Basically the answer for those who demand their treatment interventions must be supported by the so-called “gold standard” of evidence based medicine (randomized controlled clinical trials, and metastudies or systematic reviews of such trials) -- these are not generally available for botanicals & cancer. In other words, our expert-guided approach to botanicals for people with cancer is NOT suitable for those who insist upon clinical trial support, simply because it does not exist (there some very limited trials of some commercial herbal formulae and a few single products but these are generally small scale, of questionable methodology, and not of general applicability).
- There are several reasons for the lack of clinical trial data. One example is politics and funding; pharmaceutical companies are de facto uninterested in crude natural compounds (although they do provide valuable resources for cancer drug development) because they cannot patent them.
- Government funding for “CAM” is limited to interventions supported by restrictive criteria. These criteria tend to exclude evaluation of whole systems and complex multifactorial combination interventions (such as a complex botanical/nutritional protocols combined with genomically profiled targeted chemotherapy). Sadly, the limited funds of NCCAM are often allocated to poorly designed and limited studies of questionable agents, modalities or approaches that have very little real relevance to effective integrative oncological practice.
- The institutional and historico-political dead-weight of mainstream oncology and its handmaiden of pharma cancer drug development has become massively unwieldy, encumbered by rules and regulations, and is inherently conservative. Drug development is hugely expensive. Clinical trials are costly, difficult to design and execute, take a long time to plan, fund and perform, and as a result the well known time-lag between preclinical research of promising anticancer agents and their incorporation into clinical practice has become longer and longer and the required returns in terms of both patient benefits and profits have become more constrained even for "fast-tracked" pharma drugs. In this setting there is not only minimal interest in botanicals, but de facto a negative or hostile attitude towards "unproven CAM approaches" that are seen as irrelevant at worst or competing for resources, at best.