Alternative therapies up close

The touted cures couldn't be more outlandish: To relieve stress and other mind-related disorders, try a walnut-based remedy, because the walnut, after all, looks like the brain. For those suffering from cancer, inject fermented mistletoe extract into the body because mistletoe bears a striking resemblance to malignant tumours.

As ridiculous as these remedies are, and despite the fact that there is not a shred of evidence that they actually work, millions of people around the world swear by such alternative therapies.In Trick or Treatment, British authors Simon Singh and Edzard Ernst expose the false claims and profiteering of alternative medicine while sounding the alarm about the dangers of many of the therapies.

The authors are well-suited for the task: Singh is an acclaimed science writer with a PhD in particle physics, while Ernst is an MD, as well as a PhD in the field of blood research. What's more, Ernst is a professor of complementary medicine who used to believe in the efficacy of homeopathy until his scientific studies proved to him otherwise.Keeping open minds, the authors combed through the results of hundreds of clinical trials on alternative therapies (walnuts and mistletoe included) to determine whether any live up to the hype.

From homeopathy and acupuncture to chiropractic and herbal medicine, alternative health care has grown into an $80-billion-a-year industry. Sadly, with the exception of perhaps massage therapy, they found that much of alternative medicine doesn't work beyond the placebo effect."In general, the global multi-billion-(dollar) alternative medicine industry is failing to deliver the sort of health benefits that it claims to offer," they write. "Therefore millions of patients are wasting their money and risking their health by turning towards a snake-oil industry."

But what about the ancient Chinese system of acupuncture? Surely a treatment that has been endorsed by the World Health Organization is more than just quackery?

The authors reveal how the WHO endorsement was highly politicized and has since been discredited. They cite the latest scientific papers that show that acupuncture is useless for the treatment of addiction, Bell's palsy, stroke rehabilitation and many other ailments it purports to heal. Studies have demonstrated that it is somewhat effective for pain and nausea, but the authors suggest that many conventional drugs do a better job. And they warn that acupuncture is not without risk: there have been cases of accidental lung punctures and of patients contracting hepatitis from needles that were not sterilized.

Homeopathy doesn't fare any better. Based on the premise of "like cures like," homeopathic medicines are supposed to contain infinitesimal traces of active ingredients. But the authors argue quite persuasively that these medicines are nothing more than expensive sugar pills. Again, they warn that some patients with serious illness might be endangering their lives if they take homeopathic medicines to the exclusion of proven conventional treatments.

The sections on chiropractic and herbal medicine - which, incidentally, relate a number of Canadian case studies - are equally damning. The authors tell the story of Laurie Mathiason, a young woman from Saskatoon who died of a ruptured vertebral artery following a chiropractic neck manipulation. And they relate the case of Charlene Dorcy, a Vancouver woman who suffered from severe depression and paranoid schizophrenia. Even though she had been responding well to one of her medications, Dorcy switched to St. John's wort.

Although the herbal medicine has been shown to be effective in the treatment of mild to moderate depression, it's not appropriate for severe depression or schizophrenia and can interfere with other drugs. Several weeks after taking St. John's wort, Dorcy drove her two children to an abandoned quarry, shot them to death and then gave herself up to police.

(The authors also evaluate 36 other alternative therapies - from the Indian Ayurvedic tradition to colonic irrigation - in an easy-to-read appendix. The observations are mostly negative.)

Despite their brilliant and often amusing critique of alternative therapies, the authors nonetheless fail to recognize the irony of how mainstream medicine has contributed to the problem. The authors are quick to blame the news media for trumpeting alternative therapies, as 60 Minutes did in a piece on shark cartilage. They accuse universities of lowering their academic standards by offering programs in homeopathy, and they criticize governments for neglecting to regulate the industry.

But aside from a half-page mention of the rudeness and arrogance of some doctors, Singh and Ernst don't address how shady practices in modern medicine are driving many people to alternative therapies. No cases are reported about conflicts of interest among physicians, falsified medical research or how drug companies have systematically withheld negative results of some of their studies. Given the continuing paternalistic attitude by the medical establishment and its lack of transparency, some people could be forgiven for turning to alternative therapies.

However, before doing so, people who look favourably onQ-rings, crystals and magnet therapy should read Trick or Treatment. Its dissection of the industry should make them think twice about popping a homeopathic pill.