At an American Cancer Society meeting, researchers present evidence of the efficacy of non-standard treatments.
By WES ALLISON
© St. Petersburg Times, published March 28, 2000
TAMPA -- Maitake mushrooms may incite the immune system to kill cancer. PC-SPES, a blend of Chinese herbs and saw palmetto that's widely sold over the Internet, seems to drive prostate cancer cells to kill themselves. And acupuncture can ease nausea in chemotherapy patients.
After decades of being relegated to the fringes of American medicine, alternative treatments are gaining new respect, and research dollars, in cancer care.
The latest proof of the new standing held by treatments that might once have been considered downright wacky came Monday in Tampa. For the first time in the event's 42-year history, the American Cancer Society presented a full panel discussion on alternative medicine at the annual science writer's conference.
And while leading oncologists at the conference were quick to note that many herbal or "natural" over-the-counter medicines are ineffective, and sometimes dangerous, they agreed that others deserve a closer look.
They also acknowledged that the push for better research has been driven largely by the demand of cancer patients, who increasingly are seeking alternative treatments in the media and on the Internet.
Recent studies by the American Cancer Society show that as many as 75 percent of cancer patients use some sort of alternative medicine, in addition to standard treatments such as chemotherapy. And many don't tell their doctors, although they should.
"So many people are in fact using them, it is important for us to determine to the best of our abilities which ones are helpful and which ones are not," said Dr. Gerald L. Woolam, president of the American Cancer Society.
"We want to get it out in the open, and we think those treatments should be subjected to the same sorts of standard analysis as other treatments."
Oncologists cite increasing evidence that some alternative treatments are helpful when used in conjunction with traditional therapies, and Monday's guest researchers didn't disappoint. Dr. Abraham Mittelman, associate professor of medicine at New York Medical College in Valhalla, presented evidence that PC-SPES, a popular supplement typically bought over the Internet, helps to thwart prostate cancer.
He based his findings on research in test tubes, in mice and in a small group of cancer patients who were taking it. PC-SPES consists of eight Chinese herbs and saw palmetto that somehow work together to attack the cancer.
"What happens with the tumor is that it commits suicide," he said. "There is still a great deal unknown about PC-SPES (but) it is effective. There's no doubt in my mind."
In the laboratory, the herbs also seemed to have similar effects on breast cancer cells, Mittelman said. The compound may work for other cancers as well, but he noted that both breast and prostate cancer are affected by hormones.
Prostate cancer is among the most common forms of cancer, and it's difficult to treat unless it's caught early. More than 180,000 American men will get it this year, and 31,900 will die.
Prostate cancer produces antigen by-products, called PSA, that show up in blood tests. Mittelman said he began experimenting with PC-SPES after patients with falling PSA levels told him they were taking it.
The herbs also seemed to reduce the pain associated with prostate cancer, to boost patients' appetites and make them feel better overall.
But Mittelman stopped short of recommending that patients begin taking PC-SPES without first talking with their doctors. It's expensive, at about $85 for a 10-day supply, and can cause potentially serious side effects, including blood clots in the lungs.
More study also is needed to determine the long-term effects and the proper dosage, and Mittelman is seeking approval for a controlled clinical trial that would involve about 35 men.
The American Cancer Society's medical director said provisions should be made for faster, more efficient testing of some alternative therapies, such as PC-SPES.
More successful research could also mean more headaches for state officials and ranchers who have been fighting an increasingly difficult battle against palmetto poachers. The berries, which are used in several advertised prostate treatments, have at times fetched more than $3 a pound, sparking widespread reports of trespassing and illegal harvesting on state and private lands.
Also Monday, Dr. Lixing Lao, an assistant professor in the complementary medicine program at the University of Maryland-Baltimore, issued new research showing that electro-acupuncture at the wrist or behind the kneecap can help relieve nausea, one of the worst side effects of chemotherapy.
Anti-nausea drugs don't always work, he noted, and often carry their own sickening side effects. Electro-acupuncture, which stimulates certain nerves with a slight electric charge through a needle, appears to work best when used in conjunction with very low doses of anti-nausea drugs. He is leading a large clinical trial scheduled for this year.
And Dr. Denis R. Miller, a respected oncologist and hematologist and former chairman of pediatrics at Memorial Sloan-Kettering Cancer Center in New York, also presented evidence of the curative effects of another timeworn Asian remedy: the maitake mushroom, a large fungus similar to the shiitake that tastes a bit like roasted chicken and that has been used as Chinese medicine at least since 200 B.C.
Citing his own research as well as studies in Japan and China, Miller said sugars within the maitake mushroom apparently stimulate the "soldiers of the immune system," which then attack and kill cancer cells.
But again, as with many alternative therapies, Miller said good clinical trials in people are lacking. The mushroom or its extract, which is sold at most health food stores for about $30 for 60 pills, doesn't seem to have any dangerous side effects, but its benefits aren't fully proved, either.
This budget year, the National Institutes of Health elevated its Office of Alternative and Complementary Medicine to a full-fledged center, like the National Cancer Center, and its budget has jumped from about $25-million to $75-million within the last three years.
The American Cancer Society also spends $3-million to $4-million on research and education about alternative medicine, compared with virtually nothing just five years ago.
Dr. Harmon Eyre, the society's medical director, said provisions should be made for faster, more efficient testing of some alternative therapies, such as PC-SPES.
He noted that another study released Monday illustrated the danger of relying too much on a treatment that may seem like a good thing, but isn't proved: High doses of vitamin C, enthusiastically touted in some quarters as a cure for cancer, actually may make it worse.
That research paper, presented by Dr. David W. Golde, physician-in-chief at Memorial Sloan-Kettering, indicated that cancerous tumors seem to have a capacity for absorbing vitamin C. High doses may feed the tumor, as well as block radiation treatments from reaching it.
"The public is using these therapies, and doctors don't know it," Eyre said. "We need to do research more rapidly."