Spring 2005 ACAM Conference Report by L. Farrow On May 20th to 22nd, The American College for Advancement in Medicine held its spring conference in Orlando. The theme was menopause and andropause, which is relative to quality of life issues for cancer patients but also because so many cancers seem to strike at middle age when the hormones seem to de- stabilize or decline. One of the main questions raised at the conference was, “Do hormones make a difference? If so, how?” In the wake of the Women’s Health Initiative Study results, many practitioners discouraged HRT. Yet still others have pointed out the WHI used only synthetic hormones and results of the study regarding breast cancer were statistically insignificant at 2% in the Prempro (combined Premarin and progestin) arm. Whereas the results of the Premarin (estrogen only) arm, which was quietly released in 2003, showed a huge reduction in breast cancer and colon cancer. ACAM’s practitioners by definition practice complementary, alternative and integrative medicine (CAIM) so, predictably, when they prescribe hormones, they are likely to be bioidentical and not the synthetics used by the WHI because they feel bioidenticals are less likely to be toxic to the body. High Dose Cyclic HRT: The Wiley Controversy The fireworks started at the conference when self-described housewife and author, T.S.Wiley, introduced the theory behind her controversial, high dosed bioidentical hormone replacement regimen. Wiley’s book, Sex, Lies and Menopause, asserts that most major diseases such as cardiovascular disease and cancer begin at menopause. Thus the solution, she holds, is to give estrogen and progesterone in doses high enough to duplicate the blood levels of a 20 year-old woman. Since no research had been done on this regimen, trademarked as the Wiley Protocol, the clinicians in the audience raised many questions about safety and liability issues. Wiley, however, remained unconcerned and claimed she took dozens of cell phone calls every day from patients on the protocol or doctors seeking her guidance. One of Wiley’s responses was, that “Suzanne Somers and other cancer patients are on this protocol.” Wiley also said her own 89 year-old mother used the high dose hormones and was happy to cycle and get periods because she felt better. ACAM President, Allan Magaziner, D.O., said, “We knew Wiley would be the most controversial speaker but the organization does not like to censor unique viewpoints whether they turn out to be valid or not.” Debu Tripathy, MD, on Tibetan and Chinese Herb Research While many doctors treat patients with alternatives work outside of mainstream medicine, and often pay the price, losing, for instance, their hospital privileges, oncologist Debu Tripathy has apparently chosen to work within the system. As Professor and Director of Internal Medicine at the Komen/UT Southwestern Breast Cancer Research Program at University of Texas Southwestern Medical Center at Dallas, he has not only focused on chemotherapeutic trials, but also on herbal therapy. His strategy has paid off as the medical establishment continues to support his alternative approaches. The Food and Drug Administration has given him their first Investigational New Drug License to study an Asian herbal formula to reduce side effects of adjuvant chemotherapy. Even more outside the mainstream, the State of California has given him a grant to assess Tibetan herbal formulae as sole therapy for metastatic cancer. Dr. Tripathy’s presentation at the ACAM conference was titled “Models of Research for Complementary Medicine in Breast Cancer.” The most striking information from his talk addressed those who claim the only reason alternative treatments such as herbs aren’t studied is that drug companies can’t make any money out of herbs. There are many inherent difficulties in testing herbs, especially when they are part of a whole different tradition of medicine. But bringing alternative treatments, particularly Asian herbal treatments with a long history, into Western labs is becoming more important yearly. The doctors say they are open to their patients taking other treatments as long as those treatments meet the requirements of evidence based medicine – which today means, primarily, double blind studies. But how can that be done? For Traditional Chinese Medicine/ Tibetan Medicine no such studies are possible for several reasons. First, botanical/herbal products are inconsistent from year to year and even crop to crop. Add that to the fact that each practitioner may evaluate a patient differently and prescribe a different course of herbs. But Dr. Tripathy is trying to make some inroads in standardizing by using what he calls a “black box” approach in a pilot trial of Tibetan Medicine for Stage IV breast cancer. The requirements are that the women be at a similar stage of disease and take similar FDA-approved Tibetan herbs. This model is a huge advance in getting acceptance by Western Medicine. But another problem arises. What about double blind, placebo-controlled studies? Few cancer patients want to roll the dice with a placebo. In one of Dr. Tripathy’s studies, 30 patients out of 60 planned to enroll. Only 10% of the eligible patients finally did enroll because of the reluctance of the others to be randomized to a placebo. Still, Dr. Tripathy has made a good start and continues to find new ways of testing old medicine. This was one of the presenters ACAM President, Dr. Magaziner had in mind, when he said, “There is a lot of scientific information as well as clinical pearls in these speakers– and the energy of the audience was in sync with them.” Dr. Sherri Tenpenny and the Role of Iodine in Breast Health Although she did not give a formal presentation, a highlight of the conference was meeting Sherri Tenpenny, D.O, of Cleveland. Dr. Tenpenny is already well known for her work against vaccines (see www.novaccines.com) but she is now vigorously pursuing the role of iodine deficiency in the breast in her practice. This idea has been on the edge of breast disease therapies for a while but it seems like it’s finally igniting. What does iodine have to do with the breast? First, let’s look at fibrocystic breast disease. Reporting on years of research by Ghent and Eskin, Dr. Tenpenny cites a 40-70% improvement in pain and measurable reduction of breast fibrosis. Secondly, Ghent observed a two-fold reduction in the incidence of breast cancer in patients treated with iodine compared to the local population in Ontario. Tenpenny makes the case that breast tissue is a “sponge” for iodine, and asserts “the minimum amount of iodine to protect the breast from fibrocystic disease and cancer is 20-40 times more than is needed to prevent goiter (i.e., 3-4 mg/day for breasts.)” She cites Ghent’s article in the Canadian Journal of Surgery (1993). What is the mechanism of action? One theory is that the iodine helps rid the congested tissues of the breast from dead cells and toxins. Dr. David Derry, a previous speaker at the World Breast Cancer Conference, agrees that adequate iodine metabolism in the breast operates as “a surveillance system for removing abnormal cells from our bodies.” He goes on to say “low iodine intake allows cells to proceed and develop towards cancer. This is more indirect because the gradual increase in abnormal cells are just not being eliminated from the body because there is inadequate iodine to carry this out.” Also, consider Krouse et al. (1979) artificially blocked iodine in young rats, they developed changes similar to fibrocystic breast disease. As they grew older, the rats showed more serious mammary changes. If this is true, that might be one reason Japanese women who eat an iodine-rich, seaweed-containing diet, are diagnosed with much less breast cancer. Dosing ranges of supplemental iodine may vary so finding a practitioner like Dr. Sherri Tenpenny or others who have clinical experience with this therapy is essential. ACAM’s Fall 2005 conference in Anaheim, CA, will further explore the role of iodine with Presenter David Brownstein, MD. Ann's NOTE: This writer runs AMAZON, a listserv for those with breast cancer and a strong interest in alternative medicine. Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.