Alternative Medicine Use Can Influence Initiation of Chemotherapy in Breast Cancer Patients

Several factors can affect whether women diagnosed with breast cancer begin chemotherapy.

Early-stage breast cancer patients who use dietary supplements and several types of complementary and alternative medicine (CAM) are less likely to start chemotherapy, according to a recent study.

The study, published in JAMA Oncology, examined a group of 685 women diagnosed with early-stage non-metastatic invasive breast cancer. Participants were younger than 70-years-old and recruited from Columbia University Medical Center, Henry Ford Health System, and Kaiser Permanente Northern California between 2006 and 2010.

Within the study, 5 types of complementary therapies were used, including: dietary supplement use of vitamins and minerals; herbs and botanicals; other natural products; mind-body self-practice; and mind-body practitioner-based. Within the study, 45% of participants were clinically indicated to receive chemotherapy per National Comprehensive Cancer Network guidelines.

The results of the study showed that 87% of women reported the use of alternative therapies. At 12 months, 89% of women reported initiation of chemotherapy who were indicated. The other women for whom chemotherapy was discretionary had a rate of 36% of initiation.

Despite the survival benefits associated with adjuvant treatment for breast cancer, not all women initiate it because of the psychosocial factors, belief systems, and clinical, demographic and provider characteristics involved in the decision.

CAM therapies have increased in the last 2 decades among breast cancer patients, with the most commonly used forms being dietary supplements and mind-body practices. In the study, women used 2 of the therapies on average, but almost 40% of women said they used 3 or more CAM therapies.

Researchers stated the importance of considering other possible explanations for the study’s findings.

“Though the majority of women with clinically indicated chemotherapy initiated treatment, 11% did not,” said lead researcher Heather Greenlee, ND, PhD. “A cautious interpretation of results may suggest to oncologists that it is beneficial to ascertain use of complementary and alternative medicine therapy among their patients, especially dietary supplement use, and to consider use of alternative treatment as a potential marker of patients at risk of not initiating clinically indicated chemotherapy.”