153 - Alternative Cancer Treatment Clinics in North America: Evidence Gaps, Regulatory Concerns, and Financial Burden

08:40am - 08:50am ET

Room 107

Presenter(s)

Zakaria El Kouzi, MD - MD Anderson Cancer Center, Houston, TX

Z. El Kouzi¹, A. Samman², M. K. Rooney¹, R. Kouzy³, A. Fetooh⁴, and O. Mohamad⁵; ¹Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, ²University of Houston, Houston, TX, ³The University of Texas MD Anderson Cancer Center, Houston, TX, ⁴Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, ⁵American University of Beirut Medical Center, Beirut, Lebanon

Purpose/Objective(s):

Pursing alternative cancer treatments in lieu of evidence-based conventional therapy is associated with higher mortality and higher cost. This study aims to characterize alternative cancer treatments promoted to patients in North America and to evaluate the scope and type of evidence associated with these therapies.

Materials/Methods:

We identified alternative cancer treatment clinics using two gray-literature sources: Google searches and a patient-facing clinic directory (Heal Navigator). These sources were selected to approximate how patients typically search for information on alternative treatments. We used the following search strings: “alternative cancer treatment United States”, “alternative cancer treatment Mexico”, and “alternative cancer treatment Canada”. Following clinic identification, two independent reviewers systematically navigated each clinic’s website and extracted predefined variables. To obtain data not available on the clinic website, we implemented a standardized mystery-shopper protocol. The investigator contacted the clinic as a prospective patient using structured email inquiries to assess medical team oversight, clinical evidence supporting treatments, communication of benefits and risks, patient eligibility, and cost transparency.

Results:

Most identified clinics 34 (72%) were in the United States. The most promoted cancers for treatment were breast, prostate, lung, and colorectal cancers, which were mentioned by 16 clinics (34%), while most clinics 32 (66%) did not specify any specific cancer site. The most alternative used therapy was high-dose intravenous vitamin C (54%); fenbendazole (23%), ivermectin (21%), mistletoe therapy (25%), and low-dose chemotherapy 10 (21%). Only 6 clinics (13%) cited supporting scientific evidence on their website, which were exclusively limited to pre-clinical studies, case reports, reviews, or nonrandomized clinical trials. Notably, 11 clinics (23%) were led by individuals with documented professional licensure issues, including license revocation, practice bans, or restrictions on clinical practice. When contacted, only 20 (42%) clinics responded. Three clinics (6%) did not have an available email contact, and 25 (52%) did not reply. Out of the 20 clinics that responded, 6 declined to provide the requested information and instead required a phone consultation. The median cost of care per regimen for alternative cancer treatments was $47,000 (interquartile range: $36,000–$113,250).

Conclusion:

Overall, alternative cancer clinics demonstrated considerable variability in transparency, especially in providing clear information on the evidence supporting their therapeutic claims and the costs of treatment. This highlights the importance of patient counselling and education with reliance on high quality evidence-based medicine in order to make an informed decision. Further research is encouraged to better define the safety and efficacy of alternative treatments.