Lung cancer survival with herbal medicine and vitamins in a whole-systems approach: Ten-year follow-up data analyzed with marginal structural models and propensity score methods

Michael McCulloch, Michael Broffman, Mark Van Der Laan, Alan Hubbard, Lawrence Kushi, Alan Kramer, Jin Gao, John M. Colford

Research output: Contribution to journalArticle

13 Scopus citations


Complementary and alternative medicines are used by up to 48% of lung cancer patients but have seen little formal assessment of survival efficacy. In this 10-year retrospective survival study, the authors investigated Pan-Asian medicine + vitamins (PAM+V) therapy in a consecutive case series of all non-small-cell lung cancer patients (n = 239) presenting at a San Francisco Bay Area Chinese medicine center (Pine Street Clinic). They compared short-term treatment lasting the duration of chemotherapy/radiotherapy with long-term therapy continuing beyond conventional therapy. They also compared PAM+V plus conventional therapy with conventional therapy alone, using concurrent controls from the Kaiser Permanente Northern California and California Cancer Registries. They adjusted for confounding with Kaplan-Meier, Cox regression, and newer methods-propensity score and marginal structural models (MSMs), which when analyzing data from observational studies or clinical practice records can provide results comparable with randomized trials. Long-term use of PAM+V beyond completion of chemotherapy reduced stage IIIB deaths by 83% and stage IV by 72% compared with short-term use only for the duration of chemotherapy. Long-term PAM+V combined with conventional therapy reduced stage IIIA deaths by 46%, stage IIIB by 62%, and stage IV by 69% compared with conventional therapy alone. Survival rates for stage IV patients treated with PAM+V were 82% at 1 year, 68% at 2 years, and 14% at 5 years. PAM+V combined with conventional therapy improved survival in stages IIIA, IIIB, and IV, compared with conventional therapy alone. Prospective trials using PAM+V with conventional therapy for lung cancer patients are justified.

Original languageEnglish (US)
Pages (from-to)260-279
Number of pages20
JournalIntegrative Cancer Therapies
Issue number3
StatePublished - Sep 2011
Externally publishedYes



  • chemotherapy
  • Chinese herbal medicine
  • lung cancer
  • marginal structural models
  • propensity score
  • radiotherapy
  • survival
  • vitamins

ASJC Scopus subject areas

  • Complementary and alternative medicine
  • Oncology

Cite this