Complementary and Alternative Medicine in Parkinson’s Disease Patients in Korea

Abstract

It was a big scandal when the former president of South Korea was hospitalized to remove a needle from his lung which had been used for acupuncture [1]. Also in South Korea, a famous actress, after being diagnosed with advanced-stage gastric cancer, decided to be treated with acupuncture and moxibustion [2]. This use of complementary and alternative medicine (CAM) is not a Korean phenomenon but a global one. It was not long ago that Steve Jobs, the renowned cofounder of Apple, died of pancreatic neuroendocrine cancer after initially rejecting potentially life-saving surgery for years in favor of alternative treatments such as acupuncture, dietary supplements, and juices [3]. CAM has now become a popular choice as a treatment modality and is even selected by highly educated patients in many countries [4, 5]. The US National Center for Complementary and AlternativeMedicine defines CAM as “a group of diverse medical and healthcare systems, practices, and products that are not currently part of conventional medicine” [5]. CAM has been used by itself or with conventional medicine for a wide spectrum of diseases from mild forms such as musculoskeletal problems to incurable forms such as degenerative or malignant diseases. CAM is commonly used in neurologic diseases, including Parkinson’s disease (PD). PD is a representative neurodegenerative disorder in the aged with four cardinal motor symptoms: resting tremor, cogwheel rigidity, slowness of movement, and postural imbalance. Motor symptoms are usually controllable by dopaminergic agents, but many nonmotor symptoms of PD are less well controlled. PD cannot be cured or delayed by conventional medicine, including pharmaceuticals and surgery. Currently, CAM is filling a gap between the desire for a cure and the lack of and treatment options. There are no good systematic data on how many people use CAM instead of standard treatment with conventional medicines in PD patients in Korea. However, according to one survey on CAM use among PD patients in Korea [6], 76 % of these patients had experienced CAM, which is much higher than other reports in Western countries [7–9]. The reasons for CAM use were (1) mostly to improve PD symptoms, (2) to improve the general state of health, (3) to relieve pain or constipation, and so on [6]. These trends were similar to the results of Western studies [7, 8]. Herbal medicines, health supplement foods, and acupuncture were used most often, whereas physical therapies such as yoga, massage, and other types of rehabilitation were used less often than in Western countries [6]. Nearly 70 % of CAM users had taken herbal medicines as prescribed by Korean oriental medicine physicians [6]. In another report, CAM was concentrated mainly on dietary supplements and Korean oriental medicine [10]. In Korea, the meaning of conventional medicine [5] is somewhat different from that in Western countries. Korean oriental medicine is recognized as a form of medicine along with “Western” medicine by law in Korea. There is an oriental medical license and the public insurance system J.-Y. Kim Department of Neurology, Inje University Seoul Paik Hospital, Seoul, South Korea