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Lots of patients balk at the laundry list of untoward side effects inherent with most oncologic therapies...which leads many to ask: can I skip all the toxicity? The answer, in a word, is no. An NCDB analysis addressing this question was published last week in the Journal of the National Cancer Institute, and it’s certainly generating buzz. 280 patients receiving alternative medicine for one of the Big Four (breast, prostate, lung, or colorectal) non-metastatic cancers between 2004-2013 were matched 1:2 against similar demographics receiving “conventional therapy” (read: surgery, radiation or systemic therapy) for the same staged-disease. Over all, patients opting for alternative over conventional treatments were 2.5x more likely to die within 5 years of diagnosis. And breast cancer patients over 5x (!) as likely to lose their lives. Perhaps more predictable were the characteristics of the non-conventional cohort, including higher socioeconomic status and residing on the West Coast. But before you tell your yogi he’s bogi, remember that alternative is different than complementary or integrative therapies that incorporate--rather than abandon--the more tried and true treatments.