CLINICAL OUTCOME OF PATIENT-SELECTED CANCER THERAPY

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We propose to conduct a cohort study of patients with metastatic cancer to evaluate the clinical effects of patient-initiated unorthodox cancer treatments. This study will generate previously-unavailable comparative data on survival and quality of life of patients under unorthodox versus conventional care. Specific aims are to compare length of survival in patients who adopt unorthodox therapies versus patients who remain exclusively under conventional care, and to compare quality of life over time in patients who adopt unorthodox therapies versus patients who remain exclusively under conventional care. A consecutive sample of patients with advanced breast, colon, lung, melanoma, and pancreatic cancer under the care of two selected unorthodox-therapy clinics will be accrued. Matched controls will be identified and accrued from the University of Pennsylvania Cancer Center. Each patient will be followed for up to three years and interviewed at six-month intervals to determine quality of life and length of survival. A minimum of 50 subjects from each of the two unorthodox treatment sources and a matched conventionally-treated control for each (a total of 200 patients) will comprise the study sample. The results of this investigation should have important practical implications with regard to cancer control, patient survival, and quality of life. The clinical implications of patients' use of unorthodox cures, costly in terms of lives and dollars, represent a critical social and medical concern that is urgently in need of definitive study.