Raymond Chang, MD (Integrative Medicine)

Talk by Raymond Chang, MD, head of East West Institute, and in private practice in NYC.

November 5, 2001 at St. Lukes Hospital

Dr. Chang has taught courses in medical schools on herbs and other complementary therapies. He defined alternative medicine (CAM) as not accepted, nor used by conventional doctors and not reimbursed by insurance.

However he suggested that because of patient advocates, this situation is changing - much of what used to be alternative therapy is now considered complementary and the various areas are not mutually exclusive in some doctors' minds. The next step, he suggests, is Integrative Medicine.

He suggested that with CAM, a popular substance may not mean it is effective. CAM can improve immunity but that does not necessarily correlate with improved survival. He stated that it is a common belief that a strong immune system will help prevent cancer or that a weak immune system is a cause (particularly strong belief in relation to breast cancer). It is not useless to improve the immune system as it can reduce rates of infection, but he noted that being HIV+ does not cause people to get more breast (or other) cancers.

He stated that the most commonly consumed alternative substances he has heard about in his practice is: MGN-3, Maitake D-fraction, Noni juice and Essiac tea. He said there was not 'good evidence' on any of these.

Ann's NOTE: Start those studies immediately so that cancer patients will KNOW if it is worthwhile to use! Contact the National Center for Complementary/Alternative Medicine, or the FDA to ask for them.

He stated that what is useful for one cancer is not necessarily useful for another. Cancers are different so there 'may' not be crossover.

Ann's NOTE: Again this remains to be shown.

Another statement he considers incorrect is that what is useful for prevention is not useful for treatment. He specifically mentioned selenium which he believes is appropriate for prevention in many cancers. Soy also, is good for the non-hormonal cancers in women and for men is 'wonderful'.

Ann's NOTE: The National Cancer Institute is currently recruiting for a huge study of prostate prevention using Vitamin E and Selenium. See the Clinical Trials section.

Dr. Chang suggested that it may not be necessary to eat organic or even wash one's vegetables if one already had cancer.

Ann's NOTE: Again, strongly disagree. Cancer patients need as many nutrients as they can absorb and the few studies we have on organic versus pesticide/herbicide-sprayed foods suggest that there are reduced vitamins and minerals in non-organic foods.

Dr. Chang did make it clear that what works in animal studies does not necessarily translate into humans. Many substances can defeat cancer in animals, few work as well in humans.

He warned breast cancer patients to avoid:

Soy, flax and other estrogenic foods (where ER+ cancer is found)

Estrogenic herbs, rosemary, ginseng, black/blue cohosh, dong quai

Antihistamines, prolactinogens (tryptophan, Tagamet, Cimetidine)

Copper, niacin (B3) which he suggested increases serum estrogen, boron

DHEA and progestational creams (like Progest)

Dr. Chang suggested that people may absorb differently, and it is difficult to measure foods (like soy where a low dose may be stimulatory but a higher dose, therapeutic). He stated that 1-2% of PR+ (breast cancer) patients may respond to estrogenic foods.

Ann's NOTE: Again, a dispute- in my opinion, the one size fits all pharmaceutical pill dispensing can really be no different than eating foods and receiving different doses. Indeed there is the same measured amount in each pill, but different size people are taking them (and with different health profiles).

Ann's NOTE: Flax is considered extremely beneficial by those of us in the CAM community. It is a wonderful source of Omega-3 Essential Fatty acids. Additionally there is a question as to whether estrogenic Phytochemicals (from plants) can occupy estrogen receptors in breast tissue and be of benefit. If occupied by these 'weakly' estrogenic substances, are we protected from the negatives of stronger estrogens?

He stated that copper induces angiogenesis (development of blood vessels) and might cause cells to grow, while niacin can lower blood cholesterol, it might increase blood flow (at microcirculatory levels).

Ann's NOTE: I tried to find some studies indicting niacin, but could not. It has been my understanding that niacin does expand blood vessels but I am not clear why that would cause a change in cancer cells.

Histamines were said to be in trials for cancer.

Dr. Chang spoke well of melatonin. He said there were many articles/studies on its value to cancer patients (as opposed to MGN-3 which has two). Good data shows that the lower the melatonin levels in the body, the higher the risk of (breast) cancer.

Melatonin is used in Italy as a therapy and can reduce the adverse effects of chemotherapy. It is also synergistic with Tamoxifen. Since the majority of the studies are not done in the U.S., it has not been prescribed here, but it is cheap and available over-the-counter.

Mistletoe, Dr. Chang suggested, does not have the data to support its use. He said there was limited gain, adverse effects and an injection was needed every day. Additionally he mentioned the fact that it was not reimbursed by insurance.

A discussion of Mistletoe can be found on the NCI website nci.nih.gov. Also see Relevant Studies section on our site.

Maitake, Dr. Chang said was very popular. He said he was "fond of mushrooms" in his practice and used PSK (Krestin, Coriolus versicolor) for which he said there were good studies. It is approved as a drug in Japan. Unfortunately he said that what was available on the Internet was not the same product. He felt there were no good studies on Maitake, though the company does have an IND from the Food & Drug Administration (a form of a go-ahead).

He thought green tea was okay even though there have been no randomized trials, because it was low cost and easy to use. He stated though, that 12 cups a day might be needed for primary prevention and secondary might need more.

Ann's NOTE: There are green tea capsules available which may be the equivalent of 10 cups per pill.

CoQ10, Dr. Chang said, had been patented to Merck and was often used by breast cancer patients. He felt the existing studies had too few patients to be sure of results. But he uses it when patients are taking adriamycin (doxirubicin-the A of) chemotherapy, to reduce toxicity (to the heart) and fatigue.

He supports the use of ganoderma (mushroom), calcium D-glucorate, astralagus, IP6. He suggested a patient have their Vitamin A and Vitamin D-3 blood levels checked if they were using those vitamins.

He considers acupuncture an adjunctive therapy to help with nausea, pain and relaxation.

He says that NAC (N-acetyl cysteine) is useful for detoxifying, preventing adverse effects and improving lung function.

Sugar is an AVOID and suggested people check their foods against a glycemic index as it is not always obvious what has the most sugar.

He said that the government had established a database for CAM at http://cancernet.gov/cam.

Dr. Chang has many patients who are referred to him from Memorial Sloan Kettering as he was on staff there prior to entering his private practice.

Summary by Ann Fonfa

Talk by Ramond Chang, MD (Integrative Medicine)

Health Facts, July 1988

Patient Perspective on Raymond Chang, MD

J, a New York City cancer patient speaks, 6/04

"Extremely Happy":  Patient Perspective

Email received February 2006

"Wonderful Doctor": Patient Perspective

Email, February 2008

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