A 2005 Health Canada poll found that 71 per cent of Canadians had used alternative health products. Of these, the biggest groups were vitamins at 57 per cent; echinacea 15 per cent; herbal remedies, and algal and fungal products 11 per cent.

The poll also found that while 77 per cent of Canadians believe natural health products can be used to maintain or promote health and 68 per cent to treat illness, just 43 per cent considered such products better than conventional medicines.

Some 46 per cent of Canadians believe claims made by the manufacturers of such products are unproven, but only 14 per cent believe the products to be harmful.

Hazenberg has struggled to find her way through the conflicts. She said news of the cancer came at a time when she felt adrift, without purpose. The concept of "poisoning" her body with chemo and radiation seemed overwhelming. She refused the treatment, opting instead for alternative healing methods.

When that decision created a split with her family doctor and some of her friends, she found support through the Centre for Integrated Healing - since renamed Inspire Health Integrated Cancer Care - in Vancouver. The non-profit centre incorporates conventional and alternative forms of medicine, offering patients not just medical doctors but practitioners of naturopathy, massage and acupuncture, while offering advice and information on exercise and nutrition.

"Everything was falling in place," Hazenberg recalled. "I'm not weird."

When the cancer returned in October 2006, it became clear that alternative medicine alone could not save her at this stage of her illness. She agreed to a second operation, followed by chemotherapy and radiation.

Even then, Hazenberg did it her way. She put stickers on the syringe during chemo and on the radiation machine - words such as "healing" and "gratitude," to maintain a positive attitude. She insisted on listening to relaxing new-age music on her CD player during the operations.

She also found success with yoga and meditation, music and art therapy, removed sugar from her diet, drank vegetable juice, and ate organic food. She turned to seaweed, kale, dandelion leaves, red beets and milk thistle as part of a general regimen to cleanse her body. She found the world of alternative medicine to be a minefield of bewildering options.

"I got very confused," she confirmed. "Shall I do acupuncture, try a naturopath, or use these or those medications? A part of me was desperate. Am I looking for the needle in the haystack?"

Dr. Hal Gunn, a medical doctor who co-founded Inspire Health a decade ago, says he has watched alternative medicine gain increasing acceptance from conventional medicine over the past two decades.

"The shift is happening and very quickly."

Over-the-counter herbs Acupuncture is just one example: once considered a treatment largely for Asians, it is now accepted by the B.C. government as a form of treatment for low-income British Columbians. As well, treatments such as naturopathy are funded through extended health plans.

Gunn adds that B.C. is a national leader in alternative medicine, which he says is reflected in recent statistics published by the Canadian Cancer Society/National Cancer Institute of Canada showing the province has the lowest incident rates for all cancers: 421 occurrences per 100,00 males compared with a national figure of 454, and 328 for females compared with 358 nationally.

"When people are actually engaged in their health, it makes a difference," he said.

One area in which conventional and alternative medicine remain far apart is the widespread sale of over-the-counter herbs and medicine. Walk into a health food store and you'd think that there was a miracle cure for anything that ails you. You will find a $43.99 bottle of Healthy Lung Smokers-Pro multi-antioxidant formula vegetable capsules "for preventing the cellular damage caused by smoking."

A $55.49 bottle of RespirActin's "treasured 150-year-old formula" certain to "bring respiratory system back into balance." A $33.39 bottle of Stress Advantage hexane-free soft gel capsules that will give you the "strength and silence of a confident warrior eloquently poised for battle." A $28.99 bottle of Bell Shark Cartilage that is "guaranteed to work" and comes with the endorsements of customers who could "walk again for hours without pain" and could "climb stairs without hanging onto the railing."

Are these the rational claims of an industry yearning for broader public and professional respect

The B.C. Medical Association is concerned that claims of alternative medicine can be unproven and unregulated, and is preparing its own report aimed at providing guidance for its members and the public.

Association president Dr. Geoff Appleton said one of the problems is that patients often don't want to tell their physician they are taking alternative medicines, and therefore put themselves at risk of side-effects or adverse reactions when simultaneously taking prescription drugs.

One example is foxglove (used as a heart medication), which can be "extremely dangerous" if taken in excessive dosage, Appleton said.

"There is a feeling out there that because they are natural, they are obviously harmless. Nothing can be further from the truth."

He added that a lot of natural medicines "have not been studied very well" in comparison with "well-researched prescription drugs." Even if these products are safe in small dosages, he asked whether they achieve the results that they promise.

"We like to see factual evidence: if you take this for a certain condition, you'll have this outcome. Walk into any health food store and look at the labels of some of the products. Basically, it'll tell you that product will cure anything. That kind of magic doesn't occur in real life."

The counter-argument from Harlan Lahti is that people wouldn't be buying the products if they didn't work. He worked for three years as a pharmacist at Vancouver General Hospital. Today he owns Finlandia Natural Pharmacy on West Broadway, where natural products represent 90 per cent of his business. Lahti is trained to look for potentially dangerous reactions for patients taking both prescription drugs and over-the-counter alternative medicines, including those on heart medication, blood thinners or antidepressants. He agreed that consumers might not be aware of such things.

"With general health food stores, there is a potential problem if they don't question the client. And in most cases they do not. And if they did, they wouldn't know what to ask anyways."

Having said that, Lahti said the medical profession "tends to exaggerate" such problems, and the majority of people taking natural products are healthy and not taking prescription drugs. Of course, for every person who says herbs and alternative forms of medicine work, there is another who believes it is modern-day snake oil.

Those sentiments factored into the Health Canada poll that found 76 per cent of Canadians felt the federal government should regulate natural health products the same way they regulate prescription drugs. But is that what's happening?

Sorting through products Since 2004, the Natural Health Products Directorate has been sifting through natural health products in hopes of separating the safe and effective ones from those unproven or potentially dangerous. Among the 42,000 such products marketed in Canada are vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines such as Chinese medicines, probiotics, and products such as amino acids and essential fatty acids.

About 10,000 of the 42,000 have a registration number issued under the Food and Drug Regulations, prior to the new Natural Health Products Regulations coming into effect in 2004. Since then, almost another 5,000 products have been licensed. More than 6,000 other products have been either withdrawn by the applicant or rejected based on concerns over safety or quality.

The institute is busy trying to assess the rest by 2010, although a continuing stream of new products means the process is never expected to reach a conclusion.

Dr. Robin Marles, director of the federal Bureau of Clinical Trials and Health Sciences, says the products are reviewed for safety and effectiveness based on traditional knowledge such as Chinese herbal medicines, as well as conventional pharmacological information. Marles confirmed the government doesn't "always look for huge clinical trials" to support claims that have long-standing acceptance.

"We try to set a reasonable limit for the amount of evidence, and make sure on the label that the context of the claim is clear such as 'a traditional Chinese medicine for sore throats.' "

And what if new research debunks the claims of a natural health product? Is the registration then revoked?

An extensive study by the University of Virginia School of Medicine (financed by the National Institutes of Health and reported in the New England Journal of Medicine in 2005) found echinacea of no benefit in preventing or treating the common cold. Yet the Natural Health Products Directorate website continues to describe echinacea as a product "traditionally used to fight off colds, flus and infections" and a "supportive therapy in the treatment of colds, flus, upper respiratory infections and urinary infections."

Marles counters that the Virginia study used only one-third of the amount of echinacea recommended by Health Canada.

"You can pick pretty well any medicine and find positive and negative studies. There is no medicine that works perfectly for everybody."

The American College of Chest Physicians reports that smoking patients who participated in one hypnotherapy session were more likely to be non-smokers after six months, compared with patients using nicotine replacement therapy alone or patients who quit cold turkey. Using acupuncture before and during surgery significantly reduced the level of pain and the quantity of potent painkillers needed by patients after the surgery is over, according to Duke University Medical Center anesthesiologists who combined data from 15 small randomized acupuncture clinical trials.

A study by the M.D. Anderson Cancer Center at the University of Texas found that patients with inoperable cancer who received a shark cartilage solution lived just 14.4 months, whereas those who received a placebo survived 15.6 months.

As for Hazenberg, awaiting her next ultrasound and blood tests in November, "Having had cancer saved my life," says Hazenberg, who quit her job as assistant to an insurance underwriter to work with special needs children. "I'm extremely grateful to be where I am today."

lpynn@png.canwest.com

-- Canada.com