Clinical Research in Complementary and Alternative Therapies in Cancer: Where's the evidence?

* Why there is almost no clinical research on complementary and alternative medicine (CAM) and cancer?
Negative attitude toward CAM by mainstream medicine
Because most cancers are potential fatal
Belief that current therapies are only hope, regardless of how toxic
Failure to recommend and use standard of care is unethical

* Ethics of using CAM as ALTERNATIVE to standard of care
Only 'acceptable' uses of CAM are for managing pain, and for coping
Even in hopeless cases, doctors still advise against CAM and for destructive conventional treatments

* Bias in severity stage when people begin CAM treatment
An obvious CAM 'given': treat at early stage; much more likely to have an effect
But, most uses of CAM are a set-up for failure
Usually try conventional therapies first
When they fail, they turn to CAM
Cancer now more progressed
Body weakened by toxic cancer treatments
Likelihood of anything working is thus diminished

* FDA has vigorously and relentlessly pursued and prosecuted CAM ['unproven'] therapies for [especially] cancer

* Historically, most CAM interventions involve ingested substances; supplements, chemicals, herbs, etc. Brief set of examples will be discussed

* Other interventions, including energy healing, prayer, QiGong, etc.; often popular but virtually unstudied

* So what is the research evidence?
Burzynski;
Issels;
Other therapies
Latest evidence from 2001 Harvard/UCSF CAM research conference

* Conclusion: where do we go from here?
'Evidence is in the eye of the beholder'