Alternative Medicine and Cancer: Why Don’t Oncologists Get On Board?

Dr. Richard Frank—

"Doctor, do you believe in alternative medicine to treat cancer?" As a medical oncologist, this is a question I am frequently asked by cancer patients.

I totally understand why someone affected by cancer asks this question. The main reasons seem to be:

  1. A desire to do "all that they can" to fight cancer successfully.
  2. A desire to prevent the side effects ("protect the healthy cells") caused by cancer treatments, such as chemotherapy and radiation.
  3. To support the immune system during cancer treatment.
  4. The belief that non-prescription herbs, supplements and vitamins are natural and, therefore, without the potential to cause harm.

Complementary and Alternative Cancer Therapies

I wish to better define the term "alternative medicine." Technically speaking, alternative medicine is the use of non-FDA (Food and Drug Administration of the US Government) approved medicines or treatments instead of conventional (FDA-approved) therapies to treat diseases and ailments. Because most people use alternative therapies along with conventional treatments, the recommended term is Complementary and Alternative Medicine or CAM. Another commonly used term is Integrative Medicine.

(For an accessible review of CAM and cancer, visit the medical resource UpToDate)

As it relates to cancer, CAM includes:

  • Alternative cancer treatments, such as:
    • special diets (macrobiotic, Gonzalez regimen, others)
    • herbal supplements (Chinese herbal medicines, curcumin, green tea, mistletoe, others)
    • non-herbal supplements (melatonin, shark cartilage, lycopene, vitamins/minerals, others)
  • Complementary therapies, such as:
    • acupuncture
    • massage, Reiki, exercise
    • music, art, yoga, reflexology
    • prayer, support groups 

There are also alternative medical systems, such as homeopathy and ayurvedic medicine. For an overview of these, consult the book After Cancer Treatment by Julie Silver, MD.

Today, most oncologists and cancer centers embrace complementary therapies and offer an array of them. These therapies help to provide a more holistic approach to patient care and promote a person's overall sense of well-being. As I discuss in Chapter 8 of my book, not enough cancer patients avail themselves of the programs and support groups that could help them and their families better cope with the many emotional challenges wrought by cancer.

  • I encourage every cancer patient to have at least one session with an oncology-trained counselor (usually a social worker, nurse, or family therapist) to at least acknowledge the psychological effects of a cancer diagnosis on them and their loved ones.

The Crux of the Problem

Whereas complementary programs are universally accepted, many cancer patients find that their physicians and hospitals are not up to their expectations in the area of alternative cancer treatments. Many individuals take vitamins on a regular basis and continue to take them during cancer treatment; others hear of possibly helpful supplements and immune-boosters and start taking these. Although many patients do not disclose to their oncologists what they are taking, many appropriately do.

I have found that the vast majority of cancer patients want their oncologists to be familiar with the alternative medicines they may be taking or have heard about. They want their oncologists to work with their naturopaths, if they have one, or to recommend the best of conventional and alternative medicine and to know when there may be a negative interaction (for example, St. John's wort can reduce the levels of many chemotherapy drugs in the bloodstream, resulting in their diminished effectiveness).  But even the most highly regarded oncologists usually only recommend conventional cancer treatments and prescription drugs to counteract their side effects. (I like to define the best oncologists as those offering skilled, dedicated, compassionate patient care and clinical trials from the National Cancer Institute that test the cancer treatments of tomorrow).

Although many oncologist may suggest alternative medicines to counteract a treatment related side effect, such as nausea (ginger) and peripheral neuropathy (vitamin B6, glutamine, alpha-lipoic acid), most do not routinely recommend an entire regimen of herbal supplements and vitamins to go along with standard therapies. Why is this? Are oncologists ignorant or biased as some claim? Or are we cautious, perhaps overly-so, concerned that "what we don't know CAN hurt us (our patients)?"

With all the exciting information on the web, in books and on TV about alternative cancer medicines for the treatment and prevention of cancer, why don't oncologists get on board?


In Search of Evidence

As an oncologist/hematologist, I deal with very serious illnesses and see people through the most difficult times in their lives. I realize that when the diagnosis is an incurable cancer, there is an urgent need to do all that is possible to live. I get it. Yet, I have a solemn responsibility to do what is best for each patient I care for and a legal responsibility to practice according to accepted standards of care. As physicians, my colleagues and I are bound by oath and conscience to be very mindful of what we prescribe and to base our medical recommendations on evidence that what we prescribe will do more good than harm. Trust me, as a patient, you do not want it any other way.

So, what is the evidence that alternative medicines can diminish the side effects of chemotherapy and radiation, boost the immune-system, improve survivals and do no harm? Let's look at some examples.

Chinese Herbal Medicine (CHM)

The belief that CHM reduces chemotherapy induced side effects is prevalent, especially in Asia where CHM use is widespread. In order to put the belief in CHM to the acid test, chinese physicians and researchers from Hong Kong studied breast and colon cancer patients undergoing adjuvant chemotherapy (given after all the cancer has been removed surgically, explained in Chapter 6 of my book). 125 patients were randomly assigned to one of three licensed, university trained herbalists who were allowed to treat each patient according to their own practices. 225 types of commonly used herbs were available and stocked in packaged form. Half of the patients received packages with the prescribed herbs, whereas the other half received packs of placebo containing tea/bean paste/sugar and coloring and flavoring that mimicked herbal preparations. Neither patient nor practitioner knew what was in the packages (called a "double-blind, placebo-controlled randomized study," the gold standard in proving if a new treatment works). The patients were followed to determine if CHM could prevent the lowering of blood counts, hair loss, loss of appetite, constipation/diarrhea, fatigue, rash, dizziness, headache, insomnia, nausea/vomiting, pain, altered liver function or mouth sores.

The result? CHM fared no better than placebo in diminishing any chemotherapy side-effect except for a mild improvement in nausea. Given the many excellent medicines we have to control nausea today (such as zofran, anzemet, emend, others), CHM would hardly seem worth it. To read more about this study, click on Annals of Oncology 2007.

While this study says nothing about the thousands of other herbal and non-herbal products touted to prevent chemotherapy side effects, it does give us pause. When someone recommends a natural product to "protect the healthy cells of the body" you should ask: "What is the data? Has a randomized trial been run to prove that it works?" It is also worth inquiring if those promoting a product are profiting from it.

Recommendation: In most cases, it is up to the individual to decide if taking a product with "claims" of effectiveness, without good science to back them up, is worth it. If a product is not thought to interfere with treatment (ask the oncologist and check out the resources listed below) and may help, it may be worth a try. But be objective in determining if it is helping so that you don't continue to pay for and put faith in something that has not been proven.

Ridding the Body of Toxins: Proteolytic Enzyme Therapy to Treat Pancreatic Cancer

Pancreatic cancer is one of the most difficult to treat cancers. It is a biologically aggressive cancer that spreads (metastasizes) early in its development and responds to only a few chemotherapy drugs. For many years, there were claims made by some doctors that an intriguing alternative medicine regimen, called proteolytic enzyme therapy or the "Gonzalez regimen," of orally ingested proteolytic enzymes, nutritional supplements, detoxification (including coffee enemas and liver flush) and an organic diet that required at least 70% of the food to be raw or minimally cooked, led to superior outcomes compared with chemotherapy treatments. Growing enthusiasm and patient testimonials for this approach led the National Cancer Institute to sponsor a clinical trial to compare the Gonzalez regimen with chemotherapy for patients with pancreatic cancer.

The result was reported in 2009 in the Journal of Clinical Oncology and was indeed striking: those who received chemotherapy lived for an average of 14 months whereas those who were treated with the enzyme therapy lived for only 4 months; quality of life was also better with chemotherapy.

Take Home Points: This study shows once again that any promising new therapy for cancer must be put to the acid test before it can be regarded as effective; patient testimonials cannot replace hard evidence.

Boosting the Immune System Naturally

Of all the claims made about CAM therapies for cancer, this is the biggest attraction. Wouldn't it be wonderful if a person with cancer could take a natural herb or supplement and boost their immune system to better fight the disease? If only it were that easy.

Our immune system is exceedingly complex. It consists of dozens of distinct cells (such as T- and B-cells, dendritic cells, neutrophils, macrophages) that communicate via hundreds of secreted chemicals (such as the interleukins and interferons) and molecules on their surfaces; many aspects of these interactions are yet to be discovered. Scientists do not understand why the immune system turns against the body in autoimmune diseases such as lupus and multiple sclerosis. And they are far from understanding how cancer cells can evade the immune response by inducing "immune tolerance." Immune tolerance makes cancer cells essentially invisible and unrecognizable by the immune system. 

For over a century, researchers have been earnestly trying to crack the immune response/cancer problem. Many millions of dollars have been spent and continue to be spent (righly so) on solving this problem: get a person's immune system to recognize their cancer and voila!, the cancer is gone. So far, exciting studies with cancer vaccines, lymphocyte activated killer cells, stem-cell transplants and other immunologic approaches using the most sophisticated molecular science have not succeeded. Even a vaccine uniquely created (with great science and at great expense) against an individual's lymphoma failed to make an impact on the cancer in recently completed studies. So, to me, it seems very unlikely that something off the shelf in CVS or out of a catalog or promoted by a celebrity or businessman claiming miracle cures is going to do the job.

This is not to say that some herbal supplements do not affect the immune system, because many actually do. For example, a recent study presented at the Society for Integrative Oncology reported that Grifola frondosa (Maitake extract) caused both immune stimulation and depression in cancer patients; no effects on cancer recurrences were reported.  More encouraging are studies with Viscum album or white-berry mistletoe (Iscador), which has been used for many years in Europe to treat cancer patients. In a recent overview of clinical studies published on Iscador use to prevent cancer recurrences, researchers from Germany concluded that although many of the studies were not of high quality, there did seem to be accumulating evidence that Iscador can improve survival. They called for definitive studies to determine the true benefit of this approach. Currently, the National Institutes of Health is sponsoring a study of Iscador and the chemotherapy gemcitabine to treat pancreatic cancer.

Take home points: Some herbal products affect the immune system, often in ways that are poorly understood and sometimes in ways that may be harmful. Many have been shown to have positive effects against cancer cells in a petri dish or in a laboratory animal, articfical situations which often don't carry over when given to humans. As of today, none have been clearly shown to improve survival. Use them with caution. Consult reputable websites (see below) for research updates.

Does "Natural" Mean Safe?

Most herbal products in the US are considered dietary supplements, not medicines. Therefore, they are not required to meet the standards for drugs specified by the Federal Food, Drug, and Cosmetic Act; they may be produced without the same manufacturing standards as drugs; and they may be marketed without prior approval of their effectiveness and safety by the Food and Drug Administration (FDA). Because of this, there are numerous reports of herbal products containing adulterants and contaminants, such as microorganisms, pesticides and heavy metals, which can damage the heart, liver, kidneys or nervous system. For example, kava has been linked to severe liver damage.

Furthermore, there are also many possiblelinteractions between herbs and conventional drugs, including chemotherapy medicines, as discussed in the resources below. The strong anti-oxidant properties of many herbal products may interfere with the cell killing activity of chemotherapy.

According to a review from The Hague published in The New England Journal of Medicine, "Contrary to popular belief, the use of herbal remedies can pose serious health risks."

Recommendation: Most herbal products are being tested as cancer prevention agents, not as treatments. Use herbal remedies with chemotherapy with great caution and only after discussion with your oncologist.


Concluding Thoughts

We should no longer live in an "us" versus "them" world, in which oncologists prescribe clinically tested treatments and herbalists offer less tested alternative medicines. Whatever works or could work should be properly studied and, when proven, recommended by any health care provider who truly cares about the person in front of them, often searching for hope. I realize that many cancer patients will take alternative medicines as well as standard cancer therapies and decide for themselves what works for them. I do support each individual's right to decide what to put into their own bodies.

Salespeople touting alternative cancer cures often claim that the "mainstream" cancer community is not interested in natural products. Nothing could be further from the truth. In fact, as discussed in my book, many chemotherapy drugs in use today are derived from plants, bacteria and marine life (such as Taxol from the yew tree, Adriamycin from bacteria and Yondelis from soft coral). Many other herbs and natural products are being intensively studied today in research centers across the nation. Once the active compounds in these products are isolated, studied and shown in clinical trials to help fight cancer, oncologists will jump right on board to prescribe them. Until that time, don't believe the hype about any cancer cure, always ask for study results in cancer patients (not personal anectodes/testimonials or laboratory findings) and never forego standard cancer treatments.   

Recommended On-line Resources

National Center for Complementary and Alternative Medicine

NIH Office of Dietary Supplements

National Cancer Institute

MSKCC About Herbs


Society for Integrative Oncology


Richard C. Frank, M.D., is director of cancer research at the Whittingham Cancer Center of Norwalk Hospital, medical director of Mid-Fairfield Hospice, and Clinical Assistant Attending at Weill Cornell Medical College. He has been appointed cancer expert for WebMD and was named a “Top Doc” in the New York Metro area by Castle and Connelly.

Further Reading:


31 Discussions on
“Alternative Medicine and Cancer: Why Don’t Oncologists Get On Board?”
  • Dear Dr. Frank
    What is the hope of cure for prostate cancer? I have read about the use of radiation and hormone-like chemotherapy used for this purpose, as well as surgery, but it seems some doctors don’t treat it at all because it is slow-growing and if the man is of advanced age, it is assumed he may die from something else before the cancer. Is it reasonable to hope that prostate cancer can be cured with treatment?
    Margaret Brooks

  • Dear Margaret,
    Thank you for your question regarding the treatment and cure of prostate cancer (PC).
    Prostate cancer remains the most commonly diagnosed cancer in men because of screening efforts which rely mainly on yearly PSA measurements from the blood and digital rectal examinations to check for any changes in the size or shape of the gland. The goal of “screening” for a cancer is to detect it at an early stage, before it has had a chance to spread elsewhere in the body. At an early stage, most cancers are highly curable, whether with surgery or radiation therapy. Hormone therapy may be used for cancers that have a high risk of returning.
    But, screening has met with mixed success. Over twenty years ago, before the adoption of screeing, too many men were diagnosed with prostate cancer when it had spread to their bones and they ultimately died of the cancer. So, it is clear to urologists and oncologists who have cared for these individuals, that catching prostate cancer early is far better than waiting for symptoms. Still, cancer death rates from PC have not fallen fast enough for those who feel we are “over-screening.” So, the controversy now exists about the value of screening and the usefulness of the PSA test as a screening tool (recent New York Times articles on this).
    Also, many articles have focused on the excess cost and of course the unwanted side effects from treating prostate cancer, such as impotence and incontinence. What every man (and their mates) want to know is, should the cancer, once found, be treated? A related issue for society is how much screening should be recommended?
    These are complicated issues that are being clarified by ongoing studies. Presently, many physicians involved do not see the controversy so black and white as portrayed in lay articles. This is because not all men found to have prostate cancer necessarily need the cancer treated. As you mentioned, some men, especially those who are older and are found to have a small, non-aggressive form of PC (Gleason score less than 6) may only need to have the cancer observed rather than undergo surgery or radiation. The cancer will not likely be a threat to their lives.
    For those who are younger, have larger cancer growths in the prostate, are African-American or have a family history of PC, treatment may be advocated by their physicians because it may save their lives. Individuals at high risk of prostate cancer should also consider taking finasteride to prevent the disease and discuss this with their physicians.
    I think the controversy over screening will diminish once doctors and researchers have found a way to minimize the side effects of treatment, which can have such a major impact on a man’s life. We are still not there yet and so must tread prudently in each case.

  • Dear Dr. Frank, I am excited to see a medical professional who embraces alternative natural medicines and spirituality to treat cancers, such as prostate cancer.
    It sad that the successes of these eastern medical treatments are not reported in major US medical journals.
    I heard a interview with a doctor who eventually embraced her intuitive skills to help treat her patients in addition to using western medicines.
    I don’t think too much if my mom had embraced alternative medicines sooner, cold she have survived her breast cancer?
    I am definitely subscribing to your blog.
    I would like to discuss having you as a featured medical specialist on my blog, which focuses on natural cures for men’s health issues.

  • Dear Ken,
    Thank you for your comment. I am for whatever works and for whatever helps a person get through cancer or live with it as well as possible, whatever the case may be.

  • Dear Medical Oncology in India,
    Thank you for your comments. Certainly, alternative therapies that are proven to have merit, such as acupuncture to relieve pain and nausea, should be recommended. As for how to judge what is effective, please read my previous blog on this.
    Regarding the escalating costs of cancer care, a surprising new study in the US showed that rising costs are not due so much to the price of medicines but rather to an increasing number of people diagnosed with cancer. The fact is people are living well into their 80’s and cancer is predominantly a disease of older individuals.
    I believe that research that somehow prevents the damage to DNA that occurs with aging, without necessarily “reversing” the aging process may ultimately reduce the incidence of cancer in the elderly.

  • The state of our conventional cancer care is still in the ‘dark ages’. The old ‘cut, poison and burn’ is what we have continued to use over the past 50 years. The sad truth is that you don’t make someone better by dropping poison in the body and *hoping* that you poison the tumor before you poison the rest of the patient’s body; sounds like the old practice of bleeding people to make them better.
    You don’t help someone’s body fight a disease by weakening the patient and that is precisely what most conventional cancer therapies do. My advice; if it is something they can cut out, let them do so – but I personally, wouldn’t opt for follow-up radiation/chemo.

  • the future can be anything we want to make it. We can take the mysterious, hazy future and carve out of it anything that we can imagine, just as a sculptor carves a statue from a shapeless stone.

  • Dear James,
    thank you for your comments. I would suggest that you read my book to become more familiarized with modern cancer therapies. They have become smarter, more targeted, associated with fewer side effects and thankfully, better outcomes. We have a long way to go before most cancers are cured. Still, every year will bring new and better ways to fight cancer. So stay tuned and informed. Contact me again after you read my book, I would like to know what you think!
    Dr. Frank

  • I got your point that it is yet to be understood what provokes cancer cells to behave the way they do and turn against the body. But in the case of lung cancer, most cases are tobacco related (is that correct) so that it is easy to advice people to avoid tobacco to avoid lung cancer. In the case of other types of cancer, I am inclined to believe just what i read in many articles that cancer cells could be cause by what we put in our bodies.
    Henceforth, would oncologist and probably pharmaceuticals as part of their social responsibility to consider taking more aggressive advocacy on proper human diet as preventive measure or as precautionary measure for cancer patients undergoing treatment.
    Lastly, may i know if their are diet/food related studies by the NCI to prevent or cure cancer?

  • Dear Anson,
    Certainly there have been hundreds of millions of dollars spent on investigating the effects of diet on the prevention of cancer. Overall, diets low in saturated fats, and high in fruits/vegetables seem to lower the risk of cancer. But regular exercise and maintaining an ideal body weight are also key. I would also recommend a daily dose of vitamin D3 as most of us do not get enough sunlight year round.
    Dr. Frank

  • Hello sir, thank you for posting an interesting topic concerning alternative medicine and the modern technology as this would help improve one’s knowledge on the benefits and disadvantages of dmae creams and other alternative herbal medications. I know that you have no obligations to learn things that concerns alternative healing and I understand your side, as I know that you are responsible for another person’s life and there are certain parameters being set up to. Having a person’s life in your hands is something that one cannot joke or fooled around just like what, “Dr. House”, is doing with his patients in the drama series.

  • This was a fantastic post. Really loved reading your weblog post. The information was very informative and helpful. I hope you proceed posting and updating frequently. Wanting forward to your next one.

  • A healthy immune system will protect your body against minor ailments and even more serious ones,, that can be fatal.
    You need to eat the right foods for a healthy immune system. If you do, not only will you have see improvements in your skin and also receive an energy boost. Great review.

  • If you have a good healthy personality then your immune booster is much power as to other. A person may regularly illness; they have not a good immune system. Daily your body doing all kind of works it must so tied them. By this work you have losses you energy or ill day of the week.

  • Natural products support healthy immune system function are popular & with good reason. Many of these immune system supplements have been subject of scientific studies. Herbal and botanical products may pose less risk of side effects than vaccinations and anti-viral medications. In one controlled study, people who were given immune system supplements missed less work and developed infections less frequently than those who were given placebo. The same study concluded those who used immune system supplements and became infected with flu developed fewer complications & less likely to be hospitalized.

  • Dear Beres drops,
    Thank you for your comment. We all hope for simple, non-toxic, natural ways to prevent and treat disease. Unfortunately, many studies of these products to achieve the desired goals do not pan out. I would love to see a reference on the study you mention so that I can comment on it and share with other readers here.
    Dr. Frank

  • I had a good friend who died of breast cancer a few years ago and she was adamant that it was something that she ate or “ingested” and we would have long discussions about that. I dont know what to believe because I am not educated enough to make a scholarly guess but I am grateful for your type of blogs. Thank-you.

  • Dear Kim,
    My mother liked to say, “you are what you eat.” I think she meant it more in how heavy or thin a person was and on the health of their internal organs such as the heart, liver, etc. Certainly, cancer is “fed” by bad diets high in fat, low in fiber and good nutrients found in vegetables and fruits. Having said that, a diet cannot initiate cancer, as explained in my book.
    Many thanks,
    Dr. Frank

  • Certainly, alternative therapies that are proven to have merit, such as acupuncture to relieve pain and nausea, should be recommended. Regarding the escalating costs of cancer care, a surprising new study in the US showed that rising costs are not due so much to the price of medicines but rather to an increasing number of people diagnosed with cancer. The fact is people are living well into their 80’s and cancer is predominantly a disease of older individuals.

  • What a great article , I think its unfortunate that many still regard natural supplements as an inferior way to heal, Most herbs have been around for centuries and have contributed to healing long before modern medicine.
    The fact that much research proves herbal products dont work I believe the pharmaceutical companies have a lot to do with this reserach.
    There was an interesting article some time back in wired magazine called the placebo effect well worth reading and gives insigh o both herbal supplements and prescription meds.

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