The Ongoing Problem with the National Center for Complementary and Alternative Medicine In spite of statements to the contrary by its director, the NCCAM continues to fund and promote pseudoscience. Political pressures and the Centers charter would seem to make this inevitable. Ethics and the public interest are compromised. KIMBALL C. ATWOOD IV, M.D. he National Center for Complementary and Alternative Medicine (NCCAM) was established in T1998, seven years after the creation of its predecessor, the Office of Alternative Medicine (OAM). The OAM had been formed not because of any medical or scientific need, but because Iowa senator Tom Harkin and former Iowa represen- tative Berkeley Bedell believed in implausible health claims as a result of their own experiences. Bedell thought that "Naessens Serum" had cured his prostate cancer and that cow colostrum had cured his Lyme disease (Jarvis 1996). He rec- ommended "alternative medicine" to his friend Harkin, who subsequently came to believe that bee pollen had cured his hay fever (Marshall 1994). SKEPTICAL INQUIRER Seplember/October 2003 23 Political wrangling, but little science, marked the history of diis adulteration was discovered, the NCCAM had been spon- the organization throughout the 1990s (Gorski 2001). soring four studies of PC-SPES. The studies had been justified Although the OAM was officially a part of the National by preliminary data suggesting that PC-SPES may be effective Institutes of Health (NIH), it was managed more by for the treatment of prostate cancer. That effect, however, has "Harkinites" than by scientists (Marshall 1994; Satel and now been explained by the presence of diethylstilbestrol and Taranto 1996). Science magazine recounted a 1993 congres- indomethacin (Sovak et al. 2002). Nevertheless, after a brief sional hearing held by Harkin, with Bedell as a witness: pause the NCCAM intends to resume three of die studies "because of die promising data from the early studies of PC NIH, Bedell said, should hire staffers to locate anyone who claims to have a successful therapy, search the files, a n d "just sim- SPES" (NCCAM Web site 2002a). ply find out whether what he claims is correct," Straus warned of "some herbal medicines . that interfere wirJi the metabolism of drugs used to treat cancer or AIDS" [Subsequent to the hearing] Bedell brushed aside questions about how his field studies could be designed to avoid bias. This is a (Straus 2002). By this he meant, mainly, St. John's wort. But technical detail, Bedell said, and "I'm not a scientist." But he St. John's wort has for years been recommended as a treatment insisted at the hearing—and still insists—that field s t u d i e s can be for the HIV by the naturopathic Bastyr University AIDS done quickly and easily, without fancy statistics or double- Research Center, funded by die OAM/NCCAM since 1994 blinded controls (Marshall 1994). (BUARC Web site 2002). The Bastyr Web site does not men- tion die danger of mixing St. John's wort with HIV protease inhibitors, although that Political wrangling, but little science, fact had been known since 2000 (Piscitelli marked the history of the organization et al. 2000). How many people carrying the HIV may have developed AIDS or relapses throughout the 1990s. Although the OAM because of such promotion is a mystery, but was officially a part of the National Institutes there is no indication that anyone at Bastyr or the NCCAM is wondering. of Health (NIH), it was managed more The director of the Bastyr University by politicians than by scientists. AIDS Research Center is naturopath Leanna Standish. She was a member of the NCCAM advisory council from The creation of the NCCAM as an "NIH Center" in 1998, 1999-2001. She is the Principal Investigator of an NCCAM- followed by the appointment of Stephen Straus as its director sponsored clinical trial to study "Gallic in hyperlipidcmia in 1999, marked a noticeable change. Straus is the first direc- caused by HAART [highly active anti-retroviral therapyl." But tor of the OAM/NCCAM to have legitimate qualifications as garlic is another substance that reduces blood levels of lifesav- a biomedical scientist. He promised "to explore CAM healing ing HAART agents (Piscitelli et al. 2002), a fact that is men- practices in the context of rigorous science, to educate and tioned in neither the NCCAM nor the Bastyr descriptions of train CAM researchers and to disseminate authoritative infor- the trial. mation about CAM to the public" (Straus 1999). Three years Standish is the lead author of a chapter in the major text- later he felt confident enough to tell The Scientist, regarding book of naturopathy that recommends more than 100 "thera- scientific opinions of die NCCAM, "I think there's very little peutic suggestions" for HIV infection and its complications skepticism left" (Russo and Maher 2002). (Standish et al. 1999). The authors state that these treatments This article argues that in spite of Dr. Straus's convictions, constitute "comprehensive care that is concordant with several the NCCAM continues to be committed more to pseudo- naturopathic principles" and that the program is being studied science and CAM advocacy than to rigorous science. "through a three-year cooperative agreement grant with the NIH's Office of Alternative Medicine" (now the NCCAM). In Pointless Research and Dangerous Promotions addition to St. John's wort and garlic, some of the recom- Director Straus, referring to NCCAM-sponsored research, mended treatments are "acupuncture detoxification auricular recendy wrote, "Some people believe diat any such undertaking program," whole-body hyperthermia, "adrenal glandular," is a pointless exercise" (Straus 2002). That is correct, and some homeopathy, "cranioelectrical stimulation," digestive enzymes, of the reasons for this were evident in his short article. He noted and colloidal silver, a toxic heavy metal that the FDA has that the herbal mixture PC-SPES was recendy found to be adul- declared useless for any medicinal purpose. terated by prescription drugs. He did not mention that when The audiors offer numerous references to support the use of diese methods, but all are inadequate or irrelevant. The cita- Dr. Atwood is an anesthesiologist at the Newton-Wellesley tion for colloidal silver, for example, is a report of its use as a Hospital in Newton, Massachusetts. He is Assistant Clinical preservative. The authors admit, near die end of their twenty- Professor at the Tufts University School of Medicine and page chapter, that proof of their assertions is lacking. Contributing Editor of the Scientific Review of Alternative Nevertheless, on the first page they have promised diat die Medicine. E-mail: [email protected]. program "should guide die physician is assisting patients in 2 4 September/October 2003 SKEPTICAL INQUIRER optimizing their health, slowing disease progression, improv- "Biofield," according to an OAM publication, is defined as "'a ing quality of life, and possibly improving immune function." massless field' dial: (a) is not necessarily electromagnetic, (b) surrounds and permeates living bodies, (c) affects die body, and Implausible Claims and Unacknowledged (d) possibly is related to qV (Raso 1997). According to the Scientific Fraud NCCAM Web site, "This Center facilitates and integrates According to the Bastyr Web site, die NCCAM also sponsors research on die effects of low energy fields. The research is a study of "Distant Healing Therapy in HIV/AIDS." focused on developing standardized bioassays (cellular biology) Investigators include Standish and the late Elisabeth Targ, pre- and psychophysiological and biophysical markers of biofield viously the subject of a SKEPTICAL INQUIRER column by effects, and on die application of the markers developed to mea- Martin Gardner (March/April 2001). "Distant Healing" in sure outcomes in die recovery of surgical patients." diis case means that anonymous people pray, from a distance, for patients who are unaware of it. The study is to "extend pre- The NCCAM funds Elisabeth Targ's distant liminary work," by which is meant Targ's healing studies, presumably 1998 study, famous in CAM circles (Sicher et al. 1998). The NCCAM also funds justified by her 1998 study. another of Targ's distant healing studies, That study, however, has now been presumably also justified by her 1998 study. That study, however, has now been revealed revealed as a scientific fraud. as a scientific fraud (Bronson 2002). At the time of this writing neither the Bastyr Web site nor the NCCAM has acknowledged this, and the The center's Principal Investigator is psychologist Gary NCCAM apparently has no plans to discontinue the now- Schwartz, a colleague of alternative medicine guru Andrew baseless current studies. Weil at the University of Arizona. Schwartz has published a Anodier of Standish's studies, sponsored by the NCCAM, book in which he claims to have shown scientifically diat "con- is "Transfer of Neural Energy." It proposes to find "that visu- sciousness continues after ally evoked potentials generated in one human brain (Subject death" and that mediums, A) by photostimulation can generate a correlated EEG signal in the brain of another human subject (Subject B) who is located at a distance (14.5 meters) and is not visually stim- ulated" (BURP 2003). In other words, it hypothesizes the recurrent paranor- mal claims of thought transmis- sion and "remote viewing," both of which are implausible and never demonstrated despite thousands of attempts (Kurtz 1985). Standish was an original member ot the recently formed Institute of Medicine (IOM) panel on "Use of Complementary and Alternative Medicine by the American Public,' sponsored by a $1 million grant from the NCCAM (IOM Web site 2003). This panel will not consider die validity of CAM claims, but seems intended to pro- vide justification for the NCCAM's con- tinued existence. Research Centers, More Implausible Claims, and "Integrative Medicine" Centers The NCCAM funds several "research centers," among which is Bastyr University.