By Melissa Pang, The Straits Times, 14 Jun 2012
CANCER patients who take complementary and alternative medicine come down with fewer infections than those who do not, a local study has found.
They are also less likely to be hospitalised or need antibiotics.
The study also noted that the difference in outcomes between users and non-users of these treatments is starker among patients with Stage 4 cancer.
The study of 357 patients of the National Cancer Centre Singapore (NCCS) was a follow-up to an earlier one.
The older study found that more than half - 56 per cent - of 403 of the NCCS' adult cancer patients used alternative medicines. The follow-up, done on the same group of patients, evaluated the effectiveness of these treatments on them after six months.
But 46 patients were left out because of incomplete records or because they were not receiving chemotherapy or other cancer treatments at the time of the follow-up study.
The National University of Singapore's Associate Professor Alexandre Chan, who was involved in both studies, said they were undertaken because doctors often ask whether the use of complementary treatments together with chemotherapy would compromise patients' kidney or liver functions.
Patients also often ask doctors how effective such treatments are. Neither question has been well investigated, he said.
The researchers grouped the patients into users - 54.6 per cent - and non-users of oral-based alternative medicines. (See below.)
The study found no decline in patients' kidney and liver functions as a result of taking them along with the cancer treatments.
This is what typically concerns doctors, because these organs, if compromised, cannot process and rid the body of the toxins from the chemotherapy drugs.
Prof Chan, also an oncology specialist pharmacist at the NCCS, said the findings were significant, given the lack of knowledge in this area.
One limitation, however, came from the surveyed patients' having different cancers and being at different stages of the illness. They were also taking different complementary treatments, he said.
Patients' lifestyle choices, which could affect how they ride out the infectious complications, were also not factored in.
Dr Yong Wei Ping, of the National University Cancer Institute Singapore, said the study's broad classification of complementary and alternative medicines 'makes it difficult to tease out which of these contributed to the differences seen in a patient's outcome'. He also said the study did not address whether they affected the efficacy of chemotherapy. But he said it was 'reassuring' to know that these treatments are 'generally safe'.
Dr Raymond Ng of the NCCS said the study delved into an issue that oncologists and patients often deal with, but should not alter doctors' stance for or against alternative medicines. This is because it had limitations in terms of the relatively small number of patients involved; other limitations lay in its 'retrospective nature'. He was referring to the fact that the study entailed examining patient records going back to 2007-2008, and to the sheer variety of such treatments.
The senior consultant added that at the NCCS, patients who take them can check with the pharmacy on whether there would be problems taking them while being treated for cancer.
'This provides a safety net to minimise any potential complications,' he said.
Comparing the outcomes
THE study surveyed 357 patients from the National Cancer Centre Singapore.
Of these, 195 used complementary and alternative medicines, while the remaining 162 were non-users. The treatments encompassed:
- traditional Chinese medicine, including herbs, ginseng, lingzhi and cordyceps;
- food supplements, including barley green, bird's nest and essence of chicken;
- special diets, comprising organic vegetables and fruits;
- vitamins; and
- minerals.
The following were the differences in outcomes recorded by the study:
- 46.3 per cent of non-users came down with infections, against 34.4 per cent of users.
- 22.2 per cent of non-users required hospitalisation as a result of those infections, against 14.4 per cent of complementary and alternative medicine users.
- 42.6 per cent of the non-users needed courses of antibiotics, against 32.3 per cent of users.
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