Could Alternative Medicine Cause Cancer Treatment to be Ineffective?

Some complementary or alternative medications can have an adverse reaction mixed with cancer drugs.

Patients with cancer could be inhibiting their treatment regimen by taking complementary or alternative medicines (CAMs) that thought to be all-natural, a recent study suggests. However, these natural treatments can have negative chemical and biological responses to cancer treatments.

“Currently, few oncologists are aware of the alternative medicines their patients take,” said Ginah Nightingale, PharmD, an assistant professor in the Jefferson College of Pharmacy at Thomas Jefferson University. “Patients often fail to disclose the CAMs they take because they think they are safe, natural, nontoxic and not relevant to their cancer care, because they think their doctor will disapprove, or because the doctor doesn’t specifically ask.”

Several CAMs are known by scientists to cause adverse reactions when used in combination with cancer treatments. For example, St. John’s wort can make some cancer therapy less effective, according to the National Institutes of Health.

Other alternative medicines can affect a patient’s ability to stay asleep under anesthesia. However, not all reactions have been thoroughly researched.

Because CAMs are not regulated by the FDA due to their status as a health supplement, the dose and potency can vary greatly between products and patients. Additionally, in the geriatric community, adding CAMs to an already daunting treatment regimen can affect adherence to prescription medications.

“Numerous pills, or what we call polypharmacy in the field, can increase the risk for medication non-adherence, potential drug-drug interactions and increase the risk for drug-disease interactions in a population that has been reported to take several medications and have several medical conditions,” Dr. Nightingale said. “The use of CAM in this subpopulation warrants substantial interest and concern on behalf of medical oncologists and allied health professionals because of the potential clinical implications associated with CAM use. Patients may be combining these agents while receiving concurrent systemic chemotherapy, radiation therapy and/or surgical interventions which have the potential to compromise the safety and efficacy of treatment interventions.”

Researchers examined the senior oncology patient population who came to Jefferson for consultations in the Senior Adult Oncology Multi-Disciplinary clinic. As part of their visit, patients were required to see 5 different medical professionals including a medical oncologist, geriatrician, clinical pharmacist, social worker and dietician. Additionally, patients’ medicine cabinet contents were examined and the medications that were actively used were reviewed and recorded.

The findings showed that 26% of patients were taking CAMs as part of their treatment regimen. The highest usage was among women over the age of 80. In fact, 68% of the population reporting CAM use was over the age of 80.

Some of the alternative medications that were commonly used in this population were alternative therapies for macular degeneration, stomach probiotics, joint health, and mega-dose vitamins or minerals.

The adverse effects associated with these medicines was not taken into account, but Nightingale assures the general public that “we know that some can have a biochemical effect on the body and other drugs.”

“It is very important to do a comprehensive screen of all of the medications that older cancer patients take, including CAMs,” Dr. Nightingale said. “Clear and transparent documentation of CAM use should be recorded in the patient’s medical record. This documentation should indicate that patient-specific communication and/or education was provided so that shared and informed decisions by the patient can be made regarding the continued use of these medications.”

The use of CAMs in patients with cancer could potentially be the difference between survival and death as several “natural” medications can have biochemical reactions within the body to other drugs and treatment methods, rendering them ineffective in the fight against cancer. Patients should take responsibility for their treatment regimens and adhere to the guidelines set forth by their doctors to get the best care possible for their conditions.

“Oncology health care is undergoing significant transformation in the delivery of effective clinical services and is ripe for greater engagement of pharmacists to reduce drug-related problems and unnecessary medications, in order to optimize medication prescribing,” Dr. Nightingale said.