Many oncologists are barraged with questions
and declarations from patients regarding therapies and products that
are available from drug or health food stores or other unconventional
sources. Individuals faced with a potential life-threatening problem
often explore their options by consulting friends or the Internet and
are often promised wonderful results from treatments with which
physicians are unfamiliar.
Already overwhelmed by stacks of medical literature dealing with
conventional medicine, however, few physicians have the time or
energy to delve into the science of alternative and complementary
medicine. The Alternative Medicine Handbook: The Complete Guide to
Alternative and Complementary Therapies promises to provide a
quick, easy-to-read overview of therapies that are popular or gaining
popularity, and it succeeds in fulfilling this mission. It also gave
this reader an unpleasant reminder of just how susceptible the
general population is to believing advertisements and quick promises.
The author, Dr. Barrie Cassiletha professor of medicine who
serves on the Advisory Council of the National Institutes of Health
(NIH) Office of Alternative Medicinedivides her book into
alternative and complementary therapies. Not all therapies that are
thought to fall under the heading of alternative medicine are truly
alternative. Alternative therapy is prescribed instead of
conventional medicine, while complementary therapy is used to
supplement conventional treatment. The alternative therapies tend to
be unproved and can sometimes be dangerous.
The book is divided into seven sections: spiritual healing
approaches, dietary and herbal remedies, mind-body medicine,
alternative biological treatment, bodywork therapies, sensory
treatment, and the use of external energy forces. Each chapter within
each section addresses a different therapy, providing a historical
overview and some scientific background on that therapy and
attempting to place it within the spectrum of potential medical
management of cancer.
As some therapies are not easily categorized, however, there is some
overlap of material within the book. Furthermore, this is not the
book to use if one is searching for data on clinical trials of
treatments; rather, it provides capsule summaries of known information.
The author avoids making judgments about the various therapies, but
rather, offers objective commentaries on what is known. Such an
approach is useful when one wants to photocopy a chapter for an
inquisitive patient. The photocopied chapter can then provide a
jumping-off point for a discussion between physician and patient.
In addition, the book offers several very useful resources, including
a list of vitamins and minerals, their functions, recommended doses,
signs of deficiency and overdose, and the need for supplementation.
Licensure and professional organizations are listed at the end of
each chapter, so that further information on treatment or qualified
practitioners can be obtained. The index and glossary also increase
the books value as a resource.
Specific chapters deserve further mention. In the chapter on herbal
medicine, a list sizes up the different herbs that are available or
touted in health food stores, with their potential effects on
disease. However, while the chapter provides little scientific data
(the author notes that the quality of many studies is poor), it does
include tables that warn of potential dangers.
In addition, I found the chapter on dietary therapy to be
particularly helpful. Several of my patients are on vegetarian and/or
macrobiotic diets, and this chapter provides a short overview on
I also learned about homeopathy, which uses the approach of treating
like with like. For example, vomiting and
diarrhea are treated with a very dilute substance of an herb,
mineral, or other substance known to cause vomiting and diarrhea (an
approach akin to inoculation). Most of these solutions are so dilute
that a bottle may contain only one potentially effective molecule,
however. A quick scan of a shelf in a health food store allows one to
see just how easily consumers can be duped.
Complementary therapies are also discussed. Some of these, such as
yoga, massage, tai chi, biofeedback, acupuncture, and various
hydrotherapies, may be familiar to clinicians. I was aware of, but
not particularly familiar with, other complementary therapies
described in the book, including rolfing (structural therapy),
craniosacral therapy, reflexology, pure chiropractic medicine, and
Alexander techniques. Having read this handbook, I now have increased
insight into these therapies when my patients discuss their use.
In summary, I applaud Dr. Cassileth for completing a fair,
well-organized text. This book is not the ultimate source of
information with which to judge the scientific merit of alternative
or complementary therapies. Instead, its accessible, short chapters
represent a useful resource for busy physicians, as well as
information-hungry patients. Ultimately, patients interested in these
approaches should be encouraged to enroll in clinical trials, such as
those currently evaluating retinoids, shark cartilage, and melatonin.