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Asian Medicine: How Effective is it for People With Cancer?

Healthfacts, April, 2001 by Maryann Napoli

About 30-40% of cancer patients use complementary and alternative medicine, according to surveys, as do almost all people with AIDS as they near the end of life. The increasing use of CAM among people with life-threatening illness has led to some obvious questions: Does it work? Will it improve the quality of remaining life?

Last month, a conference held in New York City concentrated on the scientific evidence supporting the most popular forms of CAM. The three-day conference entitled, From Tradition to Modernity: Asian Therapies for Cancer, was the first to give all traditional Asian methods of healing equal representation at the same meeting. Many people with cancer do not tell their physicians about the CAMs they are using, and many cancer specialists are uninformed about these approaches to healing. The gathering attracted a wide variety of practitioners, as well as people with cancer.

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"This conference is about promoting dialogue and understanding among doctors and patients," said its chairman, Raymond Chang, MD, who is president of the Institute of East-West Medicine in New York City. "Our mission is to encourage an evidence-based approach to integrating positive elements from Asian healing traditions for cancer care."

The body-mind therapies, such as meditation, have the greatest amount of studies showing efficacy, and homeopathy stands out among the non- Asian alternative treatment modalities for having the largest number of randomized controlled clinical trials, though none involved cancer treatment. Acupuncture had enough supporting research for a 1997 National Institutes of Health Consensus Development Conference to declare its efficacy for the treatment of nausea and vomiting associated with surgery and chemotherapy.

There is also a great deal of interest in the Asian diet as the key to cancer prevention. Traditional Asian diets are low in total fats, particularly saturated fats. Fruit and vegetables are consumed in high amounts; whereas, fish, poultry and eggs are consumed in low amounts. Lawrence Kushi, ScD, professor of Nutrition, Columbia University, New York City, displayed multi-nation charts showing "the tremendous variation" in breast cancer incidence, with the highest in the U.S. and Northern European countries and the lowest in Asian countries. Prostate cancer rates show similar differences with the lowest rates in Japan, China, India, and the highest rates in Western countries. Women in Japan who get breast cancer, observed Dr. Kushi, tend to live longer than their American counterparts.

As more and more Asians consume a Western diet, cancer rates increase accordingly. For example, Japan and India have had a low rate of colon cancer since 1963, but their respective rates have increased greatly in the last 20 years, especially in Japan where the diet is changing dramatically. Soy intake is currently thought to be the explanation for the low cancer rates in Asia, but research singling out certain foods sometimes produces mixed results. For example, several population studies show high intake of soy to be associated with lower rates of prostate cancer, but one study, inexplicably, found a higher rate of Alzheimer's disease among men with the highest soy intake.

The Iowa Women's Health Study found that women who ate any amount of soy had a somewhat decreased risk of breast cancer, but this study was not conclusive because only "a tiny percentage of women ate soy products," said Dr. Kushi. Another study involving Japanese women "suggested an effect." In explaining the research interest in soy, Dr. Kushi noted, "Protease inhibitors are in soy which have strong anti- cancer properties and anti-inflammatory effects, though it's questionable whether they survive the cooking process."

Until research provides more definitive answers, Dr. Kushi said that people should eat whole soy foods like tofu, tempeh, and miso because these are the types of foods consumed by people in the population studies showing reduced rates of prostate and breast cancers. There is a consensus among researchers, says Dr. Kushi, that people should avoid taking isolated components of soy, such as powdered genistein and isoflavones, sold in health food stores.

This advice is particularly important for people with breast or prostate cancer. Whether any type of soy food is safe for women with estrogen-dependent breast cancer remains an open question. Dr. Kushi said that the danger here is theoretical and comes solely from lab studies. Soy foods are estrogenic and could induce cell proliferation. For years some researchers focused attention on low fat intake as the reason for low breast cancer rates in Asian countries, but Dr. Kushi has assessed all relevant studies and concluded that there is "not much of an association between fat intake and breast cancer."

In the U.S., people seem to fear food; whereas in Asia, food is viewed as health giving, said Nina Simonds, author of Spoonful of Ginger, an Asian cookbook. Food is also viewed as therapeutic (see Web site below). The shiitake, maitake, and oyster mushrooms have been validated in studies as having immune strengthening properties. In Japan, says Ms. Simonds, people with cancer and autoimmune diseases are encouraged to eat these mushrooms. Common combinations of foods tend to have therapeutic effects. For example, ginger and garlic have antibacterial effects and are often found together in Asian meat dishes. Also, the lines between food and medicinal herbs are blurred in Asian cooking.

Asian Medicine: How Effective is it for People With Cancer?

Healthfacts, April, 2001 by Maryann Napoli

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