Delay in breast cancer diagnosis associated with ineffective
alternative therapies.
C.M McNeil, F.J Collinson, K. Smith, R.Dunleavey, J.
Boyages, R.F. Kefford; University of Sydney at Westmead
Hospital, Westmead, NSW, Australia.
Background: Alternative therapies are used by between 28%
and 83% of women with breast cancer but their impact in
causing deleterious delay has been poorly documented.
Methods: The clinical and psychological details were studied
in six women who presented to Westmead and Nepean Hospitals
(WNH) over a 4 year period, with delay in commencement of
conventional therapy due to protracted use of alternative
therapies. Results: The patients were aged 39 to 54 years at
presentation.. All were operable Stage I-II at initial
presentation, and delay in commencement of conventional
therapy was 6 to 24 months. All had declined conventional
therapy at initial presentation, choosing instead
ineffective alternative therapies including dietary
manipulations, urine therapy and laetrile. One patient
received prolonged alternative therapy from a registered
medical practitioner, including high dose intravenous
vitamin C. At presentation to WNH all had advanced breast
cancer with extensive fungating chest wall disease. Five
patients subsequently accepted salvage conventional therapy,
and responded for variable periods up to 43 weeks. Three
patients have died (15 to 24 months), and 3 are still alive
(1- 17 months). Three patients had tertiary education, one
of whom was an oncology nurse. Reasons for avoidance of
conventional management included loss of personal control;
dissatisfaction with, and lack of confidence in,
conventional treatments, and denial. There was a significant
past psychiatric history in one patient and high anxiety
levels were noted in four patients. Conclusion: Alternative
therapy was used ineffectively and in isolation for possibly
curable breast cancer by six women, three of whom died
within months of presentation for conventional therapy. *The
dangers of delay caused by ineffective therapies may have
been underestimated in a medico-political climate that
favors accommodation of non-traditional adjuncts to cancer
therapy.* (my emphasis- PJM)
Papaer presented at the American Society of Oncology in May.
Peter Moran