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Complementary and Alternative Medicine in Cancer

TO THE EDITOR: The informative article by Weiger and colleagues (1) on complementary cancer therapies is an important step in creating dialogue between biomedicine and its alternatives. However, I feel that it repeated certain popular misconceptions about the macrobiotic diet. The authors describe the diet as radical but do not define the scientific baseline from which it is a radical departure. The word radical instead appears to reflect a subjective world-view. I would characterize a diet such as raw-juice fasting as radical because it cannot sustain long-term health and it has never sustained a human community. By these criteria, macrobiotics is not radical. Macrobiotic practitioners argue that their diet resembles traditional diets worldwide, whereas today's U.S. diet is a radical and unhealthy departure from the human norm. The risk that the macrobiotic philosophy may cause rejection of conventional therapy is not inherent in the diet but could apply to any alternative therapy. I would argue that for every patient with cancer who forgoes standard medical treatment in favor of macrobiotics, perhaps thousands forgo healthy dietary and lifestyle changes and instead rely entirely on biomedical intervention to keep them alive and well. What philosophy is influencing them to do that? There is no more risk for malnutrition with macrobiotics than with the typical U.S. diet. Only a minority of Americans eat five or more daily servings of fresh, plant-based foods. In fact, every successive revision of the U.S. Department of Agriculture (USDA)'s food guidelines comes closer to macrobiotic recommendations. Finally, women with reproductive cancer can easily eat macrobiotically without consuming soy phytoestrogens.