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How do alternative treatments fit into traditional medicine?


Congress and the Food and Drug Administration (FDA) should get involved with industry and scientists to investigate the effectiveness of alternative therapies, according to an Institute of Medicine report.

While some alternative treatments may be useful, troubling skin conditions can occur as a result of the therapies themselves when used to treat non-dermatologically related medical conditions - i.e. an allergic reaction to glucosamine-chondroitin when used for joint health.

Paul S. Cabiran, M.D., in Highlands, N.C., has seen problems that can arise with alternative treatments.

"I had a patient about a year ago who was using a black paste he got off the Internet for treatment of a skin cancer. Basically, the salve ate a hole through his ear - and he still had the skin cancer.

"Some of this stuff should be tested. If that happened with any of the medications we use - eating a hole through somebody's ear - we would get reported, the FDA would look into it, and it might even get pulled from the market."

Dr. Cabiran, in practice for nine years, thinks most alternative remedies should be approached the same way as pharmaceuticals.

"It would be very useful if the FDA would regulate and basically require testing of herbal medications the same way they've required testing of allopathic medications. Presently, we see a lot of side effects from herbal medications and supposedly natural therapies - these things have never been tested on humans."

He adds, "natural" doesn't mean "safe;" many naturally occurring compounds are not safe for human consumption. He says patients taking herbal medication for prolonged periods of time can develop liver problems.

Reasons not to regulate

The complaint most commonly heard about the FDA is that approval takes too long and costs too much. Dr. Cabiran says ,"The FDA isn't a perfect system, but it's all we have." He takes issue with alternative therapies being totally unregulated.

In Walnut Creek, Calif., Jerome R. Potozkin, M.D., laughs ironically at the idea of the government getting involved in alternative treatments.

"It's a great idea to evaluate alternative therapies. I personally don't know if the federal government is the best vehicle for that - although federally funding that research is a great idea."

Proven efficacy versus belief

In practice for 13 years specializing in Mohs surgery, it frustrates Dr. Potozkin that people take alternative treatments at face value.

"Echinacea is a non-dermatological example. Every time I would sneeze, my sister and mother - who aren't in medicine - would tell me to start taking echinacea. That's what they did, and they swore by it.

"Now this big multi-center study comes out that says echinacea is of no clinical proven value - but they are still taking it."

He says too much of the support for alternative treatments is anecdotal.

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