<DOC>
[106th Congress House Hearings]
[From the U.S. Government Printing Office via GPO Access]
[DOCID: f:61437.wais]
THE ROLE OF EARLY DETECTION AND COMPLEMENTARY AND ALTERNATIVE MEDICINE
IN WOMEN'S CANCERS
=======================================================================
HEARING
before the
COMMITTEE ON
GOVERNMENT REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTH CONGRESS
FIRST SESSION
__________
JUNE 10, 1999
__________
Serial No. 106-61
__________
Printed for the use of the Committee on Government Reform
Available via the World Wide Web: http://www.house.gov/reform
__________
U.S. GOVERNMENT PRINTING OFFICE
61-437 WASHINGTON : 2000
COMMITTEE ON GOVERNMENT REFORM
DAN BURTON, Indiana, Chairman
BENJAMIN A. GILMAN, New York HENRY A. WAXMAN, California
CONSTANCE A. MORELLA, Maryland TOM LANTOS, California
CHRISTOPHER SHAYS, Connecticut ROBERT E. WISE, Jr., West Virginia
ILEANA ROS-LEHTINEN, Florida MAJOR R. OWENS, New York
JOHN M. McHUGH, New York EDOLPHUS TOWNS, New York
STEPHEN HORN, California PAUL E. KANJORSKI, Pennsylvania
JOHN L. MICA, Florida PATSY T. MINK, Hawaii
THOMAS M. DAVIS, Virginia CAROLYN B. MALONEY, New York
DAVID M. McINTOSH, Indiana ELEANOR HOLMES NORTON, Washington,
MARK E. SOUDER, Indiana DC
JOE SCARBOROUGH, Florida CHAKA FATTAH, Pennsylvania
STEVEN C. LaTOURETTE, Ohio ELIJAH E. CUMMINGS, Maryland
MARSHALL ``MARK'' SANFORD, South DENNIS J. KUCINICH, Ohio
Carolina ROD R. BLAGOJEVICH, Illinois
BOB BARR, Georgia DANNY K. DAVIS, Illinois
DAN MILLER, Florida JOHN F. TIERNEY, Massachusetts
ASA HUTCHINSON, Arkansas JIM TURNER, Texas
LEE TERRY, Nebraska THOMAS H. ALLEN, Maine
JUDY BIGGERT, Illinois HAROLD E. FORD, Jr., Tennessee
GREG WALDEN, Oregon JANICE D. SCHAKOWSKY, Illinois
DOUG OSE, California ------
PAUL RYAN, Wisconsin BERNARD SANDERS, Vermont
JOHN T. DOOLITTLE, California (Independent)
HELEN CHENOWETH, Idaho
Kevin Binger, Staff Director
Daniel R. Moll, Deputy Staff Director
David A. Kass, Deputy Counsel and Parliamentarian
Carla J. Martin, Chief Clerk
Phil Schiliro, Minority Staff Director
C O N T E N T S
----------
Page
Hearing held on June 10, 1999.................................... 1
Statement of:
Gordon, James, M.D., Center for Mind Body Medicine,
Washington, DC; Susan Silver, George Washington University
Integrative Medical Center; Daniel Beilin, OMD, LAC, Aptos,
CA; Edward Trimble, M.D., Head, Surgery Section, Division
of Cancer Treatment and Diagnosis, National Cancer
Institute; and Jeffrey White, Director, Office of
Complementary and Alternative Medicine, National Cancer
Institute.................................................. 124
Mack, Priscilla, executive co-chair of the National Race for
the Cure; and Michio Kushi, the Kushi Institute, Brookline,
MA......................................................... 39
Zarycki, Carol, New York; N. Lee Gardener, Ph.D., Raleigh,
NC; and Linda Bedell-Logan, Saco, ME....................... 88
Letters, statements, etc., submitted for the record by:
Bedell-Logan, Linda, Saco, ME, prepared statement of......... 106
Beilin, Daniel, OMD, LAC, Aptos, CA, prepared statement of... 139
Burton, Hon. Dan, a Representative in Congress from the State
of Indiana, prepared statement of.......................... 6
Cummings, Hon. Elijah E., a Representative in Congress from
the State of Maryland, prepared statement of............... 29
Gardener, N. Lee, Ph.D., Raleigh, NC, prepared statement of.. 98
Kushi, Michio, the Kushi Institute, Brookline, MA, prepared
statement of............................................... 47
Mack, Priscilla, executive co-chair of the National Race for
the Cure, prepared statement of............................ 41
Mink, Hon. Patsy T., a Representative in Congress from the
State of Hawaii, prepared statement of..................... 25
Sanders, Hon. Bernard, a Representative in Congress from the
State of Vermont, prepared statement of.................... 13
Silver, Susan, George Washington University Integrative
Medical Center, prepared statement of...................... 131
Slaughter, Hon. Louise, a Representative in Congress from the
State of New York, prepared statement of................... 36
Towns, Hon. Edolphus, a Representative in Congress from the
State of New York, prepared statement of................... 32
Trimble, Edward, M.D., Head, Surgery Section, Division of
Cancer Treatment and Diagnosis, National Cancer Institute,
prepared statement of...................................... 146
Zarycki, Carol, New York, prepared statement of.............. 91
THE ROLE OF EARLY DETECTION AND COMPLEMENTARY AND ALTERNATIVE MEDICINE
IN WOMEN'S CANCERS
----------
THURSDAY, JUNE 10, 1999
House of Representatives,
Committee on Government Reform,
Washington, DC.
The committee met, pursuant to notice, at 10:37 a.m., in
room 2154, Rayburn House Office Building, Hon. Dan Burton,
(chairman of the committee) presiding.
Present: Representatives Burton, Gilman, Morella, Horn,
Mica, Biggert, Ose, Chenoweth, Waxman, Mink, Norton, Cummings,
Kucinich, Schakowsky, and Sanders.
Staff present: Kevin Binger, staff director; Daniel R.
Moll, deputy staff director; Barbara Comstock, chief counsel;
David Kass, deputy counsel and parliamentarian; S. Elizabeth
Clay, professional staff member; Mark Corallo, director of
communications; Carla J. Martin, chief clerk; Lisa Smith-
Arafune, deputy chief clerk; Laurel Grover, staff assistant;
Nicole Petrocino, legislative aide; Phil Schiliro, minority
staff director; Phil Barnett, minority chief counsel; Sarah
Despres, minority counsel; Ellen Rayner, minority chief clerk;
Jean Gosa, minority staff assistant; and Andrew Su, minority
research assistant.
Mr. Burton. Good morning. A quorum being present, the
Committee on Government Reform will come to order.
I ask unanimous consent that all Members' and witnesses'
written opening statements be included in the record. Without
objection, so ordered.
We will have other Members--I see some of them coming in
right now--joining us, so they will be coming in just a few
moments.
We are here today to talk about a subject that has probably
touched every family in America, cancer. Specifically, today we
are going to talk about women's cancers. At hearings in the
future, we will be talking about some of the major concerns
that men have, prostate cancer. I have talked to Michael
Milken's staff. We are going to be talking to Senator Dole's
staff. We will be talking to the minority also about people
that they might want to have testify about men's problems,
prostate cancer and other issues, as well as diets that might
assist men in fighting this dreaded disease as well.
But today, we are going to be talking about women's
cancers. In this country, every 64 minutes a woman is diagnosed
with a reproductive tract cancer. One in eight women today will
get breast cancer, one in eight. It is an absolute epidemic.
Some people believe that that figure will grow to as many as
one in three or four.
This is turning out to be a very busy week in Washington
for cancer issues. Last Sunday, over 60,000 people participated
in the National Race for the Cure, sponsored by the Susan B.
Komen Breast Cancer Foundation. This foundation has done a
phenomenal job raising awareness of breast cancer and raising
money for research and treatment. I applaud their work, and my
colleagues do as well.
Today the Government Reform Committee will receive
testimony from researchers, health care providers, and patients
on the role of early detection and complementary and
alternative health practices in women's cancers. This coming
weekend, the Center for Mind, Body, Medicine, and the
University of Texas, Houston Medical School, in cooperation
with the National Cancer Institute and the National Center for
Complementary and Alternative Medicine is conducting the second
annual comprehensive cancer conference. They will bring
together researchers, practitioners, and patients, to discuss
research advances and patient needs in both conventional and
alternative medicine.
This week, this same week, 1,355 women in America will lose
their lives to one of these cancers. Overall, more than 10,000
men, women, and children, will die from cancer in America this
week, 10,000. We say to their families and loved ones, we in
Congress recognize that the war on cancer declared by President
Richard Nixon in 1971 is far from over. We cannot, after 28
years and tens of billions of dollars in research declare
victory, because we are not yet close.
My wife suffered from breast cancer several years ago.
Thankfully, she is a 5-year survivor. Last year, I lost my
mother and my step-father to lung cancer. So I know, as well as
many of my colleagues, what families go through when loved ones
have to fight cancer. Every additional year a patient lives is
a victory. Every new treatment, drug, or surgical technique is
a potential victory. However, we have not won this war on
cancer. But we will not give up.
The committee has been working to break through barriers of
institutional bias to get more research done in complementary
and alternative therapies for cancer, and to improve the
information available to the public from the Federal Government
on treatment options. We cannot abide by institutional biases
within the Government that says something is not acceptable
because it is alternative or unconventional. We must ensure
that there is a balance between genetics, drug development,
natural product development, and alternative therapy research
within the National Cancer Institute.
To combat this bias, I am introducing the ``Inclusion of
Alternative Approaches in Cancer Research Act.'' This bill, my
bill, would ensure that every advisory group of the National
Cancer Institute would have at least one member who is an
expert in complementary and alternative medicine. One leading
drug treatment for breast cancer and ovarian cancer, Taxol, was
originally derived from the yew tree and was developed through
the natural products program. It is important to continue to
look to nature for other opportunities for drug development. It
would be a shame if reductions in funding for the natural
product drug program resulted in missing the next Taxol that
might save lives.
I have previously mentioned that less than 1 percent of the
National Cancer Institute's $2.7 billion annual budget goes to
research in complementary and alternative medicine. That is
very disappointing. Unfortunately, the director of that
institute does not see the need to change that ratio, and told
me in December that he has no plans to extend that, even though
half of America's cancer patients will include a complementary
or alternative treatment in their plan to fight cancer. I
believe that since we are giving them $2.7 billion, 1 percent
is not enough. We will do everything in our power to make sure
that more of those funds are given to alternative and
complementary research.
Taxol, Tamoxifen, and other drugs are important tools in
the fight against cancer, so are pap smears and mammograms, and
so is an integrated treatment plan. We have been pleased with
the assistance we have received from several of the
professional medical associations involved in these areas,
including the Society for Gynecological Oncology, and the
American Society of Clinical Pathologists.
Dr. Edward Trimble will present information on the National
Cancer Institute's research in early detection and the
integration of complementary and alternative health practices
in women's cancers. Cancer is a disease, but its victims are
heros and heroines. They are people, real people with families,
jobs, and communities. They make a difference in our lives.
People like Sally McClain, from Indianapolis, IN, who lost her
life to breast cancer that metastasized to her spine. Sally was
a friend of Claudia Keller on my staff. She also was the
daughter of a man who taught me in high school, who was a good
friend of mine. It is a shame that one so young should die so
young because of a disease like this. But Sally didn't give up
the fight, not one single day. Or Lynn Lloyd, a high school
English teacher in Montgomery County, MD. After two bouts with
breast cancer, she is now hospitalized with cancer in her brain
and her lungs. Even when she was receiving chemotherapy last
year, she scheduled it around her classes so she could keep
teaching and stay involved with her students. Now that's real
dedication. Most of her students didn't even realize that she
was battling cancer until her most recent hospitalization.
We are honored today to have another one of those heroines
with us, a lady that's a very, very good friend of mine. Her
husband and I were elected to Congress together back in 1982.
We are going to miss Senator Mack in the U.S. Senate. His
lovely wife, Ms. Priscilla Mack, is the executive co-chair of
the National Race for the Cure. As a breast cancer survivor,
she knows from personal experience the importance of early
detection. She has worked hard to raise awareness about women's
cancer issues. With the energy that Ms. Mack brings to this
fight, we will hopefully begin winning more of these battles,
saving more lives, getting research funded that will get the
answers about prevention, early diagnosis, treatment, and
hopefully one day very soon, a cure.
Biomedical research already knows that there is not a magic
bullet cure for cancer. What we do know at this time is that
the earlier cancer is diagnosed, the greater the chances of
long-term survival. That is why pap smears are such an
effective tool in saving lives. We do know from good research
and practice, that when someone develops a holistic cancer
treatment plan, including attention to mind, body, and spirit,
then recovery is more likely, with better quality of life and
extended life as well.
Dr. James Gordon, director of the Center for Mind Body
Medicine here in Washington, and an internationally recognized
leader in the field of complementary medicine and alternative
medicine, will be testifying also about advances in
complementary and alternative medicine cancer research.
When Jane Seymour, a very prominent movie star, testified
before our committee in February, she shared the story of
several of her friends who had gone the conventional route of
cancer treatment and then been told by their doctors that they
had done everything they could and it was in essence hopeless.
They were basically told to go home and die. These women did
not accept that death sentence. They sought other healthcare
professionals and advice from friends and family on other
approaches to treating cancer. They learned, as many others
have, that in order to survive the conventional treatments for
cancer, radiation and chemotherapy, that a body needs to be
strengthened through good nutrition. I am delighted that Michio
Kushi is here today to talk to us about the macrobiotic diet,
and that the importance of nutrition is essential in cancer
patients. Mr. Kushi is recognized throughout the world as the
foremost authority in this field. The Smithsonian Institute has
just opened the Michio Kushi family collection on the history
of macrobiotics and alternative and complementary health
practices at the National Museum of American History.
We'll also be hearing from Susan Silver of the new Center
for Integrative Medicine at George Washington University. This
center has developed a program for women in cancer treatment
with an integrative approach.
Dr. Daniel Beilin is here today to update us on a new tool
in the arsenal of early detection, regulation thermography.
This low cost test can be used as a complement to mammography
for early detection of changes in breast tissue. It has been
used in Germany, I believe, for about 10 years extensively. It
is also proving to be a valuable tool in detecting other
cancers like ovarian cancer and prostate cancer. We are looking
into advances in research in prostate cancer, as I said
earlier, and we plan to have a hearing early this fall.
We expanded this investigation to cover all women's cancers
because there is so much that needs to be done in breast cancer
and other areas as well. For example, there is no reliable
early detection test for ovarian cancer; 75 percent of ovarian
cancers are not detected until the late stage, three or four,
and there is only a 25 percent survival rate of more than 5
years. However, of those that are discovered in early stages,
there is a 95 percent survival rate of more than 5 years.
The symptoms of ovarian cancer are vague. They are
bloating, sudden weight gain, gas, pressure, and lethargy.
There is research to indicate that eating lots of meat and
animal fats may increase a woman's risk of ovarian cancer. We
need more good research in these areas to find solutions. The
members of this committee on both sides of the aisle are very
involved in these areas, including Congresswoman Mink, who
introduced H.R. 961, the Ovarian Cancer Research and
Information Amendments of 1999.
Linda Bedell-Logan's sister died from cancer. During her
battle, Linda's sister, like many cancer patients, suffered
with lymphedema. Linda, who was involved in healthcare,
researched her sister's treatment options and learned about
combined decongestive therapy. As a result of this experience,
she has helped many cancer patients gain access to this
treatment by getting their insurance companies to cover the
costs. Lymphedema is a serious complication for many cancer
survivors. It causes swelling, usually in an arm or leg. It can
be very painful, and it reduces a cancer survivor's quality of
life.
We are also going to hear from two cancer survivors. Their
stories show the struggles that women face with cancer and how
they go through them, the need to develop an individualized
treatment plan to find reliable information on all treatment
options, and to be comfortable with the treatment choices they
make. Lee Gardener and Carol Zarycki are two more cancer
heroines. I hope I pronounced your names correctly. If I
didn't, correct me when you come forward. Even though they have
faced the most daunting enemy you can imagine, they have
recovered, returned to living and to helping others face
cancer.
The hearing record will remain open until July 25th for all
those who wish to make written submissions on the record.
[The prepared statement of Hon. Dan Burton follows:]
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Mr. Burton. I now recognize my friend Mr. Waxman, for his
opening statement.
Mr. Waxman. Thank you very much, Mr. Chairman. I am pleased
that we are having this hearing on such an important issue.
Breast cancer is the second leading cause of cancer death among
women. Cervical cancer will kill close to 5,000 women this
year. At least another 20,000 women will die this year from
uterine and ovarian cancers.
The real issues before us are how can we safely and
effectively prevent, detect, and treat cancer, and how can we
make sure that all women have access to good treatments and to
accurate information about their treatment choices? Proper
screening techniques can and have lowered mortality rates for
breast and cervical cancer. We must continue to work hard to
ensure that women have access to the screening techniques
currently available, and we must continue to educate women
about the importance of being screened for these cancers. But
this is not enough. We also have to make sure that healthcare
providers follow up with women, notify them of their test
results, and encourage them to return for further tests if
necessary. We also have to make sure that quality treatments
are available to all women.
At the same time, we need to continue to research better
ways to detect cancers. Currently there is no good test for
ovarian cancer, the fifth leading cause of cancer death among
women in the United States. While mammography has been proven
to reduce the number of breast cancer deaths in women over 50
years old by at least 30 percent, it has not been as effective
in reducing cancer deaths among younger women. We need to
continue to research screening techniques.
We should also be looking at ways to prevent cancer. In
1993, I sponsored legislation that mandated a study of why
certain localities were experiencing elevated incidence of
breast cancer and elevated mortality rates. Studies such as
these are important tools in understanding why women get
cancers and how to prevent it. We need to know whether the
causes are environmental, genetic, dietary, and any other
plausible theory. We need to understand what is going on, and
why some localities, for no reason that we can otherwise
understand, seem to produce an extraordinarily high number of
breast cancers.
We must concentrate our efforts on developing safe and
effective ways to prevent cancer, to detect cancer, and to cure
cancer. We need to make sure that these therapies are available
to all women. We have an extraordinarily high rate of Americans
who lack insurance; 42 million was the last figure of uninsured
people in this country. No one is served by battling over the
relative merits of alternative versus traditional medicine.
Instead, our goal should be to develop the most safe and
effective therapies possible, regardless of how they are
classified.
Mr. Chairman, I am pleased that we are going to hear from
so many important witnesses today. I want to apologize in
advance, because I have a conflict in my schedule. There is a
markup in another committee, so I won't be here to listen to
all of the witnesses. But I will have an opportunity to review
the testimony, and, I look forward to doing that, and to
working with you and our colleagues to accomplish the goals
that we all share.
Mr. Burton. Thank you, Mr. Waxman.
Mr. Mica.
Mr. Mica. Thank you, Mr. Chairman. I don't have a formal
opening statement, but I want to congratulate you on conducting
this hearing, and again reminding us of the importance of early
detection, prevention, and treatment. I again compliment you on
this, and also reserve some time to introduce one of our
witnesses. Thank you.
Mr. Burton. Thank you, Mr. Mica.
Mr. Sanders.
Mr. Sanders. Thank you very much, Mr. Chairman. Mr.
Chairman, I think you know as well as anybody that this has
been a very contentious committee over the last couple of
years. You have heard that, I know.
Mr. Burton. You're kidding.
Mr. Sanders. Yes, I know. You and Mr. Waxman know that. It
is very nice to see us getting away from that type of partisan
hostility to focus on an issue of enormous concern to every
man, woman, and child in this country. I thank you very much
and the staff very much for putting on this hearing.
The remarks that you have made and Mr. Waxman have made
cover a lot of what my opening statement was going to be. But I
just want to say a few additional words. You know, first of
all, the fact that we are having a hearing on cancer today,
probably 30 years ago, there would never have been a hearing
like this because people said well cancer, we don't know why it
happens. God strikes somebody and that's the way it goes. There
is no cause for cancer. In fact, we don't even talk about
cancer. It's such a terrible thing. We use the ``C'' word, but
we don't even talk about it because there is just nothing that
can be done about it.
So as a result of the work of a lot of people, we have come
a long way. We are now beginning to take a rational look at the
causes of cancer and how we can effectively treat it. Just
think, not so many years ago, when you and I were younger, we
watched on television and we saw physicians telling us the
particular brand of cigarette they smoked. Remember that?
Telling us that they liked this brand of cigarette. That was
physicians advertising cigarettes. Well, we have come a long
way from that ``conventional'' wisdom of doctors telling us
about which cigarettes to smoke.
Twenty or thirty years ago, forty years ago, breast feeding
was told to women and mothers as to be a terrible thing. You
certainly don't want to do that. That was physicians. That was
the norm. That was what doctors were telling mothers.
I can remember 15 years ago in the city of Burlington,
talking to one of the leading physicians at our local hospital.
I said, ``Well what do you think about diet and disease?''
``Oh, there's no connection between diet and disease. It
doesn't matter what you eat.'' Now I think every American
understands the important connection between diet and disease.
Every day, we are learning more and more about the relationship
between indoor air, between pollution in general, between
stress and disease, the fact that there is not a huge gap
between mind and body, as you indicated. People who are
depressed, people who are under stress are more likely to come
down with a variety of illnesses than other people.
We have also learned in recent years that some of those
therapies and treatments that people around the world have been
practicing for thousands of years are not quite as crazy as
some of our ``leading specialists'' have told us. It was maybe
20 years ago--I may be wrong, it was James Reston of the New
York Times ended up in China, and he was ill. They practiced
acupuncture on him. Suddenly acupuncture became acceptable in
the United States, where for years our leading specialists had
told us what a quacky and ridiculous idea that was.
My point is that we are learning more and more about causes
and treatments. I think this hearing is an important part in
that process. I agree with you that we should be doing a lot
more in expanding the Office of Alternative Medicine, for
example. I should tell you that we had Wayne Jonas, who was the
very capable head of that office in Vermont a couple of years
ago. Five hundred people came out to a town meeting on
alternative health in the State of Vermont on a snowy day in
the central part of the State.
I am working on legislation, I know many other people are,
to begin expanding complementary healthcare, making sure that
Americans have access to that type of care. The other point I
would make is that one of the very sad aspects of what is going
on in this country today is even when there are treatments
available for cancer, we have millions of people who do not
have health insurance. So I would hope that we will join the
rest of the industrialized world, and on this issue you and I
may disagree or we may not, but the time is now that the United
States should join the rest of the world and have a national
healthcare system, guaranteeing healthcare to all people. What
is the sense of having treatments out there if you have
millions of people who cannot afford that treatment?
Where we do agree is I think we should expand and broaden
our knowledge in terms of complementary healthcare. Europe is
already way ahead of us, maybe less dependency on some powerful
drugs if there are natural cures out there. Mostly as I think
you have indicated, let's study what's going on out there.
Let's learn. Maybe the treatments don't work, fine. But there
is nothing wrong with exploring all of the options that are out
there.
So I really do appreciate your holding this hearing, and
look forward to working with you.
[The prepared statement of Hon. Bernard Sanders follows:]
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Mr. Burton. Thank you very much, Mr. Sanders.
Mrs. Morella.
Mrs. Morella. Thank you, Mr. Chairman. I want to thank you
also for holding this important hearing. During my tenure in
Congress, I have been very actively involved in women's health
issues, as you know, as a member of the Congressional Caucus on
Women's Issues, and former chair. I have been working with my
colleagues very diligently to increase the funding for women's
health, including breast, ovarian, and cervical cancer
research. As Chair of the Technology Subcommittee of the
Science Committee, I have been working to facilitate technology
transfers between Government agencies and the private sector.
Efforts such as missiles to mammograms, that project between
the Public Health Service, the Department of Defense, the
intelligence community and NASA, are critically important in
applying new technologies to the fight against breast cancer.
The Congressional Caucus for Women's Issues has spent a
great number of years attempting to address the neglect of
women's health research at the National Institutes of Health,
which as you know, is in my district. The caucus asked the
General Accounting Office back in 1989 to investigate the NIH
policy regarding the inclusion of women in clinical studies.
Women had been routinely excluded from many studies, such as
the physicians health study, which studied the effects of
aspirin on heart disease on 22,000 male physicians. Just this
week, however, I found it astounding. I read in the Washington
Post that ``drinking at least two cups of caffeinated coffee a
day lowers a man's risk of developing gallstones.'' Now more
than 46,000 men took part in this study that spanned a decade.
But what about women?
In 1990, the caucus introduced omnibus legislation, the
Women's Health Equity Act, which included the establishment of
the Office of Research on Women's Health, and the requirement
that women and minorities be included in all the clinical
trials and protocols wherever appropriate in research studies
funded by NIH. That has been working. In the fall of 1990, in a
meeting of caucus members, NIH announced the formation of that
office and quite frankly, we codified it in Congress, so it is
a permanent office. Since that time, great progress has been
made in funding for women's health concerns, particularly
breast, ovarian, cervical cancer, osteoporosis, and the Women's
Health Initiative. For example, breast and ovarian cancer
funding at NCI, the National Cancer Institute, has more than
quadrupled since 1990.
Recently, I initiated a letter to the House Subcommittee on
Defense Appropriations, asking for continued funding for the
Department of Defense peer-reviewed breast cancer research
program for fiscal year 2000. You know that we have 223 Members
of this House who have signed onto that letter.
However, our job is far from over. Despite great strides in
women's health research, we still have to be vigilant, have to
address issues that aren't receiving public attention and
research priority that they deserve. That is why I think we are
all open to the suggestions and enhancing alternative medicines
too.
More than 14,000 women will die of ovarian cancer this
year. Early detection is essential in the treatment of ovarian
cancer. Yet there is no reliable early detection test. We know
that if diagnosed and treated early, the survival rate for
ovarian cancer is 95 percent. However, there are no obvious
signs or symptoms until late in its development, and only about
25 percent of all cases are detected at the localized stage.
Congresswoman Mink has been very much involved in that project.
There are 2.6 million women living with breast cancer in
the United States today. Each year, approximately 175,000 women
are diagnosed, 43,300 women will die of breast cancer, which is
the leading cancer among women. Despite these frightening
statistics, there are only three methods for detecting breast
tumors, self examination, a clinical breast exam by a
physician, and the mammogram.
I do want to comment that the first panelist is Priscilla
Mack, as you mentioned. I am just very proud of the fact that
she is the executive co-chair of the Susan G. Komen Race for
the Cure. I have a picture of Priscilla that was taken of my
running in the race just last Saturday. It was the 10th
anniversary; 67,000 people ran in that race, bringing in a
great deal of money which will help with all the research
projects. I am sure you will tell us about that.
As an aside, since we are all affected in some way by
cancers that affect women, my sister died 23 years ago of
cancer. At that time, we began raising her six children, I
think successfully.
Lung cancer kills more women than breast cancer. Yet there
has been very little emphasis on lung cancer in general. In
1998, 23,000 women died of lung cancer. Between 1974 and 1994,
there was a 147 percent increase in women diagnosed with lung
cancer. Lung cancer tends to be a silent disease, and there are
no good early detection programs in place for women or for men.
So, Mr. Chairman, I applaud you for holding this important
hearing on the early detection and alternative treatment of
women's cancers. I look forward to the testimony from the
experts and from those who have had some experience. Again, I
applaud you. Thank you. I yield back.
Mr. Burton. Thank you, Mrs. Morella. I was looking at this
picture of you in the race. What was your time? [Laughter.]
Mr. Kucinich.
Mr. Kucinich. Thank you very much, Mr. Chairman. Thank you
for your continuing leadership in this area and for the
participation of members on this panel, as well as our guests
here today.
Over 500 years ago, people thought the Earth was flat. It
caused many not to want to go on a voyage that could cause them
to fall off the corner of the Earth. Today there are still
people who think that illness and disease is something that's
outside of us and that we can turn our health over to other
people who will then tell us how we can be healthy. But through
the work of people like Michio Kushi, who is one of the
panelists today, we have learned that we have the ability to
take responsibility for our own health. What a miracle that is.
Think about that for a moment. That the conditions which create
disease may come from things that we do. So if that is in fact
the truth, how empowering it is that we can have some control
over the conditions which are internal to our disease and which
become externalized and can cause us to have a debilitation in
our quality of life.
Mr. Kushi, in joining this panel today, brings to it a
tremendous amount of experience in his work as one of the
foremost proponents in the world of macrobiotics. As all of the
students of Greek and of medicine know, macrobiotics comes from
the word ``macros'' and ``bios'' in Greek, which means a great
life or long life. That was a term that was coined by
Hippocrates about 2,500 years ago.
Today people know macrobiotics in a much more popularized
way through foods like brown rice and seitan, which is a wheat
cutlet, whole wheat sourdough bread, vegetable sushi, and rice
cakes. The standard macrobiotic diet has been practiced widely
throughout history by all major civilizations and cultures. The
diet centers on whole cereal grains and their products and
other plant qualities.
Over the last 30 years, Michio Kushi has taught throughout
the United States and abroad, giving lectures and seminars on
diet, health consciousness, and the peaceful meeting of eastern
and western philosophies. In 1978, Mr. Kushi and his wife,
Adaline, founded the Kushi Institute, which is an educational
organization for the training of future leaders of society,
including macrobiotic teachers, counselors, and cooks. The
Kushis in 1986 founded One Peaceful World. It is an
organization which provides information on macrobiotics and
helps to guide society toward world health and world peace.
Now one of the things that I think ought to be called to
the attention of the Members before we begin hearing from the
witnesses because many of you are already aware of this, later
this year, the National Institute of Health is expected to
issue a long-awaited study on the macrobiotic approach to
cancer, which is currently being completed by researchers at
the University of Minnesota and at Harvard University. Another
report, which is a case control study from Italy, shows that
macrobiotics can significantly lower the risk of breast cancer.
That report is awaiting publication.
The American Cancer Society describes macrobiotics as ``the
most popular anti-cancer diet'' today. On its Internet site,
the American Cancer Society states,
Macrobiotics may help prevent some cancers. It may reduce
the risk in developing cancers that appear related to higher
fat intake such as colon cancer and possibly some breast
cancers. The macrobiotic diet, like other fat free diets, can
lower blood pressure, and perhaps reduce the chance of heart
disease. Taking part in a macrobiotics program may provide some
sense of balance with nature and harmony with the total
universe, and as such, promote a sense of calmness and reduce
stress.
So when we think in terms of health today, perhaps rather
than thinking in terms of simply winning a war with cancer, we
can also look toward changing the analogy and talk about
prevention of cancer, because some see cancer as a lack of
balance. As we bring our bodies more into their natural
harmony, as Mr. Kushi I'm sure will be testifying about, we can
find that conditions of health can be created where some may
have thought previously it was impossible to do so.
So this hearing today, through the testimony of the
witnesses and through the testimony of other experts, such as
Mr. Kushi, will be an exercise in raising the Nation's
consciousness over the importance of looking at alternatives to
healthcare, the importance of finding better ways to treat
disease, and the importance of giving individuals an
opportunity to reclaim power in their own lives to improve the
quality of their lives, and through their courage and example,
give others hope that they can do the same.
So, with that, Mr. Chairman, I thank you very much for your
efforts in calling these hearings. I look forward to the
testimony of the witnesses. I am awaiting a call to go to the
floor for the debate on the Kosovo spending bill, so I may not
be able to be here the whole time, but I appreciate being here
now.
Mr. Burton. Thank you, Mr. Kucinich. You have been a big
help. I appreciate your continued assistance.
I might just hold up before our next member speaks, that
these are some of the books that Mr. Kushi has, co-written by
Mr. Alex Jack. Here's a book also, ``Let Food Be Thy
Medicine.'' There are a number of books out like this. I am not
just touting these particular books. I don't get a commission.
But I think it's really important for anybody who is watching
on television, who is in the audience, to take a look at some
of these books because change in diet I think has been proven,
and will be proven in the future, to be a real help in
preventing various forms of cancer.
With that, Ms. Norton.
Ms. Norton. Thank you, Mr. Chairman. May I, like my
colleagues, thank you and compliment you on your initiative in
holding this hearing. As a Chair last year, along with Nancy
Johnson of the Women's Caucus, I am particularly appreciative
for this effort.
The Women's Caucus has perhaps devoted more of its time to
cancer, and especially breast cancer but other forms as well,
including ovarian cancer, than it has to any other women's
issue. Last year, when Tamoxifen was announced as a drug that
had proved so effective in treating breast cancer that they
were stopping the trials and letting it go forward, we held a
whole hearing on that with the Surgeon General, the FDA, and
others coming in, including women who had participated in the
trials.
The progress in dealing with women's cancers is so
extraordinarily hopeful today. Just yesterday a major
controversy resurfaced that arose last year about whether women
should begin to have mammograms at 40 or 50, where the women in
Congress took the position that they should begin at 40. Where
there is some difference among the experts, then for goodness
sakes, let's err on the side of the expert that may save the
most lives. Now there is an additional study just announced
yesterday that affirms 40 as the age that you should start
mammograms.
Just today, I believe--again, I'm thinking it was
yesterday, perhaps reported yesterday--a study again reported
confusion among women and families about the role of estrogen.
We are told that estrogen in fact does tend to be a factor in
some breast cancer, but those are the breast cancers that are
easiest to combat, and that apparently it is not as much of a
factor as we thought.
We all know that the most effective thing that a woman and
a family can do to prevent breast cancer is early screening,
and that an early mammogram could not be more important. We had
come to the point where breast cancer was breaking down along
income lines and insurance lines. I am very pleased at the way
in which mammograms, or mammography, has become available to
low income women and minority women who were being left out,
and therefore, being subjected to discovery of their cancers
much later, when they are often not curable.
The fact is that breast cancer, for example, and ovarian
cancer are becoming curable diseases based almost entirely on
early detection. Therefore, the emphasis on prevention in this
hearing could not be more important. We are learning that
cancer is many different diseases that act like, or at least a
disease that acts like many different diseases. I am going to
say for that reason, cancer is nothing to play around with.
Prevention and, once the disease sets in, responsible treatment
is going to be very important. The notion of alternative
medicine, it seems to me, is critical here. If you believe that
prevention is the best cure, the developing science on the role
of fat and diet must be taken very seriously, not only with
respect to women's cancers, but generally.
What I would like to leave the hearing with--and I hope to
be able to stay through most of it, I am going to have to come
and go because of other hearings--is with what I regard as the
great need. That is a word that I will take from what the
chairman said. He used the word ``integration.'' That is to say
the integration of so-called alternative medicine with
traditional medicine as is practiced largely in the West. The
fact is, that the reason that we are able to cure so much
cancer has to do with the genius of American medicine. Now if
we look further into alternative medicine, we may find the
genius that enables us to help prevent cancer. Then we will be
able to bring the two together in a successful integration.
I would hate to see the development of polar notions of
medicine, that there's alternative medicine, and then there's
the other medicine. That is a tragedy. That is a false
dichotomy. Moreover, we should not allow different sets of
standards to develop for testing what is effective. Women have
a right to know from their government what is effective,
whether it comes out of nature in some pure sense or whether it
is manufactured by a pharmaceutical company, and the role of
government is to make sure that somehow, we can do our best
work by finding safe, economical ways to integrate so-called
alternative medicine with more traditional medicine so those
words disappear and it's all medicine.
Finally, Mr. Chairman, let me say that with the members of
the Women's Caucus, I went to the Labor, HHS, Appropriations
Committee where we go every year. Instead of talking about the
diseases of women, I proposed a new program which I call LIFE.
I chose that acronym for lifetime improvement in food and
exercise, because I am appalled at the way in which,
particularly the baby-boomers and children, are setting
themselves up for cancer, diabetes, arthritis, and every deadly
disease known to man through overweight and obesity. The
notions of fat and diet are very important, but they are
important because of the natural ways in which they prevent
disease.
I look forward to what our witnesses will have to say about
not only their experiences, but also about these ways of
preventing similar experiences. If I could just say on a
personal note that I particularly am pleased to welcome Mrs.
Connie Mack, because her husband and I have worked as closely
together as I have with any Member of the Senate or the House.
He is not of my party. He has been extraordinary in the way in
which he has used his problem-solving skills to work with me on
tax matters. I know any man that is as good as that must have
an awfully good woman for a wife.
Thank you, Mr. Chairman.
Mr. Burton. I am sure that Priscilla guides him in
everything he does.
Mrs. Mink.
Mrs. Mink. Thank you, Mr. Chairman. I, too, want to join my
colleagues in commending you for calling these hearings on such
an important matter as the discussion on the needs for early
detection and discussions of other kinds of preventive measures
that could be taken with respect to women's health issues.
Mr. Chairman, for 8 years I have been trying to get the
Congress to focus on the one issue that I thought was terribly
neglected, having to do with the research necessary for finding
some way in which we could detect the presence of ovarian
cancer early enough to assure that the life of the woman could
be saved. I discovered in 1991 through efforts by researchers
at NIH and elsewhere, that only $8 million of the entire NIH
budget was devoted in any respect to the research needed in
ovarian cancer. Notwithstanding efforts of hundreds of women on
this specific issue, we have only risen to a paltry level of
$40 million. I have legislation, and Mr. Chairman, in which I
invite your cosponsorship, calling for a budget of $150
million, which even by itself is modest if we are to really put
the research efforts that are there to discover a reliable
early detection test that could save lives.
It is important to talk about prevention and all the other
aspects of your hearing today, but it seems to me that with the
scientific knowledge and the intelligence and training and
research capabilities of our health researchers throughout the
country, that we ought to be able to find a reliable test that
could save thousands of lives of women who are diagnosed today,
too late to have their lives saved. So many of these women are
young, just beginning in their life situation. It is something
which I feel very, very strongly about that has been neglected.
Mr. Chairman, this is really the first hearing in all these
years of effort to call attention to this deplorable situation
and neglect, that we have allowed. I have been to the
Appropriations Committee, as my colleague here has indicated,
every year, asking for earmarked money for this research
effort. The Appropriations Committee has refused to earmark any
money for ovarian cancer research. They have included report
language, but never any earmarked money.
So I urge my colleagues to consider the legislation that is
before this body, and join me in cosponsoring. I believe it is
essential, and I believe that we are on the threshold of a
research breakthrough. What is required is a commitment on the
part of this Congress to steer our health research industry to
focus on this very, very pathetic neglect. If we can clone
sheep and mice and other things with our incredible
intellectual capability, it seems to me that within a few short
years, we ought to be able to come up with a reliable
test that could save thousands of lives each year. I implore
this committee to continue this effort in calling attention to
this serious health research neglect.
Thank you, Mr. Chairman.
[The prepared statement of Hon. Patsy T. Mink follows:]
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Mr. Burton. Thank you. I will be happy to cosponsor your
legislation. I think Dr. Beilin may have some information that
might be helpful in the research toward these cancers.
Mrs. Mink. Thank you. Thank you, Mr. Chairman.
Mr. Burton. Are there any other Members that wish to be
heard? Mr. Ose. Mr. Cummings.
Mr. Cummings. Thank you very much, Mr. Chairman. As I look
down our list of witnesses, it makes my heart glad to know that
they are all in this room. They are special people who have
decided that they want to touch other people's lives and are
doing so every day. So I thank them for being with us today. I
look forward to your testimony.
Mr. Chairman, I am also pleased that this hearing regarding
detection and treatment of women's cancers has been scheduled
today. The medical and scientific community has made tremendous
breakthroughs in the early detection and treatment of women's
cancers in the past few years. Even with all the options
currently available for the early detection and treatment, the
estimates for new incidences of these cancers are unacceptable.
The National Cervical Cancer Coalition estimates that 2 million
American women will be diagnosed with breast or cervical cancer
in the 1990's, and half a million will lose their lives. A
disproportionate number of deaths will occur among minorities
and women of low income.
It is interesting that in my district in Baltimore, sits
Johns Hopkins Hospital. Johns Hopkins does a tremendous job of
outreach, but at the same time, I know many women who are dying
of these cancers every year. Virtually all of these deaths can
be prevented by making life saving screening services available
to all women at risk. Common barriers to early detection
screening include, and this is very interesting, women
attempting to escape knowledge that they have cancer,
prohibitive costs and unawareness of the availability of low
cost programs, lack of access to transportation to screening
locations, communication barriers, lack of physician referrals,
and lack of childcare.
The Breast and Cervical Cancer Mortality Prevention Act of
1990 authorized the Center for Disease Control to implement a
national cancer screening program. Through September 1996, the
CDC has provided more than 1.2 million screening tests to low
income, uninsured, or under-insured minority women.
Alternative and complementary approaches to treating these
cancers have also gained momentum. In 1998, the National Center
for Complementary and Alternative Medicine was established
within the National Institutes of Health. This has effectively
engaged traditional biomedical research in the evaluation of
alternative medical treatment using scientific models. However,
until more is known about the many alternative and
complementary treatments, conventional treatment methods hold
the most promise. We hope for a cure in the near future. In the
absence of a cure, the ability to implement a national program
to detect and treat women's cancers depends in large part on
the involvement of various partners in State and local
governments, physicians, national and private sector
organizations, and consumers.
In the spirit of greater understanding and education of
varied treatments of this disease, I look forward to hearing
the experiences and opinions of today's witnesses. Thank you.
[The prepared statements of Hon. Elijah E. Cummings, Hon.
Edolphus Towns, and Hon. Louise Slaughter follow:]
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Mr. Burton. Thank you, Mr. Cummings.
We have two votes on the floor. We should be back here in
about 15 minutes. I apologize to the people who will be giving
testimony, but we will get right to you, just as soon as we get
back. So please excuse us. We stand in recess to the call of
the gavel, about 15 minutes.
[Recess.]
Mr. Burton. The committee will come to order.
Sorry for the delay. We had some votes on the floor of the
House. I am sure Members will be coming back in here as they
leave the floor.
I would like for our first series of witnesses, Ms. Mack
and Mr. Kushi, to come forward please and take their seats. Ms.
Mack, you can sit on the left. Mr. Kushi can sit on the right.
I think I will recognize my colleague from Florida for an
introduction.
Mr. Mica. Thank you, Mr. Chairman. I am, indeed, delighted
to have this opportunity to introduce someone very special to
me. For the past two decades, I have known the Mack family. I
had an opportunity to be a friend and also recently to be a
colleague of Senator Mack. I think that there have been several
comments already about the Mack family. Certainly Senator Mack
is a gentleman. We have a gentlelady with us today, his wife.
Both are very accomplished in their particular areas of
endeavor.
The Mack family, like many American families, and we have
also heard that among our Members of Congress cited today, have
been afflicted by the rages and ravages of cancer. Their
family, the Mack family, has been victimized by this disease.
Mrs. Mack, Priscilla Mack is a cancer survivor. What is great
about Priscilla Mack is that she took this adversity and this
disease and she turned it into a personal campaign of public
awareness, a public education effort to have millions and
millions of American women become aware of the need for
prevention, self-examination, and the problems that are related
to breast cancer.
So I am, indeed, delighted and privileged to introduce a
leader in our State and in our Nation. She is really our first
lady in Florida in the fight against cancer, and really our
first lady in the Nation who has brought to the public, to the
American women, the need again for early prevention, detection,
and treatment.
So, Mr. Chairman, thank you for this honor and welcome,
Mrs. Mack.
Mr. Burton. Thank you, Mrs. Mack. I can recall back when
Connie and I first got elected in 1908.
Mrs. Mack. It seems that long.
Mr. Burton. It was 1982. Connie came over to my condo over
in Alexandria. We sat on the floor and watched Chariots of
Fire. You were down in Florida at the time. So Connie and I
have been good friends for a long time, as well as you. I
remember watching your boy grow up. So I am really happy you
are here today.
Mr. Kushi, we are very happy you are here today. I am going
to read your book. Hopefully that will save my life for a
couple of years.
So we will start off with you, Mrs. Mack.
STATEMENTS OF PRISCILLA MACK, EXECUTIVE CO-CHAIR OF THE
NATIONAL RACE FOR THE CURE; AND MICHIO KUSHI, THE KUSHI
INSTITUTE, BROOKLINE, MA
Ms. Mack. Mr. Chairman, members of the committee, I would
like to thank you for the opportunity to appear before the
Committee on Government Reform, and I commend you for holding
this important hearing. I am here both as a breast cancer
survivor, as well as executive co-chairman of the Susan G.
Komen Breast Cancer Foundation's National Race for the Cure.
In October 1991, I was diagnosed with breast cancer. Prior
to the time of my diagnosis, I had followed all the
recommendations with regard to having annual mammograms and
clinical breast exams. However, it was through breast self-exam
that I discovered my lump in my left breast. I underwent a
modified mastectomy, followed by 6 months of preventative
chemotherapy, 5 years of Tamoxifen. In May, the following year,
I completed my reconstructive surgery.
I also want to note that I had had my mammogram 9 months
before I found my lump. I had had my clinical exam 3 months
before I found my lump. Early detection saved my life through
my breast self-exam. Today I am a breast cancer survivor.
My goal is to share with as many women as possible the
lessons I have learned as a breast cancer survivor. The most
important lesson is a simple one, educate yourself. When
confined to the breast, the 5-year survival rate is more than
95 percent. But women have to do three things, and through the
American Cancer Society, of which I work also in Florida, we
call it triple touch. You'll see when I mention these three
things, why triple touch saved my life. One is your breast self
exams monthly. Two, mammograms, as indicated by your physician.
Three, your clinical exams. My message to women is simple but
important. Early detection saved my life, and it can save yours
too.
One of my efforts to help in the fight against breast
cancer is my work on behalf of the Susan G. Komen Breast Cancer
Foundation's National Race for the Cure. Since its inception 10
years ago, the race has grown to the world's largest 5K walk/
run. The 10th Anniversary Komen National Race for the Cure took
place this last Saturday, June 5, with the record number of
66,148 participants. I also found out that 43,000 crossed the
finish line. I believe Congresswoman Morella was 1 of those
43,000.
We were honored that Vice President Al Gore and Tipper Gore
served as our honorary chairs for the race. Breast cancer
survivors took part in a special salute to survivors which
began with an inspirational walk at the foot of the Washington
Monument. We also had a large bipartisan contingency of
Washington lawmakers and more than 2,500 participants from 72
countries around the world. Most importantly, thousands of my
breast cancer survivors, wearing pink T-shirts, all
participated from all across this great land.
Last year, the Komen National Race for the Cure awarded
$1.8 million in grants to 24 Washington, DC, area hospitals,
research centers, breast health organizations, and the national
grant programs of the Susan G. Komen Breast Cancer Foundation.
These grants provide funding for breast health programs
including research, screening, treatment, and education
programs.
This year, we are pleased to announce that we will give
approximately $2.5 million in grants, to be awarded from this
year's race. Since its inception, the Susan B. Komen Breast
Cancer Foundation has raised more than $136 million through the
work of its local affiliates in more than 100 communities
across the country.
Once again, let me offer my heartfelt thanks to the many
Members of the Senate and the House of Representatives who
participate in the Komen National Race for the Cure series
throughout the year. With each advance we make in finding a
cure for breast cancer, we are one step closer to winning the
race.
I would like to, before I close, mention to you all how
cancer has touched our lives personally. Through this all, I
want you to keep in mind that many of us are alive today
because of early detection. My husband's mother was a 25-year
breast cancer survivor. My husband's brother died of melanoma
at the age of 35. His was not detected early. My daughter is a
10-year survivor of cervical cancer. Early detection saved her
life. Because it was detected early, we now have a third
grandson after the fact. She is in perfect health. My husband
was diagnosed with melanoma right after he was elected to the
Senate. Early detection and due to the profound experience we
had with his brother, early detection saved my husband's life.
Then I was diagnosed with breast cancer. Early detection saved
my life. Unfortunately, Connie's mother died of renal cancer.
Connie's father died of esophageal cancer. My stepmother died
of ovarian cancer.
When we say early detection until we find a cure saves
lives, meaningful things like this hearing and all that the
doctors and the researchers are doing, I pray to God we'll end
this dreaded disease.
Mr. Chairman, I thank you for the opportunity to appear
before this committee.
[The prepared statement of Ms. Mack follows:]
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Mr. Burton. Thank you very much, Priscilla. It is good
seeing you again. I was not aware of all the tragedies that
your family had to endure. We have had some ourselves, but,
that's a lot. So you are to be commended, and Connie is to be
commended, for all the extra efforts you put forth to help out.
Mr. Kushi.
Mr. Kushi. Thank you very much for this opportunity, Mr.
Chairman and committee members, I very much appreciate the fact
that conventional medicine has developed its technology with
the goal of diagnosing and treating various illness. We desire
the continuous support of the physical and the other approaches
that conventional medicine offers for the treatment of
sickness.
On the other hand, the conventional approach is a
symptomatic approach, and therefore, does not focus on
revealing or applying understanding of the cause which
underlies disease. No. 2, professionals engaged in the practice
of conventional medicine often lack an understanding and
support of other healthcare approaches. No. 3, conventional
treatment, including its methods of diagnosis has always
produced side effects. This is especially true when treatments
are over-applied, and often results in the severe suffering of
those who receive such treatments. Four, conventional methods
of diagnosis and medical treatment are always expensive and
often beyond the average person's income. As a result, costs
often become the responsibility and burden of the government,
the public, and the insurance systems.
Based upon these points, the tendency of individuals to
search out these alternative approaches, so-called alternative
and complementary health practices, has increased over the past
many years beginning, commencing from about 40 years ago.
Currently, approximately 50 percent of those who are suffering
from disease are searching for and receiving unconventional
methods of treatment.
As a demonstration of these trends, consider the example of
cancers that affect women. One, over the past 40 years, it has
been my experience, as well as that of my associates, that many
women are hesitant to receive chemotherapy, radiation, and the
other intensive treatments. Two, many women who receive
conventional care seek alternative methods as a result of
intense suffering, both physical and emotional, that they
experience by conventional medical treatment. They seek out
milder approaches. Three, many patients desire to know the
cause of the cancer from which they are suffering, yet they do
not receive satisfactory answers.
The causes of women's cancer, as is true of the majority of
physical and emotional sicknesses, lie in daily lifestyle and
dietary practices. For example, in the case of breast cancer,
the major causes are over-consumption of high-fat foods,
including dairy food and simple carbohydrates such as refined
sugar and sweets. In the case of ovarian cancer, the major
dietary factors are the over-consumption of eggs and poultry,
as are high fat, high cholesterol animal foods.
In the case of uterine cancer, dietary causes include over-
consumption of animal foods and heavy dairy fats such as those
found in cheese. In the case of cervical cancer, similar to
prostate cancer in men, the primary dietary factors are the
over-consumption of oily and greasy foods, salty foods, hard
baked flour products, and heavy animal foods. In the case of
thyroid cancer, the primary causes are the over-consumption of
eggs, poultry, dairy fats, and hard baked flour products. In
the case of pancreatic cancer, consumption of poultry, cheese,
shellfish, and hard baked flour products are contributing
factors.
In the case of skin cancer, causes include over-consumption
of oily foods, sweets, and dairy fat, high-fat foods. In the
case of leukemia and lymphoma, dietary causes include over-
consumption of dairy fats, sugar, and sweets, as well as oily
and greasy foods. Over-consumption of stimulants and aromatic
substances, such as hot spices, alcoholic beverages, and
caffeine, accelerate the spread of the cancer condition.
Other lifestyle factors, such as cigarette smoking,
physical inactivity, exposure to high levels of electromagnetic
fields or radiation, and the consumption of chemically treated
foods and water also contribute to the development of cancers.
Non-organic chemically cultivated agriculture, irradiation,
microwave cooking, and similar methods of unnatural food
production and artificial processing, as well as daily
unnatural lifestyle, are potential factors as well.
The macrobiotic approach, which attempts to correct these
undesirable characteristics of the current American lifestyle
and dietary behaviors, has been practiced by many individuals
since the 1960's. Beginning as a grassroots movement, the
macrobiotic approach has led to the initiation of the natural
food movement and organic agriculture. The macrobiotic approach
continues to gain popularity, and currently influences many
millions of people. As a healthcare practice, this approach has
helped to prevent disease and speed recovery times associated
with numerous sicknesses, including many types of women's
cancers.
Among those in today's audience, the following six or seven
ladies are present that have experienced various types of
cancer and also have recovered through the macrobiotic
approach: Chris Akbar, a former physicist from Pennsylvania,
who recovered 14 years ago from inflammatory breast cancer,
which is predicted to have a lifetime of 2 or 3 months; Marlene
McKenna, a mother of five, radio/television commentator, and
investment broker from Rhode Island, who recovered 16 years ago
from malignant melanoma spread to the small intestines; Judy
MacKenney, a clothing designer from Florida, who recovered 8
years ago from non-Hodgkins lymphoma, stage 4; Kathleen Powers,
Stone Mountain, GA, diagnosed in 1985 with endometrial cancer,
stage 4, and diagnosed in 1993 with non-Hodgkins lymphoma,
stage 3, terminal; Debora Wright, Athens, GA, diagnosed in 1995
with infiltrating ductal cancer, stage 2B; Lynn Mazur,
Arlington, VA, diagnosed in 1989, Hodgkins lymphoma, stage 4B;
Lizzz Klein, Tampa, FL, diagnosed in 1985, 30 various kinds of
symptoms, including brain damage and breast cancer, suspected
results due to breast implants; Mr. Norman Arnold, a business
leader and philanthropist from South Carolina, who recovered 17
years ago from pancreatic cancer spread to the lymph and liver.
These ladies and gentleman will be available for interview
later, if you wish. Not only have they survived their
illnesses, but they have actively contributed to society for
many years following recovery, without recurrence of cancer.
The majority of those cases were all terminal. These people are
only a few examples of many who have recovered from cancer. In
addition, many hundreds of women and men have received benefits
from the macrobiotic approach.
The National Institutes of Health made a small grant of
about $30,000 to the School of Public Health at the University
of Minnesota. This fund was applied for the collecting of data
and gathering of medical records. The data are now under review
by a research group from Harvard Medical School and oncologists
from Beth Israel Deaconess Medical Center in Boston.
In contrast to the conventional approaches, the macrobiotic
approach also includes--not denying the conventional approach
also, but also such practices as oriental herb medicine,
acupuncture, moxibustion, and shiatsu massage, as well as other
physical body care, emotional meditation, and psychological
therapy practices, as they are necessary.
We highly recommend that the Government support the
following: One, please make available public education
regarding a proper healthy way of eating, mainly using grain
and vegetable bases; and more natural lifestyles.
Two, increase funds available for research regarding the
effectiveness of alternative and complementary approaches for
both prevention and recovery, including diet and lifestyle as
the base.
Three, make recommendations to all health facilities and
medical schools to accommodate healthful menus and cooking
instructions, as well as to teach a proper healthy lifestyle.
Four, advise selected hospitals or healthcare centers to
establish a pilot plan for macrobiotic diet or similar diet and
lifestyle, together with data creation as a clinical trial.
Five, please advise medical and healthcare professionals of
simple, practical ways of diagnosis, based upon oriental
diagnoses of the face, pulse, meridians, and vibration, in
order to effect low-cost, early detection.
Six, establish community-based and school-based educational
programs, including school lunch programs and high school home
economics classes, to recover home cooking and healthy
lifestyles.
Seven, we would be happy to cooperate with such
governmental efforts or public efforts by dispatching or
sending well-experienced macrobiotic educators, counselors, and
cooking instructors to any potential facilities. We recommend
the funding of educational training centers at the level of
college or professional schools.
Women are, in my humble opinion, strong opinion, the center
of love, beauty, health, and longevity, and happiness among
humankind. Home and family are the base for health and
happiness. If this country establishes these ways of health and
happiness, and prevents and treats physical and emotional
disorders in a more natural way, America will become a symbol
of health and happiness for the entire planet. America will
become a leading light for all humankind, beyond the
establishments of power, politics, and economies. This is the
way of a great America, to open a new era
of humanity for the 21st century. In this way, America will
become the creator of one peaceful world for a healthy mankind.
Thank you very much for this wonderful opportunity.
[Applause.]
[The prepared statement of Mr. Kushi follows:]
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Mr. Burton. Sounds like some people like you quite a bit. I
don't even get that kind of applause when I go home.
[Laughter.]
First of all, let me ask a few questions here.
Ms. Mack, when you had your breast cancer, did you have it
in any of your lymph nodes?
Ms. Mack. No, I did not. It was diagnosed early enough. I
had no lymph node involvement. Therefore, my prognosis was much
better.
Mr. Burton. Did you have any chemotherapy?
Ms. Mack. Yes, I did. I had 6 months of preventative
chemotherapy. At the time I was diagnosed, the protocol for
breast cancer without node, lymph node involvement, had gone to
6 months of preventive chemotherapy following a mastectomy.
That wasn't done even a year before. Usually they didn't follow
along with anything. And then the 5-years of Tamoxifen after
that.
Mr. Burton. Did you have radiation, too?
Ms. Mack. No, I did not.
Mr. Burton. Did not have to have radiation?
Ms. Mack. No, I did not.
Mr. Burton. I recall when my wife had her breast cancer and
she did have it in five of her lymph nodes, and that's why the
prognosis was not that good. One of the most tragic things that
people go through is, when they start, women start to lose
their hair after the chemotherapy. So I just wish everybody in
America could have the opportunity to share the kinds of pain,
mental pain, that women and their husbands go through when that
sort of thing occurs, in addition to the other side effects of
cancer that affect the family life.
You are to be commended for what you are doing. We really
appreciate it. I am sure other Members will have questions for
you.
I do want to ask Mr. Kushi a few questions. You have--
apparently a lot of these people had diseases that would have
been deemed terminal illnesses before they went on your
program. Some of those people you mentioned had lymphatic
cancer and they also had cancer that had spread into the
stomach and into the pancreas. I heard one that said the liver,
which I always thought was a terminal situation. How do you
account for the reversal of their problems? Is it strictly
because of the macrobiotic diet you talked about?
Mr. Kushi. All cancers are heavily related to and caused by
daily eating. For example, pancreatic cancer, as I mentioned,
is caused by heavy poultry eating.
Mr. Burton. Poultry?
Mr. Kushi. Poultry and egg eating, and also shellfish
eating, and hard-baked flour, et cetera; of course heavy fatty,
oily foods. So now when we approach this cancer, we must
reduce, eliminate or reduce those foods which we're eating, and
we are recommending more grain, vegetables, and other healthy
ones. We try to eliminate as soon as possible from her body or
the patient's body the effects of accumulated fat and those
accumulated bad influences.
Mr. Burton. How do you eliminate that? Some people talk
about these like chelation therapy. Do you just do it by diet?
Mr. Kushi. Through the diet, a very simple way. I would
like to present maybe one example.
Mr. Burton. Sure. Go ahead.
Ms. Akbar. Hi. My name is Chris Akbar. I am one of Michio's
assistants in Boston. In 1985, I was diagnosed with
inflammatory breast cancer at Yale-New Haven Hospital. I was a
grad. student working on a Ph.D. in physics at the time. My
diet consisted primarily of ice cream, chocolate, cheese
omelets, and pizzas. I was very fat. I weighed 170 pounds.
Primarily dairy food and sweets.
I discovered a red hot inflammation in my breast, very
painful. I went and had penicillin for 2 weeks and nothing
happened. Then I had a mammogram that showed nothing. I had
ultrasound; it showed nothing. I finally had a surgical biopsy.
They told me I had inflammatory breast cancer. This was in
1985. They told me I had 2 or 3 months to live. They said it
was the most lethal; it was immediately in my lymphatic system.
I said ``Why do I have cancer?'' to my doctors. This was at
Yale Medical School, and they had a lot of research there. They
said, ``It's genetic.'' But nobody ever had cancer in my whole
family.
Then I said, ``What can I eat? I am huge. I am obese. What
can I eat?'' They said, ``Don't lose an ounce, because if you
lose any weight, the cancer is going to be killing you even
faster, if your body is starting to waste away. So have some
Chocolate Ensure, which is made out of basically sugars and
oils.'' They served us chocolate-covered donuts in the waiting
lounge of the radiation laboratory where I was going. I thought
something was a little bit strange.
Anyway, I started chemotherapy the next day. It was CAF. It
was adriamycin, 5-FU, and cytoxan. Adriamycin made my hair fall
out within 3 weeks, and I was devastated by that, plus
nauseated. I went through menopause at the age of 33,
basically, because of the drugs. Then I did radiation twice a
day for 6 weeks. That was a very intense experience also.
Meanwhile, I had read a book about macrobiotics. It was by
a physician from Philadelphia who had prostate cancer that had
spread throughout his bones. He was basically a hopeless case.
He was the chairman of Methodist Hospital. He picked up some
hitchhikers who were hippies back in the late 1960's who said
``Try a macrobiotic diet, it will save your life.'' Well, he
did. After 1 year of macrobiotics, he was completely cancer-
free, with no other medical treatment. He was on a gourmet
French diet, with heavy fats, heavy meats, heavy sauces, wine,
everything. He was from Philadelphia and he went to Le Bec Fin
Restaurant, basically.
I was on a gourmet chocolate diet. I said this is the cause
of my problem. I really think dairy food goes to the mammary
part of my body and creates a problem. It just makes sense. I
picked up a book, the Cancer Prevention Diet Book you have. It
said, ``Dairy food and sweets is the primary cause of breast
cancer.'' That was the main thing I was doing. It said, ``Stop
those things and start taking some things to clean it out.''
Well, I came to Michio for counseling. His wife had just
done her cookbook. I said this is my bible. I am just going to
follow this book. I did. Michio gave me very simple remedies.
He gave me a plaster made out of barley and cabbage that I just
put on my breast every night. In 5 days, I felt the tumor
getting smaller and softer. He gave me something to reduce my
weight, simple vegetables like daikon, which is a long white
radish, and carrots. I just grated them and ate that every day.
I lost 50 pounds within like 2 months. All this fat came off of
me.
I had a really bad pancreas from so many eggs and cheese I
had eaten. He gave me a simple drink made out of cabbage,
carrots, onions, and squash, called Sweet Vegetable Drink. I
took that and my pancreas cleaned out. I no longer had sweet
cravings. I didn't want chocolate every afternoon at 4. I had
chronic constipation. I think that is often associated with
breast cancer, because the toxins sort of buildup in your body
and you can't eliminate them. He gave me something to
strengthen my intestines, a simple like oriental drink made out
of a white powder, a root powder, like a starch that
strengthened my intestines.
I just did his diet. I never have touched, in 14 years
since, I haven't touched any ice cream or chocolate or dairy
food or meat, and I don't miss it at all, or sugar. After 2
months, I got incredible diarrhea one night. I wondered what
was happening. The next morning I had realized that my entire
tumor that was hanging on here was completely discharged out of
my body naturally.
What had happened was in your intestines, when you eat, the
nutrients from the foods that you are eating are absorbed and
it changes the quality of your blood. If you are taking these
things like I mentioned, these macrobiotic-type things, it
actually goes through like a solvent and goes in and through
your body and cleans everything out. So as I was losing all of
this fat, everything was literally, along with the tumor, was
just absolutely discharged out of my body. It was very
effective.
I am a scientist, so I kept very careful records of what I
was doing and how my body was reacting. I found if I took any
extra oils--he had told me oil is like throwing oil onto a
flame, which was this inflammatory tumor--if I ate any oil, the
redness would come back. In fact, it did, the inflammation. I
could actually cause the inflammation to come back. I just
literally eliminated all of that stuff that caused the cancer,
took these things, these vegetables and grains and beans and
seaweeds, and whatever, to clean out. Literally it flushed out
of my body and saved my life.
So in 2 months, when I was supposed to be dead even with
the medical treatments, it saved my life. It was so effective.
It literally used the food as a cleaner to go through and clean
out my body, very effective. I was really impressed. So I'm
alive; 14 years later, here I am.
Mr. Burton. I would guess you would be impressed.
[Applause.]
Mr. Kushi. Those friends, besides many hundreds of other
people, have been experiencing similar ways.
Mr. Burton. Well thank you, Doctor.
My time has expired. Let me yield now to my colleague, Ms.
Norton.
Ms. Norton. Thank you very much. Both of these testimonies
have been very, very impressive and very important.
I would like to know, Mr. Kushi, what is your training or
your background that led you to the development of your
approach?
Mr. Kushi. Fortunately, I was not in medical school. I was
a political science student, international law. After the end
of the war, the World War, I wanted to have world peace. So I
became a world federalist. Mr. Norman Cousins and a friend
sponsored me, and I came at the age of 23 years old to America,
50 years ago. Then while I was studying in Columbia
University's graduate course, accumulating various kinds of
documents, the drafts of world constitutions and other related
documents, I started to wonder whether even if this world
government, world federation is born, how about sickness, how
about love, how about sharing of people, how about prejudice or
discrimination, those mental problems. And then I wondered,
unless those things were corrected, there is no world peace.
So I started to search for a solution, including visiting
Dr. Einstein and Mr. Norman Cousins and various others, Thomas
Mann, and so forth. But there were no active clear answers. But
we have made religions, hoping to make people better. But
between religions, then fights arise. Then we hoped education
had high expectations, and also material prosperity; then
again, unfortunately, sickness spread, crime spread.
So I started to--I gave up all political science studies
and I started standing on a corner in New York's Times Square.
Since I had been here, I started to watch people. What is
humanity; what is humanity? It took 2\1/2\ months; then I
understood. Everyone had been, mankind has been made by two
factors: one, environment, and two, what we eat.
What we eat is entirely in our hands, freedom. Individual
people are freely choosing, freely cooking and so forth. Now if
proper diet is eaten, and the environment, certain clean
environment is done, then happy conditions come. If not, then
sickness arises, crime arises, violence arises. So then I found
that in the American diet of the 19th century, 20th century,
comparing 19th century and 20th century, tremendous change
occurred. More increase in animal food. More increase in dairy
food. More increase in refined sugar. More increase in mass
production of food, agricultural products, et cetera, and so
forth.
Exactly parallel with this change of diet, heart disease is
increasing, cancer is increasing, and various kinds of so-
called degenerative diseases are increasing, as well as so-
called virus diseases and also mental problems have increased.
So I wanted to change our current way we're eating. Then we
began the so-called natural food movement and cooking classes.
This is my background.
Ms. Norton. It is certainly true, particularly when
studying populations of different countries, research has begun
to show the associations that you indicate. I also note that in
your testimony you seem to have an integrative approach as
well. You indicate the debt we owe to conventional medicine,
and then you indicate that there are certain things that
medical schools and others can do to integrate these approaches
in order to get better results for people who have the disease
or to prevent the disease.
May I ask if the people who are under your care, if you
require that they not engage in conventional treatment or if
some of them have also been engaged in conventional treatment
while being involved with your diet?
Mr. Kushi. Those things are up to the patient. The entirety
of patients have entire freedom. However, because the cause is
diet and lifestyle, so basically the cure is, basically the
diet, proper diet and proper lifestyle. Then in addition to
that correction, patients, if they want chemotherapy or
radiation or acupuncture or herbal medicine, that's fine. They
can attach these. But I hope this treatment can be mild and not
overdosed. Because in my opinion, and in other people's
opinions, by overdose of chemotherapy, overdose of radiation,
this often affects so much the suffering of the patients, not
only suffering, I wonder maybe shortening their life also. A
moderate approach, I hope, the medical treatment can take.
Ms. Norton. I just want to say to Mr. Kushi, I think
increasingly many people adopt the point of view you just
expressed, that the treatment is worse than the cure, and many
people forego such treatments.
I just want to say in closing to Ms. Mack, how important
her leadership has been, that when you have come forward and
others like you have come forward, you cannot imagine the
effect you have had on people who would not otherwise come
forward. By doing the race, there are women whose attention we
could not possibly get except through the dramatic intervention
of well-known women who are first, willing to indicate that
they have had the disease, and then willing to show that the
disease can be defeated. I certainly want to thank you for
that.
I have a sister who is now president of a college, who has
had breast cancer and feels herself entirely cured. Since I am
her sister, not only do I want her to be cured for that reason,
but because this thing may also run in families. I certainly
appreciate the leadership you have given to this work.
Thank you, Mr. Chairman.
Mr. Burton. Thank you, Ms. Norton.
Mr. Mica.
Mr. Mica. Thank you, Mr. Chairman.
Mrs. Mack, I just had a couple of questions. First of all,
your leadership has been tremendous in the private sector in
providing awareness and also raising funds. You cited in your
testimony how much money had been raised privately just by the
activities you have been involved in. Maybe you could comment
to the committee on your suggestions for research and for
funding, and what do you think would be an appropriate private-
public mix of funds?
Ms. Mack. Well, I believe the Congress is doing an awful
lot in the doubling of the moneys for NIH which Connie has been
involved with. Getting the funding doubled for NIH will help
all diseases. I believe that all that we do in research is
where we are going to find the true answer to not just cancer,
but all other diseases, and through research, through
alternative medicines. Research in every way is going to make
the difference. Public and private, we all have to work
together. It is a large problem. The Government can't do it
alone, and neither can the private sector. I think whenever we
can partner and whenever we can work together, the cures and
the research will come to make a difference.
Mr. Mica. One of the other things that I wanted to ask
about was that you had talked about awareness and self
examination. There seems to be somewhat of a lack of public
awareness. How do you think we should best approach these
campaigns from a private sector's standpoint or public or a
combination? What do you think is most effective in getting the
message that you are trying to get out to women and others?
Ms. Mack. Well, I believe it is through hearings like this,
through races, through advocacy, that all the women in this
room, and all the people in the cancer communities do. We are
blessed in this country with many generous, wonderful people
who raise money in the private sector, but also our Congress
and our administration, work diligently to find the answers to
cancer, in particular, and diseases in particular. But I just
think we have to continue. We can't sit, rest on our laurels.
We have to continue to be out front and continue the fight, and
to make more people aware.
I mean, as obvious or as outfront as I have been and Dr.
Kushi and everyone else, there are many, many people out there
who haven't heard a word we have said. We have to continue to
get to the underserved. We have to continue to get the message
out that early detection, until we find a cure, is the way to
deal with most diseases if you find it, or prevention through
ways that have been proven to make a difference. It takes a lot
of money. It takes a lot of time, and it takes a lot of heart.
Through public and private, we can do it together. We cannot do
it alone.
Mr. Mica. Thank you.
Mr. Kushi, you spoke quite a bit about diet and changes in
lifestyle and prevention. What do you see as the role of
research today and how important do you think that is in
finding a cure for cancer or addressing cancer treatment?
Mr. Kushi. There are many approaches for cancer treatment
and many ways we should also examine, and research should be
done. However, as I pointed out, basic problems of cancer and
other disease are what we are eating and daily life. Therefore,
do research to associate diet and daily life with cancer, and
if more research goes there and finds what kinds of results are
coming, such as test in the clinical trials, in the hospital,
this and that, et cetera; and data accumulation. For example,
it's very easy to confirm that blood pressure comes down or
cholesterol comes down, it is very easy by changing diet. Same
thing, like for diabetes, it is very easy to offset, even
though insulin has been consumed. Situations are also very easy
by dietary control.
In a similar way, if you subject patients to a study about
this type of cancer, or just study this type of sickness, how
diet is related. I suppose I or someone else, we will be very
happy to confirm that this kind of diet will offset or reduce
or prevent that; while, if the current way of eating continues
together with any medical treatment, how different outcomes
will result. It is very clear, you can see that. Then after you
have accumulated those data, then you can apply these clinical
tests in the hospitals, you can apply it in other health
clinics. Those data can be created easily in 6 months, 1 year,
or at most 2 years' time, enough data which we can convince the
people who are watching the healthcare field and educational
field.
Mr. Mica. Thank you, Mr. Chairman. I yield back.
Mr. Burton. Thank you, Mr. Mica.
Mrs. Mink.
Mrs. Mink. Thank you, Mr. Chairman. I want to compliment
both of our witnesses. You have very inspirational messages,
not just to this committee and the Congress, but to the
American people at large.
I detect the common theme of both of your testimonies, is a
sense of personal responsibility. In your case, Mrs. Mack, your
detection was by yourself through self examination. The message
there is that notwithstanding all the medical instruments that
are now available for detecting breast cancer, there is really
no substitute for the once-a-month self-examination procedure.
In your case, Mr. Kushi, the knowledge that what you eat is
what you are, I think, is an important message that we have to
take very, very seriously. I do think that the points you make
in your testimony, Mr. Kushi, have been well expressed by
nutrition experts, by people in the medical profession who are
constantly hammering on your diet, don't eat fats and stay away
from this or that. So I think the general message is not that
different in terms of the medical profession and what you are
espousing.
The point, however, of getting the message earlier in life,
particularly in places like the school lunch program in our
schools and in our training programs. I have been told that
medical doctors have less than one course subject on nutrition
and the diet. They go out and they are treating patients with
very serious illnesses, with very little perception about the
importance of diet. So I think we have to carry the message to
the professionals and convince them that the words they expound
about diet truly have meaning. I think that that is what you
have brought to this committee. I commend you for your work and
for your leadership, and commend your book. I will get a copy
and read it from cover to cover. Thank you very much.
Mr. Kushi. Thank you.
Mr. Burton. Thank you, Mrs. Mink.
Mrs. Morella.
Mrs. Morella. Thank you, Mr. Chairman. It is a pleasure to
have heard both of you and to Mr. Kushi, to have had the women
who have appeared here and gentleman to comment on the
successes.
Priscilla Mack, you are so right. You know, over and over
again, you said early diagnosis makes the difference. I am
pleased that in my area with the American Cancer Society, with
a number of hospitals involved, with Hadassa, we have been
bringing a program called Check it Out to high schools, and
inviting the 11th and 12th grade females to come together in an
assembly and to learn self-examination. They ask very graphic
questions. They learn it not only so they can get into the
habit of doing it, but so that they can be the messenger, to
bring the message to their older sisters, their mothers, their
grandmothers, their friends. I guess that this is something
from what you said, in terms of how you even discovered that
you had a challenge, it is through the self detection.
So I want you to know how much I appreciate what you have
done, and the fact that you have brought an enthusiasm and such
strength to the whole concept of research and our own personal
involvement, and certainly the Komen Race for the Cure. No
wonder the money has doubled over the last year, because we
have had inspirational people. So thank you.
I am interested, Mr. Kushi, whether or not first of all,
these people who are such great testimonials to the concept of
the dietary facet of it, do they come to you as a last resort?
And how do they hear about you? Do you have any centers in
Maryland?
Mr. Kushi. Your home, I hope your house will become a
center in the near future.
First of all, many people are coming to see me or my
associates, or teachers. Many of them have already received
medical treatment. They were declared--no way, terminal cases,
or they themselves were dissatisfied with the results of the
medical treatment. Those people come. Of those people who come,
maybe 40 percent of people are this type.
Second is the people who got sickness and got diagnosed.
Then they start before they receive conventional treatment,
they start to search for alternative ways and come to us. That
is the second approach. That may be about 30 percent or so.
Another number of people for the sake of keeping their
health, for the sake of precaution, they also come. And people
who have come to us because they found at that time maybe stage
one, two, or three of cancer, different stages. But as I said,
and as you know, many women are hesitant to go in for drastic
treatment. So before receiving treatment, they search.
Otherwise, after they receive some drastic treatment, then they
still are told there is no hope. Then they start to search.
Mrs. Morella. Do they hear about you basically through your
book?
Mr. Kushi. Yes, through words, through books.
Mrs. Morella. Word of mouth, words spread.
Mr. Kushi. Yes, that's right. We are not a commercial
venture, so we never advertise. But through books, through
education, and also our educational center, the Kushi Institute
in Massachusetts. However, through that dedication for many
years, many graduates have come. I develop those teachers.
Throughout the world, several thousand teachers are out there.
In this country, many States, many cities have also macrobiotic
teachers. They are doing cooking classes, they are doing health
advice or various social work.
Mrs. Morella. You would, it seems to me, suggest that
doctors, that all doctors, all of the health practitioners
include as part of their treatment that there be the
recognition of how food as well as exercise and other moderate
lifestyles, the role that food plays.
Now she mentioned some of the mixtures that you made. I
mean do you have to have it in mixture form? Can you just have
like good vegetables and have a list of dos and don'ts? Does it
have to be mixed in a certain proportion?
Mr. Kushi. It depends on the condition. For example, you
know, like colon cancer, that more is caused by beef and pork
and cheese, eggs. Eliminating that effect, then we need like
grated daikon, grated carrots, green leafy vegetable juice, and
so forth. More opposite factors we bring, and other factors to
balance the condition. In the case of, like I would say
intestinal problems, then there, traditionally the oriental
countries have been using kuzu and also pickled plums, which
are very good for digestion; and also, suppose, if you want to
straighten out pancreatic cancer, then you better have sweet
vegetables like cabbage, carrots, squash and onions: those
finely chopped in equal amounts, and with three or four times
water, cooked 25 minutes. That's a sweet vegetable drink. Drink
every day, one cup, two cups. That makes it easy to solve the
cancer.
In the same way, our approach is, No. 1, the safest
approach. No. 2, cost value is low. No. 3, at home they can
practice and use foods, food which they can get very easy.
Using them, they make home remedies.
Mrs. Morella. I guess I am going to have to buy the book.
Thank you very much.
Thank you, Mr. Chairman.
Mr. Burton. Mr. Cummings.
Mr. Cummings. Thank you very much, Mr. Chairman.
To Ms. Mack, I want to thank you for being a leader in this
area. So often what happens is, I think it was Martin Luther
King, Sr., who said that you cannot lead where you do not go,
and you cannot teach what you do not know. So often people go
through difficulties. Once they get through their difficulties,
they almost act like it never happened. But not only have you
remembered, but you have acted on them to try to help other
people. I think that there is no greater thing that we can do
as human beings than to use our pains and our problems to turn
them around and use them as a passport to help other people. So
I thank you for your leadership.
As I was looking at the statement of our good friend Mr.
Kushi, I just want to ask you a few questions because I am
truly fascinated. Mr. Chairman, I am so glad you had this panel
because I did not expect it to be so interesting. [Laughter.]
Mr. Burton. Are you inferring that this committee is not
interesting? [Laughter and applause.]
Mr. Cummings. One of the things that you talk about is
cost,* [see below] that so many people, they can't get
healthcare because of the cost. I guess they may not have
insurance or whatever. I am sure it must be very frustrating to
you and probably I'm sure you too, Ms. Mack, when you are on
this mission to help people and to know that cost of treatment
is something that because people can't afford certain
treatments, that people are literally not only suffering, but
dying. I mean that must be a very frustrating thing for you
all. I just would like for you all to comment on that.
Mr. Kushi. I agree, and for example, more in conventional
medicine, doctors learn in medical school training there is no
single course for nutrition, and diet; but by eating we form
blood, we form our limbs, we form all sides of our bodies.
Without understanding that, there is no way to understand
cause.* [It seems that Mr. Kuchi heard ``cause'' instead of
``cost'' in the question of Mr. Cummings. Therefore, he
addresses the frustrations of symptomatic medicine where
``cause'' is not eliminated.] Therefore, all patients are
frustrated. If treated with a symptomatical approach, symptoms
maybe might be temporarily eliminated; but then the cause still
continues, still taking heavy meat, et cetera. Then again,
symptoms come back 2 years later, 3 years later, all very
shortly. Again, in the hospitals, even in hospitals, what are
patients fed in there? They are fed the cause of the sickness,
that beef or ice cream or whatever. This is a very ironic
situation!
While trying to help sickness, they are creating more
sickness, and endless heavy treatment, more increasing
chemotherapy; more radiation is needed; and doctors themselves,
I know, many doctors are frustrated. Why should we not open our
eyes to the cause. Without knowing the cause, there is no way
of cure. That's the medicine of symptoms, but not cure. But
cause is, day to day our own way of eating, our own way of
lifestyle! There probably, our thinking, consciousness must
change. We want to have the prosperity, we want to have that.
Our thinking must need to change, but at the same time, we can
begin from day to day life now.
We lost family cooking, with all outside fast food and this
and that, et cetera; and together we are losing family cooking.
Our family relations between father and mother and the children
are becoming more and more troubled. Also in school, the
concentration of students becomes troubled. The school lunch
program is more fatty food, more heavy food, more sugary food.
They can't concentrate in the school. Then unless we bring back
to America and the entire world, which is influenced by
America, good way of eating again, there is no way to solve
this. America and other countries are all sinking down
physically and economically.
Mr. Cummings. I must tell you that you already had an
impact on me. I have gone back there to the little room here to
eat my potato chips, roast beef, and my Coke, and I could
hardly get it down. [Laughter and applause.]
As a matter of fact, I left three-fourths of the bag of
potato chips out there. I think I am going to throw them in the
trash.
Mr. Kushi. Let us think of our ancestors, your ancestors,
all mankind's ancestors. Traditionally, we have been eating
whole grains day to day. Right? Either bread form or rice form
or whatever, and then vegetables, then beans. From beans, bean
products we have been getting more vegetable quality proteins.
Some countries may be getting seaweed, and so forth, a mineral
source. Then we are doing home cooking. Animal food, like beef,
our ancestors consumed much, much less. I have no objection to
having that, animal food, but much less percentage, and not
like currently, like antibiotics--or hormone-treated beef, and
so forth. Then we didn't have cancer in the 19th century, 18th
century. Why not? The tremendous change in the diet. Tremendous
decline of what we are eating!
Mr. Cummings. Thank you very much. Thank you, Mr. Chairman.
Mr. Burton. Thank you, Mr. Cummings. I didn't know you were
a standup comedian, but you are pretty good. [Laughter.]
Mrs. Biggert.
Mrs. Biggert. Thank you, Mr. Chairman.
Mr. Kushi, your diet seems to be quite the opposite of
several diets that are popular right now in this country as far
as losing weight.
Mr. Kushi. For example?
Mrs. Biggert. Like the Zone diet or sugar busters, those
high protein diets, which are high in fat, animal and dairy.
But do you think that these type of diets then will contribute
to greater cancer risks?
Mr. Kushi. To certain period, for certain period, to
certain symptoms they maybe contribute. But what macrobiotics
recommends is very traditional, thousands of years or maybe a
million years, mankind's experience, generations to
generations, whole grain and vegetables, beans, et cetera. And
that is the base. It then depends on climate, depends on where
you live. Cooking methods change, and also combination of
vegetables, combination of foods change. But the base is there,
grains and vegetable base. Animal food you can add 5 percent,
10 percent, depends on your condition. Fruits also you can add,
it depends on the seasons.
Suppose we didn't have in Washington, DC, our 20th century
banana, because it simply didn't grow here. Now we are taking a
banana every day. Or sugar, we didn't have sugar cane. We are
not growing it here. All climates are different. Therefore, we
need for those things to have moderation--tropical products, et
cetera. That means environmental consideration is needed.
Mrs. Biggert. What about the role of exercise then?
Mr. Kushi. Oh yes. The role of exercise is great. However,
recently they are recommending that some special exercise is
very popular now, certain types of exercises. I would say yes,
you may do so. However, more important is day to day work, day
to day active living. I am recommending to the sick people, the
people who are sick and my associates, I am recommending every
day with hot wet towel squeeze, scrubbing their whole bodies
twice, morning and night, making blood circulation active, and
so forth. Then take a walk at least a half hour, taking a walk
if they can walk. Then if they can do any light exercise, fine.
But not strenuous exercise. Then every day, singing a song,
happy song--``You Are My Sunshine'' or whatever, not a
depressing song--every day. That opens the chest and makes the
breath and circulation better, and the emotions up. Also I am
recommending people wear cotton clothing, and more cotton
bedsheets and pillow case, instead of synthetic ones; and more
also putting green plants in the home, which emit oxygen and
keep the house better. Also, this may be a problem now, not
using a computer much if you are sick.
Mrs. Biggert. It sounds like a whole positive attitude.
Mr. Kushi. Yes. Also microwave cooking is very
questionable, microwave cooking. Now 75 percent of the American
families are using microwave cooking. This is a big problem,
question. Traditional cooking, like charcoal cooking, or the
gas stove is much, much better. Furthermore, the like
electromagnetic environment it is better to examine. Also, as
home family cooking will be recovered, and I hope they have a
chance, the whole family has a chance some evenings at dinner
time, to talk to each other. They should sleep not at midnight,
more like 10 or 11, and so forth. In other words, healthy,
normal healthy life!
Mrs. Biggert. Thank you.
Mrs. Mack, I really appreciate your testimony and your
presence here after the Race for the Cure last Saturday. It is
amazing how across the country this type of activity is being
conducted. I know in Illinois we had a big event there. I have
to say that we didn't have quite the 66,000 people that were
here in Washington, DC. But I think that does so much to raise
the consciousness of the problem.
But in your work with breast cancer survivors, are there
characteristics that you find that people have in common that
are successfully overcoming their cancers?
Ms. Mack. Well, I will have to speak only for myself and
the people I speak to, my impression of that. But I find like
Mr. Kushi says, if you have a higher power and you do
everything on your behalf that you can do to further your
recovery, take care of yourself to find out what's out there to
take care of it, and then what you can't do, let go and let God
handle. Also, if you can do that and you have the serenity to
do the right things for yourself and have that positive
attitude, I find that through all of these things, we are
changing the mindset that cancer is a deathnell. When we
continue to do that, we also bring to that good mental health,
which also affects your physical health.
Mrs. Biggert. Thank you. Thank you, Mr. Chairman.
Mr. Burton. Well, thank you, Priscilla. You have been
lovely as always, and we really appreciate your comments,
especially the last ones you made. I think those are very
important about having the higher power, the supreme being. A
little prayer doesn't hurt. It doesn't hurt a bit. It kind of
calms the soul and helps stabilize everything.
Mr. Kushi, I pledge to you, every morning I am going to
start singing ``You Ain't Nothing But a Hound Dog'' so I can
get myself off to the right start.
Let me thank you both. I think it has been very, very
enlightening. We really appreciate it. Mr. Kushi, your book, I
am going to recommend it to a number of my colleagues. I think
they would like to read it as well. So thank you both very
much.
Mr. Kushi. May I just add one thing about diagnosis? Very
simple. For the family, to know where diagnosis is about cancer
conditions, in the beginning stage. At this place,* [Mr. Kushi
points to the outside edge of his hand, below the little
finger] if green color comes out, then we have to suspect in
the near future cancer may begin.
Mr. Burton. Here?
Mr. Kushi. Yes. In the case of breast cancer, this center,
green straight line * [Mr. Kushi points to an imaginary line
running down the center of the underside of his arm, up through
the center of the palm, to his middle finger] comes, in the
case of risk. This begins 6 months before cancer, one of the
symptoms. This is an acupuncture meridian, the so-called
``heart governor'' meridian. It goes across this breast. If
that meridian is clogged from the breast, then down the arm, it
then becomes a green color in the case of cancer.
In the case of the uterine cancer or ovarian cancer, here *
[Mr. Kushi grasps his chin with his thumb and index finger] if
we have a very fatty, large deposit, and especially a hard one,
then uterine cancer, ovarian cancer or cervical cancer is very
suspected. Prostate cancer too, is very suspected for men.
Mr. Burton. Right here under the chin?
Mr. Kushi. This. It's because low in the head reflects low
in the body. It's very accurate. Various simple way of
detection are available also, as information for home use.
Mr. Burton. Thank you, Doctor, very much. Thank you both.
We really appreciate it. Thank you all those who are
applauding. I appreciate that as well.
We would like to now have Dr. Gardener, Ms. Zarycki, and
Ms. Bedell-Logan come forward, please.
Dr. Gordon, since you have time constraints and you have to
leave right away, you said you have a relatively brief
statement you would like to make. So we will allow you to do
that. Then we will go right to our ladies.
Dr. Gordon. Sure. I wanted to be able to stay around for
questions though, if you would like to ask the questions too. I
just was saying that I have to be back there by 3.
Mr. Burton. In that case, if you wouldn't mind, Dr. Gordon,
I think we will go ahead with this panel, and then we'll hold
you, because I think we will be finished by 3.
Dr. Gordon. OK, great.
Mr. Burton. Let's start with Ms. Zarycki. Did I pronounce
that correctly?
Ms. Zarycki. It's Zarycki.
Mr. Burton. Zarycki, I'm sorry.
STATEMENTS OF CAROL ZARYCKI, NEW YORK; N. LEE GARDENER, PH.D.,
RALEIGH, NC; AND LINDA BEDELL-LOGAN, SACO, ME
Ms. Zarycki. I was going to say good morning, but it's
really good afternoon.
Mr. Burton. Well, these hearings sometimes run a little
ways into the afternoon, but they are very important.
Ms. Zarycki. Yes, they are. Thank you for the opportunity
to testify regarding complementary and alternative practices,
which I will call CAM, and the role of women's cancer
treatment. I am Carol Zarycki, an advocate and breast cancer
survivor of 2 years. In my written testimony, I have outlined
issues and instances where we as patients have had to do most
of our own research in seeking out CAM protocol. I will
highlight some of these points and summarize my personal
approach.
I am speaking for myself and other patients and advocates
whom I'll call we, to request legislation for CAM medical
research and funding rather than to continue regulation of
standard allopathic treatments, the costs of which are
ultimately borne by the taxpayer and the Government, and which
do not show an increase in cancer survivor statistics. We are
tired of hearing about measures such as time to recurrence,
tumor regression rate, or time to disease progression, when the
real issue is preventing cancer in the first place. We would
like to see a shift of funding and research attention to the
review of a standard cancer protocol that is less toxic, better
targeted, and more effective, while at the same time, focusing
on CAM therapies.
The role of insurance coverage is a primary factor in the
CAM choice process, and needs to be addressed, not just for
patented drugs or diseases with a name, thereby endorsing
insurance coverage, but for natural alternative treatments, so
that we don't have to invent new names for new types of
cancers. We need to have access to treatments and clinical
trials that will work with us as individuals rather than be
limited in choices. Some toxic medical procedures given
routinely can leave the immune system in deep disrepair, making
one more susceptible to recurring disease for this very reason.
Ironically then, one would have to seek alternative treatment
not covered by insurance to alleviate or attempt to alleviate
this previously non-existing damage.
Information needs to be made available so that individuals
are fully informed of options and possible treatment outcomes,
including quality of life and survival rates for the treatments
they are choosing. Most women given Tamoxifen do not need the
drug, and may even get the danger of side effects of blood
clots in the legs or lungs, uterine cancer, strokes or heart
attacks. A few of these women will have disease progression or
recurrence anyway.
New legislation is required for alternative therapies in
cases where old or even new drugs may not demonstrate an
increased survival rate or even a better rate of progression-
free survival.
There needs to be a recognition of chemicals in the
environment and their effect on hormones from the fish we eat
to our plastic-bottled drinking water. Our country regularly
imports fruits, vegetables, and foods that have been treated by
toxic methods, even when the imported food is labeled organic.
Since it has been demonstrated that hormonal imbalances are an
underlying factor in a growing number of breast and
reproductive cancers, wouldn't it make sense to research
natural hormones rather than add synthetic tamoxifen,
raloxifine or premarin to an already overloaded hormonal
system?
Evidence-based testing methods and not just scientific
competition within the medical community, without regard for
the population being studied, need to be employed. Trials which
indicate life extension should additionally be able to
demonstrate that this means for more than a few weeks, and
should also discuss quality of life issues.
Non-toxic and non-invasive methods of cancer detection
should be standardized, instead of encouraging mammograms which
strongly increase a woman's chances of getting breast cancer in
her lifetime. Also, for younger women with dense breasts and
therefore, unidentifiable or undetectable cancer, mammograms
can weaken the still growing tissues, thereby promoting future
malignancies.
A focus on preventive measures which strengthen the immune
system rather than early detection methods, which can also be
too late detection, and with their own set of risks and
hazards, can be incorporated into an individual's lifestyle.
Allopathic medicine used on its own needs to clinically
understand the traumas and debilities it is in itself creating,
not curing. We want to be able to live in peace with the
treatment decisions we are making, without fear that
mammograms, therapies, toxic and synthetic drugs are doing a
potential future harm to another part of our bodies. We do not
want to hear about 5 or 10 year guidelines that we are being
measured against, but rather experience peace by knowing about
immune strengthening practices which will eliminate the need
for these guidelines and also the topic of recurrence.
We are requesting a sharing of both conventional and
alternative medicine, so that it can truly be called an
integrative complementary medical practice. We must try a new
approach because the old ways are simply not effective in
reducing mortality rates. We must try a new approach because
the old ways are simply not saving our best friends' lives.
For my personal approach and upon initial diagnosis, I
spoke to my herbalists, each of whom had started their
practices due to family members' involvement with cancer. I
contacted local and national organizations, including SHARE in
New York City, becoming involved in support groups and
informational workshops. I spoke with whomever I came in
contact with who had gone through a similar experience. I
started keeping a daily journal, prayed more, and learned about
meditation. I made appointments with alternative naturopaths
and noted visualization authors. I began juicing and
nutritional therapy, checked out nutritional cleansing, enzyme
and vitamin therapies, started ancient Eastern practices of Qi
Gong and Jin Shin Jitsu, went to healing services and
ceremonies of different cultures, bought more herbal books, and
took classes to begin making my own combinations. I became a
devout fan of acupuncture and studied homeopathy. I wouldn't
say I did anything radically alternative, but then some
consider meditation or acupuncture radical.
I began to teach others what I was learning about my
favorite non-toxic personally tested alternative methods of
healing. I have been blessed with a team of surgeons,
oncologists, and alternative practitioners who have come into
my life exactly when I needed them, and with whom I continue to
discuss alternative information and ideas, even though they
express doubt about the methods I am using.
There is, I found, a fine line between being cured and
being healed. While we all want to think of ourselves as being
cured or on the way to finding new cures, the only way this can
happen is by allowing a healing to take place on all levels,
mind, body, and spirit, and which standard allopathic medicine
does not fully address. This is a highly individual process
involving reflection and recognition of our relationship with
surroundings, why we are here, and what we are called here to
learn, and then working with this process rather than fighting
it or attaching blame. When we approach this awareness, we have
already begun to heal and our own energy, spirit, vital force,
qi, and prana, are strengthened from within, turning the
healing process into a curative journey. Thank you.
[The prepared statement of Ms. Zarycki follows:]
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Mr. Burton. Thank you very much, Ms. Zarycki.
Ms. Gardener. I wanted to say thank you, Mr. Dan Burton,
and also committee members, for your role as David in
confronting Goliath. I appreciate and admire you.
I had originally planned to sort of talk about my story and
that's not what happened. But my story has led me to where I am
now, the place I am now, and to what I have to share with you.
I also have an intimate knowledge as a result of my
personal odyssey with breast cancer, of both conventional and
non-conventional approaches. I probably would have just--I knew
nothing about breast cancer or cancer really, but that people
died from it, and was frightened by it. But ended up really
very much using both of them in depth.
Up front, I want to say two things. I do not think any one
approach, any one approach within either of those systems also,
is right for anyone or for everyone. I have suffered no
irreparable harm from any non-conventional approach, despite
having had extensive exposure to many. I feel that every one of
them has helped me in some way, some more than others. I say
that because I know that's a concern that a lot of people have
and a reservation they have about supporting the use of non-
conventional therapies or making them available to people.
On the other hand, unfortunately, I have to say that--well,
let me preface it by saying that I think that conventional
physicians, most of them are very well-meaning and competent in
what they do. I think they are often more fearful of cancer
than the patients, and perhaps it's because they are being
expected to cure something that they know they really don't
understand. So that can be a very frightening thing, and maybe
can lead them to be very rigid in the way they treat us as
patients, feeling like we can't have any deviations and we
can't waste any time because they are really so very frightened
themselves.
But basically in contrast to my experience with non-
conventional approaches, I do feel that I have suffered
considerable and irreparable harm because of my treatment with
conventional methods. I think most of us have. Some of us are
more willing to acknowledge it than others because there's kind
of a cognitive dissonance there that we want to believe that
what we did was the best and that everything is OK, and we want
to minimize I think, the price we have paid in many instances.
Of course some people have had less treatment than others.
I guess part of my situation too is that I do not feel that if
my point of view had been respected, I don't believe I would
have ever ended up with the number of very invasive kinds of
procedures that I did have to undergo, from which I continue to
suffer the effects. One of them is lymphedema, which no one has
mentioned so far, can be life threatening because if you have
chronic swelling of the limb, there is a rare type of sarcoma
which is a very lethal kind of cancer that can develop. It is
rare, but all of these things are statistics.
So I guess every day there are people who conventional
medicine has sent home to die that are finding their way back
to life, even after they have had, been subjected to the often
times brutal procedures of conventional medicine. I just wish I
didn't have to say these things. I really do. I wish that my
experience had been different, and I wish the experiences of
many, many of my friends, some of whom I have lost and some of
whom I have seen go through terrible suffering, who have
sometimes made it through and survived. I wish I didn't have to
say these things and have those perceptions.
I wanted to say a lot of things which I am not going to
have time to say. I guess maybe I can say that--it's hard to,
and I know everyone is wanting to go and I am too, because I
have had a peach to eat today, that's it. I guess maybe let me
say this. I think we have to find another way to approach
cancer than conventional approaches, because conventional
approaches are based on killing cancer. That does not guarantee
in any way that it is going to heal us or keep us alive. There
are no guarantees made of that. It is kind of like killing
alligators instead of draining the swamp. We are not dealing
with causation, and we are not dealing with healing. I had
planned to give you some evidence to back up some of that, but
we won't have time for that.
I'll just, in ending here, I will say that if anything that
you hear today makes a difference to you or enough of a
difference to you, then you will have to do something to make
some changes. You will have to make some choices. I believe
that when we choose, we are not choosing just for ourselves. We
have to keep in mind that we are choosing really now for all
because it is one world. We are starting to realize that, and
see that vision I think more and more, that we are choosing for
the human race and for the survival of Earth.
In one sense, both David and Goliath are within us, within
each individual. So we have to decide whom we are going to
serve, whom we are going to choose to serve. I do pray that
each of us will choose well for the well-being of all of us.
[The prepared statement of Ms. Gardener follows:]
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Mr. Burton. Thank you very much. Any information that you
want to submit for the record, we can enter that into the
record, even though you haven't had a chance. Maybe during
questions and answers, we can cover some of that.
Ms. Bedell-Logan.
Ms. Bedell-Logan. Thank you, Mr. Chair, for this
opportunity. In 1987, my sister was diagnosed with a Ewing's
Sarcoma in the calf of her right leg. The protocol for Ewing's
is amputation, chemotherapy, and radiation. This was a very
aggressive cancer. Thankfully, the physicians found it in time.
I remember her fear of having her leg amputated at 25 years
old.
We were in her room when an oncologist came in and said
that there was a new experimental treatment for Ewing's Sarcoma
where they would take a tube and slide it down through her
vein, starting at the groin, and drop chemotherapy directly on
her tumor. She was told that the likelihood of survival would
not be changed, and that it very well may save her leg. On the
strength of this, my sister opted for the new therapy.
At the beginning of the fourth treatment that she had, the
technician couldn't get the tube down through her groin any
longer, and they took her down to sonogram and found a
grapefruit-sized tumor right where they had been going down
with the tube. Because of the obstruction of the tumor, my
sister developed massive bilateral lymphedema in both legs,
which is a swelling of the limbs due to the inability for
lymphatic fluid to move in and out of the limb appropriately.
This is a very debilitating and very painful process, and
because of that pain, the surgeons cut incisions into my
sister's thighs and put permanent drains in them to continue to
drain the lymphatic fluid. Both of these sites became extremely
infected, and my sister was put on large doses of morphine and
antibiotics and was dead in 4 months.
After her death, we found out that she had been a guinea
pig. They had never done this procedure in this hospital
before, and the physicians were not trained to perform the
procedure appropriately. We have also found out that the worst
thing you can do to a lymphedema patient is cut into them. This
was never subjected to randomized control trials, and it's not
used today as standard protocol.
A month after my sister's death, I started working for
Medicare. My goal was to get into the trenches of the
healthcare system to find out what makes it tick. I received an
excellent education from the Federal Government, and went to
work after that for a very large family practice and urgent
care center. I have seen the system work from the perspective
of the patient, the payer, and the provider.
I opened my company, Solutions in Integrative Medicine, 10
years ago. My company provides billing and practice management,
consulting, and education services for patients, providers, and
insurance companies. We have been at the forefront of a change,
actively advocating for patients whose insurance companies
denied payment for effective, but unconventional services. One
of the things that I have heard here today was talk about the
uninsured. For those people who are insured, there is a very
big problem with getting coverage for anything outside of
opening a flower with a hammer.
We have been instrumental in developing the administrative
and clinical basis for coverage of a host of integrative
therapies, often at greatly reduced cost. But this effort has
been very tedious, which makes it difficult to make a large
enough impact for global change. One of the problems with
research is that the researchers sit in their ivory towers and
do research, and come up with sometimes very good outcomes for
randomized control trials, but we can't implement them at the
insurance level. Sometimes it takes 10 years to get a
randomized control trial accessible to patients.
The U.S. Public Health Service estimates that 70 percent of
the current healthcare budget is spent on the treatment of
approximately 33 million chronically ill individuals. As the
population ages, such conditions will consume an even larger
portion of the national healthcare dollar. With this in mind,
my company's vision is to change the perspective of the
healthcare industry by providing professional education to
insurance carriers, Medicare, physicians, and patient
consumers.
An example of this education is lymphedema. Twenty percent
of all women who have breast cancer, axillary lymph node
dissection, mastectomy, will have lymphedema. Those numbers are
even higher for men with prostate cancer. These survivors have
now contracted lymphedema, the three consequences of lymphedema
are swelling, recurrent infections, and tumor formations,
called lymphangeosarcoma, which is untreatable. The lymphedema
patients who do not receive early intervention may develop
elephantiasis, which can lead to amputation of a limb.
Prompt treatment by specially trained lymphedema therapists
who manually drain the engorged tissue has been shown to save
limbs, save lives, and save healthcare dollars. The therapy is
called combined decongestive therapy [CDT]. It has been a
standard treatment in Europe for decades. But today, it is
considered an experimental therapy in the United States, and is
not a typically covered service. In the United States, our
standard approach is to use expensive pumps that mechanically
compress and decompress the affected limb, even though this
therapy has been shown to have little benefit. In fact, it can
press lymphatic fluid in the wrong direction and lead to a
worsening of symptoms. For this reason, mechanical pumps for
lymphedema have actually been banned in European countries.
In the past 2 years, we have been able to begin educating
the insurance industry about CDT. We have been able to obtain
coverage for Medicare patients in Maine, New Hampshire,
Vermont, Massachusetts, and Florida, as well as many commercial
insurance beneficiaries all over the country. This type of
education and common sense is extremely important when it comes
to medicine. Unfortunately, the rest of the public receives
conventional treatment, costing insurance companies millions of
dollars each year.
The treatment of lymphedema is just an example of the
education and common sense needed in the insurance industry.
The illusion is that the best medical practices are based on
the result of randomized control trials. It was recently
estimated that only 15 percent of medicine today has been
subjected to randomized control trials. It is a sad fact that
since there is little to be gained by drugs or medical
equipment companies from the lymphedema treatment regimen I
described earlier, little attention or marketing is focused on
such common sense therapies. This is why healthcare cannot
simply be left to the private sector. Too often the perverse
incentives of our system lead to short-term thinking and
pharmaceutical band-aids, rather than comprehensive chronic
disease management. The result, strangely, is poor quality
healthcare at a higher cost. Those who can break out of the
system can afford to pay out of pocket. Integrative medicine is
becoming rich people's medicine.
We must put prevention of chronic illness in the hands of
patients, treatment of chronic disease in the hands of
integrative medicine teams, and acute and traumatic episodes in
the hands of conventional medical providers.
I will say in closing that my brother died of AIDS in 1994.
He was diagnosed in 1980. He was on the television show, 48
Hours, as one of the longest living AIDS patients in the
country. They asked him how he did it. He said, ``I stayed away
from conventional medicine. I used my conventional medicine
doctors to help me decide what were the best alternative
treatments for me, and did nothing but alternative therapies,''
and he lived 14 years with a very high quality of life, and
died of Karposi Sarcoma. Thank you.
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Mr. Burton. Well, thank you very much. That last, not the
last thing that you said, but the second-to-last thing that you
talked about was very interesting. You are saying that in
Europe, they have been using for lymphedema a different
approach and it's been done for a good many years, and they
have actually outlawed or done away with the pumps that are
still being used as conventional medicine here in the United
States?
Ms. Bedell-Logan. That is correct.
Mr. Burton. How do you account for that? You mentioned the
pharmaceutical companies and some of the companies that produce
these things. Do you think it is because of influences of these
institutions?
Ms. Bedell-Logan. I do. In 1997, which I have the report
with me, Medicare spent on the East Coast alone, $13 million on
pnuematic pumps. Most of those pumps are contraindicated. This
is because when lymphatic fluid is simply pushed from the arm
or the leg back into the body, it can create genital lymphedema
in men and it can create lymphedema built up in the chest of
women, which can create lymphangeosarcoma.
What these specially trained therapists do, who are trained
by the Vodder method, which was really born in Germany, is they
manually through a massage technique open up the passages for
the lymphatic fluid to move out of the arm appropriately, and
then they bandage the patient with a compression bandage to
stop the arm or leg from filling back up.
Through this process, they are actually teaching the
patients to take care of themselves at home. We don't want to
have patients keep coming back and coming back for treatment
because that is not cost-effective. But what we do want to do
is make sure that these patients are completely self-sufficient
in taking care of their own lymphedema. There is no cure for
lymphedema, but we can certainly----
Mr. Burton. Minimize it.
Ms. Bedell-Logan. Minimize it, exactly.
Mr. Burton. So through massage and through the bandaging?
Ms. Bedell-Logan. Exactly. It is a very inexpensive
treatment. They usually last anywhere between 2 to 4 weeks,
depending on the severity of the case.
Mr. Burton. Well, now some women are told by their doctors
to wrap their arms or put a casing on their arm every day. Are
you talking about that as well?
Ms. Bedell-Logan. That can be helpful with minimal
lymphedema. But when lymphedema becomes fibrotic and the limb
gets very hard, the compression bandaging doesn't work unless
those fibrosis are broken down through massage therapy.
Mr. Burton. Through massage therapy.
Ms. Bedell-Logan. Right.
Mr. Burton. OK. Thank you.
Ms. Zarycki, you were very critical of a lot of the
conventional thinking. I presume you have done a lot of study
on this. How did you come to all these conclusions that you
came to? It's very interesting to me.
Ms. Zarycki. I initially used conventional treatment. When
I first started out, I wanted to take a chance and explore
alternative options. I was told by a myriad of conventional
doctors that I went to that basically it was OK if I did
alternative and it was OK if I did some herbs and this and
that, but if I really wanted to make an impact and to live, I
should really go with conventional treatment and I should not
wait, and if I wanted to do alternative, I could always do that
later. That was the comment that I got.
So instead of feeling like I had time to do more research,
I felt like I really had to jump in and do the standard
treatment. So in a sense, it would have been nice if both of
those practices could have worked together as they do in other
countries, as they do around the world, but not always in this
country.
Mr. Burton. From a personal standpoint, how do you account
for those in Europe having more advanced treatments or optional
treatments and the United States doesn't?
Ms. Zarycki. I think they are more open to research than we
are, and I think that they are putting funding in other areas
and concentrating it in other areas, rather on prevention more
so than we are. We are using machines for detection when we
should be using ourselves and our own inner energies to
understand and work with our immune systems.
Mr. Burton. You don't think that the companies that
manufacture pharmaceuticals and products are exerting any
influence here in the United States, or you haven't had that
experience?
Ms. Zarycki. Well, I feel that is a large part of it, yes,
in terms of the conventional side, sure. It is all tied
together. But when they start getting the funding and when the
smaller alternative organizations don't have a chance and they
don't have the money to run any trials, clinical trials,
randomized trials, that is what is happening in this country.
So that is why we need more funding to go for those sorts of
efforts.
Mr. Burton. For alternative therapies?
Ms. Zarycki. Yes.
Mr. Burton. Dr. Gardener, you mentioned that you suffered a
great deal because you weren't exposed to or aware of
alternative therapies and you continue to suffer because of
those. Do you want to elaborate?
Can you pull the mic closer? I can't hear you.
Ms. Gardener. No, that's not what I said.
Mr. Burton. OK. I must have misunderstood.
Ms. Gardener. Yes. I said it was not because I wasn't aware
of them. I became aware of them. But it was because I was not--
conventional medicine, first of all, did not respect my right
to make choices about myself, about my own situation. It
started out, for example, I wanted to have a needle biopsy of
the lump, and they wanted to take it out right away.
Mr. Burton. In the form of a mastectomy?
Ms. Gardener. No. No, not before they did a biopsy, no. Not
before they did a biopsy.
Mr. Burton. They didn't want to do a needle biopsy?
Ms. Gardener. They didn't want to do a needle biopsy. They
wanted to just remove the lump. I wanted to just have a piece
of it taken out, to see if it might be cancerous. At that
point, we had no idea. I was in very excellent health. I had
never felt better, in a sense. I have heard other people say
that too, just before they are diagnosed.
Mr. Burton. OK. Thank you very much.
Mrs. Mink.
Mrs. Mink. Thank you very much. I certainly compliment all
three of you for your very interesting and informative,
provocative testimony. I know the time doesn't permit me to go
into details of what you have to offer this committee and the
Congress. I do have one or two points that I think need
clarification.
Carol Zarycki, on your page 4 of your testimony, you said
that you were personally not planning to have mammogram
followups, and went on to discus the reasons for that
conclusion. You heard earlier that there is still overwhelming
dependence on mammograms, and that it is one of the major
educational thrusts that the medical field is promoting and all
the people that are into breast cancer are promoting. I would
like to hear some amplification on the reasons you have come
to, your own personal conclusion.
Ms. Zarycki. Well, I think mainly, using it as a personal
experience, I suffered immense pain and suffering and that had
continued on after a mammogram. That had nothing to do with
just having a mammogram for having your breast analyzed. So the
intense pain and the trauma and that sort of thing which can
lead to a chronic condition, is something that women aren't
really made aware of.
The other thing is that I think as we know, not all
mammograms detect all cancers. So in other words, it can be a
hit or miss situation. So why should I not subject myself to
more immune-enhancing procedures, such as daily breast massage,
which is much more immune enhancing when used with a castor oil
and almond oil base and protects the person, and we can start
our daughters and our children and our nieces on these. It will
protect them. It will protect their endocrine, their
reproductive systems. If anything is going to protect us, we
need to strengthen our bodies. So why tear ourselves apart with
machines and biopsies and synthetic drugs when we should be
building up our systems.
Ms. Gardener. Could I speak to that also?
Mrs. Mink. Yes, please.
Ms. Gardener. Also we know that mammography is extremely
ineffective for young women. Even for myself, I was not that
young, but my lump which was very easy to feel, did not show up
on a mammogram. Also, there is I know of one researcher at the
University of North Carolina, who submitted a proposal, and
this is an established researcher, well published, et cetera,
who submitted a proposal to the Department of Defense to have
funding to study sub-populations of women who were particularly
susceptible to the radiation from mammograms. There is
considerable evidence which was the support for this proposal,
that there are these sub-populations in which breast cancer is
increased when they are subjected to mammograms.
There are alternatives such as thermography, which are
completely non-invasive and completely harmless.
Mrs. Mink. So what is your comment then on the lowering of
the age to 40 years for suggested annual mammograms?
Ms. Gardener. I don't plan to have any mammograms the rest
of my life. I tell my daughter not to have them. I think they
are dangerous and potentially very damaging. I think there are
alternatives equally or more effective.
Mrs. Mink. I thank you for those personal comments. I want
to add to the record that I was astonished to find that nurses
in one particular hospital that I am familiar with, all
indicated to me that they were not going to take any of the
mammograms, for precisely the reasons that you have indicated.
So it strikes me that we really need to open up the dialog on
this issue and not put such tremendous reliance on this one
technique as the way to make sure that we have early diagnosis
and early detection of breast cancer.
Mrs. Mack certainly reemphasized your point, that
notwithstanding the fact that she had had the mammogram and
other clinical examinations, it was her own self examination
that detected her cancer. So I think there is a great deal in
your testimony that needs to set our thinking machines back on
again in this very, very critical and vital area.
Ms. Bedell-Logan, one point that disturbs me which some of
my constituents point out to me frequently, is that when they
participate in trials or other types of research endeavors,
that they are not covered by their insurance, not covered by
Medicare, not covered by any health plan, and that they have to
assume the costs of these trials individually and personally.
Is that your personal understanding to what happens in these
medical trials?
Ms. Bedell-Logan. Absolutely. What we have been doing with
insurance companies to try to bring randomized control trials
that are very positive to a point of coverage and accessibility
for patients much sooner than they are right now, is by
creating relationships with insurance companies at the
integrative medicine center level, where we treat that
particular treatment as a petri dish at that one place. So the
insurance company covers that particular service for a period
of time, and we measure the outcome of a number of patients
using that particular service. The patients get reimbursed for
what they do, what they get out of those services, and we look
to see what the long-term outcomes are.
But this is, as I said, one center at a time. It is tedious
and very slow. But in the big picture, it can take up to 10
years to get a randomized control trial accessible to patients.
That is extremely frustrating. It's frustrating for
researchers. A lot of the healthcare dollars that are going
toward research, by the time they actually get accessible to
patients, there is something better that can be used. So it's
really, to a degree, a waste.
Mrs. Mink. Mr. Chairman, that is really a very, very
important point that we need to pursue why it is that our
health policies established by Congress do not recognize the
important contributions that these health trials, research
trials are making to the ability of cures and other kinds of
processes being developed. Unless they are covered by the
medical insurance plans and health insurance plans, even our
own Federal insurance plans, or Medicare, Medicaid, it is a
real gap in our policy understanding.
Mr. Burton. Why don't I work with you, and maybe we can
draft some amendments to some of the healthcare legislation?
Mrs. Mink. I would be very happy to. I believe there is a
bill pending somewhere, but it needs to really be focused.
Mr. Burton. I will have Beth check on that. But let me just
say before I yield to my colleague, Mrs. Morella, my wife had a
tumor in her breast for the estimated 7 to 8 years that was not
picked up by mammograms. She picked it up by accident through
physical examination. When she told me about it, I said to her,
you really ought to have the doctor check it. She thought it
was a fibrous tumor. She went to the doctor and almost walked
out of the office without having it checked because she didn't
think it was anything, and of course it was. Not only had she
had it, but it had spread to her lymph nodes. So they miss
about 15 percent of them. That is why you cannot look at a
mammogram as a panacea, as these ladies have mentioned.
Incidently, our next panel is going to talk about some
alternative machines, I believe, that are being used in Europe
through heat that will tell whether or not there's a cancer
present. We ought to take a look at those too. So I hope you
will stick around for the next panel.
Mrs. Morella.
Mrs. Morella. Thank you, Mr. Chairman. I want to thank the
three of you for putting a personal face on it and giving us
your experiences. As I try to pull this together, it seems to
me we are saying first of all, self examination is probably the
best way of diagnosing or noting that there is a problem with
breast cancer. I also, and I'm going to let you all comment on
these observations, second, that there is not enough research
that is being done on alternative therapies. Third, is there a
problem that researchers who are doing research on medicine,
maybe the conventional medicine, don't want to share? I mean do
we have a problem of territoriality and possessiveness? I mean
should there be some sharing? And then how do people find out
about alternative therapies? Should they just experiment, read
a book?
Finally, do you see a role for diet, exercise, as we heard
on the previous panel? What kind of a role does that play? I
guess that gets you started, and then if I have more time, I
will fire away with some more questions. I guess you could do
it in any order that you want.
Ms. Zarycki. I will start out. I will just say that I
think, as you mentioned, I think sharing is very important. I
have come up with the same question between the two
communities, because I in some instances had to be a go-
between. I would ask my conventional doctor and tell him
something that I was doing alternatively, that an alternative
doctor would tell me, and they had worked at the same
organization. I said well, why don't you two talk. He said,
``No, no. Why don't you arrange a meeting for us. I don't have
time to talk to him.'' So I would get comments like that.
So my question was, do they really each just want to stay
in their own little area of expertise, or do they really not
know about each other's expertise? That was my question
throughout the whole process. I think it may be half and half.
I am not sure. So I think that's real important in terms of
sharing. I mean it would be wonderful to share all the
information together and come up with some better protocol.
Mrs. Morella. It could also be difficult for a person to
make a determination about what alternative therapy to use too.
Ms. Zarycki. Well, when you are first diagnosed, you are
kind of hit with everything. My whole learning in this has been
if you want to find something, you will. So you have to trust
yourself and in a sense, just in the beginning it's very hard,
which obviously a lot of us kind of go to whatever seems to be
the appropriate thing, which it is at the time. But eventually,
you learn about a lot of different things, and then you learn
specifically what works. Then you learn that there is a lot out
there in terms of the alternative field, but it's not
necessarily for breast or women's reproductive cancers. So
while I see a lot of my friends doing a lot of different
things, a lot of those things may not be as specific as we can
be. So I feel my personal responsibility, and I do that with
colleagues and friends, and I do that on a personal basis now,
is to inform them as to what they really need to do, not to add
negative information into their system, be it in the way of a
supplement that they may not need or a lot of different things
that are just thrown out there on the market as a marketing
tool.
Mrs. Morella. And diet? Do you want to comment?
Ms. Zarycki. Diet is very important. I initially started
out looking at a few different programs that basically
eliminated fat, eliminated meats, eliminated dairy, a lot of
that. Then I integrated that. I spoke to a few different noted
practitioners and noted people who had successfully gotten rid
of cancers. They all have very positive programs. What I found
worked best for me is not to take just one specific program and
say I am only going to stick with this program and I am never
going to eat this or that, but to really combine them and to
use them all and come up with my own program. That is what I
teach others today.
Mrs. Morella. I would like to give Dr. Gardener and Ms.
Bedell-Logan an opportunity to quickly comment on it too.
Ms. Gardener. You ask some great questions, and a lot of
them very quickly. Self exam is best. OK, I have to really
question that. First of all, early detection is too late. We
need to get it way before that. Thermography actually, if we
could start to use that, that would actually detect things much
before you could even find your own tumor, find your own lump.
In the 1960's, they were doing trials--and thermography
came out of the space satellite age, Sputnik and all that. They
were using it to be able to sense. Anyway, sorry. I got off
into a tangent. But basically, they were finding a lot of false
positives. So they said well, this isn't working, we need to
find something else. We are getting too many. False positives
are when you say the person has a problem and they don't. OK?
What they did in a followup study of those that they had
assessed was that they found that really those people did
develop a significantly higher rate. They did develop breast
cancer. So this was in effect a very early detector of cancer.
Those are studies that were being done in conjunction with
radiologists.
Also, the problem that you said about researchers, not
enough research. I have to say we need not more research,
necessarily, but better research. We need to look at
interactions. Right now we have rigorous trials, but they are
very simplistic. The answer is not simplistic. I know about
breast cancer, and we need to look at psychosocial factors,
diet, environment, exposures, all of that sort of thing. So we
need international sophisticated studies.
The third thing, researchers don't want to share. Many
people are not aware that a publicly funded, Government-funded
study, that data that is collected is not available to any
other researchers unless those researchers choose to share it
with them. There are precedents now, an increasing number of
research centers who are putting their data on the web. It is
called public use data bases. That is something that can help
us to break down the real barriers to progress that exist now
because of political turf issues and wanting results to come
out the way you want them to come out, basically. It is
research but it's not science. Then the role of diet and
exercise--lifestyle is critical.
Ms. Bedell-Logan. Let me take 30 seconds, if that's OK.
Mr. Burton. Sure, go ahead.
Ms. Bedell-Logan. Self-care and diet, in my opinion, only
works for those people who really believe they are going to get
cancer. Most people don't. So it takes a wake-up call to stop
eating sugar and fat and all of that.
Second, the research needs to be more pointed and
integrated with complementary and alternative medicines, so
that we get all sides of the research instead of just one. I
believe we have disease in this country called academic
constipation. I think we need a legislative colonic to change
that. [Laughter.]
Third, I think we need to heal the business of healing and
really get information out to the public as to what is going on
in this country.
Mr. Burton. Legislative colonic? Well, you know, you hear
everything up here after a while.
Mr. Cummings.
Mr. Cummings. Thank you very much, Mr. Chairman. I, as I
was sitting here, I was trying to listen very carefully to the
last two responses. I guess when I sit here and I think about
this being the most powerful country in the world, and we're
able to do all kinds of things, and here you are here before
this Congress of the United States and we can't solve all
problems, but certainly we are here to solve problems and lift
up the people of this great country.
I was just wondering, and sort of piggy back on what you
just answered, but a little bit more specific. Sometimes I do
believe that there is a disconnect between the public and the
Congress. Sometimes I think we don't get it. I speak for all of
us. At some point and on different issues, we don't get it. You
all have been kind enough to come here and open your lives to
us. Believe it or not, open your lives to America, because C-
SPAN is covering this. So this is your moment.
What do you want us to do? What would you like to see us do
as the folks who represent you, the 435 of us on this side and
the 100 in the Senate? I mean what do you want to see us do?
And do you think we get it? Ms. Bedell-Logan.
Ms. Bedell-Logan. First, I would like to see the Access to
Medical Treatment Act looked at a little more closely. I think
it is an extremely important bill. I think it needs some
attention. Raising the Office of Alternative Medicine to NCCAM
was an extremely smart move on the part of the legislation.
I think that you are right. There is definitely a
disconnect between the people and Congress. So many people just
don't know what happens here, but they do know what happens at
home. What was very interesting in my personal experience is
that my sister, who had a very treatable cancer, was dead in 6
months, and my brother who had a terminal illness, was dead in
14 years. We need to get that kind of information out to
patients.
One of the worst things and one of the best things that has
happened recently is the Internet. Unfortunately, it can be a
very scary thing to surf the Internet about cancer treatments
when a patient has no idea what of it is bunk and what of it is
actually real. So I think that to a degree, people are getting
scared to death, literally. In order to really change that, we
have to start to take conventional medicine and move it into an
area that allows patient access to the types of things that
will soothe the soul as well as the physical body. We don't
have those things available to us right now. In every single
oncology center, there should be an acupuncturist who controls
nausea, instead of giving people contra-indicated medications.
There should be a massage therapist in every emergency room, to
be dealing with migraine headaches. All of these things, we
tend to open flowers with a hammer, as I said earlier. Adverse
drug reactions are a huge part of that.
What I believe that is going to start with is things like
the Access to Medical Treatment Act, which I hope is very much
supported in this room. Thank you.
Mr. Burton. Would the gentleman yield, real briefly?
Mr. Cummings. Certainly.
Mr. Burton. Let me just say that I met with Congressman
DeFazio this morning--yesterday. We are working to get the
Access to Medical Treatment Act in proper form. We will be
contacting all of you. If you are so inclined, we would love to
have you as cosponsors. He will be the primary sponsor. He is
the one who came up with the idea. It is a Democrat sponsor. I
will be a cosponsor, and we will see if we can't get enough
Members to move that thing through.
Mr. Cummings. I am so inclined, Mr. Chairman. I think that,
just to say to you, I think that's wonderful that we can move
in a bipartisan manner.
That is what I want you all to understand, that you put a
face on what we do here. I mean sometimes things happen,
something happens over here, something happens in Iowa,
something happens in Baltimore, something happens in Nevada,
and all these things are happening and here we have an
opportunity. You represent so many people who are in pain. That
is why your testimony here is so very, very important. We just
want you to understand that we hear you and we want to connect.
We want to get it. So I want to thank you.
May I just ask one more question? I would like to have Ms.
Zarycki, could you answer that same question? I think the
doctor had pretty much answered the last time.
Ms. Zarycki. Sure.
Mr. Cummings. What would you like to see us do as a
Congress?
Ms. Zarycki. I think most importantly, since in this
country, women faced with cancers initially go to conventional
doctors and for conventional treatment, I would just like them
to be aware of all the options and to let people, and let us
know as patients what options are out there in terms of other
things that they may not be promoting, but at least make us
aware of them. I think that is all we're asking, so that we can
each make our own choices, because it really is an individual
process for each of us.
Mr. Cummings. So I take it if you don't--somebody, I mean
you hear this all the time, Mr. Chairman, the statement that
the best patient is the well-informed patient, the one who goes
out there and learns as much about his or her illness and
whatever, so that they can ask the right questions and I guess
do the right things. I guess that's another thing that the
American people have to do. Would you all agree with that?
Ms. Bedell-Logan. I don't really, because I have heard many
physicians say to me that the informed patients are the ones
who cause the most trouble, so to speak. What happens in many
cases is that patients come in after reading off the Internet
about acupuncture and herbs and all of this, and their doctors
say, ``We don't know anything about that. That's not
efficacious.'' My sister had a bottle of garlic on her
nightstand, and the oncologist walked in the room and threw it
in the trash and said, ``We don't want to give you false hopes.
Garlic isn't going to help you.''
What we need is a healing between the complementary,
alternative medicine community and the conventional medicine
community so that each one of those sectors of medicine come
together and know what the other person is doing. There is
nothing more frustrating than a physician getting caught with
his shorts down by not knowing what acupuncture does. The
physicians get very frustrated, and they say it doesn't work
because they don't understand it. We need to change our medical
education, which is a huge part of this process as well.
Mr. Cummings. Thank you, Mr. Chairman.
Mr. Burton. Thank you, Mr. Cummings.
The National Cancer Institute gets $2.7 billion, and less
than about 1 percent of that is used on alternative therapy
research. I think what we need to do is get them to realize
that there is a strong sentiment in the hinterlands that we
take a hard look at these alternative therapies, and maybe more
money should be taken from that budget for alternative therapy
research as well as conventional research.
So thank you, ladies, very, very much. We really appreciate
your testimony.
We will now go to our last panel. I think this will be a
very enlightening panel as well. We have Dr. Edward Trimble
with the National Cancer Institute; Daniel Beilin, from Aptos,
CA. I have never heard of that one before, Doctor; Susan
Silver, from George Washington University Integrative Medicine
Center; and James Gordon, M.D., Center for the Mind Body
Medicine out of Washington, DC.
Thank you all for being so patient. Dr. Gordon has to leave
very shortly, so Dr. Gordon, we'll start with you.
STATEMENTS OF JAMES GORDON, M.D., CENTER FOR MIND BODY
MEDICINE, WASHINGTON, DC; SUSAN SILVER, GEORGE WASHINGTON
UNIVERSITY INTEGRATIVE MEDICAL CENTER; DANIEL BEILIN, OMD, LAC,
APTOS, CA; EDWARD TRIMBLE, M.D., HEAD, SURGERY SECTION,
DIVISION OF CANCER TREATMENT AND DIAGNOSIS, NATIONAL CANCER
INSTITUTE; AND JEFFREY WHITE, DIRECTOR, OFFICE OF COMPLEMENTARY
AND ALTERNATIVE MEDICINE, NATIONAL CANCER INSTITUTE
Dr. Gordon. Thank you very much, Mr. Chairman. I am really
glad to be here. I appreciate the Members who are here. It has
been wonderful listening to the presentations and listening to
the dialog and seeing the composition of these panels, because
what we have here is the kind of integration that we are
talking about and that you are talking about. We have on this
panel, we have conventional physicians, people who work with
complementary and alternative therapies, we have patients, and
patient advocates, and people who are using healing systems of
other cultures. I think it is exactly this kind of integration
that we need in our healthcare system.
I am a physician. I work here in Washington, DC. I have a
private practice. I also for the last 9 years, I have founded
and have led a non-profit called the Center for Mind Body
Medicine. I was for 10 years before that, a research
psychiatrist at the National Institute of Mental Health. I was
the first chair of the Advisory Council to NIH's Office of
Alternative Medicine.
I have been interested in therapies other than conventional
therapies for 35 years. In fact, I was reminiscing with Michio
Kushi that I met him some 35 years ago when I was a medical
student at Harvard and his teacher, George Osawa, had come over
to this country and was bringing macrobiotics here. So this is
a movement with some history, and I have some history with this
movement.
I want to focus today on what I hope is one specific answer
to some of the questions that are being raised, which is the
comprehensive cancer care conference integrating complementary
and alternative therapies that you mentioned when you
introduced me at the beginning, which is a conference that was
created by the Center for Mind Body Medicine, but is now
cosponsored by the National Cancer Institute and by the
National Center for Complementary and Alternative Medicine, as
well as the University of Texas.
This conference is particularly relevant here. Incidently,
I would like to invite anybody who would like to come to please
come to this conference. We are in pre-conference workshops
now. The conference begins tomorrow morning at 9 at the Hyatt
Regency in Crystal City. We welcome everybody, whether or not
they can afford the full fee. We have generous scholarships and
no one is ever turned away from any of our activities for lack
of money. So I want to invite you to participate in this.
This conference was in a very real sense created to answer
some of the questions that have been raised here, and questions
that have been raised particularly by women. The questions are,
are there any things other than conventional cancer care that I
can use for my treatment, complementary or alternative? How do
I know if any of them work? How do I know if they are safe? How
do I integrate them with complementary and alternative care?
Who do I find who knows something about these things? How can I
inform my oncologist about them? And how can I get them paid
for?
So we created this conference last year and brought
together about 120 presenters from all over the world. This
year we have about 130 presenters. What we are doing is trying
to answer these questions in a thoughtful way. We are having
people like Michio Kushi. In fact, the study that you heard
about on macrobiotic treatment of cancer, an early phase of
that study was presented last year. We are having the people
who are doing the most interesting work in complementary and
alternative therapies present their work to the pillars of the
American cancer establishment who are open-minded, who are
interested in critiquing the work, interested in creating a
dialog, and interested in developing the most effective kind of
cancer care.
I particularly want to acknowledge the National Cancer
Institute as well as the National Center for Complementary and
Alternative Medicine, and Dr. Klausner, who at one of your
hearings actually came up to me and said, ``We love the
conference you are doing. Is there anything we can do?'' I said
yes, you can cosponsor it and help support it. He said great.
Dr. Wittis, his deputy director, who participated with us last
year, and Dr. Jeffrey White, who is here, who has developed a
whole series of panels for this year's conference. We hope we
will continue to collaborate with them on this conference in
the years ahead.
What we have done is both to have the material presented
and critiqued at the conference. If you look through the
program, you will see the whole variety of plenary sessions and
panels that are presented. Then we have also put this
information, the presentations together with the critiques, up
on our website, which is www.cmbm.org, www.cmbm.org. So the
information is there.
I think the kind of information that the last panelists
were looking for, and that I think everybody with cancer is
looking for, is let me see the best that is being done around
the world, not only in the United States, but in Germany and
China and Japan and South America. Let me see it presented, and
let me see some people who really know their stuff
scientifically, but who are open-minded, take a look at this
literature and tell me what they think, and then let me make up
my own mind.
I say this conference began with questions about these
therapies for cancer, and that those questions were mostly
asked by women. I am talking of course about cancers that women
have, but I am also talking about cancers in other members of
the family. The Office of Alternative Medicine, 60 to 70
percent of the calls the office receives were about questions
about cancer. Most of those calls were from women. In my
practice, at our center, it's women not only asking about
themselves, but asking about their husbands and parents and
children. So women are the ones who are doing much of the
investigation. It is their questions we are trying to answer.
Let me just share with you three broad areas where I think
it is very important to make advances and to make changes, and
then I will be happy to answer some questions before I have to
leave to go back and give a talk there. The first has to do
with this issue of sharing knowledge. We have knowledge
available on our website. The National Cancer Institute is
beginning to provide some of that knowledge as well. We need to
make knowledge, the best possible information about these
complementary and alternative therapies available, just as we
need to make the best possible information about conventional
therapies available.
Second or as part of that issue of sharing knowledge, I
spoke with Dr. Klausner about a year ago and I want to continue
speaking with him about training oncologists, physicians,
nurses, oncology nurses to provide this kind of counseling, to
provide enough time, enough emotional support, enough
thoughtful guidance, and enough information about complementary
and alternative therapies so that each person who comes who has
cancer can have that kind of guidance. This is crucial. I think
it is a missing element. People often feel pressured into doing
one or another kind of therapy. I think there needs to be a
time for reflection. We are very eager at the Center for Mind
Body Medicine to create a training program for these
counselors. We do it at our center. We believe it needs to be
done at a national level so that every patient with cancer
should have this kind of informed, sensitive counselor
available for a significant period of time. When I work with
people with cancer, I spend about an hour and a half to 2 hours
with them, discussing their options, discussing their feelings
about both conventional and alternative treatment. So that's
No. 1, knowledge and how to share it.
No. 2 is the creation of healing partnerships. Again, this
is a theme that I have heard this morning. This requires that
we spend more time with patients, and especially that
oncologists spend more time with patients. I know a number of
oncologists in town. There are oncologists whom every one of my
patients loves and loves to go see, and there are oncologists
whom they dread seeing. The characteristics of the ones whom
they love to see are that these are generally extremely kind
people, they are people who take time, they are people who
listen to questions, and they are people who if they tend to
have preconceptions or areas of ignorance, they say ``I don't
know. I would really like to find out more.'' Or ``I may be a
little prejudiced. Maybe you could help me see this more
clearly, or who should I talk to.''
So I think this is crucial, that from the side of the
practitioners, and of course not just oncologists, all of us
who are physicians, I think that we need to share information.
This needs to be encouraged, that all physicians should be
sharing the best possible information about all the treatments
they do, whether it is for cancer or any other condition,
whether it's conventional, complementary, or alternative.
I also think that it is important that we encourage, and in
this instance, women particularly. Women have been the leaders
in the movement for self care and in the movement for creating
healing partnerships with their physicians. They are the ones
who first said, ``What's going on down there, you tell me. I'm
not ignorant. I want to know what's happening. I want to take
part in my care.'' I think we need to encourage this, not only
at the clinical level, but at the national level. I think it is
very important, not only that people who are expert in
complementary and alternative therapies, but that women like
the panelists who are on the last panel, be part of the
advisory committees to the different institutes and centers at
NIH.
Finally, or not finally, next to last, coming to the issue
of research. Research is crucial, but there need to be new and
more imaginative models of research. Coming out of last year's
cancer conference, Nicholas Gonzales presented a very
interesting, very promising therapy for the treatment of
pancreatic cancer, a comprehensive therapy. NCI responded and
agreed to fund, and is funding a clinical trial of this
therapy, a very comprehensive alternative therapy which is
being funded by NCI, and studied by Columbia University. This
is the kind of partnership we need. We need to expand from
studying single modalities to looking at comprehensive
approaches, and we also need to understand that each person who
has cancer is an individual, and that an approach that may work
for one may not work for others. We need to design research to
accommodate that individuality.
We also need to understand that there is a great deal, and
this was brought out in the first panel, that all of us, and
anyone who has cancer can do on her or his own behalf, and we
need to study those therapies and put much more of an emphasis
and much more of a financial emphasis on some of those mind
body therapies, changes in attitude, meditation, relaxation,
group support, nutrition, exercise, and to really see what is
possible for people to do on their own behalf.
Finally, I would like to echo the suggestion, and I know
your strong feeling, that it is time to pass the Access to
Medical Treatment Act. It is time to open up the arena of
treatment to all therapies that are offered by responsible
people, and to understand that people can assume in partnership
with a variety of healers, responsibility for their own care.
Thank you very much.
Mr. Burton. Thank you. We will push very hard to get that
passed. We'll try to get as many cosponsors as possible.
We are going to have a vote. I would like to have one more
of our witnesses speak. Ms. Silver, would you like to go ahead
and speak? Then we will run and vote, and we will come right
back and try to not have any more unnecessary demands on your
time.
Dr. Gordon. I am going to have to go, though, when you
break for the vote. I am sorry I do, but I have to speak at 3
in Virginia.
Mr. Burton. That's OK, Dr. Gordon. I am going to try to see
you tomorrow anyhow, so we'll talk further.
Dr. Gordon. Terrific. Thank you.
Mr. Burton. Ms. Silver.
Ms. Silver. Thank you for the opportunity to address the
committee today. All of us who work in the field of
complementary and alternative medicine are grateful for the
visibility and the validation that you bring to the field by
holding this hearing. The Center for Integrative Medicine is a
division of the Medical Faculty Associates of the George
Washington University Medical Center. Our program includes
research, education, and clinical services. Patient care began
in April 1998, and from the outset, we included a program for
patients with cancer. That program is called the Quality of
Life program, and it serves as an adjunct to conventional
cancer treatment.
We share the committee's interest in research and the
current level of knowledge about complementary and alternative
medicine and its effectiveness in people with cancer. We have
submitted two research proposals to NIH to investigate the use
of reiki and guided imagery by patients with breast cancer and
those undergoing radiation. As we all know, research is in its
early stages. Thanks to the Center for Complementary and
Alternative Medicine at NIH, the pace at which we receive
documentation of complementary and alternative medicine's
effectiveness will increase as researchers are supported in
investigating these vital questions.
At the Center for Integrative Medicine, we are as anxious
as anyone for those results. In the meantime though, we ask
whether we can proceed with unproven, and note that I said
unproven rather than disproven, modalities to assist cancer
patients. Our answer is a resounding yes. We have asked
ourselves this fundamental question: How can we enhance the
quality of life of the person as patient?
Traditionally, on assuming the role of patient, a person
has willingly surrendered quality of life, her sense of
orientation and personal control in exchange for a cure. But we
are beginning to suspect that surrender may be self defeating.
We would suggest that successful medical outcomes are
diminished when the patient lacks control, information, and
support. Conversely, if these inputs are maximized, the patient
may recover more quickly and completely, and have a higher
quality of life, whatever the ultimate outcome.
Most cancer patients say that from the moment of their
diagnosis, everything in life is changed. A life that was going
on routinely is suddenly out of control. The entire focus on
the what if's of cancer treatment and its outcome.
The Quality of Life program of the Center for Integrative
Medicine can assist the patient throughout the course of her
illness. At whatever stage of the illness the relationship with
the center is initiated, we help determine and meet the
patient's needs and goals in a comprehensive way. For patients
newly diagnosed and awaiting treatment, we offer stress
reduction with a focus on personal control and empowerment,
immune system enhancement to help combat the disease, relief
from symptoms caused by anxiety or depression as appetite loss,
nausea, or sleeplessness.
For patients undergoing aggressive curative treatment, we
offer relief from side effects of treatments, such as nausea or
post-operative pain, immune system enhancement to help maximize
the effectiveness of the treatment, relaxation and stress
reduction to help restore the mind and body between enervating
treatments.
For patients in remission, we offer stress reduction during
periods of watchful waiting, rebuilding of stamina and
flexibility following medical and surgical treatments, and
resumption of healthful diet and nutrition, with added emphasis
on cancer prevention.
For patients who experience a relapse, all of the services
and objectives of the pre-treatment and treatment phase program
can be resumed with even greater intensity. For patients with
illnesses not responsive to curative treatment, we offer
control of pain and symptoms of a progressive illness,
mobilization of the powers of the mind to maximize quality of
life, and reduction of stress to allow for end-of-life planning
and resolution. Overall, the Center for Integrative Medicine
aims to restore a sense of control and well-being, and offer
the patient the freedoms to heal physically, emotionally, and
spiritually.
Let me offer just two examples of cases in which we are
treating women with cancer. The first is a patient with
recurrent endometrial cancer. Immediately following surgery,
she was referred to our medical center for radiation. Thanks to
an active partnership with the Division of Radiation Oncology,
the Center for Integrative Medicine was called into the case as
the patient came for her initial consultation. Along with vital
information about her radiation treatment, the patient was
given information about the center and the role of
complementary medicine in easing her way through the course of
illness. She was given a meditation tape focused on breathing
and relaxation exercises that incorporate the details of the
radiation experience.
In the following weeks, the patient participated in
meditation and reiki and used both skills to reduce stress
during treatment and to assist her in sleeping through the
night. As the radiation progressed, side effects became
extremely bothersome. Stomach and intestinal upset were
frequent. But a combination of acupuncture and nutritional
guidance got them under control.
As the radiation neared completion, the patient began
focusing on the future. She requested further nutrition
counseling, both to help restore her energy following
treatment, and on a larger scale, sought advice on a diet that
would do most to prevent a recurrence of her cancer. After 28
successive days of radiation therapy, the patient suddenly felt
apprehensive about what to do without it. She had grown
attached to her radiation team and to the routine of daily
radiation appointments. But she found comfort and support in
the relationships that she had formed with the providers in the
Center for Integrative Medicine. She continues to practice the
modalities that she learned and is looking forward to adding
yoga to her routine to help build stamina and regain
flexibility. She intends to check in with her complementary
medicine team indefinitely for encouragement and renewal.
The second patient is a young woman with advanced breast
cancer. At the time of diagnosis, she was offered several
treatment options, and chose the most aggressive. She is
currently undergoing high dose chemotherapy. Before her first
treatment, the patient learned reiki and guided imagery. As she
faced her initial dose of chemotherapy, she used both
modalities actively to reduce her fear and the anticipatory
side effects that she experienced. Today, as she continues in
treatment, the center's reiki provider meets her at the
oncology clinic and practices reiki with her as the medication
is administered. Nausea and vomiting seemed inevitable side
effects of her treatment, but the patient has found substantial
relief with acupuncture.
This patient's prognosis is guarded. However, she has
expressed confidence in the center's ability to maximize her
wellness and comfort. She has learned skills for stress
reduction and relaxation that she will utilize throughout her
life. Whatever the outcome, feels empowered to maintain control
of her life.
Let me say again that the Center for Integrative Medicine
offers an adjunctive program of care for women with cancer. We
are keenly aware of the remarkable advances in oncology,
through medicine, surgery, and radiation. We are in partnership
with specialists who practice those techniques. But the goal
and the value of our program is this. We change the experience
of the cancer patient by placing her at the center of care and
treating the whole person, mind, body and spirit.
Our patients convince us daily of the benefits that the
center offers. But what of the patients we never see? The
Center for Integrative Medicine operates on a fee-for-service
basis, and our patients rarely have insurance coverage for our
treatments. Consequently, our program is accessible only to
those with the greatest financial wherewithal. Personally, I
find it heart breaking to tell callers who are filled with
hope, and sometimes desperation, that our services are out of
their reach. That is an every day occurrence. I hasten to add
that our providers offer a remarkable amount of pro bono care.
But the reality remains that to be viable, the center must
charge for its services.
The issue for payment for complementary and alternative
medicine is inextricably linked to research and policy. Only
when research demonstrates the efficacy and cost benefit of
alternative medicine will it be incorporated into mainstream
third party coverage. We need your leadership to harness the
demand of millions of Americans to press for pure science,
pilot programs, and demonstration projects that will assess the
real value of complementary and alternative medicine. We need
mandated benefits that will expand the scope of private and
public insurance policies to even the most basic complementary
modalities. We need Medicare to act as a model by including
alternative medicine in its coverage. The Medical Nutrition
Therapy Act of 1999, H.R. 1187, would mandate nutrition
counseling as a core benefit of Medicare for the purpose of
disease management.
Mr. Burton. Pardon me, Ms. Silver. We have a vote on the
floor. Would you mind----
Ms. Silver. I have just about four more sentences.
Mr. Burton. All right. Go ahead.
Ms. Silver. That bill is languishing, pending major reform
of Medicare.
Mr. Burton. And the bill number on that again is?
Ms. Silver. The House version is H.R. 1187. On the Senate
side, it's S. 660.
Mr. Burton. OK.
Ms. Silver. As we meet here today, 60 million Americans are
utilizing complementary and alternative medicine. A substantial
number of them are women with cancer. As the Center for
Integrative Medicine treats our small share, we are guided by
the principle that wellness during illness is not a
contradiction in terms.
Again, I would like to thank the committee for the
opportunity to address you today. In a larger sense, I want to
thank you on behalf of those who so urgently need our help.
[The prepared statement of Ms. Silver follows:]
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Mr. Burton. Thank you, Ms. Silver.
Dr. Beilin and Dr. Trimble, we will be back in just a few
minutes. We have one vote on the floor. I am anxious to hear
from both of you, so we will be right back.
[Recess.]
Mr. Burton. I want to first of all thank you for your
patience. This has been a very, very long day. I am a little
disappointed that what you are going to tell us is probably
very, very significant and we didn't have you on earlier in the
program. Nevertheless, I can assure you that what you tell us
today will be taken to heart and used, and we will talk to the
various agencies about it.
So let's start, I guess go down the list with you, Dr.
Beilin.
Dr. Beilin. OK. Thank you very much, Mr. Chairman, and
members of the committee. Thank you for the opportunity to be
here today. My name is Dr. Dan Beilin, OMD, LAc. I have a
doctorate in herbal and oriental medicine, and hold a degree in
physiology, as I was physiologist at the UCLA Department of
Gastroenterology. I am in private practice in California in
European complementary medicine and oriental medicine. I have
been working in cooperation with a group of doctors and a
radiologist, who have been measuring changes in the skin and
the nervous system of patients who develop devastating
diseases, such as cancer and autoimmune disorders. We have
found a high correspondence between the nervous system's
ability to control metabolism and circulation, also referred to
as thermoregulation or heat regulation, and the growth of
tumors and other degenerative disorders.
In complementary medicine, we try to step back one step and
view the patient in terms of the interactions between the
internal organs and tissues. Traditional orthodox medicine too
often focuses on a single organ of the body, when in reality,
many organs are involved in a subtle or not-so-subtle manner in
the advancement of a particular disease state. Yet when we look
at the body as a collection of systems, each interrelated with
the others, we can actually begin to search for the cause of
illness. Fortunately, I believe that we are approaching a
technology which will provide a bird's eye view of the body as
a whole, providing information about multiple organ expression
and painting a picture of biological processes that may bring
us closer to finding the cause of such diseases as breast
cancer.
One technology is called regulation thermography, developed
in Germany and legally marketed in the United States now.
Regulation thermography offers a serious addition to the
arsenal of physicians evaluating patients at risk of cancer or
cancer recurrence. It works by taking temperature measurements
of neurologically controlled points on the skin often above the
organ in question, stressing the body with cool air, and then
taking a second measurement of the same points. Computer
software analyzes the response of the points and their
adaptation to the rapid temperature change. More than 25 years
of experience has demonstrated a relationship between such
responses in organ pathology. The test is non-invasive,
painless, and the machine is small enough to fit into a
briefcase.
Regulation thermography is not intended to be a substitute
for mammography or other methods of cancer detection. What it
does do is provide information to the practitioner about the
environment in the body that could be contributing to the
cancer growth, allowing the practitioner to design a treatment
strategy utilizing the principles of alternative and
complementary medicine, staying within the constraints of good
science.
I prepared a few slides that better illustrate the theory
behind regulation thermography and its contribution to cancer
detection and treatment. So if you will check the monitors, the
first slide is the idea of terrain versus tumor. Here, we see a
large box, which represents healthy cells and fluids of the
body. The small box represents a tumor which has grown for some
reason and has now been diagnosed say by a mammogram. Medicine
as of 1999, today, has given special attention to the
destruction of the tumor, whether by surgery, chemotherapy, or
radiation, but has neglected the internal environment that has
contributed to the development of that tumor. Until recently,
there have not been scientifically verifiable methods for
measuring the factors in that tumor terrain. But this is
critical if we are to develop therapeutic approaches aimed at
treating the whole patient, not simply mounting a frontal
attack on the tumor alone.
The second slide illustrates how we are internally wired,
that the internal organs, such as the stomach, pancreas, liver
or prostate, are capable of talking to the nervous system by
taking precise measurements of skin temperature as we stress
the body, similar to a stress ECG by the cardiologist, we can
see how the organs and other tissues of the body behave around
that stress. Changes in the way the body behaves to stress can
indicate the possible presences of pathologies or pre-
pathologies. German and Swiss researchers have gathered data
over the last 20 years which have established normal values for
stress reactivity in every skin region. Furthermore, many
disease states have been documented for their patterns of skin
dysfunction over the whole body.
Mr. Chairman, this is a method that is objective,
reproducible, and very serious consideration for inclusion into
every new complementary medicine hospital and program. It
measures the pattern of response to stress which takes place in
the terrain of the body. The information gathered can act as a
marker test for lifestyle change prescription effect and
preventive measures that have the potential to cut the
increasing cost of cancer care.
In slide three, we see a thermogram above done with this
new technology. Above, a normal thermogram, and below, a
chaotic thermogram. You can see how there is a complete
disruption of a certain pattern. The top one looking
homogeneous, the next looks mixed up, showing a lack of
regulation, of homeostasis or balance by the organs and nervous
system. This is the whole body, with data taken from 80 points.
In the next slide, this is a study done by Professor Wagner
in Germany. We see this, that 63 patients on the left bar with
confirmed breast cancer by pathology, were sent to blind
doctors doing clinical exams alone, with mammography added, and
then with regulation thermography in conjunction with
mammography. Interestingly, a higher percentage of tumors were
identified using regulation thermography in conjunction with
mammography than with mammography alone.
This and other studies conducted in Europe demonstrate that
dynamic thermography can be a valuable tool in helping to
diagnose the presence of occult disease. In fact, some studies
suggest that in some cases, regulation thermography offers a
viable alternative to mammography. If proven true, this would
particularly be useful in geographic regions lacking
mammography facilities or as a preliminary screening device for
the family physician. In addition, studies suggest that
regulation thermography may be able to detect the changes in
the body that may preface the development of cancer. With
regard to breast cancer and other types of tumors, research
indicates that most tumors have taken at least 5 years from
their inception to develop into a viewable size. What has
occurred to the body's immune mechanisms during those years
which creates the pre-tumor and then tumor? What do we know
about the fertility of our inner soil, if you will, which
nourishes or depletes the development of tumors? For these
reasons, I strongly urge consideration for funding for studies
in the United States.
On the last slide, of course breast cancer is not the only
disease for which this technology may be utilized. Here is a
statistical average of three patients with a progression of
PSAs used as a prostate marker, and their corresponding
thermogram of the prostate points taken by this method. Note
the correspondence of a higher PSA, say on the left is 12.53,
to the higher degree of rigidity of response seen in the
thermogram are quite evident. When we see the lowering of the
PSA, we see a better thermograph coming out as a result.
The point I make is that complementary medicine is not only
comprised of non-scientifically based methods. It has in the
past been shunned from the mainstream, but the effect has been
to throw the baby out with the bath water. In recent years,
Congress has taken important steps to address this issue,
primarily through the creation of the Center for Alternative
Medicine at the NIH, and the provision of increased funding for
research in alternative medicine. Many leading teaching
hospitals and other medical centers have established programs
focused on researching and using alternative and complementary
therapy. One of the roles for the Center of Alternative
Medicine should be to act to bring these integrative centers
together for advanced research on key technology, such as
regulation thermography, and to provide additional funding for
research so that the valuable alternative therapies will assume
their proper place within the entire healthcare system.
Finally in closing, I also recognize that Congress this
year will be dealing with the critical issue of patient rights
with regard to Government funded and private healthcare plans.
Unfortunately, alternative medicine has been neglected in the
coverage decisionmaking of many healthcare programs. I ask you
while considering this critical legislation, to keep in mind
the proven benefits of alternative medicine, and the desires of
a significant portion of the American public to have access to
such treatment.
Thank you, Mr. Chairman, for inviting me here today. I
appreciate this wonderful opportunity to share my opinions
regarding present and future trends in medicine. I hope we can
work together in the future.
[The prepared statement of Dr. Beilin follows:]
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Mr. Burton. Dr. Beilin, before we go to Dr. Trimble, I hope
when we get to the questions and the answers, that you will
talk about, I think it was a proton device that can attack
prostate cancer?
Dr. Beilin. There is a type of hyperthermia that is a local
hyperthermia device that is being reviewed right now.
Mr. Burton. I want to ask you about that when we get to the
questions and answers.
Dr. Trimble, thank you, sir, for being so patient with us
today.
Dr. Trimble. Chairman Burton, members of the Committee on
Government Reform, thank you for inviting me to represent the
National Cancer Institute at this hearing. I am head of the
surgery section at the Division of Cancer Treatment and
Diagnosis at the NCI. Sitting behind me today is Dr. Jeffrey
White, who is Director of the NCI's Office of Complementary and
Alternative Medicine.
By training, I am an obstetrician/gynecologist and
gynecologic oncologist. My own patients include many women with
cervical, uterine, ovarian, and breast cancer. My experiences
in medicine as well as my own experiences caring for family
members with cancer have made clear to me the importance of a
holistic approach in cancer care.
The NCI is committed to fostering the integration of
complementary and alternative medicine into modern cancer care.
In 1989, we funded key research conducted by Dr. David Spiegel
and his colleagues at Stanford and the University of California
which demonstrated that psychosocial support prolonged long
survival in women with metastatic brain cancer. Working with
the National Center for Complementary and Alternative Medicine,
we have established a cancer advisory panel for the National
Cancer Institute. This panel, which meets three times a year,
includes members from the conventional and the CAM cancer
research community. This panel will help advise the NCI's
Office of Complementary and Alternative Medicine run by Dr.
White, on how best to evaluate CAM therapies, how to develop
accurate CAM information for the public. We are also working
with the National Center for Complementary and Alternative
Medicine and other NIH institutes to establish centers for CAM
research across the United States.
I would like to mention a few examples of the NCI's
commitment to complementary and alternative approaches in
cancer research. As Chairman Burton mentioned, for many years,
the NCI has had a program evaluating natural products for anti-
cancer activity. One of these products, Taxol, which is found
in the bark of the Pacific yew tree, has been shown to improve
survival significantly for women with breast, ovarian cancer.
We have extended our study of natural products from plants to
marine products. We are currently evaluating another natural
product, shark cartilage, among patients with breast and lung
cancer. We have evaluated chrono-biology, the delivery of
chemotherapy timed to a person's circadian rhythms, in women
with uterine cancer. We funded an important study conducted at
the Harvard Medical School and published last week in the New
England Journal of Medicine, which showed that new use of
alternative medicine was a marker for greater psycho-social
distress and worse quality of life in women with newly
diagnosed breast cancer. We have started an unconventional
innovations program to spur the development of new technology
in the diagnosis and treatment of cancer.
We have heard some discussion of the problems of lymphedema
today. We have recently opened two phase III trials evaluating
the safety of sentinel lymph node biopsy in women with breast
cancer. If this is proved safe and efficacious, then we will be
able to eliminate the need for axillary lymph node dissection,
and spare these women the risk of lymphedema.
We are pleased to cosponsor the workshop described by Dr.
Gordon, which opens tomorrow, on the integration of
complementary and alternative therapy in cancer care. We look
forward to continued interaction with the complementary and
alternative medicine community in our efforts to improve
prevention, screening, early diagnosis, treatment, and quality
of life for women with cancer. I would be happy to answer any
questions you might have.
[The prepared statement of Dr. Trimble follows:]
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Mr. Burton. Thank you, Dr. Trimble. Let me start with you.
I am not sure I understood exactly what you just said about the
lymph nodes. Is there a non-invasive way to check the lymph
nodes? Is that what you are saying? So you don't have to remove
them? So that you would not run the risk of lymphedema?
Dr. Trimble. What has been shown in smaller studies is that
by the use of either a dye or a radioactive material, one can
find the one or two lymph nodes to which the cancer drains.
Those lymph nodes are removed and then examined
microscopically. If those lymph nodes are not involved by
cancer, then that person does not need a full axillary lymph
node dissection. So that's the theory that supports our trial,
in which half the people would get a full lymph node
dissection, and the other----
Mr. Burton. Let me just ask you, in some cases, they don't
take out all the lymph nodes. They just take out some of them.
If they take out some of the lymph nodes, don't people run the
risk of getting lymphedema, even though they haven't taken them
all?
Dr. Trimble. Well, the risk of--you are correct. There is a
risk of lymphedema with only removing some. But in, let's say
when a full axillary lymphedectomy is performed, then 20 to 30
lymph nodes may be removed. Whereas in the new sentinel lymph
node procedure, only one or two lymph nodes are removed. So the
incidence of lymphedema following that sentinel node procedure
is almost nothing.
Mr. Burton. I see. OK. So instead of taking out 20 or 25
and then finding 5 that had cancer cells in them, you would
just take out those that you were able to pinpoint through the
radiation?
Dr. Trimble. Right. Pinpoint that those are the ones that
are closest to the cancer. That is where the lymph fluid would
drain from that tumor.
Mr. Burton. I see. OK. All right.
Dr. Beilin, you and I talked before the hearing. We were
talking about other forms of cancer, such as prostate cancer.
You told me that in Europe, they are using a new technology
that would eliminate, in many cases, the need for, let's say,
in prostate cancer, the prostate to be removed. You could just
attack the cancer and part of the prostate. Is that correct?
Dr. Beilin. Well, I hesitate to say eliminate the need for
it, because every case is individual, and I think that we need
a lot more research to be done. But currently there are a
number of hyperthermia devices, one in particular is made in
Spain, that is going through FDA review right now to be brought
over. That involves a penetrating radio frequency hyperthermia
that heats tissue beneath the surface of the skin that
specifically could be directed toward tumor. There is fair
science behind it. So there is a stack of literature that is
available privately now, because it's being FDA reviewed by the
company. That's just all I know about it.
Mr. Burton. How long has that been used in Europe?
Dr. Beilin. It's about 6-year-old technology that's now
getting to be big in Europe.
Mr. Burton. If it's 6 years in Europe, they must have
records on this.
Dr. Beilin. Yes, they do.
Mr. Burton. Well, does the FDA here in the United States
ever solicit those records, or do they just start all over from
scratch?
Dr. Beilin. That is a very interesting question. My
impression with working with the FDA that I have done with the
regulation thermography is that they look at most cases as new,
and that they do not ask for studies that have been done in
foreign countries such as Germany, Switzerland, countries that
have the integrity of medicine that we do here. There are
countries that are developed in the Western world just like
ours, and I think that there should be some kind of movement to
accept or at least be interested in the review of previous
research that's been done abroad with such things as diagnostic
early screening equipment.
Mrs. Mack, who spoke earlier, she said she did an early
detection by palpation, by just feeling. Well, the tumor, when
it is 1 centimeter in diameter is already multi-celled with
thousands of cancer cells. That is not really early detection.
We are talking about recognizing patterns of disarray and the
control of tissue 5 years before it would be visable by other
methods. So I think we need a little bit of creative expansion
in our paradigm.
Mr. Burton. Let me ask you about our paradigm. So there are
two examples of where the FDA is looking at new technologies
that have been used in Europe from anywhere from 6 to 10 years.
Dr. Beilin. From 6 to 15 years.
Mr. Burton. From 6 to 15 years.
Now you are here from the FDA, are you not? Do we have
anybody here from the FDA today? You are from the FDA? Could
you come up to the table, please? Are you prepared to answer
any questions? You are only here to monitor the hearing?
Well, I will give you a question. We have been told in the
last 24 hours of two cases, one involving the instrument
involving hyperthermia, and the other instrument we're talking
about as far as early detection is concerned, even before it's
readily apparent through mammography or through physical
testing, that these have been used in Europe for 15 years in
one case, and 6 years in another, and they have not yet been
approved by the FDA, and they could be a real adjunct to our
therapies and research here in the United States and early
detection. I would like for you to have the head of the FDA
give me a written reason on why they are dragging their feet on
these two things. OK? I would like to have that as quickly as
possible.
Dr. Beilin. Mr. Chairman, if I may add that recently, the
FDA has made some changes that are actually positive in that
they have granted new areas of possible registration of
instruments, diagnostics and treatment that has allowed for
marketing approvals more readily than they used to. So at the
same time, they may seem slow to acknowledge technologies that
have existed with good data, they are also moving in the right
direction, from what I can tell.
Mr. Burton. Well, I'm glad to hear that, but we still have
technologies that could really, really help, at least from
every appearance that I have seen, that they are still dragging
their feet on. I just hate to see any bureaucracy get in the
way of progress that is going to help save lives.
Ms. Silver, let me just ask you one question, and I'll
yield to my colleague. In your statement, and I am trying to
recall exactly how you put it, but you indicated that if
there's new treatments or new things that people could take who
have an illness that's very severe, they should be able to go
ahead and take it even though there hasn't been approval yet if
their life is at risk. Did I understand you correctly?
Ms. Silver. I was referring to the complementary and
alternative modalities that we practice in our center. In other
words, those have not been proven, by and large. But they have
not been disproven. That is to say that no one has suggested or
proven that those modalities cause harm or are not efficacious.
They have simply not been studied. So for that reason, we ask
the question should we withhold those modalities, knowing as we
do anecdotally that they can be effective with patients.
Mr. Burton. And your answer is what?
Ms. Silver. Our answer is we don't want to withhold those
modalities.
Mr. Burton. And you do go ahead and use them at the current
time?
Ms. Silver. We do use them.
Mr. Burton. Are you having trouble with the FDA because you
do that?
Ms. Silver. No, no. These are non-invasive, apart from
acupuncture, but the other modalities are non-invasive
modalities. Many of them are mind body techniques that people
can use routinely. So there is no oversight, as it were,
because these are not drugs and they are not invasive
procedures. But we also don't want to hold out false hope. We
don't want to claim that any of these things is effective. We
certainly don't claim that we cure cancer. We do say though
that we can change the quality of life of a patient with some
of these modalities, and our patients agree that their quality
of life has been improved.
Mr. Burton. Do you have some questions?
Ms. Chenoweth. Mr. Chairman, I just want to thank you so
much, for your continuing work in this area and your leadership
nationally in this area. It is so very important to us in
looking at American health and the role of Government in
helping the American people stay healthy and to help them have
access to the resources that help them stay ahead of the fight
before the disease catches up with them.
I experienced a very difficult passing of my own mother
through radical, as a result of radical surgery because of
cancer. So I have strong feelings about this, and am very
grateful to you, Mr. Chairman, and to your witnesses. I think
that we in this committee need to focus, as you are doing, on
helping Government get out of the way. You know, first do no
harm is not only a good motto for physicians, but also for
legislators. I am afraid that some of our policies that we have
implemented have caused harm to the individual in not being
able to take control of their life. I am concerned that
whenever we try to help, we end up interfering and making the
lives of our constituents harder. That is simply unacceptable.
Too often, access to public treatments is cutoff because
the Federal Government is unsure of its safety. But to people
with termi-
nal or potentially terminal illnesses, this seems to be a cruel
joke, as it was in the case of my family. I think we need, as
you have begun, to seriously question the role of Government in
relating to certain institutions that may either help or
prevent access to either new treatments or to education and
information that will help us prevent disease. So thank you
very, very much, Mr. Chairman for this hearing.
I want to ask Dr. Trimble, could you explain to me what
circadian rhythms are?
Dr. Trimble. Well, circadian rhythms----
Ms. Chenoweth. In relation to a patient receiving
chemotherapy.
Dr. Trimble. Right. Circadian rhythms refer to any of the
natu- ral rhythms, whether that is day and night or the seasons
and how they affect a person's physiology and the functions of
their body.
In this case, we have some preliminary research suggesting
that you could decrease the toxicity of chemotherapy if you
gave one of the medicines, doxorubicin, at 6 a.m., and the
other one, Cisplatin, at 6 p.m. So in a small study, it seemed
as though there was less damage to the nerves and less damage
to the bone marrow if you staggered the chemotherapy that way.
The NCI sponsored a large study in which half the women re-
ceived their chemotherapy at any old time, whenever it was
ready, prepared by the pharmacy. The other half got it at 6
a.m., and 6 p.m. Then they looked to see whether there was any
difference in the toxicity and damage to nerves or to bone
marrow. Unfortunately, in the larger study, there was no
difference between the two. But we did think it was an
important question and we are continuing to look and see how we
can decease the toxicity of our therapies.
Ms. Chenoweth. You know, Dr. Trimble, American women and
probably women in most of the Western countries, subject them-
selves to some unpleasantries, mammograms, pap smears. We are
careful about self-examination for breast cancer. With 14,500
deaths from ovarian cancer though in 1999, I am deeply
concerned that there is no early detection program for this
type of cancer. Seventy-five percent of ovarian cancers are not
detected until the later stages of disease. So I wanted to ask
you, what is the Na- tional Cancer Institute doing to help
women be able to detect ovar- ian cancer before it reaches the
critical stages?
Dr. Trimble. Well this is obviously an extremely important
area that we have been working on for some time. We are making
a number of efforts to try to improve screening and early
detection of ovarian cancer. We are funding a very large trial,
the PLCO trial, involving 73,000 women and 73,000 men. The
women are being, half of them are being screened with
ultrasound and a blood test, CON-25 blood test, for ovarian
cancer. So that is a test of the best available technology that
we have, versus standard medical care.
We are also trying to develop some new tests. We have an-
nounced an initiative called the Early Detection Research
Network, which is an opportunity for us to encourage laboratory
research and clinical research into coming up with new tests,
new screening tests for a variety of cancers. I know for this
particular initiative, there are seven laboratories in the
United States which specialize in ovarian cancer that have put
together an application just to focus on detecting earlier
tests in ovarian cancer.
In addition, the NCI is committed to funding what is called
a SPORE or potentially more than one SPORE in ovarian cancer.
We have a SPORE, which stands for Special Program of Research
Excellence, in breast cancer and colon cancer, prostate cancer.
It has been a very successful program. It is designed to bring
research from the bench to the bedside. Nine centers have
applied for that program. Those applications will be reviewed
at the end of this month.
So between these three initiatives, we think we are putting
a lot of time and attention and money into trying to find a
better screening. But you are absolutely right. We need a
better screening.
Ms. Chenoweth. Thank you, Dr. Trimble. I see that my time
is up, but I had some questions for Dr. Beilin. So with the
chairman's permission, I would like to submit them in writing.
Mr. Burton. No, you can ask the questions. If you would
just yield to me though, I have a question that I would like to
add and then I will let you proceed. Will you yield to me?
Ms. Chenoweth. We're on.
Mr. Burton. Dr. Beilin, this device that they have used in
Europe for 15 years that you demonstrated with your slides
earlier, would it detect something like ovarian cancer?
Dr. Beilin. In some cases. You know, there's no device that
is going to be 100 percent or even maybe 80 percent, but there
are cases that have been found when they haven't been found in
any other way. We send them in. We refer them to radiology or
to ultrasound, and do CA-125, the normal blood tests. So we are
able to in a small percentage, reveal more than would have
normally in other ways been revealed.
Mr. Burton. I presume it is the same for prostate cancer or
cervical cancer, or any other kind of cancer?
Dr. Beilin. There are more cases found, but it's not a
system that in any way could be used 100 percent of the time.
That's just not the way to think about these things.
Mr. Burton. But it would be a good adjunct?
Dr. Beilin. It would be a great adjunct, and the cost is
very little. The machines are costing less than $15,000, which
is about a tenth of any of the other medical scanning or
radiological devices.
Mr. Burton. Dr. Trimble, I don't want to put you on the
spot or the people over at NCI on the spot, but I can't
understand why at FDA there's new technologies that have been
used for 15 years with some modicum of success, a modicum of
success in Europe, that have not been approved by FDA that
could help you in detecting early cancer in places like my
colleague was just talking about, cervical cancer and ovarian
cancer. It seems to me that the bureaucracy isn't working
together and there's no communication back and forth.
I mean if this has been going on for 15 years, even if it
would only help one-tenth of 1 percent of the women who have
ovarian cancer, it is something that should be looked at. Does
your agency ever talk to FDA or look at these things that are
going on in Europe and elsewhere?
Dr. Trimble. Well, we have very close relations with the
FDA, particularly in the areas of chemotherapeutic drugs. We
have worked closely with them to design really international
systems for monitoring toxicity of drugs and response to
chemotherapy, in part so that as products are developed in
Europe, we might be able to use that data to submit it to the
FDA for approval, so we would not have delays waiting for data
to come in on patients in the United States.
Mr. Burton. Have you ever heard of this machine before
that's been used in Europe?
Dr. Trimble. I work in the division of cancer treatment, so
we have been focused on treatment. We have opened several new
initiatives in imaging, one for unconventional imaging. We have
also recently funded the American College of Radiology to set
up an imaging network to evaluate new imaging in the treatment
of cancers. I met yesterday with Dr. Beilin to discuss how this
particular technology could be integrated into our research
portfolio.
Mr. Burton. As well as the other technology he was talking
about, the heat device? You talked to him about that as well?
Dr. Trimble. No. I did not talk to him about that
yesterday, but we would be happy to talk with him.
Mr. Burton. I wish you would, because it sounds like it's
very promising, and it's been used for 6 years in Europe and
it's not moving very fast through FDA.
Can I make a request, and if you would write this down I
would really appreciate it. I would like to request that the
NCI provide a list to our committee of the cancer treatments,
including drugs, devices, and other therapies that are
available in Europe and Canada that are not available in the
United States. The reason I am asking for that is because I
have a feeling that you, and I'm sure you are very dedicated
scientists as well as your colleague back there, but I have a
feeling because there is so much on your plate right now, a lot
of these things that are happening in other parts of the world
that may have been going on for some time, may not have been
really explored. As a result, some of those things, may be a
good idea that might help us.
I can remember after World War II, we were bringing all the
rocket scientists over here from Germany, many of whom should
have been strung up, to help us with our rocket program because
they were so far advanced and so far ahead of us. I would just
like to know if you could give us a list of all these drugs,
devices, and other therapies that are available in Canada and
Europe that are not available here, because if we get that
list, then we can start seeing what might be helpful. Then we
can talk to you about those.
This is not in any way to denigrate the work you are doing.
It is just to say that there might be some adjuncts out there
that could be helpful to you.
Dr. Beilin. Mr. Chairman, if I might ask the question of
Dr. Trimble.
Mr. Burton. Sure.
Dr. Beilin. What is the status of mistletoe, because
mistletoe therapy is being used in many oncology clinics in
Europe? From what I understand, is that our drug companies here
are trying to recreate a patentable mistletoe to be used as
chemotherapy, but without the original mistletoe therapy with
the research results that they have gotten being acceptable by
FDA.
Mr. Burton. Before you answer that question, Dr. Trimble,
this is one of the things that really bothers a number of
people in Congress, because many people in Congress, including
myself, suspect that some of the pharmaceutical companies have
undue influence at the Food and Drug Administration and some of
our National Health Institutions. I hope that's not the case,
but we have that concern. When we hear things like what he just
mentioned, that there is a therapy or a substance that is being
used like mistletoe in Europe to help in areas like
chemotherapy, and instead of using that or exploring what
Europeans have done, which is very cost-effective and
inexpensive, we have got the pharmaceutical companies trying to
come up with something that is patentable from some synthetic
property, some synthetic thing. The FDA then tests it, runs it
through, they get a 6, 7, 8, or 9 year patent--I don't know how
long the patents run on those things--so that they can make
money. Who suffers? The patients do when there might be
something much less expensive that's on the market over in
Europe. Those are things that really bother people in this
country.
Anyway, go ahead. I'll let you answer.
Dr. Trimble. Well first, I'll take a pass on the mistletoe
because I do not know anything about it. We will get back to
you. But that is not an area that I have studied.
Mr. Burton. OK. Well that would fall under the category of
all the questions I just asked.
Dr. Trimble. Yes. No, I can comment or I would like to
comment on our interaction with our colleagues in Europe and
elsewhere. The National Cancer Institute has made a sincere
effort to exchange information with colleagues from around the
world. We sponsor a meeting in conjunction with the European
Organization for Research and Treatment of Cancer every 2
years, to discuss new drug development. We have regular
meetings with colleagues in Japan. We also have been
strengthening the ties between our clinical researchers in this
country, those in Canada, and those in Europe.
Approximately 3 weeks ago, at the national meeting of the
American Society for Clinical Oncology in Atlanta, I
participated in a meeting to discuss trials in ovarian,
cervical, and uterine cancers with representatives from
Australia, Scotland, England, Norway, Sweden, Germany, Austria,
and Italy. This is something that is happening in many other
cancer sites as well. So we are definitely trying to find out
what is going on elsewhere around the world, and make sure that
people in the United States have access to the best ideas,
wherever they are from.
Mr. Burton. Dr. White, I understand that you may know
something about the question that was asked about mistletoe?
Dr. White. Yes. I can tell you a little bit about what we
have done in this area. As you probably know, the National
Center for Complementary and Alternative Medicine has 10 or I
guess now 13 centers that it funds for various different
diseases. It has a cancer center at the University of Texas,
Houston, which we, NCI, co-funds with the NCCAM. That center is
actually doing a phase I study of mistletoe in advanced
esophageal cancer. They also have done a variety of pre-
clinical studies with other herbal approaches that are used
outside the United States predominantly.
There are a variety of different preparations of mistletoe
that are used in Europe and in Australia and various places.
This is using one of those five or six that are available.
Mr. Burton. How long has it been used in Europe, do you
know?
Dr. White. I don't know when it first started. The last
randomized clinical trial that I am aware of that was done in
Europe was published in 1988.
Mr. Burton. 1988?
Dr. White. Yes.
Mr. Burton. That was 11 years ago. And we haven't gone
through the studies yet on it here in the United States?
Dr. White. Well, there has not been a study done in the
United States, that I am aware of. But the review of that
material, as I said, has been done at the University of Texas.
Mr. Burton. You know, I have had cancer in my family. I
have had people appear at this table here who have little
children who are dying, and there's alternative therapies
available to them, and we run into stonewalls with some of the
agencies, FDA or others, and even doctors who have used some of
these therapies they have tried to put out of business. When we
hear of therapies, technologies, or simple products like
mistletoe, that's being used in Europe with some effectiveness,
and people are dying here, and I have to look at these kids and
their parents, or some men that had Hodgkins disease that was
going to be terminally ill, and he had to go outside the bounds
of what's considered law and order to be treated, it really
boggles your mind and bothers you. I just can't understand why
we are having this kind of a problem.
If there is a technology or some substance that can be used
in Europe and is being used for 10, and you said 11 years ago
they were testing this and using it, why is it that the United
States, the most advanced country in the history of
civilization, is 11 years behind, 15 years behind in this other
area, 6 years behind in another area, and when I ask these
questions, they say of the FDA, this young lady that's sitting
back there, she says, ``Well we'll check on it and get back to
you.'' But there really isn't any answer. I just don't
understand it.
It seems to me that Dr. Trimble and you, Dr. White, and
others, ought to be constantly looking at these alternative
therapies along with the Food and Drug Administration, to try
to make sure that we are giving the American consumer, the
American patient, the very best opportunity to live a healthy
life and to survive if they are in big trouble. I know you are
trying to do that. But it seems to me that some place the golf
club is missing the ball. That is why I asked that question of
Dr. Trimble, that we get a list of all the cancer treatments
they are using in Canada and Europe, and the devices and the
other therapies, so that we can at least look at them and see
what the heck is going on over there that we are not doing.
It is really frustrating to me when I hear this kind of
stuff. Go ahead.
Dr. White. Yes. I would just like to put a little bit of
perspective on the mistletoe issue. I understand the broader
scope of what it is that you are saying, but specifically on
mistletoe, the largest clinical trial that I am aware of was a
randomized trial with three arms on it, one arm that patients
did not receive any supplemental care after their surgery--this
is for breast cancer. Another arm received standard
chemotherapy, plus or minus radiation therapy for their breast
cancer. This is all adjuvant therapy. The third arm received
mistletoe.
The mistletoe arm did better than no therapy, but the
chemotherapy arm did better than no therapy. The mistletoe arm
did no better than chemotherapy. So I think it's not--so we're
talking about first of all, adjuvant therapy. So this is not in
advanced forms of cancer. Second, it is not something that
represented in that study a step above what was already
available to the patients.
Mr. Burton. Dr. Beilin.
Dr. Beilin. If I may comment that there are statistics
being gathered an immunologist and oncologist colleague in
Austria for the Germanic countries. They have discovered that
statistics seem to be coming out that using chemo plus
complementary therapy such as mistletoe together resulting,
like in breast cancer, the number is 25 percent less recurrence
rates when you use both together. So I think that those kind of
statistics need to kind of leap over here so that we can begin
to take the best and to integrate them and add them together to
have an additive effect. That same statistic came out for
prostate and melanoma.
Dr. White. Is that published information?
Dr. Beilin. I believe so. I can lead you to it.
Dr. White. I would be happy to review that.
Mr. Burton. Well see, this is the kind of communication
that every American would like to see all the time, not just at
the table here at a hearing.
So let me just ask two more questions, then I'll yield to
my colleague. Then we'll wrap this up, because we have all been
here a long, long time. The NCI gets $2.7 billion, $2.7 billion
for cancer research. You are spending less than 1 percent of
that on alternative therapies. We are hearing things here today
that indicate that there are some alternative therapies with
promise. I am sure you are going to give me a list of other
things that have promise that we're going to get from Europe.
Why is it that we only spend $20 million out of $2.7 billion on
alternative therapies when half of the Americans who have
problems are using and trying to find alternative therapies. It
just doesn't make any sense to me. Can you give me an answer to
that, Dr. Trimble? Why are we only spending $20 million?
Dr. Trimble. Well, as I know that Mr. Chairman, that you
have had some discussions with my director, Dr. Klausner, on
this issue. We realize that we need to provide the American
public with accurate information on complementary and
alternative medicine, and we need to provide them with accurate
appraisal of these techniques in terms of whether they work so
that people in the United States can decide for themselves
whether they wish to avail themselves of various complementary
and alternative medicine techniques.
Mr. Burton. But I think you are making my point. We need to
spend more money than just less than 1 percent on that.
Wouldn't you agree with that?
Dr. Trimble. Well, I agree that we need to do more
research. To that end, we have agreed to co-fund with the other
institutes, centers for alternative medicine research across
the United States. We are actively soliciting new ideas that we
can test at these centers and through with their existing
cancer centers. So we hope that we can make more information
available and have more and better treatment which combine
standard treatment, complementary medicine and alternative
medicine for the people of the United States.
Mr. Burton. Let me yield to my colleague. She has to leave.
Ms. Chenoweth. Dr. Trimble, could you commit to us how much
the National Cancer Institute will dedicate to alternative
medicine studies and research?
Dr. Trimble. No. That's above my pay level to make that
kind of a commitment. I will commit that we are actively
recruiting studies. We have committed to setting up centers to
study complementary and alternative medicine. We will continue
to forge a joint approach with our colleagues in other medical
disciplines in this area.
Ms. Chenoweth. Mr. Chairman, I wonder as a member of your
committee, if I might ask that you would ask whoever is in the
pay grade----
Mr. Burton. Dr. Klausner.
Ms. Chenoweth. Dr. Klausner, how much? I would like to know
as a Congressman.
Mr. Burton. I think what we ought to do is as the Congress
take a look at the amount of money we are appropriating for
NCI, and talk to the people on the Appropriations Committee.
Maybe since NCI of their own volition isn't going to authorize
more money for alternative therapies, maybe we should just
specify in the appropriations bill how much you have to spend
for that. If we did that, maybe that would break the log jam.
But I will try to talk to Dr. Klausner. I want you to make a
note that we do that.
I don't have any other questions. Do you have any other
questions?
Ms. Chenoweth. Mr. Chairman, I just wanted to share on the
record with you an observation that I have made. You know, we
broke all the barriers down when we passed NAFTA and GATT. Now
we have the World Trade Organization. We are importing 22
percent of our beef that comes from foreign countries, and we
don't know where. They have certainly different standards than
we have. Yet we are consuming that beef not knowing that it's
coming from foreign countries. Forty percent of our lamb
sometimes comes from 7,000 miles away and we don't seem to ask
a question about that. You know, we have toys that come from
China, and we have hotwheels that come from Malaysia, and we
have dog bones that come from Argentina. Nobody seems to worry
about that in this whole global economy.
But what about getting information from Europe that we can
use on a par the studies and benefit from them? It just seems
absolutely incredible to me that we always have to reinvent the
wheel when it comes to medicine. Yet in every other arena in
this global economy, but medicine, and freedom from medicine,
and freedom from the institutions of the individuals sometimes
when we make that choice, is what is sorely lacking.
I am afraid this Congress unfortunately is supporting the
institutions and the patients have become a byproduct or just a
necessary function for the institutions, instead of the
institutions being a necessary function to better healthcare.
So, Mr. Chairman, I would love to work with you on perhaps
requiring something in NAFTA or GATT that would mandate that
these studies be accepted by FDA on a par.
Mr. Burton. We'll take a look at it. I will get together
with you and we will have Beth look into it, and see if we
can't maybe do some of that.
Ms. Chenoweth. Thank you.
Mr. Burton. I think that at the very least, those
technologies should not languish for 6, 7, 8, 10, 15 years
before they are utilized here in the United States.
I was just informed that shark cartilage, for instance, I
think Dr. Trimble said they are testing that, 7 years ago they
started talking about it and we are just now doing it. So it
seems like there is a lot of foot dragging.
Well, I don't have any other questions for you. Thank you,
Mr. White. You weren't scheduled to speak, but we do appreciate
your coming before us. Dr. Trimble, Dr. Beilin, thank you very
much. Ms. Silver, thank you very much. I want to thank you once
again for your patience.
We stand adjourned.
[Whereupon, at 3:45 p.m., the committee was adjourned.]
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