Children Use "Alternative Therapies"

By Editorial Staff

A recent article in the electronic edition of Pediatrics¹ sought to compare the use of "alternative therapies" by children with cancer vs. children receiving routine check-ups in a medical outpatient setting. While this study has a significant bias in that it only includes children receiving care within the medical model, it still underscores a trend that the medical community cannot help but recognize.

The study interviewed the parents of 81 children with cancer and 80 children receiving routine medical care. What they discovered is that most parents who utilize medicine for their children's health care also utilize forms of care that extend beyond what is traditionally offered under the medical model.

The authors begin by reciting the usual litany on the significance of alternative therapy in the United States:

"Alternative therapy (AT), also known as complementary, non-allopathic, unconventional, holistic, or natural therapy, refers to healing practices that have become increasingly popular with the general public, but not widely accepted by the medical profession. Examples of AT techniques include therapeutic massage, acupuncture, imagery, energy healing, prayer, and use of medicinal herbs. According to 1990 data, the number of visits to practitioners of AT was greater than the number of visits to all primary care physicians nationwide.² Reasons patients use AT include a belief that it will cure or help a condition not treatable by conventional medicine, dissatisfaction with allopathic medicine, and a desire to use more natural methods of healing."
"It is estimated that Americans spend >$10 billion a year on unproven cancer remedies.³ AT is thought to be used more frequently in patients with cancer than in patients with minor illnesses.³ According to Fletcher⁴, between 20% and 50% of cancer patients use or consider using AT."

One of the unique qualities of this study is its inclusion of "prayer" in the list of "alternative medicine used." But the authors defended their decision citing:

"Many parents questioned the inclusion of prayer as an AT. We included it when it was being used specifically to treat illness, because few physicians prescribe prayer or consider it part of standard therapy. Religion and spirituality are not consistently addressed in medical school curricula, and even may be considered inappropriate teaching subjects.⁵ However, physicians are beginning to recognize the role of spirituality and prayer in the healing practices of their patients, as indicated by conferences sponsored by the National Institutes of Health."^6,7
"The findings suggest that many Americans use prayer and faith healing as a therapeutic adjunct. Discussions of spiritual practices may improve well-being and compliance. In a much reported study, Byrd conducted a randomized, double-blind study of 393 patients, in which patients on the University of California, San Francisco, coronary care unit were prayed for by various religious groups who had only their first name and a brief description of their condition.⁸ The test patients and families did not know they were being prayed for. Fewer patients in the prayed-for group died, and significantly fewer developed pulmonary edema, received antibiotics, or needed intubation. The researchers concluded that the prayed-for group endured less suffering. Although this study has been criticized for its design, it shows the important role that prayer may play in illness."⁸

The study results are presented in the following graph which provides an interesting profile of the current use of alternative care by parents of children:

Type of AT	Cancer Patients	Control Patients
Prayer	64.2%	40.0%
Exercise	16.1%	6.3%
Spiritual healing	16.0%	21.2%
Relaxation techniques	11.1%	17.5%
Other	9.9%	3.8%
Medicinal herbs	8.6%	6.3%
Massage therapy	7.4%	25.0%
Megavitamin therapy	7.3%	3.8%
Imagery	4.9%	3.7%
Folk remedies	2.5%	13.7%
Energy healing	2.5%	2.5%
Macrobiotic diet	2.5%	1.3%
Self-help group	2.5%	0%
Homeopathy	1.2%	2.5%
Biofeedback	1.2%	1.3%
Chiropractor	1.2%	1.3%
Acupuncture	0%	2.5%
Hypnosis	0%	0%

Another interesting facet of the study was the reasons given for using alternative forms of care:

Reason for Use of AT Cancer Patients Control

No reason given 58.0% 62.5%

Faith, spiritual 21.0% 10%

Supplement to conventional medicine 7.4% 5.0%

Dissatisfied with conventional medicine 2.5% 3.7%

Lifestyle, general well-being 2.5% 1.3%

Want to help 2.5% 0%

Other 2.5% 2.5%

Support, participation in illness 1.2% 0%

Hope 1.2% 1.3%

Belief in treatment 1.2% 10%

Relaxation 0% 3.7%

In addition, the study reveals how the parents learned about the alternative care:

Sources From Which Parents Received Information about AT

Cancer Patients Control Patients

Friends and family 58.8% 56.1%

Other 29.4% 19.5%

Doctor 15.7% 12.2%

Health food store 9.8% 2.4%

The authors conclude that "use of AT is not limited to children with life-challenging illnesses, but is commonly practiced by those with routine medical problems." They go on to cite the increase inclusion of "AT and other integrated health approaches" in half of the US medical schools. They also discuss the need for MDs to learn more about alternative forms of care.

But there is a louder message for the chiropractor.

This study shows that a majority of parents seek alternative care for their children. And while most don't give a reason, they learn about the benefits of alternative care from their friends and family.

The use of chiropractic is quite low in children who routinely seek medical care. Why? The parents are obviously open to alternative care, but they haven't heard about chiropractic enough to make that choice.

Chiropractic has attracted a significant portion of the population that is dissatisfied with medical care. But, according to this study, only a tiny percentage (less than 2%) of the children of current medical users are also chiropractic users.

This group obviously represents a majority of the US population. The chiropractic profession should explore ways to better communicate with this portion of the public, particularly through current chiropractic patients who are the "friends and family" of those who routinely utilize medical care.

References

Friedman T, Slayton WB, Allen LS, Pollock BH, Dumont-Driscoll M, Mehta P, Graham-Pole J. Use of alternative therapies for children with cancer. Pediatrics December 1997, vol. 100, no. 6, p. e1.
Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 1993;328:246-252.
Cassileth B, Lusk E, Guerry D. Survival and quality of life among patients receiving unproven as compared with conventional cancer therapy. New England Journal of Medicine 1991;324:1180-1185.
Fletcher DM. Unconventional cancer treatments: professional, legal and ethical issues. Oncol Nurs Forum 1992;19:1351-1354.
King D, Bushwick B. Beliefs and attitudes of hospital inpatients about faith healing and prayer. J Fam Pract 1994;39:349-352.
Marwick C. Should physicians prescribe prayer for health? Spiritual aspects of well-being considered. JAMA 1995;273:1561-1562.
Dossey L. Prayer and healing: reviewing the research. In: Healing Words: the Power of Prayer and the Practice of Medicine. New York, NY, Harper Collins, 1993, pp. 179-184.
Byrd RC. Positive therapeutic effects of intercessory prayer in a coronary care unit population. South Med J 1988;81:826-829.