Delay in conventional breast cancer treatment associated with alternative therapy usage

Abstract

593 Background: Alternative therapies are used by between 28% and 83% of women with breast cancer, but their impact in causing deleterious delay in commencing empirically validated conventional therapies has been poorly documented. Methods: A retrospective qualitative study examined the clinical and psychological profiles of women presenting to Westmead and Nepean Hospitals (WNH) with breast cancer, over a 4 year period, after initially refusing conventional treatment in favor of alternative therapies. Results: Six patients were identified, aged 38 to 53 years, all with operable stage I-II breast cancer at initial presentation. Three patients had tertiary educational qualifications, one was a qualified oncology nurse. Elevated anxiety levels were noted in four patients, however only one had a significant past psychiatric history. All declined conventional therapy at initial presentation, choosing instead alternative therapies including high dose vitamin C, urine therapy and laetrile. One patient received prolonged alternative therapy from a registered medical practitioner. Reasons elicited for refusal of conventional management included perceived loss of personal control, dissatisfaction and lack of confidence in conventional treatments, and denial. At subsequent presentation all had advanced breast cancer with extensive fungating chest wall disease. The delay in commencement of conventional therapy was 6 to 24 months. Five patients accepted salvage conventional therapy, and responded for variable periods of up to 43 weeks. Three patients have so far died from their disease. Conclusions: Alternative therapy was used in isolation for potentially curable breast cancer by six women. Poor outcomes have been observed in all patients. The dangers of delay caused by ineffective alternative therapies may have been underestimated in a medico-political climate that favors accommodation of non-traditional adjuncts to cancer therapy. No significant financial relationships to disclose.