A rant against naturopathic medicine (in the treatment of cancer)

I started off my day today with a very sad case. A patient in their 60s was admitted to our service with stage IV cancer that had spread throughout their body. It would appear from their labwork that the organs in their body were starting to shut down. The patient is young and got a really crappy diagnosis, and they made some poor decisions when it came to choosing treatment, and now they are dying.

The patient was diagnosed not too long ago and started chemotherapy less than a month after the diagnosis. Then they heard about a naturopathic "doctor" who was doing colonic hydrotherapy here in Nanaimo and treating patients with cancer. When they saw this practitioner, he promised to treat them but stated he preferred his patients to NOT be on chemotherapy. With hope in their eyes, my patient quit the chemotherapy and went ahead with an unproven and RISKY treatment, advocated by a naturopath.

My problem with this scenario is many-fold.

When we, as medical practitioners, are trying to decide on a therapy for our patients we use the best available evidence to guide our rationale. We use the studies, to the best of our abilities, to give the patient the best information possible to help them make the best decision possible. For example, if I believe a patient needs a blood transfusion we go over the benefits and risks of having this procedure. If they want to know the risk of acquiring HIV or Hepatitis C from the transfusion, I can quote those numbers. After we're done talking, the patient chooses to sign a waiver of consent saying they understand the risk vs. benefit of the procedure and that they would like to go ahead or waive having it done. Same goes for surgery. And if I start a patient on a new medication we go through benefits and risks of this medication and they decide if they want to take it or not. Never would I tell my patient "I'll only give you this medication if you promise to stop ALL of your other medications, even if they are life-sustaining drugs".

The problem with procedures like colonic hydrotherapy is that there are NO GOOD STUDIES to lead into a discussion of cost vs. benefit for having the treatment done. There are no randomized control trials, there aren't even trials testing the colonic hydrotherapy vs. chemotherapy, or vs. surgical treatment. So very vulnerable people who may or may not have the education to make decisions about these kinds of procedures are paying money up the wazoo for a procedure that is risky at best. And we have nothing to prove that there is ANY benefit to the patient. How can I get consent from a patient when there are no studies? How can they know the cost vs. benefit analysis when it's never been done (and likely will never be done for obvious reasons).

To add insult to injury my patient recently started having falls. And the family was merely told that she was "attention seeking".

If I, as a medical practitioner, had done any of the above I WOULD HAVE MY LICENSE REVOKED. I would like be sued for negligence and I would certainly not be asked to work in the hospital, and likely BC, ever again.

Going back to my case, I discussed the prognosis with my patient's twenty-something year old daughter as she bounced her 4 month year old son. The daughter had tears in her eyes as I explained that we would do everything possible to stabilize her parent so that we could get them back on chemotherapy and potentially gain them a few more months of life. She asked me how the naturopathic doctor could be allowed to practice. I wish I could give her a better answer. I just don't know.