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

Radix Salviae Miltiorrhizae (Danshen) is a herbal remedy that is part of many TCM herbal mixtures. Allegedly, Danshen has been used in clinical practice for over 2000 years.

But is it effective?

The aim of this systematic review was to evaluate the current available evidence of Danshen for the treatment of cancer. English and Chinese electronic databases were searched from PubMed, the Cochrane Library, EMBASE, and the China National Knowledge Infrastructure (CNKI), VIP database, Wanfang database until September 2018. The methodological quality of the included studies was evaluated by using the method of Cochrane system.

Thirteen RCTs with 1045 participants were identified. The studies investigated the lung cancer (n = 5), leukemia (n = 3), liver cancer (n = 3), breast or colon cancer (n = 1), and gastric cancer (n = 1). A total of 83 traditional Chinese medicines were used in all prescriptions and there were three different dosage forms. The meta-analysis suggested that Danshen formulae had a significant effect on RR (response rate) (OR 2.38, 95% CI 1.66-3.42), 1-year survival (OR 1.70 95% CI 1.22-2.36), 3-year survival (OR 2.78, 95% CI 1.62-4.78), and 5-year survival (OR 8.45, 95% CI 2.53-28.27).

The authors concluded that the current research results showed that Danshen formulae combined with chemotherapy for cancer treatment was better than conventional drug treatment plan alone.

I am getting a little tired of discussing systematic reviews of so-called alternative medicine (SCAM) that are little more than promotion, free of good science. But, because such articles do seriously endanger the life of many patients, I do nevertheless succumb occasionally. So here are a few points to explain why the conclusions of the Chinese authors are nonsense:

  • Even though the authors claim the trials included in their review were of high quality, most were, in fact, flimsy.
  • The trials used no less than 83 different herbal mixtures of dubious quality containing Danshen. It is therefore not possible to define which mixture worked and which did not.
  • There is no detailed discussion of the adverse effects and no mention of possible herb-drug interactions.
  • There seemed to be a sizable publication bias hidden in the data.
  • All the eligible studies were conducted in China, and we know that such trials are unreliable to say the least.
  • Only four articles were published in English which means those of us who cannot read Chinese are unable to check the correctness of the data extraction of the review authors.

I know it sounds terribly chauvinistic, but I do truly believe that we should simply ignore Chinese articles, if they have defects that set our alarm bells ringing – if not, we are likely to do a significant disservice to healthcare and progress.

44 Responses to Danshen, an effective treatment for cancer?

  • EE…Even though the authors claim the trials included in their review were of high quality, most were, in fact, flimsy.

    Since only 4 of the 13 papers reviewed were in English, how did you conclude that most were flimsy?

    • I conclude that from the review authors’ extraction of the data.

      • I see.

        So you state “…we should simply ignore Chinese articles, if they have defects that set our alarm bells ringing..”

        And you conclude the papers reviewed are flimsy based upon authors extraction of data.

        And the authors are from China reviewing mostly Chinese papers.

  • The most powerful pain killer known is morphine, it is made from poppy flowers. One the most popular and widely used medicines in history is aspirin, it is made from the willow tree. One of the most widely used heart drugs is digoxin, called after digitalis, the scientific name for the flower that the drug is made from, foxglove. And they tell you plant based medicine doesn’t work !!?? They’re already using it under a diffrent guise, while they tell you not to. What a crowd.

    • “And they tell you plant based medicine doesn’t work !!??”
      WHO DID?
      certainly not I, and certainly not in that post.

      • Very good Ed. There is a common concensus promoted in the medical profession that you should use drugs not nature. One local GP in my area told a patient,’ you would be better eat the grass from your garden as use that (herbal medicine)’. This kind of ignorance spreading is common, I have other examples. The man on the street does not know of the many plants used in western medicine. These people are often those who have spent thousands of hours watching ‘science’ programs and consider themselves well informed. Mass media, the (mis)education system and the scientific and medical professions are responsible, alongside the individuals personal responsibility. Did our local GP really not know ? or was he lieing. Ignorance or lies, it has to be one or the other. A century of propaganda from big pharma through the school and university to your local ignorance spreading GP. You know Ed, and everyone else here knows too. The result is unnessesary death, disease and suffering. Advances should be used alongside what already works, not corruptly used to stop it. The drug pushing billionaires and their millionaire followers would disagree. Opiate based painkiller pushing pharma executives are in the US courts as we speak, for bribeing doctors to prescribe dangerous painkillers to patients that trust them. Over 400 are killed each day by pharma painkillers, multiply that by 365. The tip of the iceberg. And we’re suppossed to trust that profession ? with our health ? our lives ? The industry that you and other mouth pieces here represent and defend is rotten to core, and you all know it.

        • with all these drug everywhere, it’s a shame that they have not managed to get your paranoia under control yet – please keep on trying.

          • Excuse me ? 400+ deaths every day from opiate painkillers. Paranoia ? Cheap insult ed. You have no argument. Pathetic, and you do this for a living.

          • sorry to tell you that you are wrong again:
            1) i don’t do this for a living
            2) opiate death have nothing to do with it

          • If you prop it up, it is yours.

    • I am an oncologist. Some commonly used chemotherapy drugs are:

      Etoposide – derived from the May apple (called the mandrake in the USA, but in Europe the name mandrake refers to a different plant altogether)
      Vincristine, vinblastine, vindesine, vinorelbine, navelbine – derived from the periwinkle
      Paclitaxel (Taxol) docetaxel – derived from the yew tree
      Daunorubicin, doxorubicin, epirubicin – derived from a red fungus found in Puglia – the home of the ancient Dauni tribe
      Bleomycin – derived from a fungus

      They are all powerful drugs, and if not used correctly they can be ineffective, fatally toxic or both. Actually that also applies to digoxin, which has a narrow therapeutic window.

      • Good list there Julian, how many cancer patients are told that each year ? Funny your name is Julian money. Can’t patent a herb, eh ? Give doctors nurses pay and see how many still want to be doctors, so that they can ‘help people’.

        • how many cancer patients are told that each year

          Most cancer patients have a huge amount of information to take in, and the history behind the development of the drugs used to treat them is not a priority for most.

          Funny your name is Julian money

          Are you just being rude here? Funny your name is Joe C Appal…

          Can’t patent a herb, eh ?

          Point of information – you can.

          Give doctors nurses pay and see how many still want to be doctors, so that they can ‘help people’.

          It may be different where you live, but since you seem to be making assumptions about me personally, then you should inform yourself about NHS payscales in the UK, where I live, including rates for overtime and unsocial hours, bearing in mind that many doctors work significantly longer than their contracted hours for no additional pay. You might also want to compare their income to similarly qualified professionals in other types of employment.

          • Yes, it is not a priority to tell the people that nature holds the most powerful cures. The pharma industry would be out of business. Billions $$$$$ keeping people sick diseased and suffering. Tell that to your car dealer. Poor doctors, around here you better not get sick at the weekend or out of hours, the majority of GP’S refuse to work outside 9-5 mon to fri. As for NHS payscales we can count the jags and mercs in the carpark, it isn’t the nurses that are driving them. You know it’s all corrupt and steered by billionaire drug corp owners, maybe you’re uncomfortable admiting that.

          • Joe

            You seem to be the wise one here. Tell us about these free cures that nature has.

            You seem to be rather embittered by the concept of clever and skilled individuals being financially rewarded for exercising these skills. Why is this?

            Do you want us to help you pull over a few statues, Joe? Will that make you feel better? Burn the libraries as well? All that false learning?

            It’s the ruling secret elite isn’t it, Joe? Keeping their secrets. Keeping you in your place.

            Just as well you know The Truth.

          • As for NHS payscales we can count the jags and mercs in the carpark

            I don’t think you will find that a typical NHS doctor’s salary will pay for those. Of course some doctors do other work in their spare time, as do many people in other walks of life. Others prefer to see their families now and then.

          • Think I saw a doctor heading towards the foodbank the other day. What planet are you living on there Julian. Nice portrait, well done. Makes you look a bit pompous and self important, though a good likeness captured ? I don’t know you, but thats how the painting looks. Did you commission it yourself ? Not cheap that kind of work. A gifted artist. Maybe you’re an ok fellow, but you must admit the industry you protect is riddled with ego, self importance, arrogance and money grubbing and 400 per day + multiplyed by 365 days a year dead by opiate painkillers each year in the US alone. Thats 146 thousand, did you get that.. 146,000 per year ! by just one drug in one country. Thats 1.5 million in the last 10 years by just one drug in one country. Good work. What more is there to say. I think they call it the healthcare business.

          • what more is there to say?
            perhaps this: most doctors work 5 days a week and get about 5-6 weeks holidays.
            so, perhaps you got your sums wrong – but that would not be the only thing, wouldn’t it?

          • Joe

            It all boils down to this, MDs have a liscense to kill, homepaths don’t.

            So if and when a homeopath kills someone, they’ll be prosecuted to the fullest extent of the law. However, if and when a MD kills sombody, it’s just part of doing business.

          • “It all boils down to this…”
            this sounds as though you have boiled down your little grey cells

    • “And they tell you plant based medicine doesn’t work !!??”

      Nope, in what has happened is that people told you that modern medicine says that plant based medicine doesn’t work. So none of those who told you that knew what they were talking about, and were more interested in selling you their products and undermining any form of quality control or proper testing.

    • Just a couple of factual tidbits
      – morphine is not the most potent opioid around so what is your definition of “powerful”?
      – aspirin is not present in nature; while salicylic acid glycosides are quite prevalent aspirin was actually formulated to quench the side effects of willow bark and spiraea flowers…
      – digoxin is used less and less due to safety issues and questions of efficacy outside a rather narrow indication of CHF…
      Pharmacognosy is a healthy science, rewarded with a Nobel prize for the discovery of artemisinin (at the same time as the discovery of avermectin and its development) which – for anyone reading up on Tu Youyou’s work – had very little to do with TCM.

        • What sums ? What are you talking about ? Do those 1.5 million deaths mean absolutely nothing to you ed ? What numbers did I get wrong ?

          • another comment that looks utterly moronic

          • Over 400 are killed each day by pharma painkillers, multiply that by 365. 146,000 per year ! by just one drug in one country. Thats 1.5 million in the last 10 years

            If 400 per day are being killed by pharma painkillers, and this is just one drug, then you are saying that the others must be safe. Which particular painkiller are you saying is responsible?

            What numbers did I get wrong ?

            By multiplying an annual rate by ten to get the numbers over ten years, you are assuming that the rate hasn’t changed over that time. Most people are actually concerned that the rate is rising.

            According to figures from the CDC database, CDC Wonder, the total number of deaths from overdoses of all drugs (that is, prescribed as well as illegal drugs, and not limited to painkillers) in 2007 was 36,010 and in 2017 it was 70,237; I haven’t found the figures for 2018.

            However, I do accept your calculation that 400 x 365 x 10, rounded to two significant figures, is 1.5 million.

      • Leif it out Leif, the point being that all the drugs listed come from plants. You know the point, stop being obtuse.
        Salicylate rich plants have been used for thousands of years for painkilling. Aspirin was derived from this. ‘Aspirin’ is a brand name of the Bayer drug company. Morphine is the most commonly used powerful painkiller. You can dissect what i’m saying to appease yourself, it makes no difference to the point.

        • @Joe Cappal

          You just might be missing the point here. Leif said “Pharmacognosy is a healthy science, rewarded with a Nobel prize for the discovery of artemisinin (at the same time as the discovery of avermectin and its development) which – for anyone reading up on Tu Youyou’s work – had very little to do with TCM.” His comment seems to have gone right over your head.

          We all acknowledge that huge numbers of drugs originate from natural products (plants, fungi and filamentous bacteria being the richest sources). The science of discovering the pharmacologically active compound in a natural source is called ‘pharmacognosy’. It’s better and safer to treat patients with pure compounds than herbs (or whatever the ‘natural’ product may be) because the pure compounds can be produced and dosed in a dependably reproducible manner.

          Please note that ‘essential oils’ as used to ‘help’ or ‘treat’ patients are halfway through the process of migration from crude ‘herbal’ product to pure chemical.

          • Maybe you should look up the stats on the number of people killed by doctors drugs in the last 10 years. Oh, better and safer. I see. You can start with opiate painkillers in the US, it’s in the news right now, shouldn’t be too hard to find how safe they are.

          • and what does this have to do with a bogus TCM cancer cure?

        • I’m not being obtuse – I am being factual.
          You’re comment contained questional arguments, some even plainly wrong. Not to worry though – as you keep on making arguments without factual merit you only emphasize my point: if you can’t get your facts correct…

  • Another not-very-bright chiro who isn’t smart enough to realise they aren’t smart enough to argue with someone who is.

    DC (is that an acronym for Dead Cranium?), the prof has been doing research for longer than you have been a charlatan. Do you not understand that?

  • @ Lenny. You couldn’t be more wrong Lenard. It’s they that count the material as success and it is you that is bitter. It comes out in your tone, you sound snide. I love your profile shot, you’re soooooo cool. Bit old for that t shirt and it’s a size or two too small though :)) ‘Hey i’m lenny the cool dentist who secretly wants to be a rockstar’, thanks for the laugh len. XO
    I never said anything about free, just corruption, which the dogs on the street know. No secrets, just denial.

  • @Julian Money Kryle. ‘You must be saying..’ I said nothing about any other drugs nor did I infer such, where in God’s name did you get that from ? The number 400 per day dead is for opiate painkillers in the U.S. It is in fact averaged at over 400 per day or 146,000 per year and the number is rising. This is the the official figure quoted from all the main media sources that report the story. This number does not include all the other deaths caused by all the other dangerous drugs handed out legally across the world, there are around 200 countries, do a quick calculation yourself it amounts to millions. Meanwhile, for example, canabis oil, that stops epileptic seizures is being withheld from very ill children. Cannabis has never once been demonstrated to have killed a single person. But it is not a patentable million selling drug industry cash cow, is it ? Admit what you’re part of or don’t, it makes no difference to the reality. It is fair to and reasonable to multiply the last few years figures by ten to get a good estimate of the staggering numbers for the past decade then the decade before that……1, 2 3, 4, 5 ? 000,000……… How many Julian, how many ? For the whole world in the last 50 years ? It’s terrible. you and the the Ed’s of the world can say what helps you , you cannot escape the truth.

    • you really must consult someone about your mental state; let us know when you are better.

      • You’re like a man without a defence there Ed. Silly thing to say a silly reply that shows your fans and detractors what are really all about. Whats that mark on the back of your trousers ed ? oh i think it’s Prince charles’ boot print. :))))

        • sorry to see that you also are not good at humour

        • “You’re like a man without a defence there Ed.”

          [citation required]

          For Prof Ernst to mount a defense, you must first supply something against which to defend. Insults and numbers pulled out of your ass don’t count, durr.

    • “The number 400 per day dead is for opiate painkillers in the U.S.”

      Nonsense on stilts. See that red banner up top? That’s there for you.

      https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

      The US sees something like 200 overdose deaths per-day, about a quarter of which are prescription opiates, with combined fentanyl abuse being an increasingly common factor. That’s 45 out of ~7500 total deaths per-day; roughly half a percent. Still lamentably high, mind, but nowhere close to your fever-dream numbers. Whatever it is you’re smoking, you should really cut down on it.

      • The number 400+ per day is the accepted number quoted from all main media sources, if you read what I say, it doesn’t come from me. ‘You’re smoking too much’,’you’re stupid’, ‘you’re mad’, ‘that’s rubbish’, ‘thats bs’, you’re a sad bunch when that’s all the defence you have. When you’re ass gets kicked with simple facts and figures that expose the evil you’ve nothing more to say than something silly like that.
        There are currently 2000 law suits in the US pending on this issue, taken by local government and state authorities as well as individuals against the drug business. Lets just say for arguments sake the number is half what I quoted, it’s still millions round the world over the past decades. Why do you defend it. Wait till it’s someone in your family.

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