cult
How often have we seen it stated on this blog and elsewhere by enthusiasts of so-called alternative medicine (SCAM) that COVID vaccinations were useless or even harmful? Here is some rather compelling evidence that should make them think again.
This population based cohort study investigated the effectiveness of primary covid-19 vaccination (first two doses and first booster dose within the recommended schedule) against post-covid-19 condition (PCC).
All adults (≥18 years) participated from the Swedish Covid-19 Investigation for Future Insights (a Population Epidemiology Approach using Register Linkage (SCIFI-PEARL) project, a register based cohort study in Sweden) with covid-19 first registered between 27 December 2020 and 9 February 2022 (n=589 722) in the two largest regions of Sweden. Individuals were followed from a first infection until death, emigration, vaccination, reinfection, a PCC diagnosis (ICD-10 diagnosis code U09.9), or end of follow-up (30 November 2022), whichever came first. Individuals who had received at least one dose of a covid-19 vaccine before infection were considered vaccinated.
The primary outcome was a clinical diagnosis of PCC. Vaccine effectiveness against PCC was estimated using Cox regressions adjusted for age, sex, comorbidities (diabetes and cardiovascular, respiratory, and psychiatric disease), number of healthcare contacts during 2019, socioeconomic factors, and dominant virus variant at time of infection.
Of 299 692 vaccinated individuals with covid-19, 1201 (0.4%) had a diagnosis of PCC during follow-up, compared with 4118 (1.4%) of 290 030 unvaccinated individuals. Covid-19 vaccination with any number of doses before infection was associated with a reduced risk of PCC (adjusted hazard ratio 0.42, 95% confidence interval 0.38 to 0.46), with a vaccine effectiveness of 58%. Of the vaccinated individuals, 21 111 received one dose only, 205 650 received two doses, and 72 931 received three or more doses. Vaccine effectiveness against PCC for one dose, two doses, and three or more doses was 21%, 59%, and 73%, respectively.
The authors concluded that the results of this study suggest a strong association between covid-19 vaccination before infection and reduced risk of receiving a diagnosis of PCC. The findings highlight the importance of primary vaccination against covid-19 to reduce the population burden of PCC.
This study should make the anti-vaxers re-consider their views. Sadly, I have little hope that they will. If they don’t, they provide rational thinkers with yet further evidence that they are cultists who are beyond learning from compelling data.
I was alerted to a new book entitled “Handbook of Space Pharmaceuticals“. It contains a chapter on “Homeopathy as a Therapeutic Option in Space” (yes, I am not kidding!). Here is its abstract (the numbers were inserted by me and refer to the short comments below):
Homeopathy is one of the largest used unorthodox medicinal systems having a wide number of principles and logic to treat and cure various diseases [1]. Many successful concepts like severe dilution to high agitation have been applied in the homeopathic system [2]. Though many concepts like different treatment for same diseases and many more are contradictory to the allopathic system [3], homeopathy has proved its worth in decreasing drug-related side effects in many arenas [4]. Various treatments and researches are carried out on various diseases; mostly homeopathic treatment is used in joint diseases, respiratory diseases, cancer, and gastrointestinal tract diseases [5]. In this chapter, readers will have a brief idea about many meta-analysis results of most common respiratory diseases, i.e., asthma, incurable hypertension condition, rheumatoid arthritis, and diarrhea and a megareview of all the diseases to see their unwanted effects, uses of drugs, concepts, and issues related to homeopathy [6]. Various limitations of homeopathic treatments are also highlighted which can give a clear idea about the future scope of research [7]. Overall, it can be concluded that placebo and homeopathic treatments give almost the same effect [8], but the less severe side effects of homeopathic drugs in comparison to all other treatment groups catch great attention [9].
Apart from the very poor English of the text and the fact that it has as good as nothing to do with the subject of ‘Homeopathy as a Therapeutic Option in Space’, I have the following brief comments:
- I did not know that homeopathy has ‘a wide number of logic’ and had alwas assumed that there is only one logic.
- Successful concepts? Really?
- So, homeopaths believe that the ‘allopathic system’ treats the same diseases uniformly? In this case, they should perhaps read up what conventional medicine really does.
- I am not aware of good evidence showing that homeopathy reduces drug related adverse effects.
- No, homeopathy is used for all symptoms – Hahnemann did not believe in treating disease entities – and mostly for those that are self-limiting.
- I love the term ‘incurable hypertension condition’; can somebody please explain what it is?
- The main limitation is that homeopathy is nonsense and, as such, does not really require further research.
- Not ‘almost’ but ‘exactly’! But thanks for pointing it out.
- Wishful thinking and not true. Firstly, the author forgot about ‘homeopathic aggravations’ in which homeopaths so strongly believe. Secondly, I know of many non-homeopathic treatments that are free of adverse effects when done properly.
Altogether, I am as disappointed by this article as you must be: we were probably all hoping to hear about the discovery showing that homeopathy works splendidly in space – not least because we have known for a while that homeopaths seem to be from a different planet.
The British doctor and outspoken anti-vaxer Aseem Malhotra has featured several times on this blog, e.g.:
- UK Cardiologist Dr. Aseem Malhotra receives a well-deserved award
- Dr Aseem Malhotra and Dr Steven James: candour and complacency
Now, there has been a potentially important new development in his story. The Good Law Project recently announced the following:
During the pandemic, we depended on doctors telling us how we could protect ourselves and our loved ones. We trusted their advice would be based on the most reliable and up-to-date research.
But when the British cardiologist Dr Aseem Malhotra went on television, or posted to his hundreds of thousands of followers on social media, he repeatedly claimed the vaccine was ineffective and posed a greater threat than Covid, causing “horrific unprecedented harms including sudden cardiac death” – suggestions refuted by medical experts and branded false by factcheckers.
The General Medical Council is responsible for regulating doctors in the UK and investigating those whose conduct falls short of the required standards. Despite the clear risk to public health of vaccine misinformation, it has so far refused to launch an investigation into Malhotra’s public pronouncements, originally saying that they “don’t consider that the comments or posts made by the doctor call his fitness to practice into question…” and subsequently upholding that decision after a number of doctors challenged it.
Good Law Project is supporting a doctor who is taking the regulator to the High Court over their failure to investigate whether Malhotra has breached standards. The judicial review has now been given permission to proceed by the High Court, which held that it raises an “issue of general public importance” as to how the GMC exercises its functions.
According to the claimant, Dr Matt Kneale, medical professionals “should not be using their professional status to promote harmful misinformation”.
“When doctors repeatedly say things that are incorrect, misleading and put people’s health at risk – for example by encouraging them to refuse a vaccine – the GMC must hold them to account,” Kneale said.
For the Good Law Project Executive Director, Jo Maugham, the regulator’s failure to investigate doctors spreading misinformation forms part of a wider pattern.
“What we have learned from both the pandemic inquiry and the calamitous economic consequences of Brexit,” Maugham explained, “is quite how serious are the consequences of deciding, as Michael Gove did, that we have ‘had enough of experts’.”
The council may prefer to avoid becoming embroiled in a controversy over free speech, he continued, but “its primary obligation is to protect the public – and it’s really hard to see how its stance delivers on that objective.”
Dr Malhotra is far from the only proponent of vaccine misinformation in the UK. Open Democracy revealed that anti-lockdown MPs, including Tufton Street’s Steve Baker, took large donations from a secretive group called The Recovery Alliance, which has been linked with a fake grassroots organisation that campaigned against the vaccine.
We’re working to stop misinformation from going unchallenged, and to make sure that regulators like the General Medical Council hold dangerous doctors who make unfounded claims accountable.
By helping to fund this case, you’ll be fighting for trust in the medical profession and to make sure public safety is doctors’ first priority. Any support you can give will help us make positive change.
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The ‘Good Law Project’?
Who are they?
Good Law Project is a not for profit campaign organisation that uses the law for a better world. We know that the law, in the right hands, can be a fair and decent force for good. It is a practical tool for positive change and can make amazing things happen. We are proud to be primarily funded by members of the public, which keeps us fiercely independent. We want to inspire hope in difficult times by showing that you can make a difference, with the backing of good law. Our mission is to use the law to hold power to account, protect the environment, and ensure no one is left behind. You can learn more about our organisation and achievements in 2022-23 in our annual report.
You might even decide to support this splendid organization!
I hope you do.
Congratulations to Joseph Prahlow, MD, who is the winner of the Excellence in Homeopathy Award! Here are the conclusions of his winning essay. Special thanks to Hermeet Singh and Boiron for their prize donation.
Despite the many obstacles and challenges which face homeopathy in the 21st century, the homeopathic community should be emboldened and encouraged by the fact that there are also many opportunities for the advancement of homeopathy as an alternative choice in health care.
Proclaim the Truth: Homeopathy Actually Works
Notwithstanding the challenges involved (especially for a student) in arriving at the correct simillimum for a case, let alone the appropriate follow-up and case management, the truth of the matter is that homeopathy does, in fact, work! Those of us who have been the beneficiaries of homeopathic care, or who have seen the benefits in others, know with no doubt whatsoever that homeopathy represents a truly amazing form of alternative medicine that is able to successfully treat patients having a wide range of health concerns, including some very ill individuals. And it’s not just based on “experience” or “perception,” although such evidence should not be discounted. Numerous studies show the effectiveness of homeopathy.6-9 The fact that homeopathy actually works represents one of the biggest and most important opportunities for homeopathy. The corresponding challenge relates to “getting the word out” into the general community as well as the medical community. Instead of homeopathy being the “last resort,” it should increasingly become the “first choice” amongst patients. Only by “spreading the word” of its success can this become a reality.
What intrigued me here was the evidence that an award-winning homeopath believes might justify the claim that
“Numerous studies show the effectiveness of homeopathy”
6. Mathie RT, Lloyd SM, Legg LA, et al. Randomised placebo-controlled trials of individualized homeopathic treatment: systematic review and meta-analysis. Syst Rev. 2014 Dec 6;3:142. doi: 10.1186/2046-4053-3-142.
As we have discussed previously that meta-analysis is phoney and created a false-positive result by omitting at least two negative studies.
7. Taylor JA, Jacobs J. Homeopathic ear drops as an adjunct in reducing antibiotic usage in children with otitis media. Glob Pediatr Health 2014 Nov 21;1:2333794X14559395. doi: 10.1177/2333794X14559395.
This study had the notorious A+B versus B design and thus was unable to test for specific effects of homeopathy. Moreover, the lead author, Dr Jennifer Jacobs, was a paid consultant to Standard Homeopathic Company.
8. Sorrentino L, Piraneo S, Riggio E, et al. Is there a role for homeopathy in breast cancer surgery? A first randomized clinical trial on treatment with Arnica montana to reduce post-operative seroma and bleeding in patients undergoing total mastectomy. J Intercult Ethnopharmacol 2017 Jan 3;6(1):1-8. doi: 10.5455/jice.20161229055245.
This study showed no significant result in the intention to treat analysis. The positive conclusion seems to be based on data dredging only.
9. Frass M, Lechleitner P, Grundling C, et al. Homeopathic treatment as an add-on therapy may improve quality of life and prolong survival in patients with non-small cell lung cancer: a randomized, placebo-controlled, double-blind, three-arm, multic0-e1955enter study. Oncologist 2020 Dec 25(12):e1930-e1955. doi: 10.1002/onco.13548.
This study is since months under investigation for fraud. The reasons for this have been discussed previously.
Perhaps the award winning author should chance the crucial sentence into something like:
Numerous studies have shown how homeopaths try to mislead the public?
In any case, please do not let this stop you from reading the full paper by the award-winning author. I promise you that it will create much hilarity.
What does homeopathy offer our modern ailing world?
NOTHING!
According to Healthcare.gov, a primary care provider in the US is “a physician (MD or DO), nurse practitioner, clinical nurse specialist or physician assistant, as allowed under state law, who provides, coordinates or helps a patient access a range of healthcare services.” A growing movement exists to expand who can act as a primary care privider (PCP). Chiropractors have been a part of this expansion, but is that wise? This is the question recently asked by Katie Suleta of THE AMERICAN COUNCIL ON SCIENCE AND HEALTH In it, she explains that:
- chiropractors would like to act as PCPs,
- chiropractors are not trained in pharmacology,
- chiropractors receive some training in supplements,
- chiropractors wish to avoid pumping the body full of “synthetic” hormones and substances.
Subsequently, she adresses the chiropractic profession’s stance on vaccines.
First, look at similar professional organizations to establish a reasonable expectation. The American Medical Association has firmly taken a stance on vaccines and provides resources for physicians to help communicate with patients. There is no question about where they stand on the topic, whether it be vaccines in general or COVID-19 vaccines specifically. Ditto the American Osteopathic Association and American Association of Colleges of Osteopathic Medicine. There is a contingent of vaccine-hesitant MDs and DOs. There is also an anti-vax contingent of MDs and DOs. The vaccine hesitant can be considered misguided and cautious, while anti-vaxxers often have more misinformation and an underlying political agenda. The two groups pose a threat but are, thankfully, the minority. They’re also clearly acting against the recommendations of their professional organizations.
Let’s now turn to the American Chiropractic Association (ACA). Unlike the American Medical Association or American Osteopathic Association, they seem to take no stance on vaccines. None. Zip. Zilch. As of this writing, if you go to the ACA website and search for “vaccines,” zero results are returned. Venturing over to the ACA-CDID, there is a category under their “News and Articles” section for ‘Vaccines.’ This seems promising! However, when you click on it, it returns one article on influenza vaccines from Fox News from 2017. It’s not an original article. It’s not a perspective piece. No recommendations are to be found—nothing even on the COVID-19 vaccines. Basically, there is effectively nothing on ACA-CDID’s website either. We’re oh for two.
The last one we’ll try is DABCI University. No, it’s not a professional organization, but it does train DCs. The words ‘university’ and ‘internist’ are involved, so they must talk about vaccines…right? Wrong again. While there is a lot of content available only to paying members and students, the sections of their website that are publicly available are noticeably short on vaccine information. There is a section dedicated to articles, currently including five whole articles, and not a single one talked about vaccines. One report addresses the pharmacokinetics of coffee enemas, but none talks about one of the most fundamental tools PCPs have to help prevent illness.
Why It’s Important
Chiropractic was defined by DD. Palmer, its founder, as “a science of healing without drugs.” It relies on spinal manipulation. In traditional chiropractic, there is no room for medications at all. A rift has developed within the profession, and some chiropractors, those seeking that internal medicine certification, “try to avoid pumping the body with synthetic hormones and other prescriptions.”
During the COVID-19 pandemic, several prominent chiropractors publicly pushed anti-vaccine views. To highlight just a few prominent examples: Vax Con ’21, Mile Hi Chiro, and Ben Tapper. Vax Con ’21 was organized and orchestrated by the Chiropractic Society of Wisconsin. It featured Judy Mikovits, of Plandemic fame, as a speaker and touted her book with a forward written by Robert F. Kennedy Jr. It offered continuing education units (CEUs) to DCs to attend this anti-vaccine conference that peddled misinformation about COVID-19 vaccines and other prevention measures. Healthcare providers are often required to complete a certain number of continuing education units to maintain licensure, ensuring that they stay current and sharp as healthcare evolves or, in this case, devolves.
This conference was not unique in this either. Mile Hi Chiro was just held in Denver in September of this year, had several questionable speakers (including RFK and Ben Tapper of Disinformation Dozen fame), and offered continuing education. If professional conferences offer continuing education units for attendees and push vaccine misinformation, that should concern everyone. Especially if the profession in question wants to act as PCPs.
Despite training in a system that believes “the body has an innate intelligence, and the power to heal itself if it is functioning properly, and that chiropractic care can help it do that,” without medications, but frequently with supplements, roughly 58% of Oregon’s chiropractors were vaccinated against COVID-19. That said, their training and inclination, along with the silence of their professional organizations and the chiropractic conferences featuring anti-vaccine sentiment, make them a profession that, at the very least, doesn’t consider vaccinations or medications viable health alternatives. We’re now talking about an entire profession that wants to be PCPs.
Irrespective of your belief about the efficacy of COVID-19 vaccination, the germ theory of disease remains unchallenged. Anyone unwilling to work to treat and prevent infectious diseases within their community with the most effective means at our disposal should not be allowed to dispense medical advice. Chiropractors lack the basic training that a PCP should have. I’ve said it before and I’ll say it again: I want healthcare accessible for everyone. But, if you’re looking for a PCP, consider going to an MD, DO, NP, or PA – they come fully equipped for your primary care needs.
Regular readers of this blog will be aware that I have discussed the thorny issue of chiros and vaccinations many times before, e.g.:
- Chiropractic and Public Health
- The International Chiropractors Association’s Statement on Vaccination
- The General Chiropractic Council’s ‘Registrant Survey 2020’ has just been published
- Far too many chiropractors believe that vaccinations do not have a positive effect on public health
- Vaccination: chiropractors “espouse views which aren’t evidence based”
- Patients consulting chiropractors, homeopaths, or naturopaths are less likely to agree to the flu jab
- “The uncensored truth” about COVID-19 vaccines” … as told by some chiro loons
- Beliefs and behaviors of US chiropractors
- Media attention forces (some) chiropractors to get their act together
- Ever wondered why so many chiropractors are profoundly anti-vax?
I agree with Katie Suleta that the issue is important and thank her for raising it. I also agree with her conclusion that, if you’re looking for a PCP, consider going to an MD, DO, NP, or PA – they come fully equipped for your primary care needs.
Do not consult chiropractors.
Bioenergy therapies are among the popular so-called alternative medicine (SCAM) treatments. They are used for many diseases, including cancer. Many studies deal with the advantages and disadvantages of bioenergy therapies as an addition to established treatments such as chemotherapy, surgery, and radiation in the treatment of cancer. However, a systematic overview of this evidence is thus far lacking. For this reason, the available evidence was reviewed and critically examined in this paper.
A systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and Medline) to find randomized clinical trials concerning the use, effectiveness and potential harm of bioenergy therapies including Reiki, Therapeutic Touch, Healing Touch and Polarity Therapy on cancer patients.
From all 2477 search results, 21 publications with 1375 patients were included in this systematic review. The patients treated with bioenergy therapies were mainly diagnosed with breast cancer. The main outcomes measured were anxiety, depression, mood, fatigue, quality of life (QoL), comfort, well-being, neurotoxicity, pain, and nausea. The studies were predominantly of moderate quality and for the most part found no effect. In terms of QoL, pain and nausea, there were improved short-term effects of the interventions, but no long-term differences were detectable. The risk of side effects from bioenergy therapies appears to be relatively small. Most studies only had a passive control group. Accordingly, in contrast to the active bioenergy therapies groups, attention effects may strongly affect the results. In the comparisons with an active control group, for example a sham group, no effects were detectable.
The authors concluded that, considering the methodical limitations of the included studies, studies with high study quality could not find any difference between bioenergy therapies and active (placebo, massage, RRT, yoga, meditation, relaxation training, companionship, friendly visit) and passive control groups (usual care, resting, education). Only studies with a low study quality were able to show significant effects.
This conclusion will not surprise anyone who is capable of rational thinking. Energy healing methods are implausible; further research into this area is a pure wast of money and arguably unethical.
We have repeatedly discussed the fraud committed by many chiropractors. A recent article provided further information on this lamentable issue. Here are a few excerpts:
Fraud in US chiropractic care is on the rise. A shocking 82 percent of the chiropractic services billed to Medicare is unallowable, according to a recent audit by the Office of Inspector General. The audit found a lack of effective controls allowed an estimated $358.8 million in taxpayer funds to be improperly billed to Medicare.
Chiropractors engage in fraudulent billing practices in a variety of ways. Sometimes they target environments like nursing homes or substance abuse rehabilitation centers, looking for new patients who may – or may not – require their services.
In one case, a St. Louis-based chiropractor bribed police officers to get access to personal information about individuals who had been in car accidents. The chiropractor then contacted the accident victims and claimed to be from an insurance company or the state to arrange appointments at his practice.
In another case, a Houston-based chiropractor and his medical group settled with the federal government for $2.6 million and were also banned from billing federal programs for 10 years due to their involvement with a fraudulent billing scheme.
Lastly, in 2021, a chiropractor was found guilty of federal criminal charges, including five counts of healthcare fraud. The chiropractor was accused of defrauding health insurers by submitting $2.2 million in billings for chiropractic services that were never provided, office visits that never occurred, false diagnoses, and falsely prescribed medical devices.
Although other medical specialties also have bad actors, certain specific reasons can be identified as to why fraudulent billing and abuse have been increasing among chiropractors. These practitioners have fewer lower-cost codes to bill for, which means they need more patients to boost their earnings. For example, a service may only be billed at $25 or $50, but if this is billed to every patient on every visit, it quickly adds up. Because employers often have limited resources, it’s easy for minor charges to go unnoticed.
According to a 2018 report, the inspector general has conducted numerous evaluations and audits of chiropractic services since 2005 and has identified hundreds of millions of dollars in overpayments for services that did not meet Medicare requirements. The report also noted that the OIG’s investigations and legal actions involving chiropractors have demonstrated that chiropractic services are susceptible to healthcare fraud.
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Personally, I am not surprised by such reports. Sure, not all chiropractors committ financial fraud. But arguably ALL chiropractors are dishonest when they tell their patients that their spinal manipulations are effective and safe for a wide range of conditions. To put it bluntly: chiropractic was founded by a crook on a bunch of lies and unethical behavior, therefore, it is hardly surprising that today the profession has a problem with honesty and fraudulent behavior.
‘The Cult of Chiropractic’ is the title of a video that has just been released. I think it is very good and, if you are interested in the subject at all, I recommend you have a look. You can watch it here:
The Cult of Chiropractic : r/h3h3productions (reddit.com)
The video is not just well-done, it also is fun and informative. I learned a few things from it that I did not yet know. It also brings Simon Singh and myself together after we had not met for several years; and that is always a pleasure!
But back to ‘The Cult of Chiropractic’ and the question whether this assumption is true. Some time ago, I published a post about so-called alternative medicine and cultism. I listed a few questions we should ask ourselves to determine whether chiropractic is a cult. Let me adapt them slightly:
- Is chiropractic based on dogma? The answer is yes – think, for instance, of the assumptions that subluxations exist.
- Does chiropractic demand acceptance of its dogma or doctrine as truth? For straight chiropractors, the answer is yes.
- Is the dogma set forth by a single guru or promulgator? Yes, DD Palmer.
- Is chiropractic supposed to cure all ills? For many chiros, the answer is yes.
- Is belief used by chiropractors as a substitute for evidence? Yes.
- Do chiropractors determine their patients’ lifestyle? Yes.
- Do chiros exploit their patients financially? Yes.
- Does chiropractors impose rigid rules and regulations? Yes.
- Do chiros practice deception? Yes.
- Do chiropractors have their own sources of information/propaganda? Yes.
- Do chiros cultivate their own lingo? Yes.
- Do chiros discourage or inhibit critical thinking? Yes.
- Are questions about the values of chiropractic discouraged or forbidden? Yes.
- Do the proponents of chiropractic reduce complexities into platitudinous buzz words? Yes
- Do chiros assume that health problems are the result of not adhering to the dogma? Yes.
- Do chiros instill fear into members who consider leaving? Yes.
- Do chiros depict conventional medicine as ineffective or harmful? Yes.
- Do chiros ask others to recruit new members to their cult? Yes.
Based on these 18 questions, I conclude that chiropractic is indeed a cult. What about you? Even if you disagree, please have a look at the excellent video, ‘THE CULT OF CHIROPRACTIC’.
Conspiracy beliefs (CBs) can have substantial consequences on health behaviours by influencing both conventional and non-conventional medicine uptake. They can target powerful groups (i.e. upward CBs) or powerless groups (i.e. downward CBs). Considering their repercussions in oncology, it appears useful to understand how CBs are related to the intentions to use conventional and so-called alternative medicines (SCAM), defined as “medical products and practices that are not part of standard medical care” including practices
such as mind–body therapies, botanicals, energy healing or naturopathic medicine.
This paper includes two pre-registered online correlational studies on a general French population (Study 1 N = 248, recruited on social media Mage = 40.07, SDage = 14.78; 205 women, 41 men and 2 non-binaries; Study 2 N = 313, recruited on social media and Prolific, Mage = 28.91, SDage = 9.60; 154 women, 149 men and 10 non-binaries). the researchers investigated the links between generic and chemotherapy-related CBs and intentions to use conventional or SCAMs. Study 2 consisted of a conceptual replication of Study 1, considering the orientation of CBs.
Generic CBs and chemotherapy-related CBs appear strongly and positively correlated, negatively correlated with intentions to take conventional medicine and positively with intentions to take SCAM. The link between generic CBs and medication intention is fully mediated by chemotherapy-related CBs. When distinguished, upward CBs are a stronger predictor of chemotherapy-related CBs than downward CBs.
The authors concluded that the findings suggest that intentions to use medicine are strongly associated with CBs. This has several important implications for further research and practice, notably on the presence and effects of CBs on medication behaviours in cancer patients.
Sadly, the influence of CBs is not confined to the field of oncology but applies across all diseases and conditions. We have seen and discussed these issues in several previous posts, e.g.:
- Conspiracy Beliefs Predict Health Behavior and Well-being during the Pandemic
- Coronavirus conspiracy beliefs, mistrust, and compliance with government guidelines
- Mistrust + Misinformation —> CONSPIRACY THEORY
- Conspiracy theories and dangerous recommendations via YouTube videos
- Conspiracy theories, assumptions, opinions, evidence and scientific facts
- A conspiracy theory seems to be driving the popularity of alternative medicine
The most impressive evidence, however, is regularly being provided by some of the people who post comments on this blog. Collectively, this evidence has prompted me to postulate that SCAM itself can be seen as a consiracy theory.
Mistletoe, an anthroposophical medicine, is often recommended as a so-callled alternative medicine (SCAM) for cancer patients. But what type of cancer, what type of mistletoe preparation, what dosage regimen, what form of application?
The aim of this systematic analysis was to assess the concept of mistletoe treatment in published clinical studies with respect to indication, type of mistletoe preparation, treatment schedule, aim of treatment, and assessment of treatment results. The following databases were systematically searched: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL, and “Science Citation Index Expanded” (Web of Science). The researchers assessed all studies for study types, methods, endpoints and mistletoe preparations including their ways of application, host trees and dosage schedules.
The searches revealed 3296 hits. Of these, 102 publications with a total of 19.441 patients were included. The researchers included several study types investigating the application of mistletoe in different groups of participants: cancer patients with any type of cancer were included as well as studies conducted with healthy volunteers and pediatric patients. The most common types of cancer were:
- breast cancer,
- pancreatic cancer,
- colorectal cancer,
- malignant melanoma.
Randomized controlled studies, cohort studies and case reports make up most of the included studies. A huge variety was observed concerning the type and composition of mistletoe extracts (differing pharmaceutical companies and host trees), ways of applications and dosage schedules. Administration varied widely, e. g. between using mistletoe extract as sole treatment and as concomitant therapy to cancer treatment. The researchers found no relationship between the mistletoe preparation used, host tree, dosage, and cancer type.
A variety of different mistletoe preparations was used to treat cancer patients. Due to the heterogeneity of the mistletoe preparations used, no comparability between different studies or within single studies using different types of mistletoe preparations or host trees is possible. Moreover, no relationship between mistletoe preparation and type of cancer can be observed. This results in a severely limited comparability of studies with regard to the different cancer entities and mistletoe therapy in oncology in general. Analyzing the methods sections of all articles, there are no information on how the selection of the respective mistletoe preparation took place. None of the articles provided any argument which type of preparation (homeopathic, anthroposophic, standardized) or which host tree was chosen due to which selection criteria. Considering preparations from different companies, funding may have been the reason of the selection.
Dosage or dosage regimens varied strongly in the studies. Due to the heterogeneity of dosage and dosage regimens within studies and between studies of the endpoints the comparability of the different studies is severely limited. Duration of mistletoe treatment varied strongly in the studies ranging from a single dose given on one day to the application of mistletoe preparations for several years. Moreover, the duration of treatment frequently varied within the studies. Mistletoe preparations were administered by different ways of application. Most frequently, the patients received mistletoe preparations subcutaneously. The second most common way was intravenous administration of mistletoe preparations. According to the respective manufacturers, this type of application is only recommended for Lektinol® and Eurixor®. Other preparations were given as off-label intravenous applications. No dosage recommendations from the respective manufacturers were available. Only in two studies the dose schedules were mentioned: according to the classical phase I 3 + 3 dose escalation schedule or in ratio to the body surface area.
The authors concluded that despite a large number of clinical studies and reports, there is a complete lack of transparently reported, structured procedures considering all fields of mistletoe therapy. This applies to type of mistletoe extract, host tree, preparation, treatment schedules as well as indication with respect of type of cancer and the respective treatment aim. All in all, despite several decades of clinical mistletoe research, no clear concept of usage is discernible and, from an evidence-based point of view, there are serious concerns on the scientific base of this part of anthroposophical treatment.
A long time ago, I worked as a junior doctor in a hospital where we used subcutaneous misteloe injections regularly to treat cancer. I remember being utterly confused: none of my peers was able to explain to me what preparation to use and how to does it. There simply were no rules and the manufacurer’s instructions made little sense. I suspected then that mistletoe therapy was a danerous nonsense. Today, after much research has been published on mistletoe, I do no longer suspect it, I know it.
I would urge every cancer patient to stay well clear of mistletoe and those practitioners who recommend it.
