Osteosarcoma and alternative medicine in children

Dear Editor, The use of complementary and alternative medicine (CAM) is widespread throughout the world and encompasses a wide range of different approaches. Research shows that in developed countries a significant number of people use various methods of CAM in their treatment [1]. Scientists believe that the effect of most alternative thera­pies can be attributed to the placebo effect. The most commonly used methods are homeopathy, acupuncture, chiropractic, bioenergy therapy, dietotherapy, and the consumption of medicinal herbs, vitamins, minerals, etc., and each of these methods has a whole range of variations. A meta-analysis in several countries has shown that more than half of all cancer patients use CAM methods [2]. Most CAM products are over-the-counter and belong to the group of dietary supplements. An increasing number of cancer patients are taking CAM products without the knowledge of their doctors, believing that such treatment will help them recover faster or even lead to a cure [3, 4]. It is important to note that when it comes to treating children, the percentage of parents who opt for CAM methods is similar [5]. Parents often do not even consult a paediatrician, but do everything on their own initiative, consulting with unverified sources of information [6]. The ethical question is: Who is the appropriate decision-maker in this case, the parent or the doctor? Although conventional medicine provides far more evidence, on the basis of which the doctor makes his/her decision, it is the parent who must also consider all reasonable options and decide what is in the best interests of the child. We are aware that legislation on the rights of patients and their parents differs from state to state, so there is no uniform pattern of action. The doctor and the parent, based on common sense and the latest guidelines, must make the best decision for the child [7, 8]. Osteosarcoma (OS), a common primary bone malignancy in children and adolescents, occurs primarily in the metaphysis of long bones and is characterized by early lung metastases, high mortality, and poor prognosis [9]. For many years, amputation has been the mainstay of OS, with a 5-year survival rate of approximately 20%. The inclusion of chemotherapy in treatment regimens has increased cure rates from 20% to current levels of 65–75% [10, 11]. It is important to emphasize that if OS is identified at an early stage, surgical methods in the removal of pathological tissue have a success...


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