Iscador
Suzanne Somers, born Suzanne Marie Mahoney on October 16, 1946 in San Bruno, California, was an American actress, author and businesswoman. Somers has published several best-selling self-help books, such as I’m Too Young for This! and The Natural Hormone Solution to Enjoy Menopause. In 2001, it was reported that she had breast cancer and was opting for so-called alternative medicine (SCAM) to treat it, In particular, she used Iscador, a preparation of mistletoe that we have discissed many times before on this blog, e.g.:
- A systematic analysis of the mistletoe prescriptions used in clinical studies
- Prof Harald Walach reviews mistletoe and arrives at a positive conclusion
- Mistletoe treatment for cancer is useless and should be discouraged
- Mistletoe for cancer: Does it improve patients’ quality of life?
- Mistletoe for cancer: the saga continues
- Mistletoe, a cancer therapy? You must be joking!
In an interview with Larry King in 2001, Somers revealed that she had been receiving treatment for a year. She also explained that she refused to go through with chemotherapy and instead used SCAM. “I decided to find alternative things to do,” she continued. “Because I have done so much work in my books about hormones, and that hormonal balance is why people gain or lose weight, and, it was my belief that a balanced environment of hormones prevents disease. And the first thing they said to me, we are taking of off all hormones. I said no, I’m going to continue taking my hormones, which is the first thing against the common course…”
Recently, it was reported that Somers has died of cancer aged 76. Earlier this year, Somers said they had “used the best alternative and conventional treatments to combat it [her cancer].” But now, a source close to the star shares that many around her didn’t like it. Somers’ friends tried to convince her to ditch SCAM in favor of chemotherapy. “She was advised by several people to consider the more conventional approach, but she did not listen,” a source close to Somers told the Daily Mail. The source continued, “She has always rejected chemo, so it wasn’t even an option. Her friends and loved ones urged her to reconsider so many times during her cancer battles and at the end.” A statement read. “Her family was gathered to celebrate her 77th birthday on October 16th. Instead, they will celebrate her extraordinary life, and want to thank her millions of fans and followers who loved her dearly.”
Perhaps this sad case is an apt occasion for rephrasing the warning that I posted only a few days ago:
be very cautious about using SCAMs for cancer and seek professional advice, preferably NOT from a SCAM provider.
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.
Many of you will be familiar with the ‘ALTERNATIVE MEDICINE HALL OF FAME’. It is my creation and meant to honour reserchers who have dedicated much of their professional career to investigating a form of so-called alternative medicine (SCAM) without ever publishing negative conclusions about it. Obviously, if anyone studies any therapy, he/she will occasionally produce a negative finding. This would be the case, even if he/she tests an effective treatment. However, if the treatment in question comes from the realm of SCAM, one would expect negative results fairly regularly. No therapy works well under all conditions, and to the best of my knowledge, no SCAM is a panacea!
This is why researchers who defy this inevitability are remarkable. If someone tests a treatment that is at best dubious and at worst bogus, we are bound to see some studies that are not positive. He/she would thus have a high or normal ‘TRUSTWORTHINESS INDEX‘ (another creation of mine which, I think, is fairly self-explanatory). Conversely, any researcher who does manage to publish nothing but positive results of a SCAM is bound to have a very low ‘TRUSTWORTHINESS INDEX‘. In other words, these people are special, so much so that I decided to honour such ‘geniuses’ by admitting them to my ALTERNATIVE MEDICINE OF FAME.
So far, this elite group of people comprises the following individuals:
- Helge Franke (osteopathy, Germany)
- Tery Oleson (acupressure , US)
- Jorge Vas (acupuncture, Spain)
- Wane Jonas (homeopathy, US)
- Harald Walach (various SCAMs, Germany)
- Andreas Michalsen ( various SCAMs, Germany)
- Jennifer Jacobs (homeopath, US)
- Jenise Pellow (homeopath, South Africa)
- Adrian White (acupuncturist, UK)
- Michael Frass (homeopath, Austria)
- Jens Behnke (research officer, Germany)
- John Weeks (editor of JCAM, US)
- Deepak Chopra (entrepreneur, US)
- Cheryl Hawk (chiropractor, US)
- David Peters (osteopathy, homeopathy, UK)
- Nicola Robinson (TCM, UK)
- Peter Fisher (homeopathy, UK)
- Simon Mills (herbal medicine, UK)
- Gustav Dobos (various SCAMs, Germany)
- Claudia Witt (homeopathy, Germany/Switzerland)
- George Lewith (acupuncture, UK)
- John Licciardone (osteopathy, US)
You will notice that the group does not yet contain a representative of anthroposophic medicine. Today, I intend to rectify this oversight by admitting Helmut Kiene (1952-). He has published plenty of studies and reviews on his pet subject; here are the ones that I found on Medline:
- Anthroposophic therapies in chronic disease: the Anthroposophic Medicine Outcomes Study (AMOS). Eur J Med Res. 2004 Jul 30;9(7):351-60.
- Anthroposophic medical therapy in chronic disease: a four-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.BMC Complement Altern Med. 2007 Apr 23;7:10. doi: 10.1186/1472-6882-7-10.
- Anthroposophic art therapy in chronic disease: a four-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.Explore (NY). 2007 Jul-Aug;3(4):365-71. doi: 10.1016/j.explore.2007.04.008.
- Rhythmical massage therapy in chronic disease: a 4-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.J Altern Complement Med. 2007 Jul-Aug;13(6):635-42. doi: 10.1089/acm.2006.6345
- Anthroposophic vs. conventional therapy for chronic low back pain: a prospective comparative study. Hamre HJ, Witt CM, Glockmann A, Wegscheider K, Ziegler R, Willich SN, Kiene H.Eur J Med Res. 2007 Jul 26;12(7):302-10.
- Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research. Kienle GS, Glockmann A, Schink M, Kiene H.J Exp Clin Cancer Res. 2009 Jun 11;28(1):79. doi: 10.1186/1756-9966-28-79.
- Anthroposophic therapy for children with chronic disease: a two-year prospective cohort study in routine outpatient settings. Hamre HJ, Witt CM, Kienle GS, Meinecke C, Glockmann A, Willich SN, Kiene H.BMC Pediatr. 2009 Jun 19;9:39. doi: 10.1186/1471-2431-9-39
- Predictors of outcome after 6 and 12 months following anthroposophic therapy for adult outpatients with chronic disease: a secondary analysis from a prospective observational study. Hamre HJ, Witt CM, Kienle GS, Glockmann A, Willich SN, Kiene H.BMC Res Notes. 2010 Aug 3;3:218. doi: 10.1186/1756-0500-3-218.
- Pulpa dentis D30 for acute reversible pulpitis: A prospective cohort study in routine dental practice. Hamre HJ, Mittag I, Glockmann A, Kiene H, Tröger W.Altern Ther Health Med. 2011 Jan-Feb;17(1):16-21.
- Use and safety of anthroposophic medications for acute respiratory and ear infections: a prospective cohort study. Hamre HJ, Glockmann A, Fischer M, Riley DS, Baars E, Kiene H.
- [Clinical research on anthroposophic medicine:update of a health technology assessment report and status quo]. Kienle GS, Glockmann A, Grugel R, Hamre HJ, Kiene H.Forsch Komplementmed. 2011;18(5):269-82. doi: 10.1159/000331812. Epub 2011 Oct 4.
- Anthroposophical medicine: a systematic review of randomised clinical trials. Kienle GS, Hamre HJ, Kiene H.Wien Klin Wochenschr. 2004 Jun 30;116(11-12):407-8; author reply 408. doi: 10.1007/BF03040923.
- Eurythmy therapy in chronic disease: a four-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.BMC Public Health. 2007 Apr 23;7:61. doi: 10.1186/1471-2458-7-61.
- Long-term outcomes of anthroposophic therapy for chronic low back pain: A two-year follow-up analysis. Hamre HJ, Witt CM, Kienle GS, Glockmann A, Ziegler R, Willich SN, Kiene H.J Pain Res. 2009 Jun 25;2:75-85. doi: 10.2147/jpr.s5922.
- Health costs in anthroposophic therapy users: a two-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.BMC Health Serv Res. 2006 Jun 2;6:65. doi: 10.1186/1472-6963-6-65.
- Use and safety of anthroposophic medications in chronic disease: a 2-year prospective analysis. Hamre HJ, Witt CM, Glockmann A, Tröger W, Willich SN, Kiene H.Drug Saf. 2006;29(12):1173-89. doi: 10.2165/00002018-200629120-00008.
- Anthroposophic therapy for chronic depression: a four-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.BMC Psychiatry. 2006 Dec 15;6:57. doi: 10.1186/1471-244X-6-57.
- Health costs in patients treated for depression, in patients with depressive symptoms treated for another chronic disorder, and in non-depressed patients: a two-year prospective cohort study in anthroposophic outpatient settings. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Kienle GS, Willich SN, Kiene H.Eur J Health Econ. 2010 Feb;11(1):77-94. doi: 10.1007/s10198-009-0203-0.
- Outcome of anthroposophic medication therapy in chronic disease: a 12-month prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Kienle GS, Willich SN, Kiene H.Drug Des Devel Ther. 2009 Feb 6;2:25-37.
- Clinical research in anthroposophic medicine. Hamre HJ, Kiene H, Kienle GS.Altern Ther Health Med. 2009 Nov-Dec;15(6):52-5.
- Anthroposophic therapy for attention deficit hyperactivity: a two-year prospective study in outpatients. Hamre HJ, Witt CM, Kienle GS, Meinecke C, Glockmann A, Ziegler R, Willich SN, Kiene H.Int J Gen Med. 2010 Aug 30;3:239-53. doi: 10.2147/ijgm.s11725.
- Anthroposophic therapy for asthma: A two-year prospective cohort study in routine outpatient settings. Hamre HJ, Witt CM, Kienle GS, Schnürer C, Glockmann A, Ziegler R, Willich SN, Kiene H.J Asthma Allergy. 2009 Nov 24;2:111-28.
- Anthroposophic therapy for migraine: a two-year prospective cohort study in routine outpatient settings. Hamre HJ, Witt CM, Kienle GS, Glockmann A, Ziegler R, Rivoir A, Willich SN, Kiene H.Open Neurol J. 2010;4:100-10.
- Antibiotic Use in Children with Acute Respiratory or Ear Infections: Prospective Observational Comparison of Anthroposophic and Conventional Treatment under Routine Primary Care Conditions. Hamre HJ, Glockmann A, Schwarz R, Riley DS, Baars EW, Kiene H, Kienle GS.Evid Based Complement Alternat Med. 2014;2014:243801.
- An assessment of the scientific status of anthroposophic medicine, applying criteria from the philosophy of science. Baars EW, Kiene H, Kienle GS, Heusser P, Hamre HJ.Complement Ther Med. 2018 Oct;40:145-150.
- Anthroposophic vs. conventional therapy of acute respiratory and ear infections: a prospective outcomes study. Hamre HJ, Fischer M, Heger M, Riley D, Haidvogl M, Baars E, Bristol E, Evans M, Schwarz R, Kiene H.Wien Klin Wochenschr. 2005 Apr;117(7-8):256-68. doi: 10.1007/s00508-005-0344-9.
- Long-term outcomes of anthroposophic treatment for chronic disease: a four-year follow-up analysis of 1510 patients from a prospective observational study in routine outpatient settings. Hamre HJ, Kiene H, Glockmann A, Ziegler R, Kienle GS.BMC Res Notes. 2013 Jul 13;6:269. doi: 10.1186/1756-0500-6-269
- Eurythmy Therapy in anxiety. Kienle GS, Hampton Schwab J, Murphy JB, Andersson P, Lunde G, Kiene H, Hamre HJ.Altern Ther Health Med. 2011 Jul-Aug;17(4):56-63
- Mistletoe in cancer – a systematic review on controlled clinical trials. Kienle GS, Berrino F, Büssing A, Portalupi E, Rosenzweig S, Kiene H.Eur J Med Res. 2003 Mar 27;8(3):109-19.
- Anthroposophic therapy of respiratory and ear infections. Hamre HJ, Fischer M, Heger M, Riley D, Haidvogl M, Baars E, Bristol E, Evans M, Schwarz R, Kiene H.Wien Klin Wochenschr. 2005 Jul;117(13-14):500-1. doi: 10.1007/s00508-005-0389-9
- Complementary cancer therapy: a systematic review of prospective clinical trials on anthroposophic mistletoe extracts.
Eur J Med Res. 2007 Mar 26;12(3):103-19.
- Review article: Influence of Viscum album L (European mistletoe) extracts on quality of life in cancer patients: a systematic review of controlled clinical studies. Kienle GS, Kiene H.Integr Cancer Ther. 2010 Jun;9(2):142-57.
- [Anthroposophic medicine: health technology assessment report – short version].
Forsch Komplementmed. 2006;13 Suppl 2:7-18. doi: 10.1159/000093481. Epub 2006 Jun 26.
- Bilateral Asynchronous Renal Cell Carcinoma With Lung Metastases: A Case Report of a Patient Treated Solely With High-dose Intravenous and Subcutaneous Viscum album Extract for a Second Renal Lesion. Reynel M, Villegas Y, Kiene H, Werthmann PG, Kienle GS.Anticancer Res. 2019 Oct;39(10):5597-5604. doi: 10.21873/anticanres.13754.
- Long-term survival of a patient with an inoperable thymic neuroendocrine tumor stage IIIa under sole treatment with Viscum album extract: A CARE compliant clinical case report. Reynel M, Villegas Y, Werthmann PG, Kiene H, Kienle GS.Medicine (Baltimore). 2020 Jan;99(5):e18990. doi: 10.1097/MD.0000000000018990
- Long-Term Survival of a Patient with Recurrent Dedifferentiated High-Grade Liposarcoma of the Retroperitoneum Under Adjuvant Treatment with Viscum album L. Extract: A Case Report. Reynel M, Villegas Y, Werthmann PG, Kiene H, Kienle GS.Integr Cancer Ther. 2021 Jan-Dec;20:1534735421995258. doi: 10.1177/1534735421995258.
- Intralesional and subcutaneous application of Viscum album L. (European mistletoe) extract in cervical carcinoma in situ: A CARE compliant case report. Reynel M, Villegas Y, Kiene H, Werthmann PG, Kienle GS.Medicine (Baltimore). 2018 Nov;97(48):e13420.
- High-Dose Viscum album Extract Treatment in the Prevention of Recurrent Bladder Cancer: A Retrospective Case Series.
Perm J. 2015 Fall;19(4):76-83. doi: 10.7812/TPP/15-018.
- Disappearance of an advanced adenomatous colon polyp after intratumoural injection with Viscum album (European mistletoe) extract: a case report. von Schoen-Angerer T, Goyert A, Vagedes J, Kiene H, Merckens H, Kienle GS.J Gastrointestin Liver Dis. 2014 Dec;23(4):449-52. doi: 10.15403/jgld.2014.1121.234.acpy.
- Viscum Album in the Treatment of a Girl With Refractory Childhood Absence Epilepsy. von Schoen-Angerer T, Madeleyn R, Kienle G, Kiene H, Vagedes J.J Child Neurol. 2015 Jul;30(8):1048-52. doi: 10.1177/0883073814541473. Epub 2014 Jul 17.
- Improvement of Asthma and Gastroesophageal Reflux Disease With Oral Pulvis stomachicus cum Belladonna, a Combination of Matricaria recutita, Atropa belladonna, Bismuth, and Antimonite: A Pediatric Case Report. von Schoen-Angerer T, Madeleyn R, Kiene H, Kienle GS, Vagedes J.Glob Adv Health Med. 2016 Jan;5(1):107-11. doi: 10.7453/gahmj.2015.019. Epub 2016 Jan 1.
- Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomized and randomized matched-pair studies nested within a cohort study. Grossarth-Maticek R, Kiene H, Baumgartner SM, Ziegler R.Altern Ther Health Med. 2001 May-Jun;7(3):57-66, 68-72, 74-6 passim
WHAT A LIST!
It makes several things very clear to me:
- Kiene is a productive researcher
- He likes observational studies and case reports
- He dislikes the idea of rigorously testing a hypothesis
- He never publishes a negative finding about anthroposophical medicine
- He certainly deserves to be admitted to the ALTERNATIVE MEDICINE HALL OF FAME!
Welcome Helmut
Recently, I received an email with this ‘special offer’ for purchasing a book and was impressed – but not in a positive sense:
Dr Farokh’s commendable work at upto 22% off – Healing Cancer. For Limited time period only.
Healing Cancer: A Homoeopathic Approach
As a homeopath one should not deter oneself in dealing with any type of cases, be it cancer. But for executing that an ultimate guidance is needed. Cancer is so much prevalent and challenging medical problem of today that a trustworthy source of accurate information becomes pertinent and this work of Dr. Farokh Master immediately propels at the top of quality books for cancer. Based on Master’s 40 years of experience this book was written for students to understand the basis of oncology and for practitioners for brushing-up of their knowledge in this growing discipline. Author says that to get a grasp on cancer cases we should believe in the potential of the homeopathic treatment, that healing from cancer refers to internal process of becoming whole and feeling harmonious with yourself and your environment.To even start with handling the cases of cancer one should be aware of understanding of cancer, its cause, pathophysiology, different types, conventional treatment and their side effects, integrative medicines, social problems in the treatment, such topics are well casted by Volume 1 of the book.
Peak points of Volume 1- • A full chapter is dealing with Iscador, a relatively old method, very effective but unfortunately underemployed.• Published papers about Homeopathy in the treatment of cancer are presented before the last chapter which is on some of most used allopathic drugs in cancer with a focus on their side-effects. After the coverage of basic information on oncology in Volume 1 comes the Volume 2 which explores topics like understanding cancer from homoeopathic point of view, constitutional remedies, therapeutics of individual cancers, nutrition, general management.
Peak points of Volume 2-• A whole chapter on Cadmium salts and cancer.• 51 “lesser known remedies” are briefly quoted and their usefulness in different situations and types of cancer exposed.• A long chapter deals with the “Indian drugs”, it is important that these remedies are used mostly in tincture or low potencies, as herbal or Ayurvedic remedies or food supplements relieving the patients. • The choice and differentiation between the remedies is then helped by the “Repertory of Cancer”, very well compiled and a highly useful section. “Clinical tips from my practice” given as a sub-chapter. • It ends with recommendations on how to deal with radiation illness and the side-effects of conventional treatment, as well as the treatment of pain and help with palliative care.
For fighting and curing cancer and improving the quality and quantity of life of people, knowledge of Homeopathy, both philosophically and scientifically is needed which this work of art portrays delightfully.
About Book Author:
Dr. Farokh J. Master’s birth into homeopathy was in the year 1976, when he joined Bombay homeopathic medical college, after giving up his studies at the orthodox school of medicine. Dr Master was instrumental in starting homeopathic out-patient dept in many allopathic hospitals viz. Bombay Hospital, KEM Hospital & Ruby Hall, Pune. Besides his work as a senior Homeopath of the HHC, Dr. Farokh Master is teaching homeopathy (advanced level) at the Mumbai Homeopathic Medical College, part of Mumbai university. He is also teaching at other homeopathic colleges in India and abroad. He has given seminars in various countries like Austria, Australia, India, Japan etc. Dr Master has written more than 50 books like -The Homeopathic Dream Dictionary, Cross References of the Mind, Perceiving Rubrics of the Mind, The State of Mind affecting the Foetus, Tumors and Homeopathy, The Bedside Organon of Medicine, The proving of Mocassin Snake, Bungarus, etc. Dr. Master is the originator of many recent new approaches and insights in homoeopathy.
Some people claim that homeopaths are not dangerous and argue that their placebos cannot harm patients. I have long disagreed with this position. As homeopathy is not an effective therapy (it has no effects beyond placebo), its use simply means allowing diseases to remain untreated.
- If we are dealing with a common cold, this might be little more than a costly nuisance.
- If we are dealing with a chronic condition such as arthritis, it means causing unnecessary suffering.
- If we are dealing with life-threatening diseases like cancer, it means shortening the life of patients.
This is the politest way I can put it. There are of course other, less polite terms for ‘shortening a life’! Most of us shy away from using them in the context of homeopathy. In the case of the author of this book, we might make an exception. In my view, he is someone who is deluded to the point where he is ready to kill his patients with homeopathy.
PS
Iscador is not even a homeopathic remedy.
Today, I received an email advertising a book – nothing unusual, of course. But the book and its author are both quite unusual. Here is the text:
Dr. Farokh J. Master’s birth into homeopathy was in the year 1976, when he joined Bombay homeopathic medical college, after giving up his studies at the orthodox school of medicine. Dr Master was instrumental in starting homeopathic out-patient dept in many allopathic hospitals viz. Bombay Hospital, KEM Hospital & Ruby Hall, Pune. Besides his work as a senior Homeopath of the HHC, Dr. Farokh Master is teaching homeopathy (advanced level) at the Mumbai Homeopathic Medical College, part of Mumbai university. He is also teaching at other homeopathic colleges in India and abroad. He has given seminars in various countries like Austria, Australia, India, Japan etc…
Healing Cancer: A Homoeopathic Approach
As a homeopath one should not deter oneself in dealing with any type of cases, be it cancer. But for executing that an ultimate guidance is needed. Cancer is so much prevalent and challenging medical problem of today that a trustworthy source of accurate information becomes pertinent and this work of Dr. Farokh Master immediately propels at the top of quality books for cancer. Based on Master’s 40 years of experience this book was written for students to understand the basis of oncology and for practitioners for brushing-up of their knowledge in this growing discipline. Author says that to get a grasp on cancer cases we should believe in the potential of the homeopathic treatment, that healing from cancer refers to internal process of becoming whole and feeling harmonious with yourself and your environment.To even start with handling the cases of cancer one should be aware of understanding of cancer, its cause, pathophysiology, different types, conventional treatment and their side effects, integrative medicines, social problems in the treatment, such topics are well casted by Volume 1 of the book…• A whole chapter on Cadmium salts and cancer.• 51 “lesser known remedies” are briefly quoted and their usefulness in different situations and types of cancer exposed.• A long chapter deals with the “Indian drugs”, it is important that these remedies are used mostly in tincture or low potencies, as herbal or Ayurvedic remedies or food supplements relieving the patients. • The choice and differentiation between the remedies is then helped by the “Repertory of Cancer”, very well compiled and a highly useful section. “Clinical tips from my practice” given as a sub-chapter. • It ends with recommendations on how to deal with radiation illness and the side-effects of conventional treatment, as well as the treatment of pain and help with palliative care. For fighting and curing cancer and improving the quality and quantity of life of people, knowledge of Homeopathy, both philosophically and scientifically is needed which this work of art portrays delightfully.
__________________________
It is clear that Dr. Farokh J. Master does not suggest using homeopathy in addition to conventional cancer therapies. He foremost wants to employ it as an alternative cancer cure. It is also clear that, if his concepts were generally adopted, they could kill millions.
Some defenders of homeopathy might claim that this is not what most homeopaths would advocate; they would merely recommend homeopathy as an adjunct to conventional oncology. Yet, there are many examples to the contrary, and not just from India – after all, Hahnemann, the inventor of homeopathy, insisted that homeopathy must never be combined with ‘allopathic’ medicines.
So, the next time someone claims homeopathy to be harmless, please show them this post.
Today, a 3-day conference is starting on ‘INTEGRATIVE MEDICINE’ (IM) in London. Dr. Michael Dixon, claims that it is going to be the biggest such conference ever and said that it ‘will make history’. Dixon is an advisor to Prince Charles, chair of the College of Medicine and Integrated Health (CoMIH, of which Charles is a patron), and joint-chair of the congress. The other co-chair is Elizabeth Thompson. Both have been the subject of several previous posts on this blog.
Dixon advertised the conference by commenting: “I am seeing amongst by younger colleagues, the newly trained GPs, that they have a new attitude towards healthcare. They are not interested in whether something is viewed as conventional, complementary, functional or lifestyle, they are just looking at what works for their patients. Through this conference, we aim to capture that sense of hope, open-mindedness, and patient-centred care”. I believe that this ‘history-making’ event is a good occasion to yet again review the concept of IM.
The term IM sounds appealing, yet it is also confusing and misleading. The confusion starts with the fact that our American friends call it integrative medicine, while we in the UK normally call it integrated medicine, and it ends with different people understanding different things by IM. In conventional healthcare, for instance, people use the term to mean the integration of social and medical care. In the bizarre world of alternative medicine, IM is currently used to signify the parallel use of alternative and conventional therapies on an equal footing.
Today, there are many different definitions of the latter version of IM. Prince Charles, one of the world’s most ardent supporter of IM, used to simply call it ‘the best of both worlds’. A recent, more detailed definition is a ‘healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies’. This seems to imply that conventional medicine is not healing-orientated, does not account for the whole person, excludes aspects of lifestyle, neglects the therapeutic relationship, is not informed by evidence, and does not employ all appropriate therapies. This, I would argue is a bonanza of strawman fallacies, i.e. the misrepresentation of an opponent’s qualities with a view of defeating him more easily and making one’s own position look superior. Perhaps this is unsurprising – after all, Dixon has been once named ‘a pyromaniac in a field of (integrative) strawmen’.
Perhaps definitions are too theoretical and it is more productive to look at what IM stands for in real life. If you surf the Internet, you can find thousands of clinics that carry the name IM. It will take you just minutes to discover that there is not a single alternative therapy, however ridiculous, that they don’t offer. What is more, there is evidence to show that doctors who are into IM are also often against public health measures such as vaccinations.
The UK ‘Integrated Medicine Alliance’, a grouping within the CoMIH, offers information sheets on all of the following treatments: Acupuncture, Alexander Technique, Aromatherapy, Herbal Medicine, Homeopathy, Hypnotherapy, Massage, ,Naturopathy, Reflexology, Reiki, Tai Chi, Yoga Therapy. The one on homeopathy, for example, tells us that “homeopathy … can be used for almost any condition either alone or in a complementary manner.” Compare this to what the NHS says about it: “homeopathic remedies perform no better than placebos (dummy treatments)”.
This evidently grates with the politically correct definition above: IM is not well-informed about the evidence, and it does use inappropriate treatments. In fact, it is little more than a clumsy attempt to smuggle unproven and disproven alternative therapies into the mainstream of healthcare. It does render medicine not better but will inevitably make it worse, and this is surely not in the best interest of vulnerable patients who, I would argue, have a right to be treated with the most effective therapies currently available.
The conference can perhaps be characterized best by having a look at its sponsors. ‘Gold sponsor’ is WELEDA, and amongst the many further funders of the meeting are several other manufacturers of mistletoe medications for cancer. I just hope that the speakers at this meeting – Dixon has managed to persuade several reputable UK contributors – do not feel too embarrassed when they pass their exhibitions.
Together with a co-worker, Prof Walach conducted a systematic review of mistletoe extracts (Rudolf Steiner’s anti-cancer drug) as a treatment for improving the quality of life (QoL) of cancer patients. They included all prospective controlled trials that compared mistletoe extracts with a control in cancer patients and reported QoL or related dimensions.
Walach included 26 publications with 30 data sets. The studies were heterogeneous. The pooled standardized mean difference (random effects model) for global QoL after treatment with mistletoe extracts vs. control was d = 0.61 (95% CI 0.41-0.81, p < 0,00001). The effect was stronger for younger patients, with longer treatment, in studies with lower risk of bias, in randomized and blinded studies. Sensitivity analyses supported the validity of the finding. 50% of the QoL subdomains (e.g. pain, nausea) showed a significant improvement after mistletoe treatment. Most studies had a high risk of bias or at least raise some concern.
The authors concluded that mistletoe extracts produce a significant, medium-sized effect on QoL in cancer. Risk of bias in the analyzed studies is likely due to the specific type of treatment, which is difficult to blind; yet this risk is unlikely to affect the outcome.
This is a surprising conclusion, not least because – as reported on this blog – only a year ago another German team of researchers conducted a similar review and came to a very different conclusion. Here is their abstract again:
Purpose: One important goal of any cancer therapy is to improve or maintain quality of life. In this context, mistletoe treatment is discussed to be highly controversial. The aim of this systematic review is to give an extensive overview about the current state of evidence concerning mistletoe therapy of oncologic patients regarding quality of life and side effects of cancer treatments.
Methods: In September and October 2017, Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL and “Science Citation Index Expanded” (Web of Science) were systematically searched.
Results: The search strategy identified 3647 articles and 28 publications with 2639 patients were finally included in this review. Mistletoe was used in bladder cancer, breast cancer, other gynecological cancers (cervical cancer, corpus uteri cancer, and ovarian cancer), colorectal cancer, other gastrointestinal cancer (gastric cancer and pancreatic cancer), glioma, head and neck cancer, lung cancer, melanoma and osteosarcoma. In nearly all studies, mistletoe was added to a conventional therapy. Regarding quality of life, 17 publications reported results. Studies with better methodological quality show less or no effects on quality of life.
Conclusions: With respect to quality of life or reduction of treatment-associated side effects, a thorough review of the literature does not provide any indication to prescribe mistletoe to patients with cancer.
How can this discrepancy be explained? Which of the reviews is drawing the correct conclusion? Here are some relevant details that could help finding an answer to these questions:
- Walach is a psychologist by training, while the senior author of the 2019 review, Jutta Huebner, is an oncologist.
- Huebner included only randomised clinical trials (RCTs), whereas Walach included any interventional and non-interventional prospective controlled study.
- Huebner included 17 RCTs that reported QoL data, while Walach included 26 publications with 30 data sets including 5 non-randomised studies.
- Several of the primary studies had been published multiple times at different stages of completion. Walach included these as independent data sets, while Huebner included each study only once.
- Huebner looked at QoL, whereas Walach also considered measurements of self-regulation as outcome measures.
- Both reviews point out that the methodological quality of the primary studies was often poor; Walach drew a positive conclusion regardless, while Huebner did not and pointed out that studies with better methodology show less or no effects on quality of life or side effects of cancer therapy.
- Walach’s review was funded by funded by the Förderverein komplementärmedizinische Forschung, Arlesheim, Switzerland, a lobby group for mistletoe therapy, while Huebner’s work was funded by the German Guideline “S3 Leitlinie Komplementärmedizin in der Behandlung von onkologischen PatientInnen (Registernummer 032-055OL)” funded by the German Cancer Aid (Fördernummer 11583) within the German Guideline Program in Oncology and by the working group Prevention and Integrative Oncology of the German Cancer Society.
I am sure there are other important differences, but the ones listed above suffice, I think, to decide which of the two papers is trustworthy and which is not.
Mistletoe treatment of cancer patients was the idea of Rudolf Steiner. Mistletoe grows on a host tree like a parasite and eventually might kill it. This seems similar to a cancer killing a patient, and Steiner – influenced by the homeopathic ‘like cures like’ notion – thought that mistletoe should thus be an ideal treatment of all cancers. Despite the naivety of this concept, it somehow did catch on, and mistletoe has now become the number one cancer SCAM in Europe which is spreading fast also to the US and other countries.
But, as we all know, the fact that a therapy lacks plausibility does not necessarily mean that it is clinically useless. To decide, we need clinical trials; and to be sure, we need rigorous reviews of all reliable trials. Two such papers have just been published.
The aim of the systematic review was to give an extensive overview about current state of research concerning mistletoe therapy of oncologic patients regarding survival, quality of life and safety.
The authors extensive literature searches identified 3647 hits and 28 publications with 2639 patients were finally included in this review. Mistletoe was used in bladder cancer, breast cancer, other gynecological cancers (cervical cancer, corpus uteri cancer, and ovarian cancer), colorectal cancer, other gastrointestinal cancer (gastric cancer and pancreatic cancer), glioma, head and neck cancer, lung cancer, melanoma and osteosarcoma. In nearly all studies, mistletoe was added to a conventional therapy. Patient relevant endpoints were overall survival (14 studies, n = 1054), progression- or disease-free survival or tumor response (10 studies, n = 1091). Most studies did not show any effect of mistletoe on survival. Especially high quality studies did not show any benefit.
The authors concluded that, with respect to survival, a thorough review of the literature does not provide any indication to prescribe mistletoe to patients.
The aim of the second systematic review by the same team was to give an extensive overview about the current state of evidence concerning mistletoe therapy of oncologic patients regarding quality of life and side effects of cancer treatments. The same studies were used for this analysis as in the first review. Regarding quality of life, 17 publications reported results. Studies with better methodological quality showed less or no effects on quality of life.
The authors concluded that with respect to quality of life or reduction of treatment-associated side effects, a thorough review of the literature does not provide any indication to prescribe mistletoe to patients with cancer.
In 2003, we published a systematic review of the same subject. Here is its abstract:
Mistletoe extracts are widely used in the treatment of cancer. The results of clinical trials are however highly inconsistent. We therefore conducted a systematic review of all randomised clinical trials of this unconventional therapy. Eight databases were searched to identify all studies that met our inclusion/exclusion criteria. Data were independently validated and extracted by 2 authors and checked by the 3rd according to predefined criteria. Statistical pooling was not possible because of the heterogeneity of the primary studies. Therefore a narrative systematic review was conducted. Ten trials could be included. Most of the studies had considerable weaknesses in terms of study design, reporting or both. Some of the weaker studies implied benefits of mistletoe extracts, particularly in terms of quality of life. None of the methodologically stronger trials exhibited efficacy in terms of quality of life, survival or other outcome measures. Rigorous trials of mistletoe extracts fail to demonstrate efficacy of this therapy.
As we see, 16 years and 18 additional trials have changed nothing!
I therefore think that it is time to call it a day. We should stop the funding for further research into this dead-end alley. More importantly, we must stop giving false hope to cancer patients. All that mistletoe therapy truly does is to support a multi-million Euro industry.
“When orthodox medicine has nothing more to offer” is the title of an article by Dr Elizabeth Thompson, a UK medical homeopath. The article was written years ago, but it is still an excellent example for disclosing the dangerously false and deeply unethical reasoning used by many alternative practitioners. The notion that all sorts of disproven treatments like homeopathy are justified when orthodox medicine has nothing more to offer is so very prevalent that I decided to do this post analysing it.
In the following, you see the most relevant sections of Dr Thompson’s original article (in normal print) and my brief comments (in brackets and in bold):
…Some people come when conventional treatments can no longer offer them anything to save their lives. This is a frightening time for them and although the homeopathic approach may not offer a cure at this late stage of their illness (Is she implying that, in some cases, homeopathy can cure cancer?), it can often offer hope of a different kind. (Surely, one does not need homeopathy for giving patients hope). Sometimes it helps people to outlive the prognosis given to them by months or even years. (A prognosis is not a precise time of death; it is based on statistics and therefore depicts a likelihood, not a certainty. Thus patients outlive their prognosis all the time regardless of treatments.) Sometimes it helps them need less (less than what? there is no control group and therefore the statement seems nonsensical) in the way of conventional medicine including pain killers and offers them continuing support despite progressive disease (is she trying to say that in conventional medicine patients with progressive disease do not get continuing support?).
As a doctor working in both conventional and complementary cancer care I have learned the importance of integrating these two perspectives (the integration of unproven therapies into EBM can only render the latter less effective). Ideally the doctor practising homeopathy would work as an integral part of a much wider team which would include family members, nurses, general practitioners, oncologists, surgeons, palliative physicians and other complementary therapists (the concept of a multi-disciplinary team for cancer is one from conventional medicine where it has long been routine). It is disappointing sometimes to see that other healthcare professionals can be unsupportive of a person’s desire to use complementary therapies and for some people the knowledge that the team is not working together can cause doubt and insecurity (for the majority of patients, however, it might be reassuring to know that their oncology-team is evidence-based).
Some patients come at the beginning of their diagnosis wanting to support their bodies with gentler (homeopathic remedies are not gentler, they are ineffective) approaches and help themselves recover from some difficult and powerful treatments such as chemotherapy and radiotherapy (Why are they being told that alternative therapies are effective in achieving these aims when there is no good evidence to show that this is true? Isn’t that unethical?). As well as using homeopathic medicines (no good evidence of effectiveness!!!), the GHH also has experience in using Mistletoe which is given by injection and has been shown to stimulate the group of white cells whose numbers can be depleted during chemotherapy and radiotherapy (also no good evidence that it works clinically!!!).
Other patients come when they have finished most of their treatments but may still not be feeling well despite being given the all clear by their doctors (same again: no good evidence!!!)…
One wonderful aspect of the homeopathic approach is that it can be a very important opportunity to help someone re-evaluate their life and their health (We don’t need to prescribe placebos for that, this aim is better reached by employing a clinical psychologist).
Sometimes hurts in the past have never been healed and sitting with someone as they describe difficult experiences can be itself therapeutic. Combining this therapeutic listening time with substances from nature that gently stimulate the body’s own healing potential (where is the evidence for that claim?) can be an approach that through patient demand and research (what research?) we can demonstrate is really worth offering to many more people…
END OF QUOTE
This text shows in an exemplary fashion how desperate patients can be convinced to make dramatically wrong choices. If you read Dr Thompson’s text without my comments, it probably sounds fairly reasonable to many people. I can understand why patients and carers end up thinking that homeopathy or other disproven therapies are reasonable options WHEN ORTHODOX MEDICINE HAS NOTHING MORE TO OFFER.
But the claim of homeopaths and others that mainstream medicine has, in certain cases, nothing more to offer is demonstrably wrong. Supportive and palliative care are established and important parts of conventional medicine. To deny this fact amounts to a lie! The implied scenario where a patient is told by her oncology team: “sorry but we cannot do anything else for you”, does quite simply not exist. The argument is nothing else but a straw-man – and a vicious one at that.
Moreover, the subsequent argument of homeopaths, “as ‘they’ have given you up, we now offer you our effective homeopathic remedies”, is not supported by good evidence. In other words, one lie is added to another. To call this unethical, would be the understatement of the year, I think.
Cancer patients are understandably desperate and leave no stone unturned to improve their prognosis. Thus they become easy prey of charlatans who claim that this or that alternative therapy will cure them or improve their outlook. One of the most popular alternative cancer therapies is mistletoe, a treatment dreamt up by Rudolf Steiner on the basis of the ‘like cures like’ principle: the mistletoe plant grows on a host tree like a cancer in the human body. One of many websites on this subject, for instance, states:
Mistletoe therapy
- integrates with conventional cancer treatments
- can be used for a wide range of cancers
- may be started at any stage of the illness….
potential benefits…include:
- Improved quality of life
- generally feeling better
- increased appetite and weight
- less tired/more energy
- reduced pain
- better sleep pattern
- felling more hopeful and motivated
- reduced adverse effects from chemo and radiotherapy
- reduced risk of cancer spread and recurrence
- increased life expectancy.
Mistletoe extracts have been shown in studies to:
- stimulate the immune system
- cause cancer cell death
- protect healthy cells against harmful effects of radiation and chemotherapy.
In fact, the debate about the efficacy of mistletoe either as a cancer cure, a supportive therapy, or a palliative measure is often less than rational and seems never-ending.
The latest contribution to this saga comes from US oncologists who published a phase I study of gemcitabine (GEM) and mistletoe in advanced solid cancers (ASC). The trial was aimed at evaluating: (1) safety, toxicity, and maximum tolerated dose (MTD), (2) absolute neutrophil count (ANC) recovery, (3) formation of mistletoe lectin antibodies (ML ab), (4) cytokine plasma concentrations, (5) clinical response, and (6) pharmacokinetics of GEM.
A total of 44 study participants were enrolled; 20 were treated in stage I (mistletoe dose escalation phase) and 24 in stage II (gemcitabine dose escalation phase). All patients had stage IV disease; the majority had received previous chemo-, hormonal, immunological, or radiation therapy, and 23% were chemotherapy-naïve.
Patients were treated with increasing doses of a mistletoe-extract (HELIXOR Apis (A), growing on fir trees) plus a fixed GEM dose in stage I, and with increasing doses of GEM plus a fixed dose of mistletoe in stage II. Response in stage IV ASC was assessed with descriptive statistics. Statistical analyses examined clinical response/survival and ANC recovery.
The results show that dose-limiting toxicities were neutropenia, thrombocytopenia, acute renal failure, and cellulitis, attributed to mistletoe. GEM 1380 mg/m2 and mistletoe 250 mg combined were the MTD. Of the 44 patients, 24 developed non-neutropenic fever and flu-like syndrome. GEM pharmacokinetics were unaffected by mistletoe. All patients developed ML3 IgG antibodies. ANC showed a trend to increase between baseline and cycle 2 in stage I dose escalation.
6% of patients showed a partial response, and 42% had stable disease. Of the 44 study participants, three died during the study, 10 participants requested to terminate the study, 23 participants progressed while on study, one terminated the study due to a dose limiting toxicity, 6 left due to complicating disease issues which may be tied to progression, and one voluntarily withdrew.
An attempt was made to follow study subjects once they terminated study treatment until death. At the last attempt to contact former participants, three were still alive and five others were lost to follow-up. The median time to death of any cause was approximately 200 days. Compliance with mistletoe injections was high.
The authors explain that a partial response rate of 6% is comparable to what would be expected from single agent gemcitabine in this population of patients with advanced, mostly heavily pretreated carcinomas. The median survival from study enrollment of about 200 days is within the range of what would be expected from single agent gemcitabine.
The authors concluded that GEM plus mistletoe is well tolerated. No botanical/drug interactions were observed. Clinical response is similar to GEM alone.
These results are hardly encouraging but they originate from just one (not particularly rigorous) study and might thus not be reliable. So, what does the totality of the reliable evidence tell us? Our 2003 systematic review of 10 RCTs found that none of the methodologically stronger trials exhibited efficacy in terms of quality of life, survival or other outcome measures. Rigorous trials of mistletoe extracts fail to demonstrate efficacy of this therapy.
Will this stop the highly lucrative trade in mistletoe extracts? will it prevent desperate cancer patients being misled about the value of mistletoe treatment? I fear not.
