Dealing With Cancer
Can alternatives help?
July 24, 2000 -- After more than 17 years of battling malignant melanoma, Nick Steiner knew he had few options left. Steiner, 65, is a physician himself. Diagnosed with this deadly form of skin cancer in 1980, he'd watched the tumors spread into his lungs and then into his brain. He'd tried everything medicine has to offer -- from surgery to an experimental cancer-fighting vaccine. When the disease surged back again in 1997, he recalls, "It looked like I was at the end of the road."
Desperate, he turned to something he might once have scoffed at: Chinese herbs. "I heard about an herbal expert named George Wong. I gave him a call, knowing I had nothing to lose."
It's hardly surprising that thousands of cancer patients like Steiner are turning to alternative (also called complementary) therapies. Despite decades of research, scientists still haven't found a cure for most forms of cancer, and conventional treatments are usually highly toxic. What is surprising is that many mainstream cancer specialists are now willing to give unconventional therapies a try.
Around the country, leading cancer centers now offer "integrative" treatment programs, which combine standard therapies such as radiation and chemotherapy with alternative approaches like acupuncture, massage, hypnosis, Chinese herbs, and even aromatherapy. When Nick Steiner first contacted George Wong, PhD, for instance, the specialist in Chinese medicine was working in a small private practice in Manhattan's Chinatown district. Today Wong serves on the staff of the highly respected Strang Cancer Prevention Center (associated with Cornell University) in New York City. This past June, New York's Beth Israel Medical Center opened a new Center for Health and Healing, which offers a wide choice of alternative therapies. And Stanford University Medical Center in Palo Alto, Calif., has also just established a new center that specializes in mind-body therapies designed to ease cancer patients' pain and discomfort -- and perhaps enhance their survival.
The trend is being driven in part by the sheer popularity of alternative medicine among consumers. Americans now spend $27 billion out-of-pocket on unconventional treatments -- about as much as they spend visiting conventional physicians, according to a study published in the November 11, 1998 issue of the Journal of the American Medical Association. But many researchers are also beginning to take alternative approaches more seriously. "More and more physicians are discovering that some of these approaches really do have something to offer," says Jeffrey White, MD, who heads up the program of research into complementary and alternative medicine at the National Cancer Institute (NCI).
Improving Quality of Life
When it comes to relieving pain, easing anxiety, and improving the quality of life of cancer patients, experts say, alternative therapies can make a big difference.
"Cancer patients should be wary of any alternative therapy that offers a miracle cure," says White. "If we had a magic bullet, believe me, every cancer center in the country would be offering it. But even if we can't offer patients a cure, we can do more to provide them with the best quality of life. When patients choose to undergo chemotherapy or radiation, it's up to us to help ease the side effects. And complementary approaches can be remarkably useful."
Barrie Cassileth, MD, who heads up the Integrative Medicine Outpatient Center at New York's Memorial Sloan-Kettering Cancer Center, agrees. "We know that many of these supportive techniques help patients," she says. "Probably the most broadly effective, safe, and helpful complementary therapy is massage. Other helpful approaches include mind-body techniques, such as progressive relaxation. Music therapy is also great as a way to help patients relax and relieve the inevitable tension they experience while fighting cancer." Cancer patients at Memorial Sloan-Kettering are also offered herbs like mint or ginger, which can help relieve chemotherapy-induced nausea.
So far, most of the evidence for alternative approaches is still anecdotal: Patients simply report feeling better after trying them. Proponents believe that's reason enough to offer therapies that are safe and noninvasive.
Fortunately, evidence from clinical trials is beginning to suggest that certain alternative techniques offer measurable benefits. At Stanford University Medical Center, psychiatrist David Spiegel, MD, has been testing the power of such mind-body techniques to improve quality of life. In a 1999 study of 111 patients with breast cancer reported in the June 1999 issue of the journal Psycho-oncology, Spiegel showed that patients taking part in support groups experienced a 40% decrease in their scores on a scale that measures mood disturbance.
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