Use of alternative medicine for cancer and its impact on survival.

Abstract

e18175 Background: There is limited available information on the patterns of utilization and efficacy of alternative medicine (AM) for patients with cancer. The primary objective was to compare survival between patients with cancer receiving AM and conventional cancer treatment. The secondary objective was to determine cancer patient characteristics associated with selection of AM. Methods: Patients diagnosed with non-metastatic breast, prostate, lung, or colorectal cancer were identified between 2004-2013 using the National Cancer Database (NCDB). Alternative medicine use was defined as ‘Other-Unproven: Cancer treatments administered by nonmedical personnel’ administered as sole anti-cancer treatment among patients who did not receive chemotherapy, radiotherapy, surgery, and/or hormone therapy. Treatment selection was evaluated by the chi-square test, t-test, and logistic regression. Patients were 2:1 matched on age, clinical group stage, Charlson-Deyo comorbidity score, insurance type, race, year of diagnosis, and cancer type. Overall survival was analyzed using the Kaplan-Meier method, log-rank test, and Cox proportional hazards regression. Results: We identified 281 patients who chose AM in lieu of conventional cancer treatment. Approximately 44% of these patients had breast cancer, followed by prostate (25.5%), lung (18.4%) and colorectal cancer (12.1% of patients). Independent covariates associated with increased likelihood of AM use included breast or lung primary site (vs. prostate), higher socioeconomic status, Intermountain West or Pacific location (vs. Northeast), stages II or III (vs. I) and Charlson-Deyo comorbidity score of 0 (vs. 1). Alternative medicine was independently associated with greater risk of death compared to conventional cancer treatment overall (HR: 2.50, 95% confidence interval 1.88-3.27) and in subgroups of patients with breast, lung, and colorectal cancer. Conclusions: Alternative medicine utilization in patients with cancer is rare and varied by geographic, socioeconomic, and disease-related factors. Patients who chose alternative medicine for primary treatment of their curable cancer had greater risk of death compared to those who chose conventional cancer treatment.