MISINFORMATION on the internet is driving more people with cancer to try “cure” diets, highlighting the importance of doctor–patient communication on appropriate nutrition and treatment, according to experts.
Clare Hughes, nutrition adviser for Cancer Council Australia, told MJA InSight that while diets claiming to cure or prevent cancer were not a new development, more Australians could now go online to access information about these diets, which were often marketed in misleading ways.
“Despite limited scientific evidence, proponents of natural cancer therapies will often provide a rationale that sounds completely plausible to the average person”, she said.
“They’ll also provide testimonials from people who claim that their cancers have been cured by natural diet therapies.”
Ms Hughes was commenting on an MJA Reflections article discussing strategies to help patients with cancer “negotiate their way through a seemingly expanding maze of ‘dietary cures’ ”. (1)
Professor Ian Haines, a medical oncologist at Cabrini Health, Melbourne, wrote that it was important to develop a trusting, therapeutic relationship with a patient, where doctors empowered patients in their treatment choices.
Education and careful explanation of the goals, benefits and adverse effects of cancer therapies were needed to address a patient’s potential distrust of scientific data, with an emphasis on “dramatic recent advances in cancer treatments”, Professor Haines wrote.
He said some patients might be struggling with an incorrect or overly pessimistic prognosis and feel they cannot plan for their future, which emphasised the importance of physicians explaining the difficulty of providing a very accurate prognosis.
“I try to provide the necessary time and detailed information that the patient seeks to enable them and their family to set realistic goals and plan their lives appropriately”, Professor Haines wrote.
Professor Phyllis Butow, from the University of Sydney’s Psycho-Oncology Co-operative Research Group, told MJA InSight that the appeal of these diets was the feeling that they were a safer alternative to evidence-based treatments.
“Furthermore, they offer hope to patients who have been told by their doctor that they have a risk of recurrence, or that their cancer is incurable, and that conventional medicine can offer little or no therapies to alleviate risk or prevent death.”
Professor Butow said that while there were general predictors of which patients were more likely to try these diets, and other complementary and alternative medicines (CAM), (such as having depression), “the best approach [for a doctor] is to openly ask them”.
She said there had been several published studies that provided guidance on how to effectively communicate information on CAM within the oncology setting, including a systematic review that provided a sequence of recommended steps for discussing CAM with patients. (2)
The steps included eliciting the patient’s understanding of their situation, actively listening and providing balanced, evidence-based advice. “Based on these recommendations, I would suggest [being] empathetic about the patient’s situation and emotions that may be promoting CAM use”, Professor Butow said.
Doctors could suggest a trial period of CAM therapy if the patient was still insistent, after which there could be a review, she said. “And document the discussion.”
Ms Hughes said that patients and doctors alike needed to be vigilant to the potential and serious consequences of trying cancer diets.
Many of these diets recommended patients remove entire food groups, which could be detrimental to their overall health, she said.
Apart from the lack of evidence to support the claims made about the diets, if patients did choose them over well established cancer treatments like surgery, radiotherapy and chemotherapy, “they may actually be harming their health and prognosis”.
“The sooner cancer is treated effectively, the better the patient outcome will be. We would never recommend a patient delay or reject a treatment option that would be more likely to treat the cancer in favour of a therapy where evidence of safety or efficacy is limited”, she said.
Ms Hughes said the Cancer Council recommended that all patients with cancer seek the advice of an oncology dietician, who could work with their GP or oncologist on a nutrition plan that met the patient’s needs.
(Photo: Emerald Raindrops / shutterstock)
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