February 10, 2012

In a series of investigative newspaper stories, journalist Trine Tsouderos recently highlighted so-called "dubious" studies conducted over the past 12 years by the National Center for Complementary and Alternative Medicine (NCCAM).

Taxpayer-funded studies of coffee enemas, chelation treatments, energy healing, lavender scent therapy, and acupuncture all took their lumps in the articles, which first appeared in the Chicago Tribune in December and were later reprinted in the Los Angeles Times.

Fitting attention was drawn to serious problems with several of the projects funded by NCCAM and other federal sources. For example, the chelation study utilized a drug withdrawn by the FDA, a fact not shared with study participants who continued to receive it as investigators explored whether it could reduce symptoms of coronary artery disease. (Spoiler alert: nope!)

© Sanjay Deva/Fotolia.com Numerous taxpayer-funded studies on alternative medicine, such as reiki healing, were taken to task in a recent series of newspaper articles.

The writer rehashed results of a well-known, profoundly flawed, decade-old pancreatic cancer study, in which patients on standard chemotherapy outlived those receiving coffee enemas and pancreatic enzyme supplements by 10 months, and with less reported pain.

While the series was well-researched and generally balanced, Ms. Tsouderos pandered to populist astonishment at seemingly outrageous expenditures of taxpayer money, without putting the numbers into realistic perspective.

Little attention is given to the immense personal costs, both monetary and emotional, of alternative medical treatments by desperate, taxpaying American citizens who might benefit from fair and well-designed trials to see whether these treatments actually work.

The sidebar on energy healing is a ripe example, mocking the channeling of energy as what Dr. David Gorski of Wayne State University calls "brain-meltingly bad … faith healing (posing as science)." Maybe so. But the grant to study it in 76 breast cancer survivors with fatigue cost a mere $104,000.

The results? Patients receiving energy healing felt less fatigued, as did patients who received sham energy treatments from skeptical scientists. Only those receiving no treatment – the control group – failed to improve. In other words, energy healing did no harm, caused no side effects, and helped people with a symptom – fatigue – that can paralyze a survivor’s days and prevent a return to a satisfying and productive life.

Placebo effect, you say? I say, bring it on, for $104,000.

I have worked with people who report benefit from energy treatments, massage, acupuncture, Qi Gong, yoga … and, dare I say… psychotherapy.

Ms. Tsouderos notes that patients still flock to the practice of an early proponent of coffee enemas for pancreatic cancer, saying that the $1.4 million study "changed few minds." This may be so, and it is certainly worth revisiting the inexcusable lapses in a study that allowed participants to choose which treatment they would receive, employed the services of investigators of highly questionable ethics, and exposed subjects to painful, potentially dangerous procedures on the basis of a research question devoid of a scientific rationale.

On the other hand, I know of patients and personal acquaintances who assuredly would be swayed by the negative findings of a study of coffee enemas for pancreatic cancer, who would indeed decide to put their bets on conventional chemotherapy based on its results. More to the point, such patients might save their money for a once-in-a-lifetime final vacation, competent caregivers for their remaining months, or a college fund for their kids, rather than spending it on a treatment that science has shown to be a sham.

Dr. Josephine Briggs, the current director, insists in the series that, "We are not your grandmother’s NCCAM."

A new strategic plan emphasizes studies of yoga, massage, and acupuncture, as well as supplements and natural products, rather than energy healing or distant prayer. Her $121 million budget, she notes, amounts to less than half a percent of the total budget of the NIH. Which leads me to wonder, what percentage is that of the $683 billion Defense Budget? It’s hard to even imagine.

Personally, as a taxpayer, I’m quite on board with consumer science, the kind that asks the question, "What works?" and not necessarily, 100%, why?

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