MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

The title of this post is a statement recently made in an article by Mike Adams in ‘Alternative Medicine News’:

The cancer industry goes to great lengths to deny patients access to any information that they might use to prevent, treat or cure cancer without requiring expensive (and highly toxic) medical interventions. That’s what makes the BMJ documentation of this curcumin cancer cure so astonishing: In years past, the BMJ never would have even tolerated the publishing of such a scientific assessment. So what changed? In truth, the evidence of natural cures for cancer is now so overwhelming that even the BMJ cannot remain in a state of denial without appearing to be hopelessly out of touch with scientific reality.

The story is based on one single patient who apparently was cured of cancer using curcumin (turmeric). The case was also recently (3/1/18) featured on BBC’s ‘YOU AND YOURS’ (http://www.bbc.co.uk/programmes/b09k0ng7) in a similarly uncritical way: no expert was asked to provide an evidence-based assessment and bring some reason into the discussion. Even the DAILY FAIL reported about the story, and predictably, critical assessment had to make way for sensationalism.

So what?

We hear about such nonsense almost every day!

True, but this case is different; it is based on a publication in the highly-respected BMJ (well, actually, it was the ‘BMJ CASE REPORTS’ and not the BMJ, as reported). Here is the article:

START OF QUOTE

A woman aged 57 years was initially diagnosed with monoclonal gammopathy of undetermined significance (MGUS) in 2007 following an incidental finding of M-protein (18 g/L) during investigation for hypertension.

Within 15 months, the patient had rapidly progressed to ISS stage 3 myeloma with M-protein 49 g/L, urinary protein 1.3 g/24-hour, Bence-Jones protein 1.0 g/24-hour, Hb 9.7 g/dL and increasing back pain. She initially declined antimyeloma treatment but 6 months later, following vertebral collapse at T5 and T12, started cyclophosphamide, thalidomide and dexamethasone (CTD) treatment. However, after a week, the patient was admitted with idiosyncratic syndrome including hyponatraemia, a fall in albumin and worsening of blood counts. She received red cell transfusion and her electrolyte abnormalities were carefully corrected.

Although there was evidence of a response to CTD (M-protein 34 g/L), bortezomib and dexamethasone treatment was initiated as an alternative, but this was discontinued after three cycles due to progressive disease (M-protein 49 g/L). The patient was then treated with lenalidomide and dexamethasone with the aim of reducing disease burden prior to high-dose therapy and autologous stem cell transplantation. Treatment was frequently interrupted and dose adjusted to account for neutropenia and despite a minor response after six cycles (starting M-protein 47 g/L, finishing M-protein 34 g/L), in October 2009, she proceeded with stem cell mobilisation. However, neither cyclophosphamide nor plerixafor/GCSF priming were successful. A bone marrow biopsy revealed 50% myeloma cells and a course of CTD was restarted with cautious titration of thalidomide.

The patient achieved a partial response with CTD retreatment over the course of 17 cycles (M-protein 13 g/L) with no further episodes of idiosyncratic syndrome. However, attempts to harvest stem cells in February 2011 and again there months later, both failed. By then, her M-protein had risen to 24 g/L and the patient was too neutropenic to be considered for a clinical trial.

At this point, the patient began a daily regime of oral curcumin complexed with bioperine (to aid absorption), as a single dose of 8 g each evening on an empty stomach. A few months later, she also embarked on a once-weekly course of hyperbaric oxygen therapy (90 min at 2 ATA) which she has maintained ever since. Her paraprotein levels gradually declined to a nadir of 13 g/L, her blood counts steadily improved and there was no evidence of further progressive lytic bone disease.

Outcome and follow-up

The patient continues to take oral curcumin 8 g daily without further antimyeloma treatment. Over the last 60 months, her myeloma has remained stable with minimal fluctuation in paraprotein level, her blood counts lie within the normal range and she has maintained good quality of life throughout this period. Repeat bone imaging in 2014 identified multiple lucencies <1 cm in the right hip and degenerative changes in both hips, but these were attributed to osteoarthritis rather than the myeloma. Recent cytogenetic analysis revealed she had no abnormal cytogenetics by fluorescent in situ hybridisation.

Discussion

A small but significant number of myeloma patients consume dietary supplements in conjunction with conventional treatment primarily to help cope with the side effects of treatment, manage symptoms and enhance general well-being. Few, if any, use dietary supplementation as an alternative to standard antimyeloma therapy. Here, we describe a case in which curcumin has maintained long-term disease control in a multiply-relapsed myeloma patient. To the best of our knowledge, this is the first report in which curcumin has demonstrated an objective response in progressive disease in the absence of conventional treatment.

Curcumin is a polyphenol derived from the perennial herb Curcuma longa (turmeric) and has, for centuries, been used as a traditional Indian medicine. Several reports published over the two decades have claimed various health benefits of curcumin and this has led to its increasing popularity as a dietary supplement to prevent or treat a number of different diseases.

The biological activity of curcumin is indeed remarkable. It is a highly pleiotropic molecule which possesses natural antioxidant, anti-inflammatory, antiseptic and analgesic properties. More recently, it has demonstrated antiproliferative effects in a wide variety of tumour cells including myeloma cells and exerts its antiproliferative effects through multiple cellular targets that regulate cell growth and survival.

In vitro, curcumin prevents myeloma cell proliferation through inhibition of IL-6-induced STAT-3 phosphorylation and through modulation of the expression of NF-kB-associated proteins such as IkB〈,Bcl-2, Bcl-xL, cyclin D1 and IL-6 and apoptosis-related molecules including p53 and Bax. In other studies, curcumin was shown to circumvent resistance to dexamethasone, doxorubicin and melphalan as well as potentiate the effects of bortezomib, thalidomide and lenalidomide. Furthermore, curcumin-induced cell death was not influenced by myeloma molecular heterogeneity.

The antimyeloma effects of curcumin in the clinical setting however are less clear. Only one phase I/II study has evaluated curcumin treatment in myeloma patients. These patients were either asymptomatic, relapsed or had plateau phase disease. Treatment with curcumin downregulated the expression of NFkB, COX-2 and STAT3 in peripheral blood mononuclear cells, but no objective responses were observed in any subgroup of patients. This may be as a result of small sample size in this study, follow-up was limited to 3 months and clinical responses may have been observed with longer follow-up. However, downregulation of NFkB, COX-2 and STAT3 expression may not correlate with the clinical activity of curcumin and there may be further mechanisms of action that remain unclear, possibly through the modulation of another target. We would not be able to identify any patient-specific mechanisms of activity in this case study, as the patient has been taking curcumin for some time now and baseline bone marrow or peripheral blood samples are not available. However, in the setting of a clinical trial, it may be possible to use next-generation sequencing to help identify a mutation that may be a potential target for curcumin.

Another study examined its effects in preventing the progression of MGUS and smouldering myeloma to myeloma. The results showed that curcumin exerted a trace of biological activity with modest decreases in free light chain and paraprotein levels and a reduction in a marker of bone resorption with curcumin treatment, suggesting the therapeutic potential of curcumin in MGUS and smouldering myeloma. However, more studies are needed to address this further.

Whether such effects are observed in patients with active disease remains to be seen. The fact that our patient, who had advanced stage disease and was effectively salvaged while exclusively on curcumin, suggests a potential antimyeloma effect of curcumin. She continues to take daily curcumin and remains in a very satisfactory condition with good quality of life. This case provides further evidence of the potential benefit for curcumin in myeloma. We would recommend further evaluation of curcumin in myeloma patients in the context of a clinical trial.

END OF QUOTE

What should we make of this?

I think that much of the reporting around the story was grossly irresponsible. It is simply not possible to conclude that curcumin was the cause of the remission. It could be due to a whole host of other factors. And a case report is just an anecdote; it never can prove anything and can only be used to stimulate further research.

I fully agree with the authors of the case report: curcumin seems worthy of further investigation. But recommending it to patients for self-medication is vastly premature and quite simply dangerous, unethical and naïve bordering on stupid.

And, of course, the above-cited drivel of Mike Adams is just beyond the pale – the evidence for ‘alternative cancer cures‘ is very, very far from ‘overwhelming’; and the ‘cancer industry’ is doing what they can to determine whether turmeric or any other natural remedy can be used to treat cancer and other diseases.

If they are ever successful, the Adams of this world will shout ‘EXPLOITATION!!!’

If their endeavours are not successful, they will complain ‘CONSPIRACY!!!’

11 Responses to “The cancer industry is a medical conspiracy against humanity” (The Turmeric story)

  • A small correction: the programme concerned was You and yours, which claims to be a consumers’ advocate, not Woman’s Hour. I heard this programme and thought it was deplorable. They said they contacted several doctors to appear but found none willing. In which case, they should have postponed the transmission until they did find someone available to talk sense. It’s not as if it was a hot issue; the case report was published in April, 2017!

    Reading the case report, I’m struck by the fact that the patient is also receiving regular hyperbaric oxygen treatment (another unproven favourite for cancer woo). So how does anyone know it’s the curcumin that’s holding the myeloma at bay and not the high-pressure oxygen?!

    A diagnosis of any cancer will result in several life-style changes for a victim. How does anyone know it’s not something totally other than the turmeric or the oxygen?! Or just a patient whose disease stabilizes for unknown reasons: it happens all the time.

    When so much escalation is made of a simple case report (I totally agree curcumin is worthy of further investigation) the journalists involved should be ashamed of themselves. That the case was presented on a programme that claims to champion consumer affairs puts the BBC in disgrace.

  • We cannot know how many people will be misled by the BBC’s uncritical reporting of this (alleged) story, but given the popularity and esteem of Radio 4, I think it is likely that many patients will waste their time and money on curcumin pills* – and there’s real risk that some will forgo or limit conventional (most effective) treatment as a consequence.
    *The woman who makes the claims about curcumin and her condition advised that the raw spice is inadequate and instead pills are required – which she admitted are very expensive.

  • Post hoc, ergo propter hoc!

  • Let me see if I got this right. About any and every conventional treatment available was thrown at this patient but after all this, it was clearly tumeric that “cured” her. Certainly it was not anything done earlier!

    Personally I’m betting on the hyperbaric oxygen treatment. It’s been “shown” to work for horses.

    On the other hand, after reading your post hyperbaric oxygen treatment which I missed earier, I think I will add a bit more turmeric to the chicken curry.

    Sheesh.

  • No surprise about the Daily Mail and Mike Adams picking the story up. The case study may make good copy, but represents execrable evidence of a miracle cancer cure. “Evidence” is not the right word for what this case study provides. “Story” is the correct word.

    The facts of the case report do not justify the authors’ claim that turmeric cured this patient’s cancer. Any more than hyperbaric oxygen, or any of treatments received before them.

    Peer review failed. The BBC should have dismantled the story. They failed too.

  • While it is fashionable on this blog to dismiss ALL natural cures to illness, it is old knowledge that Big Pharma and its sidekick, the FDA have been working together to try to stop natural cures for cancer, which is why many Americans go to Mexico and elsewhere for treatment. Natural cures are bad for business.

    If you get cancer, you have a choice between the Big Three (chemotherapy, radiation, and surgery) and natural cures, and we all know that you will die soon after treatment with the Big Three. If you have to pay for the treatment, your surviving family may find your life savings cleaned out.

    But changing to a plant-based diet combined with exercise alone can work wonders. There is a lot of evidence for this, and here is some:
    https://nutritionfacts.org/video/how-not-to-die-from-cancer/

    Natural cures have been curing people of cancer for decades, even if the readers of this blog cannot accept this. But if people here wish to choose the Big Three, then go ahead. Get your affairs in order first though, as they say.

    Finally, regarding turmeric and cucrcumin, perhaps you might like to look at this before dismissing it: https://nutritionfacts.org/video/topical-application-of-turmeric-curcumin-for-cancer/

    • @Peter

      You said

      While it is fashionable on this blog to dismiss ALL natural cures to illness…

      Wrong: only the natural cures unsupported by robust evidence.

      You carried on

      it is old knowledge that Big Pharma and its sidekick, the FDA have been working together to try to stop natural cures for cancer

      Please advise where you get this ‘old knowledge’ from. It’s news to me. Big Pharma would delight in developing any new cure for cancer, natural or otherwise. But it needs to be supported by robust evidence of efficacy.

      You ended the paragraph

      which is why many Americans go to Mexico and elsewhere for treatment. Natural cures are bad for business.

      Do you really imagine those Mexican ‘cancer cures’ are free? If so, more fool you. Many of the people seduced to Mexico for long-since-debunked cancer cures have to resort to crowd funding to pay the huge fees involved! Do you not realize that pseudo-medicine is very big business indeed? 34 billion dollars, according to a 2013 report, and expected to grow to almost $200 billion by 2025.

      Then you went on to say

      we all know that you will die soon after treatment with the Big Three.

      Sorry, Peter, we certainly don’t all know this. Try reading this document to discover how desperately wrong you are. For a start, what’s your definition of ‘soon’. My link states that 50% of people (in England and Wales) survived their cancers for 10 years or more, and those are figures for 2010–11, so they’re not even the most recent. Now, put up an argument, instead of your bloody videos: where are your comparable survival statistics for people who ingest food to treat any/all kinds of cancer?

  • Wow! Dr Greger has a dedicated public/media relations team made up of some very healthy looking – positively blooming – young people to help him realise his business model. I am sure they are all passionate about healthy eating. Long may they be so.

    I would not like to look at the video before dismissing it.

  • The results are in for the Big-Cancer industry 2000 – 2014. Interesting how India, with its abundance of Homeopaths, Ayurvedic cures and turmeric-laden diet is lagging behind. Wonder why?

    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33326-3/abstract

    I take the liberty of copy-pasting the entire summary here:

    Background
    In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival as a metric of the effectiveness of health systems and to inform global policy on cancer control. CONCORD-3 updates the worldwide surveillance of cancer survival to 2014.

    Methods
    CONCORD-3 includes individual records for 37·5 million patients diagnosed with cancer during the 15-year period 2000–14. Data were provided by 322 population-based cancer registries in 71 countries and territories, 47 of which provided data with 100% population coverage. The study includes 18 cancers or groups of cancers: oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast (women), cervix, ovary, prostate, and melanoma of the skin in adults, and brain tumours, leukaemias, and lymphomas in both adults and children. Standardised quality control procedures were applied; errors were rectified by the registry concerned. We estimated 5-year net survival. Estimates were age-standardised with the International Cancer Survival Standard weights.

    Findings
    For most cancers, 5-year net survival remains among the highest in the world in the USA and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway, and Sweden. For many cancers, Denmark is closing the survival gap with the other Nordic countries. Survival trends are generally increasing, even for some of the more lethal cancers: in some countries, survival has increased by up to 5% for cancers of the liver, pancreas, and lung. For women diagnosed during 2010–14, 5-year survival for breast cancer is now 89·5% in Australia and 90·2% in the USA, but international differences remain very wide, with levels as low as 66·1% in India. For gastrointestinal cancers, the highest levels of 5-year survival are seen in southeast Asia: in South Korea for cancers of the stomach (68·9%), colon (71·8%), and rectum (71·1%); in Japan for oesophageal cancer (36·0%); and in Taiwan for liver cancer (27·9%). By contrast, in the same world region, survival is generally lower than elsewhere for melanoma of the skin (59·9% in South Korea, 52·1% in Taiwan, and 49·6% in China), and for both lymphoid malignancies (52·5%, 50·5%, and 38·3%) and myeloid malignancies (45·9%, 33·4%, and 24·8%). For children diagnosed during 2010–14, 5-year survival for acute lymphoblastic leukaemia ranged from 49·8% in Ecuador to 95·2% in Finland. 5-year survival from brain tumours in children is higher than for adults but the global range is very wide (from 28·9% in Brazil to nearly 80% in Sweden and Denmark).

    Interpretation
    The CONCORD programme enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed worldwide every year. It contributes to the evidence base for global policy on cancer control. Since 2017, the Organisation for Economic Co-operation and Development has used findings from the CONCORD programme as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries worldwide. Governments must recognise population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer.

    Funding
    American Cancer Society; Centers for Disease Control and Prevention; Swiss Re; Swiss Cancer Research foundation; Swiss Cancer League; Institut National du Cancer; La Ligue Contre le Cancer; Rossy Family Foundation; US National Cancer Institute; and the Susan G Komen Foundation.

  • And here is the alternative[sic]

    https://academic.oup.com/jnci/article/110/1/121/4064136

    Abstract
    There is limited available information on patterns of utilization and efficacy of alternative medicine (AM) for patients with cancer. We identified 281 patients with nonmetastatic breast, prostate, lung, or colorectal cancer who chose AM, administered as sole anticancer treatment among patients who did not receive conventional cancer treatment (CCT), defined as chemotherapy, radiotherapy, surgery, and/or hormone therapy. Independent covariates on multivariable logistic regression associated with increased likelihood of AM use included breast or lung cancer, higher socioeconomic status, Intermountain West or Pacific location, stage II or III disease, and low comorbidity score. Following 2:1 matching (CCT = 560 patients and AM = 280 patients) on Cox proportional hazards regression, AM use was independently associated with greater risk of death compared with CCT overall (hazard ratio [HR] = 2.50, 95% confidence interval [CI] = 1.88 to 3.27) and in subgroups with breast (HR = 5.68, 95% CI = 3.22 to 10.04), lung (HR = 2.17, 95% CI = 1.42 to 3.32), and colorectal cancer (HR = 4.57, 95% CI = 1.66 to 12.61). Although rare, AM utilization for curable cancer without any CCT is associated with greater risk of death.

    (The emphasis is added)

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