Dear survivors, please be wise when visiting ‘Doctor Google’

What you need to know:

  • She was devastated that her tumor was returning after treatment. She was also losing confidence in the conventional treatment procedures.

Few months ago I attended to a young woman with cancer of the uterus. She had previously undergone surgery, chemotherapy, and radiation for an early-stage tumor and this had done well for a time until she came to me complaining of vaginal bleeding. The cancer has spread widely in her body.

She was devastated that her tumor was returning after treatment. She was also losing confidence in the conventional treatment procedures.

That’s when she began doing research online and discovered alternative options; the natural medicines.

I encouraged her to consider a clinical trial and offered her one available at my work station, it was testing a novel antibody drug conjugate that had showed promise in other tumors.

After much discussion, she chose to pursue the clinical trial.

“Can I take other medications?” she asked.

“Well, it depends. What kind?” I asked.

“I would like to try vitamins and herbal combination that someone told me about.”

“Unfortunately, the treatment protocols don’t allow you to take alternative or integrative therapies. We do not know about the safety of other medications, especially with a drug that is still being tested.”

“Oh, ok,” she said.

I presumed the issue was resolved, so we went about enrollment, and she was put on the trial.

After two cycles, she had experienced a partial response; by the fourth cycle, she appeared to be veering toward remission.

I was elated with these results, and she was too. Following her fourth treatment, however, she called complaining of profound shortness of breath.

Looking back, it had been gradual — the effort required to climb a flight of stairs slowly had been increasing, though she never complained about it at the time.

Now, she could only take four or five steps before experiencing shortness of breath.

It was through a phone conversation when she told me all this she is going through, I was alarmed and called her into the hospital next morning where a chest X-ray showed she had signs of pneumonitis.

I looked back at the consent form. This was not listed as a known toxicity, not even among “rare” side effects. I asked her if anything had been different in the past month; had she started taking any medication? Traveled anywhere on her off weeks?

“Well, I did start taking herbal supplements last month,” she said.

I looked at her a little dumbfounded. “What kinds of supplements?”

She named off a list of 15 supplements, many of which I had never heard of.

As she did, I was tempted to become angry. But I didn’t. Not because she had taken these treatments, but because she did so when it was expressly forbidden as part of the trial … and also because she never told me.

“It’s possible that what’s happening to your lungs is due to the drug, though it has not been reported that I can see. But it’s also possible that any of these supplements could have caused the issue by Through an interaction with the drug we are trying for your cancer,” I told her, trying not to sound angry.

She started crying. “I never imagined that my supplements could cause a problem. They’re natural, and I didn’t need a prescription or anything for them and what I saw on the web made them sound so helpful,’ she said.

I said to her, “Well, for now, we need to stop them, and we need to hold off on the trial therapy. I want to see you weekly so I can make sure things get better, which I hope will happen.”

“OK,” she said.

It took time, but she did get better. Unfortunately, the delay from waiting for her lung function to improve was too long, and we were forced to withdraw from the trial due to toxicity.