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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)
Thank you Charlotte – a most timely article. It complements Professor Ian Haines new article in the MJA: Aug 17: Negotiating the complex maze of claims of dietary cures for cancer, and it mirrors our experience.
As a director of a cancer charity working at the cancer coalface in a hands-on capacity, we are seeing an increase in patients who have harmed their health while experimenting with fad cancer diets that they firmly believed will cure their cancer.
We also see unnecessary death in patients who either delayed or abandoned completely their medical treatments lulled into a false sense of security fanned by internet salesmen (and women). If these represent just 10% of cancer patients that figure amounts annually to 4.600 – a figure that after a few years, dwarfs military deaths, domestic violence, the road toll and terrorism.
My co-director, who has worked with cancer patients for 40-yrs says this alt/med trend is growing much faster than some decades ago and much of her work these days is ‘alt/med’ rescue. Clearly the internet enables patients to think they are doing ‘research’ when in fact they are often fooled by people like Wellness Warrior and Belle Gibson. I’m glad they were somewhat exposed by recent media – especially Richard Guilliatt in the Australian. Nevertheless it is tragic that both Wellness Warrior and her mother died from cancer having placed their faith in the Gerson diet to cure them
But there are many other cancer entrepreneurs in Australia who are still making a ‘killing’ via their books, seminars and CDs who have a huge but deadly influence on patients.
From 2005?
I’d rather not see another Ainscough
Is there any evidence that dietary therapy can change the course of cancer?Yes. Here is a randomised controlled clinical trial demonstrating that a whole foods, plant-based diet combined with other lifestyle changes can halt the progression of prostate cancer:http://www.ncbi.nlm.nih.gov/pubmed/16094059
Well said Peter, thank you!
Despite limited evidence that so called Cancer Diets will cure cancer, there is significant evidence that bad diets can cause many medical conditions and impact adversely on a person’s health. They will certainly increase tyhe risk for a variety of conditions.
Whilst we should encourage patients to follow conventional evidence based treatments, diet should play a significant part of that treatment.
Most of these so called Cancer Diets involve eliminating those ingredients that are generally known to increase the risk of disease.
If these diets lead to healthy eating then we should encourage their use regardless of their claims and it is important that there be candid communication between doctors and their patients regarding their treatments.
For too long their has been this rigid line between conventional and CAM treatments. Patients should be encouraged to comply with conventional treatment but you do not have to be a rocket scientist to know that some CAM treatments will certainly not do you any harm and may in fact complement convention therapies.