Assessment of outcomes at alternative medicine cancer clinics: a feasibility study.
OBJECTIVE
This pilot study tested the feasibility of performing outcomes and more advanced research regarding cancer patients at two complementary and alternative (CAM) clinics. The primary objectives were to determine the feasibility of (1) obtaining and collecting data from medical records, (2) determining 5-year survival, and (3) comparing 5-year survival to that of conventional treatment. In addition, in this paper we present the barriers and recommend strategies to facilitate high-quality research.


METHODS
The Bio-Medical Center in Tijuana, Mexico, and the Livingston Foundation Medical Center in San Diego, California.


METHODS
New patients who were treated for cancer during 1992 at the Livingston Foundation Medical Center and during the first quarter of 1992 at the Bio-Medical Center.


RESULTS
Charts were available for 89.6% of the 307 new patients treated at the Bio-Medical Center; 149 (54%) patients were treated for cancer and 65 (43.6%) cases were confirmed by pathology reports. In contrast, all records were available for 193 new patients treated for cancer at the Livingston Clinic; 152 (78.8%) cases had pathology confirmation. At both clinics, patients were equally divided by gender and were predominantly Caucasian, were married, and were U.S. residents. On average, patients were 51-54 years old and within 1 year of diagnosis for breast, colorectal, lung, or male genital cancer. Most patients (61.1%-63.7%) arrived with distant or regional disease after conventional surgery and/or chemotherapy/radiotherapy. Survival at 5 years was determined for 57.0% at the Bio-Medical Center (11.4% were alive and 45.6% were deceased) and 94.8% at Livingston (14.5% were alive and 80.3% were deceased). The limited number of cases by cancer site prevented comparison to conventional treatment.


CONCLUSIONS
Historical, widespread use of clinics such as these with anecdotal reports of extraordinary survival merit prospective, systematic monitoring of patient outcomes. For data to be meaningful, however, disease status must be pathologically confirmed and patient follow-up improved.
University of Texas--Center for Alternative Medicine Research, The University of Texas--Houston Health Science Center School of Public Health, USA. marich@mail.nih.gov
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Richardson
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Russell
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Sanders
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Barrett
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Salveson
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D002173:Cancer Care Facilities / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D000529:Complementary Therapies / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records / Q000592:standards; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy*; D010865:Pilot Projects; D016019:Survival Analysis; D016896:Treatment Outcome