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Capstone

Treatment Outcomes in Women With Breast Cancer Who Choose Alternative Medicine as a Means of Primary Therapy

1 August 2004

Abstract

Context: The numbers of persons considering alternative and complementary methods for treating their cancer is increasing. Conventional cancer treatments such as radiation therapy, chemotherapy, and surgery are the only medically proven methods of treating cancer. Cancer patients who choose alternative medicine as a replacement for conventional cancer treatments may be placing themselves at an enormous and unnecessary risk. Even temporary delays or interruptions in conventional treatment can pose a dangerous risk to cancer patients, as they are giving up the only proven methods of treating their disease. Objective: The purpose is to investigate the outcomes, as defined as relapse or recurrence of breast cancer, in patients who do not complete traditional methods of cancer treatment. What is the expected 10-year morbidity rate and relapse rate of women with breast cancer who choose homeopathic therapy as a primary means of treatment? Design: This study is a retrospective chart review study. Charts of women with known diagnosis of breast cancer, incomplete therapy and a known history for use of alternative methods met the criteria for inclusion. Using information such as age, tumor size, lymph node involvement, estrogen receptor, tumor grade and comorbidity, expected 10-year mortality and relapse values were calculated. Two data values were collected: the first value was based on expected outcome based on stage at time of initial presentation; the second was based on re-stage at time of re-presentation. Information was stored in a Microsoft Access database and an Excel spread sheet for data analysis. Subjects: There were 35 subjects identified from a single surgical oncology practice. Patients were evaluated if they used alternative therapy in place of recommended surgery or adjuvant chemotherapy or radiation. After initial diagnosis, most patients had a delay in treatment or incomplete therapy, and then were seen by the same diagnosing surgeon. Results: Thirty-five patients met criteria; ages ranged from 35 to 76, mean age 51.2. Twenty-six patients had surgical therapy; 22 lumpectomy and 4 mastectomy. 11 of 22 patients did not complete radiation; one had positive margins with no re-excision. Three had a delay in surgery. Nine patients had no surgical intervention. Twenty-six patients did not complete adjuvant chemotherapy and 30 did not complete adjuvant hormonal therapy. There was one death and 16 recurrences of breast cancer. The average time for recurrence of disease was 3.5 years. Three patients presented with stage 0; one had delay in treatment and restaged at stage 4, two had lumpectomy with no adjuvant radiation and were restaged at stage 1. Eleven presented at stage 1; five had treatment with no progression, one was restaged at stage 3 due to delay in surgery, five were restaged at stage 4 due to delay in surgery, two had no surgery and one had lumpectomy with no adjuvant therapy. Three presented with stage 3, .two had no progression; one was restaged at stage 4 due to no surgery and delay in adjuvant chemotherapy. One presented with stage 4, had no surgical or adjuvant chemotherapy. She died in 15 months due to disease. When comparing the expected mortality and relapse mean responses a value of p


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