pseudo-science
The German ‘TAZ’ recently reported about an interesting homeopathic research project. Here I have translated a few excerpts for you:
The title of the research project at the University of Oldenburg is unspectacular: ‘Microbiological investigation of the maturation process of mother tinctures’. However, the sponsor and the word ‘mother tincture’ make you wonder. The project, which ran from 2016 to 2023, investigated the microbiome of various medicinal plants that are used to produce ‘mother tinctures’. These are the undiluted starting materials for homeopathic remedies. The project was financed and largely controlled by the homeopathy company Wala … According to the German Medical Association, homeopathy is generally incompatible with rational medicine and medical ethics. So why is a state university researching ‘mother tinctures’?
The person responsible is marine biologist Meinhard Simon … a member of the university’s Commission for Good Scientific Practice since 2020 and is therefore responsible for ensuring compliance with scientific standards. Prior to that, he was Chairman of the Ethics Committee for ten years. Meinhard Simon describes questions about ethical aspects of the collaboration with Wala as ‘pointless’. When asked, he explained that current studies do indeed prove the effectiveness of homeopathy. Publications and press articles stating otherwise are ‘one-sided’ and ‘tendentious’.
For years, he has used his position to give homeopathy a scientific veneer. He has co-authored several studies on the subject, supported by homeopathic companies and lobby groups. If he and his colleagues are unable to prove an effect despite funding from the homeopathy industry, they simply blame the study design for the failure, as in a 2011 study, and remain in line with the funders, despite their own data. Simon and colleagues assume ‘force-like (immaterial) resonance effects’ of homeopathy. In other words: magic.
In the past, Wala has funded a lobbyist who has publicly denounced scientists and journalists who have criticised homeopathy and warned of its risks. Among them was Edzard Ernst who said of the university’s collaboration with Wala: ‘I take a rather critical view, especially when it’s a company whose advertising misleads customers.’
‘As a basic researcher in microbiology, I believe that cooperation projects with a company like Wala are not only justifiable in terms of medical ethics, but also important and in keeping with the times,’ explains Simon. He himself is a member of a lobby group for alternative medicine, which is part of the Wala-affiliated ‘Foundation for Integrative Medicine & Pharmacy’. Among other things, it campaigns for the treatment of cancer with mistletoe.
When asked, the University of Oldenburg explained that it saw no reason to judge Simon’s research as negative and referred to his good reputation. It does not answer questions about Wala’s dubious methods or how Simon’s relaxed relationship with science can be reconciled with his role as a guardian of scientific rigour and ethics.
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Prof Simon’s papers on homeopathy include the following:
Development of a test system for homeopathic preparations using impaired duckweed (Lemna gibba L.).
Effects of potentised substances on growth rate of the water plant Lemna gibba L.
Duckweed (Lemna gibba L.) as a test organism for homeopathic potencies.
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All of this seems to beg the following question: should Simon be adnitted to my ALTERNATIVE MEDICINE HALL OF FAME?
I think the answe is a clear YES!
So, welcome, Prof. Meinhard Simon, you are in excellent company:
- Richard C. Niemtzow (acupuncture)
- Helmut Kiene (anthroposophical medicine)
- 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)
Some people seem to be impressed by the amount of publications that is currently being published on so-called alternative medicine (SCAM). Last year, for example, Mediline listed around 1 500 articles on the subject.
Is that really impressive?
No!
- Firstly, compared to other subjects, the number is small. If you look in Medline for ‘pharmacological treatments’, for instance, the number is 10 times larger.
- Scecondly, and more importantly, most of the SCAM articles are complete rubbish.
Let me give you just one example of a paper I came across the other day. It is typical in that there are hundreds of very similar articles every week. Its title is “Assessing Perceived Healthcare Access and Attitudes Towards Complementary and Alternative Medicine Amongst Parents in Cebu City”
(Cebu City is in the Philippines.)
Let’s for a moment assume that the information in the paper is of interest to a wider audience. In this case, such information should also be interestiong form the hundreds of other cities in the region. And if that is so, why focus on the Philippines? There are hundreds of thousands of cities around the world that would matter at least as much as Cebu City.
And why survey just parents? Why not childless adults, or children, or older people?
And why just healthy individuals? Surely, this information would be even more relevant, if it related to ill people!
As there are thousands of different illnesses, we would need thousands of different papers reporting the relevant information.
I am sure you see where I am going. If the hundreds of papers like Assessing Perceived Healthcare Access and Attitudes Towards Complementary and Alternative Medicine Amongst Parents in Cebu City are interesting to sufficient amounts of people to merit publication, we need millions of similar papers to cover the subject properly. What is more, as the situation about perceived healthcare access changes rapidly depending on a whole host of factors, we really would require yearly updates. That would mean millions of papers each year for the sole reason of monitoring the perceived healthcare access of various group of people in various locations. This means we need millions of researchers spending millions of hours and millions of dollars conducting millions of surveys.
Alternatively, we could take a step back and ask whether my above-made assumption (that the named paper is interesting) was correct. It does not require much contemplation to conclude it was, in fact, incorrect: the paper is neither interesting nor relevant to anybody.
And, once you look at the myriad of useless papers that are being published in SCAM, you arrive at the conclusion that the effort and funds needed for conducting these nonsensical pseudoscientific studies must urgently be re-directed towards answering some of the many more meaningful research questions. To me, this is nothing less than an ethical imperative.
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END OF RANT
You might remember that I recently reported of TWO studies sponsored by the ‘Carstens Stiftung’ and wonder whether the second is any better that the first. Here is its published outline: Multimodal online programme and biosignal analysis:
Here, too, the basic principles of a plant-based wholefood diet, Kneipp hydrotherapy, naturopathic self-help strategies and elements of holistic therapy and mind-body medicine are taught – but online. ‘The study represents a prototype for the optimal use of modern digital tools in naturopathic care situations and could serve as a best-practice model for online therapy approaches,’ says Dr Michael Jeitler, Deputy Research Coordinator at the Charité University Outpatient Clinic for Naturopathy at Immanuel Hospital Berlin. There is an urgent need for this, as it is known that only one sixth of the population in Germany is reached with appropriate lifestyle interventions taught in a practical manner.
The hypothesis: The physical resilience of patients with post-COVID syndrome improves more with a combination of naturopathic therapy in an online setting and routine care than with routine care alone. A total of 120 subjects will be included in the two-arm randomised controlled trial.
Group 1 will receive online training lasting 120 minutes once a week over a period of 2 months. In addition, there will be a recommendation to consolidate what has been learnt in daily 30-minute exercises at home. An online diary will also be kept. The observation period per patient is 12 months.
Group 2 will initially be placed on a waiting list.
A highlight of the project is a physiological sub-study focusing on the establishment and validation of a biosignal characterisation of post-COVID syndrome and in particular the prominent symptoms of fatigue. To this end, heart rate, blood pressure, respiratory rate, pulse, electrodermal activity and brain activity are measured simultaneously in patients with fatigue. ‘This approach should make it possible to objectively quantify the clinical symptom changes of fatigue, which have been difficult to objectify up to now,’ says Jeitler. ‘We hope to gain a better understanding of fatigue itself and its role in post-COVID syndrome. Ideally, this will improve diagnosis in the future.’
There will also be an embedded qualitative sub-study. After two months, both some of the test subjects and the GPs treating them will be interviewed individually about their perceptions and experiences in order to better adapt the naturopathic interventions to the needs and requirements of the patients in the long term.
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What is in my view particularly noteworthy is the fact that both studies pretend (like proper science) to test a hypothesis. This is, of course, not true. A true test of a hypothesis would be open to either its confirmation or its rejection. However, with the present study we have a situation where only a confirmation is on the cards. This discloses one thing very clearly: we are dealing here not with proper science, but with proper pseudoscience.
This study follows (just as the first trial) a ‘A+B versus B’ design and thus has the same major flaws as the first trial sponsored by the ‘Carstens Stiftung’. The reason for using this study design seems all too obvious: it will always generate a positive outcome. There is, of course, a prize: the study is unable to show that the intervention has any effects other than placebo. The Carstens Stiftung is happy to pay this price; their main interest seems to be not to answer meaningful research questions but to generate findings that lend themselves to promoting so-called alternative medicine (SCAM).
Bach Flower Remedies are popular despite a paucity of clinical trials testing their effectiveness. This is why I am excited each time a new trial emerges.
This study analyzed the effectiveness of Bach flower therapy compared to placebo in reducing perceived stress levels in primary health care nursing professionals. It was designed as a “pragmatic, parallel randomized clinical trial” conducted with 87 primary care nursing professionals with self-identified stress, from October 2021 to June 2022, in the cities of Osasco and São Paulo, Brazil. The intervention group (n=43) received the collective flower formula, and the placebo group (n=44) received only the diluent. Data analysis was performed using the linear mixed model, and effect size was measured by partial Eta squared, significance level 5%.
The results showed a significant reduction in perceived stress levels within groups (p=0.038). However, there was no significant difference between the study groups (p=0.750). Participants in the intervention group reported a greater perception of changes than participants in the placebo group, but without statistical significance (p=0,089).
The authors concluded that the floral formula was not more effective than the placebo formula in reducing perceived stress. There was a significant stress reduction among nursing professionals in both study groups, although with a small effect size.
I must congratulate the authors for their courage to report a squarely negative result [in a controlled clinical trial only the inter-group differences are relevant!]. At the same time I ought to criticize them for not being more straight about it. The conclusions should be much simpler:
THE FINDINGS SHOW NO SIGNIFICANT EFFECT OF BACH FLOWER REMEDIES.
And why might anyone think that such a treatment could cause a significant effect?
Search me!
Bach Flower remedies do not contain sufficient amounts of active ingredients to cause any health effects beyond placebo!
This means that the prior probability of such a study generating a positive finding is very close to zero. In turn, this means that research funds are more wisely spent elsewhere. One could easily be a bit more rigorous and argue that conducting clinicl trials on such hopeless topics is not ethical.
The Carl and Veronica Carstens Foundation is providing EUR 600,000 for 2 research projects to identify effective so-called alternative medicine (SCAM) therapies for post-COVID syndrome. The one that I will focus on here is headed by a member of my ALTERNATIVE MEDICINE HALL OF FAME, Prof Dr Gustav Dobos, Essen University Hospital.
The project is entitled: Multimodal group programme based on Kneipp
It is being described as follows:
A team of researchers led by Prof Gustav Dobos and Dr Heidemarie Haller, in cooperation with Prof Mark Stettner and Prof Christoph Kleinschnitz from the Department of Neurology at Essen University Hospital, will conduct a single-blind, randomised controlled study with two arms. A total of 86 subjects with post-COVID syndrome will be included and randomly divided into two groups.
Group 1 will undergo a 10-week group programme based on the Kneipp therapy pillars. The subjects will meet once a week, so there will be two sessions for each Kneipp pillar. These will include an educational and a practical part with the aim of developing their own strategies for coping with illness and actively integrating these into their everyday lives.
- Plant-based wholefoods and medicinal teas will be used to strengthen convalescence.
- Mindful exercise sessions in nature should help to utilise the effect of daylight and vitamin D on the immune system.
- In the area of hydrotherapy, water treatments, dry brushing, wraps and compresses will be used.
- There will be medical advice on herbal medicine options for individual symptoms such as sleep disorders, digestive problems, pain, coughs, anxiety or circles of thought.
The aim is to facilitate a balance of lifestyle in professional, family and social areas by means of organisational therapy. Relaxation and meditation techniques, for example, are taught for this purpose. In order to consolidate what they have learnt, participants in group 1 also receive a self-help book and homework.
Group 2 is the control group and is initially placed on a waiting list. In both groups, standard therapy is (additionally) permitted at any time. A symptom and therapy diary will also be kept in both groups.
The primary aim is to test whether the group programme as an add-on to standard therapy can improve self-help skills and alleviate the burden of post-COVID symptoms more than standard therapy alone. Parameters of quality of life, cardiovascular and pulmonary performance and the so-called flourishing of the test subjects as motivated personalities are also recorded at 4 points in time before, during and up to 16 weeks after the end of the intervention phase.
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And why do I call this study ‘nonsensical’?
Mainly because the results of the trial are known before even the first patient was recruited!
How come?
Because, as we have previously discussed here at nauseam, A+B will always be more than B alone. Kneipp therapy plus usual care will have more effects than usual care alone, even if Kneipp therapy generates nothing but placebo effects. This is particularly true, of course, for subjective outcome measures.
So, the conclusion of the trial, once it is published, will state something like this:
Our study has shown that the multimodal group programme based on Kneipp is effective in reducing the symptoms of post-COVID.
And what is wrong with that?
Plenty!
It means that money and effort will be wasted, that science will be undermined, and that we will be potentially misled about the effectiveness of mixed bag of treatments called ‘Kneipp therapy’. Perhaps it is effective (beyond placebo), but perhaps it’s not – this study will not tell us either way.
Uterine fibroids are a common gynaecological condition often impacting quality of life. While conventional treatment options exist, there is growing interest in so-called alternative Medicine (SCAM) such as homeopathy. The objective of this review paper was to assess the effectiveness of homeopathic medicines in treating uterine fibroids through the analysis of recent clinical trials and observational studies, aiming to provide insights into the potential role of homeopathy as a SCAM for uterine fibroids.
A thorough search of databases such as PubMed, Google Scholar, Scopus, and pertinent medical journals was undertaken to locate recent studies on the efficacy of homeopathic medicines for uterine fibroids. Only studies meeting predefined inclusion criteria, including randomized controlled trials, prospective observational studies, and systematic reviews, were included in the review process.
Recent studies investigating the efficacy of homeopathic medicines in treating uterine fibroids consistently demonstrated positive outcomes, including symptom alleviation, reduction in fibroid size, and improved quality of life. Various remedies showed effectiveness across various potencies. Symptom severity scales, including the Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), and Verbal Multidimensional Scoring System (VMSS), were utilized to assess pelvic pain, menstrual bleeding, and discomfort. Quality of life measures like the WHOQOL-BREF scale provided insights into overall well-being.
The authors concluded that the collective findings from these studies provide robust evidence supporting the efficacy and safety of homeopathic medicines in the management of uterine fibroids. By employing individualized treatment approaches tailored to patient-specific symptoms and characteristics, homeopathy offers a holistic and personalized approach to addressing fibroids and improving the quality of life for affected individuals. Overall, these studies provide robust evidence supporting the efficacy and safety of homeopathic medicines in treating uterine fibroids.
This is a very odd paper:
- The authors call it a “comprehensive review”, a term that is next to meaningless.
- It certainly is not a systematic review.
- The reason for merely including “recent studies” is unclear; it also makes a mockery of the attribute “comprehensive”.
- The reason for including observational studies, however, seems to be very clear: it is an age-old trick to generate a false-positive result.
- There was no assessment of the quality of the primary studies.
- In total, there were just 6 primary studies none of which was anywhere near to being rigorous.
- The authors never even investigated the safety of homeopathic remedies, yet they draw firm conclusions about it.
My conclusion is that this “comprehensive review” is comprehensive example of how to comprehensively mislead with comprehensively dishonest research. And why would anyone set out to do such a thing? Perhaps the authors’ affiliation provide some hints:
- Department of Homoeopathic Pharmacy,
- Homoeopathic Medical College & Research Centre.
I only just came across the announcements for two conferences that made me almost speachless:
No 1 Homeopathy in Cancer Care – Aug. 29, 2024
Hosted by the newly formed Special Interest Group (SIG) on Research in Homeopathy in Cancer Care, this webinar aims to shed light on the role of homeopathy in cancer care, focusing on both its research status and practical applications in supportive treatment.
Supportive and palliative care are pivotal components of cancer treatment, offering avenues to enhance quality of life and potentially extend survival rates. Homeopathy emerges as a prominent integrative modality embraced by patients worldwide, notably in Europe, India, and Latin America. Despite varying perspectives on its efficacy, homeopathy’s emphasis on empathic listening and its unique approach to symptom management garner significant attention.
In the United States, homeopathy’s popularity surged during the 1990s, with over 5 million people reported to have used it by 2015. While some attribute its effects to a placebo response, clinical studies suggest tangible benefits in cancer care, particularly in alleviating symptoms like fatigue, anxiety, and hot flashes. Homeopathy is one of the leading integrative oncology modalities in Europe. Observations from France reveal that homeopathy supplements conventional treatments in about 30% of cancer patients, yielding notable improvements in symptomatology. Homeopathy was the most commonly used integrative therapy in cancer care in Belgium and in the top five in six other countries Turkey, Czech Republic, Sweden, Italy, Spain, and Greece. (Molassiotis 2005)
The speakers are:
Dr. Moshe Frenkel is a clinical associate professor at the University of Texas and founder of the Integrative Medicine Clinic, at The University of Texas M. D. Anderson Cancer Center, Houston Texas where he served as a full faculty until he returned to Israel in 2010. Up to 2014 Dr Frenkel was chairing the clinical practice committee of The Society of Integrative Oncology and was acting as the chair of The Israeli Society of Complementary Medicine (A section of The Israel Medical Association) until 2016. Currently, Dr Frenkel is the medical director of the Integrative Oncology Service in RAMBAM Medical Center Oncology Department, a comprehensive oncology center and the largest in Northern Israel, as well as leading a feasibility study in homeopathy in cancer care.
Elio Rossi, MD will provide a brief overview of his practice and discuss symptom management, particularly focusing on radio dermatitis and leading homeopathic remedies that he utilizes. Director of the homeopathy outpatient clinic at the Campo di Marte public hospital in Lucca Italy, was established in 1998 and to date more than 7,500 patients have been consecutively examined. Of these 1100 are cancer patients who required an ‘integrated’ homeopathic treatment to reduce the adverse effects of anti-cancer therapies and improve their quality of life. Works as a homeopathic doctor and expert in integrative medicine, collaborating with a local oncologist. Collaborated as Co-Chair, in the organization of many national and international congresses on Integrative Oncology (2017, 2019), specific sessions within other congresses organized in Italy (ECIM 2012 Florence, WCIMH 2023 Rome) and regional workshops, which have been attended by hundreds of CIM experts and oncologists.
Jean Lionel Bagot, MD will share insights from his practice, focusing on homeopathic remedies for fatigue and potential remedies for skin afflictions. A specialist in integrative cancer supportive care treatments in private practice as well as coordinating doctor of the Outpatients Department for Integrative Care in Groupe Hospitalier Saint Vincent Strasbourg, France; President of the International Homeopathic Society of Supportive Care in Oncology (SHISSO); Scientific officer of the French Society for Integrative Oncology (SFOI); Associated Member of the University College of Integrative and Complementary Medicine (CUMIC); Lecturer in the Medicine and Pharmacy Faculty in Strasbourg University.
Elizabeth Thompson, MD will have the opportunity to briefly describe her previous NHS practice and discuss symptom management, specifically addressing hot flushes and leading homeopathic remedies. Homeopathic Physician in NHS, NCIM Founder, CEO & Integrative Medicine Doctor, National Centre for Integrative Medicine (NCIM) www.ncim.org.uk, Chair, Integrative and Personalized Medicine Congress, London, June 2022. Past President ECIM 2021 and Board Member European Society Integrative Medicine, Council Member British Society of Integrative Oncology, Council Member College of Medicine.
No 2: “Pushing the Boundaries” Yes to Life Annual Conference 2024, 28th September
Integrative Medicine is a living, rapidly expanding science, with new understandings and potential being unveiled on a daily basis. This year’s conferences – one online in the Summer, and one in-person in the Autumn – share the title ‘Pushing the Boundaries’, as we have decided to devote them both to looking at the latest developments in Integrative Medicine, across the board. So that includes new techniques, new scientific understandings, and new applications for existing therapies, and you’ll be hearing fresh insights from some of your most trusted clinicians and scientists, and led into unfamiliar territory by pioneering speakers who may be as yet unfamiliar. The conferences are being co-created by Patricia Peat from Cancer Options and the Peat Institute and Yes to Life, with the aim of sending our audiences home with a wealth of resources on which to be able to draw for their own needs. Both events will be priced for accessibility, and the in-person Autumn Conference will include an extensive Exhibition that will offer yet more knowledge and resources to delegates.
The speakers are:
- Dr Penny Kechagioglou MBBS (Honours), MRCP, CCT (Clin Onc), MPH, MBA Clinical oncologist
- Dr Britt Cordi PhD
- Dr Robert Verkerk MSc DIC PhD FACN
- Robin Daly Yes to Life Founder and Chairman
- Patricia Peat Founder of Cancer Options
- Mark Sean Taylor Patient Led Oncology Founder
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Yes, you remembered correctly: some of the speakers have in the past featured on this blog, e.g.:
- Dr Elizabeth Thompson, NCIM Holistic Doctor & Clinical Lead, says she has had the coronavirus and recommends homeopathy
- When orthodox medicine has nothing more to offer
- Homeopathy in Bristol: from bad to dismal
- Robert Verkerk (Alliance for Natural Health) at his finest
- Corona pandemic: What Quacks Don’t Tell You
Crucially, we have encountered the YES TO LIFE charity:
- Survive cancer, but not thanks to this charity called ‘SURVIVE CANCER’
- Is the promotion of dubious therapies a charitable activity? The Charity Commission wants to know
- Uncharitable charities? The example of ‘YES TO LIFE’
But please do not let me spoil your enthusiasm of attending these meetings!
I do mean it: can someone please attend?
I offter a guest post to any critical thinker who wants to write up his/her experience.
GOOD LUCK
The American Society of Clinical Oncology (ASCO) and the Society for Integrative Oncology have collaborated to develop guidelines for the application of integrative approaches in the management of:
- anxiety,
- depression,
- fatigue,
- use of cannabinoids and cannabis in patients with cancer.
These guidelines provide evidence-based recommendations to improve outcomes and quality of life by enhancing conventional cancer treatment with integrative modalities.
All studies that informed the guideline recommendations were reviewed by an Expert Panel which was made up of a patient advocate, an ASCO methodologist, oncology providers, and integrative medicine experts. Panel members reviewed each trial for quality of evidence, determined a grade quality assessment label, and concluded strength of recommendations.
The findings show:
- Strong recommendations for management of cancer fatigue during treatment were given to both in-person or web-based mindfulness-based stress reduction, mindfulness-based cognitive therapy, and tai chi or qigong.
- Strong recommendations for management of cancer fatigue after cancer treatment were given to mindfulness-based programs.
- Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial.
- The recommended modalities for managing anxiety included Mindfulness-Based Interventions (MBIs), yoga, hypnosis, relaxation therapies, music therapy, reflexology, acupuncture, tai chi, and lavender essential oils.
- The strongest recommendation in the guideline is that MBIs should be offered to people with cancer, both during active treatment and post-treatment, to address depression.
The authors concluded that the evidence for integrative interventions in cancer care is growing, with research now supporting benefits of integrative interventions across the cancer care continuum.
I am sorry, but I find these guidelines of poor quality and totally inadequate for the purpose of providing responsible guidance to cancer patients and carers. Here are some of my reasons:
- I know that this is a petty point, particularly for me as a non-native English speaker, but what on earth is an INTEGRATIVE THERAPY? I know integrative care or integrative medicine, but what could possibly be integrative with a therapy?
- I can vouch for the fact that the assertion “all studies that informed the guideline recommendations were reviewed” is NOT true. The authors seem to have selected the studies they wanted. Crucially, they do not reveal their selection criteria. I have the impression that they selected positive studies and omitted those that were negative.
- The panel of experts conducting the research should be mentioned; one can put together a panel to show just about anything simply by choosing the right individuals.
- The authors claim that they assessed the quality of the evidence, yet they fail to tell us what it was. I know that many of the trials are of low quality and their results therefore less than reliable. And guidance based on poor-quality studies is misguidance.
- The guidelines say nothing about the risks of the various treatments. In my view, this would be essential for any decent guideline. I know that some of the mentioned therapies are not free of adverse effects.
- They also say nothing about the absolute and relative effect sizes of the treatments they recommend. Such information would ne necessary for making informed decisions about the optimal therapeutic choices.
- The entire guideline is bar any critical thinking.
Overall, these guidelines provide more an exercise in promotion of dubious therapies than a reliable guide for cancer patients and their carers. The ASCO and the Society for Integrative Oncology should be ashamed to have given their names to such a poor-quality document.
In January 2024, this remarkable paper was published in a top journal:
Macrophages are associated with innate immune response and M1-polarized macrophages exhibit pro-inflammatory functions. Nanoparticles of natural or synthetic compounds are potential triggers of innate immunity. As2O3 is the major component of the homeopathic drug, Arsenic album 30C.This has been claimed to have immune-boosting activities, however, has not been validated experimentally. Here we elucidated the underlying mechanism of Ars. alb 30C-mediated immune priming in murine macrophage cell line. Transmission Electron Microscopy (TEM) and X-ray diffraction (XRD) used for the structural analysis of the drug reveals the presence of crystalline As2O3 nanoparticles of cubic structure. Similarly, signatures of M1-macrophage polarization were observed by surface enhanced Raman scattering (SERS) in RAW 264.7 cells with concomitant over expression of M1 cell surface marker, CD80 and transcription factor, NF-κB, respectively. We also observed a significant increase in pro-inflammatory cytokines like iNOS, TNF-α, IL-6, and COX-2 expression with unaltered ROS and apoptosis in drug-treated cells. Enhanced expression of Toll-like receptors 3 and 7 were observed both in transcriptional and translational levels after the drug treatment. In sum, our findings for the first time indicated the presence of crystalline As2O3 cubic nanostructure in Ars. alb 30C which facilitates modulation of innate immunity by activating macrophage polarization.
On 21 August 2024, this paper was retracted; here is the retraction notice:
After publication, concerns were raised about the reagents used in this study, in particular that the arsenic trioxide solution is diluted beyond the point at which any active molecules are expected to be present. Post-publication peer review confirmed that the nature of the particles detected in the study is unclear. This means that without further corroborative evidence, the data presented in the paper are not sufficient to attribute the effects observed after treating cells with the compound. The Editors therefore no longer have confidence in the results reported in this Article.
Swift retractions of sloppy science, errors, fraud, scientific misconduct, misinterpretaton of results, etc. are necessary to prevent the harm caused by such unfortunate publications. The editors of SCIENTIFIC REPORTS should be congratulated to have achieved this so quickly and elegantly. This is in sharp contrast to similar events like the protracted hoo-hah that occurred until THE LANCET finally retracted the fraudulent study of Andrew Wakefield or the deplorable ongoing saga of THE ONCOLOGIST, the editor of which has still not retracted the fraudulent paper by Michael Frass et al claiming that homeopathy could prolong the survival of cancer patients.
Cancer often causes reduced resilience, quality of life (QoL) and poorer overall well-being. To mitigate these problems, so-called alternative medicine (SCAM) is often advocated for patients with cancer. This study aimed to evaluate the long-term effects of an interdisciplinary integrative oncology group-based program (IO-GP) on the resilience and use of SCAM in patients with cancer.
This was a prospective, observational, single-center study. Resilience (RS-13), SCAM usage (I-CAM-G), QoL (SF-12) and health-related lifestyle factor (nutrition, smoking, alcohol consumption and physical exercise) data were collected for 70 patients who participated in a 10-week IO-GP between January 2019 and June 2022 due to cancer. The IO-GP was offered at the setting of a university hospital and was open to adult patients with cancer. It contained elements from mind-body medicine and positive psychology, as well as recommendations on healthy diet, exercise and SCAM approaches. Patients who completed the IO-GP at least 12months prior (1-4.5years ago) were included in this study. Statistical analysis included descriptive analysis and parametric and nonparametric tests to identify significant differences (P<.05).
Resilience increased significantly ≥12months after participation in the IO-GP (n=44, P=.006, F=8.274) and had a medium effect size (r=.410). The time since the IO-GP was completed (“12-24months,” “24-36months,” and “>36months”) showed no statistically significant interaction with changes in resilience (P=.226, F=1.544). The most frequently used SCAM modalities within the past 12months were vitamins/minerals (85.7%), relaxation techniques (54.3%), herbs and plant medicine (41.1%), yoga (41.4%) and meditation (41.4%). The IO-GP was the most common source informing study participants about relaxation techniques (n=24, 64.9%), meditation (n=21, 72.4%) and taking vitamin D (n=16, 40.0%). Significantly greater levels of resilience were found in those practicing meditation (P=.010, d=−.642) or visualization (P=.003, d=−.805) compared to non-practitioners.
The authors concluded that IO-GPs have the potential to empower patients with cancer to continue using SCAM practices—especially from mind-body medicine—even 1 to 4.5 years after completing the program. Additionally, resilience levels increased. These findings provide notable insight into the long-term effects of integrative oncology interventions on resilience and the use of SCAM, especially in patients with breast cancer.
Really?
“Long-term effects of integrative oncology interventions”?
I am sorry, but I see no effects here at all. All I do see are correlations.
For all we know, the outcomes might have even been better if no SCAMs had been offered.
For all we know, the main reason for the observed changes is simply the passage of time.
CORRELATION IS NOT CAUSATION!
There is, of course, little wrong with conductiong studies of this nature – even though they are never really informative, in my view – but there is much wrong when the bias of the authors kicks in and they imply (in the title and throughout the text of their paper) that their interventions were the cause of the observed outcome. This does not provide “notable insight”, it merely misleads some people who are less able to think critically.
WISHFUL THINKING IS NOT SCIENCE!
Sadly, this simple lesson seems to be ever so hard to comprehend by SCAM researchers. One does not need to look far to find hundreds of SCAM studies that are plagued by the same or similar biases. As a result, SCAM research is gradually becoming the laughing stock of real scientists.
