Complementary and Alternative Medicine:
Expanding Approaches to Cancer Treatment
While NCI's Office of Cancer Complementary and Alternative Medicine (OCCAM) is only 6 years old, it embodies a spirit of struggle with cancer that goes back to the early days of NIH in the 1940s, and ultimately to traditions in China and other cultures. NCI is not alone in pursuing the many possibilities of nutritional approaches, botanicals, herbal products, and interventions, such as yoga and acupuncture for the treatment of cancer symptoms and side effects of treatment.
Many of the major cancer centers in the United States have a formal program or center in CAM, which is also known as integrative medicine. Partnerships with and program funding for integrative research centers, at the University of Texas M. D. Anderson Cancer Center, Memorial Sloan-Kettering Cancer Center, and the Dana-Farber Cancer Institute, for example, illustrate that good medicine yields meaningful clinical results.
"NCI created OCCAM in 1998," says Dr. Jeffrey White, director of OCCAM. "We have a big job to do, but fortunately we have many partners. We work with several other NCI programs to expand NCI's ability to extend its search for effective therapies into areas outside the mainstream of conventional biomedical research."
"We also support research and information products which explore the potential value of integrating aspects of general health promotion, such as diet and exercise, into the therapeutic prescription for cancer patients," continued Dr. White.
A recent example is NCI's Selenium and Vitamin E Cancer Prevention Trial (SELECT), the largest study ever conducted on prostate cancer prevention. NCI dollars are being invested to study specific nutritional therapies which appear to reduce risk by as much as 60 percent (selenium) and 30 percent (Vitamin E). Also, only a large clinical trial like SELECT can provide the kind of data that individuals from both the East and the West respect.
From less than $30 million in FY 1998, NCI's CAM research portfolio has grown to $129 million in FY 2004, which goes to more than 400 projects in the form of intramural projects, grants, cooperative agreements, supplements, or contracts. Recently, several aspiring CAM researchers attended a workshop in Bethesda, Md., to learn how to win such support for their own projects.
Dr. Wendy B. Smith, OCCAM's deputy director, noted that CAM cuts across disease types and has a role in cancer prevention, diagnosis, and treatment, as well as in managing the side effects of conventional cancer treatments and enhancing the quality of life of cancer survivors.
Dr. Smith also serves as director of the office's Research Development and Support Program. "Emphasizing methodology is crucial because it can provide a solid foundation for the field. CAM research can be just as rigorous as any other," she explained. "Unfortunately, the debates often revolve around methods, not results."
Dr. Lorenzo Cohen, who directs the Integrative Medicine Program at M.D. Anderson, agrees. He works with faculty from multiple departments there and collaborates with other Texas institutions. Recently, he led an OCCAM-supported project to create the International Center of Traditional Chinese Medicine for Cancer, a partnership between M.D. Anderson and the Cancer Hospital at Fudan University in China. "Many of our drugs come from the Chinese pharmacopeia," said Dr. Cohen, "and we hope open communication and exchange of ideas will allow Western practitioners to learn about concepts of traditional medicine while exposing Chinese practitioners to our approach to clinical research."
Another of OCCAM's areas of interest is the mind-body connection. Dr. David Rosenthal, past president of the American Cancer Society (ACS), became the first medical director of Dana-Farber's Leonard P. Zakim Center for Integrated Therapies. "There's no question that the mind-body programs increase a person's sense of well-being and relaxation, thus making them better able to tolerate and accept their therapy," he said.
Dr. Rosenthal became an advocate for CAM, and his involvement accelerated while at the helm of ACS. He continues to advocate for the inclusion of evidence-based CAM into U.S. medical practice in his current position as president of the Society for Integrative Oncology.
For more information on NCI's activities in CAM, funding opportunities, and upcoming workshops, see http://www.cancer.gov/cam.
By Addison Greenwood