May 26, 2015
Cancer patients under age 65 are much more likely than older people to explore alternative and complementary medicine for easing their symptoms and side effects of treatment, a new study suggests.
“We found that the baby boomers are much more likely to use complimentary and alternative therapies than their parents in part due to a social change in the U.S. in the 60s and 70s with a big social movement toward things like a macrobiotic diet and yoga that made these things more mainstream,” said senior study author Dr. Jun Mao, director of integrated oncology at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia.
Mao and colleagues surveyed adults with breast, lung and gastrointestinal tumors who were treated at the cancer center between June 2010 and September 2011.
They asked whether patients had used any complimentary or alternative medicine therapies since starting treatment, and offered examples such as acupuncture, chiropractic care, art therapy, massage, yoga, tai chi, special diets or herbal supplements.
The 969 people who completed the survey were 59 years old on average; 63% were women and most were white and college-educated.
Slightly more than half the participants had been diagnosed with cancer more than a year before completing the survey. About 59% had tried at least one form of complimentary or alternative medicine therapy since their diagnosis.
Patients who were female, age 65 or younger, or college-educated were much more likely than other study participants to expect alternative or complementary treatments to be beneficial, the researchers report online May 26 in the journal Cancer.
People who were working, or who had been living with their cancer diagnosis for longer, were also more likely to believe in the potential benefits of nontraditional treatments, as were people who had already tried these options.
The people in the study who tried alternative and complimentary therapies were generally 65 or younger, had at least some college education, didn’t have chemotherapy, and had their diagnosis for more than a year.
Barriers to alternative and complimentary treatments included lack of knowledge about these options, lack of insurance coverage and the inability to find a provider. Non-white patients were more likely to perceive barriers to this type of care.
The study only included patients with three types of cancer, and it wasn’t designed to assess how often or extensively participants might use alternative or complimentary therapies, the researchers acknowledge.
Another drawback of the study is that it didn’t distinguish between alternative medicine, approaches that lack any evidence of effectiveness, and complimentary therapies that have been found to relieve symptoms, said Barrie Cassileth, founding chief of the integrative medicine program at Memorial Sloan Kettering Cancer Center in New York.
“Once you lump these together, you don’t know what people are responding to when you ask them about their beliefs,” said Cassileth, who wasn’t involved in the study.
All comprehensive cancer centers in the U.S. include programs in integrative medicine that offer patients additional tools to manage the symptoms of cancer as well as side effects from treatment, as well as palliative care at the end of life, Cassileth said.
These programs focus on evidence-based medicine that can be offered along side traditional cancer treatment, but steer clear of approaches without any science to suggest they might be effective, said Dr. Lorenzo Cohen, director of the integrative medicine program at the University of Texas MD Anderson Cancer Center in Houston.
Patients considering complimentary medicine to ease symptoms should ensure that the practitioner offering options like yoga or acupuncture is familiar with the side effects of cancer and willing to coordinate care with an oncology team, he said. While such providers may be on staff at a comprehensive cancer center, patients should exercise caution when seeking a provider on their own, he noted.
“It’s very important that they have experience in working with cancer patients, and that they absolutely don’t recommend something in place of conventional care,” said Cohen, who wasn’t involved in the study. “I wouldn’t go to a person who recommended supplements and told me to go off chemo, or someone who didn’t take the time to ask what medications I have had so far to treat cancer.”