Sunday, April 29, 2007

Saudi Arabia: 60 Percent of Cancer Patients Using Alternative Medicine

The number of cancer cases in Saudi Arabia is estimated at 7,000 annually, a figure that is expected to rise to 30,000 within the next 15 years, the chairman of the Saudi Cancer Society (SCS), Dr. Abdullah al Amr, revealed to Asharq al Awsat.

Al Amr also revealed that the most common forms of cancer afflicting women in Saudi Arabia are breast and thyroid cancers, in addition to lymphoma and liver cancer, while most cancer cases among men were colon cancer. Al Amr indicated that the most challenging cancers to treat are pancreatic and liver cancers, and some types of brain cancer.

Pointing out that the world’s cancer recovery rate is estimated at 60 percent, Dr. al Amr said that the rate is lower in Saudi because a significant number of patients visit hospitals and specialized oncology centers at advanced stages of the disease.

Al Amr disclosed that random interviews conducted with patients showed that 60 percent resort to unconventional medicine and that many of them are seeking treatment using popular herbal medicines. He added that the SCS is supporting a comprehensive survey so as to ascertain the accurate figures involved.

The chairman of the SCS said that the Ministry of Health has been making steady efforts to increase public awareness and is investing in educating the community. He said, however, that it is unlikely that the SCS would resort to legal action against those selling such herbal medicines and added that the aim was to educate the people about the detriments of some herbal medicines that have obscure composition and unproven effectiveness.

The SCS issued a statement at the beginning of this week that cautioned against treatment by harmful popular medicines, affirming that it has become a common phenomenon over the past few years. Al Amr stated that the SCS, in cooperation with specialized laboratories will keep record and undertake analyses of these medicines so as to ensure the safety an efficacy of cancer treatment. He furthermore indicated that the kingdom lacked proven scientific studies on the effect of these substances on cancer patients and that outlets that sold such substances were poorly controlled.

The SCS stressed the harmful effects resultant of using these popular medicines, as some are contaminated by bacteria. Cancer patients characteristically have weakened immune systems and thus the detriments can be quite severe. The SCS stated that the side effects resulting from radiotherapy and medical drugs are worse when simultaneously combined with some herbs, all of which delays recovery.

From heresy to beneficial: Alternative therapies outlined

Not too long ago, their book would have been considered medical heresy.

But medicine has changed so much that a team of medical providers at Mayo Clinic has now produced a book about alternative therapies.

Patients often use things like herbal remedies, steeped concoctions and body-mind connections to heal their symptoms, aches and infections -- without sharing what they're doing with their health providers.

The authors of the "Mayo Clinic Book of Alternative Medicine," hope patients will instead openly discuss their non-traditional efforts with their doctors.

Alternative therapies -- anything used to treat the body not typically taught in medical school -- include today's widely accepted acupuncture and massage. The melding of traditional and alternative therapies, or "integrated medicine," has gained popularity as the doors to "integrated medicine" open.

"I think that people will have an open-minded perspective and recognize that some of the information in this book relates more to common sense than it does to esoteric new approaches to health," said Dr. Paul Limburg, one of the authors, and associate director for research in the Complementary and Integrative Medicine Program at Mayo.

General internist Dr. Larry Bergstrom said nutrition, spirituality and herbalism all come under the umbrella of integrative therapies that can be combined with traditional Western medicine.

Bergstrom said patients shouldn't keep secrets about what they're doing, because combinations of some medicines and herbal remedies can be dangerous.

Congress in 1994 passed legislation that made dietary supplements such as vitamins, minerals, herbal mixtures and amino acids a class of compounds not considered food or considered drugs.

"That really left a lot of safety implications," said general internist Dr. Mark C. Lee, one of the several authors. If the patient is doing something on his own and not telling his doctor, that sometimes works against traditional therapies, he said.

The book separates therapies into categories of green light for effective for indicated conditions, and safe; yellow for caution, studies show the therapy might be effective but there might also be risks; and red for therapies that should not be used because risks far outweigh benefits.

Beneficial alternative therapies as shown through science:

? Glucosamine and chondroitin "appear to be safe and produces fewer adverse side effects" than medications like NSAIDs against osteoarthritis. Some studies conflict, but side effects are low. People with severe symptoms were the most likely in one study to see a benefit.

? Massage "is a great complementary and alternative treatment," the authors say. "Almost everyone feels better after a massage."

? Spinal manipulation is "an effective treatment for uncomplicated low back pain, especially if the pain has been present less than four weeks."

? Peppermint "has some benefits in treating certain digestive disorders such as irritable bowel syndrome and possibly heartburn. However, its muscle-relaxing qualities could worsen hearburn symptoms associated with gastroesophageal reflux disease, so take it under a doctor's supervision."

What's not beneficial?

Goldenseal, for example, "has demonstrated some antibiotic and anti-inflammatory qualities. But studies about its effectiveness and safety are poor quality. Goldenseal was given a red light because "it can produce serious side effects if used for longer periods, and there's insufficient evidence that it works."

Tuesday, April 17, 2007

Doctor uses natural, old-fashioned medicine

Good health comes naturally to Dr. John Kule and his patients at the East Aiken Health Center.

In a small cinderblock building nestled on the edge of a sprawling horse farm between Aiken and Wagener, Kule and his staff practice medicine the old-fashioned way — with natural remedies and an emphasis on wellness.

Herbs and other vitamin supplements line the walls of the waiting room, but the exam rooms are equipped with high-tech laptop computers that gauge fitness and heart durability. According to Kule, his is "alternative medicine," to be sure, but it is first and foremost good family medicine.

"There isn't one in 100 that actually knows what alternative medicine means. So, yes, I have to do a lot more education of my patients," Kule said, sitting on the edge of one of his examination tables.

In a middle room, patients receiving intravenous treatments relax in leather recliners. In the lobby, "green-friendly" cleaning supplies and homeopathic remedies are displayed on tables surrounded by horse art prints on the walls and patient information printed simply on laserprinter paper.

"More and more, primary care is coming along my way because you see all the things about nutrition and concerns about prescription medications," Kule said. "Wouldn't it be wonderful if all the Vioxxes worked with no side effects? But they don't. That's not life. To have good health is work. It's a commitment."

Kule's education has taken him from his native Pennsylvania (where he studied biology at Pennsylvania State University) to Canada (where he explored the physical education and sports culture of Soviet Russia) to Bogota, Colombia (where he earned his medical doctorate from Pontificia Universidad Javeriana). He taught middle school science in Georgia and worked as a medical interpreter in Los Angeles before completing his residency at the Medical University of South Carolina in Charleston. He was a partner in family medical clinics in Swansea for six years until he opened East Aiken Health Center in 2000.

His patients say Kule and his staff are willing to spend hours delving into their health histories and trying to find the root causes of their maladies. "He is known to spend two hours with a patient," wrote one client, named Linda, in a letter praising her physician. "His practice is an incredible alternative to conventional health, concentrating on the body, the mind and the soul working together to create a healthy, happy individual."

Kule says that he is bucking an unfortunate trend in modern medicine — health care driven largely by insurance and Medicare reimbursements.

"I think that most doctors in primary care would like to do something like what I'm doing except that the reimbursements from the insurance companies are terrible," Kule said. "I don't think it's satisfying to see 50 patients a day and have three offices on this side and three offices on this side and the nurses come in and do most of the history-taking and you just zip in and focus on one column, write a script and go on to the next patient and drink coffee and push, push, push until you get your 50 patients in."

In fact, Kule accepts only one insurance provider, plus Medicare and Medicaid, which cover only the cost of the office visit. For the most part, his patients must pay out-of-pocket for other, less conventional procedures and natural treatments not reimbursed by the insurance industry.

First-time patients go through the traditional battery of tests — blood pressure, heart rate and the usual vital signs — but Kule and his staff also conduct high-tech tests for heart rate durability and urine and saliva chemistry. They take blood samples and read the splotches under dark-field microscopes, looking for tell-tale signs of fatigue, dysfunctional body systems and other deficiencies in the "live blood."

"All I'm doing is going one step further and saying, I would like to catch things before they get real bad and make some changes," Kule said. "When I do this kind of testing, I'm trying to figure out where they are functionally before all these things arrive at pathology. Any good doctor should be looking for that, too. I'm looking for things before they get bad. I'm also looking for things to go toward an optimal. I'm looking more at, like the Greek ideal, that there is some optimal function out there, looking at health more like what an athlete would look like."

If traditional pharmaceuticals are needed, Kule will write a prescription, of course. But he is just as likely to prescribe changes in nutrition and overall lifestyle to encourage the body to heal itself.

"When I do this kind of medicine, I'm giving people choices," Kule said. "These things make more work for me and for the patient, but it gives them a chance to allow their own natural healing mechanisms to start working again."

Kule knows that some people may scoff at the idea of holistic or "alternative" medicine, but he points to his training and experience and, more importantly, he says, to his patient successes.

"I went through a lot of training to get where I am, and I have to continue my training. I should be respected for the tools that I use," he said. "When a colleague in town is using different tools, I still respect him. As long as my patients are doing well, I don't care whether it's really alternative or conventional or whatever you want to call it.