A DIFFERENT WAY TO HEAL?
John Angier and David Huntley
"Today there's growing interest in a branch of medicine that many doctors don't consider medicine at all," says Alan Alda in "A Different Way to Heal?". The program, which aired Tuesday, June 4, 2002,8-9 p.m. on PBS, puts "alternative" or "complementary" therapies to the test.
Acupuncture, herbal medicine, chiropractic and therapeutic touch are part of a booming, multi-billion dollar industry. But do they hold up under scientific examination? Retired Stanford Medical School oncologist Wally Sampson, editor of the Scientific Review of Alternative Medicine, tells Alda that the scientific basis of healing is establishing cause and effect. Most people recover from illness spontaneously, yet people often incorrectly attribute their improved health to whatever therapy they tried just before getting better.
Sampson and Alda visit a Chinese herbal medicine shop and a health store selling hundreds of loosely-regulated "nutritional supplements." Sampson points out that traditional herbal remedies and popular supplements--like Echinacea for colds or IP-6 for cancer--have either never been scientifically studied, or have shown equivocal effects at best.
In the mid 1990's, researchers at the University of California, San Francisco attempted to conduct a clinical trial of PC-SPES, a nutritional supplement that became popular as a prostate cancer remedy. PC-SPES (PC stands for prostate cancer; SPES is Latin for "hope") is a mixture of eight traditional medicinal herbs--seven Chinese, one American. Initially, patients in the trial showed dramatic improvement, but suspicion grew that the remedy had been laced with DES, a synthetic hormone that is a standard prostate cancer therapy. Lab analyses revealed traces of DES, although the UCSF team was unable to say what medical effect, if any, it might have. Nevertheless the trial was halted, and PC-SPES is now off the market.
The PC-SPES story demonstrates the difficulty in getting scientifically rigorous results with herbal remedies. An herbal mixture may contain hundreds of different chemicals, and it's hard to know which ingredients might be active--or even what they are. Although PC-SPES might still be useful, we may never know for sure--and that's true of most herbal remedies.
A healthy dose of skepticism led John Badanes, a qualified and experienced chiropractor, to leave his field. Invented by Daniel Palmer in 1895, chiropractic aims to correct blocked nerves--what Palmer claimed were the cause of all disease--with "adjustments" to the spine. But, as Badanes tells Alda, chiropractic has no basis in anatomy. Conducting a typical examination, Badanes shows how a simple error can lead a chiropractor to assess that a patient's legs are different lengths, requiring chiropractic adjustment to bring them into line--even though that's anatomically impossible. Badanes explains how patients and chiropractors alike misinterpret the popping sound that accompanies spinal manipulation. Really it's dissolved gas being released in the joint fluid (the same thing that happens when you crack your knuckles) and not a sign that vertebrae are changing position--another anatomical impossiblility. Like Badanes, physician Robert Baratz, executive director of the National Council Against Health Fraud, takes issue with chiropractic. Baratz is concerned about the risk of injury during neck manipulation, which can place severe strain on a vertebral artery, leading to blood clotting and stroke.
Although chiropractors maintain this type of injury is very rare, a recent Canadian study estimated that 20 percent of all strokes caused by artery damage could be a result of neck manipulation. That figure translates into more than 1,300 strokes a year in the United States.
Perhaps the most widely accepted alternative therapy is the ancient Chinese practice of acupuncture, although the scientific jury is still out on its efficacy.
In animal studies, John Longhurst, Chief of Cardiology at the University of California, Irvine Medical Center, found a link between acupuncture and the release of natural opiates in the brain, which reduced the animals' reaction to stress, suppressing blood pressure. Now he's trying to find out if the same is true for humans, but results so far are hard to interpret.
Subjects pedal on an exercise bike until they're exhausted, when their blood pressure reaches its peak. Subjects who got acupuncture before exercising showed significantly lower peak blood pressure than those who did not--even though some of the acupuncture points used in the trials weren't supposed to affect the cardiovascular system. Longhurst believes that acupuncture--and most alternative therapies--works by turning on the body's own opiates.
At Columbia-Presbyterian Hospital in New York City, researchers have studied therapeutic touch, an increasingly popular alternative therapy whose practitioners claim to remotely manipulate people's "energy fields." The study looked at patients recovering from heart bypass surgery. Some received treatment from therapeutic touch practitioners, some received a sham treatment and some received nothing. The same treatments were given to cancer cell cultures, but no identifiable effects were seen anywhere.
In 1996, a science project by 11-year-old Emily Rosa cast doubt on a fundamental principle of therapeutic touch--the ability to detect another person's energy field. With therapeutic touch practitioners unable to see what she was doing, Rosa placed one of her hands near one of the practitioner's hands--and asked them to state which of their hands she was near. Practitioners' success rates were no better than pure chance. Rosa's study was considered rigorous enough to be published in the Journal of the American Medical Association, making her the youngest author to appear in its august pages.