MD, PhD, FMedSci, FSB, FRCP, FRCPEd

alternative therapist

Many posts on this blog have highlighted the fact that homeopathic remedies, when tested in rigorous RCTs, are demonstrably nothing more than pure placebos. Homeopaths, of course, negate this fact but here is a surprising bit of new evidence that further confirms it – and it comes from the highest authority in homeopathy: from Samuel Hahnemann himself!

A well known psychic has been in contact with the great doctor who consequently has dictated a letter to her. Here it is (it came in German, but I took the liberty of translating it into English):

TO ALL HOMEOPATHS OF THE WORLD

I have been watching what you have been doing with my noble healing art for some time now, and I cannot hold back any longer. Enough is enough. You are all fools, bloody fools!

Sceptics and scientists and anyone else who can read the research that has been done with those ‘randomised trials’ that the allopaths are currently so fond of should know that homeopathic medicines, as you monumental idiots employ them, are ineffective. The results of these studies are perfectly true. Instead of asking yourself what you are doing wrong and how you are disobeying my most explicit orders, you insist on doubting that these modern methods generate the truth. How incredibly stupid you are!

I have provided you with a detailed set of instructions – but does any of you pseudo-homeopaths follow them? No, no, no! You are all traitors and ignorant dilettantes. Read my Organon and follow what I wrote; there is no need to re-invent the rules.

Let me remind you what I said in the Organon; I made it perfectly clear that a person receiving homeopathy must have:

  • no coffee
  • no spices
  • no carbonated drinks
  • no use of perfumes
  • no smoked meat
  • no cheese
  • no duck
  • no shellfish
  • no large amounts of animal fat
  • no sausages
  • no spicy sauces
  • no pastries or cakes
  • no radishes
  • no celery
  • no onions or garlic
  • no parsley
  • no pepper
  • no mustard
  • no vanilla
  • no bitter almonds
  • no cloves
  • no cinnamon
  • no fennel
  • no anise
  • no green tea
  • no spiced chocolate
  • no liquors
  • no herbal teas
  • no tooth powder
  • no excessive labour
  • no mental exercise

That is simple enough, isn’t it? Or are you too moronic to follow even the simplest of instructions? As you constantly ignore my orders, how do you think my medicines can work?

Those who insist that the current evidence for homeopathy is negative are entirely correct. It is negative because you have been witless and incompetent! I have said it before and I say it again: HE WHO DOES NOT WALK ON EXACTLY THE SAME LINE WITH ME, WHO DIVERGES, IF IT BE BUT THE BREADTH OF A STRAW, TO THE RIGHT OR TO THE LEFT, IS AN APOSTATE AND A TRAITOR, AND WITH HIM I WILL HAVE NOTHING TO SAY.

Now, instead of finding excuses, go home and contemplate what I am telling you. Then do the right thing, conduct a randomised trial testing my proper method, and you will see.

I am very annoyed with all of you! And I am fast running out of patience.

Do as I say or become an allopath.

Sincerely angry

Samuel Hahnemann

At this point, I should admit that the letter was, of course, not written by the inventor of homeopathy but by me, Edzard Ernst. Yet it could have been written by him; historians invariably describe him as intolerant, cantankerous and inflexible. Crucially, the dietary instructions outlined in the letter are those of Hahnemann as outlined in the ‘Organon’, his ‘opus maximus’. If he could send a letter via a psychic, Hahnemann would certainly complain about his followers disobeying his orders and he most likely would do it in a most disgruntled tone (the sentence in capital letters is actually a quote from Hahnemann).

This post is a bit of innocent fun, sure. But it also has some relevance to today’s homeopathy, I hope: modern homeopaths make a big thing out of following Hahnemann’s gospel to the letter. But, if we look carefully, we find that they only follow some of it, while ignoring entire sections of what their ‘über-guru’ told them. They argue that these bits are useless or erroneous or implausible and they want to be seen to be scientific and evidence-based. The obvious truth, however, is that everything Hahnemann has ever written about homeopathy is useless, erroneous and implausible and nothing of it is scientific or evidence-based. Homeopaths should draw the only possible conclusion and ignore the lot!

My 2008 evaluation of chiropractic concluded that the concepts of chiropractic are not based on solid science and its therapeutic value has not been demonstrated beyond reasonable doubt. It also pointed out that the advice of chiropractors often is dangerous and not in the best interest of the patient: many chiropractors have a very disturbed attitude towards immunisation: anti-vaccination attitudes till abound within the chiropractic profession. Despite a growing body of evidence about the safety and efficacy of vaccination, many chiropractors do not believe in vaccination, will not recommend it to their patients, and place emphasis on risk rather than benefit.

In case you wonder where this odd behaviour comes from, you best look into the history of chiropractic. D. D. Palmer, the magnetic healer who ‘invented’ chiropractic about 120 years ago, left no doubt about his profound disgust for immunisation: “It is the very height of absurdity to strive to ‘protect’ any person from smallpox and other malady by inoculating them with a filthy animal poison… No one will ever pollute the blood of any member of my family unless he cares to walk over my dead body… ” (D. D. Palmer, 1910)

D. D. Palmer’s son, B. J. Palmer (after literally walking [actually it was driving] over his father’s body)  provided a much more detailed explanation for chiropractors’ rejection of immunisation: “Chiropractors have found in every disease that is supposed to be contagious, a cause in the spine. In the spinal column we will find a subluxation that corresponds to every type of disease… If we had one hundred cases of small-pox, I can prove to you, in one, you will find a subluxation and you will find the same condition in the other ninety-nine. I adjust one and return his function to normal… There is no contagious disease… There is no infection…The idea of poisoning healthy people with vaccine virus… is irrational. People make a great ado if exposed to a contagious disease, but they submit to being inoculated with rotten pus, which if it takes, is warranted to give them a disease” (B. J. Palmer, 1909)

Such sentiments and opinions are still prevalent in the chiropractic profession – but today they are expressed in a far less abrupt, more politically correct language: The International Chiropractors Association recognizes that the use of vaccines is not without risk. The ICA supports each individual’s right to select his or her own health care and to be made aware of the possible adverse effects of vaccines upon a human body. In accordance with such principles and based upon the individual’s right to freedom of choice, the ICA is opposed to compulsory programs which infringe upon such rights. The International Chiropractors Association is supportive of a conscience clause or waiver in compulsory vaccination laws, providing an elective course of action for all regarding immunization, thereby allowing patients freedom of choice in matters affecting their bodies and health.

Not all chiropractors share such opinions. The chiropractic profession is currently divided over the issue of immunisation. Some chiropractors now realise that immunisations have been one of the most successful interventions ever for public health. Many others, however, do still vehemently adhere to the gospel of the Palmers.  Statements like the following abound:

Vaccines. What are we taught? That vaccines came on the scene just in time to save civilization from the ravages of infectious diseases. That vaccines are scientifically formulated to confer immunity to certain diseases; that they are safe and effective. That if we stop vaccinating, epidemics will return…And then one day you’ll be shocked to discover that … your “medical” point of view is unscientific, according to many of the world’s top researchers and scientists. That many state and national legislatures all over the world are now passing laws to exclude compulsory vaccines….

Our original blood was good enough. What a thing to say about one of the most sublime substances in the universe. Our original professional philosophy was also good enough. What a thing to say about the most evolved healing concept since we crawled out of the ocean. Perhaps we can arrive at a position of profound gratitude if we could finally appreciate the identity, the oneness, the nobility of an uncontaminated unrestricted nervous system and an inviolate bloodstream. In such a place, is not the chiropractic position on vaccines self-evident, crystal clear, and as plain as the sun in the sky?

Yes, I do agree: the position of far too many chiropractors is ‘crystal clear’ – unfortunately it is also dangerously wrong.

Times are hard, also in the strange world of chiropractic, I guess. What is therefore more understandable than the attempt of chiropractors to earn a bit of money from people who want to lose weight? If just some of the millions of obese individuals could be fooled into believing that chiropractic is the solution for their problem, chiropractors across the world could be laughing all the way to the bank.

But how does one get to this point? Easy: one only needs to produce some evidence suggesting that chiropractic care is effective in reducing body weight. An extreme option is the advice by one chiropractor to take 10 drops of a homeopathic human chorionic gonadotropin product under the tongue 5 times daily. But, for many chiropractors, this might be one step too far. It would be preferable to show that their hallmark therapy, spinal adjustment, leads to weight loss.

With this in mind, a team of chiropractors performed a retrospective file analysis of patient files attending their 13-week weight loss program. The program consisted of “chiropractic adjustments/spinal manipulative therapy augmented with diet/nutritional intervention, exercise and one-on-one counselling.”

Sixteen of 30 people enrolled completed the program. At its conclusion, statistically and clinically significant changes were noted in weight and BMI measures based on pre-treatment (average weight = 190.46 lbs. and BMI = 30.94 kg/m(2)) and comparative measurements (average weight = 174.94 lbs. and BMI = 28.50 kg/m(2)).

According to the authors of this paper, “this provides supporting evidence on the effectiveness of a multi-modal approach to weight loss implemented in a chiropractic clinic.”

They do not say so, but we all know it, of course: one could just as well combine knitting or crossword puzzles with diet/nutritional intervention, exercise and one-on-one counselling to create a multi-modal program for weight loss showing that knitting or crossword puzzles are effective.

With this paper, chiropractors are not far from their aim of being able to mislead the public by claiming that CHIROPRACTIC CARE IS A NATURAL, SAFE, DRUG-FREE AND EFFECTIVE OPTION IN THE MANAGEMENT OF OBESITY.

Am I exaggerating? No, of course not. There must be thousands of chiropractors who have already jumped on the ‘weight loss band-waggon’. If you don’t believe me, go on the Internet and have a look for yourself. One of the worst sites I have seen might be ‘DOCTORS GOLDMINE’ (yes, most chiropractors call themselves ‘doctor these days!) where a chiropractor promises his colleagues up to $100 000 per month extra income, if they subscribe to his wonderful weight-loss scheme.

It would be nice to be able to believe those who insist that these money-grabbing chiropractors are but a few rotten apples in a vast basket of honest practitioners. But I have problems with this argument – there seem to be far too many rotten apples and virtually no activity or even ambition to get rid of them.

Some time ago, I published a post entitled HOW TO BECOME A CHARLATAN. This prompted ‘THE NORWEGIAN ACADEMY OF SCIENCE AND LETTERS’ to invite me to give a lecture on the subject, a great honour, I am sure. Consequently, I have thought about this somewhat unusual subject quite a lot.

Obviously, my thoughts come from the perspective of someone who has researched alternative medicine for many years. Pseudoscientists seem to love alternative medicine and proponents of alternative medicine love pseudoscience. As a result, alternative medicine is densely populated by pseudoscientists.

But what is the characteristic of pseudoscience? Reflecting on this question, I found not one but several hallmarks (and for each of them, there are many posts on this blog which provide further explanations):

Based on these 12 hallmarks, one could create a simple score which indicates the likelihood of the presence of pseudoscience. In other words, it might be useful to consider pseudoscience in terms of a sliding scale. Some things in alternative medicine can be just a bit pseudoscientific, others quite a lot, while others again are hopelessly so.

The issue of pseudoscience is by no means just academic; it is very real problem and has many important, practical implications. The most important one probably is that, in health care (and other areas as well), pseudoscience can be harmful, even to the point that it costs lives of vulnerable patients who believe that everything masquerading as science can be relied upon.

In all walks of life, we have complete nutters who claim utter nonsense – in homeopathy probably more than in other areas. I knew that for quite some time, of course, but what I discovered on ‘the world’s leading homeopathy portal’ was still somewhat of a revelation to me: the overt promotion of homeopathy as an alternative cancer cure!

Hard to believe? See for yourself!

What follows (in italics) are excerpts from a long and detailed interview with a homeopathic physician published on this website.

Q: What does a typical treatment day look like for the patient?

A: Treatment starts with a comprehensive anamnesis that lasts several hours and includes the entire history of the patient till the occurrence of the tumor. This is followed by the analysis and evaluation of symptoms to find the basic homeopathic remedy [2] and the presently indicated remedy of the patient. We search for remedies for possible miasmatic blockages and also tumor specific remedies. We keep an eye on all iatrogenic damages caused by chemotherapy or radiation and try to have remedies at hand. When these complex considerations are finished an individual treatment concept is worked out. We prepare a list of parameters together with the patient that includes all currently present and disturbing symptoms such as pain, sleep disturbances, appearance and extent of the tumor, psychic problems like anxiety and grief etc. We also include laboratory values such as tumor markers, the erythrocyte sedimentation rate and blood pressure as important control parameters.

After applying the homeopathic remedy, usually in Q-potency, we analyze the patient’s symptoms daily to check their reaction to the remedy. It is very important to assess the patient’s reaction to the Q-potency as the development of symptoms shows us how to proceed with their treatment. The big advantage in the hospital is that we can observe our patients daily and investigate their reaction to the Q potency…

Q: I wish more homeopathic hospitals would be built here in Europe and worldwide! Where do you see the main problems for the establishment of homeopathic hospitals and which difficulties did you have to overcome?

A: A broader acceptance of homeopathy is necessary. Many health insurances still refuse to pay the costs, even though homeopathy is much cheaper than conventional cancer treatment with its chemotherapy or radiation.

I think outpatient clinics should be built first, where cancer patients can be treated without the necessary investment in hospitals. Orthodox medicine and the pharma industry should be open for cooperation with homeopathic physicians…

When homeopathic treatment is successful in rebuilding the immune system and reestablishing the basic regulation of the organism then tumors can disappear again. I’ve treated more than 1000 cancer patients homeopathically and we could even cure or considerably ameliorate the quality of life for several years in some, advanced and metastasizing cases.

Q: Do you include chemotherapy and radiation in your treatment?

A: Orthodox medicine considers the tumor to be a mass of abnormal cells which has to be combated. But it is important to know that the immune system has been disturbed long before the tumor appeared. We try to activate the immune system and to initiate an immune modulation by means of homeopathy. If this is successful tumors can disappear again. I have a very critical view of chemotherapy and radiation as the benefit is often very small and they diminish the chance of a real cure. Radiation can be useful in cases where metastases have invaded the spinal column and there is danger of fracture or there are already some broken vertebral bodies.

Chemotherapy may be useful in children suffering from leukemia, in Hodgkins-Lymphoma, testicular cancer and some forms of ovarian tumors. But these types of cancer only constitute 6% of all tumors. In all other types of cancer the benefit is more doubtful. We apply chemotherapy to gain some time in patients acutely affected by very rapidly growing tumors. But how can chemotherapy or radiation cure a patient ? It is only the immune system that can recognize the damaged DNA of the tumor cell and combat the tumor. However, the more chemotherapy the patient gets the more their immune system is weakened.

A: Yes, even in incurable cases homeopathy can help palliate without detrimental side effects.Even if our primary goal is to cure and prevent cancer, many patients are far beyond this stage. You describe some successfully treated patients with long time follow up in your book. Do any particular cases stand out in your memory?

JW: There are many cases I recall. These are the moments when you are sitting together with the patient to do the case anamnesis, hearing their history and feeling their despair when they were given up “officially” by orthodox medicine.

Now, tell me again that homeopathy is not dangerous – its remedies might be relatively harmless, but its practitioners certainly aren’t.

Imagine an area of therapeutics where 100% of all findings of hypothesis-testing research is positive, i.e. comes to the conclusion that the treatment in question is effective. Theoretically, this could mean that the therapy is a miracle cure which is useful for every single condition in every single setting. But sadly, there are no miracle cures. Therefore something must be badly and worryingly amiss with the research in an area that generates 100% positive results.

Acupuncture is such an area; we and others have shown that Chinese trials of acupuncture hardly ever produce a negative finding. In other words, one does not need to read the paper, one already knows that it is positive – even more extreme: one does not need to conduct the study, one already knows the result before the research has started. But you might not believe my research nor that of others. We might be chauvinist bastards who want to discredit Chinese science. In this case, you might perhaps believe Chinese researchers.

In this systematic review, all randomized controlled trials (RCTs) of acupuncture published in Chinese journals were identified by a team of Chinese scientists. A total of 840 RCTs were found, including 727 RCTs comparing acupuncture with conventional treatment, 51 RCTs with no treatment controls, and 62 RCTs with sham-acupuncture controls. Among theses 840 RCTs, 838 studies (99.8%) reported positive results from primary outcomes and two trials (0.2%) reported negative results. The percentages of RCTs concealment of the information on withdraws or sample size calculations were 43.7%, 5.9%, 4.9%, 9.9%, and 1.7% respectively.

The authors concluded that publication bias might be major issue in RCTs on acupuncture published in Chinese journals reported, which is related to high risk of bias. We suggest that all trials should be prospectively registered in international trial registry in future.

I applaud the authors’ courageous efforts to conduct this analysis, but I do not agree with their conclusion. The question why all Chinese acupuncture trials are positive has puzzled me since many years, and I have quizzed numerous Chinese colleagues why this might be so. The answer I received was uniformly that it would be very offensive for Chinese researchers to conceive a study that does not confirm the views held by their peers. In other words, acupuncture research in China is conducted to confirm the prior assumption that this treatment is effective. It seems obvious that this is an abuse of science which must cause confusion.

Whatever the reasons for the phenomenon, and we can only speculate about them, the fact has been independently confirmed several times and is now quite undeniable: acupuncture trials from China – and these constitute the majority of the evidence-base in this area – cannot be trusted. The only way to adequately deal with this problem that I can think of is to discard them outright.

A recent US study found that belief in conspiracy theories is rife in health care. The investigators presented people with 6 different conspiracy theories, and the one that was most widely believed was the following:

THE FOOD AND DRUG ADMINISTRATION IS DELIBERATELY PREVENTING THE PUBLIC FROM GETTING NATURAL CURES FOR CANCER AND OTHER DISEASES BECAUSE OF PRESSURE FROM DRUG COMPANIES.

A total of 37% agreed with this statement, 31% had no opinion on the matter, and 32% disagreed. What is more, the belief in this particular conspiracy correlated positively with the usage of alternative medicine.

Essentially, this implies that the current popularity of alternative medicine is at least partly driven by the conviction that there is a sinister plot by the FDA or more generally speaking ‘the establishment’ that prevents people from benefitting from the wonders of alternative treatments.

I think it was Woody Allen who noted that, just because you are paranoid does not mean that they are not following you. So, let’s look for evidence suggesting that the FDA or any similar organisation is suppressing alternative medicine.

A prime candidate is, of course, the often implicated, thoroughly evil ‘BIG PHARMA‘. I am not a fan of the pharmaceutical industry and I know few people who are. But where is the evidence for BIG PHARMA’s conspiracy against alternative medicine? In the many years of researching this sector, I have never come across a jot of evidence to support this notion. On the contrary, BIG PHARMA seems all to keen to jump on to the alternative bandwagon and make a few quick bucks from the gullibility of the consumer.

What about the rest of the medical establishment? All I see is that universities, hospitals, charities and other organisations in health care currently bend over backwards in order to accommodate as much alternative medicine as they possibly can get away with in view of the often embarrassing lack of convincing evidence for the treatments in question. Conspiracy against alternative medicine? I don’t think so.

The closer we look, the more we arrive at the conclusion that the conspiracy against alternative medicine is a myth and a figment of the imagination of those who religiously believe in alternative medicine. They seem to long for an explanation why their favourite therapy is not in even more wide-spread use. Cognitive dissonance seems to prevent them to consider that the lack of evidence has anything to do with this situation. Consequently, they prefer to invent a conspiracy theory.

And this is where an interesting question emerges, in my view: do people who believe that the FDA or other organisations prevent the public from getting more alternative medicine really need more alternative medicine, or do they perhaps just need an effective treatment for their paranoia?

It is not often that we see an article of the great George Vithoulkas, the ‘über-guru‘ of homeopathy, in a medical journal. In fact, this paper, which he co-authored with several colleagues, seems to be a rare exception: in his entire career, he seems to have published just 15 Medline- listed articles most of which are letters to the editor.

According to Wikipedia, Vithoulkas has been described as “the maestro of classical homeopathy” by Robin Shohet; Lyle Morgan says he is “widely considered to be the greatest living homeopathic theorist”; and Scott Shannon calls him a “contemporary master of homeopathy.” Paul Ekins credited Vithoulkas with the revival of the credibility of homeopathy.

In his brand new paper, Vithoulkas provides evidence for the notion that homeopathy can treat infertility. More specifically, the authors present 5 cases of female infertility treated successfully with the use of homeopathic remedies.

Really?

Yes, really! The American Medical College of Homeopathy informs us that homeopathy has an absolute solution that can augment your probability of conception. Homeopathic treatment of Infertility addresses both physical and emotional imbalances in a person. Homeopathy plays a role in treating Infertility by strengthening the reproductive organs in both men and women, by regulating hormonal balance, menstruation and ovulation in women, by escalating blood flow into the pelvic region, by mounting the thickness of the uterine lining and preventing the uterus from contracting hence abating chances of a miscarriage, and by increasing quality and quantity of sperm count in men. It can also be advantageous in reducing anxiety so that the embryo implantation can take place in a favourable environment. Homoeopathy is a system of medicine directed at assisting the body’s own healing process.

Imagine: the 5 women in Vithoulkas ‘study’ wanted to have children; they consulted homeopaths because they did not get pregnant in a timely fashion. The homeopaths prescribed individualised homeopathy and treated them for prolonged periods of time. Eventually, BINGO!, all of the 5 women got pregnant.

What a hoot!

It beggars belief that this result is being credited to the administration of homeopathic remedies. Do the authors not know that, in many cases, it can take many months until a pregnancy occurs? Do they not think that the many women they treated unsuccessfully for the same problem should raise some doubts about homeopathy? Do they really believe that their remedies had any causal relationship to the 5 pregnancies?

Vithoulkas was a recipient of the Right Livelihood Award in 1996. I hope they did not give it to him in recognition of his scientific achievements!

 

 

As promised in the last post, I will try to briefly address the issues which make me uncomfortable about the quotes by Anthony Campbell. Readers will recall that Campbell, an ex-director of what was arguably the most influential homeopathic hospital in the world and a long-time editor of the journal HOMEOPATHY, freely admitted that homeopathy was unproven and its effects were most likely not due to any specific properties of the homeopathic remedies [which are, in fact, pure placebos] but largely rely on non-specific effects.

I agree with much that Campbell wrote but I disagree with one particular implication of his conclusions:Homeopathy has not been proved to work but neither has it been conclusively disproven….” and “…it is impossible to say categorically that all the remedies are without objective effect…”

This is an argument, we hear from proponents of alternative medicine with unfailing regularity:MY TREATMENT MAY NOT BE SUPPORTED BY GOOD SCIENCE [BECAUSE GOOD SCIENCE IS EXPENSIVE, AND WE CANNOT AFFORD IT] BUT IT HAS NOT BEEN DISPROVEN EITHER – AND, AS LONG AS IT IS NOT DISPROVEN, NOBODY SHOULD STOP US USING IT”

Campbell does not explicitly draw this latter conclusion but he certainly implies it. In his book, he explains that, even though homeopathic remedies probably are placebos, homeopathy does a lot of good through the placebo effect and through its spiritual aspects. And that is, in his view, sufficient reason to employ it for healing the sick. The very last sentence of his book reads: “Love it or loathe it, homeopathy is here to stay”

So the implication is there: alternative therapies can be as bizarre, nonsensical, implausible, unscientific or idiotic as they like, if we scientists cannot disprove them, they must be legitimate for general use. But there are, of course, two obvious errors in this line of reasoning:

  1. Why on earth should scientists waste their time and resources on testing notions which are clearly bonkers? It is hard to imagine research that is less fruitful than such an endeavour.
  2. Disproving homeopathy [or similarly ridiculous treatments] is a near impossibility. Proving a negative is rarely feasible in science.

In the best interest of patients, responsible health care has to follow an entirely different logic: we must consider any treatment to be unproven, while it is not supported with reasonably sound evidence for effectiveness; and in clinical routine, we employ mostly such treatments which are backed by sound evidence, and we avoid those that are unproven. In other words, whether homeopathy or any other medicine is unproven or disproven is of little practical consequence: we try not to use either category.

While I applaud Campbell’s candid judgement regarding the lack of effectiveness of homeopathic remedies, I feel the need to finish his conclusion for him giving it a dramatically different meaning: Homeopathy has not been proved to work but neither has it been conclusively disproven; this means that, until new evidence unambiguously demonstrates otherwise, we should classify homeopathy as ineffective – and this, of course, applies not just to homeopathy but to ALL unproven interventions.

These days, there is so much hype about alternative cancer treatments that it is hard to find a cancer patient who is not tempted to try this or that alternative medicine. Often it is employed without the knowledge of the oncology team, solely on the advice of non-medically qualified practitioners (NMPs). But is that wise? The aim of this survey was to find out.

Members of several German NMP-associations were invited to complete an online questionnaire. The questionnaire explored areas such as the diagnosis and treatment, goals for using complementary/alternative medicine (CAM), communication with the oncologist, and sources of information.

Of a total of 1,500 members of the NMP associations, 299 took part in this survey. The results show that the treatments employed by NMPs were heterogeneous. Homeopathy was used by 45% of the NMPs, and 10% believed it to be a treatment directly against cancer. Herbal therapy, vitamins, orthomolecular medicine, ordinal therapy, mistletoe preparations, acupuncture, and cancer diets were used by more than 10% of the NMPs. None of the treatments were discussed with the respective physician on a regular basis.

The authors concluded from these findings that many therapies provided by NMPs are biologically based and therefore may interfere with conventional cancer therapy. Thus, patients are at risk of interactions, especially as most NMPs do not adjust their therapies to those of the oncologist. Moreover, risks may arise from these CAM methods as NMPs partly believe them to be useful anticancer treatments. This may lead to the delay or even omission of effective therapies.

Anyone faced with a diagnosis of CANCER is understandably keen to leave no stone unturned to bring about a cure of the disease. Many patients thus go on to the Internet and look what alternative options are on offer. There they find virtually millions of sites advertising thousands of bogus cancer ‘cures’. Others consult their alternative practitioners and seek help. This new survey shows yet again that the advice they receive is dangerous. In fact, it might well be even more dangerous than the results imply: the response rate of the survey was dismal, and I fear that the less responsible NMPs tended not to reply.

None of the treatments listed above can cure cancer. For instance, homeopathy, the most popular alternative cancer treatment in Germany, will have no effect whatsoever on the natural history of the disease. To claim otherwise is criminally irresponsible.

But far too many patients are unaware of the evidence and of the dangers of being misled by bogus claims. What we need, I think, is a major campaign to get the word out. It would be a campaign that saves lives!

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