Federal center pays good money for suspect medicine
Feds dole out millions of dollars for questionable studies on treatments ranging from energy healing to acupuncture
Harry Bosk receives an acupuncture treatment for a pulled calf muscle from Marcos Y. Hsu, a licensed acupunturist at the University of Maryland School of Medicine, Center for Integrated Medicine. (Lloyd Fox/Baltimore Sun)
The National Center for Complementary and Alternative Medicine also helped pay scientists to study whether squirting brewed coffee into someone's intestines can help treat pancreatic cancer (a $406,000 grant) and whether massage makes people with advanced cancer feel better ($1.25 million). The coffee enemas did not help. The massage did.
NCCAM also has invested in studies of various forms of energy healing, including one based on the ideas of a self-described "healer, clairvoyant and medicine woman" who says her children inspired her to learn to read auras. The cost for that was $104,000.
A small, little-known branch of the National Institutes of Health, NCCAM was launched a dozen years ago to study alternative treatments used by the public but not accepted by mainstream medicine. Since its birth, the center has spent $1.4 billion, most of it on research.
A Tribune examination of hundreds of NCCAM grants, dozens of scientific papers, 12 years of NCCAM documents and advisory council meeting minutes found that the center has spent millions of taxpayer dollars on studies with questionable grounding in science. The cancer treatment involving coffee enemas was based on an idea from the early 1900s, and patients who chose to undergo the risky regimen lived an average of just four months.
The spending comes as competition for public research money is fierce and expected to get fiercer, with funding for the NIH expected to plateau and even drop in coming years.
"Some of these treatments were just distinctly made up out of people's imaginations," said Dr. Wallace Sampson, clinical professor emeritus of medicine at Stanford University. "We don't take public money and invest it in projects that are just made up out of people's imaginations."
"Lots of good science and good scientists are going unfunded," said Dr. David Gorski, a breast cancer researcher at Wayne State University, who has been a vocal critic of NCCAM. "How can we justify wasting money on something like this when there are so many other things that are much more plausible and much more likely to result in real benefit?"
The director of the center and other advocates say it is worthwhile to use taxpayer dollars to study certain alternative treatments.
"They deserve scientific attention," said NCCAM Director Dr. Josephine Briggs, who noted that the center's $128 million annual allotment amounts to less than half a percent of the total NIH budget.
Briggs, a respected NIH researcher and physician who has headed NCCAM for nearly four years, said in an interview that she is dedicated to evidence-based medicine and that the center, under her leadership, is committed to rigorous scientific studies.
The center's recently adopted strategic plan focuses on studies of supplements and other natural products along with the effect of "mind and body" therapies like yoga, massage and acupuncture on pain and other symptoms. In fiscal years 2008-2011, NCCAM funded more than $140 million in grants involving mind and body therapies, including $33 million for pain research in fiscal 2011.
The new strategic plan "reflects real change or an evolution in our mission," Briggs said. "We are not your grandmother's NCCAM."
Studies of energy healing or distant prayer likely would not get funded by NCCAM today, she said.
Yet many mind and body treatments that are being studied, like qigong and acupuncture, also involve the purported manipulation of a universal energy or life force, sometimes called qi — metaphysical concepts unproved by science and incompatible with our modern understanding of how the body works.
In an email, Briggs wrote that it isn't necessary to invoke qi or other ancient concepts to study therapies that may benefit people with chronic pain, a significant health problem.
NCCAM's continuing interest in acupuncture comes even though many of its studies have found that acupuncture and similar therapies work no better than a sham treatment at easing symptoms like pain and fatigue.
To most scientists, that would mean the treatments are failures — drug companies cannot sell medicines that work no better than salt water or a sugar pill. But in the case of acupuncture and other mind and body medicine, the center and its supporters say it's unclear whether the benefits represent a placebo response or something more complicated.
Critics of the center say it's telling that NCCAM was conceived not by scientists clamoring to study alternative medicine, but by Sen. Tom Harkin, D-Iowa, a member of the powerful Senate subcommittee that helps oversee the NIH budget.