Alternative medicine and cancer patients in less developed countries

Abstract

The practice of alternative medicine may cause delayed administration of conventional treatment, risking serious harm, unnecessary suffering, and sometimes death. The amount of money spent internationally on alternative medicines exceeds one billion dollars a year (equivalent to the amount spent on cancer research each year). False promises of a guaranteed cure, the quest for a remedy in hopeless cases, the desire for less invasive treatment, local religious beliefs, and medical practices all encourage the use of non-conventional treatments. In India, where there is a severe shortage of basic health facilities, illiteracy and poor education have lead to an increase in the number of practitioners specialising in alternative approaches to cancer treatment. Naturotherapists, nutritional therapists, reiki therapists, religious therapists (eg self-healing with prayers, confession, good deeds, religious holidays), those advocating meditation, yoga, or laughter, and black magicians, are just a few examples of the growing list of ‘cancer healers’ in India. These approaches can be an expensive alternative to conventional medicine, often resulting in serious financial hardship. A random survey of 550 cancer patients visiting the Jawaharlal Nehru Cancer Hospital (Bhopal, India) was carried out at the time of registration, and again one month later, while the patients were receiving treatment, or during follow-up. Two hundred and six patients (38%) had visited practitioners who offered alternative anticancer treatments before coming to the hospital. Of these, 80% came from rural communities while 20% came from urban areas. Delay in diagnosis ranged from 46 days to 2 years and two thirds of those who visited alternative clinics had stage III or stage IV disease. Interestingly, women were more likely to use alternative medicines (83%) than men (17%), and 75% of patients didn’t even know that they had cancer. Although the range of conventional therapies available and the potential harm caused by following an exclusively alternative approach was explained to all the patients, a follow-up survey revealed that nearly a quarter of the patients did not return to hospital, but continued with their ‘less toxic, less invasive’ treatment. One third of the patients continued their alternative therapy while receiving conventional treatment. Furthermore, 60% of those patients who had discontinued an alternative approach prior to visiting the hospital, visited an alternative practitioner within one month of the diagnosis, 12% were persuaded to discontinue conventional therapy, and 34% supplemented their conventional treatment regimen with a nonconventional therapy. The number of patients who