Alternative Medicine Center Will Probe Cancer, Pain Therapies

SAN FRANCISCO—A new center for alternative medicine, one of only a handful in the nation, will soon open at the Biomedical Research Institution of the University of California, San Francisco (UCSF), educators announced at a symposium on integrative care.

Funded by the philanthropy of the Osher family, the new program—the UCSF Osher Center for Integrative Medicine—will investigate alternative medicines and therapies, testing their efficacy, as well as treating patients with such illnesses as cancer and chronic back pain through acupuncture and herbs.

“The center will provide a new kind of medicine—a medicine that honors healing the whole person as much as it honors curing the disease,” said Haile Debas, MD, future chancellor and current dean of the UCSF Medical School.

Instead of bringing in a cadre of alternative practitioners to practice their art, however, Dr. Debas believes that the new Osher Center can best serve the public through stringent investigations of alternative therapies and education of physicians and residents about integrative medicine.

His interest in alternative medicine began when he read a 1993 study by David Eisenberg, MD, of Harvard University, showing that Americans spend more than $10 billion a year on alternative medicine—and that the number of visits to alternative practitioners exceeds those to primary care providers. “It was a vote of no confidence in western medicine—information that we felt we had to take seriously,” Dr. Debas said.

Dr. Eisenberg has now formed a center of alternative medicine at Harvard, where he is assistant professor of medicine. “One of the most startling observations of our initial national study was that 72% of the people who used alternative therapies for the treatment of serious illnesses never discussed them with their physicians. That is sobering,” he said. “We have a moral imperative to set that right.”

That’s why Dr. Eisenberg believes that more universities such as Harvard and UCSF need to sponsor centers that will investigate alternative therapies.

“Right now we have a market-driven tidal wave,” he said. “Instead, we need rigorous scientific evaluation of alternative medicine. We also need to train the next generation of nurses and physicians to know how to have a responsible conversation with patients about the use or avoidance of alternative medicine.”

UCSF is already beginning research in alternative medicine—specifically a program that studies the worth of intensive psychosocial support and lifestyle changes for breast cancer patients. The researchers will be testing the use of standard psychotherapy as well as yoga, meditation, nutrition, guided imagery, and expressive arts and movement.

Additionally, a small group of 20 patients with advanced metastatic breast cancer will be treated with the herbal remedies of Tibetan medicine, all selected by renowned Tibetan physician Yeshi Dhonden. The herbs, however, will first be tested for toxicity, and patients will be monitored for liver function. The trial will continue only if the herbs prove as effective as standard therapy.

“Our goal in treating breast cancer is not only to treat the cancer but also to return a woman to a life she wants to live, a life that is hopefully better than before,” said Laura Esserman, MD, MBA, director of the UCSF Breast Care Center. That’s why the center will be studying lifestyle changes and herbs along with numerous conventional therapeutics.

“In studying Tibetan herbs, we’ve found that some do have antitumor effects; they kill cell lines. At the same time, we’ve also found some to be toxic. There is simply a lot to be learned through careful testing and careful science,” she said.

UCSF already sponsors classes for its medical school students in alternative therapies such as homeopathy, classes the school hopes to expand and continue through the Osher center. The Osher program will be centered in the medical school, but other professional schools, such as the schools of nursing and dentistry, have been invited to participate.

Ward Glenn Gypson, MD, associate clinical professor of orthopedics, UCSF, and medical director of rehabilitation services, San Francisco General Hospital, will spearhead the effort to bring alternative medicine to the university’s orthopedics clinics. Health professionals will administer acupuncture for pain relief, and the clinics may offer classes in guided imagery, hypnosis, tai chi, and yoga.

“These techniques approach pain in a different way than conventional medicine. They deal with the emotional and psychological aspects of pain, as well as the physical symptoms,” Dr. Gypson said. “An additional benefit is that patients will learn these techniques not from someone off the street but from educators and qualified health professionals,” he said.