Feature on healthy aging, health challenges of elderly
Search This Blog
Wednesday, September 9, 2015
High Use of Alternative Medicine in Senior Oncology Patients
Many seniors with cancer are also using complementary or
alternative medicines that could interfere with their cancer treatment.
Newswise, September 9, 2015-- Alternative medicines are widely thought
to be at least harmless and very often helpful for a wide range of discomforts
However, although they’re marketed as “natural,” they often
contain active ingredients that can react chemically and biologically with
Researchers performed a comprehensive review of all of the medications
taken by senior oncology patients and found that as 26 percent were using
complementary or alternative medicines (CAM), in a report published August
12th, in the Journal of Geriatric Oncology.
“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
There are a number of CAMs that are known to interfere with certain
cancer treatments. For example, St. John’s wart can make some cancer therapy
less effective, according to the National Institutes of
Others can interfere with anesthesia during surgery for cancer. But not
all interactions have been studied. Because CAMs fall under the category of
health supplements, they are not regulated by the Food and Drug Administration
(FDA), which means that dose and potency (and therefore reaction in the body)
can vary widely between products, and between patients.
In addition, in an elderly population of cancer patients, CAMs can
simply add additional medications to an already long list of drugs taken for
various ailments. “Numerous pills, or what we call polypharmacy in the field,
can increase the risk for medication non-adherence, potential drug-drug
interactions and increase the risk for drug-disease interactions in a
population that has been reported to take several medications and have several
medical conditions,” says Dr. Nightingale,
“The use of CAM in this subpopulation warrants substantial interest and
concern on behalf of medical oncologists and allied health professionals because
of the potential clinical implications associated with CAM use.
“Patients may be combining these agents while receiving concurrent
systemic chemotherapy, radiation therapy and/or surgical interventions which
have the potential to compromise the safety and efficacy of treatment
Dr. Nightingale and colleagues surveyed the senior oncology patients who
came to Jefferson for consultations in the Senior Adult Oncology
Over the course of one visit, patients were seen by professionals from
five different areas crucial to maintaining a senior’s health throughout
oncology treatment, including a medical oncologist, geriatrician, clinical
pharmacist, social worker and dietician.
As part of this assessment, the patients brought in the contents of
their medicine cabinets, and the medications that were actively used were
reviewed and recorded.
The research team found that 26 percent of patients were taking CAMs at
some point during the continuum of their cancer care, with the highest usage
among women over the age of 80 – a population that hadn’t been captured by
previous studies. Among those taking complementary medicine, 68 percent were in
the over-80-year-old range.
Some of the alternative medications that were commonly used in this
population were alternative therapies for macular degeneration, stomach
probiotics, joint health, and mega-dose vitamins or minerals.
While the current study did not examine the potential adverse events
caused by these medications, “we know that some can have a biochemical effect
on the body and other drugs.” says Nightingale.
“It is very important to do a comprehensive screen of all of the
medications that older cancer patients take, including CAMs,” says Dr.
“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
“Oncology healthcare is undergoing significant transformation in the
delivery of effective clinical services and is ripe for greater engagement of
pharmacists to reduce drug-related problems and unnecessary medications, in
order to optimize medication prescribing,” says Dr. Nightingale.