First Transagency Fellowship in Cancer CAM Awarded
Scott Miller, M.D.
Scott Miller, M.D., of Iowa City, Iowa, is the first recipient of a new fellowship in medical oncology and CAM jointly sponsored by NCCAM, the National Cancer Institute (NCI), the NIH Clinical Center, and the U.S. Food and Drug Administration (FDA). The 3-year fellowship is designed to help new researchers gain expertise in CAM and cancer research, policy and regulatory affairs, and clinical investigation.
"Cancer patients have a high rate of CAM use," said Patrick Mansky, M.D., Director of NCCAM's Complementary and Integrative Medicine Consult Service at the NIH Clinical Center. "This fellowship provides physicians the opportunity to study CAM approaches in oncology. Dr. Miller brings an excellent degree of training and experience to this position."
Dr. Miller graduated from the University of Iowa College of Medicine. He completed a residency in family medicine at Loma Linda University Medical Center, Loma Linda, California; served 2½ years as a physician with the Indian Health Service in Kotzebue, Alaska; and completed a 1-year oncology fellowship at Iowa.
Dr. Miller's training included experience at a clinic whose focus was cancer patients and CAM. A major challenge in patient care, he said, came from "unsafe duplication. Some clinic patients were using multiple products, up to 15 or 20 at once. [Also,] some preparations such as 'tonics' have multiple ingredients. I recall one patient who was taking a group of combination products; five contained selenium that, when added together, exceeded recommended levels. Our clinicians would review all of a patient's products, attempt to produce a rational strategy (if possible), and try to avoid these duplications." Another challenge was the fact that some herbs, such as St. John's wort, can interfere with chemotherapy.
Tai chi is one of the CAM therapies available at the NIH Clinical Center
© Bob Stockfield
Some of Dr. Miller's areas of concentration in the CAM oncology fellowship will be to:
- Learn about and gain experience in the use of CAM in cancer pain, symptom management, and rehabilitation
- Perform patient evaluation and patient care as part of a team
- Learn about regulatory issues pertinent to the use of CAM therapies, especially botanicals, through a rotation at the FDA
- Participate in NCI's Best Case Series Program, reviewing documents submitted about patients treated with CAM approaches in order to determine whether NIH support for further investigation is warranted
- Learn about clinical trials methodology and design and carry out an original research project.
At the NIH Clinical Center, Dr. Miller's experience will include rotations at the Rehabilitation Medicine Department and the Pain and Palliative Care Service. Dr. Miller will also work with the Complementary and Integrative Medicine Consult Service (recently established by NCCAM), which coordinates the resources of these existing efforts and develops programs and services in clinical, research, and education areas.
