Talking to your medical team

Monday 2 February, 2009

Reviewed: A/P Michael Jefford,Consultant Medical Oncologist, Peter Mac; Dr Raymond Snyder, Director of Oncology, St Vincent's Hospital; Beth Wilson, Health Services Commissioner, Victoria; Dr Amanda Hordern, Director, Cancer Information and Support Service. Developed with funding from the Victorian Department of Human Services.

On this page: Keeping an open mind ι What if my family or friends want me to try an alternative therapy? ι Why do alternative therapies work for some people? ι Are health professionals hiding the ‘real cure' for cancer? ι What do health professionals know about therapies? ι Talking to your doctor

You always have the right to refuse treatment. Even if you decide to stop conventional cancer treatment to use a therapy your medical team disagrees with, they should still respect your right to make this decision. It is important your decision is acknowledged. However, they may want to let you know what risks are involved. They may also have concerns that the therapy you have chosen will cost you a lot of money and offer false hope.

Keeping an open mind

If you go ahead with an alternative therapy, your specialist cancer doctor may ask you to think about stopping the therapy if it has not helped to control or cure your cancer within a certain timeframe. If your cancer remains unchanged or worsens in this time, they are likely to suggest you consider conventional cancer treatment again. It can be worth keeping an open mind in these situations. 

The most important factor is that you and your medical team communicate. If your doctor is aware of your thoughts they can plan the best way to support you. That way you can make your decisions based on accurate and up-to-date information.

You may find it helpful to read the section titled ‘Unethical practices (cancer quackery)'.

Keep in mind that there is a big difference between a therapy making you feel better and it actually treating your cancer.

What if my family or friends want me to try an alternative therapy?

Your family or friends may read about an alternative therapy and encourage or pressure you to use it. This can be difficult, especially because you know they care and are well meaning. But you have to be sure it is what you want to do.

Find out all you can about the therapy they are suggesting before making any decision. Know about your conventional cancer treatments and their proven benefits. If possible, take the person suggesting the therapy along to your next doctor's appointment. You can then discuss the issues together.

You may also find it helpful to talk things over with someone outside the family - your nurses, a social worker or a friend - or call the Cancer Council Helpline on 13 11 20 and speak with an experienced cancer nurse. The important thing is you feel you have enough support and reliable information to make your decisions.

Why do alternative therapies work for some people?

You may read or hear about people who claim their cancer was cured by an alternative treatment. It is only natural to want to believe these positive stories. Sadly, individual stories about miracle cures are not enough evidence that a treatment works.

Often there is no way of knowing how true a story is. What many stories often fail to mention is these people have also had conventional cancer treatment, such as chemotherapy or radiotherapy, either before or alongside the therapy. Conventional treatments can sometimes take weeks or months to work.

But even if you feel better taking an alternative therapy, an improvement in your mood should not be confused with curing your cancer. Any treatment - proven or unproven - may make you feel better in the short term. This is called the ‘placebo effect' - feeling better simply because something has been done that you expected to help. Many studies suggest placebos can relieve a wide variety of symptoms. However, the treatment has done nothing for the underlying problem.

Most cancers show no symptoms during much of their course, so many people with cancer who use an unproven therapy can be misled into believing they have been cured, even though the cancer is still progressing. You may end up unwell again only a short time after you thought you were cured. This is why doctors wait at least two years before telling someone that their cancer is cured.

Doctors can't always predict the course of a cancer. Some cancers grow and spread much faster than expected. In other cases, a person may live many months or years longer than the doctor predicted. Very occasionally a cancer will simply go away, quite unexpectedly. Doctors call this ‘spontaneous remission'. We don't know why this happens, but these people have almost always had some conventional cancer treatment. Some may have also used a complementary or alternative cancer therapy, but others have not.

Most people who promote alternative cancer ‘cures' don't usually publicise their failures - those people for whom the therapy does not work, who die or never return to the therapist. 

The only way of knowing whether a treatment works is by doing clinical trials. Read more on Research into therapies.

Are health professionals hiding the ‘real cure' for cancer?

Some people claim that health professionals (doctors and scientists) and/or certain companies (drug companies) are hiding the ‘real cure' for cancer. They believe these people are making too much money from providing their services or drugs to sick patients to ever admit that herbal remedies, meditation or a special diet, for example, could help treat or cure cancer. There have also been claims that ‘off-patent' drugs that might help with treating cancer are not being investigated properly because there is no money in it for the drug companies.

This doesn't make any sense. First, there are over 200 types of cancer and the way they act and respond to conventional treatment varies considerably. The causes are different for different types of cancers. It is very unlikely that any single treatment would ever work to treat all types of cancer.

The fact that a drug is ‘off-patent' is not a barrier to its development as a treatment for any type of disease, including cancer. An extensive amount of research is being done into a broad range of drugs that may help treat or cure cancer. This research needs to be done before we can prove any treatment is safe and effective. With many alternative therapies there is no evidence to prove that it controls or cures cancer - it is just ‘thought' that it might. Imagine the outrage if scientists started to use cancer treatments they ‘thought' might help but which had not been through a series of clinical trials to prove it.

Remember - doctors, scientists and those working for drug companies also have families and friends who can get cancer. And doctors get cancer at the same rate as everyone else. If they knew the cure they would want to let people know. The reason why most health professionals are wary of certain complementary therapies and alternative therapies is because they have concerns about their safety.

 

What do health professionals know about therapies?

It's very important to tell your doctor if you are taking any non-medical therapies, since they could affect your conventional cancer treatment.

It's a good idea to talk to members of your medical team about complementary therapies and alternative therapies if you are thinking of taking them.

With hundreds of different types of therapies available, it is difficult to know about them all. Most health professionals will be willing to find out how to access reliable and up-to-date information for you.

Health professionals are receiving more education in this growing area of interest. Cancer Council Victoria runs workshops to help health professionals communicate better about these therapies and encourage patients to ask questions and talk about what they might be using. Good communication will be the most effective protection against the use of harmful therapies.

Talking to your doctor

Most health professionals working with people with cancer are positive about them using complementary therapies. They are generally only concerned with the use of unsafe therapies, or if someone decides to give up conventional cancer treatment for an unproven alternative therapy. They want to be sure that a therapy won't cause serious side effects or interfere with a conventional treatment. Your cancer doctor wants what is best for you. Despite this, many people don't talk to their medical team about alternative therapies.

You may feel your doctor is too busy to discuss these treatments. Even if your doctor does not ask, it is still important to tell them. They will want to know so they can plan your care in the best way possible. It ensures your conventional cancer treatment will continue to work as well as possible. Having an open and honest discussion with your cancer doctor will help you decide which therapies are going to be safe for you to use.

If you are having trouble discussing any unconventional therapies in an open and supportive manner with your medical team, you may want to consider getting a second opinion. But if you and your doctor can work together and willingly talk about these types of therapies, it will help you get the best care and treatment for your cancer. 

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