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From the Townsend Letter
August/September 2007


– Special Report –
Performance of OAM and NCCAM
Re: Unconventional Cancer Treatment,

by Marcus A. Cohen
Townsend Letter's New York Observer

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In 1992, Congress created the Office of Alternative Medicine (OAM) within the National Institutes of Health (NIH) to evalu-ate unconventional treatments for numerous illnesses. In 1997, Congress replaced OAM with the National Center for Complementary and Alternative Medicine (NCCAM). Congress had given OAM an initial budget of $2 million (which OAM's first director characterized as "homeopathic funding") and had left decisions on which studies to fund largely in the hands of NIH. In establishing NCCAM, Congress greatly enlarged the center's budget and provided it with more autonomy in selecting and funding projects.

This special report, in two installments, reviews OAM's and NCCAM's record in organizing evaluations of unconventional cancer treatment. The concentration here on cancer is appropriate, because OAM and NCCAM came into being in response to a study of unconventional cancer therapies in the US published by the Office of Technology Assessment (OTA) in 1990. (OTA, an investigative arm of Congress, was shut down after the Republicans gained control of Congress in 1994.)

For this update, I interviewed individuals in and outside the Federal government deeply involved with the creation and operations of OAM and NCCAM. I e-mailed variations of three questions to each:

1. What were your expectations in helping to set up OAM and NCCAM?
2. How have OAM and NCCAM functioned afterward?
3. What do you envision for NCCAM during its second decade?

The first interview follows.

Frank WiewelFrank Wiewel, Founder, People Against Cancer (PAC)
A musician with a rock band in the early 1980s, Frank Wiewel got involved with alternative cancer therapy in the mid-1980s. His father-in-law had developed cancer and was doing well under immuno-augmentative treatment at a clinic in the Bahamas run by the late Lawrence Burton, PhD. Closure of Burton's clinic by the Bahamian government in the summer of 1985 transformed Wiewel into an advocate for Burton's patients. He led the patients' support group between 1985 and 1990, and in this capacity, he played a key role in getting Congress to authorize the OTA study of unconventional cancer therapy. (Initially, the OTA intended to concentrate on Burton's approach.)

Since 1990, Wiewel has been a force behind the scenes in promoting government evaluation of unconventional cancer treatment. Currently, he directs People Against Cancer (PAC), in Otho, Iowa, a non-profit grass-roots organization dedicated to obtaining clinical trials for CAM approaches in general. Wiewel, respected worldwide as an authority on alternative cancer therapy, also offers information on cancer treatment on a fee basis under The Alternative Therapy Program; this program aims at finding the best cancer treatment for PAC members.

I had interviewed Wiewel for my column in the Townsend Letter in 2004.1 At that time, he had expressed disappointment over the lack of progress by OAM and NCCAM in setting up trials for unconventional cancer therapy, and pointed to directors of the NIH for frustrating efforts toward obtaining evaluations.

MC: In our interview three years ago, you said: "When Congress established the OAM…we felt it might promote the organized evaluation of alternative cancer therapies, broadening the base for later evaluations."2 Readers of the Townsend Letter will be interested in hearing the specifics. Can you provide them?

FW: The Office of Alternative Medicine was originally formed to "investigate and validate" alternative forms of medical treatment. I was a founding member of the National Advisory Board and Co-Chairman of the Pharmacological and Biological Treatments Committee of the OAM.

Originally, the intent was to conduct field investigations of innovative treatments for the major causes of death: cancer, heart disease, and AIDS. I proposed that this be accomplished in a three-step system:

1. Find the major alternative treatments.
2. Determine if there were sufficient numbers for evaluation.
3. Determine if the proponents were willing to work with us to assemble a retrospective best case series, publishing the results after peer-review; conduct a small pilot study of 25 or more patients, again publishing the results after peer-review; then, for those that show promise, conduct a large-scale study with matched controls treated conventionally.

MC: Kindly recollect OAM's performance at the start.

FW: Joseph Jacobs, MD, the first director of OAM, a bright, well-educated man, clearly did not have a scholar's grasp of alternative medicine. He was not personally an advocate of the use of alternative medicine. He admitted to being not remotely aware of the depth or the scope of alternative medical approaches to treatment of cancer, heart disease, and AIDS.

In the first year of OAM, I arranged for a site visit by Dr. Jacobs to The Burzynski Research Institute (BRI) in Houston Texas, where we met with Stanislaw Burzynski, an MD and PhD who had been an assistant professor at Baylor University. At Baylor, Dr. Burzynski had discovered non-toxic substances in the blood, tissue, and urine that signaled the cancer cell – which grows endlessly out of control – to live and die normally. Burzynski called these substances antineoplastons and established the Burzynski Research Institute to conduct clinical trials and treat patients with them.

Dr. Jacobs was totally amazed to find a full-fledged company producing "natural" pharmaceuticals, occupying a city block in Houston, and a full-scale medical practice, that employed 75 MD and PhD-level doctors, scientists, and health care staff. During that site visit, Dr. Burzynski provided us with a study of terminal brain tumor cases, patients who were treated by antineoplastons and had remarkable recoveries. Jacobs comment to me after the site visit was, "I know where I would come if I had cancer."
Dr. Burzynski's work with antineoplastons presented an important opportunity for OAM.

A licensed MD specializing in oncology with a PhD in biochemistry and an assistant professor at a major university, Dr. Burzynski was well-qualified for at least a pilot study by OAM; and he was completely willing to cooperate with OAM. Members of OAM's Advisory Board repeatedly suggested that Burzynski be evaluated. To date, no such evaluation has ever been conducted.

MC: When I interviewed you in 2004, you related incidents and meetings indicating that the NIH was dead set against doing the "right thing" with OAM and NCCAM.3 What's your understanding of the NIH's attitude?

FW: The tiny OAM quickly became the center of a firestorm of controversy within NIH. At its formation, Dr. Jay Moscowitz, acting director of NIH, confided to me that there was more press interest in OAM than in the entire NIH. So from day one, NIH resented the OAM! After Harold Varmus, MD, took over as director of NIH, he quickly developed a hatred for OAM, reportedly advising an NIH colleague: "You can do two things for me. Get OAM and NCI (National Cancer Institute) off my back." Evidently, Dr. Varmus, a Nobel laureate, heading what some have characterized as the "black hole" of molecular biology, was not about to allow OAM to do anything which would challenge the "status quo." In no way would Dr. Varmus allow "carrot juice and coffee enemas" to share the stage with "the dance of the electrons." Dr. Varmus did allow Ruth Kirchstein, a long-term NIH bureaucrat, to ride herd on what he regarded as a rogue office, to make sure that OAM did nothing of substance.

After six years of intense conflict and bureaucratic stonewalling, it was apparent that OAM was not going to evaluate or validate anything substantial – certainly not treatments for the major killers; cancer, heart disease, and AIDS. Instead, OAM busied itself diligently planning trials to see if "massage therapy" made dying AIDS patients feel better. Designing studies into the cause and cure of cancer, heart disease, or AIDS was simply beyond OAM's vision! Embattled, Dr. Jacobs resigned once he realized that OAM's problems were not so much scientific as political, quipping, "I prefer the 'ticks' of Connecticut to the 'Poli-ticks' of Washington."

MC: What happened after Congress replaced OAM with NCCAM, giving the new center a much bigger budget and more autonomy in decisions on projects than its predecessor? Wasn't that expansion aimed at getting around the stonewalling at NIH?

FW: Some politicians did believe OAM could do more if it was enlarged and officially designated a "National Center." The term "complementary" was coupled with "alternative" as a way to make the new center palatable to NIH and conventional doctors. (It linked carrot juice with chemo.) "Complementary therapy" also suggested that such therapy would not replace (or compete with) conventional medicine as a true alternative. And NIH bureaucrats found someone who fit all their qualifications for director of NCCAM, Dr. Stephen Strauss.

Dr. Strauss knew absolutely nothing about the world of alternative medicine. He knew absolutely nothing about alternative treatments for cancer, heart disease, and AIDS. He could not be called an advocate for CAM because he did not personally use it. Under his direction, no evaluations of alternative primary treatments for cancer, heart disease, or AIDS were undertaken. Recently, Dr. Strauss resigned from NCCAM and died soon thereafter. Now that Dr. Ruth Kirchstein is acting director of NCCAM, there's is no real risk that anything of value will take place as long as she's on the job, keeping everyone at NCCAM "inside the box."

MC: What about a second decade for NCCAM? No change for the better on the horizon? Would it serve any medically useful purpose to fund NCCAM ten more years?

FW: I hope the "mothership" will come back to earth and take those involved with running NCCAM back to the planet where they belong. They certainly don't belong on planet earth.

Sadly, the NIH has an institutionally obligated bias against alternative medicine. As part of what I and others term the "Disease Industry Monopoly," they are fixated on disease. Instead of embracing all innovative and alternative ideas, they are fighting a desperate fight against proposed innovative and alternative solutions.

After six years in "Looney Land," I was totally fed up with Washington. Government officials there seem to know little about those they're elected or appointed to serve – and seem to care even less.

This year, roughly 1.4 million Americans will be diagnosed with cancer; 560,000 will die, notwithstanding the best conventional treatments. During their lifetime, four in ten Americans will develop cancer. Increasingly, then, we see our friends and family members dying of cancer after devastating treatments feared more than the disease itself. We are losing the war on cancer! We cannot afford to overlook any alternatives for any reason.

Townsend Letter readers who wish to contact Frank Wiewel can reach him at:
People Against Cancer
604 East St.
Otho, Iowa 50569
Fax 515-972-4415

Note: Part Two of this special report will feature interviews with former Congressman Berkley Bedell and Senator Tom Harkin

1. Cohen M. News from the cancer war: "back to square 1 on the CAM front"; "metronomic therapy" advances on the mainstream line. Townsend Letter. July 2004; 252:26-27.
2. Ibid.
3. Ibid.

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August 30, 2007

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