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Written by James Randi   

This last Sunday I posted "We Should be Insulted," a commentary on the seeming endorsement of acupuncture by US agencies. Following that, I sent an inquiry to Ms. Cynthia Bass at the National Cancer Institute [NCI] - a division of the National Institutes of Health [NIH] - with this direct comment and question:

I have seen references in NCI literature to the use of acupuncture in cancer treatment, to relieve certain side-effects of chemotherapy. My question: Is there any scientific, double-blind research that shows acupuncture is effective?

Please note: I specified "double-blind" because many non-blinded tests of acupuncture have been done, with mixed results, but no such tests can be considered as evidential unless done that way, and I've never found any records of double-blinded tests of this claim. Ms. Bass did not answer the question. She referred me to a list of frequently-asked questions - and the official answers - on the NCI site; this is not unexpected, considering the volume of inquiries that the agency must receive. I have selected here those that almost respond to my inquiry. The questions are in bold font, followed by the answers:

Have any clinical trials (research studies with people) of acupuncture been conducted?

Most studies of the use of acupuncture in cancer patients have been done in China. In 1997, the National Institutes of Health (NIH) began evaluating the safety and effectiveness of acupuncture as a complementary and alternative therapy.

Not a response, only a side-step. The double-blind provision is not answered.

Studies of the effect of acupuncture on the immune system

Human studies on the effect of acupuncture on the immune system of cancer patients showed that it improved immune system response.

Double-blind? We're not told. Another side-step.

Studies of the effect of acupuncture on pain

In clinical studies, acupuncture reduced the amount of pain in some cancer patients. In one study, most of the patients treated with acupuncture were able to stop taking drugs for pain relief or to take smallerdoses. The findings from these studies are not considered strong, however, because of weaknesses in study design and size. Studies using strict scientific methods are needed to prove how acupuncture affects pain.

"Findings" that are not "strong"? Interpretation, please? What were these "weaknesses," why were the results of those tests not summarily thrown out, and the "weaknesses" not subsequently corrected? "In one study"? How many others were done, with what size of database, by whom, and with what results? This is a blatant dodge, very carefully worded to be technically correct, but basically meaningless! The average inquirer might be dazzled by such verbiage, but this inquirer is an experienced and dedicated curmudgeon...!

Studies of the effect of acupuncture on nausea and vomiting caused by chemotherapy

The strongest evidence of the effect of acupuncture has come fromclinical trials on the use of acupuncture to relieve nausea and vomiting. Several types of clinical trials using different acupuncture methods showed acupuncture reduced nausea and vomiting caused by chemotherapy,surgery, and morning sickness. It appears to be more effective in preventing vomiting than in reducing nausea.

I persist: were these double-blind protocols? Again, no idea of database size, actual "types of clinical trials," or figures, have been made available. No, I don't expect that all that would appear in this sort of brief response, but I must ask where that data might be available...

Studies of the effect of acupuncture on cancer and symptoms (other than nausea) caused by cancer treatment

Clinical trials are studying the effects of acupuncture on cancer and symptoms caused by cancer treatment, including weight loss, cough, chest pain, fever, anxiety, depression, night sweats, hot flashes, dry mouth, speech problems, and fluid in the arms or legs. Studies have shown that, for many patients, treatment with acupuncture either relieves symptoms or keeps them from getting worse.

How many studies? With what significance? This NCI "response" is a series of generalized, weak, feel-good comments designed to not offend the naïve who choose to accept acupuncture as legitimate, nor to annoy practitioners of the quackery. I demand a hard, definitive, answer to my simple, direct question: Is there any scientific, double-blind research that shows acupuncture is effective?

But this one tops them all:

Have any side effects or risks been reported from acupuncture?

There have been few complications reported. Problems are caused by using needles that are not sterile (free of germs) and from placing the needle in the wrong place, movement of the patient, or a defect in the needle. Problems include soreness and pain during treatment; feeling tired, lightheaded, or sleepy; and infections. Because chemotherapy andradiation therapy weaken the body's immune system, a strict clean needle method must be used when acupuncture treatment is given to cancer patients. It is important to seek treatment from a qualified acupuncture practitioner who uses a new set of disposable (single-use) needles for each patient.

How reassuring that the "qualified acupuncture practitioner" - whatever that may be - is urged to use clean needles! What else? This is mind-boggling! And, the "soreness and pain during treatment; feeling tired, lightheaded, or sleepy; and infections," are well-established side-effects of chemotherapy, but I got the impression that the application of acupuncture - which is the element we're discussing here - is supposed to relieve those problems! What am I missing?

The last applicable NCI/NIH comment here is simply classic. It poses a simple, direct question and then totally avoids providing any answer!

Is acupuncture approved by the US Food and Drug Administration (FDA) for use as a cancer treatment in the United States?

The FDA approved acupuncture needles for use by licensed practitioners in 1996. The FDA requires that sterile, nontoxic needles be used and that they be labeled for single use by qualified practitioners only.

Yes, the Federal Drug Administration approved acupuncture needles, in the same way they have approved thousands of devices - for safety. The needles won't break, they're flexible and sharp. That's it! I'm reassured to know that they must also be "nontoxic." Again, what else? As compared to "toxic" needles? This non-response has no reference to the efficacy or application of these needles in regard to cancer treatment - which was the question the NCI posed, itself!

Folks, this is a betrayal, a farce, an avoidance of the responsibility of the National Cancer Institute - and thus of the National Institutes of Health - to answer questions. It's professional baloney put out by experienced cover-my-ass bureaucrats who we pay - apparently - to dodge direct inquiries.

So, to the NCI and the NIH: here's the answer to my question, which is: "Is there any scientific, double-blind research that shows acupuncture is effective?" No, there is not. Acupuncture is a well-developed mythology of pseudoscientific mumbo-jumbo that ranks high in the quackery constellation, fails carefully-designed tests, and makes fortunes for the practitioners largely because of the reluctance - no, the refusal - of the NCI and NIH to level with the citizens of the USA.

I urge those of you who are as alarmed as I am, to contact such individuals as Ms. Cynthia Bass at the Client Access Unit of CancerCare - cbass@cancercare.org - and make your displeasure known. Expect references to other sites, but stick with it. You're taxpayers, you pay salaries of those at the NCI and the NIH, and you have a right to know...

FOLLOWUP:

A reader volunteered this astute observation on this item:

In the Q & A section, the NCI/NIH offered the equivalent of posing the question: "Are journeyman plumbers certified to work on the space shuttle's toilet?" Their response was the equivalent of saying they approved the use of Stillson wrenches for this work, if they were made by a reputable manufacturer. A non-answer indeed.

Touché!