Be Smart About Integrative Medicine

Integrative medicine and its cousin, alternative therapies, offer a wealth of new and often unfamiliar treatment choices. But before you sign up, you should know where to look, who to contact, and what kind of information you can trust.

"You want to avoid literally the thousands of bogus claims out there," says Barrie Cassileth, PhD, chief of the Integrative Medicine Service at Memorial Sloan-Kettering Cancer CenterMemorial Sloan-Kettering Cancer Center in New York City.

For instance, does cholesterol spinach, a plant touted as a "miracle cure" in Hawaii, really lower cholesterol? Can Integrative Medicine Home Pagesupplying high levels of oxygen to the body kill cancer cells? Can taking bee pollen boost athletic performance?

Scientists haven't found proof that any of the above treatments work. So when it comes to choosing a good integrative medicine center, or alternative or complementary therapies, it really pays to do your homework.

Finding a Reputable Integrative Medicine Center

Integrative medicine is gaining acceptance among more doctors and more hospitals around the country, but the movement is still just starting to build momentum.

Susan Folkman, PhD, director of the Osher Center for Integrative Medicine at the University of California, San FranciscoOsher Center for Integrative Medicine at the University of California, San Francisco, says if you're interested in finding a reputable integrative medicine center near you, visit the Consortium of Academic Health Centers for Integrative MedicineConsortium of Academic Health Centers for Integrative Medicine, which is a group of 31 academic health centers -- including the Osher Center and others at HarvardHarvard, ColumbiaColumbia, GeorgetownGeorgetown, and the University of PennsylvaniaUniversity of Pennsylvania.

Folkman, who is the chairwoman of the consortium, says you can find an academic center in your region and call for recommendations.

You can also get a listing of integrative medicine clinics through the Bravewell Clinical NetworkBravewell Clinical Network, a philanthropic organization dedicated to furthering the philosophy and implementation of integrative medicine.

Herbs, Vitamins, and Botanicals

It also pays to know how to properly evaluate some of the therapies that you may encounter.

Some complementary or alternative medicine (CAM) therapies have been shown in clinical trials to be useful; for example, acupuncture to relieve nausea after chemotherapy. But how can the bewildered consumer tell the possibly beneficial therapies from the useless or downright dangerous? And how does one find a trustworthy practitioner instead of a quack?

Fortunately, many reliable and informative resources exist to help.

Just because an herbal remedy is labeled "natural" doesn't necessarily mean that it's safe. The U.S. Food and Drug Administration doesn't require herbs or other botanicals, vitamins, and minerals to be tested and approved before they're marketed, as the agency does with mainstream medicines.

The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center maintains a web site, "Information Resource: About Herbs, Botanicals and Other Products,""Information Resource: About Herbs, Botanicals and Other Products," that is constantly updated to inform the public about claims and scientific research. An oncology-trained pharmacist and botanicals expert manages the site.

A cardinal rule: although you may feel reluctant, always tell your doctor about all CAM therapies that you're using so that he or she can monitor your condition. Some herbs and supplements can interact with medications or make other drugs less effective. As one example, the popular St. John's wort can reduce levels of the HIV protease inhibitor indinavir.

Some herbs can also interfere with cancer treatment, or they may hamper the blood's ability to clot. "People have [bled excessively] on the operating table because they took a lot of herbs before surgery," Cassileth says.

Researching various therapies

Don't try a CAM therapy just because you read a glowing testimonial or because a friend or co-worker swears by it. Find out for yourself whether any scientific studies have been done on the particular therapy. That way, you can make an informed decision based on your understanding of the potential benefits and risks.

Not every CAM therapy has been studied, but many have. Here are some tips from the federal government's National Center for Complementary and Alternative MedicineNational Center for Complementary and Alternative Medicine (NCCAM) on how to get reliable information:

• Ask your doctor if he or she knows about the therapy you're considering. For example, is it safe and effective? Will it interact with your prescription or over-the-counter medications or other medical treatments? Your doctor may be able to help you interpret scientific studies that you've found on your own. If your doctor isn't able to answer your questions, ask if he or she can refer you to someone who is knowledgeable.
• Do an Internet search -- but pay close attention to the source of information. Sites that are operated by the government, a reputable university, or a well-regarded medical or health-related association are more reliable than sites that are sponsored by product manufacturers. Check the purpose of the site. Is it to educate the public or to sell a product or service? Also look at the origins of information. Does it come from scientific evidence with clear references, or from advice, personal stories, and opinions? To make sure that you're getting current information, check whether the site is reviewed and updated frequently.
• For the results of scientific studies on CAM therapies, visit the databasedatabase "CAM on PubMed," developed jointly by NCCAM and the National Library of Medicine.
• If you don't have Internet access, call the NCCAM Clearinghouse toll-free at (888) 644-6226. Staff members can help you search the medical and scientific literature for information on various CAM therapies.
• Go to your local library or medical library to see if books or scientific articles have been published about the CAM therapy. A reference librarian may be able to help you find reliable sources.

Finding a CAM Practitioner

If you go to a hospital or university medical center with an integrative medicine program, you'll find CAM practitioners on staff who have been trained in acupuncture, biofeedback, hypnosis, herbal medicine, and other therapies. Or the program may refer you to affiliated practitioners in the community.

If you're searching for a CAM practitioner, keep these tips in mind and choose carefully:

• Before you choose a CAM practitioner, tell your doctor about the therapy you're considering so that Integrative Medicine Home Pagehe or she can offer any advice. Then ask if he or she can recommend a CAM practitioner or is willing to make a referral. You can also contact a hospital or medical school to see if it can recommend CAM practitioners.
• Call a professional organization for the type of practitioner you seek to learn about the type of training required, as well as any licensing or certification requirements in your state. Ask a librarian to help you find directories that contain professional organizations. Or go online to the Directory of Health OrganizationsDirectory of Health Organizations, where you can search for listings of numerous CAM organizations.
• Regulatory agencies and licensing boards for certain types of practitioners exist in many states. Your city, county, or state health department may be able to help you find such entities so you can get information about practitioners in your area.
• Find out if your insurance will cover the therapy -- for example, chiropractic visits. If it's covered, find a practitioner who accepts your insurance. But be aware that even with insurance, you may still need to pay a portion of the cost.

Published March 10, 2006.

SOURCES: Barrie Cassileth, PhD, chief, Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York City. National Center for Complementary and Alternative Medicine: "Are You Considering Using Complementary and Alternative Medicine (CAM)?" National Center for Complementary and Alternative Medicine: "Selecting a Complementary and Alternative (CAM) Practitioner."