CAMophobia at NEJM

The New England Journal of Medicine published an article in 1999 that made an erroneous association between poorer psychological outcomes in women post breast cancer surgery and their use of CAM.

Here’s the summary quote (my italics). Note the emphasis in the NEJM study on assessment before surgery, while others focus on post surgical assessment results.

“Mental health scores were similar at base line among women who decided to use alternative medicine and those who did not, but three months after surgery the use of alternative medicine was independently associated with depression, fear of recurrence of cancer, lower scores for mental health and sexual satisfaction, and more physical symptoms as well as symptoms of greater intensity.”

The problem with the study was that these 480 patients with newly diagnosed early-stage breast cancer were recruited from a Massachusetts statewide cohort of women participating in a study of how women choose treatment for cancer.

Even back then it was recognized that the response to surgery varies among women. Some experience a strong sense of loss and need time to grieve. Others need time to adjust to an altered body image. Many patients feel a sense of relief following surgery, but worries about the long-term prognosis and follow-up therapy can cause added anxiety.

More recently, investigators found that the process of “denial coping” following surgery is a powerful predictor of future health fears. They concluded that there is a need to identify the interventions that can decrease this denial, and whether this then decreases health fears in the aftermath of breast cancer surgery.

7/30/06 16:44 JR