Death by Alternative medicine

Death by alternative medicine: Who’s to blame? is a great post by Respectful Insolence, one of the Science Blogs I read.

The surgeon described how he dutifully did an ultrasound-guided fine needle aspiration of the small nodule.
The results? Adenocarcinoma. Breast cancer.
Here’s where things get interesting. Apparently, this woman is a die-hard altie. And I do mean “die hard,” as she will quite likely die very hard for her beliefs. She absolutely refused any surgery or treatment for her cancer. It was explained to her that a less than 1 cm tumor with no evidence of spread to the lymph nodes carried a highly favorable prognosis, with upwards of 93% long term survival with proper surgery and adjuvant chemotherapy and/or hormonal therapy.
This woman would have none of it. She wanted to pursue “alternative” medicine. And pursue it she did, with a vengeance. For three years, she disappeared off the radar screen.
A few weeks ago, she reappeared in this surgeon’s office. In the interim, she had tried Essiac tea, homeopathy, the Hoxsey therapy, the Gerson treatment, and Reiki therapy, among others, all the while visiting various “healers.” The results? If you’ve been reading here, you can guess the result.
Her tumor had progressed.
Not only had the tumor progressed, but it had progressed a lot. When the surgeon saw her again, now more than three years after her diagnosis, her tumor had grown to 5-6 cm in size. It was now stuck to the chest wall, distorting her nipple, and ulcerating through the skin in a five centimeter area of bleeding, disgusting goo.

Let me tell you of a similar tale in our shores. The patient is a relative of a colleague of mine, an ENT surgeon. He found out about her having breast cancer. She was afraid of surgery and instead landed in the clutches of a doctor who practiced Ozone therapy.

Advanced_Breast_Cancer
(advanced breast cancer : picture from emedicine.com)

Ozone therapy was administered on a daily basis, each session costing RM400 or thereabouts. Apparently through out the course, the patient was not assessed for response in anyway by the doctor concerned. Eventually another relative of the patient (a nurse I believe) confronted this practitioner who hastily referred her away to a surgeon. By that time the tumour had progressed and the patient now has lymph node and liver metastases.
Breast cancer is generally quite slow growing and patients can live with advanced disease and metastases for quite some time, sometimes even for years. This gives ample opportunity for Quacks to ply their trade. The sad part is these women are being sentenced to Death by Alternative Medicine. So what can we do about it? Who’s to blame?
Do we blame the patient for making the decision? Do we as doctors blame ourselves for not trying hard to convince the patient to do so otherwise (often we can advise patients till we are blue in the face but they ultimately will make up their own minds). What about rogue physicians who undertake unorthodox practices like Ozone therapy for breast cancer? Shouldn’t they be blamed and even punished? We mentioned a high profile case in Holland where Doctors were suspended for use of Complementary medicine in a celebrity with Breast cancer. I have yet to see similar cases in Malaysia involving doctors who use unorthodox methods in cancer patients. These doctors are causing harm by denying patients a chance for proper care with proven methods. By administering ineffective unorthodox treatment, the cancer will progress to incurable stages. So should we blame the system for failing to discipline these doctors? The system here demands that patients complain about these doctors to the Malaysian Medical Council. I am waiting for the day that happens.

[tags] breast cancer, alternative medicine, ozone therapy, quack, doctor, complementary[/tags]

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Malaysian physician, haematologist, blogger, web and tech enthusiast

Posted in - CAM watch, - Palmdoc
7 comments on “Death by Alternative medicine
  1. poor doctor says:

    I had the similar expereience where I diagnosed a patient with early stage of uterine cancer. She insist want to have massage therapy and other alternative medicine such as homeopathy or acupucture. I sit with here for 30 minutes to explain the excellent prognosis of her disease after surgery but she refused. So finally I told her that she has the right to choose her own treatment even the right to die due to her stupidity. The doctor will only give the best advise but she choose to have her own way even to die than so be it!.

  2. Winston says:

    I think that for minor aches and pain, alternative treatment like acupuncture may be appropriate.
    But for serious problems like cancer, no way.
    Further, the stupidity of it all is that our government wanted to implement alternative medicine in public hospitals.
    This will further enhance the view of the public that alternative medicine is appropriate for every illness because even the government gave it its stamp of approval.
    The only consolation from this sad state of affairs is that the patients, who seek alternative medicine, when they noticed that they are in deep shit, will spread the message of their stupidity and try to warn others not to repeat what they had done!
    For them, it’s a gone case.

  3. huajern says:

    why seek treatment for minor aches and pains? sometimes I feel we are medicalizing too many ‘normal’ phenomena, though I am sure others will disagree. if ‘treatment’ is risk-free/low risk, then go for it by all means. unfortunately acupunture, chiropractice, herbs etc are not risk free.

    ‘The only consolation from this sad state of affairs is that the patients, who seek alternative medicine, when they noticed that they are in deep shit, will spread the message of their stupidity and try to warn others not to repeat what they had done!’
    On this I beg to differ. Most patients with a bad experience with alternative medicine will keep quiet, for whatever reason. Probably like you mentioned, they don’t want others to laugh at their stupidity.

  4. Palmdoc says:

    Time and time again I see patients deteriorating at the hands of quacks and alties and when they end up in hospital in pretty bad shape it’s a tough time trying to piece them together. Yet our patients will almost always never complain about these quacks and alties to the authorities.

  5. Jonathantg says:

    “Death by Alternative medicine” is really not a good topic to start off right at the beginning!! Why?
    Alternative medicine has it’s own benefit and value. As far as i know, herbs and supplements are doing fine only if you know what are the contains & what are their benefits and side effects. Of course, you need to be trained and qualified to prescribe the herbs and supplements to suit every individual needs.

    May be diagnosis is important afterall, so do not just pop into a store and buy what you think you need most, get to someone that is qualified and let them make the decision.

    Herbs and Supplement is helping you to boost immunity, clean your intestine, helping you with all of problem like insomnia, depression,psoriasis, Eczema, acne, indigestion, allergies, anxiety, arthritis, Prevent/ reduce BPH (benign prostatic hypertrophy/ hyperplasia), diarrhea, constipation, fibromyalgia, Autism, Weight loss (healthily), reduce chances to get artherosclerosis, Alzheimer’s, Diabetes and many more.

    Herbs and supplements are preventive measure for your future health and Medicine is helping you when you really ill, may be Cancer, AIDS, Accident and some many more.

  6. Palmdoc says:

    Well it is a striking title because in the examples it cites, it is so true. The message we are trying to drive home about herbs is:
    1) They are not free of side effects. “Natural” does not automatically equate to “safe”. Some are downright dangerous.
    2) Be critical about claims of efficacy. We often come across claims which are unsubstantiated – no proper clinical trials, very poor quality of evidence
    3) Be wary of fraud. It is common in Malaysia where herbs are laced with potent drugs like NSAIDs, steroids, viagra etc.

    Previous MMR blog posts about herbs:
    http://medicine.com.my/wp/Index.php?s=herbs

  7. Jonathantg says:

    Palmdoc,

    You are there! Herbal medicine is not safe at the moment due to most of the reasons as you have mentioned. I am very impressed with what you actually know. I totally agree with you.
    As many of us know herbs just like drugs, you need to have right amount of active ingredients to make it work.

    Besides, my worry is more on how there are manufactured?
    1) Are the manufacturers really following the GMP?
    2) Where are the sources from (i.e. contaminated or not)?
    3) What are these herbs doing in our bodies?
    3) More clinical trial is required for herbs like Black Cohosh, Capsicum pepper, CoQ10, Gingko, Gotu Kola, Ginseng, Chamomile and Bilbery. (These are herbs that actually have been proven [1] to have effect in human bodies and clincal trials have been done but the size of each trial is rather small and the most important is that these herbs have less side effect than Ephedra, Licorice, Yohimbe, Kava and St. John wort.[1]

    [1] Rotblatt M & Ziment I, ediors.Evidence-Based Herbal Medicine.California: Hanley&Belfus 2002 pg63-385
    [2] Ottariano S G, editor.Medicinal Herbal Therapy ‘A Pharmacist’s Viewpoint’.Portsmouth: NicolinFields 1999
    [3] Webb G P,editor. Dietary supplements & Functional foods.Oxford:Blackwell 2006

    Those are good books that show you most of the advantage and disadvantage of common Herbal medicine.
    Always remember, prevention is better than cure! Antioxidants is a prefect example that can prevent many diseases like:(Atherosclerosis-> heart diseases,Diabetes,Cataract and Aging)just to name some…

    Hope all of you enjoy your life healhtily.

    Best wishes,
    Jonathan