Originally created 01/10/01

Effort to inform about alternative medicines



WASHINGTON -- The 55-year-old refused surgery for sinus cancer and instead bought off the Internet unregulated pills touted to fight tumors. Four months later, he was dead - not from his still-present cancer but from liver and kidney failure that an autopsy blames on those pills.

An estimated four in 10 Americans uses some form of alternative medicine, from acupuncture or hypnosis to herbs or Internet-touted wonder remedies. Some may work; in fact, some of the nation's best-known hospitals have begun offering certain remedies. But others can be quackery or outright dangerous. How is a patient to know the difference?

A new presidential commission is traveling the country on a two-year quest to determine how to help doctors and consumers sort out what works, what doesn't and what's too risky, and to integrate alternative remedies that do prove effective into mainstream health care.

It's an ambitious effort, funded with $2 million in taxpayer dollars, to breach the medicine wars and recommend to Congress a national policy on alternative therapies.

But it's drawing fire from some critics who complain the White House Commission on Complementary and Alternative Medicine Policy is packed with proponents of the unconventional.

That doesn't mean they champion all alternative remedies, insists commission chairman Dr. James Gordon, a psychiatrist whose Center for MindBody Medicine in Washington often works with local doctors.

"What I'm interested in is what works for people, ... what has the fewest harmful side effects," says Gordon, who offers everything from well-tested acupuncture to the admittedly "far-out, strange treatment" of putting a rheumatoid arthritis sufferer on a weeklong watermelon-only diet.

"We want to protect the public health," says Dr. Joseph Fins of New York-Presbyterian Hospital, one of three commissioners who doesn't practice or promote alternative therapies. "There is a healthy amount of skepticism."

And doctors reluctant to learn about alternatives "need to appreciate that there is this other parallel universe out there," Fins says: millions of Americans using remedies without their physicians' knowledge and without unbiased information about safety and effectiveness.

Sometimes those choices prove fatal. Last month, doctors reported in the journal Annals of Internal Medicine about the 55-year-old who died from hydrazine sulfate, a controversial, unregulated chemical. While such severe toxicity seems rare, National Cancer Institute studies say hydrazine sulfate doesn't fight cancer, begging the question of how many patients would use it if they saw the NCI's report.

Other studies suggest certain treatments may work but are risky if used the wrong way.

The herb St. John's wort, widely used for mild depression, can dull the effectiveness of birth control pills and cancer, AIDS and organ transplant drugs. Patients aside, how many U.S. doctors are trained enough about alternative remedies to know that?

However, some top hospitals have begun offering certain unconventional remedies as "complementary therapy," add-ons to traditional medicine, when studies show they help.

Boston's Beth Israel Deaconness Hospital, for instance, recently reported that patients suffer significantly less pain during surgery by using self-hypnotic relaxation. The University of California, Los Angeles, employs acupuncturists to treat children's pain.

But there is little science behind other alternative remedies. The National Institutes of Health is spending tens of millions of dollars this year testing some of them.

Proof may be years in coming, but the White House commission is charged with determining how to ensure doctors and patients learn the available evidence - and if something works, how to pay for it.

Indeed, at meetings in Seattle, San Francisco and Washington, alternative practitioners - including a controversial cancer doctor who has faced scrutiny for pushing coffee enemas and pancreatic enzymes - have touted untested remedies and begged for funds.

Don't expect a push to pay for alternative remedies before getting Medicare to pay for proven disease-fighting medications, cautions Fins. Will other commissioners agree? The panel's first draft report to Congress is due in July.

EDITOR'S NOTE - Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

On the Net:

White House Commission on Complementary and Alternative Medicine Policy: http:/www.whccamp.hhs.gov/