MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

The principal aim of this survey was to map centres across Europe that provide public health services and operating within the national health system in integrative oncology.

Information was received from 123 (52.1 %) of the 236 centres contacted. Forty-seven out of 99 responding centres meeting inclusion criteria (47.5 %) provided integrative oncology treatments, 24 from Italy and 23 from other European countries. The number of patients seen per year was on average 301.2 ± 337. Among the centres providing these kinds of therapies, 33 (70.2 %) use fixed protocols and 35 (74.5 %) use systems for the evaluation of results. Thirty-two centres (68.1 %) were research-active.

The alternative therapies most frequently provided were acupuncture 26 (55.3 %), homeopathy 19 (40.4 %), herbal medicine 18 (38.3 %) and traditional Chinese medicine 17 (36.2 %); anthroposophic medicine 10 (21.3 %); homotoxicology 6 (12.8 %); and other therapies 30 (63.8 %).

Treatments were mainly directed to reduce adverse reactions to chemo-radiotherapy (23.9 %), in particular nausea and vomiting (13.4 %) and leucopenia (5 %). The alternative treatments were also used to reduce pain and fatigue (10.9 %), to reduce side effects of iatrogenic menopause (8.8 %) and to improve anxiety and depression (5.9 %), gastrointestinal disorders (5 %), sleep disturbances and neuropathy (3.8 %).

The authors concluded that mapping of the centres across Europe is an essential step in the process of creating a European network of centres, experts and professionals constantly engaged in the field of integrative oncology, in order to increase, share and disseminate the knowledge in this field and provide evidence-based practice.

DISSEMINATE KNOWLEDGE?

EVIDENCE-BASED PRACTICE?

WHAT KNOWLEDGE?

WHAT EVIDENCE-BASED PRACTICE?

Where is the evidence that homeopathy or homotoxicology or Chinese medicine are effective for any of the conditions listed above? The answer, of course, is that it does not exist.

I fear the results of this survey show foremost one thing: ‘integrative oncology’ is little else but a smokescreen behind which quacks submit desperate patients to bogus treatments.

13 Responses to Integrative oncology is but a smokescreen for quacks

  • This is particularly upsetting since these are not the “walking worried” seeking extra pampering. These patients patients are seriously ill and some will die. They are facing unpleasant and, in the US, expensive treatments. They do not need useless treatments providing distraction at considerable expense. This sort of thing is happily provided by Cancer Treatment Centers in the US where they never saw a profit center they did not like. This is not a time in a patient’s life when they at the top of their game to critically evaluate the merits of various offered treatment. To treat patients this way requires something in the way of postmodernist ethics based on some alternate reality.

    • couldn’t agree more!

      • Note: The World Health Organization (WHO) defines complementary or alternative medicine as ” A broad set of health care practices that are not part of that country’s own tradition and are not integrated into the dominant health care system.”

        This could be why many CAM practitioners and supporters are currently keen to use the term ‘integrated’ (generally ‘integrative’ in US).
        If CAMs were to be integrated, by definition, they would cease to be complementary or alternative.

        It’s a stitch up by the Federation Internationale de Fakes et Alternatives (FIFA).

      • One of the most disturbing aspects of sCAM is the way its practitioners leap in cheerfully to exploit desperate, terminally ill patients. The weasel expression “integrative medicine” is indeed a smokescreen to cover the true intentions of those who work for the Big Snakeoil industry.

  • Integrative Medicine… usch,peanuts!
    Wait till you see alternatively thinking nurses at large with their version of “Integration”.
    I had a brief look at some of the abstracts and prior scientific work of faculty members for the 1st International Integrative Nursing Symposium, recently completed in my home city of Reykjavik, Iceland.
    My sentiment might be described thus: They manage to elevate misuse of the term ‘science’ to a new altitude.
    .
    Here’s an example by one of the chairpersons of this symposium, a lecturer at the faculty of nursing at Univ. of Iceland:
    “Healing crisis in reflexology: becoming worse before becoming better.” The link should allow perusal of the full text. The co-author is a professor[sic] at the same faculty.
    .
    Another article, seemingly from the same material of a “qualitative study” on 6[sic] individuals:

    Title: “Effects of reflexology on fibromyalgia symptoms: a multiple case study.”

    Thora Jenny Gunnarsdottir
    Faculty of Nursing, University of Iceland, Reykjavik, Iceland.
    Cynthia Peden-McAlpine
    University of Minnesota Twin Cities

    Complementary therapies in clinical practice

    08/2010;
    16(3):167-72.
    DOI: 10.1016/j.ctcp.2010.01.006

    ABSTRACT To explore the effects of reflexology on pain and other symptoms in women with fibromyalgia syndrome [FM].
    Multiple case study method as developed by Stake was used to investigate the effects of reflexology on six cases of women with FM which were given ten sessions of weekly reflexology. Data were collected with observation, interviews and diary and then analyzed within cases and across cases.
    Reflexology affected the symptom of pain in multiple areas such as head, neck and arms. Pain started to isolate and decrease.
    Reflexology may be helpful to decrease fibromyalgia symptoms. Qualitative research methods and individually tailored interventions are important when researching complementary and alternative therapies.

    Effects of reflexology on fibromyalgia symptoms: a multiple case study. – ResearchGate. Available from: http://www.researchgate.net/publication/45150343_Effects_of_reflexology_on_fibromyalgia_symptoms_a_multiple_case_study [accessed Jun 1, 2015].

    “Multiple case study method as developed by Stake” seems to be used here as a kind of “do as you like” methodology of interviewing a few patients, registering everything they say and sorting and selecting what you think is interesting and draw conclusions. Reminds somewhat of Homeopathic provings, don’t you think.
    OK, qualitative research methodology certinly can be used when appropriate, to evaluate many things, like attitudes and behaviour,but to use the term to justify make-believe reearch in this way seems to me be the penultimate insult to scientific ardour.
    I admit this comment may be a wee bit offside of the matter of the original posting but I am in such a state of shock after finding this yesterdy that I simply had to call this out.
    .
    I think Edzard is absolutely right. The whole concept of “integrative medicine/oncology/nursing” is simply an excuse for dabbling in fantasy-based medicine and the kind of make-believe “research” I have described is part of the smokescreen.
    Anyone know of good further reading about the misuse of “qualitative methodology” in medical research?

    • An important disclaimer to my comment above:
      I do consider nurses in general to be intelligent, hard working, well educated, unselfish and fantastic health-care colleagues who deserve all admiration and respect. The subgroup of the nursing profession whose ideas of reality are wayward, is not large but considerably important as their striving for acknowledgement and upheaval is fierce and they often get into influential positions.

    • @Bjorn,
       
      “Anyone know of good further reading about the misuse of “qualitative methodology” in medical research?”
       
      I knew of qualitative research as a tool used in the social sciences and in opinion polls. Politicians base almost all decisions on ‘gut feeling’, which is the same as qualitative methodology only it’s done without bothering even to ask other people. Qualitative methodology is the equivalent for science of throwing dice for gambling.
       
      I was impressed at the first hit I obtained when I googled the term ‘qualitative methodology’. http://fieldresearch.msf.org/msf/bitstream/10144/84230/1/Qualitative%20research%20methodology.pdf goes on at great length appearing to justify the approach, but — in my opinion — digging the hole deeper with each new paragraph.

  • Even if these “integrative” centres would cease to exist, cancer patients would feel under pressure to peruse every possible intervention, be it as implausible or disproven as it may. These patients have reason to grab each last straw, and according to my experience, there typically is more than one person attrackted to woo in the circle of “friends” or acquaintances.

    The problem? Woo-practitioners and -fans are often the first to tell your that that altmed intervention doesn’t work just because you don’t believe enough (cue “The True Scotsman”). And when you’re desperate, these things hit home.

    I have my fair share of cancer-ridden friends and relatives around me, and some, who have already been force off this earth by their illness, and trust me, I do as much as I can to find out about treatments that work, to monitor distracted and sometimes unmotivated doctors, even to the point that reading the information to be found makes it hard not to become desparate and depressed.

    And then I personally had a woo-attached common “friend” tell me that the bad shape of a dear friend of mine with her lung cancer is due to me being a skeptic, because with a skeptic around her, these things could work, although of course they usually did. I still wonder why I did not leave the room at that moment to never return again, but may be I’m just not that kind of person.

    The money is a problem, and traditional care is neither comfortable nor without error all the time (chemo and radiation therapy is hard on patients, but at least it has been shown to help at least for a large part of the patient population), but I have yet to see a similar amount of shaming imposed on seriously and sometimes terminally ill patients and their supporters than I have seen from fans and practitioners of alternate or “complementary” medicine. I am lucky that my “fosterlings” have neither given up on “conventional” medicine nor lost hope, but others may not be in as comfortable a position.

  • First, it was “alternative”, then when people realized that wasn’t medicine, it became “complementary”, as if it added something useful to the practice of medicine.

    “Integrative” invites the assumption that it has proven value and should thus be made a part of standard medical practice.

    Quackery thus puts more effort into wordplay than medical research!

  • Can I flag this here, as it is troubling me? I was reading the Telegraph yesterday, and my eye was caught by an article by Karol Sikora headed ‘Miracle-cure hype fuels the modern quest for immortality’. Oh good I thought, a much-needed rubbishing of irresponsible media reporting of cancer cures. And to some extent it was.

    However, I was mystified and surprised to read this statement:

    “Novel surgical techniques, precision radiotherapy with pin head accuracy and good psychological care bolstered by complementary medicine are all part of the total package we need to offer.”

    In what way does complementary medicine ‘bolster’ cancer care exactly?

    http://www.telegraph.co.uk/news/health/news/11642739/Cancer-breakthroughs-the-hope-and-the-hype.html

    • In what way does complementary medicine ‘bolster’ cancer care exactly?

      It doesn’t (yeah, I’m answering a rhetorical question).

      Chemo, surgery and precision radiotherapy are doing the major part of the work, psychological care helps patients deal with the psychological trauma associated with having cancer and being confronted with possible unexpected death considered premature, and the “complementary” interventions typically only take credit for the results from the former: “Well of course it was the homeopathic remedy that led to the partial or complete response of your small-cell lung cancer and not the large amounts of cisplatin and etoposide combined with the radiation therapy that you got in addition to swallowing sugar pills! Yeah, all that chemo was just for the fun of seeing you vomit your heart out, loose your hair and generally feel worse than you ever thought you could feel.”

      But still, I think that this is merely a minor problem with this piece. We could also be discussing the author’s argument constructed around the term “terminal”.

      But the general direction is right: If it’s too good to be true, then it’s probably false. Scientists should be careful about the right time for criticism in detail, as it may be that the more important and true aspect of such texts directed at the “general public” (at least those that read The Telegraph) are overshadowed by controversy stirred up over small details.

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