# Use of alternative medicine for cancer and its impact on survival

Source: https://onco.cc/key-papers/paper-johnson-alternative-medicine-jnci-2018/  
OnCo record `paper-johnson-alternative-medicine-jnci-2018` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

People with curable breast, lung or bowel cancer who chose alternative medicine instead of conventional treatment were two and a half times as likely to die during follow-up as matched patients who had standard treatment.

## Summary

Using the US National Cancer Database (2004 to 2013), the authors identified 281 patients with non-metastatic breast, prostate, lung or colorectal cancer whose only recorded treatment was 'other-unproven: cancer treatments administered by non-medical personnel', and matched each to two patients (560) who received conventional treatment on cancer type, age, stage, comorbidity, insurance, race, year and clinical group.

Alternative medicine users were more likely to be younger, female, wealthier and better educated, and more likely to have breast or lung cancer and stage II or III disease. Five-year survival was lower with alternative medicine overall, and the adjusted hazard ratio for death was 2.50 across cancers, 5.68 in breast cancer, 4.57 in colorectal cancer and 2.17 in lung cancer; in prostate cancer, where observation is often reasonable, there was no significant difference. The companion JAMA Oncology paper showed that complementary medicine users were more likely to refuse surgery, chemotherapy, radiotherapy or hormone therapy and that this refusal explained their worse survival.

## Fields

- Kind: Key paper
- Last checked: 2026-09-10
- Tags: complementary
- Journal: JNCI: Journal of the National Cancer Institute
- Year: 2018
- DOI: 10.1093/jnci/djx145
- Authors: Johnson SB, Park HS, Gross CP, Yu JB
- Findings: 281 alternative-medicine-only patients matched to 560 conventionally treated patients from the National Cancer Database, 2004 to 2013.; Hazard ratio for death with alternative medicine: 2.50 overall (95% CI 1.88 to 3.27).; By cancer: breast 5.68, colorectal 4.57, lung 2.17; prostate not significantly different.; Users were younger, more often female, with higher income and education, and more often had stage II or III disease.
- What it means: Complementary approaches used alongside treatment are one thing; substituting an alternative therapy for surgery, chemotherapy, radiotherapy or hormone therapy in a curable cancer is associated with a large increase in the risk of dying. The finding is the evidence base for offering complementary therapies inside cancer centres and for asking every patient, without judgement, what else they are using.
- Caveats: Observational and reliant on a single coded field; the specific alternative therapies are unknown.; Patients who choose alternative medicine may differ in unmeasured ways, although matching and adjustment reduced the imbalance.; Follow-up ended at a median of around five years; the absolute survival difference varies by cancer and stage.

## Sources

- Johnson et al., Use of alternative medicine for cancer and its impact on survival (JNCI 2018): https://doi.org/10.1093/jnci/djx145
- Companion analysis: complementary medicine, refusal of conventional therapy and survival (JAMA Oncol 2018): https://doi.org/10.1001/jamaoncol.2018.2487

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Prostate cancer](https://onco.cc/cancers/prostate/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- technologies: [Alternative medicine used instead of standard treatment](https://onco.cc/technologies/alternative-medicine-instead-of-treatment/), [Evidence-based integrative oncology](https://onco.cc/technologies/integrative-oncology/)
- bottlenecks: [Misinformation and unproven therapies](https://onco.cc/bottlenecks/b-misinformation/)
- journals: [JNCI: Journal of the National Cancer Institute](https://onco.cc/journals/jnci/)

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