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
"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.
In Search of a Cure
Can alternative approaches also help patients fight the disease? This question sparks fierce controversy. Hundreds of so-called "alternative" treatments for cancer are being hawked in health food stores and on the Internet -- treatments that have never been tested in human studies. Some, in fact, are still sold despite convincing evidence that they are worthless. Laetrile, for instance, which first became popular as an "underground" cancer drug in the 1950s, is making a comeback, much to the chagrin of scientists who point to convincing studies that it offers no benefit.
One worry is that unscrupulous purveyors of quack medicine are taking advantage of patients' desperation. Another is that some patients, enamored of these so-called "natural" approaches, will forgo conventional treatments that could help them.
Still, some mainstream experts think that alternative approaches could actually help fight cancer. Spiegel has shown that support groups can help women with breast cancer survive longer, for instance. And new research is underway to put other approaches to the test. One of the fastest-growing areas of research at the NCI is in mind-body medicine, according to White. The National Center for Complementary and Alternative Medicine (part of the National Institutes of Health) has begun testing a variety of alternative cancer treatments, from shark cartilage to Chinese herbs (see Alternative Cancer Therapies Go Mainstream).
"What's really exciting is the merging of Western medicine with other, more traditional forms of healing, such as acupuncture and Chinese herbs," says Strang Cancer Prevention Center researcher George Wong, PhD. We're finally beginning to understand that there are many ways to approach a disease like cancer -- and to help patients."
As for Nick Steiner, the New Jersey physician knew that there was no scientific proof that Chinese herbs could slow the growth of cancer. But he was also willing to put his trust in a system of healing that had evolved over thousands of years. And he liked the multifaceted approach that Wong offered, which included both herbs to help fight the tumors and herbs that might strengthen his immune system and boost his energy.
Since 1997, he has been boiling up a pot of a dozen Chinese herbs and drinking the brew five times a week -- and during that time his cancer has been in remission. "I know there's no way I can prove that the herbs are the reason I'm still alive," he says. "But I'm convinced they are. And I'm more convinced than ever that alternative treatments like this should be made available to all cancer patients."
Peter Jaret is a freelance writer based in Petaluma, Calif. His work has appeared in Health, Hippocrates, National Geographic, and many other publications.
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