Alternative cancer treatment

Alternative cancer treatments describes alternative and complementary treatments for cancer that have not been approved by the government agencies responsible for the regulation of therapeutic goods. They include diet and exercise, chemicals, herbs, devices, and manual procedures. The treatments may be untested or unsupported by evidence, either because no proper testing has been conducted, or because testing did not demonstrate statistically significantefficacy. Concerns have been raised about the safety of some of them.

Alternative cancer treatments are typically contrasted with experimental cancer treatments, which are treatments for which experimental testing is currently underway. All currently approved chemotherapeutic cancer treatments were considered experimental cancer treatments before their safety and efficacy testing was completed.

Such therapies can be categorized broadly into three groups: alternative treatments offered as a substitute to standard medical treatment; alternative treatments as an addition to standard treatment; and treatments proposed in the past that have been found in clinical trials to be useless and/or unsafe. Some of these obsolete or disproven treatments continue to be promoted, sold, and used.

Contents  [hide] 1 Background 2 Complementary versus alternative treatments 3 People who choose alternative treatments 4 Examples of alternative treatment 4.1 Under consideration 4.2 Mixed results 4.3 Unknown 4.4 Disproven or scientifically implausible 5 Examples of complementary therapy 6 Alternative theories of cancer 7 Regulatory action 8 See also 9 References 10 External links

[edit]Background

Since the 1940s, medical science has developed chemotherapy, radiation therapy, adjuvant therapy and the newer targeted therapies, as well as refining surgical techniques for removing cancer. Before the development of these modern, evidence-based treatments, 90% of cancer patients died within five years.^[1] With mainstream treatments, only 34% of cancer patients die within five years.^[2] However, while generally prolonging life or permanently curing cancer, most effective, mainstream forms of cancer treatment have side effects ranging from unpleasant to fatal, and permanent cures are not guaranteed. These side effects create appeal for alternative treatments for cancer, which purport to cause fewer side effects or to increase survival rates.

Alternative cancer treatments have typically not undergone properly conducted, well-designed clinical trials, or the results have not been published due topublication bias (a refusal to publish results showing a treatment does not work). Among those that have been published, the methodology is often poor. A 2006 systematic review of 214 articles covering 198 clinical trials of alternative cancer treatments concluded that almost none conducted dose-ranging studies, which are necessary to ensure that the patients are being given a useful amount of the treatment.^[3] These kinds of treatments appear and vanish frequently, and have throughout history.^[4]

[edit]Complementary versus alternative treatments

Complementary and alternative cancer treatments are often grouped together, but this grouping is controversial.^[4] Definitions vary, but generally speaking they are the same methods that are called "complementary" when given alongside mainstream treatments and "alternative" when they are not.^[5] Complementary therapies receive more support within the mainstream medical community than alternative treatments.

Complementary treatments are used in conjunction with proven mainstream treatments. They tend to be pleasant for the patient, not involve substances with any pharmacological effects, inexpensive, and intended to treat side effects rather than to kill cancer cells.^[6] Medical massage and self-hypnosis to treat pain are examples of complementary treatments. A 2006 systematic review of the effectiveness of complementary techniques in reducing pain concluded that although several seemed promising, conclusive evidence was lacking.^[7]

Alternative treatments, by contrast, are used in place of mainstream treatments. The most popular alternative cancer therapies are various, generally strict diets, including the macrobiotic diet. Other therapies include mind-body interventions, bioelectromagnetics, nutritional supplements, and herbs.^[4] The popularity and prevalence of different treatments varies widely by region.^[8]

[edit]People who choose alternative treatments

People who choose alternative treatments tend to believe that evidence-based medicine is ineffective, while still believing that their own health could be improved.^[9]They are impressed by physiological and other scientific-sounding information, prefer a healthcare model that treats the patient as an integrated, whole person, and are loyal to their alternative healthcare providers.^[9]

Cancer patients who choose complementary or alternative treatments in addition to conventional treatments believe themselves less likely to die than patients who choose only conventional treatments.^[10] They feel a greater sense of control over their destinies, and report less anxiety and depression.^[10]

However, patients who use alternative treatments have a poorer survival time, even after controlling for type and stage of disease.^[11] This may be because patients who accurately perceive that they are likely to survive do not attempt unproven remedies, and patients who accurately perceive that they are unlikely to survive are attracted to unproven remedies.^[11] Among patients who believe their condition to be untreatable by evidence-based medicine, "desperation drives them into the hands of anyone with a promise and a smile."^[12] Con artists have long exploited fear, ignorance, and desperation to strip dying people of their money, comfort, and dignity.

About half the practitioners who dispense complementary or alternative treatments are physicians, although they tend to be generalists rather than oncologists. As many as 60% of physicians have referred their patients to a complementary or alternative practitioner for some purpose.^[4]

[edit]Examples of alternative treatment

None of the cancer treatments on this list have substantial evidence for their effectiveness in treating cancer. Some have shown some benefits as complementary therapy, to reduce pain. Vitamin C, perhaps the most well-known and controversial, is undergoing a clinical trial based on in vitro findings and theoretical speculation as to its in vivo effectiveness. Very few suppliers of alternative medicines have undertaken scientifically controlled clinical trials for their products, although occasional preliminary testing, or testing as adjuvant therapy, has been performed. For this reason, alternative therapies generally rely on testimonial oranecdotal evidence. In the United States, FDA regulations forbid the makers of unproven products from claiming efficacy against cancer.

[edit]Under consideration

• Quercetin^[13]
• Vitamin C megadosage by intravenous infusion^[14] Oral vitamin C, regardless of dose, is disproven.^[11] This is a type of redox therapy.
• Medicinal mushrooms^[15][16]
• Selenium (Selenomethionine and Se-methylselenocysteine)^[17][18]
• Nicholas Gonzalez's metabolic program^[11]

[edit]Mixed results

• Coley's Toxins^[19]

[edit]Unknown

• Essiac tea
• Budwig diet, a diet emphasizing flaxseed oil, milk, fruits, vegetables, and fiber. More likely to be useful for preventing cancer rather than treating it.
• Sodium Bicarbonate

[edit]Disproven or scientifically implausible

Chemical substances

• Homeopathy (disproven), tiny amounts of substances, ritually diluted according to 18th century standards
• Laetrile (disproven), also known as B-17, is a cyanide-containing extract of crushed apricot pits
• Di Bella Multitherapy (disproven), a mixture of vitamins, melatonin, and other chemicals.^[11]
• Emanuel Revici's catabolic/anabolic approach (disproven)^[11]
• Hoxsey method (disproven), a caustic, escharotic paste of herbs and arsenic that is banned in the US as "worthless", "discredited" and "quackery".^[20]
• 714X, a water-based solution purported to kill "somatids", which the inventor claims cause disease^[21]
• Escharotics such as Cansema or "black salve", usually a paste that kills any skin or tissue it is applied to
• Protocel and Cancell (disproven)
• Krebiozen (disproven), diluted blood from horses^[22]
• Hydrazine sulfate, a toxic, synthetic drug^[11]
• Proteolytic enzyme therapy^[23]
• William Koch's "glyoxide antitoxin" (fraud), also called "recrystallized synthetic toxin", which proved to be distilled water^[24]
• Radio-Sulfo Brew, a poultice made of Limburger cheese (fraud)^[25]
• Livingston-Wheeler, or Virginia Livingston's Progenitor cryptocides treatments, made from the patient's urine, to kill a non-existent bacteria claimed to be the cause of cancer^[11][25]
• Lawrence Burton's Immuno-Augmentative Therapy, claimed to energize the immune system^[25]
• Antineoplastons (disproven)^[11]
• Chaparral^[11]
• Shark cartilage^[11]

Diets

• Gerson therapy (dangerous and disproven), a combination of diet and enemas^[26]
• Johanna Brandt's "Grape Cure" (scientifically implausible), a diet of water and grapes^[27]
• Beverly Hills diet (scientifically implausible), a largely fruitarian diet^[27]
• Macrobiotic diet (scientifically implausible), a primarily vegetarian diet with no refined or processed foods (may be useful for cancer prevention, but not treatment)^[27]
• Edgar Cayce's diet (scientifically implausible), which prefers alkaline foods to acidic ones^[27]
• Juice fasting (scientifically implausible)

Electrical or physical treatments

• Orgone accumulators (fraud), a metal and cardboard box that the client sat in^[28]
• Magnet therapy (disproven), applying magnets to the body^[29]
• The Rife Machine (scientifically implausible), a radio frequency energy 'beam ray' tube machine^[30][31]

Energy and psychological treatments

• Anti-cancer psychotherapy (disproven), claiming that a "cancer personality" caused cancer, which could be cured through talk therapy, e.g., that of the Simonton Cancer Center,^[32] Bernie Siegel's "Exceptional Cancer Patients" (ECaP) or Deepak Chopra^[11]
• Therapeutic touch (scientifically implausible), a type of energy therapy
• Imagining successful outcomes (scientifically implausible), such as visualizing cancer cells dying, in cancer guided imagery^[33]

[edit]Examples of complementary therapy

• Acupuncture^[34][35] Useful to control certain symptoms, but does not kill cancer cells.
• Psychotherapy may reduce anxiety and improve quality of life^[11]
• Massage therapy may reduce pain

[edit]Alternative theories of cancer

Some alternative cancer treatments are based on unproven or disproven theories of how cancer begins or is sustained in the body. Some common concepts are:

• Mind-body connection: This idea says that cancer forms because of, or can be controlled through, the person's mental and emotional state. Treatments based on this idea are mind–body interventions. Proponents say that cancer forms because the person is unhappy or stressed, or that a positive attitude can cure cancer after it has formed. A typical claim is that stress, anger, fear, or sadness depresses the immune system, whereas that love, forgiveness, confidence, and happiness cause the immune system to improve, and that this improved immune system will destroy the cancer. This belief is not supported by any scientific research: people with weak immune systems have about the same rate of cancer as people with healthy immune systems. In fact, many cancers require the support of an active immune system to establish the tumor microenvironment necessary for a tumor to grow.^[36]
• Toxin theory of cancer: In this idea, the body's metabolic processes are overwhelmed by normal, everyday byproducts. These byproducts, called "toxins", are said to build up in the cells and cause cancer and other diseases through a process sometimes called autointoxication or autotoxemia. Treatments following this approach are usually aimed at detoxification or body cleansing, such as enemas.
• Low activity by the immune system: This claim asserts that if only the immune system were strong enough, it would kill the "invading" or "foreign" cancer. Unfortunately, most cancer cells retain normal cell characteristics, making them appear to the immune system to be a normal part of the body. These treatments often focus on substance said to increase the immune system's activity.
• Supposed situations within the body: In this idea, the body is incapable of coping with transient or local differences. For example, proponents will say that a lack of oxygen causes cancer.
• Hypothetical microorganisms: While infections are a significant cause of certain kinds of cancer (e.g., Hepatitis B can cause liver cancer, and some human papillomaviruses cause cervical cancer), these stories usually assert that the harmless bacteria and fungi normally present in or on the body cause cancer, or that organisms only detectable by the proponent cause cancer.

[edit]Regulatory action

Government agencies around the world routinely investigate purported alternative cancer treatments in an effort to protect their citizens from fraud and abuse.

In 2008, the United States Federal Trade Commission recently acted against companies that made unsupported claims that their products, some of which included highly toxic chemicals, could cure cancer.^[37] Targets included Omega Supply, Native Essence Herb Company, Daniel Chapter One, Gemtronics, Inc., Herbs for Cancer, Nu-Gen Nutrition, Inc., Westberry Enterprises, Inc., Jim Clark’s All Natural Cancer Therapy, Bioque Technologies, Inc., Cleansing Time Pro, and Premium-essiac-tea-4less.

[edit]See also

• Clinical trial
• Placebo effect
• Pseudoscience

[edit]References

1. ^ Schattner, Elaine (5 October 2010). "Who's a Survivor?". Slate Magazine.
2. ^ "Cancer of All Sites - SEER Stat Fact Sheets". Retrieved 6 October 2010.
3. ^ Vickers AJ, Kuo J, Cassileth BR (January 2006). "Unconventional anticancer agents: a systematic review of clinical trials". Journal of Clinical Oncology 24(1): 136–40. doi:10.1200/JCO.2005.03.8406. PMC 1472241.PMID 16382123.
4. ^ ^a b c d Cassileth BR (1996). "Alternative and Complementary Cancer Treatments". The Oncologist 1 (3): 173–179. PMID 10387984.
5. ^ "White House Commission on Complementary and Alternative Medicine Policy". March 2002.
6. ^ Wesa KM, Cassileth BR (September 2009). "Is there a role for complementary therapy in the management of leukemia?". Expert Rev Anticancer Ther 9 (9): 1241–9. doi:10.1586/era.09.100. PMC 2792198.PMID 19761428.
7. ^ Bardia A, Barton DL, Prokop LJ, Bauer BA, Moynihan TJ (December 2006). "Efficacy of complementary and alternative medicine therapies in relieving cancer pain: a systematic review". Journal of Clinical Oncology 24 (34): 5457–64. doi:10.1200/JCO.2006.08.3725. PMID 17135649.
8. ^ Cassileth BR, Schraub S, Robinson E, Vickers A (April 2001). "Alternative medicine use worldwide: the International Union Against Cancer survey".Cancer 91 (7): 1390–3. doi:10.1002/1097-0142(20010401)91:7<1390::AID-CNCR1143>3.0.CO;2-C. PMID 11283941.
9. ^ ^a b Furnham A, Forey J (May 1994). "The attitudes, behaviors and beliefs of patients of conventional vs. complementary (alternative) medicine". J Clin Psychol 50 (3): 458–69. doi:10.1002/1097-4679(199405)50:3<458::AID-JCLP2270500318>3.0.CO;2-V. PMID 8071452.
10. ^ ^a b Helyer LK, Chin S, Chui BK, et al. (2006). "The use of complementary and alternative medicines among patients with locally advanced breast cancer--a descriptive study". BMC Cancer 6: 39. doi:10.1186/1471-2407-6-39.PMC 1475605. PMID 16504038.
11. ^ ^{a b c d e f g h i j k l m} Vickers, A. (2004). "Alternative Cancer Cures: 'Unproven' or 'Disproven'?". CA 54 (2): 110–8. doi:10.3322/canjclin.54.2.110.PMID 15061600.
12. ^ Olson, James Stuart (2002). Bathsheba's breast: women, cancer & history. Baltimore: The Johns Hopkins University Press. pp. 146. ISBN 0-8018-6936-6.
13. ^ "Antioxidants and Cancer III: Quercetin -- Davis W. Lamson, MS, ND, and Matthew S. Brignall, ND 2000;5(3):196-208 -- Altern Med Rev".
14. ^ "Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo -- Chen et al. 104 (21): 8749 -- Proceedings of the National Academy of Sciences".
15. ^ Zaidman BZ, Yassin M, Mahajna J, Wasser SP (June 2005). "Medicinal mushroom modulators of molecular targets as cancer therapeutics". Applied Microbiology and Biotechnology 67 (4): 453–68. doi:10.1007/s00253-004-1787-z. PMID 15726350.
16. ^ Wasser SP (November 2002). "Medicinal mushrooms as a source of antitumor and immunomodulating polysaccharides". Applied Microbiology and Biotechnology 60 (3): 258–74. doi:10.1007/s00253-002-1076-7.PMID 12436306.
17. ^ Vadgama JV, Wu Y, Shen D, Hsia S, Block J (2000). "Effect of selenium in combination with Adriamycin or Taxol on several different cancer cells".Anticancer Research 20 (3A): 1391–414. PMID 10928049.
18. ^ Nilsonne G, Sun X, Nyström C, et al. (September 2006). "Selenite induces apoptosis in sarcomatoid malignant mesothelioma cells through oxidative stress". Free Radical Biology & Medicine 41 (6): 874–85.doi:10.1016/j.freeradbiomed.2006.04.031. PMID 16934670.
19. ^ Borrell, Brendan (2008-02-18). "Medicine / In the Lab; Germs as a Tumor Foe?; Exposure to bacteria may help ward off cancer, studies show. Scientists are milking the concept with new drugs.".
20. ^ "This Week in FDA History". U.S. Food and Drug Administration. Retrieved 2008-08-27.
21. ^ Kaegi E (June 1998). "Unconventional therapies for cancer: 6. 714-X. Task Force on Alternative Therapeutic of the Canadian Breast Cancer Research Initiative". CMAJ : Canadian Medical Association Journal 158 (12): 1621–4.PMC 1229414.
22. ^ Olson, 2002. p. 148
23. ^ Levine MN (April 2010). "Conventional and complementary therapies: a tale of two research standards?". J. Clin. Oncol. 28 (12): 1979–81.doi:10.1200/JCO.2010.28.5320. PMID 20308650.
24. ^ Oslon, 2002. p. 146
25. ^ ^a b c Olson, 2002. p. 152
26. ^ Hills, Ben. "Fake healers. Why Australia’s $1 billion-a-year alternative medicine industry is ineffective and out of control.". Medical Mayhem. Retrieved 2008-03-06. "Kefford is particularly concerned about cancer patients persuaded to undergo the much-hyped US Gerson diet program, which involves the use of ground coffee enemas which can cause colitis (inflammation of the bowel), fluid and electrolyte imbalances, and in some cases septicaemia. The US FDA has warned against this regime, which is known to have caused at least three deaths."
27. ^ ^a b c d Olson, 2002. p. 154
28. ^ Olson, 2002. p. 158-159
29. ^ "Magnet therapies 'have no effect'". BBC. 2006-01-06. Retrieved 2010-06-02.
30. ^ "Questionable methods of cancer management: electronic devices". CA44 (2): 115–27. 1994. doi:10.3322/canjclin.44.2.115. PMID 8124604.
31. ^ Limited only by the laws of physics
32. ^ Olson, 2002. p. 161
33. ^ Olson, 2002. p. 163
34. ^ Deng G, Vickers A, Yeung S, et al. (December 2007). "Randomized, controlled trial of acupuncture for the treatment of hot flashes in breast cancer patients". Journal of Clinical Oncology 25 (35): 5584–90.doi:10.1200/JCO.2007.12.0774. PMID 18065731.
35. ^ Ernst E, Pittler MH, Wider B, Boddy K (2007). "Acupuncture: its evidence-base is changing". The American Journal of Chinese Medicine 35 (1): 21–5.doi:10.1142/S0192415X07004588. PMID 17265547.

1. ^ Stix, Gary (July 2007). "A Malignant Flame". Scientific American Magazine.
2. ^ http://www.ftc.gov/opa/2008/09/boguscures.shtm

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