Considering the alternatives
I’m pretty sceptical when it comes to unconventional medical
treatments. I take the approach best expressed by Tim Minchin – “Do you
know what they call alternative medicine that’s been proved to work? Medicine.”
When it comes to cancer, alternative medicine abounds. A
range of concoctions purport to offer an easy pathway to greater longevity and
better health. Charlatan Belle Gibson made outrageous
claims about beating cancer merely through “nutrition, patience,
determination and love – as well as vitamin and Ayurvedic treatments,
craniosacral therapy, and a whole lot of other treatments”. The US-based Cancer Tutor website claims that purple
grape juice and carrot-and-beet juice are both “excellent cancer treatments
with very high cure rates”. Advocates of Gerson
Therapy say that cancer can be cured with 13 glasses of juice a day, a
range of supplements and coffee enemas. Really.
Cancer patients are particularly vulnerable to the lure of such
quackery. I think part of the reason lies in the fact the conventional medical
treatment is so toxic and arduous. To learn that the path to better health
mapped out by conventional medicine involves rounds of chemotherapy and
radiotherapy, with cells both innocuous and malicious coming under attack as
the body becomes a battleground, is confronting. It is daunting to know that debilitating
side-effects lie ahead. Another route to the same destination that avoids the
side-effects is understandably tempting.
The existential threat posed by cancer adds to the allure of
alternatives. After all, if your life it at stake, it seems foolish to not explore
all the options. Many people diagnosed with cancer will ultimately die from the
disease even with the best in conventional medicine, leading to the false and
naïve assumption that they might have been saved had they embraced the
alternatives.
Much of the support among patients for alternative medicines
comes from people who have an ingrained cynicism towards the medical
establishment and who view following its edicts as acts of conformity. For
them, embracing alternative medicine is a statement of identity; they choose
their cancer treatment in the same way they might buy their groceries. With
chemotherapy drugs expensive and major pharmaceutical companies driving
development, opting for an unscientific alternative to chemo becomes a political
statement of rebellion.
The formula most medical experts adopt is that patients can
try alternative treatments if they want, but they should continue with
conventional medicine and tell their treating doctor to make sure the
alternative treatment doesn’t interfere. If the alternative is doing no harm,
then why discourage a patient from trying? That approach makes a lot of sense.
For all their failings, alternative treatments can have some
benefit, though not in the way their advocates say. If you’re like me and you
are doubtful of the power of alternative treatments, they will do no good. But
if you’re someone who believes strongly in the power of those treatments, they
might provide some marginal benefit thanks to the placebo effect. The sense of
hope that treatment might give the patient could, in and of itself, benefit the
patient if it lifts their mood, gives them comfort or in some other way
improves their disposition.
There’s plenty of conjecture about the extent to which
psychological factors can impact on the progress of physical ailments. While scientifically
testing the impact is notoriously difficult, lived experience suggests there is
some physical benefit at the margins from a more positive psychological
outlook.
(This also reflects my thinking on the power of prayer.
Since I was diagnosed, some people have told me they are praying for me. I
don’t believe in a higher power, and so I do not think those prayers per se
will have any impact on my health. But it is comforting to hear from various
people that I am in their thoughts, and the kindness of these people lifts my
mood. But my mood is also lifted from other people that get in touch to send
good wishes rather than prayers.
That improvement in mood has some incremental positive impact on my health, but
of course it is not the “praying” that brings the benefit but the “telling me”.
As for patients themselves praying, there’s no benefit for a non-believer like
me, but there may well be for a person of faith.)
The greatest problem is among patients who discard
conventional medicine altogether and rely exclusively on alternative medicine
for treatment. Too many people in that position have lost their lives
relying on alternative medicine while cancer, or other diseases, ravaged their
bodies. While you can never say for sure that conventional medicine could have
helped, it seems likely in many cases.
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| Tasty, but not a cure for cancer. (Image courtesy of Pixabay) |
For starters, give patients the information they need in a
format they can understand. The early period after diagnosis is one in which
the patient is given great volumes of information, but much of it is technical
and laden in jargon. The material can be intimidating for a patient and prompt
them to fear that they will receive a treatment that may do them harm. In my
case, an excellent hour-long session with a cancer nurse early on gave me a
no-nonsense guide to what was coming up and a chance to ask questions. For some
later clinical decisions, though, I was left in the dark or given information
that was difficult to understand. Informed consent is impossible in these
conditions, and a patient is more likely to consider alternatives.
Which gets to the matter of choice. Many people with cancer
have a feeling of helplessness because of the disease harming their body. But I
suspect many also feel helpless that they have little agency over the treatment
they receive. The path of chemotherapy and radiotherapy can be presented as the
only option rather than the best option, leaving the patient feeling they have
no choice but to proceed. While this may lead to early patient compliance, it
may also lead to later rebellion and a search for alternatives. Better for the
patient to choose to go down the path rather than feel forced onto it.
Doctors might also benefit from being frank with their
patients about their outlook in the absence of treatment, which is essentially
what relying exclusively on alternative treatments amounts to. To hear the
prospects of death or a low quality of life in the absence of treatment makes conventional
treatment, even with its side-effects, more palatable. Remaining naïve to the
consequences of inaction can leave a person more willing to let their desire
for a treatment that reflects their identity overwhelm their survival instinct.
Ultimately, of course, patients should be free to choose the
path they think is right for them, including alternative medicine if they wish.
But they should be able to do so in full possession of the facts about the
success rates and the side-effects. Unless advocates of alternative medicine
are willing to subject their treatments to scientific rigour – which, following
the Tim Minchin line, would allow successful treatments to enter conventional
medicine – they should be treated with scepticism.
Advocates who hide painful
truths from those they are seeking to lure are doing themselves and patients no
favours.
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