Letter 46: January / February 2006

The end of 2005 and beginning of 2006, started with three shocking news reports. Out of the blue, a Dr. Liew was killed after a 720 kg cement mould fell from a building onto his car. Then, a “death” of different kind occurred in Korea. A Great Korean Scientist fell out of grace due to his fraudulent research. He admitted to the “cooking up” of his research data that had earned him great glory. Back in Malaysia, a scholar, intellectual and head of the government’s think tank, ISIS, Tan Sri Nordin, died of cancer. He was only 61 years old. That is just about my age.

It is sad to learn that many unfortunate things happened. Such episodes brought to light many messages:

• Life is so full of uncertainties – nothing is permanent.

It does not matter if you have cancer or not, we need to know that we don’t live on this earth forever. We are just temporary guests in this world. At any time we may be called “home”. But where is home? Do you know where you are going? Are you prepared or have found a home to go to? Such questions are hard to face. Some of us would prefer to ignore them entirely.

I can say this to you: To a great extent, to get sick or to stay healthy can be your choice but the same cannot be said about life and death. Unfortunately, to live or to die is not for us to decide or chose. Therefore friends, let us live life a day at a time. Let us lead a life full of compassion and love so that when we leave this world we do so with dignity, with no regrets. To cancer patients, I have this to say: Live your life the best you can and don’t worry too much. You don’t have to die from your cancer as yet. There are others who don’t have cancer and yet they still die – sometimes much sooner than you.  Remember that the day we are born, we are destined to die. This is a fact of life. Therefore, the challenge while we are still alive is to live a useful and meaningful life. Not to do so would be a tragedy and a failure.

• Manipulating and fabricating of research results.

Some thirty years ago, I was a raw and naïve graduate student. Scientists are men of great intellect. They are supposed to be honest and full of integrity. That was my perception then. When I took a course at Ohio State University, Professor Platt shattered that myth. He was an interesting professor and he did not teach us the physiology that he was supposed to teach. He came to class and talked about the great scientists and authors of books – their personalities and how some of them cheated in their efforts to become famous. So, cheating in science happened more often than we care to know.

On 17 January 2006, the BBC News carried another report of a cheating case. This one happened in Oslo, Norway involving a cancer expert. Dr. Jon Sudho reported about his study using totally false, totally fabricated data and publish his findings in the highly respected medical journal – the Lancet in October 2005. The author faked his data and concluded that long-term use of non-steroidal anti-inflammatory drugs could reduce chances of oral cancer. Dr. Richard Horton, the editor of Lancet wrote: Just as in society you cannot always prevent crime, in science you cannot always prevent fabrication.

When I read books about medical research, I learnt about ghost writers. In my 26 years of academic life I have never learnt about it. It is only after I read about research papers published by doctors in medical journals that I learnt about such practice – which seems perfectly alright and perfectly acceptable? Ghost written papers are actually not written by the doctors themselves. They were written by certain Ph.Ds. hired by the drug companies. It was said that these ghosts are paid up to US$30,000 for each article published in prestigious journals. They will write what the PR department of the drug company wants them to write and then pass on the articles to have certain doctors claim their authorship.

The misdeed in the case of the Professor in Korea is easy for us to understand. He had successfully cloned a dog. That made him the first person in the world to have been able to do that. Indeed he was a cloning genius. The government and the press played up this success and he became a National Hero. Fame and success went into his head and he wanted more of such glory. Since he had the world under his feet it was easy for him to cheat. He was said to have fabricated his results on the cloning of human embryonic stem cells –  the current hot potato in the medical world.

Ghost writing of articles may not appear “so bad”. I think it is unethical and dishonest but some people say it is more than that –  it is “professional prostitution”. You never do the research and you never write the article, but you allow your name to be used as the author of the article. You make use of your fame to collect a handsome “fee” for such “service”. By so doing, you misrepresent yourself and your science and give the impression that you are doing the work. The budding and naïve readers in your profession believe the report. From the mass media, I have often read about people “parroting” that their medicine had undergone peer-review and their research has been published in journals. I am not too sure if these “parrots” really know the “politics” of it all. The “honesty and integrity” of peer-reviewed journals have, all too often been abused and violated. 

The practice and standard of morality and integrity vary from people to people. What is wrong to some of us can be perfectly alright to some other people. However, I would like to live by a higher moral and ethical standard if I can. George Orwell once said that Omission is the greatest form of lie. Omission, my dear friends, means failing to tell you what you need to know. To put it more bluntly –  failing to tell your patients what they ought to know, failing to tell patients what you know, is according to Orwell the greatest form of lie.

To me, if I know that the treatment is causing more harm than good, and I deliberately keep that knowledge away from patients, then I am lying. If I know that I cannot help or cure the problem, but I still pretend that I know and keep giving patients more herbs just to earn extra bucks then I would be cheating. It is up to each individual to accept the moral standard set by Orwell. In my work with cancer, I felt the necessity to uphold this moral standard.

• Cancer killed many people – why is this so?

Not too long ago, Malaysians grieved over the death of the wife of our beloved Prime Minister due to cancer. Now, I am sad to learn of Tan Sri Nordin’s death – also due to cancer. These days, even with the best of medical treatments, do we still have to die of cancer? I just wonder what is happening. What has gone wrong? Is there any scapegoat? The words of a well known surgeon, Dr. Bernie Siegel, rang clearly in my ears. He wrote: Too many doctors are depressed because they only see their failures – all you know is that everyone has cancer, everybody dies. And it just wears you out.

I wonder how many see the outcome of cancer treatments the way this prominent US doctor saw it ?  I wonder how many people have the guts or integrity to admit like Dr. Siegel, that they have failed?

The reality today is that people have cancer, people die. Can we just take a pause and ask:  WHY?

• Do cancer patients die because the world is short of chemo-drugs?
• Do patients die because there are not enough oncologists?
• Do they die because there are no hospital beds for them or there are no adequate facilities?
• Or do they die because the treatments they undergo were not effective? In other words, we have not found a good enough way to “cure” cancer?
• Are we sure that what we have been assuming all along, that the “good enough” method of curing cancer, is actually good enough? Or is it just an illusion?

The Cancer War Game

For over a decade, I learnt and saw the Cancer Stage Show. A chill always goes through my spine when I think about these questions: Are We Winning the Cancer? Why Are We Loosing the Cancer War? Are We Really Interested to Win the Cancer War? Are We Really Interested to Prevent Cancer Coming into our Lives?

Sometimes, I cannot help but begin to feel that everything is only a game – a big cruel joke, leaving many of us – the educated and the uneducated, the rich and the poor, the meek and the strong, in the lurch. In my letter No: 37 of August 2004, I wrote about why Americans have lost the Cancer War. I quoted Clifton Leaf, CEO of Fortune Magazine: The question is:  are we truly winning the cancer war? Leaf said: We're not. We are far from winning the war against cancer.

Frustrated Doctor Poured Out His Concerns

The Star of 28 October 2005 featured a letter by Frustrated Doctor, who worked in a Government Hospital in Melaka. He said that he was frustrated with the attitude of cancer patients because they headed straight to the traditional healers after being diagnosed with cancer. Frustrated Doctor claimed that government hospitals may be fully equipped with the latest technologies for the treatment of cancers but patients do not come to the hospitals! What makes the situation worse, according to Frustrated Doctor, is that some of such patients are professionals. The culprit, according to Frustrated Doctor, is that traditional healers have such a strong influence that is hard to break. Then he started to bash the traditional healers. The Government should set a precedence by taking legal action against such people who make false claims.

Frustrated Doctor lamented that the treatment of cancer is extremely affordable in Government hospitals. The cost of an operation for breast cancer is less than RM 1,000; the cost of six cycles of chemotherapy is RM 300 and the cost of radiotherapy is RM 500 only.

According to Frustrated Doctor all the medical advancement and development have failed to make a big impact to the treatment of cancer in Malaysia. We are still seeing patients with late and advanced stages of cancer.

The message expressed by Frustrated Doctor appears to be that doctors get cancer patients too late, because patients go to traditional healers first. These traditional healers need to be sent to jail and by doing that it will allow doctors to cure cancer!  Such rash logic indeed portrays the ugly side of medicine. I fully agree that some (or even MANY) traditional healers are unethical and do make false claims. Some tell lies and some cheat their patients. But, I tend to think that ANYONE – doctors included, who claims that he/she can cure cancer is equally guilty of making false claims. The fact is no one on earth can guarantee a cure for cancer. By cure, I mean real CURE not temporary remission which offers the possibility of recurrence.

Following the logic of Frustrated Doctor, traditional healers must be jailed for wasting patients’ chance of a cure by delaying medial treatment. Take note, the sin here is for delaying medical treatment. Let me turn the table around. What would Frustrated Doctor say if a patient goes to him immediately for medical treatment and within a year or two while still undergoing treatment with him, the patient dies? In this case, would the doctor be guilty of causing the death of his patient? There are enough examples and documented literature to say that for cancer, often the treatment is the cause of death not the cancer itself.

Let me illustrate my points with the following stories:

Story 1: Since Frustrate Doctor is from Melaka, let me highlight a breast cancer case that occurred in his own backyard. Mei (not real name) was a 34-year nurse. She was diagnosed with breast cancer in August 2003. She underwent a mastectomy, six cycles of chemotherapy with FAC, followed by radiotherapy. Then Mei was started on Tamoxifen. Does this not sound like the familiar standard recipe for breast cancer?

Frustrated Doctor seems to forget that when all is done, the story does not normally end there. It may just be a beginning of a long adventure of agony. Dr. Lau Gi-ming, an oncologist at the Taiwan National Research Institute wrote: The thing that most frustrates modern doctors is that, after surgery, chemotherapy and radiotherapy, all they can do is keep chasing and chasing the cancer.

Barely eight months after her treatment, Mei suffered a relapse. There was a mass in her sternum and multiple nodules in her lungs. Mei underwent chemotherapy again. After five cycles with Taxol, chemotherapy was terminated because it was not effective. The cancer spread to her collarbone. Mei was given another cycle of chemotherapy with Navelbine. After one cycle, the treatment was abandoned because of severe side effects.

In April 2005, Mei was given an oral-chemo drug called Arimidex. She had radiotherapy again. In spite of the treatment the swelling in her right collarbone grew bigger. The use of Arimidex was discontinued because it was not effective and was replaced with Xeloda. In June 2005, Mei developed right pleural effusion. About 5.5 liters of fluid was tapped out of her lungs. In September 2005, Mei died (i.e. about 2 years after being diagnosed with breast cancer).

Let us learn some lessons from Mei’s experience.  She was a nurse and she did what she was supposed to do. In fact, Mei’s boss (a doctor), gave her a book on herbal therapy. She ignored it. So in Mei’s case, there is no scapegoat. All the weapons available to medicine were used on her. In spite of that she died.

Story 2: Hoon/t342, is a 41-year-old female. She was diagnosed with Stage 1 left breast cancer in May 2001. A wide excision and axillary clearance were done after which she underwent both radiotherapy (29 times) and chemotherapy (6 cycles). After that she was on tamoxifen, 20 mg daily for three years until her relapse. She was well until March 2005 (note: well, but not cured!) when she developed chronic non-productive coughs. A chest X-ray and CT scan showed recurrence of the breast cancer in both lungs. Hoon underwent chemotherapy again (11 cycles). Unfortunately a CT scan on 9 January 2006, showed that the treatment was not effective. In the lungs, the previously noted nodules have enlarged to 2.5 cm and 3.5 cm in the right lobe with 1.0 cm nodule in the left upper lobe. Then there was also an enlargement of the mediastinal and hilar adenopathy, ranging from 2.0 cm to 8.5 cm.

Take note: A Stage 1 breast cancer cannot even be cured by surgery, radiotherapy, chemotherapy and tamoxifen. Are these treatments not the standard modality that each and every breast cancer patient went through? What has gone wrong? The family spent about RM 30,000 for the first round of treatment, and another RM40,000 for the second round. Her husband said (at the same time showing me Hoon's photograph before she was ill):  Before the treatment my wife's face was so nice and pretty. After the treatment it is so round due to the swelling. I have spent so much money and she ended up like this. 

Story 3: This is an e-mail received on 20 January 2006.

Hi, Dr Teo,

My sister has lymphoma cancer. She had gone through two times of chemotherapy. The first time, she was able to cope. However, a week after the second chemotherapy, she had to go back to X Hospital, Kuala Lumpur for help. The doctor wanted to admit her into the hospital immediately. This was because her white blood cell dropped to only 0.5. The second day (18 January 2006) she had fevers, but later it was brought under control. However, on Thursday (19 January 2006) she was infected with coughs again. And currently she felt cold and hot all the times –  her condition was not stable. She cannot eat because she would vomit out all the food that she took. She also suffered pains in her bone –  throughout her whole body, from head to the legs. What can I do to help her,  to give her some relief from the cancer treatment?

Please advise. Thank you.  …. Regards,   S K.

Story 4: Choo/t189, is a 62-year old lady. In September 2004, she passed out blood in her stools. Subsequent check up indicated colon cancer. Choo underwent an operation followed by 25 times of radiation to the lower part of her abdomen. She suffered severe “burn” as a result of her treatment. A blood test on 28 March 2005 indicated elevated liver enzyme values: GGT = 60.0 High, AST = 43 High. In view of this, her family doctor recommended that Choo seek our help. Choo was prescribed liver herbs in addition to herbs for her colon cancer. A month on the herbs, Choo’s liver enzymes were restored to within normal range: GGT = 47, AST = 37.

In September 2005, Choo had difficulty passing urine. Subsequent examination showed that her left kidney was “damaged”. A tube had to be inserted to help discharge her urine. In December 2005, the tube was removed. Choo’s daughter called on 20 January 2006, saying that her mother felt burning pains in her private part. We wondered if this could be due to infection. We suggested that Choo see her doctor and find out what had actually gone wrong again.

Story 5: Poh/t 296, 54-year old female, had a 14 cm tumour in her distal sigmoid colon. She underwent surgery. The cancer was staged as Duke’s C. About two weeks after surgery, Poh underwent twenty-five times of radiation treatment and at the same time took the oral chemo-drug, Xeloda. Within a week after being on Xeloda, Poh became uncomfortable, her heart beat rapidly and she had difficulty breathing. The doctor stopped her Xeloda and replaced it with UFT. Before Poh could even finished a course of UFT,  her legs started to weaken and her entire person lost strength. She could not walk and had to be confined to a wheelchair. MRI  of her brain did not show any evidence of metastasis. There were, however, disc bulges at C5/C6, L3/L4, L4/L5 and L5/S1. This was diagnosed as lumbar spondylosis.

Poh’s husband and son came to seek our help on 4 November 2005. With tears in his eyes, he related his wife’s story.

He said: After the surgery, my wife was alright. She was normal – she could walk around perfectly, could eat and do

the normal chores in the house. It was only after she started radiotherapy and took the oral chemo-drugs that her condition deteriorated. This happened within about two months after the surgery.

Poh was indeed in bad shape. She was on morphine and had to lie down in bed unable to move by herself. If she gets up, she will feel breathless. At one time, she had to be admitted into the ICU for twelve days. The family spent about RM 50,000 for her treatment. With anger and frustration her husband said: I spent money is OK, but how could she end up like this. Poh is now a living vegetable. In total, Poh was one month in the hospital and another month in Lotus Home existing as a living vegetable. The first thing I suggested to the family is to move her out of the Lotus Home and bring her home. Take care of her diet for eating “anything you like” is never the answer for cancer. The family did exactly as told and moved Poh home the next day. Poh was prescribed Capsule A, GI1 and GI 2 and C-tea.

Note: It is not right for me to suggest that the doctor and his treatment are the causes of such misery. I know that doctors have tried their best, using the best knowledge that they know, to help cure cancer. It is just that the treatment did not work. Period. But if we must find a scapegoat for the three stories above, then who do you think are responsible?

Give Thanks for God’s Grace and Mercy: There is no doubt that I am very upset and concerned about Poh’s case.

Let me outline what happened to Poh after she started to take the herbs.

04 November 2005: Vegetable, unable to even move her head or legs. She was started on the herbs.

11 November 2005: Passed out black stools, sometimes diarrhea. First few days felt tired. Her feet cold but legs felt better. Appetite improved, more alert (or cheng sin), more oomph when talking, end of the week could walk about 10 steps. Take note: this is only about one week on the herbs.

18 November 2005: Could not feel any pain, passed out lots of stools, two to three times per day.

25 November 2005: She felt pains in her back – take note that before she was unable to feel any pain. Feeling in both legs restored. Previously, both legs had no feelings. If provided with support, she was able to hold on to it and wake up by herself. Note: previously, she was unable to even turn her head or move her legs.

11 December 2005: She could sit up for at least an hour – if too long, felt tired. Was able to get up from bed by herself. If given something to hold on, she was able to stand up by herself.

16 December 2005: Still could not walk by herself but she was able to walk slowly with help.

13 January 2006: She had more strength. She could move around the house using the walking frame. She could do all her personal chores without help – bathing, dressing, etc.

Comments: It is indeed wonderful to see God’s grace and mercy in action.  This Great feeling of satisfaction and gratitude is something that money cannot buy. We have done our lot and God poured down His mercy. He heals. We pray that many more episodes like this happen to many people. When Poh’s husband first came to see us, let me be honest – I did not expect Poh to survive or recover at all. But God works in different ways on different people. This is what we in CA Care believe in and often see happened. So, it is this Knowledge and Spirit that drive us on and on. We wish to bear witness to His Greatness. Thank you Gracious God for this wonderful healing. (Every conversation between Chris and the family members during each visit are being videotaped).

Let There Be Love and Compassion

Frustrated Doctor need not be frustrated. Some patients these days may know better than their doctors when it comes to cancer. The Sunday Star (14 Nov. 2004) reported the results of a survey by Malaysian Oncological Society involving 1,200 women in Klang valley. They were shocking: a) 80% of the women surveyed think that radiotherapy and chemotherapy are not effective and have many side effects. b) 90% would consider alternative or complementary medicine for cancer.

Many patients now read and they do not just take their doctors’ words as gospel truth any more. And if they read they may know of the following:

• Everybody knows that our present cancer drugs are lousy. Wolfgang Wrasidlo, director of drug development, Scripps Clinic, La Jolla, California.

• The existing treatments for cancer are probably the most barbaric in modern medicine. Barry Sears, Ph. D., author of Enter the Zone.    

• Our decades of war against cancer have been a qualified failure. Professor John C. Bailer II, McGill University.

• Chemotherapy is an attempt to poison the body just short of death in the hope of killing the cancer before the entire body is killed. Most of the time it doesn’t work. Dr. John R. Lee, an expert in hormone and breast cancer.

• The majority of cancers cannot be cured by radiation…because the dose of X rays required to kill all the cancer cells would also kill the patient. Professor John Cairns, Harvard University School of Public Health.

• Surgery, radiation and chemotherapy all tend to fail for a very simple reason. A tumour the size of your thumb has one billion malignant cells. Even if a treatment gets 99.9% of them, a million remain to kill you. Business Week, 22 Sept. 1986.

Having stated the above, is there any wonder why patients do not want to go for medical treatment? I believe that trying to take a simplistic view about cancer treatment is to err and trying to find a scapegoat is to display arrogance or sheer ignorance. We should practice our noble trade with compassion and there is no place for ego medicine here. Do what is right and practise what works. 

It is indeed naïve to suggest that modern technology and chemo-drug (old or new) can cure cancer entirely. I have seen many cancer patients who went to the best doctor in the best hospital using the most up up-to-date machine and drugs. They still died. In fact, I tend to come to this conclusion: the more aggressive and expensive the treatment the sooner the patient die. My comment may appear outrageous and goes against established norms. But please take note that I am not alone in coming to this sad conclusion. Professor Hardin Jones, University of California, Berkeley said:  My studies have proved conclusively that untreated cancer victims live up to four times longer than treated individuals. If one has cancer and opts to do nothing at all, he will live longer and feel better than if he undergoes radiation, chemotherapy or surgery.  Dr. Allen Levin of the University of California said: Most cancer patients in this country die of chemotherapy. Chemotherapy does not eliminate breast, colon or lung cancers. The fact has been documented for over a decade, yet doctors still use chemotherapy for these tumours.

A respected magazine in Germany, Der Spiegel of 4 October 2004, had this article: Giftkur ohne Nutzen (The Useless Poisonous Cures). This article said:  Increasingly sophisticated and expensive cellular poisons are being given to seriously ill patients … patients do not actually live a day longer.

Dr. Candance Pert is a Research Professor at Georgetown University Medical Centre, USA. She once worked at the National Institute of Health – the hot bed of medical research. In her book, Molecules of Emotion, she wrote that her father had lung cancer. He underwent chemotherapy, bone marrow transplant and radiotherapy. Dr. Pert wrote: My father died almost a year to the day after being diagnosed. Certainly, a new approach to the treatment of cancer … is desperately needed … Cancer continues to kill more people every year, often a slow and painful death made even more excruciating by toxic treatments. State-of-the-art chemotherapy … was nothing more than different combinations of the same toxic drugs given on different schedules. If my father was going to survive, I knew that a new approach, a major breakthrough in understanding and treating this disease had to happen.

For those who believe that science and technology have all the answers to cancer, may I suggest that you  read this book, Hope or Hype – the obsession with medical advances and the high cost of false promises. The authors, Richard Devo and Donald Patrick are professors at the University of Washington, Seattle, USA. This is what they wrote: We develop our own blind trust in a medical establishment that preys on our deepest fear, all the while purporting to ride to our rescue with miracle cure. The combination of industry greed, media hype, political expediency and our own techno-consumption mindset is leading more and more often to a reliance on costly treatments that are marginally effective at best – and sometimes downright dangerous.

Perhaps the world may want to take heed. Albert Einstein once said that you could not solve the problems of today by using the same type of thinking that created them. To him insanity is doing the same thing over and over again and expecting different results. I would like to believe that there are many learned and sane men in his world today.

Melaka Set the Trend for Change –  Let This Change Be Infectious!

The year 2006 indeed started with an encouraging note. According to this news report (The New Straits Times, 9 January 2006: Hospital offering alternative treatment) Putra Hospital, which is owned by the State Government of Melaka, made history today for launching a centre offering both modern and traditional medical treatment. According to the news report, the hospital is believed to be the country’s only medical facility offering alternative treatments.

Current Perceptions of Complementary and Alternative Medicine (CAM)

World Health Organisation (WHO)

According to the WHO, countries in Africa, Asia and Latin America use traditional medicine (TM) to help meet some of their primary health care needs. In Africa, up to 80% of the population uses traditional medicine for primary health care. TM has maintained its popularity in all regions of the developing world and its use is rapidly spreading in industrialized countries.

CAM in the US

The Center for Complementary and Alternative Medicine of the National Institutes of Health, USA released its report in May 2004, on the use of CAM among American adults. The report was based on 31,044 interviews. They found out that:

• 62% of adults used some form of CAM therapy. 
• Some of the common modalities were: prayer (24.4%), natural products (18.9%), deep breathing exercises (7.6%), chiropractic (7.5%), yoga (5.1%), massage (5.0%) and diet-based therapies (3.5%).
• 54.9% of Americans believe that combining CAM and modern medical treatment would help them, while 50.1% of Americans thought it would be interesting to try CAM.
• In 1997, the American public spent between US$36 billion and US$47 billion on CAM therapies. Of this amount, between US$12.2 billion and US$19.6 billion was paid out-of-the pocket as these were not covered by the insurance or provided by the healthcare system.
• The rates of CAM use are also exceptionally high among individuals with life threatening illnesses such as cancer. 

According to the Centre of Complementary and Alternative Medicine people with cancer choose CAM because of the following reasons:

• Help cope with the side effects of cancer treatments, such as nausea, pain, and fatigue;
• Comfort themselves and ease the worries of cancer treatment and related stress;
• Feel that they are doing something more to help with their own care;
• Try to treat or cure their cancer.

In 1998, David M. Eisenberg and colleagues at Harvard Medical School wrote an article in the Journal of the American Medical Association, stating that between 1990 and 1997, Americans made 629 million visits to CAM practitioners. This figure represented a 47.3 % increase, and exceeded the total number of visits to medical doctors. They also found that expenditures for alternative medicine professional services increased 45.2 percent during the same seven-year period, conservatively estimated at a staggering $21.2 billion in 1997.

CAM in Europe

Peter Fisher and Adam Ward (Complementary medicine in Europe. British Medical Journal 1994; 309:107-111) wrote that CAM are used by many doctors throughout Europe. The major CAM modalities in Europe are acupuncture, homoeopathy, manipulation and herbal medicine. A survey showed positive public attitudes towards CAM. About 20% to 50% of the population in countries in Europe used CAM.

• 60% of the public in the Netherlands and Belgium were ready to pay extra health insurance premiums for it.
• 74% of the British public favouring it being available on the National Health System.

The use of CAM in European countries is growing rapidly.

• In Holland, in 1981 only 6.4% of the population used CAM but in 1990 it was 15.7%.
• In UK, in 1984 only one in seven used CAM but in 1991 it was almost one to four.
• In France, homoeopathy is the most popular modality and in 1982 about 16% of the population used homoeopathic remedy and in 1992 its usage rose to 36%.
• The market of herbal medicine in Germany rose from 7.7% in 1985 to 10% in 1989.

The question to ask is: Why do the Americans and Europeans, among others, are ever ready to use CAM therapies? What is the reason for CAM growing in popularity? Why is it that they are even prepared to pay for CAM services / products from their own pocket rather than go for treatment provided by their national health care system?

This growing popularity of CAM may indeed be disturbing to the medical profession. The public in general are now aware that the Emperor they once revered was naked. Realising the seriousness of the writing on the wall, the American medical community cannot now sit tight and rest on their past laurel. Fortunately, they have started to respond to this new reality.

1. Hospitals in the US, offering Integrative or CAM therapies.

(information presented in italics are quoted from the websites of the respective institutions)

There are at least 17 hospitals which offer CAM therapies to their patients. Examples are:                                    

1. Center for Integrative Medicine, Cleveland Clinic: This is one of the top four hospitals in the US. According to them, traditional medicine can treat many diseases. For many, modern medicine does little to relieve symptoms… Patients typically get little assistance with dietary and other lifestyle changes that are needed to provide relief from and, in some cases, to actually reverse the effects of chronic diseases. By integrating one or some of the complementary methods offered at our center, patients can regain control of their own health.The services available at Cleveland Clinic are acupuncture, mindful cognitive therapy, massotherapy,  yoga,  tai chi,  qigong,  nutritional counseling, reiki,  mind/body coaching and weight management. As evidence continues to grow that our dietary habits play an enormous role in prevention and even treatment of most chronic conditions, patients will be encouraged to visit with our registered dietitian who will provide a “whole foods” preventive nutritional approach.

2. Beth Israel Medical Centre Centre for Health and Healing:  The term “Traditional and Indigenous Medicine” refers to the healing systems used by various countries and ethnic populations for thousands of years, before the arrival of modern medicine. Despite this long tradition of use, traditional medicine has not had strong official support in most countries since the rise of modern western medicine. Today many men and women are looking beyond conventional medicine alone to keep themselves well. Increasingly their choices include the integration of complementary and alternative approaches which address the mind, body and spirit in restoring health. At the Continuum Center for Health and Healing we stand at the forefront of this evolution in healthcare—helping to develop a new type of medicine that combines the best of both conventional and complementary/alternative therapies.

3. The Duke Center for Integrative Medicine, Duke University, N.C.: Integrative Medicine is based on a partnership between patient and practitioner, within which the best of conventional, complementary and alternative medicine practices can be explored in a whole person approach to health care and healing. We recommend …  a wide range of appropriate therapeutic interventions from both conventional and complementary/alternative practices, such as: conventional medications, herbal supplements, preventive and diagnostic medical screenings and examinations, Oriental medicine and acupuncture, physical therapy, nutritional therapy, movement, and exercise.

4. Memorial Sloan-Kettering Cancer Center: The Integrative Medicine Service: This is one of the best cancer hospital in the world for cancer. Its Integrative Medicine centre was established in 1999 to complement mainstream medical care and address the emotional, social, and spiritual needs of patients and families. In treating disease, complementary therapies are not substitutes for mainstream medical care; they are used in concert with medical treatment to help alleviate stress, reduce pain and anxiety, manage symptoms, and promote a feeling of well-being. The guiding principle at Memorial Sloan-Kettering is to offer the most effective treatment and the highest quality of care for people with cancer. The director of the centre wrote: I found that cancer patients were using a wide array of CAM therapies, some ineffective and useless, others very helpful.  My … goals … aimed to alert patients to sometimes harmful therapies promoted incorrectly as viable cancer 'treatments' and to ensure that helpful complementary therapies are available to patients as supportive care.

2. Alternative/Complementary Medicine Taught in Medical Schools in the US

                        (information presented in italics are quoted from the websites of the respective institutions)

1. University of Arizona: Program in Integrative Medicine: Dr. Andrew Weil founded the Program in Integrative Medicine at the University of Arizona in 1997. Healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies –  bringing together the best of conventional and complementary therapies. Dr. Weil wrote: It is my hope that health practitioners of the future will begin to honor the wisdom of the past and once again use food as medicine.

The University offers on line course of nutrition and health besides botanical medicine. The main forte of the program is to train medical doctors. The University of Arizona is the only institution in the world that has taken on the challenge of developing a comprehensive educational program in Integrative Medicine, to meet the growing need for academic leaders in the field.

2. Georgetown University: offers a Masters program in Complementary and Alternative Medicine. The first program of its kind, … and  places Georgetown University at the forefront of graduate education in this field

3. University of Pennsylvania – Tai Sohia Institute: Doctors at Penn are working with Tai Sohia Institute, an alternative medicine school in Maryland, on a program to teach medical students about herbal therapies, meditation and other approaches that are increasingly popular with the public. The new partnership will offer a master’s degree in complementary and alternative medicine. Such partnership or marriage was once considered a taboo seems perfectly alright today. Dr. Alfred Fishman of Penn’s medical school said: It made perfect sense to us.

4. University of California, Irvine: School of Medicine Susan Samueli Center for Integrative Medicine:  The Susan Samueli Center for Integrative Medicine is an academic center focused on scientific research and education in the broad field of complementary and alternative medicine. Some of the areas of current research activity as well as areas we wish to pursue in the future are: Traditional Chinese Medicine: This long-standing cultural tradition of medicine includes three broad areas of interest in the Center: (1) acupuncture; (2) herbal therapies; and (3) Qi Gong and tai chi. Life Style Factors: These areas of wellness and prevention include use of exercise regimens, nutrition, dietary supplements and nutraceutical products, sleep habits, substance use and abuse, and stress-related activities. Mind/Body or Psychosocial Factors: These activities and interventions include music therapy, meditation and yoga. Other Medical Traditions: These traditions include homeopathy, naturopathy, unique chiropractic and osteopathic approaches, and others.

3. Medical Schools in US that Offer Some Kind of CAM Coursework

Barbara A. Gabriel, (To Teach or Not to Teach: The Role of Alternative Medicine in Medical School Curricula) wrote: The overwhelming increase in recent years of health care consumer visits to alternative medicine practitioners has forced the question: Should CAM be included in conventional medical school curricula?

According to the Association of American Medical Colleges, more than 95 out of the 125 medical schools in the US now offer some kind of courses on CAM – the healing methods once dismissed as incompatible with the scientific Western medicine. Many medical educators agree that CAM can no longer be absent from their curricula.

The Editorial in the 20 January 2001 issue of the British Medical Journal 322: 121-123, rightly pointed out that: CAM is no longer an obscure issue in medicine. Although many medical schools …now include teaching on CAM therapies, the approaches are variable and often superficial. Looking at it positively, at least these schools are trying to play watch up with the emerging trend.

Seventy-four Medical Schools in the US Offer Some Kind of CAM Coursework.

Examples of such medical schools are:

1. Case Western Reserve University School of Medicine, Cleveland, OH. – four courses.

2. Columbia University, College of Physicians and Surgeons, New York City, NY. – three courses.

3. George Washington University School of Medicine and Health Sciences, Washington, DC. - M. S. program.
4. Harvard Medical School, Boston, MA. – four courses.
5. Mayo  Medical School, Rochester, MN. – three courses.
6. Mount Sinai School of Medicine of the City University of NY, New York, NY. – nine courses.
7. University of California - Los Angeles School of Medicine, Los Angeles, CA. – eight courses. .
8. University of California, San Francisco School of Medicine, San Francisco, CA. – five courses.

Master’s and Doctoral Degree Programmes in other Healing Professions

In additional to medical doctors, there are a variety of healing professionals in the US. Their training is as intensive and rigorous as medicine. Like the medical school, admission requirement for these programs is a basic degree (B.S.) in science. This means that students need to study at least seven years of university education before they can earn the title “doctors”. For the sake of space, I highlight only four of them.

Osteopathic Medicine

Just like MDs, Doctors of Osteopathic Medicine (DOs) are fully trained and licensed medical physicians. Osteopathic medicine is not an alternative medicine. It is a complete system of medical care with a history of 125 years. The philosophy is to treat the whole person, not just the symptoms and the appreciation of the body's ability to heal itself. DOs and MDs are the only physician in the United States who are fully trained and hold unrestricted licensed to perform surgery and prescribe medicine.

Naturopathic Medicine

The practice of Naturopathic Medicine emerges from six underlying principles of healing: The healing power of nature, Identification and treating the cause, First do no harm, Treat the whole person, The physician as teacher and Prevention is the best "cure". Just like MDs, Doctors of Naturopathic Medicine (NDs) are fully trained and licensed medical physicians.

Chiropractic

Chiropractic is a drug-free, non-surgical science and, as such, does not include pharmaceuticals or incisive surgery. Just like MDs, Doctors of Chiropractic (DCs) are fully trained and licensed medical physicians.

Oriental Medicine

Practitioners need to undergo an accredited masters or doctoral degree programs before being allowed to practice. Oriental medicine has been practiced for more than 2,500 years and includes acupuncture, herbal medicine, moxibustion, Oriental massage and Oriental nutrition. Currently, oriental medicine has gained worldwide acceptance and recognition as effective medical treatment. Over 15 million Americans have turned to it, making it the complementary treatment of choice for Americans.

Let me sum up by quoting Dr. Stephen Sagar, radiation oncologist and professor of medicine at McMaster University, Canada (in Restored Harmony): My interest in Traditional Chinese Medicine (TCM) was fueled by the fascination of the intricate and sophisticated relationships between mind, body and the environment, concepts that are surely lacking in current, conventional medicine … when I practised medicine, I was not dealing with a reductionist collection of molecules, but a whole person consisting of a unique soul driven by spirit, and subjected to all the infirmities of the physical world. The person was much more than the anatomical structure we were taught at medical school. Writing in the Foreword of the same book, Dr. James Gordon, professor of Georgetown University School of Medicine and chair of the White House Commission on CAM Policy, said: Over the last twenty years, I’ve been exploring the integration of Chinese Medicine in individualised programs of comprehensive care for cancer patients … Chinese medicine can, and should, be available to everyone who is being treated for cancer.

Take Time to Think

Many top hospitals and medical schools in the United Stated have recognised the need for change.

They are adjusting and responding to this new reality (or threat?).

Now, what about Malaysians? Still happy and proud to be under the same, old coconut shell?

Stop press: Betty (not real name), 40 years old, has been having sore throat (pain on the right side of throat) since 1991 till 2006. She had seen many doctors and was put on countless courses of antibiotics. The problem still persists. She came to us for help and was asked to take Sore Throat Tea. After only ONE glass, the sore throat was gone.