An unconventional cancer treatment lacking clinical efficacy remains available to Italian cancer patients

Aims and background.An unconventional cancer treatment known as“Di Bella mul titherapy” gained popularity among Italian cancer patients during the 90’s. In 1999, it was shown to lack any detectable antitumor activity. Access to the multitherapy was investigatedthreeyearslaterwithinthepost-bereavementItalianSurveyoftheDying of Cancer (ISDOC), whose broader aim was to investigate the end-of-life care experi ences of terminal cancer patients. Methods. ISDOC was carried out in a two-stage probability sample of 2,000 out of 160,000 Italian cancer patients deceased between March 2002 and June 2003. For each cancer patient, a non-professional caregiver, i.e., the closest and the best-in formed person about her/his last three months of life, was identified. A specific ques tion concerning the“Di Bella multitherapy” was included in a semi-structured ques tionnairethatwasadministeredface-to-facetothecaregiversbytrainedinterviewers. Weighted estimates of the frequency of patients receiving the multitherapy in the tar get population and their 95% confidence intervals were computed by taking into ac count stratification and clustering of observations. Results. During their last three months of life, 0.7% (95% CI, 0.3-1.6) of terminal can cer patients, corresponding to some 1,100 subjects (range, 480-2,560), received the multitherapy. No statistically significant difference was observed for age at death, cancer type, gender, education, marital status, or residence. Conclusions. The finding indicates that an unconventional cancer treatment proven to lack clinical efficacy remained accessible to Italian cancer patients. Ethical, deon tologic, and economic implications call for a routine monitoring of provision of and access to unproven cancer treatments.