Senior cancer patients may undermine treatment with alternative medicines

Supplements and alternative medicines commonly used by senior cancer patients can interact with other medications and affect their treatments. Photo by surajet.l/Shutterstock

 More than a quarter of senior cancer patients use complementary or alternative medicines, or CAMs, which researchers said could interact poorly with other medications they take.

Most CAMs are not regulated by the Food and Drug Administration because they are considered health supplements. Researchers said that without standard measures or research on dose and potency variances between substances and patients unexpected effects an occur when they are used.

Enough research has been done to know that some CAMs affect medical treatments. St. Johns Wort is known to make cancer treatments less effective, and others interfere with anesthetics used during surgery.
"Currently, few oncologists are aware of the alternative medicines their patients take," said Dr. Ginah Nightingale, an assistant professor in the Jefferson College of Pharmacy at Thomas Jefferson University, in a press release. "Patients often fail to disclose the CAMs they take because they think they are safe, natural, nontoxic and not relevant to their cancer care, because they think their doctor will disapprove, or because the doctor doesn't specifically ask."

Researchers surveyed 248 patients at the Senior Adult Oncology Multi-Disciplinary clinic at Jefferson University. The mean age of participants was 79.9 and 64 percent of them were women. The participants were seen by 5 specialists in areas important for seniors being treated for cancer: a medical oncologist, a geriatrician, a clinical pharmacist, a social worker and a dietician.

In addition to interviews and examinations, the participants were asked to bring in the contents of their medicine cabinets. The medications they said were actively using were reviewed by researchers and included with participant data.

The researchers found that 26.5 percent of the participants were actively taking some type of CAM while being treated for cancer. The survey results of those using them found complications, including polypharmacy -- either interaction between drugs or misuse of other prescriptions -- vision impairment, and urologic comorbidities.

Researchers recommended including a pharmacist on medical teams caring for seniors in order to monitor and advise them on using CAMs when being treated for cancer, or other conditions.

"It is very important to do a comprehensive screen of all of the medications that older cancer patients take, including CAMs," Nightingale said. "Clear and transparent documentation of CAM use should be recorded in the patient's medical record. This documentation should indicate that patient-specific communication and/or education was provided so that shared and informed decisions by the patient can be made regarding the continued use of these medications."

The study is published in the Journal of Geriatric Oncology.