Trick or treatment: The real deal behind herbal supplements for cancer
CAM and cancer patients
Cancer patients are definitely not immune to the enticing appeal of complementary and alternative medicine (CAM) approaches, the most popular of which are natural products. Cancer patients resort to CAM for various purposes, hoping to obtain symptom relief; improvement of immunity, well-being and quality of life; and cure or prolongation of life.
Herbal products are often believed as natural, safe and effective, which is further reinforced by the influence of family, friends, other cancer patients, and various forms of media, especially social media. These factors, coupled with easy access without a prescription, have helped propagate the use of dietary supplements among cancer patients, whether as their sole treatment modality or as add-on to conventional cancer treatments.
Efficacy and safety
Certain forms of CAM, including mind-body techniques, acupuncture, and massage therapy, have been shown to be relatively effective and safe in relieving symptoms and improving the quality of life of cancer patients based on available scientific studies. However, many herbal and nutritional supplements, particularly those claiming to cure cancer may pose health risks.
The efficacy and safety of these supplements are often based on laboratory or animal studies and patient testimonials to substantiate claims. These supplements can also have undisclosed harmful side effects and drug interactions, as well as problems involving product contamination, substitution, adulteration or mislabeling. Importantly, several supplements may decrease the probability and duration of patient survival because of treatment delays and decreased effectiveness or abandonment of conventional therapy.
The results of a recent study showed that cancer patients who initially chose treatment with alternative medicine alone were 2.5 times more likely to die versus patients who received conventional cancer treatments. [J Natl Cancer Inst 2018;doi:10.1093/jnci/djx145]
Approach to patient
Healthcare professionals should routinely ask patients about possible CAM use in a non-judgmental and non-threatening manner. Oftentimes, patients are either embarrassed or afraid to volunteer this kind of information. Being open-minded in exploring the patient’s perspective of his illness, as well as his beliefs and motivations behind the use of CAM, helps in approaching the issue satisfactorily.
The discussion can also be used as an opportunity to counsel patients on using balanced, evidence-based information about the efficacy and safety of specific CAM approaches while remaining respectful of their core values and beliefs.
Physicians can help patients contemplate on their intended or active CAM use by weighing in together the severity of the illness, its curability with conventional treatments, and its invasiveness or attendant toxicities, and the quality of evidence on the safety and efficacy of the desired CAM therapy. One resource particularly useful when discussing herbal supplements with patients is the Memorial Sloan- Kettering Cancer Center’s About Herbs database which can be accessed for free online or via their iOS app. [https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrativemedicine/herbs]
Lastly, it is important to evaluate the patient’s degree of understanding and acceptance of the risks and benefits of the selected treatment approach.
Role of healthcare provider
It is important for healthcare professionals to teach cancer patients how to avoid health fraud scams, fake news, and deceitful CAM practitioners, especially with their continued proliferation on the internet and social media. Patients should be educated on how to scrutinize claims, recognize red flags, ask the right questions and read supplement labels. Advise them to use discretion in believing products that discourage the use of conventional medicine or adherence to their doctor’s advice.
Many forms of cancer are curable with early diagnosis and proper conventional treatment administered by a multidisciplinary team of legitimate cancer specialists, even without the use of supplements.
Furthermore, a healthy diet is more important than taking individual supplements, as nutrients are most potent when obtained from whole food.
Dietary supplements simply cannot replicate the complex interactions between the essential nutrients contained in whole foods, and it is still unclear whether antioxidant supplements offer the same health benefits as naturally occurring antioxidants in food. Always remind patients that it is always best to talk to their doctor first before taking any over-the-counter medications, including herbal supplements.
“There is only scientifically proven, evidence-based medicine supported by solid data, or unproven medicine for which scientific evidence is lacking.” – Fontanarosa & Lundberg