© 2000 by Oxford University Press
Journal of the National Cancer Institute, Vol. 92, No. 11, 872,
June 7, 2000
© 2000 Oxford University Press
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Alternative Remedies for Cancer: An Update
Which of the alternative remedies now being used by cancer patients and even recommended by their doctors actually work? Definitive trials to prove their merit are being done or are planned, and some small studies look promising.
The National Institutes of Health has been funding studies in complementary and alternative medicine for the last few years. Barrie Cassileth, Ph.D., chief of the integrative medical services at Memorial Sloan-Kettering Cancer Center in New York, estimates that while very few cancer patients are using alternative remedies alone, about 85% to 90% of patients at major cancer centers and elsewhere are combining such treatment with their prescribed anti-cancer therapies.
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Cassileth summed up a few of the more promising treatments at the March annual American Cancer Society Science Writers Seminar in Tampa, Fla. They are:
• Electroacupuncture. Lixing Lao, Ph.D., a complementary medicine specialist at the University of Maryland, found a combination of eletroacupuncture with low dose anti-emetic drugs was better than either treatment alone, and that electroacupuncture, used alone, was roughly equivalent to ondansetron or metoclopramide in decreasing nausea and emesis.
• Maitake mushrooms. Dennis Miller, M.D., global clinical manager at Aventis Pharmaceuticals, Bridgewater, N.J., said that clinical trials of the maitake mushroom extract at the Foundation and elsewhere showed activity in GI, breast, lung, and ovarian cancers but that large-scale controlled trials are needed to ensure that "maitake will appear on both gourmet restaurant menus and on pharmacy oncology drug lists."
He said that preclinical studies strongly suggest that the mushroom’s B glucan polysaccarides have strong immunostimulatory, cytotoxic, and apoptosis-inducing activity.
• Chinese herbs. A mixture of eight Chinese herbs called PC-SPES is being purchased in large quantities over the Internet and elsewhere for prostate cancer. Abraham Mittelman, M.D., associate professor of medicine and associate director of oncology at Westchester Medical Center in Valhalla, N.Y., told of a pilot study of 16 patients who have maintained a clinically significant decrease in their prostate specific antigen levels for a year on this drug.
"We have also been able to document that some patients had reduction in their bone metastases," he said. "Decreases in the size of retroperitoneal lymph nodes were also seen, and certainly the quality of pain has improved."
He said a number of clinical trials are ongoing with this drug. While it can be used in patients now, it should be with physician monitoring, he said, because phlebitis and pulmonary embolism have occurred in a few patients.
• Vitamin C. David Golde, M.D., physician-in-chief at Memorial Sloan-Kettering, said that vitamin C is taken up by cells in its oxidized form. While in general this is good, high doses of the vitamin in patients being treated with chemotherapy or radiotherapy could counteract the effects of these treatments, he warned.
Cassileth concluded by noting that a big issue in the use of alternative medicines, at least the ingestible kind, is quality control.
"This is a very important issue," Cassileth said. "Consumer Reports a few years ago took several bottles of a brand and found a thousand-fold difference in active ingredients. Anybody can put anything in a bottle without regard for its safety or efficacy. We desperately need an office at the federal level to deal with that."
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