In an attempt to break through what he describes as "the barriers of institutional bias," Rep. Dan Burton (R-Ind.), who chairs the U.S. House of Representatives Committee on Government Reform, held the first of a planned series of hearings last month on the role of complementary and alternative medicine in the treatment of cancers.
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Burton also announced his intention to convene additional hearings on other types of cancer and CAM. The June hearing focused on the role of early detection and CAM in women's cancers, but in the fall, there will be a hearing on prostate cancer.
Throughout the day-long event, Burton expressed misgivings about NCI's "genuine interest" in exploring CAM approaches, citing his disappointment in the less than 1% of NCI's $2.7 billion budget that is now routed to CAM research. Burton said he is considering specifying language in NCI's appropriation bill that would determine how much should be spent on CAM research in the future.
Edward Trimble, M.D., head of the surgery section in NCI's Clinical Investigations Branch, testified that NCI is committed to fostering the integration of CAM into modern cancer care, and described several recent NCI research activities.
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Trimble added that NCI is actively soliciting grant applications in CAM therapies.
Another speaker, James Gordon, M.D., of the Center for Mind/Body Medicine, praised the institute's advances toward integrating CAM into mainstream medical practices, saying that this is "the kind of partnership we need."
Rep. Henry Waxman (D-Calif.), and Rep. Eleanor Holmes Norton (D-D.C.), both of whom serve on the committee, urged in their opening statements that no battle between alternative and conventional therapies be propagated and that safe and effective treatments should be sought and developed regardless of their classifications or origins.
Rep. Patsy Mink (D-Hawaii) said there was a "pathetic neglect" in the area of early detection of ovarian cancer, and others on the Committee, among them Waxman and Rep. Helen Chenoweth (R-Idaho), echoed her concern. Mink proposed considering legislation that would devote $150 million for developing a test for the early detection of ovarian cancer, and Burton offered his support as a co-sponsor.
Trimble, in his testimony, detailed the NCI's research initiatives in this area. He noted the establishment of a Specialized Program of Research Excellence grant targeting ovarian cancer and the ongoing Prostate, Lung, Colon, and Ovarian cancer clinical trial, which is designed to measure the usefulness of current testing for those types of cancer.
Witnesses who represented the views of the CAM community told the committee that cancer patients are systematically denied full access to the treatments they choose, either through inadequate information, poor availability of alternative therapies, or lack of affordability of treatments that are frequently not covered by insurance plans.
Linda Bedell-Logan, president of Solutions in Integrative Medicine, raised her concern that "integrative medicine is becoming a rich person's medicine."
Susan Silver of the George Washington University Integrative Medicine Center, Washington D.C., explained that her work involves providing cancer patients, as an adjunct to their conventional treatment plans, quality-of-life enhancing regimens featuring acupuncture and guided imagery for pain management. However, she noted, the "program is accessible only to those with the most financial wherewithal" because insurance coverage for these services is unusual. Silver suggested that insurance benefits for these types of treatment be mandated and that Medicare serve as an example.
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