Where is the line on natural remedies?

As a breast cancer specialist, Dr. Barbara Bowers uses a whole arsenal of alternative treatments to help her patients -- acupuncture, green tea extract, vitamins, meditation and yoga, to name a few.

But she calls them complementary therapies for a reason. She almost always uses them alongside the powerful chemotherapy drugs traditionally used to fight cancer -- not instead of them. She believes, from sad experience, that without modern medicine 13-year-old Daniel Hauser -- the boy at the center of a New Ulm court battle over refusing conventional treatment -- will most likely die from his cancer.

"Complementary medicine has its place," said Bowers, who practices at Fairview Southdale Hospital in Edina. "But I have never had someone miraculously cured from adjunctive therapy. I wish I had."

In the past decade, alternative medicine has made dramatic inroads at hospitals and clinics. It has grown into a multibillion dollar business, and acupuncturists, massage therapists and reflexologists are often as much a part of a medical team as doctors and nurses. Insurers now cover therapies once viewed as ineffective and even outlandish.

But for the most part, medical experts say, such treatments should be used in conjunction with standard treatments such as chemotherapy and radiation that have proven efficacy.

"We don't believe it's an either or, we believe it's a both," said Lori Knutson, executive director of the Penny George Institute for Health and Healing at Abbott Northwestern Hospital in Minneapolis.

A case in point

Doctors who testified at a hearing said that with chemo and radiation, the boy has a 90 percent chance of surviving. Without it, they said, he will almost certainly die within five years.

By coincidence, some of the world's top experts in alternative medicine are in Minneapolis this week for the North American Research Conference on Complementary and Integrative Medicine. They said the choice is seldom simple.

Marja Verhoef, who studies complementary medicine at the University of Calgary in Alberta, says research has shown that some methods, such as acupuncture or meditation, can help patients fight cancer or cope with the side effects of treatment. But she worries that patients may not be so discriminating. "People have strong feelings about [this] and they're not always based on real evidence," Verhoef said. "Sometimes it's hard arguing with beliefs."

Spirituality is a strong component of many complementary practices, experts said. But they can sometimes be a barrier to the use of Western medicine, especially among immigrant groups, said Dr. Greg Plotnikoff, medical director of the Penny George institute.

"My approach is never to fight belief, but to work with it," he said. That experience leads him to believe that the Hausers are driven less by religion than by their fervent desire to protect their son from a bad experience. "I'm not convinced that this is a deeply held religious belief, but rather wishful thinking," he said.

Often, cancer patients turn to alternative medicine only as "a last act of desperation," said Raymond Obomsawin, a scientific advisor for the National Aboriginal Health Organization in Ontario. But he said he understands why some would refuse conventional medicine. "The issue is freedom of choice," he said. "People need to be given that freedom."

Not either-or

At the conference, several natural-health practitioners said they would respect such a decision, but they don't see it as an either-or proposition. "I think it's quite simple," said Dr. Rhoda Lee, of Birmingham, England. "You look at what your best options are. That does not exclude anything."

David Brule, a natural health practitioner from Toronto, said he knows of alternative treatments for cancer, but if it were his child, "I would still go the conventional route," he said. Typically, he said, he uses holistic methods to treat the side effects of chemotherapy, not the cancer itself.

Todd Ferguson, a naturopathic doctor in Moorhead, Minn., says natural therapies, such as dietary supplements, can help cancer patients cope with chemotherapy and radiation. "Those treatments are very hard on people, and they get very run down," he said. "We're helping them ... make life more livable."