MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

Continuing on the theme from my previous post, a website of a homeopath (and member of the UK ‘Society of Homeopaths’) caught my attention. In in it, Neil Spence makes a wide range of far-reaching statements. Because they seem rather typical of the claims made by homeopaths, I intent to scrutinize them in this post. For clarity, I put the (unaltered and unabbreviated) text from Neil Spence’s site in italics, while my own comments are in Roman print.

The holistic model of health says all disease comes from a disturbance in the vitality (life force) of the body. The energetic disturbance creates symptoms in the mind, the emotions and the physical body. Each patient has their own store of how this disturbance in vitality came about and each person has individual symptoms.

What is a ‘holistic model of health’, I wonder? Holism in health care means to treat patients as whole individuals which is a hallmark of any good health care; this means that all good medicine is holistic.

Holism and vitalism are two separate things entirely. Vitalism is the obsolete notion of a vital force or energy that determines our health. ‘Disturbances in vitality’ are not the cause of illness.

We will attempt, as far as possible, to treat the whole person and to change the conditions that created your susceptibility to cancer.

Much of the susceptibility to cancer is genetically determined and cannot be altered homeopathically.

Using Homeopathy to treat people with cancer

Homeopathic treatment can help someone with cancer. It can also be helpful for people who have a history of cancer in their family or have cared for a relative or friend with cancer. There are a number of methods of using homeopathic remedies to help people with cancer.

There is no good evidence that homeopathic remedies are effective for cancer patients or their carers.

Constitutional treatment: Treat the person who suffers the illness. A constitutional homeopathic remedy suits your nature as a person and its symptom picture reflects the unique expression of your symptoms. It can arouse the bodyʼs natural ability to heal itself and this can have profound benefits. It is appropriate if your vitality is strong.

There is no evidence that constitutional homeopathic treatments increase the body’s self-healing ability.

Stimulate the immune system to fight cancer: Remedies can be used to help the body fight the cancer, using specific homeopathic remedies called nosodes. A second treatment may be used to support the weakened organ. This method is most useful for people who are not using chemotherapy or radiotherapy.

There is no evidence that nosodes or other homeopathic remedies have any effect on the immune system ( – if they did, they would be contra-indicated for people suffering from auto-immune diseases).

Support the failing organs and the functions of the body that are not working: Remedies can be used to support weakened organs; to help with appetite; to help sleep and to treat sleep disturbances; to reduce the toxic symptoms; to help the body eliminate toxins. These treatments are helpful to people undergoing chemotherapy or radiotherapy.

For none of these claims is there good evidence; they are pure fantasy. The notion that homeopathy can help eliminate toxins is so wide-spread that it merits a further comment. It would be easy to measure such a detoxifying effect, but there is no evidence that it exists. Moreover, I would question whether, in the particular situation of a cancer patient on chemotherapy, a hastened elimination of the toxin (= chemotherapeutic agent) would be desirable; it would merely diminish the efficacy of the chemotherapy and reduce the chances of a cure.

Treat the pain: Homeopathic remedies can be very effective in aiding pain control. Remedies such as calendula can be effective in situations of intractable pain. If the cancer is at the terminal stage, remedies can be used to increase the quality of life. These remedies are palliative and can assist the patient keep mentally and emotionally alert so they can have quality time with loved ones.

Where is the evidence? Pain can obviously be a serious problem for cancer patients, and the notion that calendula in homeopathic dilutions reduces pain such that it significantly improves quality of life is laughable. Conventional medicine has powerful drugs to alleviate cancer pain but even they sometimes do not suffice to make patients pain-free.

Homeopathy in conjunction with other therapies

When a patient chooses to use chemotherapy or radiotherapy to treat their cancer the homeopath will prescribe remedies to support the body and ease the side-effects. Remedies can also be very useful after surgery to encourage the body to heal and allow greater mobility at an early stage.

Again no good evidence exists to support these claims – pure fantasy.

Other therapies can complement homeopathy but the homeopath will advise that you do not use every therapy just because they are available. It may be better to choose two or perhaps three main approaches to improving your health and ensure each one has positive effects that suit you very well.

Is he saying that cancer patients are best advised to listen to a homeopath rather than to their oncology-team? Is he encouraging them to not use all possible mainstream options available? If so, he is most irresponsible.

Each person will have different needs. It is always appropriate to change your diet. Nutritional and dietary advice is of the utmost importance to support the bodyʼs healing process. Cancer has many symptoms of disturbed metabolism and a poor diet has often contributed to the disturbance in the body that allowed the cancer to flourish. It is essential to remedy this situation. Nutritional advice puts you back in charge of your body; with good homeopathic treatments this provides the basis for improving your health.

Dietary advice can be useful and is therefore routinely provided by professionals who understand this subject much better than the average homeopath.

CONCLUSION

The thought that some cancer patients might be following such recommendations is most disturbing. Advice of this nature has doubtlessly the potential to significantly shorten the life and decrease the well-being of cancer patients. People who recommend treatments that clearly harm vulnerable patients are charlatans who should not be allowed to treat patients.

58 Responses to Homeopathy for cancer?

  • Being Irish people tell me all the time they are praying for me, although I am an atheist, I think it is a nice thing to say and it is comforting that people care about you. People believe in all sorts of things including the power of the “medical gaze”.

    To be fair to the Homeopath, I interpret the homeopath as offering to “help people with cancer”, rather than curing the disease itself. The page does say

    “When a patient chooses to use chemotherapy or radiotherapy to treat their cancer the homeopath will prescribe remedies to support the body and ease the side-effects. Remedies can also be very useful after surgery to encourage the body to heal and allow greater mobility at an early stage”

    Just as prayer helps millions of people who believe, I have no doubt this homeopathic approach helps many others suffering with cancer. Thats why the third and fourth pillars of “Evidence Based Medicine” includes what the patient brings to the table. Or do you think Edzard these pillars should be removed from EBM, in the light of your research?

    • YOU HAVE NO DOUBT….
      ??????
      is that the basis for cancer treatment decisions?
      what about some evidence?

    • if you read the homeopath’s site carefully, it is hard to agree with your impression that he is not interfering in curative therapy. of course there would be the usual disclaimer to cover his back – but they are quite meaningless in the context of the text as a whole.

    • Have to say Richard your interpretation of Neil’s website is at best rather charitable.

      It’s interesting that you choose to cherry pick the part which suggests a complementary approach which will “help people with cancer” whilst seemingly ignoring the wealth of other phrases which directly contradict this, or imply its efficacy and superiority over conventional treatments.

      If as you claim Neil Spence is offering complementary treatment why does the website have two headings “Using Homeopathy to treat people with cancer” and “Homeopathy in conjunction with other therapies” with the former in bold and the latter not?

      In the context of treating cancer with Homeopathy do you believe that there is good evidence that “Remedies can be used to help the body fight the cancer, using specific homeopathic remedies called nosodes”?

      Do you think that a phrase like “This method is most useful for people who are not using chemotherapy or radiotherapy” is not likely to infer that it is an alternative stand alone treatment?

      Even ignoring all of these issues, Neil is not even in compliance with the SOH’s own Code of Ethics and Conduct which expressly forbid practitioners making claims about specific medical conditions and making misleading claims in advertising (this site is not CAP Code compliant).

      In this context do you think this he is an appropriate person to be anywhere near a cancer patient?

      I certainly don’t.

      If Homeopaths are willing to sail this close to the wind in public – and I believe there are breaches of the Cancer Act on this website – you really have to wonder how many have only curtailed their claims for fear of prosecution and imagine what is still being said to vulnerable, desperate people behind closed doors.

      Offering false hope is exploitation, and its time it stopped.

  • Many homeopaths believe that mint, menthol, camphor, and coffee cancel out homeopathic medicines. Thus, they advise their patients to avoid mint toothpaste (there are “homeopathic safe toothpastes” on the market because of this), muscle rubs like Tiger Balm, coffee, etc. I have even been told that if a jar of Tiger Balm is opened in a homeopathic pharmacy, it will neutralize all the remedies.

    What a perfect opportunity to do some basic research to prove something! One group gets homeopathy without minty exposure, another group gets the same remedies which have been exposed to menthol. Of course, this would need to be double blind to be of any use. Homeopathics are perfect for that, as all the little sugar pills look and taste the same.

    Searching for research supporting this odd belief led nowhere. It apparently hasn’t been actually tested, even in small trials.

    Could it be that it is just a convenient excuse to tell a patient when their homeopathic treatment fails? “Did you smell coffee? Did you use toothpaste? Did your partner use toothpaste, then kiss you?” LOL. I’ve seen patients of homeopaths completely convinced of the mint/coffee ban. Of course they just want to be good patients and get better. But clearly it shows that many patients, even those who are literate and educated, have a low understanding of evidence and research.

    This is why it is very useful to vocally criticize homeopathy–desperate people waste their money and time on it, including making bizarre lifestyle modifications like avoiding mint toothpaste. Imagine someone dying of cancer (or fighting it with a very small chance of survival). Perhaps they only have a couple ‘good’ hours a day. They become convinced that they should drive across town to a homeopath and add that to their regiment. The homeopath tells them how important it is to avoid minty things and coffee. Later, as the patient is nearing death, perhaps the homeopath says in some way “I could have helped you more, but I suspect you still had some toothpaste in the cupboard or coffee in the kitchen that cancelled the vibrations of my medicines…”

    • Indeed. An additional factor may be that it enhances placebo effects – if you have to deliberately avoid some things, then them there sugar pills must be mighty powerful…

      • Placebo? Nonsense. My pet dog was diagnosed with tumor of the liver. Our allopathic treatment failed and the tumor was spreading to the spleen and Kidneys. The vet gave my dog three months to live. We switched to homeopathy as a last resort. My dog lived happily for 30 months after that treated ONLY BY HOMEOPTATHY. It is best if you will not talk about things you do not know.

    • Chocolate – I have been told by a Homeopath that chocolate also nullifies the healing powers of the magic pills.

    • Many homeopaths believe that mint, menthol, camphor, and coffee cancel out homeopathic medicines. Thus, they advise their patients to avoid mint toothpaste (there are “homeopathic safe toothpastes” on the market because of this), muscle rubs like Tiger Balm, coffee, etc. I have even been told that if a jar of Tiger Balm is opened in a homeopathic pharmacy, it will neutralize all the remedies.

      I’ve seen it described as “a system of excuses masquerading as medicine”.

  • Obvious;y my experience over the last few years has given me a unique insight into the treatment of cancer. I have also talked to doctors, nurses and patients asking them what helped them deal with the ordeal of treatment. Correct me if I am wrong but the cancer research base focuses primarily on what is going to be profitable for the pharmaceutical industry. Side effects are incidental, a few extra months of life are the coin of this realm.

    Reading the evidence can be pretty depressing for people who need hope to carry on, especially when they have to deal with ridicule over the choices they have made to support their medical treatment, from Skeptic community who are very opinionated about a subject, which in my opinion them have little understanding of. Without hope, cancer treatment is incredibly hard to deal with and many give up as my father did, most oncologists do realise the importance of support for cancer treatment, whether it comes from, their priest, Macmillan nurse, homeopat, reflexologist, aromatherapy massage, or in my case my children, the third and fourth pillars of evidence based practice for the successful clinician

    • what makes you think that your experience is UNIQUE?
      there are many who have similar experiences and some might even understand medicine, oncology, evidence etc.

  • I have known many people who have died of cancer, and some who have successfully had it treated with conventional medicine. Friends, family, and patients. I’ve known good-hearted people who put off getting conventional care because they believed in ‘natural’ cures. This has led to much suffering and early death.

    When I was still doing acupuncture, I had several patients who used my services for support while undergoing conventional treatment. They also were very active in their care. They ate well, tried to keep positive, took supplements…

    I’ve read a lot of research on the matter, and it boils down to the most likely scenario: people who get acupuncture are more likely to report less nausea, pain, and fatigue. However, they will probably still vomit the same amount as people who don’t get acupuncture, and their pain and fatigue levels are likely to be the same, too. It’s hard to measure these subjective symptoms.

    Additionally, the best studies with the most careful controls and most convincing fake acupuncture (non-penetrating needles at non-traditional points) usually show the same results.

    This is the same with homeopathy–the clinical interaction (caring attention, coached relaxation) is where the benefit comes from, but that benefit is usually small and only relates to subjective symptoms.

    The same benefit can be produced by caring communication from the oncology team, relaxing touch from family or pets, etc.

    Many people don’t “get” it that telling someone (who is paying you) that your procedure is going to help them with healing when it is equivalent to sugar pills or fake acupuncture is a deceptive, unethical act. That is, once an ‘expert’ acupuncturist or homeopath learns and understands the implausibility and research regarding their interventions, a choice must be made to maintain a religious belief (i.e. faith trumps evidence) and engage in intellectually dishonest deception (i.e. still taking money from sick people and pretending your treatments are better than similar fake treatments) or you have to, as I have done, look for another line of work.

    Yes, many people are happy with lies (Santa is real, homeopathy works, ancient acupuncturists found special points which, when needled, shuttle energy around in specific ways to cure actual diseases). But for those of us who have learned the importance of good quality evidence and seen the harm that faith-based placebo medicine does to desperate sick people, it is worth it to speak out honestly.

    @Richard, it may feel good to say that cancer patients need hope and a positive attitude, but that is a two-edged sword. Often when people with cancer feel grief and depression, well-intentioned people say things like “you’ve got to keep positive or the treatments won’t work as well.” This can easily lead to more guilt and self-blame for the already-depressed patient. This has been studied as well, and it has been shown that a positive attitude does not increase the survival rate. It also has been shown that negative emotions, neurosis, and introversion don’t increase cancer incidence, though that remains a popular theory in the New Age crowd. Here’s an article on it: http://www.cancer.org/treatment/survivorshipduringandaftertreatment/understandingrecurrence/whenyourcancercomesback/when-cancer-comes-back-positive-attitude

    To suggest that the pharmaceutical industry covers up the truth about the benefits of positive attitude, homeopathic pills, etc., as they make money from cancer treatments, is a tired and ridiculous argument, in my opinion. Cancer is experienced by doctors, their families, pharmaceutical executives, and more. Cancer has higher incidence in Chinese herbalists, Chiropractors have a shorter lifespan than the average Joe (and quite a bit shorter than the average Dr. Joe, M.D.). And Hulda Clark, super-quack author of _The Cure for All Cancers_ and _The Cure for All Advanced Cancers_, died of cancer. She had convinced hundreds of people with cancer to have their teeth pulled, avoid all sorts of foods, take all sorts of supplements. If someone’s cancer didn’t go away, she just blamed it on some type of non-compliance (you slept in a house with a car in the garage, you used toothpaste instead of pure baking soda, you didn’t boil your milk long enough). Enough! Enough conspiracy theories, enough unproven and disproven treatments!

    Life is much more pleasant without the stress of superstitions (in my experience). Vague distress caused by wondering about cell phone energy, Mercury in retrograde, whether orgasms are draining or beneficial to the life force, if iced drinks hurt digestion, coffee is only good as an enema, thinking the right thoughts magically brings health and wealth (and the wrong thoughts bring disease and poverty), etc. Let it go. I know it’s hard at first, but the rewards are worth it. It may even add years to your life.

    Reference: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769457/

    “Two separate data sources were used to examine chiropractic mortality rates. One source used obituary notices from past issues of Dynamic Chiropractic from 1990 to mid-2003. The second source used biographies from Who Was Who in Chiropractic – A Necrology covering a ten year period from 1969–1979. The two sources yielded a mean age at death for chiropractors of 73.4 and 74.2 years respectively.

    The mean ages at death of chiropractors is below the national average of 76.9 years and is below their medical doctor counterparts of 81.5.”

    • There is no evidence that a sunny disposition has any effect on illness. I don’t have a link at hand but just search at sciencebasedmedicine.org. Not saying you believe this, just clarifying as this idea is such a widespread meme.

      The basic thing to remember about acupuncture is that there is not only no good evidence for its effectiveness, but there is no science based plausibility for it either. It’s a myth that it’s current form is “ancient” and even if it was, that’s just argument from antiquity–again I think you know this and I’m just clarifying.

    • Ex-Acupuncturist –
      That is precisely the point. That some people feel better for an ice cold drink and others feel worse, that some are energised by an orgasm and others are drained, cell phones have little effect on one person but send another into near collapse.

      Don’t you people understand? Everyone is different, each person is unique. Therefore they all have different symptoms and different susceptibilities to illnesses.

      Yet the whole basis of scientific clinical trials rest on everyone being the same with the same Cancer treatments for All! Like robots!

      On the other hand, the practice of homeopathy depends upon finding the unique original symptoms of each patient, in order to match them up to the unique original symptoms brought out in the Proving of a substance, which has been made into a homeopathic medicine. Like for like, rather than opposites, Antis, (eg. antibiotics, antidiuretics, anti-hypertensives, anti-depressants, etc. etc.) Remember Hippocrates said there were two laws of healing – opposites and similars.

      Sciencebasedmedicine is just that and I would suggest looking a little more widely for additional knowledge and literature.

      Irene: full marks for reading from the script correctly!

  • My experience of cancer is “unique” to me as the patient, your experience of cancer treatment Edzard is “unique” to you as a former clinician and academic. Your knowledge base would appear to come principally from the first and second pillars of EBM, mine would include the third and fourth pillar of the EBM model.

    Correct me if I am wrong, putting all four “pillars” together is what constitutes best practice in Evidence Based Medicine?

    • unique = being the only one of its kind; without an equal or equivalent; unparalleled.
      and you are wrong about the ‘pillars’ as well.

  • You know someone who has had the exact same, “equivalent”, “parallel”, experience of cancer as I have had??

    I said “correct me if I am wrong”, I am only a cancer patient, you are the one who claims to understand medicine, oncology, and evidence. So are you now saying that patient “values” and “beliefs” are not pillars of Sacketts model of “Evidence Based Medicine”? If so could you tell me what the pillars of EBM are, I may have misunderstood when I did my masters in Health Promotion at Brunell University?

    • But without robust, objective evidence that an intervention has efficacy a patients ‘values’ and ‘beliefs’ basically boil down to patient preference do they not?

      And without evidence of risk and benefits it is a choice made without fully informed consent.

      Taking Homeopathy as an example what you appear to be suggesting is that you can have evidence based medicine without the evidence.

  • The practice of “Evidence Based Medicine” was developed by David Sackett, skeptics are entitled to have opinions on Sacketts model, but the fact remains publishing evidence while an important pillar of EBM, is only one of the pillars and the one Edzard derives most of his assertions from. Presumably the reason the Royal Marsden offers cancer patients a number of therapies in conjunction with their cancer care, is not because they believe homeopathy, aromatherapy, reflexology or counseling, is the missing link in cancer treatment, but they know how difficult it is for individuals to cope with cancer treatment and anything that helps them through treatment, based on a patients particular beliefs is going to “hopefully” contribute to a positive outcome. The predicted outcome is only a “guestimate” anyway based on the evidence they have at their disposal, particularly in stage 3 and 4 cancers.

    The scientific evidence estimates that I have, 22 months (the average) of life left, from August 2013. You would have thought the tumour shrinking by 50% after 6 cycles of chemo would, place me on the positive side of this average. Unfortunately the scientific evidence does not tell them that, this is where the second pillar of EBM is important the experience of the clinician. The experienced clinician might take the view despite the lack of evidence that I would improve my life expectancy beyond 22 months, were I to adopt a healthy lifestyle as I have.

    Then there are all the other other variables which may have an effect but may not have been not looked at, relationships, were I to see a homeopath, go to Lourdes, watch porn, what effect could these factors have on human physiology and the progress of the cancer. They dont know, because their are so many variables that can influence our physiology. Good doctors will combine the published evidence with what makes the patient happy and in my case we have decided to continue with chemotherapy, reducing the does by 25%, because I know what 12 cycles of 100% dose of chemo does to me, better than the evidence which stated I would not get a peripheral neuropathy, even though, I can feel my hands going numb again after only 6 cycles. You see sometimes the patients knows better than the evidence and a good clinician listens to their patient, because the treatment delivered is standardised, the patients experience of it is “unique” to them.

    • The post is about claims that homeopathy can be used to treat cancer, or as complementary therapy. The position which Prof Ernst takes is clear and difficult to argue against – that the best evidence shows homeopathy is not effective for either of these. He makes no comment upon evidence based practice or the clinical application of homeopathy, just the evidence base which underpins it.

      And this is sufficient to dismiss Homeopathy from an EBM approach – I’ll explain why.

      If you truly believe in EBM and Sacketts model you would of course be well aware that “good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough”.

      So the point I made above which you avoided totally – the elephant in the room – is that you cannot claim an EBM approach to justify the use of a therapy solely based on a patients ‘values’ and ‘beliefs’ (individual clinical expertise) its selection must also be supported by the best external evidence as well.

      Homeopathy fails this vital test.

      • spot on!
        or in Richard’s nomenclature: you need ALL pillars not just the ones you like.

      • I have not suggested anywhere in this thread that homeopathy, aromatherapy,reflexology etc is a treatment for cancer and I am sure the Roayal Marsden dont think it is, when they offer “complementary” services to patients receiving cancer treatment. I have outlined the treatment offered to me based on the evidence, however my previous experience of 12 cycles of chemo therapy, tells me I do not respond to the chemo as a significant number of people did in the scientific studies and so my chemo dose has been changed. Anything else I do for my wellbeing, is done on the basis of the experience of the clinician and the patient (me) thats what Sackkets model of Evidence Based Practice is, its how medicine is practiced at the Royal Marsden. Edzard, to say I only choose the bits of EBM I liked is ridiculous, I would have avoided chemo, surgery, and radiation and stuck to the aromatherapy if that was the case, whats laughable is no one knows for sure the effect a choice like that would have had on my life expectancy, because the original treatment did not work.

        I ask you again Edzard in your opinion is the treatment the Royal Marsden provides for me and many others not evidence based and in line with your understanding of “best practice”.

    • Scientific evidence and research say that each tumor is different, so those average estimates of life have the same value as an average temperature of all persons in the hospital, starting from Infectious disease ward to morgue.
      It has also been found ou why each tumor is different, so homeopaths have no reason to become happy. Anyway it is not easy to evaluate effectiveness of the conventional therapy, and it is impossible to evaluate such factors as happiness.

    • As to the listening to the patients – doctors have very rigid prescriptions when dose of chemotherapy agent must be reduced; for how long; when it can be restored; whether patient can use the same dose as before the onset of serious side effects or dose must be reduced. E.g. if low WBC is the only problem, it must be very bad, if 3rd grade infection also sets in, WBC does not need to be so low, if infection is 4th grade, then doctors will certainly stop chemo sooner. There are also prescriptions if more than one side effect develops, e.g. low WBC count and neuropathy.
      The treatment now is very regulated to keep patient alive, otherwise it would be easy: just shoot him, and cancer is dead.

  • I have just describe a scenario, the “Scientific Evidence” states, I should have 12 cycles @ 100% dose. I did not want that does because of how it affected my quality of life previously, I could not exercise, poor appetite, could not work, factors which I believe contribute to my well being. So the does has been reduced by 25%, by my consultant at my request. I can also have four sessions of Aromatherapy or reflexology at Kingston Hospital or the Marsden, if I wish. In your opinion Edzard, is my Royal Marsden cancer consultant practicing Evidence Based Medicine as defined by David Sackett.

    • if your question is: “is the prescription of aromatherapy or reflexology to a cancer patient to increase his quality of life evidence-based?”, my answer is no.

  • The link to the website described is apparently not working. Is it http://www.holos-homeopathy.com/ ? Wonder that some revision is underway…

  • Edzard, you have made a career campaigning for your definition of Evidence Based Medicine, which is limiting scope of practice to published scientific evidence. Thats how you defined EBM in your book “Trick or Treatment”, thats how Simon Singh understood it and why I gave him a present of the BMJ book on Evidence Based Medicine. Your definition is not the way David Sackett defined EBM or the way the National Health Service practices EBM. Let me make it perfectly clear for you, I dont know anyone who believes, aromatherapy, or reflexology is a cure for my cancer, its available at the Royal Marsden, if I or other cancer patients feel their wellbeing might benefit from it. So for the last timer I will ask: In your opinion Edzard, is my consultant practicing Evidence Based Medicine as defined by David Sackett in reducing my chemotherapy dose by 25% at my request, when the scientific evidence states the subjects in the evidence who lived longest had a 100% dose.

    • I am not an oncologist and therefore not sure about the evidence in mainstream oncology; ask me a question related to alt med and I might give you an answer.

  • Sorry if I did not make it clear enough; The scientific published “evidence” states; “subjects who have a 100% dose of 5fluorouracil live longer (“First pillar” which Sacket based the practice of evidence medicine based on). The patient “believes” they will do better if the dose is reduced, remain active and have a few sessions of aromatherapy at the Royal Marsden (“third” and “fourth pillar” of EBM). Based on the clinicians experience ( “third pillar” of EBM) the oncologist agree with the patient and changes the treatment plan from the conclusion in the published evidence. Is this oncologist practicing “Evidence Based Medicine as defined by David Sackket and is the aromatherapist complementing the oncologists approach to patient care, within the EBM model of best practice and “Patient Centered Care”?

    • I did understand this – but you don’t seem to understand that I will not pretend I know all there is to know in this area and case and thus will not provide a comment which might be ill-informed.

  • Fair enough, I will leave it there. I take it from your response that your expertise is in published evidence on CAM, rather than the practice of “evidence based medicine”, because many Skeptics believe they are one and the same. I agree with you that the scientific evidence supporting CAM for most conditions is practically non existent, however that does not mean these interventions cannot be included in an “evidence” based approach to patient care. It would be great if you explained this distinction to skeptics, as I am sure it would help your campaign to have CAM practitioners, work on producing the rigorous research you require to stand alone as credible clinical interventions.

    • I think the majority of contributors on here are cynics rather then skeptics so will not understand the points you make. Your points are made from a patients point of veiw (although your website shows you have greater insight to the human body then the average patient) and have been pretty much dismissed by everyone on here. That is the trouble with putting all your eggs in a RCT only shaped basket.

      I pay my taxes and they help to run the hospitals. If the hospital – with its team of highly qualified medics and experts in their field – decide to spend some of the money on what maybe seen as placebo – and that placebo goes on to enhance the quality of life of someone with a terminal disease then I’m glad to have done my bit.

      The fact that your experience of cancer has been dismissed as not being unique to you totally undermines the professors understanding of a patient. I don’t doubt that he is a formidable researcher and has contributed enormously to shaking up the CAM world. But there is more to human interaction and healthcare then P values and what is statiscally relevant isn’t always clinically relavent and vice versa – thank goodness the providers of care recognize that.

      I wouldn’t waste what precious time you have left arguing over nomenclature with the cynics that frequent this blog.

      Best of luck.

      • Thanks for your words, I would also thank Edzard for posting all these comments because I believe they are so important in relation to the quality of care people get when they are ill. Yes, there are charlatans out there who take advantage of people who are ill, I just know they are not exclusively linked to CAM practitioners and most patients are not as stupid and gullible as sketics would have you believe. Published evidence is not a “truth” its a guide for the experienced clinician, who knows that in “clinical science”, unlike “physical science” a patient brings many variables to the table, “con-founders” that affect outcomes. I believe whats helped me most in dealing with cancer, was being able to get my head around the fact that I only have a limited amount of time left, but we are all on borrowed time and started to die the day we were born. I have had a great life and since I was diagnosed have crammed a lot of great living in with my young kids. If someone asked me to list the happiest years of my life the last three are up there and hopefully I will have a few more. How weird is that and why I am writing a book “Cancer drove me up the Wall” describing my experienced of dealing with adversity and cancer. In my opinion quality of life is way way more important than quantity for the patient, while family and doctors tend to focus on quantity of patients life. Few people live their lives to the full and die with regrets, A bus could take me out before the cancer and my only regret will be I did not change my lifestyle sooner.

  • when Prof. Ernst was a clinician, he used to use homeopathy to treat himself and his wife.

    http://www.theguardian.com/science/2003/sep/25/scienceinterviews.health

    Do we agree Bjön Geir that there is difference between RCT’s and clinical work?

    • this refers to ~30 years ago when the evidence on homeopathy was such that this was a little more reasonable than now; and even, if it wasn’t – we can all do mistakes and should be able to learn from them and change our mind. the fact that I once did something does not necessarily mean that it was correct to do it.

    • @ Gary

      Do we agree Bjön Geir that there is difference between RCT’s and clinical work?

      I am not sure I understand the question. I see no comment of mine in this thread. Perhaps I did enter one, which has been deleted and I have forgotten about??
      Or are you calling on me to comment on the obvious.

    • @Gary Linemaker

      If you do a search of the Grauniad’s website for “edzard ernst”, the first article you find is one called Why I changed my mind about homeopathy, which is rather more recent than the one you cited, and addresses the subject matter of your post.

  • Richard gives probably the best series of posts I have read from A Alt Med supporter and the arguments are sound, if the RCT evidence could support him I would be a convert. I have no doubt his personal quality of life has benefitted from his beliefs and I hope he lives many more years and enjoys his remaining life. However cynics are not sceptics and vice versa. Ernst has never displayed cynicism in the years I have read his work. He cannot help Richard by ignoring the evidence available, he can only help everybody else by making sure those making “choices” have the correct information available to them. Good luck Richard. I wish you the very best in your endeavours.

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