A few CAM treatments have demonstrated at least modest results. Massage shows promise for relieving postoperative pain. It was once part of routine postsurgical care, in fact, but was gradually shelved as other demands on nurses' time took priority. And studies demonstrate that acupuncture is somewhat effective at relieving nausea from chemotherapy or surgery and discomfort from dental procedures. It is used at Memorial Sloan-Kettering Cancer Center in New York, among others, for relief of chemotherapy-related nausea, and at many centers for chronic pain—from arthritis, for example.
Damaged and arthritic knees drove Joan Pettit in 2006 to see an acupuncturist at the University of Maryland School of Medicine Center for Integrative Medicine. The 51-year-old suburban Baltimore resident had been a competitive athlete from her high school days and played tennis until about eight years ago, when both knees would swell and throb painfully. "I'm always looking for something that doesn't have serious side effects," says Pettit, "so the idea of trying acupuncture was very appealing."
The pain and swelling lessened somewhat, and Pettit, a lawyer, returned for repeat sessions—partly, she admits, because they were so soothing: "It's a very pleasant experience. You lie down, they put a nice warm lamp on you, you fall asleep for half an hour, nice music." But she knew the acupuncture was treating the symptoms, not the cause, and she would ultimately face knee replacement. "I still think it gives some pain relief when there's a flare-up," she said last month, "but I've given up. I'm having replacement surgery in April."
Varied results. Disconcertingly, some of acupuncture's claimed successes seem related to the nationality of study authors. A 1998 analysis of 252 published trials found that 51 of the 52 studies conducted by researchers from Asian countries, where acupuncture is uncontroversial, were positive—a 98 percent success rate. Only 53 percent of the trials run by U.S. investigators showed success, and the rate plummeted to 30 percent in studies involving Canadian, Australian, and New Zealand researchers.
Herbals and dietary supplements are getting considerable attention from researchers, and they're employed at Maryland's integrative medicine center and the Osher Center for Integrative Medicine at the University of California-San Francisco, among other academic hospitals. The effectiveness of most herbal remedies and supplements is largely an open question, and there are issues of toxicity, side effects, and interaction with other medications. Actual dosages in off-the-shelf herbal medications and supplements often are far different from those shown on the label, and the pills may be tainted with heavy metals such as lead and mercury. Yet many of today's powerful medications, among them aspirin, statins, and anticancer drugs, were originally unearthed from trees, fungi, and other natural sources. NCI-backed CAM projects include a test of a six-herb combination, used in traditional Chinese medicine, for its ability to prevent lung cancer, and addition of mistletoe extract to chemotherapy to treat solid tumors.
Yoga, a physical activity, has understandable benefits for cancer patients, in whom it helps restore strength and flexibility to muscles weakened by treatment. Alicia Chin has been taking a weekly yoga class for cancer patients at the Osher Center. "Yoga reteaches the muscles how to work, and it makes me feel good," says Chin, a 46-year-old San Franciscan. She had a lumpectomy and had two lymph glands removed last March, followed by radiation, and now is enrolled in a clinical trial of a new chemotherapy regimen. "You get all these drugs pumped into you, you don't want to do anything," says Chin, a paralegal. She still doesn't have the strength to reach up and paint a ceiling, as she puts it, "but it really makes a difference."