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This booklet was produced in June 2000 by Cancer Education & Information Service, National Cancer Centre in Singapore.

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Alternative Therapy - Making Your Choice



Contents

Foreword

This booklet has been developed to help you understand more about alternative unconventional and unproven treatments in cancer. We hope the information from this booklet will answer some of the questions you may have. This booklet only serves as a guide and its contents are not to be taken as medical advice. You need to discuss with your doctor the best treatment for you.



Introduction

A diagnosis of cancer can be overwhelming. When cancer is first diagnosed there is often little time or energy for thought. Apart from dealing with the emotional impact of the diagnosis, people with cancer also have to make a decision about the type of treatment they need. Many people will accept the advice of their doctor and seek the best conventional cancer treatment. However, some cancer patients and their family seek alternative types of treatment. There are many alternative therapies and the information can be confusing.

You will probably receive lots of advice and information about cancer treatments and remedies, new or old. It may come from many sources - doctors, friends, family, colleagues, the Internet, pamphlets, magazines, books, etc. Some advice will be good, wise and useful; some may be confusing and misleading.

This booklet aims to help you sort through these information and ask useful questions when deciding which treatment is best for you.


What is Alternative Therapy?

Cancer treatment falls broadly into three categories : conventional or mainstream treatment, complementary therapy and alternative/unconventional therapy.

  • Conventional or Mainstream Treatment
    Conventional cancer treatment is the standard medical treatment for cancer undertaken by most doctors. This includes chemotherapy, radiotherapy, surgery and hormone treatment. Such treatments have undergone extensive testing through trials involving thousands of patients. They have been proven to be effective and the side effects are known. Although this does not mean that they will cure all cancers, they usually provide the best treatment outcome.

  • Complementary Therapy
    A number of approaches can improve well-being and quality of life for people with cancer. Complementary therapy is undertaken together with conventional cancer treatment. They include relaxation, meditation, stress management and good nutrition. There is o proof that these approaches can cure cancer, but they help patients to cope better with their illness. Most doctors see these approaches as helpful.

  • Alternative Therapy
    Some approaches claim to cure cancer, slow down its growth, or prevent cancer. They attempt to treat cancer with unconventional means. These treatments usually have little scientific basis and man have not been scientifically tested. This means that there is insufficient good evidence on which to base decisions about them, therefore they are known as unproven remedies. Some unproven remedies have been tested by scientists and/or doctors who have found no evidence that these remedies work. Very often, alternative therapies are publicized by personal accounts of people who claim to have "beaten" cancer while using some of these remedies. Yet, these people usually have had mainstream treatment as well.

    There is a long list of alternative cancer therapies including those based on diet and vitamins, chemical agents, psychic methods, immune system manipulation and use of herbs. Some of the more popular therapies include anti-neoplastons, shark cartilage, high dose vitamins and macrobiotic diets.

    It is often difficult to find comprehensive information on alternative therapy because it is not written in medical journals and books on alternative therapy are often written by just one person. However, physicians practicing conventional therapy do encourage carefully performed studies of new therapies where claims of efficacy are rationally examined and tested.

    There are varying opinions about unproven remedies. People who promote or believe in them argue that they are an important means of treating cancer. Many doctors, on the other hand, are concerned that alternative therapies can give people false hope, that some are extremely expensive and sometimes may even be harmful.


Should I try an Alternative Therapy?

People have the right to choose their own treatment. However, to make an informed decision people need to know and understand as much as possible about their cancer and its treatment. This helps them to feel in control and to make choices that are best for them.

Look carefully at alternative treatments that you read or hear about. This may include asking questions such as :

  1. What is the basis of the therapy and have the claims been tested?
  2. Where have the claims been reported or does it rely on personal testimonials as evidence that the methods work?
  3. How many people have taken up that particular therapy?
  4. What are the qualifications of the person prescribing and administering the treatment?
  5. what are the successes and where were the results published?
  6. What are the possible side effects?
  7. Can these effects be prevented or controlled?

If these questions cannot be answered satisfactorily, then you should be suspicious that the remedy has no proven value. Check that the therapy is solely a specific cancer treatment and not also recommended for a variety of other diseases such as arthritis, diabetes, heart disease, etc.

You should also consider the following :
  • Unhygienic Practices
    Some practitioners of alternative therapy may be poorly trained or have poor hygiene standards. This can lead to infection, which could be dangerous. There is a risk with remedies that use needles, injections, syringes or enemas. Always check the training and qualifications of people offering such methods.

  • Herbal Remedies
    Herbal preparations used in some therapies may contain impurities which can cause unexpected problems. Please discuss with your treating doctor if you intend to consume any herbal preparations while you are receiving conventional cancer treatment.

  • Cost
    Some alternative therapies are very expensive. Do consider the cost and benefits of the treatment before making your decision. Find out from the practitioner the duration of the treatment and how much it would cost you to complete it.

  • Impulsive Decisions
    Sometimes a person with cancer may choose an unproven remedy as the main form of treatment and reject conventional cancer treatment. When this happens, a curable cancer may become more advanced or deteriorate if it is not appropriately managed. It is a good advice to carefully consider your choices and not make hasty decisions. Discuss it with your doctor.


Talking with your Doctor

Doctors generally understand that people with cancer will consider using alternative therapies. They also understand that medicine does not have all the answers. If you are thinking of trying an unproven remedy or alternative therapy, it is best to talk it over with your treating doctor. Your doctor can help you :
  • To distinguish between approaches that may help you and those that can cause you more harm than good.
  • Be aware of any side effects that these treatments may have.
Your doctor will need to know if you are using other methods as some of these therapies can clash with mainstream treatments.

Remember, if you are well-informed and understand your treatment, this will also help your doctor. You will be better able to cope with side effects or notice any unusual signs that the doctor should be told about.


How do I start?

If you find it difficult to talk to your doctor about alternative therapies, some people find this approach works:
" I heard about the ....treatment for cancer. Can you tell me why some doctors don't accept it? Why do some people think that it works and others believe that it doesn't? Do you think this treatment will help me at all?"
By simply asking questions you have just asked for more information. You have not attacked or doubted the conventional treatment you are receiving or the person treating you. If you do not understand the answer, ask the doctor to explain it again in a different way. Doctors often use technical words without realizing and are usually happy to explain it again if you ask. You have the right to information. Some people find it helpful to write down beforehand a list of questions to ask their doctors.


Why do people turn to Alternative Medicine?

People look to alternative therapy for the same reasons they look to mainstream treatments for cancer - they want a cure, they want to remain well and be in control of their lives, they want the best quality of life possible - they want to be healed, in body and mind.

  • The Promise of a Cure
Conventional cancer treatments can never promise to cure a cancer. Many people are cured - yet many also fail to respond to their treatment.

Some people want to try all possibilities to stop the cancer. It may give them peace of mind to have tried everything. Some people cling to the belief that, however small the chance, alternative therapy might work for them.
  • Something to Consider :
  • What proof is there that the remedy works? Often it is the experience of only one or two people and there is usually no way of checking these claims.
  • Is there any information on the number of people who use the treatment but did not get any better?

  • The Promise of a Natural and Simple Approach
Conventional cancer treatments sometimes have unpleasant side effects. Surgery can be painful and some can change your body image. Chemotherapy and radiotherapy both destroy cancer cells but in the process, they also damage some normal cells and this causes side effects.

In contrast, alternative therapy often promises an approach that is 'natural', simple, effective, harmless and without side effects.

  • Something to Consider :
  • What proof is there of these promises?
  • Are there any side effects or complications?
  • What is the failure rate?
  • Were those who recovered also receiving conventional cancer treatment?If so, maybe it was the mainstream treatment that helped.

Chemotherapy, radiotherapy, surgery and hormone therapy cannot claim to be harmless. But they are getting very much better at destroying cancer cells and leaving healthy cells untouched. These treatments have a good chance of achieving their aim to cure or slow down cancer. There is usually something that can be done to reduce, prevent or control side effects.

  • Keeping Hope Alive
For some people, trying on alternative therapy is a way of keeping alive the hope of a cure when nothing else is working.
  • Something to Consider :
  • Feeling hopeful is vitally important in living with cancer, both for the person with cancer and the family. To destroy that hope can leave people hurt and depressed.
  • Pinning all hope on something that is not likely or unproven to work can lead to great unhappiness. It is important to bear this in mind when looking at unproven cancer remedies.
  • Hope that is helpful is hope for things that may be possible and those that will meet the deepest needs of the person with cancer. For many, there will be hope for recovery or survival. For some, hope may be in the form of happiness, peace, moving beyond anger and despair, the company of loved ones, absence of pain and for dignity and respect.

Why do Alternative Therapies work for some people?

You may read or hear of people who claim that their cancer was cured by an alternative therapy. Most of these people may have had conventional treatment as well, often shortly before or at the same time as they were using alternative therapy. Conventional treatment can sometimes take weeks or months to work fully.

Sometimes, the cancer is not cured but is still present or progressing although the person feels well in the short term. Most cancers show no symptoms during much of their course, so many people with cancer can be misled into believing they have been cured even though the cancer is still progressing. (This is the reason why doctors wait many years before saying that a cancer is cured.)

Doctors cannot always predict the course of cancer. Some cancers grow and spread much faster than expected. In other cases, a person may live longer than what the doctor has predicted. Sometimes a cancer will simply go away, quite unexpectedly. We do not know why this happens but these people have almost always had conventional treatment. Some may have used alternative or unproven remedies, but some have not.

It is important to remember that people promoting unproven or alternative treatments do not publicise their failures eg: - the many people for whom the treatment does not work or the ones who never return to the practitioner.


How do I know that my current treatment is the best for me?

It is sometimes difficult to decide on the best treatment for each person. This is because each person's cancer is different and some treatments are still relatively new.

For most cancers, there is one course of treatment that has proved to be most successful. Doctors use their own expertise and judgement to recommend the treatment that is most suitable. They draw on the experience of other doctors and researchers, published in medical and scientific journals.

If your doctor is a specialist in cancer care, and if you are well informed about your cancer and the options for treatment and support available, you are in the best position to decide what is the best treatment for you. If you are dissatisfied with your treatment or if you simply want someone else's view, you can always ask for a second opinion from another doctor.


Can I use Alternative Therapy while I am on conventional cancer treatment?

Many people use alternative therapy while they are having conventional treatment and usually it causes no problems. However, it is important to tell your treating doctor what you are doing or intending to do. This way, you can ensure that your conventional treatment will continue to work well and not clash with the other forms of treatment that you may be receiving.


What if I give up conventional treatment for Alternative Therapy?

You have the right to choose your treatment. However, do consider the risk of losing the benefits that conventional treatment offers. Do not make hasty decisions. Always weigh the pros and cons of each treatment before making a decision.


Some notes on Herbal Medicine

Herbal medicine is a booming industry. The use of herbs in medicine is ancient in its origins. New cancer drugs such as Paclitaxel continue to show the usefulness of plants in anti-cancer treatment. Basic to the use of herbs is the belief that the whole plant is superior to that made from certain parts of the plant, with fewer side effects. There is little evidence for this belief. The safety of many herbs is unknown.

Ma huang or ephedra contains esphedrine that can cause headache, dizziness, palpitations and possibly strokes and heart attacks. Yet it has been promoted as a safe alternative for weight loss. The consumer must interpret these claims made by manufacturers and prescribers of herbal medicines carefully.


Questions you can ask about Alternative or Unproven Remedies

The following questions will help you obtain more information and assess the treatment that you intend to take up. If these questions cannot be answered to your satisfaction by the practitioner of a particular alternative therapy, then you have the grounds to be wary about the therapy offered or the practitioner offering it. Talk it over and discuss with various people including your cancer doctor and nurse counselors at the Cancer Helpline.

About Treatment
  • Why do I want to use this treatment?
  • What do I think it will do for me?
  • Does it sound too good to be true?
  • How can it maintain or improve my general health?
  • What does the treatment actually involve?
  • How is it usually given?
  • Are there any known side effects?
  • What can be done for these side effects? Can they be prevented or controlled?
  • How much time does it involve?
  • How long do I need this treatment or how many courses do I need?
  • How much would it cost me?
  • How many people has it helped?
  • What is the failure rate like?
  • What evidence is there that it will work for me?
  • How long before I know the treatment is working?
  • Has the treatment been tested in trials before?
  • Will this treatment clash with the conventional cancer treatment that I am receiving?
  • Is this same treatment being used for any other illness apart from cancer?
About the Practitioner
  • Does the person offering it have any recognized training or qualifications?
  • If the person uses the title 'Doctor' or 'Professor', do the titles come from a recognized institution?
  • If the person calls himself/herself a specialist, what does this mean?
  • Has the person offering the treatment worked with cancer patients before?
  • How many people with my particular type of cancer has this person treated?
  • What is the success rate?
With the information obtained form asking these questions, you will be better equipped to decide on which alternative therapy you want to take up or is it even necessary to use one.

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Footnote : The Cancer Education & Information Service (CEIS) offers telephone counseling and written information through the Cancer Helpline to anyone affected by cancer. They can help with general enquiries; their oncology nurse counselors can also discuss specific issues with people who are affected by cancer. The Cancer Helpline can be reached at 2255655.

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