CA Cancer J Clin. 1989 Sep-Oct; 39(5): 311-6.

The social implications of questionable cancer therapies.

Cassileth BR.

Cancer Control Program, University of Pennsylvania Cancer Center, Philadelphia.

Questionable or "unorthodox" treatments are not selected in a vacuum; their degree of popularity and the particular types used are functions of their social and cultural context. The liquid preparations that were popular earlier in this century reflected fascination with bottled medicinals, consistent with the growing era of pharmaceutical medicine. Today's questionable remedies are similarly consistent with their social and cultural context. "Metabolic" therapies emphasizing diet, self care, vitamins, and internal cleansing, along with "immune-enhancing" regimens, represent today's reigning "alternatives." Such approaches reflect underlying social trends and values, such as belief in assuming personal responsibility for one's health, the importance of self care and physical fitness, patients' rights movements, dietary emphases encouraged by conventional and alternative medicine alike, the holistic medicine movement, and general disaffection with organized medicine. Just as questionable therapies are born of the values and beliefs of their culture, so these treatments and their use affect the social environment in which they exist. The relationship is reciprocal and cyclic, with social trends encouraging particular forms of questionable regimens and these regimens, in turn, reinforcing prevailing social beliefs. Public beliefs about cancer were reflected in responses to our studies of unorthodox cancer therapies and of psychosocial correlates of survival. Responses revealed widely held values and beliefs about cancer, cancer treatment, and medicine generally. These themes are described.