THERE WILL NEVER BE AN ALTERNATIVE CANCER CURE
This statement contradicts all those thousands of messages on the Internet that pretend otherwise. Far too many ‘entrepreneurs’ are trying to exploit desperate cancer patients by making claims about alternative cancer ‘cures’ ranging from shark oil to laetrile and from Essiac to mistletoe. The truth is that none of them are anything other than bogus.
Why? Let me explain.
If ever a curative cancer treatment emerged from the realm of alternative medicine that showed any promise at all, it would be very quickly researched by scientists and, if the results were positive, instantly adopted by mainstream oncology. The notion of an alternative cancer cure is therefore a contradiction in terms. It implies that oncologists are mean bastards who would, in the face of immense suffering, reject a promising cure simply because it did not originate from their own ranks.
BUT THAT DOES NOT NECESSARILY MEAN THAT ALTERNATIVE CANCER TREATMENTS ARE USELESS
So, let’s forget about alternative cancer ‘cures’ and let’s once and for all declare the people who sell or promote them as charlatans of the worst type. But some alternative therapies might nevertheless have a role in oncology – not as curative treatments but as supportive or palliative therapies.
The aim of supportive or palliative cancer care is not to cure the disease but to ease the suffering of cancer patients. According to my own research, promising evidence exists in this context, for instance, for massage, guided imagery, Co-enzyme Q10, acupuncture for nausea, and relaxation therapies. For other alternative therapies, the evidence is not supportive, e.g. reflexology, tai chi, homeopathy, spiritual healing, acupuncture for pain-relief, and aromatherapy.
So, in the realm of supportive and palliative care there is both encouraging as well as disappointing evidence. But what amazes me over and over again is the fact that the majority of cancer centres employing alternative therapies seem to bother very little about the evidence; they tend to use a weird mix of treatments regardless of whether they are backed by evidence or not. If patients like them, all is fine, they seem to think. I find this argument worrying.
Of course, every measure that increases the well-being of cancer patients must be welcome. But this should not mean that we disregard priorities or adopt any quackery that is on offer. In the interest of patients, we need to spend the available resources in the most effective ways. Those who argue that a bit of Reiki or reflexology, for example, is useful – if only via a non-specific (placebo) effects – seem to forget that we do not require quackery for patients to benefit from a placebo-response. An evidence-based treatment that is administered with kindness and compassion also generates specific non-specific effects. In addition, such treatments also generate specific effects. Therefore it would be a disservice to patients to merely rely on the non-specific effects of bogus treatments, even if the patients do experience some benefit from them.
ALTERNATIVE ‘PAMPERING’ AS A COMPENSATION FOR INADEQUACIES IN THE SYSTEM?
So, why are unproven or disproven treatments like Reiki or reflexology so popular for cancer palliation? This question has puzzled me for years, and I sometimes wonder whether some oncologists’ tolerance of quackery is not an attempt to compensate for any inadequacies within the routine service they deliver to their patients. Sub-standard care, unappetising food, insufficient pain-control, lack of time and compassion as well as other problems undoubtedly exist in some cancer units. It might be tempting to assume that such deficiencies can be compensated by a little pampering from a reflexologist or Reiki master. And it might be easier to hire a few alternative therapists for treating patients with agreeable yet ineffective interventions than to remedy the deficits that may exist in basic conventional care.
But this strategy would be wrong, unethical and counter-productive. Empathy, sympathy and compassion are core features of conventional care and must not be delegated to quacks.
Times of celebration are often also times of over-indulgence and subsequent suffering. Who would not know, for instance, how a hangover can spoil one’s pleasure at the start of a new year? But where is the research that addresses this problem? Scientists seem to be cynically devoid of sympathy for the hangover-victim – well, not all scientists.
During the course of my research-career, I must have conducted well over 60 clinical trials, but none was remotely as entertaining as the one my Exeter-team did several years ago to test whether an artichoke extract is effective in preventing the signs and symptoms of alcohol-induced hangover.
We recruited healthy adult volunteers from our own ranks to participate in a randomized double-blind crossover trial. Participants received either 3 capsules of commercially available standardized artichoke extract or indistinguishable, inert placebo capsules immediately before and after alcohol exposure. After a 1-week washout period the volunteers received the opposite treatment. Each participant predefined the type and amount of alcoholic beverage that would give him/her a hangover and ate the same meal before commencing alcohol consumption on the two study days. The primary outcome measure was the difference in hangover severity scores between the artichoke extract and placebo interventions. Secondary outcome measures were differences between the interventions in scores using a mood profile questionnaire and cognitive performance tests administered 1 hour before and 10 hours after alcohol exposure.
The mean number of alcohol units consumed per person during treatment with artichoke extract and placebo were 10.7 and 10.5 respectively, equivalent to 1.2 g of alcohol per kilogram body weight. The volume of non-alcoholic drink consumed and the duration of sleep after the binge were similar during the artichoke extract and placebo interventions. The hangovers we experienced the mornings after our alcohol exposure were monumental but unaffected by the treatments. None of the outcome measures differed significantly between interventions. Adverse events of the treatment were rare and were mild and transient. Our results therefore suggested that artichoke extract is not effective in preventing the signs and symptoms of alcohol-induced hangover.
While it was great fun to obtain ethic’s approval and run this trial, the results of our two binges in the name of science were, of course, a disappointment. As diligent researchers we felt we had to do a little more for the poor victims of over-indulgence.
We thus decided to conduct a systematic review aimed at assessing the clinical evidence on the effectiveness of any medical intervention for preventing or treating alcohol hangover. We conducted systematic searches to identify all RCTs of any medical intervention for preventing or treating alcohol hangover. Fifteen potentially relevant trials were found. Seven publications failed to meet all inclusion criteria. Eight RCTs assessing 8 different interventions were reviewed. The agents tested were propranolol, tropisetron, tolfenamic acid, fructose or glucose as well as the dietary supplements Borago officinalis (borage), Cynara scolymus (artichoke), Opuntia ficus-indica (prickly pear), and a yeast based preparation. All studies were double blind. Significant intergroup differences for overall symptom scores and individual symptoms were reported only for tolfenamic acid, gamma linolenic acid from borage, and a yeast based preparation.
We concluded that the most effective way to avoid the symptoms of alcohol induced hangover is to practise abstinence or moderation.
WISE WORDS PERHAPS, BUT EASIER SAID THAN DONE, I’M SURE.
2013 has been an extremely busy year on this blog. We have had so many posts and comments that it is hard to decide which were the best, most important or most thought-provoking. The following selection is an entirely subjective and personal choice. I have copied the titles of the chosen posts and linked them to the original; in addition, I have selected a short conclusion from each post to provide an impression of its content so that, if interested, you can easily read the whole thing.
I don’t think anyone doubts that medicine needs improving. However, I do doubt that Charles’ vision of a “post-modern medicine” is the way to achieve improvement – in fact, I fear that it would lead us straight back to the dark ages.
So, what does this tiny investigation suggest? … I think it supports the hypothesis that research into chiropractic is not very active, nor high quality, nor does it address the most urgent questions.
The often-used and seemingly reasonable sentence “I don’t care how it works, as long as it is helpful” turns out to be a package of fallacies used to support the use of unproven treatments.
I think it is regrettable that the journal ‘Homeopathy’ has now lost the only editorial board member who had the ability to openly and repeatedly display a critical attitude about homeopathy – remember: without a critical attitude progress is unlikely!
For 20 years, I have tried my best to dispel these dangerous myths and fallacies. In doing so, I had to fight many tough battles (sometimes even with the people who should have protected me, e.g. my peers at Exeter university), and I have the scars to prove it. If, however, I did save just one life by conducting my research into the risks of alternative medicine and by writing about it, the effort was well worth it.
The most remarkable aspect is that the BCA seems to attempt to silence its own members regarding the controversy about the value of their treatments. Instead they proscribe answers (should I say doctrines?) of highly debatable accuracy for them, almost as though chiropractors were unable to speak for themselves. To me, this smells of cult-like behaviour, and is by no means indicative of a mature profession – despite their affirmations to the contrary.
To pretend that external evidence can be substituted by something else is erroneous and introduces double standards which are not acceptable – not because this would be against some bloodless principles of nit-picking academics, but because it would not be in the best interest of the patient. And, after all, the primary concern of EBM has to be the patient.
The conclusion of such considerations is, I fear, obvious: the value of and need for these two professions [chiropractors and osteopaths] should be re-assessed.
Unethical research of this nature should be prevented, and the existing mechanisms to achieve this aim must be strengthened.
It is time that AM investigators focus on real research answering important questions which advance our knowledge, that AM-journal editors stop publishing meaningless nonsense, and that decision-makers understand the difference between promotion dressed up as science and real research.
There are many other parallels between a cult and alternative medicine, I am sure. In my view, the most striking one must be the fact that any spark of cognitive dissonance in the cult-victim is being extinguished by highly effective and incessant flow of misinformation which often amounts to a form of brain-washing.
If a clinician practices evidence-based medicine, he/she cannot possibly practice homeopathy – the evidence shows that homeopathy is a placebo-therapy. So, here we have it: a competent homeopath has to be a contradiction in terms because either someone practices homeopathy or he/she practices evidence-based medicine. Doing both at the same time is simply not possible.
To be meaningful, ethical and responsible, choice needs to be guided by sound evidence – if not, it degenerates into irresponsible arbitrariness, and health care deteriorates into some kind of Russian roulette. To claim, as some fans of alternative medicine do, that the principle of PATIENT CHOICE gives everyone the right to use unproven treatments at the expense of the taxpayer is pure nonsense. But some extreme proponents of quackery go even further; they claim that the discontinuation of payment for treatments that have been identified as ineffective amounts to a dangerous curtailment of patients’ rights. This, I think, is simply a cynical attempt to mislead the public for the selfish purpose of profit.
I challenge my critics to answer this simple question: For how many alternative therapies is there a well-documented positive risk/benefit balance?
Some homeopaths, rather than admitting they are in the wrong, are prepared to dilute the truth until it might be hard for third parties to tell who is right and who is wrong. But however they may deny it, the truth is still the truth: I have been trained as a homeopath.
This is how pseudo-scientists make sure that the body of pseudo-evidence for their pseudo-treatments is growing at a steady pace.
Not only has the truth about the libel case been turned upside down, but also the evidence on chiropractic as a treatment for infant colic seems mysteriously improved.
I am sure that, in the future, we will hear much more about Charles’ indulgence in quackery; and, of course, we will hear more criticism of it.
This is the bizarre phenomenon that ‘Ernst’s law’ seems to capture quite well – and this is why I believe the ‘law’ is worth more than a laugh and a chuckle. In fact, ‘Ernst’s law’ might even describe the depressing reality of retrograde thinking in alternative medicine more accurately than most of us care to admit.
In my experience, true believers will not change their mind; I have never seen this happening. However, progress might nevertheless be made, if we managed to instil a more (self-) questioning rationality and scientific attitudes into the minds of the next generations. In other words, we need better education in science and more training of critical thinking during their formative years.
Yes, I am afraid the fight of many homeopaths against public health is active, incessant and often criminal. Of course, they do not for one second believe that they are doing anything wrong; on the contrary, they are convinced of their good intentions. As Bert Brecht once wrote, THE OPPOSITE OF GOOD IS NOT EVIL, BUT GOOD INTENTIONS
Here is a quick reminder of some important things you should take care of before the year is out. Shops are still open; so hurry, there is no time to lose on the alternative path to holistic health.
1) Buy some Rescue Remedies
No matter whether your mother-in-law visits this Christmas or not, the ‘festive’ season can be extremely stressful. Think how often in the past a member of your family was next to a breakdown! Think of how often you felt like hitting the bottle and forgetting about the rest of the unthankful bunch. This year, you should be prepared; for just a little outlay, you can purchase these wonderful Bach Flower Remedies specifically designed to rid everyone of stress and disharmony.
2) Get yourself Prince Charles’ Detox Tincture
Some say that Christmas is the time of love, peace and quiet, but surely you were not born last Wednesday and know better: it is the time of over-indulgence. At the end of the holiday season your body will be as polluted as the toxic sewage of a Bayer Leverkusen. What you need now is detox!!! Luckily, the heir to the thrown has thought of us; his detox-tincture is just the ticket – best get two bottles, think of the looming New Year celebrations!
3) Homeopathic ‘Nux Vomica’
Alcohol hangovers are almost unavoidable during this time of the year. Based on the ‘like cures like’ principle, the homeopathic best-seller ‘Nux Vomica’ is every homeopath’s standard recommendation for this sort of thing – and we all know how valuable the advice of homeopaths invariably is.
4) Donation to ‘HOMEOPATHS WITHOUT BORDERS’
Christmas should also be the time for charity, and this fine organisation deservers your support! They do all sorts of splendid things; for instance, they make sure that AIDS-patients in Africa have enough trained homeopaths to cure then from the nasty infection once and for all without any side-effects whatsoever.
5) Support your local chiropractor
Chiropractors have had a really rough time of late: they lost a much publicised libel-case and their good reputation along with it. Now they are suffering badly from vicious in-fighting. Worst of all, the world is slowly realising that there is ‘NOT A JOT OF EVIDENCE’ for most of their therapeutic claims. You should therefore pop into your local chiro’s office and book the entire family for life-long ‘maintenance treatment’. It does not really work, but they so need your money.
6) Buy a few ear-candles
Who wants conventional candles on the Christmas tree? Ear-candles are so much more original! They are supposed to do all sorts of amazing things for your health plus they do look very becoming when worn during the festivities and make a nice alternative to those silly hats that you used to put on. An additional benefit is that your local health food shop selling the ear-candles desperately needs your trade – times have been hard, you know!
7) Protect yourself against the common cold
Echinacea is the product to buy for this purpose. Scientists still debate whether it works or not, but it would be a mistake to listen to these nit-picking pedants. Take Echinacea and take it generously, the herbal industry counts on you.
8) Give up smoking
Your acupuncturist is the person you need for meeting your perennial New Year’s target of stopping to smoke. Book now!!! By January, they will all be fully booked with people who are desperate to give up the filthy habit; they earn their living by pretending that regularly sticking a few needles in your skin makes smoking cessation a piece of cake.
9) Lose a few pounds
Look at you! The feasting has not even started properly, and you are already several pounds over your ideal weight. Luckily, the alternative medicine industry has dozens of slimming aids on offer. Do they work? You should not ask such impertinent questions – there are no guarantees in life, you know! But at the very minimum, you will lose quite a few £s.
I am sure that many of my readers have sleepless night because they cannot think of a fitting Christmas present for their alternative therapist. I have given this increasingly acute problem some thought and come up with a few handy suggestions.
FOR THE REFLEXOLOGIST
Reflexologists believe that our organs are represented on the sole of our feet. By exerting pressure on locations which correspond to specific organs, they seek to influence the function of these organs. What the reflexologist therefore needs is an insole for her shoes that is deeply cushioned so that these sensitive points are well protected from unwanted exposure to strain. Without this protection, the reflexologist’s health might be in danger; imagine her crossing the street and inadvertently putting pressure on the liver or heart area. This would stimulate these organs and the unsuspecting therapist might suffer tachycardia or her liver might go into over-drive and metabolize drugs like warfarin way too fast, thus leaving her prone to suffer a blood clot.
FOR THE CHIROPRACTOR
Chiropractic was invented about 120 years ago when D.D. Palmer adjusted a subluxation in the neck of a deaf janitor who could then hear again. Chiropractors have ever since claimed that their adjustments free vital nerves that have been blocked by spinal subluxations. I suggest to give them a textbook of anatomy; there they can read up how the inner ear is connected to the brain via nerves which do not even pass via the spine but remain safely in the skull. I am sure the chiropractor will appreciate this news; it will make her think and she might even start doubting whether the rest of the gospel of Mr Palmer is correct.
FOR THE CRANIO-SACRAL THERAPIST
I suggest to give this practitioner an integral helmet for Christmas. Cranio-sacral therapy is based on the idea that the bones of the skull move ever so slightly and that these movements have a profound influence on our health. If that is true, the head of the therapist is in urgent need of complete protection from outside interference of any kind. Even a slight touch from a friend or spouse could have unforeseeable consequences. If she does not already have one, she needs a motorcycle-helmet and must wear it at all times.
FOR THE HOMEOPATH
Homeopaths dilute their remedies endlessly and are convinced that this process which they call ‘potentiation’ renders their remedies not weaker but stronger. The most treasured remedies contain nothing at all. To make a homeopath truly happy, one therefore should give her a nicely wrapped box that contains nothing. Make sure that the box once contained something really nice; like this it will have a powerful memory of its past content which is what homeopaths are after. I am sure she will be overwhelmed by this generosity and enjoy the present for years to come.
FOR THE REIKI MASTER
Reiki is the art of channelling healing energy via the hands of the therapist into a patient’s body. Reiki masters are unusually skilled and have energy-filled hands. When they are not in action, their energy would leak uselessly from their hand; and when they need it for their good work, they may have run empty. This disastrous situation would lead to the ineffectiveness of the otherwise useful intervention. I think that a fully insulated pair of gloves could prevent this situation. My suggestion therefore is to give the Reiki master a pair of solid skiing gloves which have been fitted with insulating material and to advise the master to wear them when not doing her healing.
FOR THE TRADITIONAL CHINESE ACUPUNCTURIST
By far the most common serious complication of acupuncture is a pneumothorax; it happens when an acupuncture needle punctures a lung and means that the patient is in a spot of trouble. If the acupuncturist happens to insert needles on both sides of the thorax, both lungs can be punctured, and then the patient is in a lot of trouble. As anyone can call herself an acupuncturist, some seem to have no idea where the lungs are and are blissfully unaware that their needles can penetrate into vital organs. I think the ideal gift for such acupuncturists might be an atlas of anatomy where they can see with their own eyes what damage a little misplaced needle can cause.
FOR THE HERBALIST
Herbalists tend to promote the idea that, because herbal extracts are natural, they are necessarily safe. The most fitting present for such a therapist might be a textbook of toxicology. There she will find that some of the most powerful poisons come from the plant kingdom. It might not be an insight that she likes, but it just could save some patients from getting hurt.
FOR THE COLONIC IRRIGATIONIST
Colonic irrigation involves pouring lots of water into the part of the body where the sun doesn’t shine in order to detoxify the patient. As the notion of such ‘detox’ is entirely bonkers, I suggest that these therapists could diversify into more serious areas of medicine. Give them a tin of instant coffee for Christmas, and they will be able to claim to treat cancer. Coffee-enemas are a popular alternative treatment for cancer, and I am sure the therapist will be thankful for this opportunity to enlarge her business.
This list could be extended, of course, but I think I will stop here and give my readers the occasion to contribute their own suggestions; surely your ideas are better than mine. So, please put them into your short comments below.
Many dietary supplements are heavily promoted for the prevention of chronic diseases, including cardiovascular disease (CVD) and cancer. But do they actually work or are they just raising false hopes? The evidence on this subject is confusing and proponents of both camps produce data which seemingly support their claims. In this situation, we need an independent analysis of the totality of the evidence to guide us. And one such review has just become available
The purpose of this article was to systematically review evidence for the use of multivitamins or single nutrients and functionally related nutrient pairs for the primary prevention of CVD and cancer in the general population.
The authors searched 5 databases to identify literature that was published between 2005 and January 29, 2013. They also examined the references from the previous reviews and other relevant articles to identify additional studies. In addition, they searched Web sites of government agencies and other organizations for grey literature. Two investigators independently reviewed identified abstracts and full-text articles against a set of a priori inclusion and quality criteria. One investigator abstracted data into an evidence table and a second investigator checked these data. The researchers then qualitatively and quantitatively synthesized the results for 4 key questions and grouped the included studies by study supplement. Finally, they conducted meta-analyses using Mantel-Haenzel fixed effects models for overall cancer incidence, CVD incidence, and all-cause mortality.
103 articles representing 26 unique studies met the inclusion criteria. Very few studies examined the use of multivitamin supplements. Two trials showed a protective effect against cancer in men; only one of these trials included women and found no effect. No effects of treatment were seen on CVD or all-cause mortality.
Beta-carotene showed a negative effect on lung cancer incidence and mortality among individuals at high risk for lung cancer at baseline (i.e., smokers and asbestos-exposed workers); this effect was persistent even when combined with vitamin A or E. Trials of vitamin E supplementation showed mixed results and altogether had no overall effect on cancer, CVD, or all-cause mortality. Only one of two studies included selenium trials showed a beneficial effect for colorectal and prostate cancer; however, this trial had a small sample size. The few studies addressing folic acid, vitamin C, and vitamin A showed no effect on CVD, cancer, and mortality. Vitamin D and/or calcium supplementation also showed no overall effect on CVD, cancer, and mortality. Harms were infrequently reported and aside from limited paradoxical effects for some supplements, were not considered serious.
The authors’ conclusion are less than encouraging: there are a limited number of trials examining the effects of dietary supplements on the primary prevention of CVD and cancer; the majority showed no effect in healthy populations. Clinical heterogeneity of included studies limits generalizability of results to the general primary care population. Results from trials in at-risk populations discourage additional studies for particular supplements (e.g., beta-carotene); however, future research in general primary care populations and on other supplements is required to address research gaps.
A brand-new RCT provides further information, specifically on the question whether oral multivitamins are effective for the secondary prevention of cardiovascular events. In total, 1708 patients aged 50 years or older who had myocardial infarction (MI) at least 6 weeks earlier with elevated serum creatinine levels were randomly assigned to an oral, 28-component, high-dose multivitamin and multi-mineral mixture or placebo. The primary end point was time to death, recurrent MI, stroke, coronary revascularization, or hospitalization for angina. Median follow-up was 55 months. Patients received treatments for a median of 31 months in the vitamin group and 35 months in the placebo group. 76% and 76% patients in the vitamin and placebo groups completed at least 1 year of oral therapy, and 47% and 50% patients completed at least 3 years. Totals of 46% and 46% patients in both groups discontinued the vitamin regimen, and 17% of patients withdrew from the study.
The primary end point occurred in 27% patients in the vitamin group and 30% in the placebo group. No evidence suggested harm from vitamin therapy in any category of adverse events. The authors of this RCT concluded that high-dose oral multivitamins and multiminerals did not statistically significantly reduce cardiovascular events in patients after MI who received standard medications. However, this conclusion is tempered by the nonadherence rate.
These findings are sobering and in stark contrast to what the multi-billion dollar supplement industry promotes. The misinformation in this area is monumental. Here is what one site advertises for heart disease:
Vitamin C could be helpful, limit dosage to 100 to 500 mg a day.
Vitamin E works better with CoQ10 to reduce inflammation in heart disease. Limit vitamin E to maximum 30 to 200 units a few times a week. Use a natural vitamin E complex rather than synthetic products.
CoQ10 may be helpful in heart disease, especially in combination with vitamin E. I would recommend limiting the dosage of Coenzyme Q10 to 30 mg daily or 50 mg three or four times a week.
Curcumin protects rat heart tissue against damage from low oxygen supply, and the protective effect could be attributed to its antioxidant properties. Curcumin is derived from turmeric, which is often used in curries.
Garlic could be an effective treatment for lowering cholesterol and triglyceride levels for patients with a history or risk of cardiovascular disease, especially as a long term strategy.
Terminalia arjuna, an Indian medicinal plant, has been reported to have beneficial effects in patients with ischemic heart disease in a number of small studies. Arjuna has been tested in angina and could help reduce chest pain.
Magnesium is a mineral that could help some individuals. It is reasonable to encourage diets high in magnesium as a potential means to lower the risk of coronary heart disease.
Danshen used in China for heart conditions.
And in the area of cancer, the choice is even more wide and audacious as this web-site for example demonstrates.
So, the picture that emerges from all this seems fairly clear. Despite thousands of claims to the contrary, dietary supplements are useless in preventing cardiovascular diseases or cancer. All they do produce, I am afraid, is rather expensive urine.
Advocates of alternative medicine are incredibly fond of supporting their claims with anecdotes, or ‘case-reports’ as they are officially called. There is no question, case-reports can be informative and important, but we need to be aware of their limitations.
A recent case-report from the US might illustrated this nicely. It described a 65-year-old male patient who had had MS for 20 years when he decided to get treated with Chinese scalp acupuncture. The motor area, sensory area, foot motor and sensory area, balance area, hearing and dizziness area, and tremor area were stimulated once a week for 10 weeks, then once a month for 6 further sessions.
After the 16 treatments, the patient showed remarkable improvements. He was able to stand and walk without any problems. The numbness and tingling in his limbs did not bother him anymore. He had more energy and had not experienced incontinence of urine or dizziness after the first treatment. He was able to return to work full time. Now the patient has been in remission for 26 months.
The authors of this case-report conclude that Chinese scalp acupuncture can be a very effective treatment for patients with MS. Chinese scalp acupuncture holds the potential to expand treatment options for MS in both conventional and complementary or integrative therapies. It can not only relieve symptoms, increase the patient’s quality of life, and slow and reverse the progression of physical disability but also reduce the number of relapses and help patients.
There is absolutely nothing wrong with case-reports; on the contrary, they can provide extremely valuable pointers for further research. If they relate to adverse effects, they can give us crucial information about the risks associated with treatments. Nobody would ever argue that case-reports are useless, and that is why most medical journals regularly publish such papers. But they are valuable only, if one is aware of their limitations. Medicine finally started to make swift progress, ~150 years ago, when we gave up attributing undue importance to anecdotes, began to doubt established wisdom and started testing it scientifically.
Conclusions such as the ones drawn above are not just odd, they are misleading to the point of being dangerous. A reasonable conclusion might have been that this case of a MS-patient is interesting and should be followed-up through further observations. If these then seem to confirm the positive outcome, one might consider conducting a clinical trial. If this study proves to yield encouraging findings, one might eventually draw the conclusions which the present authors drew from their single case.
To jump at conclusions in the way the authors did, is neither justified nor responsible. It is unjustified because case-reports never lend themselves to such generalisations. And it is irresponsible because desperate patients, who often fail to understand the limitations of case-reports and tend to believe things that have been published in medical journals, might act on these words. This, in turn, would raise false hopes or might even lead to patients forfeiting those treatments that are evidence-based.
It is high time, I think, that proponents of alternative medicine give up their love-affair with anecdotes and join the rest of the health care professions in the 21st century.
Even relatively well-informed people tend to think that homeopathy might be quirky and useless but, so what, it cannot do any harm. This is perhaps true for the homeopathic remedies but it does certainly not apply to the homeopaths. As soon as there is a public health problem, homeopaths claim that their approach offers a solution – never mind the evidence to the contrary. Just look at what they presently try to sell us in terms of cold and flu treatments!
The often criminal fight of homeopaths against public health is nowhere clearer than with their never-ending propaganda against the most successful public health measure in the history of medicine, immunisation. Some professional organisations of homeopathy have issued politically correct statements about this and thus feel they are out of the firing line. But, as far as I can see, most homeopaths are against vaccinations. Their arguments are wilfully misguided; here are just a few examples:
- It is well known that measles is an important development milestone in the life and maturing processes in children. Why would anybody want to stop or delay the maturation processes of children and of their immune systems?
- Homoeopathy offers an option for disease prevention and cure. There is scientific evidence in favour of homoeopathy for prevention of diseases.
- Seek out homeopathic, osteopathic, naturopathic, or Chinese medical constitutional treatment to boost your child’s immune system and help them be as healthy as they can be.
- If your children do get sick, use homeopathy to help their immune system get over it. Homeopathy is very effective in epidemics of acute illness. Either see a homeopath, buy a book on homeopathic acute care, or take a class on acute homeopathic prescribing.
- It is possible to prevent post-vaccination damage by giving the homeopathic dilution of the vaccine shortly before and after the vaccination in the C200 dilution.
- there are many recorded cases of people making dramatic recoveries with homeopathic medicines following a bad reaction to a vaccination. Expert advice from a registered homeopath is usually required.
- As you would keep your children away from toxic chemicals in the environment as much as possible, inform yourself about the toxicity of the solutions that are being injected into their bloodstream. It’s up to you to find the information: no one loves your children the way you do.
If you think I cherry-picked these quotes, you are mistaken. I simply used the citations as they appeared on my computer screen after a simple Google search. You might try this yourself because there are hundreds, if not thousands more to be discovered.
A typical and interesting example of a homeopathic anti-vaccinationist is Oksana Frolov, D.Hom. graduate of Saint Petersburg, Russia, I.P.Pavlov State Medical University, General Medicine, and graduate of Los Angeles School of Homeopathy. She states that, although I do hold a medical degree, I am not a licensed medical health provider in the United States. As a homeopathic practitioner, I will provide you with the treatment which is alternative or complementary to healing arts that are licensed by the State of California. On her blog, she provides detailed advice for people who might be uncertain whether to vaccinate their children: immunisation… can cause some very serious side effects including permanent brain damage, epilepsy, autism, and mental retardation. With so many vaccinations being required, doctors often have to administer several shots at a time, which can often result in a disaster. Vaccines, along with the elements that are supposed to create the antibodies, also contain mercury, aluminum, formaldehyde, animal tissue, animal blood, human cell from aborted babies, potatoes, yeast, lactose, phenol, antibiotics and unrelated species of germs that inadvertently get into the vaccines. Do you really want all this to be injected into your child just to prevent him or her from having a chicken pox? Vaccines are said to work by stimulating the body to produce antibodies, which are supposed to protect us from an invasion of harmful germs. Childhood diseases, such as measles, mumps, rubella and chicken pox, affect the immune system in a way that makes most people immune to them for the rest of their lives. Vaccinations, on the other hand, create an artificial immunity that wears off and allows the person to catch the disease later in life….
Homeopathy has proved to be very effective in treatment of childhood diseases, as well as other infections. From its earliest days, homeopathy has been able to treat epidemic disease, such as cholera, typhus, yellow fever, and diphtheria, with a substantial rate of success, when compared to conventional treatments.
Doctors who practice homeopathy usually claim that only non-medically qualified homeopaths hold such deranged views. Dr Frolov shows us that this assumption is clearly not true. In my experience, most homeopaths, medical or not, advise their patients against immunizations or are at least very cagey about this subject in order to raise doubts in concerned parents. Professional organisations of homeopaths usually hide behind some powerless statement in favour of informed choice; yet they must be well-aware that many of their members fail to abide by it. And what do they do about it? Nothing!
Yes, I am afraid the fight of many homeopaths against public health is active, incessant and often criminal. Of course, they do not for one second believe that they are doing anything wrong; on the contrary, they are convinced of their good intentions. As Bert Brecht once wrote, THE OPPOSITE OF GOOD IS NOT EVIL, BUT GOOD INTENTIONS.
Yes, it is unlikely but true! I once was the hero of the world of energy healing, albeit for a short period only. An amusing story, I hope you agree.
Back in the late 1990s, we had decided to run two trials in this area. One of them was to test the efficacy of distant healing for the removal of ordinary warts, common viral infections of the skin which are quite harmless and usually disappear spontaneously. We had designed a rigorous study, obtained ethics approval and were in the midst of recruiting patients, when I suggested I could be the trial’s first participant, as I had noticed a tiny wart on my left foot. As patient-recruitment was sluggish at that stage, my co-workers consulted the protocol to check whether it might prevent me from taking part in my own trial. They came back with the good news that, as I was not involved in the running of the study, there was no reason for me to be excluded.
The next day, they ‘processed’ me like all the other wart sufferers of our investigation. My wart was measured, photographed and documented. A sealed envelope with my trial number was opened (in my absence, of course) by one of the trialists to see whether I would be in the experimental or the placebo group. The former patients were to receive ‘distant healing’ from a group of 10 experienced healers who had volunteered and felt confident to be able to cure warts. All they needed was a few details about each patients, they had confirmed. The placebo group received no such intervention. ‘Blinding’ the patient was easy in this trial; since they were not themselves involved in any healing-action, they could not know whether they were in the placebo or the verum group.
The treatment period lasted for several weeks during which time my wart was re-evaluated in regular intervals. When I had completed the study, final measurements were done, and I was told that I had been the recipient of ‘healing energy’ from the 10 healers during the past weeks. Not that I had felt any of it, and not that my wart had noticed it either: it was still there, completely unchanged.
I remember not being all that surprised…until, the next morning, when I noticed that my wart had disappeared! Gone without a trace!
Of course, I told my co-workers who were quite excited, re-photographed the spot where the wart had been and consulted the study protocol to determine what had to be done next. It turned out that we had made no provisions for events that might occur after the treatment period.
But somehow, this did not feel right, we all thought. So we decided to make a post-hoc addendum to our protocol which stipulated that all participants of our trial would be asked a few days after the end of the treatment whether any changes to their warts had been noted.
Meanwhile the healers had got wind of the professorial wart’s disappearance. They were delighted and quickly told other colleagues. In no time at all, the world of ‘distant healing’ had agreed that warts often reacted to their intervention with a slight delay – and they were pleased to hear that we had duly amended our protocol to adequately capture this important phenomenon. My ‘honest’ and ‘courageous’ action of acknowledging and documenting the disappearance of my wart was praised, and it was assumed that I was about to prove the efficacy of distant healing.
And that’s how I became their ‘hero’ – the sceptical professor who had now seen the light with his own eyes and experienced on his own body the incredible power of their ‘healing energy’.
Incredible it remained though: I was the only trial participant who lost his wart in this way. When we published this study, we concluded: Distant healing from experienced healers had no effect on the number or size of patients’ warts.
AND THAT’S WHEN I STOPPED BEING THEIR ‘HERO’.
Web-sites have become a leading source of information on health matters. This is particularly true in the realm of alternative medicine. Conventional health care professionals often know too little about this subject to advise their patients, and alternative practitioners are usually too biased to be trusted. So many consumers turn to the Internet and hope that it offers information which is reliable. But is it?
American pharmacists published a study evaluating the quality of on-line information on herbal supplements. They conducted a search of 13 common herbals – including black cohosh, echinacea, garlic, ginkgo, ginseng, green tea, kava, saw palmetto, and St John’s wort – and reviewed the top 50 Web sites for each using a Google search. Subsequently, they analysed clinical claims, warnings, and other safety information.
A total of 1179 Web sites were examined in this way. Less than 8% of retail sites provided information regarding potential adverse effects, drug interactions, and other safety information; only 10.5% recommended consultation with a healthcare professional. Less than 3% cited scientific literature to support their claims.
The authors’ conclusions were worrying: Key safety information is still lacking from many online sources of herbal information. Certain nonretail site types may be more reliable, but physicians and other healthcare professionals should be aware of the variable quality of these sites to help patients make more informed decisions.
Having conducted my fair share of similar research (e.g. here or here or here or here), I can only concur with these conclusions. When it comes to health care, the Internet is a scary place! In the realm of alternative medicine, it is dominated by people who seem not to care much about anything other than their profits.
But what can be done to change this situation? How can we protect the public from Internet-charlatans? How can one control the Internet? I wish I knew! But there are nevertheless means of directing consumers to those sites which do offer reliable information. Kite-marking high quality sites might be one way of achieving this. This task would, of course, be huge and difficult, but in the interest of public safety, governments and other official institutions should consider tackling it.