MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

After the usually challenging acute therapy is behind them, cancer patients are often desperate to find a therapy that might improve their wellbeing. At that stage they may suffer from a wide range of symptoms which can seriously limit their quality of life. Any treatment that can be shown to restore them to their normal mental and physical health would be more than welcome.

Most homeopaths believe that their remedies can do just that, particularly if they are tailored not to the disease but to the individual patient. Sadly, the evidence that this might be so is almost non-existent. Now, a new trial has become available; it was conducted by Jennifer Poole, a chartered psychologist and registered homeopath, and researcher and teacher at Nemeton Research Foundation, Romsey.

The aim of this study was to explore the benefits of a three-month course of individualised homeopathy (IH) for survivors of cancer.  Fifteen survivors of any type of cancer were recruited from a walk-in cancer support centre. Conventional treatment had to have taken place within the last three years. Patients saw a homeopath who prescribed IH. After three months of IH, they scored their total, physical and emotional wellbeing using the Functional Assessment of Chronic Illness Therapy for Cancer (FACIT-G). The results show that 11 of the 14 women had statistically positive outcomes for emotional, physical and total wellbeing.
The conclusions of the author are clear: Findings support previous research, suggesting CAM or IH could be beneficial for survivors of cancer.

This article was published in the NURSING TIMES, and the editor added a footnote informing us that “This article has been double-blind “.

I find this surprising. A decent peer-review should have picked up the point that a study of that nature cannot possibly produce results which tell us anything about the benefits of IH. The reasons for this are fairly obvious:

  • there was no control group,
  • therefore the observed outcomes are most likely due to 1) natural history, 2) placebo, 3) regression towards the mean and 4) social desirability; it seems most unlikely that IH had anything to do with the result
  • the sample size was tiny,
  • the patients elected to receive IH which means that had high expectations of a positive outcome,
  • only subjective outcome measures were used,
  • there is no good previous research suggesting that IH benefits cancer patients.

On the last point, a recent systematic review showed that the studies available on this topic had mixed results either showing a significantly greater improvement in QOL in the intervention group compared to the control group, or no significant difference between groups. The authors concluded that there existed significant gaps in the evidence base for the effectiveness of CAM on QOL in cancer survivors. Further work in this field needs to adopt more rigorous methodology to help support cancer survivors to actively embrace self-management and effective CAMs, without recommending inappropriate interventions which are of no proven benefit.

All this new study might tell us is that IH did not seem to harm these patients  – but even this finding is not certain; to be sure, we would need to include many more patients. Any conclusions about the effectiveness of IH are totally unwarranted. But are there ANY generalizable conclusions that can be drawn from this article? Yes, I can think of a few:

  • Some cancer patients can be persuaded to try the most implausible treatments.
  • Some journals will publish any rubbish.
  • Some peer-reviewers fail to spot the most obvious defects.
  • Some ‘researchers’ haven’t got a clue.
  • The attempts of misleading us about the value of homeopathy are incessant.

One might argue that this whole story is too trivial for words; who cares what dodgy science is published in the NURSING TIMES? But I think it does matter – not so much because of this one silly article itself, but because similarly poor research with similarly ridiculous conclusions is currently published almost every day. Subsequently it is presented to the public as meaningful science heralding important advances in medicine. It matters because this constant drip of bogus research eventually influences public opinion and determines far-reaching health care decisions.

17 Responses to Homeopathy for cancer: a new and remarkable study

  • Oh dear. Well Nature and Science often publish things that are statistically dodgy. So I guess it isn’t surprising that the editor of the Nursing Times has a slim grasp on what constitutes evidence.

  • How can a study be double blind when there is no control group?

    Or do they mean the editors were blinded when they published it and still cannot see it?

    • Acleron, you have written what I was thinking. The author, editors, and publisher are double-blind to the scientific method and critical thinking.

      Psychology is still trying very hard to justify calling itself a science. In my opinion, Jennifer Poole (a chartered psychologist and registered homeopath) has served only to reinforce the notion that most of psychology is nothing other than incompetent pseudoscience. This is shameful because 21st Century science- and evidence-based psychology is a wonderful self-correcting branch of science: it forms an essential role in furthering cognitive science by its strong interaction with cognitive neuroscience.

      Every illness, even the common cold, has co-morbid psychological conditions. Combining psychology with homeopathy is a recipe for patient disaster, but it seems to be a recipe for practitioner success in terms of income and status.

    • The website is down ATM, but the pdf-file I downloaded says “This article has been double-blind peer reviewed”, so maybe it means they used two blind individuals for peer review?
      They wouldn’t just claim a study was double-blind and went through peer review, would they?

  • This article has been double-blind peer reviewed
    Interesting claim. What is the use of a double-blind peer review it the trial didn’t even have a control group and wasn’t blinded in any way, I wonder? Are they trying to determine the knowledge of the peer reviewers, rather than the trialist?

    Anyway, why do they bother with such a huge group of 15 people and ridiculously long terms? Since homoeoquackery is individualised, shouldn’t they be better off with groups of 1 and trial lengths of five business days, i.e. one calendar week? They could then publish only the successful studies which are, after all, the only ones that count, and objectively claim a 100% success rate. It would simplify trials, make them a lot less expensive, and the results would be truly impressive. Now, this at least, would be top-level homoeoscience!

  • Presumably it simply means that the reviewers didn’t know who the authors were and vice-versa. However, given how few homeopathy researchers there are in the UK and the Homeopathic Action Trust gets a mention (unless that was redacted), I think even I could have had a good stab at who the researcher was. But I wonder if they tested the reviewers to see how good their blinding was?

    However, it seems almost a waste of time blinding the reviewers when Poole didn’t bother to blind the subjects in the study.

  • Has anyone written toe The Editor of Nursing Times to point out the errors of their ways?

  • If you would like to inform the Editor of NT how you feel about their promotion of nonsense:

    jenni.middleton@emap.com

    I have already sent her a link to this post.

  • The steady background buzz is all that is needed to allow general acceptance on the part of health care providers and the public. It leads to statements like “Oh, I’ve heard good things about that”. Primary care providers work with many specialists without a good grasp of what the specialists actually do. Quacks can seem just another group with additional expertise in their area. The double standard towards alternative medicine in even “real” journals only helps to feed this impression. It takes practice to read the literature well. Some will read only the abstract and conclusions, particularly when reading something outside their own field. These studies don’t have to be good they just have to be there to have the desired effect.

  • Now that the Nursing Times article is back online I shall highlight its misdirection…

    ABSTRACT, Aim:
    This study aimed to explore the effect of three months’ IH offered to users of a community, post-cancer-treatment care centre in Hampshire.

    DISCUSSION:
    This project aimed to show IH’s potential in post-cancer-treatment care.

    Pete’s Conclusion:
    The abstract falsely claims that the study was to explore the effect: the discussion section reveals the truth, which was to confirm the effect rather than to test it against the null hypothesis.

  • Here is a reply just received from the Editor at NT:

    Dear Peter

    Thank you for your concerns raised about the article. I value your contribution.

    I understand why you have raised the issue, but it is worth noting that the article does not in any way suggest that homeopathy or any other alternative treatment is or should be used a substitute to chemotherapy, radiotherapy or other forms of cancer treatment. It is a piece written about a community-based project designed to see if it helped people feel better after treatment.

    The article makes clear it is a small group, no control and that there are limitations. It spells these out and the necessary next steps to formulate a greater evidence base very clearly.

    “The study had three main limitations:

    · Absence of male participants;

    · Small group size;

    · Lack of long-term outcome measures.

    A larger, controlled study linked with an oncology outpatient unit could address each of these and be a positive next step.”

    Bear in mind that our readers, and especially of this type of article, are likely to be clinicians or even clinical nurse specialists so they will be familiar with the issue of limitations.

    We thought it raised interesting discussion – and indeed it has sparked intelligent debate about the use of alternative therapies among our readers, which I don’t believe is a bad thing. We could pretend there is no public interest in this issue, but I think that does our readers a disservice, who will be asked questions about this by their patients frequently. The article does not draw firm conclusions and is clear about its limitations. No use of homeopathy is advocated as a conclusion.

    We have not and would not ever advocate replacing evidence-based medicine or clinical treatment for cancer or other serious conditions for alternative therapies that had no evidence base to back up claims of efficacy or outcomes. This piece makes it clear exactly what the limitations are and I refer you again to the quote in the article about this so I do not believe we have published anything that is in any way “misleading”.

    Thank you again for your email

    Jenni

    • I cannot wait for the editor to explain why the article flies in the face of the Chief Medical Officer’s conclusion that homeopathy is “rubbish”.

      My conclusion is that Nursing Times has become “rubbish” by publishing this anti-science and potentially life-threatening bullshit.

  • I’m a recently retired nurse.

    It had long been my view, from such things as involvement in nurse training, that most nurses are not very good at assessing evidence nor reading research…

    As for Jenni Middleton’s claim that NT hasn’t published anything misleading, how does she explain the strap line from the article: “A community-based evaluation of individualised homeopathy for women after cancer treatment showed positive results for total, physical and emotional wellbeing”

    Now, that suggests to me that a claim is being made for the benefits of IH in this group, which is clearly misleading and inaccurate.

    The comment about “sparking discussion amongst our readers” is disingenuous, as the article is only available on-line to subscribers, i.e pay-walled, so not available to all (my NT alter ego, for example, cannot comment).

    And why one of the major nursing periodicals is discussing homeopathy at all is beyond me. This does absolutely nothing for the credibility of nursing.

Leave a Reply

Your email address will not be published. Required fields are marked *

Gravityscan Badge

Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted.


Click here for a comprehensive list of recent comments.

Categories