Prof. Donald Weaver wrote an interesting article
(Chemistry International, January 2000, Vol. 22, No. 1, pp.
1113), wherein he took to task a number of alternative medicine
practices. In particular, he cited a number of instances from his
own experience where patients ignored standard medical treatment for
alternatives that led to their death or serious complications. In
the cases he wrote about, it was clear that the patients made very
poor choices. However, there are two areas of what some may consider
alternative medical practices where the evidence of their benefit
is quite clear.
The first of these is the research by David Spiegel,
MD, who showed unequivocally1
that psychotherapeutic support groups can
have beneficial effects on both the mental and physical well-being
of the patient. Because the readers of CI may not be aware
of Spiegels research, even though his seminal paper was published
over eleven years ago, I will briefly summarize the work of his group
and its outcomes. Spiegels initial thesis was that a psychotherapy
support group would probably be helpful in easing the burdens of cancer,
but would have no effect on the physical outcomes of the disease.
They enrolled 87 women who had fourth-stage metastatic breast cancer.
Fifty women were in the intervention group and 37 in the control group.
All of the women continued to receive whatever medical treatments
their doctors recommended. The women in the support group met weekly
for one year. They were taught self-hypnosis for pain control, they
could share whatever they wished during the meetings, were encouraged
to communicate with group members outside of the meetings, and one
of the group leaders was a woman who had breast cancer that was in
remission.
The ten-year follow-up showed that all of the
women in the control group died, and that their average length of
survival from the beginning of the study was 18.9 months (SD = 10.8).
Three of the women in the support group were still alive ten years
later. The 47 women in the support group who died had lived an average
36.6 months (SD = 37.6) from the beginning of the study. This work
has been replicated and shows that a psychotherapy support group can
have a significant effect on the longevity and quality of life of
cancer patients.
The important question here, given the evidence,
is the following: "Why does not every oncologist prescribe group
psychotherapy for his/her patients?" These support groups are
probably more effective than any of the "standard"
treatments for fourth-stage metastatic breast cancer. Although there
is little evidence for special diets and herbs for helping people
with cancer and cardiovascular disease, there is a great deal of evidence
that Dr. Dean Ornishs regimen of low-fat diets, support groups,
exercise, and meditation2
has a profound effect on the course of cardiovascular
disease. Please note that Dr. Ornish does not recommend one diet,
but a total lifestyle change in several areas. Ornishs work
has stood the test of time, even though scoffers have pushed it aside
as one of those alternative things. Again, the question is as follows:
"Why doesnt every cardiologist encourage his/her patients
to follow this regimen?"
My new book3
cites the scientific evidence for mind/
body interactions for healing, and emphasizes a multi-modal approach
to working with people who have life-challenging diseases. An important
question is this: "How much does the placebo effect contribute
to both traditional and alternative medicine?" A major
component of all double-blind studies is to separate out the ever-present
placebo effect from that of the "active" ingredient or treatment.
The placebo effect is always significant, and there is a vast literature
on it. (A summary of the placebo effect is in Chapter 4 of Reference
3.) Any alternative work, of course, should always be done in cooperation
with medical doctors. As scientists, we need to be skeptical and
look for scientific proof--such proof is available for the two "alternative"
approaches described above.
References
1. D. Spiegel, J. R. Bloom, H.
C. Kraemer, E. Gottheil. Effect of psychosocial treatment on survival
of patients with metastatic breast cancer. Lancet 2, 8668,
888891 (1989).
2. D. Ornish. Dr. Dean Ornishs
Program for Reversing Heart Disease, New York: Ballantine Books
(1991).
3. R. Battino. Guided Imagery
and Other Approaches to Healing, Crown House Publishing, April
2000. Sincerely yours,
Rubin Battino, Professor
Emeritus of Chemistry
MS, Mental Health
Counseling
Associate Member, IUPAC Commission on Solubility Data (V.8)
Department of Chemistry, Wright State University, Dayton, Ohio