Original article from MedScape Medical News
Harsh criticism is being directed at a study that concluded cancer patients who used complementary medicine (CM) were more likely to refuse standard care, and as a result, faced a higher risk of death.
The use of CM in this study was associated with worse 5-year overall survival compared with patients who didn’t use CM (82.2% vs 86.6%; P = .001) and a twofold greater risk of death. The study was published last year in JAMA Oncology, and reported at the time by Medscape Medical News.
The authors now are facing a firestorm of criticism, detailed in letters to the journal from five separate groups, and the criticism has been amplified on Twitter.
One of the critics, Lars Haakon Soraas, MSc, from the Norwegian University of Life Sciences and Nordic Cochrane Centre, Copenhagen, Denmark, says in a long thread on his Twitter feed that the five letters to the journal are “completely destroying the pseudoscience article.”
He also hopes that the journal and/or authors retract the study “as its presence online will continue to misinform cancer patients worldwide.”
Lead author of the study Skyler Johnson, MD, Yale School of Medicine, New Haven, Connecticut, argues on Twitter that these letters to the editor “do not ‘completely destroy’ our work, as any thoughtful, objective reader or scientist familiar with these processes can attest.” He points out that concerns about the study have been previously addressed on Twitter, in the discussion section of the article, and again in their response to the letters to the journal.
“There is a HUGE difference between unproven anticancer therapies noted by docs (our study) and the most common complementary medicines self-reported by patients,” he adds.
Study Details
For the study, Johnson and colleagues conducted a retrospective review of data on 1,901,815 patients from the National Cancer Database. The cohort included patients diagnosed with nonmetastatic breast, prostate, lung, or colorectal cancer.
From this large cohort, 258 patients (0.01%) were identified as using CM, loosely defined as “other-unproven: cancer treatments administered by nonmedical personnel” that were given in addition to at least one conventional modality, defined as surgery, radiotherapy, chemotherapy, and/or hormone therapy.
Patients who received CM were then matched with 1032 patients who had received conventional therapy.
However, the association of CM with increased mortality was largely based on treatment delay or refusal. After adjustment for treatment refusal and delay from diagnosis to treatment, CM was no longer significantly associated with the risk for death (HR, 1.39).
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