UNPROVEN AND UNCONVENTIONAL THERAPIES
A diagnosis of cancer evokes many emotions in patients and fam-ilies, including feelings of fear, frustration, and loss of control. Despite increasing 5-year survival rates with the use of tradi-tional methods of treatment, a significant number of patients use or seriously consider using some form of unconventional treat-ment. Hopelessness, desperation, unmet needs, lack of factual information, and family or social pressures are major factors that motivate patients to seek unconventional methods of treatment and allow them to fall prey to deceptive practices and quackery. Although research is scant and accuracy of reporting may be questionable, it is estimated that 30% to 50% of patients with cancer may be using a complementary or alternative method of treatment.
Caring for patients who choose unconventional methods may place members of the health care team in difficult situations pro-fessionally, legally, and ethically. Nurses must keep in mind those ethical principles that help guide professional practice, such as autonomy, beneficence, nonmaleficence, and justice.
Unconventional treatments have not demonstrated scientifi-cally, in an objective, reproducible method, the ability to cure or control cancer. In addition to being ineffective, some unconven-tional treatments may also be harmful to patients and may cost thousands of dollars. Most unproven cancer treatments can be categorized as machines and devices, drugs and biologicals, meta-bolic and dietary regimens, or mystical and spiritual approaches.
Electrical gadgets and devices are commonly reputed to cure can-cers. Most are operated by people with questionable training who report unrealistic and unlikely success stories. Such machines are often decorated with elaborate lights and dials and produce vibrations or other sensations.
Medicinal agents, herbs, proteins (such as shark cartilage), mega-vitamins (including vitamin C therapy), immune therapy, vac-cines, enzymes, hydrogen peroxide, and sera have been frequent components of fraudulent cancer therapy. These agents have included oral, intravenous, and external medications derived from weeds, flowers, and herbs and the blood and urine of patients and animals. Many of these agents, especially in megadoses, can be toxic and can have untoward interactions with concomitant med-ications. Herbs commonly used by individuals with cancer in-clude echinacea, essiac, ginseng, green tea, pau d’arco, and hoxsey (Montbriand, 1999). Many of these treatments are costly.
Metabolic and dietary regimens emphasize the ingestion of only natural substances to purify the body and retard cancerous growth. These regimens include the grape diet, the carrot juice diet, garlic, onions, various teas, coffee enemas, and raw liver in-take. Laetrile (vitamin B, amygdalin), one of the best-known forms of cancer quackery, was advocated as an agent to kill tumor cells by releasing cyanide, which is especially toxic to malignant cells. The National Cancer Institute, in response to public demand, investigated the effects of laetrile and reported no therapeutic benefits with its use; indeed, many toxic effects (cyanide poisoning, fever, rash, headache, vomiting, diarrhea, and hypotension) were reported. Macrobiotic diets have also been advocated as a cancer treatment to reestablish balance between the major forces in the universe, yin and yang. People who adhere to macrobiotic diets tend to develop vitamin, mineral, and protein deficiencies; experience additional weight loss due to decreased calorie intake; and receive no therapeutic benefits from the diet.
Traditional Chinese medicine attempts to balance chi forces in order to heal the body. Mystical or spiritual approaches to cancer therapy include such techniques as psychic surgery, faith healing, “laying on of hands,” prayer groups, and invocation of mystical universal powers to kill cancerous growths. These techniques are difficult to disclaim because they are based on faith.
A trusting relationship, supportive care, and promotion of hope in the patient and family are the most effective means of protect-ing them from fraudulent therapy and questionable cancer cures. Truthful responses given in a nonjudgmental manner to questions and inquiries about unproven methods of cancer treatments may alleviate the fear and guilt on the part of the patient and family that they are not “doing everything we can” to obtain a cure. The nurse may inform the patient and family of the characteristics common to fraudulent therapy so that they will be informed and cautious when evaluating other forms of “therapy.” The nurse should encourage any patient who uses unconventional therapies to inform the physician about such use. Knowing this information can help prevent interactions with medications and other thera-pies that may be prescribed and avoid attributing the side effects of unconventional therapies to prescribed medications.