care (surgery, radiation, chemotherapy, hormone therapy). Through the years, I have occasionally met with a woman who ended up making this choice, but I think most people who carry these strong beliefs never make it to my office--and probably never make it to a medical oncologist or maybe even a hospital. When I have talked with these women, who are always really struggling and trying to make a decision which feels right for their beliefs and value system, it is hard for me not to get very upset as I appreciate the danger of their choice. Granted, I am a firm believer in individual choice and will always end up supporting whatever someone chooses, but I wonder how much real information people sometimes have. The statistics quoted here--a five year survival rate of 43.2% vs. 84.7%--are dramatic.
As an aside, a few of these women have returned a few years later with metastatic disease. At that moment, they have been willing to accept chemotherapy, but, by then, the possibility of cure is gone.
This article will be close to hand in my office going forward, so I can share it with anyone who is unsure which way to go.
Outcome analysis of breast cancer patients who declined evidence-based treatment.
Kurian Joseph, Sebastian Vrouwe, Anmmd Kamruzzaman, Ali Balbaid, David Fenton, Richard Berendt, Edward Yu and Patricia Tai
World Journal of Surgical Oncology 2012, 10:118 doi:10.1186/1477-7819-10-118 Published: 26 June 2012
Purpose To analyze the characteristics and outcomes of women with breast cancer in the Northern Alberta Health Region (NAHR) who declined recommended primary standard treatments Materials A chart review was performed of breast cancer patients refused recommended treatments during the period 1980 to 2006. A matched pair analysis was performed to compare the survival data between those refused or received standard treatments.
A total of 185 (1.2%) patients refused standard treatment. Eighty seven (47%) were below the age of75 at diagnosis. Majority of those refused standard treatments were married (50.6%), 50 years or older (60.9%) and from the urban area (65.5%). The five-year overall survival were 43.2% (95% CI:32.0 to 54.4%) for those who refused standard treatments and 81.9% (95% CI: 76.9 to 86.9%) for those who received them. The corresponding values for the disease-specific survival were 46.2% (95%CI: 34.9 to 57.6%) vs. 84.7% (CI: 80.0 to 89.4%).
Women declined primary standard treatment had significantly worse survival than those received alternative treatments. There is no evidence to support using Complementary and Alternative Medicine (CAM) as primary cancer treatment.
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.