Use of Alternative Medicine by Women with Breast Cancer

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Abstract
Burstein et al. report fascinating data on the use of alternative medicine by patients with breast cancer (June 3 issue).1 Both the authors and the writer of the accompanying editorial2 conclude that newly initiated use of alternative medicine is a marker for distress in such patients. However, the survey conducted by Burstein et al. suffers from serious drawbacks. There is a lack of base-line data for most of the variables, except for the components of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), for which a “recall base line” is available, and the samples in the subgroups are small. There are no intergroup differences in physical or mental health according to the recall base-line data obtained with the SF-36. For these reasons, the hypothesis that the use of alternative therapies is a marker for distress rests predominantly on variables with no base-line data. This leaves the results open to other interpretations. For instance, one could postulate that new users of alternative medicine showed considerable long-term benefits from these treatments, because the largest longitudinal changes were consistently documented in this group. Alternatively, if one assumes the missing base-line values to be similar between the groups, one might speculate that new use of alternative medicine led to considerable harm in those who tried it.

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