Since weeks I have been searching for new (2013) studies which actually report POSITIVE results. I like good news as much as the next man but, in my line of business, it seems awfully hard to come by. Therefore I am all the more delighted to present these two new articles to my readers.
The first study is a randomized trial with patients suffering from metastatic cancer who received one of three interventions: massage therapy, no-touch intervention or usual care. Primary outcomes were pain, anxiety, and alertness; secondary outcomes were quality of life and sleep. The mean number of massage therapy sessions per patient was 2.8.
The results show significant improvement in the quality of life of the patients who received massage therapy after 1-week follow-up which was not observed in either of the other groups. Unfortunately, the difference was not sustained at 1 month. There were also trends towards improvement in pain and sleep of the patients after massage. No serious adverse events were noted.
The authors conclude that “providing therapeutic massage improves the quality of life at the end of life for patients and may be associated with further beneficial effects, such as improvement in pain and sleep quality. Larger randomized controlled trials are needed to substantiate these findings“.
The second study examined the effectiveness of a back massage for improving sleep quality in 60 postpartum women suffering from poor sleep. They were randomized to either the intervention or the control group. Participants in both groups received the same care except for the back massages. The intervention group received one 20-minutes back massage at the same time each evening for 5 consecutive days by a certified massage therapist. The outcome measure was the Pittsburgh Sleep Quality Index (PSQI). The results showed that the changes in mean PSQI were significantly lower in the intervention group than in controls indicating a positive effect of massage on sleep quality.
The authors’ conclusions were clear: “an intervention involving back massage in the postnatal period significantly improved the quality of sleep.”
Where I was trained (Germany), massage is not deemed to be an alternative but an entirely mainstream treatment. Despite this fact, there is precious little evidence to demonstrate that it is effective. Our own research has found encouraging evidence for a range of conditions, including autism, cancer palliation, constipation, DOMS and back pain. In addition, we have shown that massage is not entirely free of risks but that its potential for harm is very low (some might say that this was never in question but it is good to have a bit more solid evidence).
The new studies are, of course, not without flaws; this can hardly be expected in an area where logistical, financial and methodological problems abound. The fact that there are many different approaches to massage does not make things easier either. The new evidence is nevertheless encouraging and seems to suggest that massage has relaxing effects which are clinically relevant. In my view, massage is a therapy worth considering for more rigorous research.
Whenever I lecture on the topic of alternative medicine for cancer, the first comment from the audience usually is “aren’t there any herbal treatments that are effective?” This is of course a most reasonable question; after all, many conventional cancer drugs originate from the plant kingdom – think of Taxol, for instance.
My answer often upsets believers in alternative cancer remedies. I tell them that, no, there is none and, even worse, there never will be one.
Did I just contradict myself? Did I not just state that many cancer drugs come from plants? Yes, but once the pure ingredient is isolated and synthetized, the drug ceases to be an herbal remedy which is defined as an extract of all the plant’s ingredients, not just one isolated constituent.
And why am I so depressingly pessimistic about there ever being an herbal cancer cure? Because of a simple fact: as soon as a natural substance shows the slightest promise, scientists will analyse and test it. If this process turns out to be successful, we will have a new cancer drug – but not an effective herbal remedy. Again, think of Taxol.
Since almost a decade, colleagues and I have been working on a relatively little-known project called CAM cancer. It started as an EU-funded activity and is now coordinated by Norwegian researchers. Our main aim is to provide unbiased and reliable information about all sorts of alternative treatments for cancer.
Our team is large, hard-working, highly motivated and independent – we do not accept sponsorship from anyone who might want to influence the results of what we are publishing. It is probably fair to say that most individuals who give their time working for CAM cancer are more optimistic than I regarding the value of alternative treatments. Therefore, our publications are certainly not biased against them; if anything, they are a bit on the generous side.
Much of our work consists in generating rigorously researched and fully referenced summaries of the evidence. Before these get published, they are thoroughly peer-reviewed and, whenever necessary, they also get updated to include the newest data. A good proportion of the reviews relates to herbal treatments.
Here are the crucial bits from our conclusions about those herbal cancer remedies which we have so far investigated:
Aloe vera: …studies are too preliminary to tell whether it is effective.
Artemisia annua: …there is no evidence from clinical trials…
Black cohosh: …In all but one trial black cohosh extracts were not superior to placebo.
Boswellia: …No certain conclusions can be drawn…
Cannabis: …The use of cannabinoids for anorexia-cachexia-syndrome in advanced cancer is not supported by the evidence…
Carctol: … is not supported by evidence…
Chinese herbal medicine for pancreatic cancer: …the potential benefit… is not strong enough to support their use…
Curcumin: There is currently insufficient documentation to support the effectiveness and efficacy of curcumin for cancer…
Echinacea: …there is currently insufficient evidence to support or refute the claims… in relation to cancer management.
Essiac: There is no evidence from clinical trials to indicate that it is effective…
Garlic: Only a few clinical trials exist and their results are inconclusive.
Green tea: …the findings… are still inconclusive.
Milk vetch: Poor design and low quality… prohibit any definite conclusions.
Mistletoe: …the evidence to support these claims is weak.
Noni: …evidence on the proposed benefits in cancer patients is lacking…
PC-Spes: …the… contamination issues render these results meaningless. An improved PC-Spes2 preparation was evaluated in an uncontrolled study which did not confirm the encouraging results…
St John’s wort: …there are no clinical studies to show that St. John’s wort would change the natural history of any type of cancer…
Ukrain: …several limitations in the studies prevent any conclusion.
As you can see, so far, we have not identified a single herbal cancer treatment that demonstrably alters the natural history of cancer in a positive direction. To me, this suggests that my rather bold statements above might be correct.
Of course, there will be some enthusiasts who point out that the list is not complete; and they, of course, are correct: there are probably hundreds of herbal remedies that we have not yet dealt with. And, of course, for some of those the evidence might be more convincing – but somehow I doubt it; after all, we did try to tackle the most promising herbal remedies first.
My claim therefore stands: there never will be a herbal (or other alternative) cancer cure. But, please, feel free to convince me otherwise.