Breast Cancer
Cancer Center

Women Who Use Alternative Medical Techniques Tend to Postpone Chemotherapy

Women with early stage breast cancer were less likely to start chemotherapy if they used alternative therapies, according to latest research led by Heather Greenlee, ND, PhD, associate professor of Epidemiology at Columbia University’s Mailman School of Public Health.

The study, one of the first to examine the interaction betweeh complementary alternative medicine (CAM) and chemotherapy, appeared in JAMA Oncology.

Greenlee and colleagues studied a group of 685 women with early-stage breast cancer who were recruited from Columbia University Medical Center, Kaiser Permanente Northern California, and Henry Ford Health System and enrolled 2006-2010. The women were younger than 70 with non-metastatic invasive breast cancer.

The study included five types of complementary therapies: the dietary supplement use of vitamins/minerals, herbs/botanicals, and other natural products, as well as mind-body self-practice, and mind-body practitioner-based.

Use of alternative therapies was reported by the large majority of the women studied—87 percent. By 12 months, chemotherapy was initiated by 89 percent of women for whom chemotherapy was indicated. The remaining group of women for whom chemotherapy was discretionary had a much lower rate of initiation—at 36 percent. Nearly half (45 percent) were clinically indicated to receive chemotherapy per National Comprehensive Cancer Network guidelines.

Not all women initiate adjuvant treatment for breast cancer despite the survival benefits associated with it. The decision to start chemotherapy involves psychosocial factors, belief systems, and clinical, demographic and provider characteristics.

Complementary and alternative therapy use among patients with breast cancer has increased in the past two decades. The most commonly used complementary and alternative therapies were dietary supplements and mind-body practices. On average, the women used two such therapies, although nearly 40 percent of the women reported using three or more complementary and alternative therapies.

The use of mind-body practices was not related to chemotherapy initiation. However, dietary supplements usage and a higher simultaneous use of multiple complementary and alternative therapies among women for whom chemotherapy was indicated were associated with a lower likelihood to initiate chemotherapy than nonusers, according to the results. There was no association between starting chemotherapy and using alternative medicine among women for whom chemotherapy was discretionary.