Science behind alternative medicines

Intriguing feature article in The Scientist:

While traveling in China in 1971, two-time Pulitzer Prize-winning journalist James Reston underwent an emergency appendectomy, after which Chinese medical personnel treated his pain with acupuncture. His description of the experience in the pages of theNew York Times brought the practice of traditional Chinese medicine front and center.

Two years later, Lewis Thomas, then president of Memorial Sloan-Kettering Cancer Center, delivered an address in which he said, “These are bad times for reason, all around. Suddenly, all of the major ills are being coped with by acupuncture. If not acupuncture, it is apricot pits.” Thomas was referring to laetrile, a compound extracted from the pits of apricots and bitter almonds, one of the most sought-after alternative treatments for cancer at the time, but one whose effectiveness had been the topic of bitter controversy for years. Banned since 1963 in the U.S., laetrile is reported to still be readily available in the Bahamas and Mexico and is sold online.

And the examples don’t end there. Lots of ballyhoo, head-scratching, and accusations of quackery attended growing patient demand for alternative treatments, hyped in the popular press as cures that were “natural” and based on millennia-old medical traditions practiced in places such as China and India.

In 1999, in response to a growing outcry for some kind of evidence-based scientific analysis of the safety and efficacy of this blizzard of nonconventional treatments, the National Institutes of Health, then under the direction of Harold Varmus, established the National Center for Complementary and Alternative Medicine (NCCAM). Since its founding, NCCAM has funded basic and clinical research at institutions around the world on plant and animal products such as acai, black cohosh, gingko biloba, and shark cartilage, as well as on the therapeutic value of treatments including acupuncture, yoga, massage, reiki, and meditation.

Almost 40 percent of US adults and 12 percent of US children have used complementary or alternative therapies, according to a 2007 survey by NCCAM, and much of what was once considered “alternative,” including acupuncture, is now part of more-holistic regimens offered at 40 percent of US hospitals, including Memorial Sloan-Kettering Cancer Center. According to a 2010 survey by the American Hospital Association and the Samueli Institute, a nonprofit center for the study of wellness and healing, this trend is driven by patients demanding alternative or complementary treatment options for conditions that are difficult to manage or cure, such as diabetes, chronic pain, and cancer. Most physicians have l­ukewarmly embraced such therapies, often because they feel that patients will desert conventional therapy out of desperation if they are not offered a wider range of treatment options.

Researchers who study the scientific validity of nonconventional treatments rarely see them as stand-alone remedies, preferring to call the union of conventional and nonconventional “integrated therapy.”

The Scientist staff asked experts about the scientific evidence for a number of treatments that may be on the verge of becoming incorporated into integrated therapies, from acupuncture and probiotics to marijuana and psychedelics. We sought to highlight the data that either supports or contravenes the effectiveness of these alternative therapies. As with most health interventions, we uncovered both positive and negative aspects of these treatments for which patients are clamoring and physicians are demanding evidence.

—Mary Beth Aberlin

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