CAM cancer cures and evidence-based medicine

Today's health roundup brings both information and criticism regarding complementary care approaches to health.

With a subtitle, Looking for a cancer cure in all the wrong places, a website poo-poos patient use of CAM for cancer care:

Many patients being treated for cancer hold an apparently unshakeable belief that the medical establishment must be suppressing cheap "natural" cancer treatments out of ignorance or greed. Some turn to websites that promote products such as shark liver oil or mistletoe, convinced by claims that such remedies can cure their cancer quickly and painlessly -- unlike the regimen proposed by their oncologist or hematologist.

"It's been an age-old problem, back to the snake oil salesman in a travelling wagon," Gary Coody, the FDA's National Health Fraud Coordinator, told HemOnc Today. "When there is no effective cure, people are looking for an easier cure, one that doesn't have the side effects. And especially for incurable diseases, they're looking for hope. They are so vulnerable to these false claims."

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The FDA took steps in June toward combating online sales of fraudulent cancer "cures." The agency sent letters to 23 merchants selling 125 so-called cancer cures, warning that they were in violation of the Federal Food, Drug, and Cosmetic Act by claiming their products could cure, mitigate, treat or prevent cancer.

Punishment could include "the seizure of illegal products and injunctions against manufacturers and distributors of those products."

"It's our responsibility to get those drugs off the market," said FDA spokeswoman Rita Chappelle. "We have prioritized the drugs we will go after first, based on our Compliance Policy Guide. Those drugs are the ones that pose the most harm."

The FDA's action follows a similar move by the Federal Trade Commission, which earlier this year sent letters to 112 companies selling various products that supposedly cure cancer. Coody said more enforcement action is coming."

This is not to say that all natural or holistic health products aimed at some aspect of cancer care are fraudulent. Our law office provides legal advice to guide dietary supplement manufacturers and others and help them create responsible, legally acceptable claims within the parameters of current FDA regulation, so that patients are not given misleading information.

The website also provides advice on what to tell patients:

Convincing patients to stop using complementary or alternative therapies can be difficult. Gorski said he does not try to convince them if they also agree to maintain their precribed treatments.

"If they just want to use some herbal extract to relieve symptoms and they're not giving up the normal course of medicine, my tendency is just to make sure it doesn't cause any interactions," he said. "I'm honest in saying I don't think it's going to work and why, based on science, but I'm not going to tell them not to do it so long as they keep coming back for what I know to be effective."

Telling patients that most alternative treatments have little value can be counterproductive, Gorski said. "That's about the surest way I can think of that you're going to chase such a patient out of your office and have them totally discount what you have to say."

Moyad said that patients deserve a fuller explanation than that. "I walk them through why I believe an alternative therapy doesn't work. I walk them through why the product being recommended doesn't work."

His consults can last as long as an hour, time he acknowledges that most clinicians cannot devote to a single patient. He recommends that doctors educate themselves about CAM so that they can give patients informed advice.

"As doctors become more educated, the patient is 10 times more likely to listen to the doctor vs. the quack," he said. "Nine out of 10 times, the patient wants an answer from his primary care physician or his oncologist. And if that doctor can't provide the answer, the patient will go to a less credible source.

"We'll always have snake oil salesmen; we've had them for 200 years. I don't feel like we have to go after those guys. I feel like the solution is within."

Of course, we always emphasize the medical value of shared decision-making along with informed consent, so that patients truly participate in the process and have sufficient information to make healthy choices.

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An RN promotes healthy solutions through natural health products:

Sausalito, CA September 10 2008 Natural Therapies Championed by Integrative Health Practitioners

FOR IMMEDIATE RELEASE
Global Health Media
(415) 785-7987

(SAN FRANCISCO---) If you suffer from sleep apnea, restless leg syndrome, chronic fatigue or stubborn weight gain, you may be frustrated with the inability of conventional medicine to help you reclaim your health.

That is why more people are turning to integrative health practitioners who know how to provide effective and novel strategies, combining modern medicine with time-honored traditions for healing from around the world.

How do you find an integrative health practitioner?

More graduate programs offering health professional training and medical education are beginning to offer curricula that addresses this integrative modality.

The California Institute of Integral Studies is a frontrunner in the field of education. It has developed one of the nation's first accredited graduate degree programs in Integrative Health Studies. A two-year, non-clinical master's degree program that prepares graduates to enter the innovative field of integrative health, the Integrative Health Studies Program (IHL) blends insights from scientific biomedicine with time-honored perspectives on mind-body-spirit wholeness, traditional healing, and complementary/alternative modalities.

Graduates work as wellness coaches, integrative health researchers, clinic administrators, holistic health educators and practitioners in a variety of settings, such as community agencies, clinics, HMOs, hospitals, corporations and international nonprofit organizations. They are empowered by a widened perspective and real-world knowledge of health care systems, integral philosophy, multicultural modes of healing and social advocacy. Residing at the intersection of science and spirituality, integrative health attracts students interested in deepening their holistic self-care practices, advancing the field of integrative health, and seeking to transform themselves and health care.

The IHL Program can be completed in a minimum of two years and 40 units. It includes academic classes, workshops, a 200-hour internship focused in one or more of the following areas: Topics in Integrative Practice, Complementary and Alternative Medicine Modalities, Extending Access to Vulnerable Populations, Spirituality and Healing, Global Health Issues, Integrative Health Research, Integrative Wellness Coaching, and Integrative Health Administration.

The program is Chaired by Professor Meg Jordan, PhD, RN a medical anthropologist, author, and expert in integrating modalities for holistic practice.

For more information on the program, contact Program Coordinator Chanda Williams, cwilliams@ciis.edu, or call 415 575-6199.


# # #

Meg Jordan, PhD., RN
Sausalito, CA
Phone : 415-785-7987

Here are some local classes on subjects from chocolate to complementary therapies:

The fall session of the Osher Lifelong Learning Institute (OLLI) at Oklahoma State University begins Tuesday, with some delicious new items on the menu.

A new series of classes called "The Cultivation of Taste" will be offered during the fall session. Students can taste wine and cheese, sushi, chocolate - and much more - in the classes.

"The Chocolate Connoisseur," taught by Barbara Mintmire, proved to be highly popular in this year's OLLI summer session, and OLLI leaders believe these fall classes will be just as enticing.

Course schedules and enrollment forms are available at the Stillwater Public Library or by calling 744-5868 or 1-800-765-8933. OLLI at OSU offers classes in Tulsa, as well, and anyone interested in classes at that site can call the same numbers.

Classes meet once a week on Tuesdays and Thursdays in the Stillwater Public Library, with a town hall meeting every Tuesday afternoon. OLLI courses begin Tuesday and end Oct. 23. Classes in "The Cultivation of Taste" series may be at other times.

Any adult interested in lifelong learning can become a member of OLLI. RuthAnn McCarthy Sirbaugh, director of OLLI at OSU, points out that membership in OLLI also includes participation in social events, travel opportunities, luncheons and the annual celebration dinner.

The following classes are scheduled for the fall session:

"The History of Native Americans in Oklahoma" will be taught on Tuesdays, from 10 a.m. to noon, by Dr. Mary Jane Warde. Warde has served as the Indian historian and archivist with the Oklahoma Historical Society and is highly regarded as a teacher and researcher in Oklahoma history.

Also on the schedule for Tuesday morning is "Three Philosophers," taught by Dr. Neil Luebke. Luebke will guide the class through works by Plato, Aristotle and Descartes, who are widely regarded as three of the half-dozen most influential thinkers in western civilization. Luebke, whose Ph.D. is from Johns Hopkins University, taught for 37 years at OSU. After retiring, he served as national president of the honor society Phi Kappa Phi.

On Tuesday afternoons, from 1 to 3, OLLI members will be able to take part in the Town Hall series. This fall's series is titled "Town Hall: On the Road Again." A series of speakers will discuss the different parts of the world that they have visited.

On Thursday mornings at 10, Dr. Jerry Gill will teach a class on "The Immigration Experience." The course will focus on the reality of immigration in America, with core classes in immigration history, literature, film, food and culture. Gill, who has a Ph.D. in history from OSU, was the president and CEO of the Oklahoma State University Alumni Association for more than 22 years.

Thursday morning will also feature a class on "Climate Change." Dr. Beth Caniglia, OSU professor of sociology; Dr. Steve Stadler, OSU professor of geography; Dr. Larry Sanders, OSU professor of agricultural economics; Dr. David Lewis, OSU emeritus associate professor of forestry; and Dr. Kent Olson, OSU professor of economics, will all discuss questions related to climate change and then conclude with a panel discussion.

On Thursday afternoon, Dixie Mosier-Greene will lead a class called "The Seven Deadly Sins: A Short Story Sampler." The course looks at the deadly sins through the lens of short stories by such writers as Rudyard Kipling, William Faulkner and D.H. Lawrence. Mosier-Greene has a B.A. and M.A. in philosophy from OSU.

"Complementary and Alternative Medicine" will be featured on Thursday afternoons at 1. Classes will be led by Ann Hargis on Samatva yoga; Tamera Daniel on equine therapy; Rajesh Tiwaari on herbs and herbal treatments indigenous to India; Dee M. Dutt on Tai Chi and therapeutic massage; Steven Bond on ethnobotany and traditional medicinal plants; and Nancy Van Winkle with an overview of complementary and alternative medicine. Dr. Esther Winterfeldt will summarize the course at the final session.

"The Cultivation of Taste" will feature a variety of classes at various times. For more information about these classes, call 744-5868 or 1-800-765-8933. "Wine & Cheese, A Match Made in Heaven . . ." will be led by wine guide Charles Hunt. Meeting dates are Sept. 24 and Oct. 3.

"The Artisan Brewer" will include a visit to the Marshall Brewery in Tulsa on Oct. 27. "Shabu, Shabu" is a dish thought to have been created in the 13th century by the soldiers of Genghis Khan. On Oct. 22 and 29 the class will meet in Stillwater's Tokyo Pot, where manager Dean will show how to make your own lunch creation.

"The Chocolate Connoisseur," taught by Barbara Mintmire, will meet Nov. 12 from 10 a.m. to noon. Mintmire will also teach "Discovering Your Chocolate Profile" Nov. 10 from 10 a.m. to noon.

For more information about OLLI at OSU, go to www.okstate.edu/olli. You may also e-mail OLLI at olli@okstate.edu or call OLLI at 744-5868 or 1-800-765-8933.

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A website on 'evidence-based' medicine argues that CAM is a distraction:

The Center for Disease Control (CDC) conducts an ongoing telephone survey of medical problems and health care utilization - called the National Health Interview Survey (NHIS). They recently released their data from 2007. This is the first year for which they specifically broke out questions assessing the use of so-called complementary and alternative medicine (CAM).

CAM is a political/ideological entity, not a scientific one. It is an artificial category created for the purpose of promoting a diverse set of dubious, untested, or fraudulent health practices. It is an excellent example of the (successful) use of language as a propaganda tool.

The fundamental intellectual flaw of "CAM" as a concept is that it is made to include modalities that are extremely diverse, even mutually contradictory, under one umbrella. Very deliberately modalities which are scientific and mainstream, like the proper use of nutrition, are often included under the CAM umbrella by proponents in order to make it seem like CAM is a bigger phenomenon than it actually is, and as a wedge to open the door for the more pseudoscientific modalities.

Historically, surveys of CAM use have been used to claim about about 1/3 of Americans (or more) are using CAM. Such surveys, when carefully examined, bring into focus the absurdity of the CAM label. What counts as "CAM" in these surveys? What are the implications for homeopathy that many people pray for their sick loved-ones?

In the end the very concept of CAM is meant to distract from the only assessment that makes sense - what is the plausibility and evidence for the use of a particular modality for a specific indication? Any treatment that rises above a reasonable threshold to be considered ethical science-based medicine should be, and will be, incorporated into mainstream practice. The purpose of the label of CAM is to get modalities which do not meet proper criteria in through the back door. This is a strategy that is, unfortunately, working....

Manipulation and massage for back strain do not necessarily represent a different approach to medicine, a change in medical philosophy, or a new world order. Their use for medical indications, such as manipulation for asthma, is not science-based and therefore should be considered separately. Again we see the contamination of so-called CAM as a category with treatments that can be scientifcally reasonable, but are themselves often mixed with unscientific treatments.

If we put aside physical treatments for back pain, we are left with the truly "alternative" treatments, in that they are not within the realm of science-based medicine. As you can see these modalities are used by a tiny minority of the population. Less than 4% of the US population have ever used homeopathy, despite all the buzz. Acupuncture is less than 7%, despite the nearly weekly press releases falsely claiming new evidence that acupuncture works.

And yet the alleged popularity of CAM, as a category, is used to promote its inclusion in medical schools, on insurance plans, and to justify diverting limited funds for its research.

We can agree or disagree all day long, but it would be better to drop the rhetoric and read the Institute of Medicine report on CAM, which was drafted by some of my very evidence-based medical colleagues.

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