Nothing irks Dr. Bichlien Nguyen more than the herbal supplement ads that fill the airwaves of Vietnamese television and radio.
"You'll have bottle No. 1 that will treat your kidney disease, and bottle No. 2 can treat anything from cancer to high blood pressure to diabetes," said Nguyen, an oncologist in Fountain Valley. "It's a mess, it's really bad."
Herbal products and dietary supplements do not receive the same testing and regulatory scrutiny that the Food and Drug Administration applies to drugs. And because their claims are unproven, Nguyen says, such ads can not only be misleading, they can also be dangerous. She worries that if people hear that a product can treat or cure cancer with no side effects, they may forego a medically accepted regimen like chemotherapy.
"I wonder how many people have died because they are not getting the appropriate treatment, and they're trying to use these 'cures,'" she said.
Nguyen tries to caution consumers during her weekly radio show hosted by the Vietnamese American Cancer Foundation, but she knows she is just one voice amid a deluge of advertisements. "This is a major problem," she said, "and it's a big industry."
Such untested products are especially popular in immigrant communities that have long histories of treating illness with herbs and other traditional approaches. "Many consumers, culturally, are inclined to believe that these remedies work," said Rigo Reyes, the chief investigator at the Los Angeles County Department of Consumer Affairs.
Unregulated supplements must nevertheless carry clear disclaimers on their labels that they are not intended to treat, cure or prevent diseases. But those warnings are only required to appear in English, even if the rest of the label is in a foreign language.
"It makes us cringe to hear advertisements that certain herbs can cure cancer," said Becky Nguyen, who directs the Vietnamese American Cancer Foundation and is unrelated to the oncologist. "It is a vulnerable population … people who are trying to find hope, find a cure. It's sad that they're being taken advantage of."
Nguyen has heard a few clients say they would rather try herbal medicines to treat their cancer because they fear the harsh side effects of chemotherapy. If the herbs don't work, such patients may turn to medical treatment, but by then the cancer is at an advanced stage.
Although the law requiring label disclaimers does not explicitly apply to advertisements, many print ads, like the glossy pamphlets touting herbal products in Vietnamese drugstores, include such qualifications to avoid being accused of deceptive advertising. But if the disclaimer is the only part of an ad printed in English, which may not be the primary language of the consumer, the ad could still be considered misleading, said Laura Koss, an attorney with the Federal Trade Commission in Washington.
To be effective, a disclaimer "has to be clear and prominent, and people have to be able to see it and understand it," Koss said. "If it's in small print, if it's in another language, if you can't see it … it might result in a deceptive advertisement." And just slapping on a disclaimer doesn't permit a company to still claim that its product can cure or treat diseases, Koss added.
Officials may take a range of actions against companies that produce false advertisements, from issuing warning letters to filing civil lawsuits. The FDA can also seize and destroy products marketed with fraudulent claims.
Koss said the FTC also tries to encourage media outlets to voluntarily pull false advertisements off the air. Although media organizations aren't held accountable for the truth of the advertisements they run, many have expressed interest in protecting the communities they serve, she said. "It can't just be law enforcement" going after fraud, Koss said. "There are just a lot of bad actors out there, and we have limited resources."
Experts say misleading health product ads still abound because FTC or county Consumer Affairs investigators can't catch everything. "We don't have the ability to monitor every ad that appears on TV or in the newspaper," said Tom Syta, assistant director for the FTC's western region, based in Los Angeles. Tracking the flood of suspicious claims in English language media is hard enough, and agencies don't have the staff to also screen and translate foreign language ads.
So officials heavily rely on consumers to report dubious advertising. The FTC receives hundreds of thousands of complaints every month, Syta said, and the sheer volume requires simple triage: The higher the number of people who flag a given product, the more likely the agency will investigate.
But it can also be difficult to convince members of immigrant and minority communities to complain, county investigator Reyes said. Many may be reluctant to engage the legal system or don't realize they can file anonymously.
Health fraud issues will probably become more important with the full implementation in 2014 of the federal Affordable Care Act, Reyes said. He has already seen an increase in false advertisements targeting people who now have health insurance for the first time in their lives. "Any time there's a change in any law, the scammers take advantage of confusion and uncertainty to peddle their services," he said.
The FDA has also seen a recent uptick in the number of products claiming to cure or treat severe diseases, from cancer and STDs to diabetes and heart disease, said Dan Fabricant, who directs the FDA's Division of Dietary Supplement Programs. "Unfortunately, there seems to be a rise in this sort of thing," he said. "Maybe because the economy's tight, people are looking for ways to pad their income."
The first line of fraud defense, the experts agreed, is still a consumer's common sense.