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1 Introduction The carcinoge n i s th e ger m o f ou r time . Mos t o f th e worl d s population live s i n a se a o f carcinogens : cigarett e smoke , pollution , pesti cides , asbestos , radiation , radon , exces s sunlight , foo d additives , hazardou s waste, poo r nutrition , hormones , viruse s . . . th e lis t continue s t o grow . Because ther e i s s o muc h complexit y an d uncertaint y regardin g th e ris k factors an d treatment , cance r i s mor e tha n a disease . I t i s a politica l an d social problem . Cance r i s a sympto m o f a globa l civilizatio n tha t i s ou t o f balance wit h it s biolog y an d ecology . I t i s a medica l crisi s tha t affect s millions o f individual s an d thei r families , bu t i t i s als o a politica l an d scientific crisis . Rates o f cancer incidenc e i n th e Unite d State s hav e rise n consistentl y a t about i percen t pe r year. I n th e lat e 1950 s one i n fou r person s wa s likely t o contract cance r an d on e i n fiv e woul d di e fro m th e disease , bu t b y th e 1990s the incidenc e ha d climbe d t o ove r on e i n thre e wit h ove r on e i n fou r mortalities. Shockingly , curren t estimate s indicat e tha t i n th e Unite d State s 45 percent o f males and 3 9 percent o f females wil l be diagnose d wit h cance r in thei r lifetimes . Ove r on e an d a quarter millio n American s ar e diagnose d with cance r eac h year , an d ove r a hal f millio n di e fro m th e diseas e eac h year. I t i s possibl e tha t b y th e secon d o r thir d decad e o f th e twenty-firs t century hal f o f al l Americans wil l b e diagnose d wit h cance r a t som e poin t during thei r lifetimes. 1 Of th e million s o f American s wh o hav e cance r a t an y on e time , man y have turne d t o alternativ e cance r therapie s t o complemen t thei r conven tional treatments , t o replac e officiall y recommende d therapies , o r t o us e a s a last resor t whe n thei r doctor s hav e give n the m u p a s terminal. Whe n th e hundreds o f thousand s o f cance r patient s wh o choos e alternativ e therapie s are recognize d no t a s a singl e phenomeno n bu t a s a subgrou p o f th e millions o f other Americans wh o us e alternativ e therapie s fo r othe r disease s and conditions , th e dimension s o f a grassroot s healt h car e revolutio n be come visible . Thi s se a chang e i s spurre d b y competitio n amon g health maintenance organizations , whic h ar e drive n b y marke t force s t o fun d a n 1 2 Introduction increasing variet y o f alternativ e therapies . Likewise , constituen t demand s for bette r acces s t o alternativ e therapie s hav e le d t o legislativ e reform s i n many state s and a t the federa l level. 2 This rapidl y changin g situatio n ha s give n ris e t o a widesprea d nee d for evaluation : legislators , insurers , health-car e professionals , an d abov e al l patients nee d mor e informatio n abou t which alternativ e therapie s work an d which one s d o not . Clearly , on e wa y t o answe r thi...

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