Safe & Effective Alternative Therapies for Cancer—& Which Ones to Avoid

Many patients who have cancer use complementary and alternative medical (CAM) therapies, either on their own or in conjunction with other cancer treatments. How effective—and how safe—are these natural alternative therapies for cancer? A group of researchers asked those two questions as they examined the most common complementary and alternative medical therapies used by patients with cancer. This article abstracts their findings, which originally appeared in the Annals of Internal Medicine.

Complementary & Alternative Medical Cancer Therapies

The following alternative therapies for cancer are accepted, recommended and/or discouraged on based on evidence of efficacy (i.e., how well they work) and safety.

• Dietary Fat Reduction. The evidence suggests a positive association between intake of saturated or animal fat and the progression of cancer. This evidence is suggestive but not proven, since major trials have not been performed using this as the only factor. However, there are no downsides to adopting a low-fat diet; it is highly recommended. Verdict: accept and monitor.
• Macrobiotic Diet. There is no evidence in the medical literature, but a macrobiotic diet may be beneficial as an alternative therapy for cancer treatment. There is a slight possibility of a risk. Macrobiotic diets are contraindicated in patients using phytoestrogens and eating an already restrictive diet. Verdict: accept and monitor.
• Vitamin A. Evidence from trials is inconclusive, but possibly suggest a benefit. However, in high doses, vitamin A can cause severe injury. Verdict: discouraged.
• Vitamin C. Evidence from multiple studies shows no effectiveness. There is a theoretical possibility of minimal harm. Verdict: discouraged.
• Vitamin E (for prostate cancer). Evidence from a controlled trial suggests that vitamin E may be beneficial in latent prostate cancer. It is an antioxidant and is suggested to be avoided during active treatment. Verdict: accepted, but not recommended.
• Vitamin E (for other cancers). Evidence from opinion only, not from any study, is inconclusive. There is no toxicity known. Verdict: accept and monitor.
• Soy (for breast cancer). Evidence from opinion only, not from any study, shows a high risk in certain patients. Soy is an antioxidant and thus should be avoided during cancer therapy. There is potential risk for bleeding in those who have bleeding tendency, and/or during the peri-operative period. Avoid in women with ERP with breast tumor and uterine cancers. Verdict: discouraged.
• Soy (for prostate cancer). Evidence is based on opinion only. Benefit is inconclusive. As an antioxidant, soy should be avoided during cancer therapy. Patients using soy may be at mild risk for bleeding. Verdict: accept and monitor.
• PC-SPES. Evidence from a single study is inconclusive. The level of risk is high, especially with concurrent cancer therapy. Verdict: discouraged.
• Shark Cartilage. Based on opinion only, there is no conclusive evidence of benefit as alternative therapies for cancer. The level of toxicity is moderate. Verdict: accept and monitor. Discouraged in patients with hypercalcemia and where angiogenesis inhibition may be harmful.
• Mind-Body Therapies. Evidence based on several trials is inconclusive. The toxicity is very low. Verdict: accept and monitor.
• Acupuncture (for chemotherapy-related nausea and vomiting). Evidence based on a single trial shows benefit. Only toxicity is in patients with bleeding tendencies and it is mild unless deep tissue is used. Verdict: accept; may recommend and monitor.
• Acupuncture (for chronic pain related to cancer or therapy). Evidence based on opinion only is inconclusive. Toxicity is minimal and is related to patients who are likely to bleed using deep tissue massage and those in the immediate peri-operative period. Verdict: accept and monitor.
• Massage (for anxiety). Two trials yield evidence, proving efficacy and low toxicity. Verdict: accept; may recommend. Avoid in patients with bleeding tendencies.
• Massage (for pain). Evidence from 3 randomized trials is inconclusive. Toxicity is mild and related only to patients with a bleeding tendency and only with deep tissue massage. Verdict: accept; may recommend and monitor.
• Massage (for nausea related to bone marrow transplant). Evidence from single trial showed benefit as one of the possible alternative therapies for cancer. Toxicity in patients with bleeding tendencies, who get deep tissue massage. Verdict: accept; may recommend and monitor.
• Massage, using manual drainage techniques for lymph edema. Evidence from one trial showed benefit, very low toxicity. Verdict: accept; may recommend.
• Exercise. To improve physical functioning and psychological and physical symptoms in patients receiving conventional cancer therapy. Evidence for 2 randomized trials showed benefit with minor complications. Verdict: accept, recommend and monitor.

Recommended Complementary & Alternative Medical Therapies

The following are CAM therapies that may reasonably be accepted and, in some cases, recommended for treating cancer.

• Low fat and macrobiotic diets
• Vitamin E supplementation
• Soy supplementation in prostate cancer
• Certain herbal products and biological agents
• Acupuncture for chemo-related vomiting
• Massage for anxiety or pain
• Moderate exercise
• Psychological and mind-body therapies

Complementary & Alternative Medical Therapies to Avoid

Based on the researchers’ findings, the following alternative therapies for cancer are discouraged:

• Highly restrictive dietary regimen
• Antioxidants during therapy
• Supplements with anticoagulant effects
• Phytoestrogens in breast cancer with ERP + tumors, tamoxifen therapy and uterine cancer
• Deep tissue or forceful massage in patients with low platelets, who are on anticoagulant therapy
• St. John’s Wort with concurrent chemotherapy
• High doses of vitamin A
• High doses of vitamin C

Editor’s Note: The information that appears here has been abstracted from the following source: Weiger, WA, Smith, M, Boon, H, et al. Advising Patients who Seek Complementary and Alternative Medical Therapies for Cancer. Annals of Internal Medicine 2002; 137:889–903. Also available at www.annals.org.

Posted in Cancer Treatment, Natural Remedies, Recovering from Cancer, Senior Health, Treatment Options, Treatment Options