My e-mail to the NCI – A follow up
I recently send an e-mail to the NCI criticizing them about their apparent support of acupuncture as a viable alternative for cancer patients. I received the following reply from “staff” at NCI.
Thank you for your e-mail to Dr. John E. Niederhuber, Director of the National Cancer Institute (NCI), regarding NCI information on acupuncture. We think you may be referring to the “PDQ(r) Complementary and Alternative Medicine Summary for Patients on Acupuncture,” which can be found at http://www.cancer.gov/cancertopics/pdq/cam/acupuncture/Patient on the Internet. We appreciate the time you took to share your thoughts and concerns with us. We have forwarded your comments to NCI staff responsible for this summary.
We also want to make you aware of the health professional version of this summary, which can be found at http://www.cancer.gov/cancertopics/pdq/cam/acupuncture/HealthProfessional on the Internet. This summary provides comprehensive, peer-reviewed, evidence-based information about the use of acupuncture as a treatment for cancer.
Thank you for writing.
National Cancer Institute
To point out the obvious, I was not satisfied at all with this reply. So I send a reply of my own. Next both replies will be set up in letter form and mailed to the director of the NCI’s attention. Please follow suit and send e-mails of your own.
Dear NCI Staff,
Thank you very much for your reply. I appreciate you taking the time to write back regarding my concerns. I am not sure from your reply though, if the message was forwarded to Dr. Niederhuber, as was my wish, or not. Can you clarify that for me? I intend to reproduce my e-mail in letter format and mail it to Dr. Niederhuber if you are unable to do this.
I was only partially referring to the “Summary for Patients” in my e-mail. Actually, the blog entry I linked to is referring to the Q&A section which can be found at http://www.cancer.gov/cancertopics/pdq/cam/acupuncture/patient/45.cdr#Section_45. This is the section most people doing a simple search are more likely to stumble upon, and the one that the “Summary for Patients” page links to.
I am glad to see that you have a professional version of this summary for the health care professionals. Nevertheless, I am less worried about health care professionals, who ought to be aware of the science and research, than I am about the patients and the overall positive overview the NCI gives acupuncture on the patient information section. I reiterate that the scientific consensus with regards to acupuncture is fairly unambiguous and that consensus should be prominently displayed in you website, especially in the patient Q&A section. As I already expressed, the opposite, unfortunately is true in this case.
Furthermore I find the health care professional summary quite unsatisfactory as well. For example, the Human/Clinical Studies page refers to many studies, most of whom were conducted in China. The lack of significant studies from other countries, such as the USA where according to the NCI’s website acupuncture has been practiced for over 200 years, is a major red flag in and of itself. Nevertheless, when looking at Table 2, you immediately see that the studies 1 & 2 are listed as having no control group. Study 4 is listed as possibly having sham. When I follow the link to Pubmed it turns out this one had no control group either. Sham acupuncture is not mentioned in the abstract at all, in fact it seems pretty clear the second group got conventional treatment alone. Same goes for your study #5. Leaving aside issues of credibility when all studies are coming out of one place, this casts huge doubts on the validity of these studies. In fact this is how the abstract of study 5 partially reads: “observed with double blind method. Forty patients were divided randomly into two groups, 20 for each. One group treated with acupuncture and the other one for control.” The method of the “control” is not mentioned, leading one to believe they simply did not apply anything to the second group, a non-control mechanism that does nothing to help the researches in separating real effects from placebo.
This is the sort of studies that the NCI is basing their statements on? I think the NCI’s duty is not only to report, that’s what the 10:00 o’clock news are for, credulous, unquestioning reporting, but to comment and take a stance. This issue is not one where political correctness trumps science and the evidence. The public has higher expectations of established institutions such as the NCI, and we expect such institutions to hold themselves to even higher standards. Sadly, it appears that someone made a mistake at the NCI in this case. I, and many others, are still waiting to hear about corrective actions to be taken, to properly inform the public, especially the sick ones in our midst, such as my father, about the best evidence based options available to them,and steer them away from unproven modalities, based on pre-scientific magical thinking and philosophies that do nothing but waste their limited time and money.
Please forward this e-mail exchange to Dr. Niederhuber as I am sure he would be just as disturbed, if not more,as I am about this issue.
Thank you very much