It's a cluttered, high-tech medical laboratory that looks like any other - until the eyes sweep past the digital scales and bubbling flasks to the glass jar filled with dried, brown zhe chong beetles.

East meets West here at Michael Campbell's lab at UC-San Francisco's Mount Zion Medical Center, where scientists are conducting Western-style research on ancient Asian herbal remedies, in the hope of finding new treatments for breast cancer.

Of the 71 different herbs and preparations the lab has tested so far, nearly one in three has shown some ability to inhibit cancer cells grown in test tubes - an unusually high "hit rate" for the screening of medical compounds.

"We're testing agents that have been used for hundreds of years," said Campbell, who in addition to his role testing herbs is a professor in the surgery department at the University of California at San Francisco.

Until recently, it would have been unthinkable that herbs or other ancient Eastern healing arts would be taken seriously at one of the country's top medical research institutions.

But with a growing number of patients turning to these "alternative" treatments, mainstream medicine is taking a closer look. From UCSF to Harvard University, researchers are using the rigorous methods of Western science to study treatments that have long been viewed as mystical and unproven.

Nearly a decade after Congress funded an alternative medicine program at the National Institutes of Health, the program has a budget of $89 million, up from $2 million in 1992, to study remedies ranging from gingko biloba for senile dementia to yoga for insomnia to massage for lower back pain.

Funding from state

At UCSF's Complementary and Alternative Medicine Program, the focus is on breast cancer. None of the research thus far has been funded by the NIH alternative medicine program, but it has been supported by grants totaling $781,000 from the state of California's Breast Cancer Research Program.

More than 120 herbs and traditional medicines are being evaluated with sophisticated instruments in the UCSF laboratory to find and isolate any ingredients that might be effective against tumors. "We want to determine what works, and what doesn't," said cancer specialist Dr. Debu Tripathy, who directs the UCSF alternative medicine program.

Some early results have been disappointing. The first trial to be completed was a small study of traditional Tibetan herb preparations created by Yeshi Dhonden, who had been the personal physician of the Dalai Lama.

Of nine women with advanced breast cancer who completed the trial, only one showed no tumor growth for the full year of the study - although cancer progression was delayed in another woman. The research also demonstrated that the treatments were safe, and trials with more Tibetan herbal formulas are pending.

Imported herbs are purchased from selected suppliers, ground into powders and brewed into teas or mixed with alcohols to make medicinal "wines." The potions are poured through tall glass columns that separate active ingredients by size, weight or chemical characteristic. The various ingredients are then applied to batches of human breast cancer cells that are routinely grown in racks of tiny test tubes. Those with active anti-cancer traits will kill the cells.

Tests so far have found 16 of the 71 herbs to be "highly active" against breast cancer cell growth - including rz rhei, a Chinese rhubarb root, which contains two chemicals that are particularly potent in laboratory tests. Another dozen herbs are "moderately active."

It is not unusual for drug laboratories to test plant material as potential drugs. Until the 20th century, nearly all pharmaceuticals were derived from plants.

"The most highly consumed drugs in the world today all come from plants: alcohol, coffee and tea," said Isaac Cohen, an acupuncturist, herbalist and licensed practitioner of Oriental medicine on the UCSF program's staff.

Gap in research

In the area of breast cancer, Cohen said the UCSF program is filling a gap in current research. "We are focusing on areas unmet by industry," he said. "We are targeting symptoms. We don't have a cure."

The program is also responding to consumer demand. UCSF epidemiologist Marion Lee and colleagues published a study in the Journal of the National Cancer Institute in January 2000 that found half of women with breast cancer surveyed had used at least one form of alternative therapy.

Still, among many in the medical world, the serious study of non-Western medical traditions remains highly controversial.

In 1998, the New England Journal of Medicine issued a scathing editorial criticizing alternative medicine as "an ideology that largely ignores biologic mechanisms, (and) often disparages modern science." Editors Dr. Marcia Angell and Dr. Jerome Kassirer decried the rising popularity of alternative medicine as a "reversion to irrational approaches to medical practice."

The UCSF program is, in a sense, a response to that broadside - an effort to submit untested herbal remedies to the same standards demanded of modern, chemically manufactured pharmaceutical compounds.

In addition to the Tibetan medicine study, the UCSF program includes a trial of a 21-herb formulation to treat the unpleasant side effects of chemotherapy drugs. Half the women enrolled in the study will take the herbal preparation, the rest will be given a dummy drug. This experiment is known as a randomized, double-blind, placebo-controlled study, a Western format that produces the most persuasive statistical evidence of whether a therapy works or not.

A third study set to enroll patients shortly will test another traditional Chinese herb, ban zhi lian, among women with metastatic breast cancer. Those who test this herb will use it as their only cancer treatment.

Although other breast cancer drugs are available, none is considered curative, so a test of an herbal preparation passes ethical guidelines as long as the patients are fully informed of the risks, according to Tripathy.

"If there is any progression of disease or toxicity, we would pull them off the study," he said.

Menopause research

Tripathy's UCSF program is also studying the use of Chinese herbs to treat menopausal symptoms among 20 breast cancer patients. Typically, women take estrogen supplements to ward off hot flashes and other symptoms of menopause - but women with breast cancer generally avoid estrogen because it can accelerate tumor growth.

Holly Hough, manager of the UCSF complementary medicine breast cancer program, has a special interest in conducting a scientific appraisal of herbal medicine: Last year, she was diagnosed with breast cancer herself. She brings to her work a faith in both scientific inquiry and the wisdom of traditional healing.

Hough clearly would like conventional Western science to validate alternative solutions offered from the East.

"There is more to disease than just the physical symptoms," she said. "There are emotional and spiritual aspects. My feeling is that conventional medicine doesn't address that."
 

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Herbs for Cancer

The following Chinese herbs are among 71 screened at UCSF as possible remedies for breast cancer.

Ban Zhi Lian

Scutellaria barbatae

Shown above are both living and dried versions of the herb, which inhibited breast cancer cells in the lab. It will be tested at UCSF among women with metastatic breast cancer who are taking no other cancer drugs.

Zhi Mu

Anamarrhena asphodeloides

Used in China as an anti-inflammatory to treat a range of symptoms including fever, hot flashes and irritability. In laboratory tests it was "highly active" against breast cancer cells, and is being considered for future clinical trials.

Wang Bu Liu Xing

Vaccaria sigetalis

Another herb that was "highly active" against breast cancer cells in the lab, it is used in China to stimulate menstruation and lactation, as well as to treat painful battle wounds. It is being considered for future studies as a breast cancer treatment.

Source: UCSF