Assessment of outcomes at alternative medicine cancer clinics: A feasibility study

Objective: This pilot study tested the feasibility of performing outcomes a nd more advanced research regarding cancer patients at two complementary an d alternative (CAM) clinics. The primary objectives were to determine the f easibility of (1) obtaining and collecting data from medical records, (2) d etermining 5-year survival, and (3) comparing 5-year survival to that of co nventional treatment. In addition, in this paper we present the barriers an d recommend strategies to facilitate high-quality research. Settings/Location: The Bio-Medical Center in Tijuana, Mexico, and the Livin gston Foundation Medical Center in San Diego, California. Subjects: New patients who were treated for cancer during 1992 at the Livin gston 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 C linic; 152 (78.8%) cases had pathology confirmation. At both clinics, patie nts were equally divided by gender and were predominantly Caucasian, were m arried, 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 genita l cancer. Most patients (61.1%-63.7%) arrived with distant or regional dise ase after conventional surgery and/or chemotherapy/radiotherapy. Survival a t 5 years was determined for 57.0% at the Bio-Medical Center (11.4% were al ive 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 anecd otal reports of extraordinary survival merit prospective, systematic monito ring of patient outcomes, For data to be meaningful, however, disease statu s must be pathologically confirmed and patient follow-up improved.