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UNDER THE MICROSCOPE

The National Center for Complementary and Alternative Medicine, part of NIH, is conducting research into a variety of therapies that might help cancer patients. Studies are typically funded after clinical evidence suggests a treatment shows promise. Currently under investigation:

European mistletoe
Already widely used in Europe, this plant is being tested in conjunction with the chemotherapy drug gemcitabine in patients with pancreatic, lung, colorectal and breast cancer.

Electroacupuncture
This therapy shows promise as a treatment for nausea and vomiting caused by chemotherapy.

Yoga
May be beneficial as a treatment for persistent fatigue in breast cancer patients.

Pancreatic enzyme therapy
Being tested in patients with pancreatic cancer.

Reiki/energy healing
This popular therapy is being tested in patients with prostate cancer.

Vegetable/herbal supplements
For use in patients with lung cancer.

Your Health

Battling Cancer

Fringe Therapies Go Mainstream

man gets massage

— Photo by Darryl Estrine

The doctors at Memorial Sloan-Kettering Cancer Center in New York had no choice but to remove the patient’s gallbladder and part of her liver, both riddled with cancer. They started her on chemotherapy in the hope of eradicating any renegade cancer cells left behind. Then they offered her something radical: a course in meditation.

“At least once a day I find a quiet time to meditate,” says the 66-year-old woman from Astoria, N.Y., who asked that her name not be used because her mother hasn’t been told she has cancer. “I don’t know how I would have survived without it.” When her thoughts stray into the dark woods of her deepest fears—that the cancer will roar back, that she’ll die, leaving her husband, her children, her beloved grandchildren—she uses meditation to calm her mind and loosen the knot of dread in the pit of her stomach. “I know it’s made life much more bearable,” she says.

Fringe approaches go mainstream
For years cancer patients desperate to survive have chased after unproven treatments—from herbal remedies, dietary supplements and acupuncture to mushrooms. Many never whisper a word to their doctors for fear of ridicule. Today that’s changing. A growing number of the country’s leading cancer centers now offer a range of unconventional therapies once spurned by mainstream physicians—part of a new approach to cancer care called integrative oncology.

The sea change began in 1991 with the creation of a federal office of alternative medicine at the National Institutes of Health. That office has now been elevated, becoming the National Center for Complementary and Alternative Medicine. Its mandate: to investigate approaches that lie outside mainstream medicine for treatment of cancer and other diseases. Although no magic bullets to cure cancer have been found among Chinese herbs or techniques to harness energies in the body, a variety of approaches have been shown to help patients with the disease.

Relief from symptoms
“These aren’t alternative therapies,” says Barrie R. Cassileth, chief of integrative medicine at Memorial Sloan-Kettering. “They don’t replace the very powerful weapons mainstream medicine has developed to fight cancer. But they can help relieve the unwanted side effects of treatment and improve quality of life. And that’s very important. In our department, we don’t treat the tumor. We treat the patient.”

Some of the benefits of complementary approaches have surprised even proponents. Acupuncture, for instance, which uses needles painlessly inserted into key points in the body, has been shown to relieve nausea caused by chemotherapy. For patients with head and neck cancers whose salivary glands are destroyed by radiation treatments, acupuncture can restore some salivary function. “That’s a huge benefit to people with the disease,” says Cassileth.

Self-hypnosis, meanwhile, has been found to ease the severe hot flashes that women with breast cancer sometimes experience. Support groups improve the quality of life for cancer patients, and some studies suggest that they may even increase survival time. Both massage and meditation ease stress, of course, but some experts believe that may, in turn, help the body concentrate its energy on fighting cancer.

But most integrative medicine specialists are cautious about claiming too much for the therapies they offer. “At the end of the day, we’re trying to manage symptoms that are not being effectively managed by conventional treatments,” says Lorenzo Cohen, M.D., director of the integrative medicine program at M.D. Anderson Cancer Center in Houston.

Sorting through therapies
Not all unconventional therapies work, and some may be downright dangerous.

“We worry—especially about the things cancer patients put in their mouths, such as herbal and dietary supplements,” says Cassileth.

Some, including St. John’s wort, which is used to ease depression, interfere with the liver’s ability to metabolize medications. Others, such as ginkgo, are anticoagulants that can lead to uncontrolled bleeding in patients undergoing surgery. That’s why one key role integrative programs play is warning patients away from things that might harm them—no easy task given the proliferation of unsubstantiated claims on the Internet and the ready availability of many supplements.
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