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    Complementary Medicine and Cancer

    Is the complementary approach a new model for Western medicine?

    Complementary Medicine's New Converts continued...

    "The people doing this work are not crackpots," says Heather S. Shaw, MD, co-director of the Integrative Oncology Program at Duke University. "I'm an oncologist and I spend a lot of my time parked on a laboratory bench doing research."

    Indeed, hospitals with complementary medicine divisions are spearheading research. Experts are using the same rigor in evaluating complementary therapies that they would in testing drugs or surgery. It's not enough to assume that a treatment works just because it's been used for thousands of years. Doctors want evidence.

    After seeing the benefits of complementary medicine, many doubting oncologists have been convinced.

    "My colleagues used to think I was nuts," Shaw says. "They teased me about prescribing so-called 'herbs and spices'." But now her fellow doctors are always asking her advice on new ways to help their patients.

    The Integrative Approach: Is It Proven?

    Of course, here's the big question: do we know if complementary medicine really works?

    The answer: It depends on the specific treatment. Acupuncture and massage -- which not so long ago were considered pretty far-out -- have been shown to help. Many studies have shown that acupuncture eases chemotherapy nausea, while other studies suggest acupuncture and massage may reduce pain from cancer or its treatment.

    "A lot of oncologists don't see acupuncture or massage as 'alternative medicine' anymore," says Shaw. "These therapies are so well established that they've become standard."

    Other complementary techniques aren't as well researched. So when a treatment is unproven, the question is whether its potential benefits outweigh its risks. If it's risky, it isn't used. But if the risks are very, very low, doctors may be more open.

    "If a treatment is safe but unproven, why not give it a try if the patient is interested?" says David S. Rosenthal, MD, medical director of the Center for Integrated Therapies at the Dana-Farber Cancer Institute.

    Things get trickier with herbal and botanical supplements. Despite their wide popularity, few have been shown to be either safe or effective against cancer. On the other hand, some have been shown to be both ineffective and unsafe. One example is laetrile, which contains a substance found in the pits of some fruits. The active ingredient seems to be cyanide, and it has resulted in symptoms of cyanide poisoning. Some common supplements -- like St. John's wort and high doses of vitamin C -- can interact with chemotherapy and radiation.

    "You have to be very careful with botanical and herbal supplements," says Zappa. "They are real drugs and we just don't know a lot about them." She hopes future research will show benefits. But for now, she and other experts urge caution. Given the risks, your doctor must know about all of the herbs, botanicals, and supplements you use.

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