Some complementary therapies – such as prayer and meditation – clearly do no harm and may in fact help people with cancer. But, it still is not known if other therapies, such as herbal medications, could pose a threat to the patient’s health.

The new study, published in the journal Cancer, focused on 190 men with prostate cancer. Dan Theodorescu, MD, PhD, and colleagues from the University of Virginia, Charlottesville, found 42 percent of the men used some form of complementary or alternative methods in addition to conventional prostate cancer treatments.

Commonly Used Methods

The most commonly used methods were vitamins, herbal medicines, and prayer or other religious practices. "[Complementary and] alternative medicine therapies offer hope to cancer patients who wish to leave no stone unturned and may enhance their sense of control over an illness that makes them feel helpless," the researchers wrote.

Because there are many definitions for the terms "alternative" and "complementary," the American Cancer Society (ACS) makes the following distinction between the two categories:

Alternative methods are unproven or disproven methods, rather than evidence-based proven methods to prevent, diagnose, and treat cancer. Complementary methods are defined as supportive methods used to complement evidence-based treatment and are not promoted to cure disease. Rather, complementary methods control symptoms and improve well being and quality of life.

William Fair, MD, chairman of urologic oncology at Memorial Sloan-Kettering Cancer Center in New York City, said the study confirms what many physicians dealing with prostate cancer patients already know – that patients are using complementary and alternative medicine in addition to standard treatments.

"One can infer from the study that the primary reason such therapies are so popular is because many patients feel a definite benefit from the therapies," said Dr. Fair, who is a member of ACS prostate cancer advisory group. "What is urgently needed now are well-designed studies to investigate scientifically which therapies are beneficial and which have no advantage and, in some cases, may even be hazardous."

Many Patients Don't Inform Their Doctors

According to the study’s authors as many as 72 percent of patients using complementary and alternative therapies do not inform their doctors. Some herbal medications can cause side effects and can affect levels of prostate-specific antigen (PSA) and testosterone. The researchers pointed out there is a danger that doctors unaware of a patient’s use of herbal therapies may stop an effective conventional therapy because they don’t know the side effects are the result of herbal medicine use.

It is important for doctors to clearly ask their patients about complementary and alternative medicine use, the study concluded. "Physicians must be informed of [complementary and] alternative medicine therapies used by their prostate carcinoma patients so that possible interactions and complications can be avoided and outcomes of therapies interpreted correctly."

Dr. Fair had this advice for patients interested in complementary and alternative medicines:

• First, find out as much as you can about the method by asking a knowledgeable source. For example, in the areas of diet and nutritional supplements, ask your doctor to recommend a registered dietitian for guidance. For acupuncture or Chinese herbal remedies, seek advice from an individual licensed in acupuncture and traditional Chinese medicine, instead of simply ordering herbal medications over the Internet.
• Make sure your doctor is aware and involved in your decision to use complementary and alternative therapies.
• If, after proper investigation, you want to use complementary medicine and your doctor rebukes you or embarrasses you about your choice, find another doctor more knowledgeable about such therapies and more sensitive to your concerns.

Dr. Theodorescu's research is supported in part by a career development grant from the ACS.