alternative therapist
Chronic non-specific low back pain (CNSLBP) is a major cause of disability worldwide. Conventional pharmacological treatments offer limited benefits and carry potential risks, prompting interest in alternative approaches, including homeopathy. The objective of this study was to evaluate the short-term efficacy and safety of a standardised homeopathic biotherapic (Lumbar Vertebra, LM2 potency) for CNSLBP.
A randomised, double-blind, crossover, placebo-controlled clinical trial was conducted with 120 participants diagnosed with CNSLBP. Participants received both the biotherapic and placebo in two treatment phases separated by a washout period. The primary outcome was pain intensity (numeric rating scale); secondary outcomes included functional disability (Oswestry Disability Index), adverse events and use of pain medications. Data were analysed using random effects generalised linear models.
Both the biotherapic and placebo interventions led to significant within-group reductions in pain and disability (p = 0.001 and p < 0.001 respectively). However, no statistically significant differences were observed between the two interventions for either outcome (pain: p = 0.435; disability: p = 0.840). The magnitude of change in pain intensity did not reach the pre-defined minimal clinically important difference (MCID), and mean pain scores at the study endpoint remained above the inclusion threshold. Adverse events were mild and comparable across groups.
The authors concluded that no specific effect of the Lumbar Vertebra LM2 biotherapic was demonstrated. Improvements are likely due to non-specific effects such as the therapeutic environment, patient expectations and placebo response. Clinicians should consider the substantial role of non-specific responses in CNSLBP and avoid medications with unfavourable risk–benefit profiles.
One the one hand, the authors from the Department of Medicine, Federal University of São Carlos, São Carlos, Sao Paulo, the School Health Unit, Federal University of São Carlos, São Carlos, Sao Paulo, and the epartment of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil should be congratulated for publishing a squarely negative result in the journal ‘Homeopathy’ that is known for publishing even the most implausible positive findings.
On the other hand, one might criticise them: why on earth did they ever conceive the hypothesis that homeopathy in general or “Lumbar Vertebra LM2 biotherapic” in particular might be effective for CNSLBP (the study did not receive any funding or financial support, apart from the study medications donated by HN-Cristiano Pharmacy (Santana, São Paulo, Brazil), which had no role in the study design, data collection, analysis, interpretation or discussion of the results)? I have never met a homeopaths who would make such a claim, and one could easily argue that such a trial is an unethical waste of resources.
I came across an interesting paper entitled “The Ethics of Tawas and Other Rituals in Medical Practices“. Here is its abstract:
Rituals in medical practice have either been seen as an anthropological aspect of current biomedical processes or as a pre-scientific aspect of complementary and alternative medicine (CAM). In either tendency, the literature has since failed to account for these rituals as rituals—conveyors of meaning, expressions of identity, and even as a rite of passage from illness to wellness. As an alternative to current discussions, this paper presents the case study of tawas, a diagnostic ritual from Philippine traditional medicine that determines personalistic and mystical causes of illnesses. As a non-intrusive procedure, tawas involves incantations and some ritual objects, e.g., rice, candle, axe, etc., that do not pose any direct harm nor benefit to the patient. While complete reliance on tawas at the expense of proper medical procedures could harm patients, the very ritual of tawas itself occupies a limbo within non-beneficence and non-maleficence. Following a Wittgensteinian perspective of treating rituals as meaning-laden human activities, this paper argues that rituals like tawas, much like other rituals embedded in biomedical practices, should be understood as rituals and not as empirical cures, thereby allowing their tolerance in medical practice in general.
The author seems to advocate for the cultural integration of traditional practices like tawas into a broader medical framework. They categorize tawas not as a physiological intervention, but define it as a conveyor of meaning. By addressing the “meaning-laden” aspect of illness, the ritual may address the psychological and social dimensions of a patient’s health, even if it has no effect on their physical pathology.
It is claimed that, since tawas involves non-intrusive objects (candles, rice), it is physically benign. At the same time it is acknowledged that “complete reliance” on tawas could harm patients. From a clinical safety standpoint, the “limbo” is only maintained if the ritual is strictly adjunctive rather than alternative.
The text uses a Wittgensteinian perspective, focusing on rituals as expressions rather than theories. Modern neuroscience suggests that the “ritual” of care—the white coat, the focused attention, the diagnostic process—triggers real neurobiological changes (e.g., dopamine and endorphin release). Aacknowledging the symbolic healing power that rituals have on patient anxiety and the “meaning response,” which can objectively improve health outcomes by reducing cortisol and stress.
The author identifies tawas as a diagnostic ritual which might well be the most contentious point. In science, a “diagnosis” must be reliable and valid. Tawas clearly fails the scientific criteria for validity. The author’s defence is that tawas shouldn’t be judged by those criteria at all. While this might be philosophically sound, in a clinical setting, a “mystical diagnosis” must conflict with a biological one, potentially leading to patient non-compliance with life-saving treatments.
This study was conducted to determine the effect of Reiki performed on children with leukemia between the ages of 5-7 years on pain, vital signs, oxygen saturation, and quality of life. It was a double-blind, pre-test-post-test randomized controlled experimental study. The research sample consisted of 66 children with leukemia aged 5-7 years who were hospitalized in pediatric oncology wards of a university hospital between December 2020 and November 2021. The balanced block randomization method was used for randomization. The data were collected using Information Form, Wong-Baker FACES Pain Scale (W-BPS), Vital Signs Follow-up Form, The Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module. Reiki was performed to the Reiki group for 20-30 min once per day, for 3 consecutive days and pseudo-Reiki was applied to the pseudo-Reiki group by an independent nurse during the same application period.
There was no statistically significant difference in vital signs (heart rate, respiratory rate, body temperature) and SpO2 values among the groups (p > 0.05). However, both children’s and mothers’ evaluations on days 1, 2, and 3 after the intervention showed that pain scores in the Reiki group were significantly lower than in the pseudo-Reiki and control groups (p < 0.001), and quality of life was significantly higher (child:p < 0.001; mother:p < 0.01) compared to the pseudo-Reiki and control groups.
The authors concluded that Reiki did not affect the vital signs of the children but was effective in reducing pain and increasing the quality of life compared with the pseudo Reiki and control groups. It is recommended that Reiki therapy be used in addition to medical treatment to reduce pain and improve quality of life in children with leukemia aged 5-7 years.
The whole point of having a control group receiving pseudo-Reiki is to control for placebo effects. For this purpose, it is necessary to fool the patients well and make sure that they are unable to tell Reiki from pseudo-Reiki. I would guess – I have no aceess to the full paper – that this was not the case in this study. If I am correct, the positive outcome is likely to be due to expectation of a positive healing effect and unrelated to any specific effect of Reiki.
In any case, it is irresponsible nonsense to recommend Reiki – or any therapy – on the basis of just one positive study. For that one would need several independent confirmations with high quality studies that firmly establish a cause effect relationship. The current study does not fall into that category, and I am not aware of a single trial that does.
Spinal manipulative therapies, including chiropractic and osteopathic maneuvers, are widely practiced for musculoskeletal complaints. However, serious complications such as cerebrospinal fluid (CSF) leak with subsequent intracranial hypotension (IH) have been described. The pathophysiological mechanism is presumed to involve mechanical stress on the spinal dura during high-velocity movements, leading to dural tears, particularly in the cervicothoracic region.
A team of Italian neuroscientists conducted a scoping review in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines, through a comprehensive search of PubMed and Scopus. They complemented the review with an illustrative case from their own institution.
The researchers identified 21 eligible papers, including 21 patients with IH following spinal manipulation. Most patients were women (81%), aged 29-54 years, and the majority underwent cervical maneuvers.
SMT techniques vary, most often involving high-velocity cervical maneuvers. The most frequent were axial tension with rotation in seven cases (33.3%), unspecified cervical manipulation in four cases (19%), and thoracic spinal manipulation in two cases (9.5%). Less common single-case techniques included rotation with hyperextension, combined cervical and thoracic mobilization, axial tension with lateral flexion, and occipital/shoulder tension technique (n = 1 case each).
Symptom onset was typically within the first week, and all presented with orthostatic headache, often accompanied by nausea, neck pain, tinnitus, or visual disturbances. Neuroimaging consistently revealed features of IH, with pachymeningeal enhancement and subdural collections as the most frequent findings; spinal imaging frequently demonstrated extradural CSF collections. Management was conservative in about one-third of cases, but most required epidural blood patching, which was effective in the majority. Surgical repair was necessary in rare, refractory cases, particularly in the presence of structural spinal abnormalities. Overall prognosis was favorable, with 95% of patients achieving full recovery.
The authors’ illustrative case highlights the potential for severe complications such as subdural hematomas and recurrence if the underlying leak is not addressed:
A 65-year-old patient without a previous history of headache presented with a progressively worsening headache, with orthostatic features, poorly responsive to medical therapy, that has lasted for the past 20 days. The patient denied any recent trauma. He reported having undergone cervical osteopathic manipulations within the past 3 months for recurrent cervicalgia. A brain MRI without contrast was performed, showing a large bilateral subdural hematoma with significant mass effect on the cortical gyri. The patient was admitted to the emergency department and underwent neurosurgical evacuation of a bilateral chronic subdural hematoma via burr holes. Subsequently, endovascular embolization of the middle meningeal arteries was performed as an adjunctive treatment to reduce the risk of recurrence. The surgical procedure was performed without complications. A cranial CT scan showed a reduction in the volume of the hematoma. Therefore, the patient was discharged. However, after a transient improvement in the symptoms, the patient continued to present a fluctuating headache without positional features, with four to five episodes per month. He was readmitted to our clinic and, upon arrival at the ER, a head CT scan showed an increase in pneumocephalus and a recurrence of the hematoma. The following day, an MRI of the neuraxis with contrast was performed, which revealed radiological findings suggestive of IH: pachimeningeal enhancement, subdural fluid collection, dural venous engorgement, cervical spinal longitudinal extradural collection, and effacement of the suprasellar cistern. The Bern score was 7. Given these findings, a surgical revision of the previous burr holes was performed without periprocedural complications. After the first day, a non-targeted epidural blood patch (EBP) was performed under local anesthesia by injecting 16 mL of autologous blood into the L3–L4 epidural space. The procedure was uneventful. A cranial CT scan showed satisfactory surgical outcomes, highlighting a reduction in the volume of the hematoma and of the pneumoencephalus. The patient was subsequently discharged with complete resolution of the headache.
The authors concluded that clinicians should recognize the possibility of CSF leaks after spinal manipulation, especially in patients with new-onset orthostatic headache.
I feel compelled to point out that, considering the multiple risks of upper spinal manipulations and the almost total lack of evidence of benefit from such treatments, the risk/benefit balance of spinal manipulation is clearly not positive. It follows, I think, that it would be wise for patients not to allow such therapies being carried out, and for healthcare professionals to discourage them.
I am quite fond of garlic, but not as a cancer therapy. Dr. Mohsen Ali, a former doctor whose UK medical license was revoked by the General Medical Council (GMC) in January 2015, has been permanently struck off the medical register following a Medical Practitioners Tribunal Service (MPTS) investigation into his running of an illegal clinic. The tribunal, which began proceedings on December 1, 2025, reconvened on January 14 and concluded from April 22 to 24, 2026, found Ali guilty of serious professional misconduct for preying on vulnerable cancer patients with unproven and dangerous treatments.
In 2018, Ali treated two patients from a semi-detached Leicester property described as a “squalid council house.” Patient A had stage three prostate cancer, while Patient B suffered from terminal ovarian cancer. Referred to Ali by word-of-mouth, both were told he could cure their cancers with a claimed 90% success rate. He charged Patient A up to £15,000 and Patient B between £10,000 and £12,000 for sessions involving intravenous vitamin C, garlic oil, ozone therapy, oxygenated water, and sodium bicarbonate injections.
Ali disparaged conventional medicine, asserting that the NHS was “killing them” through ineffective chemotherapy and radiotherapy, while “big pharma companies were making money.” During a phone call, he laughed off Patient A’s diagnosis, calling prostate cancer “easy to cure.” For Patient B, he overrode the NHS’s prognosis that nothing more could be done, promising her husband a full recovery. Patient B died shortly after stopping treatment, before police and Public Health England (PHE) probes began.
The case surfaced when Patient A emailed Leicestershire Police, prompting a GMC referral. A police raid uncovered a flyer at Ali’s address, advertising him as a “qualified doctor” who left the NHS because standard treatments “did not work.” It invoked “Allah the best healer” and boasted over 90% cure rates for cancers and other severe illnesses.
MPTS evidence revealed grave hygiene failures. PHE inspections described the property as a “dirty and unhygienic” shared residential-clinical space with visibly contaminated surfaces, reused equipment without decontamination, and no basic infection prevention measures. Ali reused intravenous bags, exposing patients to serious infection risks. The tribunal deemed his actions dishonest, as he knew these were not evidence-based cancer cures.
An expert witness confirmed no clinical studies support these so-called alternative medicines (SCAMs) for curing any cancer. Ali also failed to obtain informed consent, particularly from Patient B. Absent from the hearing, he emailed the GMC denying claims of cure, but the flyer and patient testimonies contradicted him.
Ali, who graduated from Cairo University in 1994 and practiced in the UK from 2001 was erased him from the register, underscoring the dangers of unqualified SCAM practitioners – even (or perhaps especially) when they have a doctor title.
The defence of anthroposophical medicine – or of any other unproven modality – as articulated, for example, by figures like Weleda CEO Tina Müller, presents a vision of patient-centred care and economic pragmatism. However, when held against the light of current clinical standards and the principles of evidence-based medicine (EBM), it reveals significant cracks.
The most profound problem lies in the definition of scientific evidence. Proponents often point to decades of “positive experience” and high patient satisfaction as proof of effectiveness. Yet, in the hierarchy of science, anecdotal success sits at the very bottom. Anthroposophical treatments lack biological plausibility. Their perceived benefits are largely indistinguishable from context effects (such as placebo). Anthroposophical medicine might provide more time, empathy, and personal attention – factors that undoubtedly improve a patient’s well-being but do not validate the effectiveness of the specific remedies used. When independent bodies subject these treatments to rigorous, high-quality trials, the purported effects usually vanishe.
Anthroposophical medicine represents merely a tiny percentage of our healthcare expenditures. Therefore, proponents argue, little money would be saved by getting rid of it. This argument is a calculated distraction from the ethical core of the issue. While the fiscal burden may be marginal, the scientific cost is immense. A statutory health insurance system is built on a social contract of solidarity; it functions under the premise that public funds are reserved for treatments of proven value and effectiveness. To fund therapies that lack plausibility as well as reproducible results is to erode the credibility of medicine and rational thought. It is not a question of the amount of money, but the principle of integrity: every Euro, £ and $ spent on unproven treatments is a euro, £, and $ diverted from underfunded and often life-saving healthcare.
The regularly made appeal to the Swiss Model as a beacon of success also requires a more critical reading. The integration of so-called alternative medicine (SCAM) in Switzerland was, at its heart, a result of direct democracy rather than evidence. While the Swiss public voted for inclusion, the majority of the medical community remains deeply sceptical. To cite Switzerland as “proof” that anthroposophical medicine has fulfilled the criteria of EBM is to conflate political popularity with scientific validation. Democracy can decide how a nation spends its money, but it cannot vote a reliable evidence-base into existence.
Finally, we must consider the human risk of legitimizing non-evidenced-based practices. When a state-sanctioned insurance system places such therapies on the same pedestal as EBM, it risks misleading vulnerable individuals. For patients facing chronic or life-threatening illnesses, the “integrative” path can lead to a dangerous delay in seeking conventional, life-saving interventions. By treating subjective belief and peer-reviewed science as equal peers, we risk entering a “post-truth” medical era where the desire for a “natural” or “holistic” experience outweighs the necessity for proof.
In conclusion, while the call for a more “human” and “holistic” medical system might be noble, it must not come at the expense of scientific rigor. It is deeply misleading to imply that this is an ‘either or’; good medicine will always be based on both. A healthcare system that prioritizes popularity over proof risks becoming a system of expensive comfort rather than one of effective healing. True patient appreciation lies not in offering unproven choices, but in ensuring that every treatment covered by the public purse is supported by sound evidence. Not following this strategy is a disservice to patients and to progress.
So, the next time you hear people defending anthroposophical medicine or any other unproven modality, please look behind the smoke screen and find out why they do it. More often than not, you will then identify a massive conflict of interest. My advice is to listen to independent experts and to dismiss the people with an axe to grind.
The case of the 14-year-old girl who died of cancer is now occupying the Klagenfurt Regional Court for the second time. The girl’s parent elected to trust miracle healers and esoteric practitioners. Ultimately, the 14-year-old arrived at the hospital far too late—the cancer was already so advanced that the girl died less than two days later.
The parents have already been convicted of torture and neglect. During their criminal trial, the doctor came into the prosecution’s focus. He had administered four infusions of “cat’s claw” to the 14-year-old. The doctor admitted to this last year during his testimony as a witness, where he raved about the “miracle plant” cat’s claw, claiming it could heal almost anything.
He was also accused of using a pendulum to “test” the girl’s tumor and certifying it as benign. His response at the time was that he does not use a pendulum; rather, he had “dowsed” the tumor using a biotensor—a small metal spring. He claimed that when he failed to get a clear result, he urgently recommended the parents seek a biopsy, which they strictly refused. He alleged they eventually broke off treatment with him.
According to the indictment, the doctor is allegedly responsible for a further patient’s death by administering the herbal infusion. The man had collapsed after receiving it, suffered a heart attack and a stroke, and died weeks later from the consequences.
Furthermore, the doctor is accused of “grossly negligently causing a danger to the life and health of at least 6,550 people from May 2007 to May 2025.” Contrary to the standards of medical practice, he is said to have intravenously administered essences that were only approved as food products. The prosecutor referred to an analysis of the infusion solutions: “These were not pure; they contained soil and ash particles.” They were reportedly “brewed together in a backyard” – the contamination, she noted, could lead to the formation of blood clots. During his questioning, the trained intensive care physician rejected all guilt: “I feel in no way responsible.” He stated he had treated numerous cancer patients—for example, with cat’s claw or high-dose vitamin C.
In the case of the 14-year-old, the doctor insisted he was able to “see that something was not right” using the device. He claimed he only learned much later that the parents had canceled a biopsy appointment after their session with him. Furthermore: “Father and daughter always rejected any conventional medical therapy or diagnostics.” He maintained that he always noted his infusions could only boost the immune system and improve well-being, but never promised anything.
Regarding the case of the other deceased man, the doctor argued that the patient had already received 17 infusions from him prior to the incident in question and had always felt better afterward. After the final infusion, the patient felt unwell for a while, but his condition supposedly improved. The doctor claimed it was absolutely not anaphylactic shock: “Otherwise, I wouldn’t have let him go home.”
The defendant questioned each and every expert opinion obtained for the case. Regarding the statement that it is impossible for a tumor to shrink due to his infusions, he said, “I wouldn’t sign off on that.” As for the infusions, he claimed they were filtered multiple times and specially prepared for intravenous use.
A date for this has not yet been set. So, watch this space!
Might this be a fitting task for AI?
Let’s see; I gave ‘Gemini’ the following task: “Give me a list of the 10 biggest charlatans in the field of alternative medicine + a short explanation why they are generally considered to be charlatans”
Here is the response:
The term “charlatan” is highly subjective and often used by critics to describe individuals who promote medical treatments that lack scientific evidence or conflict with established biology. While many practitioners in alternative medicine are viewed by their followers as pioneers, they are often labeled charlatans by the scientific community due to claims of “miracle cures,” the rejection of conventional data, or the sale of unproven products.
The following list includes ten figures who are frequently cited in skeptical and medical literature as major examples of this phenomenon:
1. Kevin Trudeau
Trudeau is perhaps the most famous modern example of a medical “hawker.” He authored Natural Cures “They” Don’t Want You to Know About, a book that alleged a massive conspiracy between the FDA and pharmaceutical companies to hide cures for cancer and other diseases.
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Why labeled a charlatan: He was repeatedly sued by the FTC for making false claims and was eventually sentenced to 10 years in prison for criminal contempt related to his deceptive infomercials.
2. “Dr. Sebi” (Alfredo Bowman)
Despite not being a medical doctor, Bowman gained a massive following by claiming he could cure AIDS, cancer, and diabetes through a strictly alkaline diet and herbal supplements.
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Why labeled a charlatan: He claimed that all disease is caused by “mucus” and that his “African Bio-Mineral Balance” could eliminate it—a claim with no basis in human physiology. He was successfully sued by the New York Attorney General for practicing medicine without a license.
3. Andrew Wakefield
A former physician, Wakefield is the primary source of the modern anti-vaccine movement. In 1998, he published a fraudulent study in The Lancet suggesting a link between the MMR vaccine and autism.
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Why labeled a charlatan: His study was found to be based on manipulated data and unethical treatment of children. He was subsequently stripped of his medical license, but he continues to profit from anti-vaccine activism.
4. Belle Gibson
An Australian wellness influencer, Gibson built a massive brand claiming she had cured her terminal brain cancer through diet, exercise, and alternative therapies.
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Why labeled a charlatan: It was eventually revealed that she never had cancer. She also admitted to withholding thousands of dollars in promised donations to various charities.
5. Joseph Mercola
Mercola is an osteopathic physician who runs one of the most profitable “alternative health” websites in the world. He has frequently promoted homeopathic remedies and criticized standard medical practices like vitamin K shots for newborns.
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Why labeled a charlatan: He has received multiple warning letters from the FDA for selling unapproved and misbranded products, such as “thermography” as a superior replacement for mammograms (which it is not).
6. Stanislaw Burzynski
A physician in Texas, Burzynski has spent decades selling “antineoplastons” as a cure for various cancers at his private clinic.
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Why labeled a charlatan: Despite over 40 years of operation, he has never produced a peer-reviewed, Phase III clinical trial proving his treatments work. Critics argue he exploits desperate patients, charging them hundreds of thousands of dollars for unproven therapy.
7. Robert O. Young
The author of The pH Miracle, Young popularized the idea that “acidosis” is the cause of all disease and that an “alkaline diet” can cure everything from obesity to Stage IV cancer.
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Why labeled a charlatan: In 2016, he was convicted of practicing medicine without a license. It was revealed that one of his “patients,” a woman with breast cancer, paid him thousands for intravenous baking soda treatments before she ultimately died.
8. Hulda Clark
Clark was a naturopath who claimed that all diseases (including cancer and HIV) were caused by parasites and could be cured by a device she invented called the “Zapper,” which used low-voltage electricity.
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Why labeled a charlatan: Her claims were entirely unscientific; she believed “electronic frequencies” could kill parasites instantly. She eventually died of multiple myeloma (a blood cancer), a disease her own device supposedly could have cured.
9. Matthias Rath
A German physician, Rath has aggressively promoted high-dose vitamin therapy as a cure for HIV/AIDS and heart disease.
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Why labeled a charlatan: He ran advertisements in South Africa discouraging people from using antiretroviral drugs, claiming vitamins were a safer alternative. This campaign is estimated to have led to thousands of unnecessary deaths.
10. Gwyneth Paltrow (Goop)
While Paltrow is an actress, her lifestyle brand Goop has become a central hub for “luxury” alternative medicine, selling items like “Jade Eggs” for vaginal health and “Body Vibes” stickers.
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Why labeled a charlatan: Goop has been forced to pay settlements for making unsubstantiated medical claims. Critics argue the brand uses “wellness” as a shield to sell pseudo-scientific products to wealthy, health-conscious consumers.
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I have to say, this list disappoints me: hardly any of the above individuals would have appeared on my personal list of the 10 biggest charlatans!
Will I disclose my personal list?
No, I don’t think so.
Innovations in both the surgical and medical management of breast cancer over the past few decades have led to reductions in treatment-related morbidity and increases in overall survival. Despite these advancements in surgery, chemotherapy, radiation, endocrine therapy, and immunotherapy, a subset of patients continues to choose so-called alternative medicine (SCAM). The objective of this study was to describe the association of SCAM with survival in patients with breast cancer.
This cohort study analyzed data from the National Cancer Database on female patients diagnosed with breast cancer from 2011 through 2021. Survival time was compared among patients who received conventional treatment, conventional treatment plus SCAM, and SCAM only. Data were analyzed from May 2025 to December 2025.
The primary outcome was 5-year survival. Unadjusted 5-year survival was assessed by Kaplan-Meier analysis, and adjusted survival was assessed with a Cox proportional hazards model controlled for age, race and ethnicity, Charlson Comorbidity index, insurance type, facility type, region, year of diagnosis, cancer stage, and income.
Of 2 169 202 female patients with breast cancer identified, 2 157 219 (median [IQR] age, 62 [52-71] years) were included in the sample. A total of 2 106 665 patients (97.6%) received conventional therapy.
- 273 (<0.1%) received SCAM alone,
- 568 (<0.1%) received a combination of SCAM and coventional therapies,
- 49 713 (2.3%) received no treatment.
Compared with patients treated with conventional therapies, those treated with SCAM alone (adjusted hazard ratio [AHR], 3.67; 95% CI, 3.03-4.44; P < .001) or no treatment (AHR, 3.53; 95% CI, 3.48-3.58; P < .001) had the highest risks for mortality. Patients who received a combination of conventional therapies and SCAM were less likely to receive endocrine therapy (eg, 40.7% vs 65.2% in stage II; P < .001) and radiation (59.5% vs 36.6% in stage II; P < .001) compared with patients treated exclusively with conventional therapies. Receipt of a combination of conventional therapies and SCAM was associated with a higher mortality compared with being treated exclusively with conventional therapy (AHR, 1.45; 95% CI, 1.22-1.72; P < .001).
The authors concluded that, in this cohort study of data from female patients with breast cancer included in the NCDB, the use of SCAM instead of conventional therapies was uncommon but was associated with a reduction in survival time. Further study is warranted.
The full text of this study is worth reading. It shows clearly that patients who use SCAM – even as an additional therapy – tend to skip some live-saving treatments. Why? Possibly because SCAM therapists persuade them that this is a good idea. I have personally seen this happening several times. It means that the SCAM might well be harmless, but the SCAM therapist is not!
The list of investigations showing that SCAM is a risk factor for cancer patients undergoing oncological treatments is growing. The message for patients is important and clear: stay away from SCAM while receiving curative treatment. Later on, during the supportive or palliative phase of care, some forms of SCAM might be helpful for improving cancer patients’ quality of life. For people with a keen interest in this area, I recommend reading my book which attempts to define which forms of SCAM might be beneficial for cancer patients at what stage of the recovery.
Pediatric vertebral artery dissection (VAD) following chiropractic cervical manipulation (CCM) is a rare phenomenon. As chiropractic care of pediatric populations increases internationally, it is imperative to increase awareness of this cause of VAD.
This case-report describes a patient encountered in the Department of Neurological Surgery, Indiana University School of Medicine, USA. He was a 20-month-old male who presented nonspecifically with acute onset of
- lethargy,
- vomiting,
- cyanosis,
- respiratory distress.
Cerebrovascular imaging revealed a luminal irregularity in the V4 segment of the right vertebral artery, consistent with dissection. The patient’s guardian later provided history of taking the child for cervical chiropractic corrections immediately prior to the patient’s presentation to the emergency department.
The patient was managed non-operatively. Intubation was performed due to respiratory distress and managed with fluids, vasopressors, antimicrobials, and high-flow oxygen. The patient was extubated four days after presentation, and pressors were discontinued upon achievement of hemodynamic stability. A few days after extubation, the patient was ambulating and able to interact with objects and caretakers. Aspirin therapy was initiated and continued after discharge. The patient was followed with annual appointments and imaging. At two-year follow-up, CTA demonstrated an asymmetrically small right vertebral artery, accompanied by encephalomalacia of the right posterior occipital lobe. MRA demonstrated diffuse narrowing of the V4 segment of the right vertebral artery, albeit less pronounced than prior MRAs. Aspirin was discontinued by an outside following team due to stability of imaging findings. The parents were advised to avoid contact sports to avoid trauma and recurrent stroke.
The authors found 2 further cases of pediatric VAD in the published literature following CCM. Non-specific presentations were noted in both of them. Appropriate diagnosis of pediatric VAD requires increased surveillance in response to a thorough history and an acknowledgment of the plethora of possible patient presentations and etiologies.
The authors concluded that there is an increasing utilization of chiropractors among the pediatric population. In a pediatric patient with nonspecific symptoms, VAD should be considered as a differential diagnosis when there is a history of CCM.
The authors’ statement that “pediatric vertebral artery dissection (VAD) following chiropractic cervical manipulation (CCM) is a rare phenomenon” should be taken with a pinch of salt. As there is no monitoring, the frequency of adverse effects and complications is essentially unknown. Crucially. the risks of CCM for children is by no means confined to VADs. For a fuller account, I recomment reading my book which has an entire chapter on this very subject.
The key messages about CCM for kids might be summarised in the following simple three facts:
- CCM has no true benefit for children.
- Thus the risk/benefit balance fails to be positive.
- Therefore we should discourage partents from taking their kids to see chiropractors.
