I Have More... PDF Print E-mail
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Written by James Randi   

Readers will know that I've been expressing my objections to National Institutes of Health/National Cancer Institute [NIH/NCI] suggestions that acupuncture can/may/might offer relief of cancer treatment side-effects. I'll begin this entry by providing some explanatory background. I'm personally involved because I'm well into the process of chemotherapy, a "clean-up" procedure following a successful operation to remove a tumor. I prepared myself by reading up on the literature, and I must say that I'm doing very well - due to very recent improvements in the process, and new medications. I've experienced none of the possible nausea, though I'm weakened physically due to a decrease in red blood cells, and I have to avoid possible infection because of a lessened resistance. This, I hope, explains my considerable reaction to the irresponsible NIH/NCI comments on the efficacy of acupuncture for the relief of chemotherapy. A typical entry in the published literature on this subject reads:

Cancer-related fatigue is a substantial problem for cancer patients and their caregivers, but no effective treatment exists. Acupuncture has been suggested to improve cancer-related fatigue, but no randomized clinical trials have been conducted. We hypothesized that true acupuncture, compared with sham acupuncture, would reduce cancer-related fatigue in cancer patients receiving external radiation therapy. The aim of this study was to determine effect size and feasibility. A modified, double-blind, randomized, placebo-controlled trial was conducted. The subject, clinical staff, and assessor were blinded, but the acupuncturist was not. Subjects received acupuncture once to twice per week during the 6-week course of radiation therapy. Data were collected at baseline, 3 weeks, 6 weeks, and 10 weeks, which was 4 weeks after that last radiation session. Twenty-seven subjects enrolled, and 23 completed the last data collection. Both true and sham acupuncture groups had improved fatigue, fatigue distress, quality of life, and depression from baseline to 10 weeks, but the differences between the groups were not statistically significant. The true acupuncture group improved 5.50 (SE, +/-1.4 points on the Functional Assessment of Chronic Illness Therapy-Fatigue Subscale (FACIT-F), whereas the sham acupuncture group improved by 3.73 (SE +/-1.92) points. This difference was not statistically significant (p=.37). All subjects guessed that they were in the true acupuncture group. Our study was underpowered to find a statistically significant difference. To demonstrate a statistically significant improvement between true and sham acupuncture would require 75 subjects per group in a future study. Owing to poor recruitment, the feasibility of a larger trial using the same methodology is low. Despite being underpowered, it appears that subjects receiving true acupuncture may benefit more than subjects receiving sham acupuncture. In the discussion section, we review our experience with using a sham-needle controlled study.

The 308 references published are astonishing. It would be difficult, I believe, to find a more scattered, undefined, unsatisfactory collection of scientific papers. We find references to "acupressure" - not acupuncture - "points," and even "acupoint stimulating points," all borrowing on the thoroughly tarnished history of this variety of quackery, and yet hinting at new and exciting varieties of the notion.  Modifiers such as "inconclusive," "possibly," "suggestive," "provides some support," "warrants further investigation," and of course "might" and "may," stick up as warnings to the careful reader, and there are frequent appeals to the need for "more research," more funding, and larger databases.

However, the more obvious failing in these 308 examples is that a large percentage of them don't deal with acupuncture at all! They ramble on about "laser acupuncture" and "electro-acupuncture," which are not in any way related to the original medieval mythology, in any respect. The former involves no needle insertion - the very basic technique of the notion - and the latter deals with a modality that consists of passing pulsating low voltage between two areas of the skin surface, which results in validated reduction of discomfort in that area - but with the distinct danger of bringing about permanent loss of sensation in that area. But these are not acupuncture!

Several persons have reported to me that they first learned of acupuncture - for whatever exotic application - from pamphlets and booklets they found in hospital lobbies and physicians' waiting rooms, the assumption being that they were approved by the agencies in which they were found. I, myself, have found large stacks of such material dropped inside the doorways of both physicians and other medical agencies with which I've been in contact. In one case, I stopped an attendant at Broward General Hospital here in Florida from distributing piles of propaganda from the Jehovah Witnesses sect - who distinctly preach against any medical treatment of any sort - and from a quack clinic that offered various "vibrations" and "aura readings." To my dismay, I later discovered that the clinic - the Imperial Point Medical Center very near our office - offered $20 sessions of sitting near a glowing halite crystal to "balance human auras"... That crystal, the attendant proudly told me, was of "natural" sodium chloride mined in Romania - the glow was from a 14-watt bulb in the base of the device. He acknowledged that he knew it was common rock salt, but it sounded better to refer to it as halite...

Going to the Imperial Point website - http://www.browardhealth.org/?id=831&sid=4 I discovered that this center was surging ahead into the 14th century in regard to the latest in medical techniques. They report:

We are constantly expanding our therapeutic options to include additional techniques such as acupuncture, auricular therapy and craniosacral therapy.

Really? Well, let's look at what Wikipedia has to say about these breakthroughs in medical science. First, we know the value of acupuncture. The others:

Auriculotherapy, or auricular therapy, or ear acupuncture, or auriculoacupuncture is a form of alternative medicine based on the idea that the ear is a microsystem with the entire body represented on the auricle, the outer portion of the ear. Ailments of the entire body are assumed to be treatable by stimulation of the surface of the ear exclusively. Similar mappings are used in reflexology and iridology. These mappings are not based on or supported by any medical or scientific evidence.

In other words, a variety of acupuncture, pure quackery. Next:

Craniosacral therapy (also called CST, cranial osteopathy, also spelled CranioSacral bodywork or therapy) is a method of Complementary and alternative medicine used by physical therapists, massage therapists, naturopaths, chiropractors and osteopaths. A craniosacral therapy session involves the therapist placing their hands on the patient, which they say allows them to tune into what they call the craniosacral system. By gently working with the spine, the skull and its cranial sutures, diaphragms, and fascia, the restrictions of nerve passages are said to be eased, the movement of cerebrospinal fluid through the spinal cord can be optimized, and misaligned bones are said to be restored to their proper position. Craniosacral therapists use the therapy to treat mental stress, neck and back pain, migraines, TMJ Syndrome, and for chronic pain conditions such as fibromyalgia. There is no scientific support for major elements of the underlying model, there is little scientific evidence to support the therapy, and research methods that could conclusively evaluate the therapy's effectiveness have not been applied.

There's much more. Everything from applied kinesiology, Bach flower therapy, biomagnetic therapy, chiropractic "techniques," reflexology, to "vibrational medicine" is offered here.

To close this rant, I quote from one Chinese report on acupuncture which found barely significant results. They ended it with:

But more randomized, double blind, controlled trials with good designs are needed to confirm this result.

This is a totally wrong approach. The scientific approach would have read:

But more randomized, double blind, controlled trials with good designs are needed to provide enough data to confirm or deny this result.

The difference between the two statements? A scientist doesn't announce his conclusions in advance of examining a sufficiently large database, that's all! No scientist sets out to prove an opinion, a theory, or a conjecture; he sets out to examine whether or not an opinion, a theory, or a conjecture is, or is not, correct.

That's Science 101 - if not earlier...