Alternative medicine comes in from the cold

FRANK DOBSON, the Health Secretary, called yesterday for "rigorous standards" to be applied to the practice of alternative medicine to ensure it is effective and safe.

Mr Dobson, who was speaking at a conference aimed at breaking down the barriers between orthodox and alternative medicine organised at the instigation of the Prince of Wales, said patients wanted treatment that was dependable, whoever was providing it. Although orthodox medicine had transformed the lives of millions of people, it was not suitable for everyone or every condition.

"It is clear that some people with some conditions do not respond to even the most modern orthodox treatment. It's also clear that some of these people can be and are being helped by forms of complementary and alternative medicine," he said.

Mr Dobson announced a grant of pounds 25,000 to the University of Exeter to help improve self-regulation by alternative medicine organisations. "More and more rigorous standards are being applied both to therapeutic practices and to the practitioners themselves. That's only right and proper. The same rigorous standards must be applied right across the board," he said.

Medical experts who addressed the conference said that critics who dismissed alternative medicine as witchcraft ought to remember that orthodox medicine was frequently unscientific and had the potential to do more harm than good.

The Prince of Wales, who opened the conference, said conventional doctors needed to understand the contribution individuals could make to their own well-being, while alternative practitioners had to recognise the power of rigorous research. He said: "I hope we shall see an increase in research, not only into the safety and effectiveness of alternative therapies ... but also into what people want from their healthcare and why they turn to less conventional care."

The conference was organised by the Foundation of Integrated Medicine, set up at the suggestion of the Prince last year, to bring the worlds of orthodox and alternative medicine closer together. Experts in conventional medicine said yesterday that the two worlds were not so far apart.

John Bell, professor of clinical medicine at the John Radcliffe Hospital, Oxford, told the conference: "Orthodox medicine is often held up as a model of how things work. In fact it is far from perfect science."

Most diseases were defined by their appearance, not their causes, many drugs were discovered by accident, not design, much treatment was based on anecdotal evidence, not systematic review, and the role of psychological and social factors was still little understood.

"As physicians, when we don't know what is going on, we make it up," he said.

Herbal preparations which had been around for thousands of years were still being "discovered" by conventional medicine. One example was artesinate, used in China for millennia but only now being adopted by medical scientists as the only effective remedy for severe drug-resistant malaria.

Professor Bell said conventional doctors were also switching focus from the disease to the individual who had it and through whom it could be expressed in different ways - something already familiar to alter- native practitioners. "We need to know what kind of patient has the disease rather than what kind of disease the patient has."

Iain Chalmers, director of the Cochrane Centre which monitors medical research, said critics of alternative medicine who claimed its mechanisms were not understood and it had the potential to cause more harm than good were guilty of applying double standards. "Who knows how aspirin relieves a headache or ECT (electro-convulsive therapy) eases depression? Orthodox medicine has far greater potential for harm because of its more powerful chemical and biological effects and because it is more widely distributed."

I believe the body tells us what it needs

for: SUSAN PEMBREY, BREAST CANCER PATIENT

AS A former nurse, Susan Pembrey knew what to expect when her breast cancer was diagnosed four years ago. She was happy to accept most of the conventional treatment she was offered, but she also wanted something more, writes Jeremy Laurance.

"At one level the whole experience [of conventional medicine] was excellent. I felt safe and well cared for and the staff were competent and kind. But I believe the seeds of ill-health lie within each of us and that the body tells us what it needs. In my treatment I was looking for both intuition and rationality."

She had a partial mastectomy followed by radiotherapy and she sought in alternative therapy something to assist and strengthen her body to withstand this assault. Being able to choose what treatment she would have gave her a measure of control over her illness.

Within 24 hours of her diagnosis, she developed flu and a friend gave her a homoeopathic remedy. "It was truly miraculous. I felt better in hours." She was later prescribed arnica to prevent bruising associated with the surgery and other remedies to help her cope with the radiotherapy. "All these were of great significance as talismans against the assault," she said.

Later she was prescribed hypericum and a healer helped cure some residual nerve damage in her arm. She also made "radical changes" to her diet, excluding milk, because it encourages the build-up of mucus. She had a long term interest in nutrition, and had practised T'ai chi and dancing for many years, but she took a new pleasure in ensuring that she was well nourished.

Speaking at the conference, Ms Pembrey urged doctors to take greater account of the individual needs of their patients and to recognise that good judgement involves a combination of hard scientific evidence allied with human sensitivity.

Time is too precious to waste on twaddle

against: CAROLINE RICHMOND, LYMPHOMA PATIENT

CAROLINE RICHMOND has lived for over three years with non-Hodgkin's lymphoma, a slow-growing cancer, and expects to survive another decade if she is lucky. Although she has tried alternative therapies in the past she has no intention of doing so now.

"I was 53 when I was diagnosed. I will probably die in my mid-sixties. That is a bit on the early side but not excessively so." She adds: "In the past friends have given me homoeopathic medicines and Bach flower remedies but I consider them total twaddle. They contain minute amounts of nothing.

"Now that my days are numbered I feel that the time left to me is far too precious to waste on twaddle."

Ten years ago, while suffering from an episode of ankylosing spondylitis, a rheumatic disease, she met an acupuncturist at a party who invited her to come for treatment. She went out of curiosity.

"He was an extremely nice man and I have a lot of respect for him. But my rheumatologist had told me I should get better in six months and I have no evidence that having the pins stuck in me made any difference."

"In voodoo you pay someone to stick pins in an effigy of your enemy. In acupuncture you pay someone to stick pins in you. It is a very odd thing to do."

She believes it did, however, help her cope with the pain. "The very act of inviting someone to stick needles in you is part of mentally preparing to deal with the pain. I was in tremendous pain and I learnt to mentally stand aside from it. Paying to have needles stuck in you may be a part of learning that strategy."

For her lymphoma, she has had six months of intermittent chemotherapy to shrink the tumours and will have more as necessary. But she has finished with alternative medicine.