The cost and side effects associated with traditional cancer therapy are major concerns, and in part many patients are seeking natural remedies such as graviola, curcumin, and moringa, due to these concerns. Traditional cancer therapy is increasingly effective, and oncologists are achieving better remission and cure rates due to innovations in combined modalities. Also, the pharmaceutical industry has been developing a vast array of drugs that offer patients significant clinical benefits, such as immune-enhancing agents, targeted antibodies, and molecular agents.
It is unwise for patients to abandon traditional medicine to seek natural therapy, given that clinical data are lacking regarding the efficacy of natural remedies. Also patients may miss out on potentially curative traditional cancer therapy, resulting in progression of their disease and early mortality.
Natural agents are widely available and increasingly used by patients without supporting clinical evidence. To assess the true effect of these medicines, they need to be held to the same standard as oncology drugs through clinical trials to evaluate their true efficacy. In what clinical setting should natural remedies be tested when traditional cancer treatment works so well? The best avenue to introduce natural agents is in the observation period.
Typically, once patients have completed treatment, they go on a period of observation. Observation is standard of care for most malignancies post–definitive therapy. Relapses are common, and most often, relapses are metastatic, with patients requiring indefinite costly therapies.
Given the favorable relative side-effect profile and relative low cost of natural medicines, the observation setting seems like the optimal arena for these drugs to be studied as maintenance agents. Rather than be generally shunned by the medical community, we should embrace these natural remedies when evidence-based as potential maintenance agents to prevent relapse, offset costs, and possibly enhance overall survival for patients. ■
—Damien Hansra, MD
Miami, Florida
