Some of it is indeed 'scary stuff', but complementary medicine should not be ignored

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The Independent Online

A quarter of the British public will use complementary medical treatments at some point, so it is perhaps odd that the UK can only boast one, lone, professor of complementary medicine. That makes the work of Edzard Ernst of the University of Exeter all the more deserving of an audience in the debate about the merits of unorthodox medical treatments.

Prof Ernst yesterday published a study of internet sites that offer complementary cancer medicine and his findings are a shock. Not one of the medicines advocated on these sites can be shown to prevent or cure cancer, as promised. Prof Ernst even found that some of these websites even go as far as actively discouraging patients from using conventional treatments, which could mean nothing less than a death sentence for any cancer sufferer who took this advice. It is difficult not to concur with the professor's view that this is "pretty scary stuff".

Common sense often disappears whenever the phrase "complementary medicine" crops up. To some it means quack cures, but to others it is nothing short of a panacea - a pain-free alternative to established medical techniques. As Prof Ernst's study shows, complementary medicine is no panacea, but its critics are wrong to ignore the fact that it can alleviate suffering in certain circumstances.

Prof Ernst was keen to stress yesterday that some complementary medicines do work. Acupuncture can alleviate back pain; hawthorne can help patients with congestive heart failure and peppermint can reduce the symptoms of irritable bowel syndrome. The problem comes when patients start to see such medicines as alternatives to conventional treatment, rather than complements. This is the reason some of the cancer-cure websites studied by Prof Ernst are so dangerous; they tell patients to shun conventional treatments altogether.

The solution is to offer advice to patients on which complementary medicines have been shown to be effective and which unorthodox treatments may help them. As research continues to differentiate the beneficial treatments from the quack cures, patients will then be able to make better-informed judgements. Prof Ernst's proposal for a seal of approval for respectable complementary medicine websites should also be explored.

However, it would be pointless to ban the medicines deemed harmful. Laertrile, a substance made from apricot stones, has been touted as a cure for cancer since the 1970s, despite the complete lack of evidence that it has any effect. There is no reason to believe that a ban would diminish the mystique this substance evidently holds or, more importantly, cut its availability.

But there is something the medical establishment could do. Many doctors are still unwilling to involve patients in planning their treatment and exploring the options available with them. When patients start taking complementary medicines (sometimes without informing their doctor) they are exercising a simple right to choose that has, sometimes, been denied them. The rise in popularity of complementary medicines is in direct proportion to the waning of the patient's adherence to the "doctor knows best" ethos.

This phenomenon is by no means limited to Britain. In the US, 60 per cent of the population will have used complementary treatment in any given year. In Germany the figure is as high as 75 per cent. The technology of the internet has made the distribution of complementary cures extremely easy. It also enables people to bypass conventional medical advice completely if they so choose.

As Professor Ernst has shown, there are dangers lurking in the expanding field of complementary medicine. Conventional health practitioners must do everything in their power to warn the public about the pitfalls, but they will not be able to prevent patients turning to complementary medicines. Some doctors may find this a bitter pill, but in the end they will have no choice but to swallow it.