FROM MAGIC OPTIONS TO THE INFORMED FEMALE BREAST CANCER PATIENT

Judith Licea de Arenas, Miguel Arenas

Facultad de Filosofía y Letras, Universidad Nacional Autónoma de México, Ciudad Universitaria, México, D.F. [email protected]

ABSTRACT

Pseudoscience, quackery and alternative and complementary medicine – defined as the grouping of practices, interventions, modalities, therapies and applications that are not part of the conventional dominant health system – appear to have awoken an interest in Mexican society for multiple reasons, including financial ones. Taking into account that a specific alternative treatment or practice may be reclassified as conventional medicine, we tried to understand alternative medicine in relation to one of the most significant causes of death in Mexico: breast cancer. We also identified the different options provided to patients, from beauty clinics or treatments provided via television through to popular magazines and discuss the need for all information professionals to link to those affected by the disease. We conclude that since the scientific method is a determinant in the evaluation and application of action mechanisms for medicine, the work of information professionals would contribute to patients and their relatives having valid information resources to improve their quality of life.

Keywords: breast cancer; CAM; Mexico

INTRODUCTION

Attempts since the 20th Century to understand the health-illness process have been notable and one can state that health care since then is one of the most notable achievements in human history. Health measures such as potable water and sanitation have considerably reduced death rates and increased life expectancy. Routine vaccinations, modern surgery techniques and available medicines have contributed towards the eradication of some diseases, or at least a reduction in their prevalence. Yet many illnesses that are important causes of mortality or morbidity still remain to be tackled (1).

1 Nowadays medicine has a scientific basis, health workers need certification to practice, medicines are tested before health authorities authorise their use, that is to say we are protected from quackery. But are we really?

Any remedy that lacks proof of efficiency is fraudulent. If the remedy is used to cheat people it is a fraud. The manufacture or sale of non-authorised medicines is illegal. The norm that distinguishes scientific medicine from other forms is the scientific method where empirical trial substitutes intuition or opinion.

The most obvious form of quackery uses the mass media to advertise pills, soaps, girdles, pastes, creams and equipment that claims to stop aging, whiten teeth, get rid of skin marks or reduce body fat. Other quacks propose “alternative” therapies that are not authorised, such as diets. In both cases, suppliers provide no names or addresses. Those who practice medicine without the right qualifications are also quacks.

The exception to the rule says that some ill people show improved health after being administered remedies that have scientifically been proven not to be effective. Some of these therapies may work because of the placebo effect, ie that without scientific merit they can improve the condition of someone who is ill but fervently wishes to be cured. When the placebo effect works there is no explanation other than that of will power which impacts on the ability to fight a disease (2).

There are therapies that are used on a daily basis in some cultures and yet are alien in others. Culture and religion shape the way in which illnesses are treated. When someone is ill, patients resort to the remedies that are available. However, if objectivity is put aside, quackery flourishes.

Before the 1960s, the large majority of the population depended on medical treatment provided by health professionals, but since then, the patient has assumed a new role in their

2 own healthcare: patients have noticed that risks can be reduced. Therefore, it can be said that the interest in certain sectors of the population in alternative and complementary medicine is on the increase, as can be proved when reviewing print media, popular magazines or television. Alternative and complementary medicine is understood as the medical systems, professions, practices, interventions, modalities, therapies, applications and theories that are not part of the dominant or conventional medical system. However, an alternative treatment or practice can be re-classified as conventional medicine if it is supported by scientific data, clinical trial of its use and a change in society’s attitude (3).

Currently, there are over 300 treatments, techniques and modalities that fall under the same umbrella: meditation, yoga, tai’chi, hypnosis, dance, traditional Chinese medicine, ayurveda, Tibetan medicine, homeopathy, ozone therapy, traditional medicine, chiropractice, electromagnetic applications, herbal treatments, Korean beds, chromotherapy, transfer factors, Bach remedies, etc. In many countries, the majority of patients combine this medicine with scientific one. One can therefore deduce that alternative and complementary medicine exist because they fulfil the needs of patients (4).

The mass media, book shops and alternative medicine shops put a lot of pressure on the population. The patient could have better information however, as these products do not always point out the risk in taking them.

Medical practitioners must get closer to popular publications in order to be able to guide their patients if need be (5) given that the possibility of this information being systematised is remote. However, some countries like China have made progress in this and have analysed literature on Oigong (6), traditional Chinese medicine (7) and acupuncture (8). Or else conduct studies like that of Gerson-Cwilich and others (9) who found that “ the use of complementary and/or alternative theories is common in young women with advanced

3 cancer and a high level of academic qualifications, who with the support of their families decide to use from one to three types of therapies, but even though the majority of their patients expressed an improvement in their overall condition, the effectiveness of the treatments and interactions with conventional medicines needs to be tested.”

In order to be able to determine the scientific aspect, publications need to conduct scientific studies of those therapy groups. In that way, a specific alternative treatment or practice may be re-classified as conventional medicine if one takes into account that one of the main causes of death in the country is breast cancer. Breast cancer is the ninth cause of death with 4,461 deaths and the fourth cause of death in women of productive age (15 to 64 years of age) with 3,043 deaths in 2006 (10).

METHODS

Publications addressed to women that appeared in women’s magazines were searched for to analyse the focus of the articles or other genre to enable us to say whether such publications constitute a health risk.

The Yellow Pages in Mexico City for the period October 2008 – September 2009 were analysed to identify those medics offering treatments to breast cancer patients, although the type of treatment offered, conventional or non-conventional, was not identified.

Documents prepared by support groups for breast cancer patients and their relatives were searched for on the Internet.

RESULTS

The widespread availability in the country’s markets of roots, leaves, animals, barks, available as extracts, solutions, creams, infusions, pills etc makes them easy to acquire.

People with a certain purchasing power read women´s magazines that are full of “advice” on how to “lead a better life”.

4 National or imported publications such as Salud Alternativa, La Botica de la Abuela, Vive,

Kena Salud y Belleza, Ganar Salud, Cuerpomente deal with issues related to breast cancer only superficially.

Two articles that could be related to the topic of interest are the following:

Tips to improve your breasts

Propoleo and curcuma against cancer.

The first article was authored by the Mexican Scientific Society of Aesthetic Medicine and the Professional Institute of Beauty and Cosmetology whose scientific character is unknown.

The telephone directory gathers ads for medical specialists or specialised private clinics in cancer treatment and oncology, the distribution is as follows:

No.

• Cancer specialists 21

• Cancer clinics 8

• Oncology specialists 19

• Oncology clinics 13

Only two ads, for cancer specialists make reference to the types of treatment offered: linear accelerator, cobalt therapy, superficial therapy, radiotherapy and chemotherapy.

Beauty, natural medicine and diet clinics are more widely advertised as can be seen below, however it was not possible to identify if any offer any cancer-related treatments:

5 No.

• Beauty clinics 282

• Natural medicine clinics 20

• Diet clinics 50

Treatments offered by beauty clinics include:

• Liposculpture

• Lipolift metabolizador de grasas corporales

• Chocolate therapy

• Wine therapy

• Cryotherapy

Treatments offered by natural medicine clinics include:

• Healing with angels

• Reiki

• Numerology

• Runes

• Ryodoraku

Treatments offered by diet clinics include:

• Masotherapy

• Homeopathy

• Magnetotherapy

• Crystallotherapy

Grupo de Recuperación Total RETO and Cima Foundation, two important support groups, are still to prepare materials addressed to those living with cancer or their relatives. The

6 document About breast cancer, prepared by Cima Foundation, is an effort that should be continued. It is also worth noting the activity by the Research Group on Library and

Information Science, who through the website of the Mexican Association of Mastology has a minisite that offers information for patients and health professionals: a current bibliography of what has been published by Mexicans or residents in Mexico on breast cancer; links to websites for support groups for patients and relatives; thesis on the issue conducted in Mexican universities and a list of commercial films on the issue.

DISCUSSION

While it appears that in Mexico the use of alternative and complementary medicine i son the rise by the general population, there are risks: poisoning of population groups that utilise roots or plants used in traditional medicine and that are available in Mexico have been notes. Another example are the risks in other therapies, such as the use of rattlesnake pills that due to the contamination in the handling of reptiles have, amongst other causes, led to reports of bacteremia and septicaemia after their use, or in other countries to salmonella infections (11-14). That is to say that natural or traditional products may bring about grave health risks to those who consume them, which is why extracts of endemic plants of different families are being tested to prove their in vitro and in vivo activity.

Scientific articles are only of interest to specialists, even when they report results that could affect impact on the development of a disease. However, those involved in the popularisarion of science can play a very relevant role as liaisons between the products of scientific work and patients or their relatives, who must be addressed with truth without creating false expectations or exaggerating potential risks. Their work would also help to fight the ignorance fed by superficial publications that appear in women’s magazines.

7 Medicine historians confirm the theory of traditional medicine, while sociological studies try to identify the meaning of illness in certain populations in the country. Studies are also being carried into the healing properties attributed to Mexican flora in different communities. In those communities where chamanes are found, attempts are being made to get close to their practices and their relationship with the patient to interpret their influence in the health-illness process. Alcoholics Anonymous, urban equivalents to healers, chamanes and midwives are not yet being studied. Women´s magazines do not make any contributions.

To conclude, it is worth mentioning that aspects of national security, commercial confidentiality and intellectual property rights can, in some instances compete with the interests of those not fully enjoying their health. Conflicts of interest can arise when there is funding from pharmaceuticals or other groups from the private sector (15). Therefore, personnel who provide information services have the responsibility to provide exact and timely information, being aware of the impact it may have on the users’ health; they must ensure that those who are part of “open” or “captive” population of units of information learn to select, evaluate and use it in the best way possible since they are exposed to charlatan (16) while giving fake expectations, may steal not just their livelihood and savings but also minutes that may save their lives. Affected women and their relatives must learn to maintain their live with quality, not in the sense of using the information in their day-to-day but to stay alive through information.

CONCLUSIONS

It is concluded that beliefs on alternative and complementary medicine must be avoided.

The types of medicine that exist are scientific medicine, based on evidence and backed by solid data, medicine that has not been tested which lacks scientific proof (17) or traditional

8 medicine that is in experimental phase such as Taraxacum officinale, L. Tridentata

(Creosote Bush), J. communis L. (Juniper Berry), A. californica (yerba mansa), Dandelion leaf and Dandelion flower and Amphipterygium adstringens. Information units are essential when seeking to guarantee women’s health.

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