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Am Fam Physician. 2007;75(5):716

Background: About 84 percent of patients with breast cancer use some form of alternative or complementary therapy. The most common of these therapies are dietary modalities (27 percent of patients), spiritual healing (24 percent), herbal remedies (13 percent), physical techniques (14 percent), and psychological methods (3 percent). Use of complementary and alternative therapies in patients with breast cancer is associated with younger age, higher education level, and history of chemotherapy. Despite their widespread use, there are no published data on cancer outcomes following alternative or complementary therapies. Chang and colleagues studied the records of women who refused or delayed standard therapy for breast cancer to assess the impact of treatment choices on prognosis.

The Study: Data were available on 33 patients with an average age of 53.2 years. Of the six women who refused surgery, five progressed to stage IV disease (one of whom died) and one remained at stage II during a median 14-month follow-up period. Nine patients with stage I or II disease substituted alternative therapy for chemotherapy or hormonal therapy. Eight of these patients remained recurrence-free during a median 22-month follow-up period.

Results: The authors calculated mean 10-year mortality rates for patients who eventually used standard therapy and for patients who substituted alternative therapy for standard therapy. For patients who delayed surgery, the 10-year relative risk of mortality associated with alternative therapy was estimated at 1.58. For those who refused chemotherapy, the relative risk was 1.54.

Conclusion: The authors conclude that, despite the many assumptions in the study, the results indicate that substituting alternative therapy for standard therapy adversely affects outcomes in patients with breast cancer.

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Copyright © 2007 by the American Academy of Family Physicians.

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