http://tinyurl.com/z8r9 Complementary medicine growing by leaps and bounds : PC-SPES, other supplements for prostate disease show gains in popularity, credibility. Urology Times, August, 1999, by Norman Bauman Dallas-After years of rejection and skepticism, physicians are finally beginning to accept complementary and alternative medicine-if the evidence is there. William R. Fair, MD, who used complementary medical techniques during his own bout with colon cancer, addressed the subject head on during a plenary session at the AUA meeting here. Dr. Fair, director of the Bendheim Prostate Diagnostic Center, Memorial Sloan-Kettering Cancer Center, New York, gave examples of controversial therapies that are showing promise in rigorous scientific studies, including PC-SPES, vitamin E, selenium, and low-fat diets for prostate cancer, and saw palmetto for BPH. "My introduction to complementary and alternative medicine was by necessity," said Dr. Fair, referring to his fight against cancer. "What I gleaned from this, with surprise, was how much science really exists in the field. While it's true that there are a lot of unknowns and a lot of things that need more exploration, that's also true of allopathic medicine. An estimated 15% of what we do is really evidence- based." Dr. Fair prefers to call it "complementary medicine" rather than "alternative medicine." He believes the term "alternative" implies something other than standard medicine, whereas "complementary" suggests using these therapies in addition to traditional medicine. Diet, supplementation, exercise, and stress reduction "really should be part of standard medicine," he said. Urologists must keep up "The growth of complementary and alternative medicine is real," said Dr. Fair. "It's being driven by patients, and we have to keep up with it. The demand is growing, and if we're not aware, the parade will pass us by. In 1997, there were more patient visits to providers of alternative and complementary medicine than there were to primary care physicians in the U.S." Ds. Fair was citing a recent study by David Eisenberg, MD, of Beth Israel Deaconess Medical Center, Boston, and colleagues (JAMA 1998; 280:1569-75). According to the study, 46% of the American population uses alternative medicine, but less than 40% of those individuals have told their physicians. However, one skeptic challenged those numbers. Stephen Barrett, MD, a retired psychiatrist who operates the Quackwatch web site (www.quackwatch.com), charged that Dr. Eisenberg "classified things as alternative that are part of standard practice so he could pump up his numbers." For example, Dr. Eisenberg's study included relaxation techniques-"which have been part of standard psychological practice for years," said Dr. Barrett-along with massage and self-help groups. Dt. Barrett was a reviewer for two other articles in the JAMA issue in which Du. Eisenberg's study appeared. The issue was devoted mainly to discussions of alternative and complementary medicine. (Quack Barrett isn't qualified to review) The Wall Street Journal estimated the annual market for complementary and alternative medicine at $50 billion, said Dr. Fair. Dr. Eisenberg, meanwhile, estimated 1997 out-of-pocket expenditures for such therapies to be $27 to $34 billion, or about equal to the $29 billion in out-of- pocket expenditures on physician services.