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

Cancer

This survey evaluated the attitude of healthcare professionals toward the use of so-called alternative medicine (SCAM) to improve current care. A questionnaire on the current practice and opinions about SCAM use was sent to healthcare professionals in Amsterdam UMC, who work for the department of hematology or oncology. Oncologists, hematologists, residents, (specialized) nurses, dieticians, (hospital)pharmacists, and pharmacy technicians were asked to participate.

Among eligible healthcare professionals, 77 responded to the questionnaire (34%). Overall, 87% of healthcare
professionals indicated it is important to be aware of their patient’s SCAM use, and all find the potential of drug–herb interactions important. However, more than half of the healthcare professionals inquire about the patient’s SCAM use infrequently. In addition, only 15% of the healthcare professionals stated they had sufficient knowledge of SCAM to advise patients on their use of SCAM.

The authors concluded that healthcare professionals are aware of the potential risks of SCAM use in combination with anti-cancer treatment. However, SCAM use is not yet discussed with every patient. This may be due to healthcare professionals’ lack of knowledge about SCAM.

This survey would in itself be fairly irrelevant; it employed only a tiny convenience sample and its findings cannot be generalized. Yet, it produced results that have been shown dozens of times before, and it might therefore be a good idea to remind ourselves of their relevance and implications.

  • Patients use SCAM whether we want it or not.
  • Contrary to what is often said, SCAM is not harmless.
  • Therefore conventional healthcare professionals need to know about their patients’ SCAM use.
  • To find out, healthcare professionals need to ask specific questions about SCAM.
  • Next, they must advise their patients responsibly (this is an ethical obligation, not a choice).
  • In order to do that they need to learn the essentials about SCAM.
  • Failing to do this means failing their patients.

Following the death from cancer of a 14-year-old Carinthian girl, the Klagenfurt public prosecutor’s office has launched an investigation against the girl’s parents. In February this year, the 14-year-old was taken to a hospital in Graz, Austria, where she died a few days later from cancer. The hospital filed charges because the tumor had been treated incorrectly with so-called alternative medicine (SCAM).

Investigations are underway on suspicion of torturing or neglecting underage, younger, or defenseless persons. Currently, the accused and witnesses are being questioned. The parents’ lawyer, Alexander Todor-Kostic, stated that the accusations were without any basis and claimed that the 14-year-old girl had decided of her own free will against being treated with chemotherapy and surgery. The parents respected this, allowed her alternative treatment methods, and acted in accordance with the applicable legal situation.

The girl had developed cancer the previous year that was not detected. Instead of seeing conventional oncologists for a reliable diagnosis and effective treatments, the parents consulted private doctors. Instead of chemotherapy, radiation, and surgery, the girl had deliberately chosen “alternative treatments” herself, the lawyer stressed.

Even though the case has been reported in several Austrian papers, I did not succeed in finding further details about it. In particular, it is unclear what type of cancer the girl had been suffering from and what type of SCAMs she received.

The Austrian skeptic Christian Kreil commented: “Sugar pills in the pharmacies, homeopathic advanced training for doctors, a proliferation of energetics offering every conceivable bullshit … the dead girl is the logical result of this esoteric foolishness covered by politics and chambers.”

I am afraid that he might have a point here: as we have discussed repeatedly on this blog, Austria is currently particularly prone to misinformation about SCAM. Here are a few examples of previous blog posts on this subject:

Misinformation about SCAM can be lethal. This is one of the reasons why responsible information is so very important.

Seventeen years after S.K. lost his thyroid gland to cancer, he was promised a miracle by Kyung Chun Oh, an acupuncturist based in the Toronto area: acupuncture could regrow the vital organ. Oh told his patient it would only work if S.K. stopped the thyroid medication he’d been on since his surgery in 2003.

Within just a few months the patient had to be admitted to hospital with a life-threatening case of hypothyroidism. His thyroid had not regenerated. “It was fortunate that the patient did not die,” a college panel wrote in a disciplinary decision, suspending Oh’s license for 12 months. “Telling the patient that he should not take his thyroid medication was irresponsible and had disastrous repercussions.”

The panel found that Oh had engaged in professional misconduct in multiple ways:

  • he had provided unnecessary treatment,
  • he had failed to advise his patient to consult a medical doctor when he learned that S.K. was suffering
    from symptoms that he knew or ought to have known indicated an urgent medical problem,
  • he had treated a condition that he ought to have known that he did not have the knowledge, skills, or judgment to treat,
  • he had failed to keep records in accordance with the standards of the profession,
  • he had falsified a record relating to his practice,
  • he had made a claim about a treatment that could not be supported by reasonable professional opinion (the claim that acupuncture combined with cessation of thyroid medicine could regrow a surgically removed thyroid gland, and the claim that S.K.’s thyroid gland was regrowing).

This is clearly an extreme incidence of misconduct and one would hope that such cases occur only rarely. But looking at the points listed above, I get the feeling that similar yet less severe cases of misconduct happen regularly in the practices of SCAM practitioners:

  • most so-called alternative medicine (SCAM) treatments are unnecessary,
  • SCAM practitioners refer patients only rarely to doctors,
  • SCAM practitioners often treat conditions that they fail to understand adequately,
  • SCAM practitioners frequently make unreasonable claims.

 

 

The claim that homeopathy has a role in oncology does not seem to go away. Some enthusiasts say it can be used as a causal therapy, while others insist it might be a helpful symptomatic adjuvant. Almost all oncologists agree that homeopathy has no place at all in cancer care.

Who is right?

This systematic review included clinical studies from 1800 until 2020 to evaluate evidence of the effectiveness of homeopathy on physical and mental conditions in patients during oncological treatment.

In February 2021 a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and Medline) to find studies concerning use, effectiveness, and potential harm of homeopathy in cancer patients.

From all 1352 search results, 18 studies with 2016 patients were included in this SR. The patients treated with homeopathy were mainly diagnosed with breast cancer. The therapy concepts included single and combination homeopathic remedies (used systemically or as mouth rinses) of various dilutions. The outcomes assessed were:

  • the influence on toxicity of cancer treatment (mostly hot flashes and menopausal symptoms),
  • the time to drain removal in breast cancer patients after mastectomy,
  • survival,
  • quality of life,
  • global health,
  • subjective well-being,
  • anxiety and depression,
  • safety and tolerance.

The included studies reported heterogeneous results: some studies described significant differences in quality of life or toxicity of cancer treatment favoring homeopathy, whereas others did not find an effect or reported significant differences to the disadvantage of homeopathy or side effects caused by homeopathy. The majority of the studies had low methodological quality.

The authors concluded that, the results for the effectiveness of homeopathy in cancer patients are heterogeneous, mostly not significant and fail to show an advantage of homeopathy over other active or passive comparison groups. No evidence can be provided that homeopathy exceeds the placebo effect. Furthermore, the majority of the included studies shows numerous and severe methodological weaknesses leading to a high level of bias and are consequently hardly reliable. Therefore, based on the findings of this SR, no evidence for positive effectiveness of homeopathy can be verified.

This could not be clearer. Some might argue that, of course, homeopathy cannot change the natural history of cancer, but it might improve the quality of life of those patients who believe in it via a placebo response. I would still oppose this notion: there are many effective treatments in the supportive treatment of cancer, and it seems much better to use those options and tell patients the truth about homeopathy.

A German newspaper reported the experience of two journalists who went undercover to consult several practitioners of so-called alternative medicine to receive treatment for Hodgkin lymphoma. Here are several passages from their important article (my translation, my bolding)

… Doctor Uwe Reuter invites us in. He is sitting behind an iMac on which he sometimes shows me pictures of his therapies. He is around 50, tall and lean, his face looks particularly serious through frameless glasses. I tell him my story. He listens attentively, and then it seems for a while as if he can’t decide what to advise me. Finally, he has it: I should first do a “diagnostic series” in his clinic, three or even better five days, for about 1000 Euros. This would include “electromagnetic measurements” for the “energy balance of individual organs”. Only then can he determine which therapy might be indicated in my case. “Hypnosis, homeopathy, vitamin B17 infusions” will probably play a role, says Reuter, and a “fever therapy” in which I will be injected with dead bacteria.

“In addition to chemotherapy or alone?”, I ask. The doctor says he can’t make this decision for me, I should make it from my “inside”. I have to understand that my illness does not come from the outside and that therapies only have a supporting effect – the healing “has to come from within”.

… In the end, Reuter suggests postponing chemotherapy for a quarter of a year and using his therapy to “push aside everything that prevents healing” – toxins, distractions, and fears. The cost? Around 10,000 Euros for the entire therapy…

[Next doctor is] the well-known alternative doctor Klaus Maar in Düsseldorf…  His wrinkled face is dominated by a large nose, his hair is enviably thick and black for a man of his age. “Well,” he says in his comforting voice, “why don’t you describe what happened to you?” I am nervous. Will he believe that I am terminally ill? I stammer and tell my story. He listens to me, looks at me, answers calmly, and takes his time – and attention that few orthodox doctors can afford today, which is one of the reasons that drive people into the arms of alternative healers.

Finally, Maar advises a “heat therapy” in which the tumor is heated locally. Yet Klaus Maar is still one of the more serious healers. He does not directly advise against chemotherapy, but warns about the side effects. In the end, he recommends postponing it for a fortnight and starting the 8,000-euro heat treatment as soon as possible. “But don’t delay, don’t blame me and say I delayed the chemotherapy,” Maar says. I guess that’s his way of hedging his bets: If he were to successfully dissuade me from chemotherapy, my family could sue him one day. I come across such phrases again and again.

… next visit; the alternative practitioner Ursula Stoll specializes in “Germanic New Medicine”. Ryke Geerd Hamer, a former doctor, founded this doctrine in the early 1980s as a reaction to “Jewish” orthodox medicine. No wonder it enjoys great popularity in völkisch circles. Hamer’s abstruse and dangerous theories led to the withdrawal of his license. He continued to practice illegally, however, and several of his patients died… Even Ursula Stoll thinks he was crazy – but not his theory…  Stoll practices in Öhringen, an idyllic little town north of Stuttgart, in her nondescript detached house. She wears a white shirt and horn-rimmed glasses, her brown hair pinned back in a plait, an accurate governess with a stern look.

As I tell her about my suffering, she quickly interrupts me: “What is cancer?” she asks. We have to get rid of the term. There is no such thing as cancer. All I have is a swelling of the lymph nodes in my neck. That’s all. The cause: a self-deprecation of a professional nature. In my case, there is also an existential fear, and like a fish on land, I store water in my body in order to survive. Hence the swollen lymph nodes. Metastases? There are none. The medical report? She skims over it casually and asks: Did you sweat when you were sick? Did the sweat smell? Did it have a color? Where exactly was the itch?

I tell her about the lecture I gave and that my boss didn’t like. Yes! That could be the reason for the cancer. She says my symptoms are a reaction to this slight, my body is trying to heal itself, but the first chemotherapy interrupted and disrupted the process. Her advice to beat the cancer: I should move back in with my parents, life as a single person is too much for me, Berlin is a terrible city anyway… I ask again about chemotherapy. “I personally wouldn’t do it,” she says, “and for my children and my parents I would decide the same.” There it is again, this nappy-soft formulation with which the healers evade their legal responsibility. One more question: isn’t it dangerous to forego chemotherapy? The alternative practitioner Ursula Stoll: “Humans can withstand a lot.”

… Since the spiritual healers Wolfgang Bittscheidt and Teresa Schuhl were favorably discussed on German TV, their practice in Siegburg near Bonn has enjoyed great popularity: appointments are made only months in advance. When we are asked into the treatment room, it is dark, the blinds are half closed. A candle burns on the dark wooden desk. Teresa Schuhl is blond, has blue eyes, and seems cool and aloof, gesticulating strangely with her hands. She whispers more than she speaks; I have to lean forward to understand her. Her advice? “If you were my son right now, I would say, hands off chemo!” For herself, she would decide the same. “One possibility is vitamin B17. Have you heard of it?”

I have heard of it. The so-called vitamin B17 is in fact not a vitamin at all, but a toxic substance, related to prussic acid. It is currently experiencing a boom in the alternative scene and has no proven benefit for cancer. Several people have died from overdoses.

Schuhl is now poking around in my spiritual life and in the relationship between me and my parents. She also suspects a trauma behind my cancer. “The thyroid represents the hormonal. The balance between male and female. Do you know where you belong? Male or female?” What is she trying to say?

“I come from Tajikistan,” he says, “where they say: sickness is a sacred time. When you are sick, God talks to you. He tells you what life really is. What we live is not life, it’s shit. Sickness asks us to make a change.” He continues, “Death is the most beautiful thing there is. Like a trip to the Caribbean. Why are we afraid of it? On this tortured planet here?”

After this introduction, my head is spinning, but now the actual treatment begins. I lie down on a couch. Schuhl runs her hands over my stomach and holds my shoulder. At the same time, she says prayers. She changes into the extinct Aramaic that is sometimes used in Christian services. Then she leaves me alone. Later, her partner, a licensed doctor, recommends that I read up on vitamin B17, come to them once a month and light a candle in a church in Cologne. I walk out of the practice befuddled…

The practitioners protect themselves legally. They make the patients sign contracts stating that the patient has been informed about orthodox medicine and that they reject it willy-nilly, even though the information is often not worth mentioning. What would be the solution?

… The doctor Achim Schuppert in Bonn suspects mobile phone radiation as the cause of my tumor and wants to measure my magnetic aura. It was important to him to “exclude electrosmog as a possible damaging factor”, he writes later.

Lothar Hollerbach, who runs an alternative practice in a Heidelberg city villa, gives a philosophical lecture: “We are spiritual beings and only for a short time in a mobile home we call a body.” Every crisis is a lesson, he says, but perhaps that lesson is for the next life. One of the things he recommends to me for recovery is Rudolf Steiner‘s lectures. How many patients has he successfully treated? He doesn’t count them, Hollerbach waves off. And after all, it’s not just about surviving. Some of his patients could have led a totally different life “in the next incarnation”. For those who long for death – his practice is highly recommended…

… The “medical director” Elke Tegel, a blonde alternative practitioner, leads me through the bright house, shows me the “inner world travel room” where traumatic situations are processed, the room for “healing music“, and also the impressive machine for “high-frequency therapy“, in which electrical energy is supplied to the cells. Costs: 13670 Euros for five weeks.

Cancer, says the alternative practitioner, is “suppressed anger and suppressed resentment”; Hodgkin’s lymphoma in particular is about guilt. She asks: “Where do you feel guilty? Guilty of being a man?” Later she advises a “biological chemotherapy” of highly concentrated vitamin C. This, she says, is far superior to conventional chemo. She confuses my well-treatable Hodgkin’s lymphoma with the fundamentally different non-Hodgkin’s lymphoma. And justifies herself: “With us, it’s not about diagnosis, that’s not of interest.” …

________________________

What I like about this report is that they exposed both doctors and non-medically trained practitioners, i.e. Heilpraktiker. We see yet again that the study of medicine does not protect people from becoming dangerous charlatans. Yet, there are important differences between doctors and Heilpraktiker:

  1. Only a very small proportion of doctors would treat Hodgkin lymphoma with ineffective quackery, whereas the proportion with Heilpraktiker would, I guess, be not far from 100%.
  2. Doctors will get struck off for such behavior, whereas this happens to Heilpraktiker as good as never.

 

 

 

So-called alternative medicine (SCAM) is widely used in Arabia. One of the commonly used methods is camel urine alone or mixed with camel milk. Camel urine is a liquid by-product of camel metabolism. Urine from camels has been used as prophetic medicine for centuries, being a part of ancient Bedouin practices. Camel urine comes out as a concentrated, viscous syrup because the kidneys and intestines of a camel are very efficient at reabsorbing water.

Camel urine is consumed and used for treating numerous ailments. Some employ it as a treatment for hair loss, for instance. The camel urine from a virgin camel is priced at twenty dollars per liter, with herders saying that it has curative powers.

A recent paper offers more information:

Camel is one of the important livestock species which plays a major role in the pastoral mode of life by fulfilling basic demands of livelihood. Traditionally, camel urine has been used in the treatment of human diseases. With regard to the health benefits of drinking the urine of camels, it has been proven by modern scientific researches. Camel urine has an unusual and unique biochemical composition that contributes to medicinal values. The chemical composition of camel urine showed the presence of purine bases, hypoxanthine, sodium, potassium, creatinine, urea, uric acid, and phosphates. The nano-particles in the camel’s urine can be used to fight cancer. Camel urine has antimicrobial activity against pathogenic bacteria. Its chemical and organic constituents have also inhibitory properties against fungal growth, human platelets, and parasitic diseases mainly fasciollosis in calves. The healthy status of the liver can be restored through ingestion of diet and minerals in camel urine. Camel urine is used by the camel owners and Bedouins as medicine in different ways. The Bedouin in the Arab desert used to mix camel urine with milk. Recently; the WHO has warned against drinking camel urine due to the modern attempt to limit Outbreaks of Respiratory Syndrome (MRS) in the Middle East. There is no scientific dosage for camel urine to be applied as medicine for different diseases and the ways of camel urine formulation and utilization for the care of patients varies from country to country. Therefore, the purposes of the present review describe the biochemical composition of camel urine will be scientifically extracted and formulated as a therapy rather than drinking raw urine and people’s health impact.

Researchers from the Medical Oncology Department, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia wanted to determine whether camel urine shows promise in the treatment of cancer. The aim of their study was to observe cancer patients who insisted on using camel urine and to devise some clinically relevant recommendations.

The authors observed 20 cancer patients (15 male, 5 female) from September 2020 to January 2022 who insisted on using camel urine. They documented the demographics of each patient, the method of administering camel urine, the reasons for refusing conventional treatment, the period of follow-up, and the outcome and side effects.

All the patients had radiological investigations before and after finishing treatment with camel urine. All patients used a combination of camel urine and milk, and treatment ranged from a few days up to 6 months. The average amount of urine/milk consumed was 60 ml/day. No clinical benefit was observed and two patients developed brucellosis. Eleven patients changed their minds and eventually accepted conventional antineoplastic treatments but 7 were too weak to receive further treatment and died from their disease.

The authors concluded that camel urine had no clinical benefits in cancer patients, and may even have caused zoonotic infection. The promotion of camel urine as a traditional medicine should be stopped because there is no scientific evidence to support it.

I fear that, yet again, ‘ancient wisdom’ turns out to be just ‘old bullshit’.

Acupuncture is a panacea, we are often told.

But is it true?

Of course not!

This study was aimed at evaluating the effect of acupuncture on myelosuppression and quality of life in women with breast cancer during treatment with anthracyclines (ANT).

Women with an indication for ANT chemotherapy were randomized into two groups:

  • the acupuncture group (AG) was submitted to an acupuncture intervention, starting before the first chemotherapy infusion, and continuing throughout the treatment;
  • the control group (CG) received no acupuncture.

A quality of life questionnaire (FACT-G) and peripheral blood levels of the participants were evaluated before and at the end of treatment.

A total of 26 women were randomized into 2 groups: AG (10) and CG (16). Of these, 26.9% had a dense dose indication according to the service’s protocol for the administration of granulocyte-stimulating factor (G-CSF) from the first cycle, not participating in the analysis. The need for secondary prophylaxis with G-CSF occurred in 72.7% in the control group versus 12% in the acupuncture group. Regarding quality of life (QoL), it was observed that the groups did not initially differ from each other. At the end of the treatment, there was a significant difference in the AG for the physical (GP) (p-value=0.011), social/family (GS) (p-value=0.018), and functional (GF) (p-value=0.010) domains, regarding the initial and final FACT-G showed a difference between the groups, where the GA average at the end rose from 80.68 to 90.12 (p-value = 0.004) and in the CG the average dropped from 81.95 to 70.59 (p-value=0.003).

The authors concluded that acupuncture was efficient in the secondary prophylaxis of myelosuppression during chemotherapy and the quality of life of women during treatment has increased.

My interpretation of these results is quite different from that of the authors.

Please let me explain.

The improvement of the quality of life can easily be explained via a placebo effect; acupuncture itself has not necessarily any part in it. But what about the effect on the bone marrow? Might it too be due to a placebo response, or the additional attention? Probably not.

Does that mean that this study proves a definite positive effect of acupuncture?

No!

Why not?

Because firstly the study was far too small for allowing such a far-reaching conclusion, and secondly one would need independent confirmation before accepting such a far-reaching conclusion.

The concept of ultra-processed food (UPF) was initially developed and the term coined by the Brazilian nutrition researcher Carlos Monteiro, with his team at the Center for Epidemiological Research in Nutrition and Health (NUPENS) at the University of São Paulo, Brazil. They argue that “the issue is not food, nor nutrients, so much as processing,” and “from the point of view of human health, at present, the most salient division of food and drinks is in terms of their type, degree, and purpose of processing.”

Examples of UPF include:

Ultra-processed food is bad for our health! This message is clear and has been voiced so many times – not least by proponents of so-called alternative medicine (SCAM) – that most people should now understand it.

But how bad?

And what diseases does UPF promote?

How strong is the evidence?

I did a quick Medline search and was overwhelmed by the amount of research on this subject. In 2022 alone, there were more than 2000 publications! Here are the conclusions from just a few recent studies on the subject:

Don’t get me wrong: this is not a systematic review of the subject. I am merely trying to give a rough impression of the research that is emerging. A few thoughts seem nonetheless appropriate.

  1. The research on this subject is intense.
  2. Even though most studies disclose associations and not causal links, there is in my view no question that UPF aggravates many diseases.
  3. The findings of the current research are highly consistent and point to harm done to most organs.
  4. Even though this is a subject on which advocates of SCAM are exceedingly keen, none of the research I saw was conducted by SCAM researchers.
  5. The view of many SCAM proponents that conventional medicine does not care about nutrition is clearly not correct.
  6. Considering how unhealthy UPF is, there seems to be a lack of effective education and action aimed at preventing the harm UPF does to us.

Drip IV is “Australia’s first and leading mobile healthcare company specialising in assisting with nutritional deficiencies”. They claim to provide a mobile IV service that is prescribed and tailored individually to your nutritional needs. Treatment plans and customised infusions are determined by a medical team to suit individual requirements. They deliver vitamins, minerals and amino acids directly to the body via the bloodstream, a method they state allows for optimal bioavailability.

These claims are a little puzzling to me, not least because vitamins, minerals and amino acids tailored individually to the nutritional needs of the vast majority of people would mean administering nothing at all. But I guess that virtually every person who consults the service will get an infusion [and pay dearly for it].

The Australian Therapeutic Goods Administration (TGA) seems to have a similarly dim view on Drip IV. The TGA has just issued 20 infringement notices totalling $159,840 to the company and to one of its executive officers. The reason: unlawful advertising of intravenous infusion products to Australian consumers on a company website and social media. Ten notices totalling $133,200 were issued to the company and ten notices totalling $26,640 were issued to an executive officer. The TGA considers the intravenous infusion products to be therapeutic goods because of the claims made about them, and the advertising to be unlawful because the advertisements allegedly:

  • contained prohibited representations, such as claims regarding cancer.
  • contained restricted representations such as that the products would alleviate fatigue caused by COVID-19, assist in the treatment of Graves’ Disease and Alzheimer’s Disease, and support the treatment of autoimmune diseases such as Multiple Sclerosis. No TGA approval had been given to make such claims.
  • referred to ingredients that are prescription only, such as glutathione. Prescription medicines cannot be advertised directly to the public in Australia.
  • contained a statement or picture suggesting or implying the products were ‘TGA Approved’. Advertising of therapeutic goods cannot include a government endorsement.
  • contained a statement or picture expressing that the goods were ‘miraculous’.

Vitamin infusions have become very popular around the globe. There are now thousands of clinics offering this service, and many of them advertise aggressively with claims that are questionable. Here is just one example from the UK:

Modern life is hectic. If you are looking to boost your wellbeing, increase your energy levels, lift your mood and hydrate your body, Vitamin IV Infusions are ideal. Favoured by celebrities such as Madonna, Simon Cowell and Rihanna, Vitamin IV Infusions are an easy, effective way of delivering vitamins, minerals and amino acids directly into your bloodstream via an IV (intravenous) drip. Vitamins are essential for normal growth and staying healthy – but our bodies can’t produce all of the nutrients we need to function and thrive. That’s why more than one in three people take daily vitamin supplements – often without realising that only 15% of the active nutrients consumed orally actually find their way into their bloodstream. With Vitamin IV Infusions, the nutrients enter your bloodstream directly and immediately, and are delivered straight to your cells. We offer four different Vitamin IV Infusions, so you can choose the best combination for your personal needs, while boosting your general health, energy and wellbeing.

My advice to consumers is a little different and considerably less costly:

  1. to ensure you get enough vitamins, minerals, and amino acids, eat a balanced diet;
  2. to boost your well-being, sit down and calculate the savings you made by NOT using such a service;
  3. to increase your energy levels, take a nap;
  4. to lift your mood, recount the money you saved and think of what nice things you might buy with it;
  5. to hydrate your body drink a glass of water.

Perhaps it is time the authorities in all countries had a look at what these clinics are offering and what health claims they are making. Perhaps it is time they act as the TGA just did.

 

In this study, the impact of a multimodal integrative oncology pre- and intraoperative intervention on pain and anxiety among patients undergoing gynecological oncology surgery was explored.

Study participants were randomized into three groups:

  • Group A received preoperative touch/relaxation techniques, followed by intraoperative acupuncture, plus standard care;
  • Group B received preoperative touch/relaxation only, plus standard care;
  • Group C (the control group) received standard care.

Pain and anxiety were scored before and after surgery using the Measure Yourself Concerns and Wellbeing (MYCAW) and Quality of Recovery (QOR-15) questionnaires, using Part B of the QOR to assess pain, anxiety, and other quality-of-life parameters.

A total of 99 patients participated in the study: 45 in Group A, 25 in Group B, and 29 in Group C. The three groups had similar baseline demographic and surgery-related characteristics. Postoperative QOR-Part B scores were significantly higher in the treatment groups (A and B) when compared with controls (p = .005), including for severe pain (p = .011) and anxiety (p = .007). Between-group improvement for severe pain was observed in Group A compared with controls (p = .011). Within-group improvement for QOR depression subscales was observed in only the intervention groups (p <0.0001). Compared with Group B, Group A had better improvement of MYCAW-reported concerns (p = .025).

The authors concluded that a preoperative touch/relaxation intervention may significantly reduce postoperative anxiety, possibly depression, in patients undergoing gynecological oncology surgery. The addition of intraoperative acupuncture significantly reduced severe pain when compared with controls. Further research is needed to confirm these findings and better understand the impact of intraoperative acupuncture on postoperative pain.

Regular readers of my blog know only too well what I am going to say about this study.

Imagine you have a basket full of apples and your friend has the same plus a basket full of pears. Who do you think has more fruit?

Dumb question, you say?

Correct!

Just as dumb, it seems, as this study: therapy A and therapy B will always generate better outcomes than therapy B alone. But that does not mean that therapy A per se is effective. Because therapy A generates a placebo effect, it might just be that it has no effect beyond placebo. And that acupuncture can generate placebo effects has been known for a very long time; to verify this we need no RCT.

As I have so often pointed out, the A+B versus B study design never generates a negative finding.

This is, I fear, precisely the reason why this design is so popular in so-called alternative medicine (SCAM)! It enables promoters of SCAM (who are not as dumb as the studies they conduct) to pretend they are scientists testing their therapies in rigorous RCTs.

The most disappointing thing about all this is perhaps that more and more top journals play along with this scheme to mislead the public!

 

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