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Blogging against alternative cancer treatments

Homeopathy For Cancer, Endorsed by ASCO?? Not Really

When searching for a non-toxic cancer treatment without any side effects, for many people homeopathy seems an attractive option. And sure enough, there are people out there who try to convince cancer patients that homeopathy is a real option. A strong sales argument would be that conventional science proves it to be effective – and precisely this claim has been made for a homeopathic remedy called Psorinum.

What is homeopathy?

Homeopathy, originated by Samuel Hahnemann in the 18th century, is a system of medical treatment based on the use of minute quantities of remedies that in larger doses produce effects in healthy people similar to those of the disease being treated (“the law of similars”). Homeopaths believe that very small doses of a medication (“the law of infinitesmals”) will have very powerful healing effects because their potency can be increased by vigorous and methodical shaking (homeopaths call this process “dynamization” or “potentization” of the remedies by means of “succussion”).

Homeopathy’s main principles  have  remained unchanged, while  our understanding of physiology (how the body works) and physics has evolved and increased tremendously. From present day understanding of physiology we know that homeopathy has no biological basis, but this was not self evident 200 years ago.

Homeopaths like to call homeopathy a “holistic” system, but this is a misnomer. A homeopath prescribes remedies based on symptoms only. It is a symptom based system in the extreme, not a holistic system, and since it occupies itself only with symptoms, it does not address the cause of the disease at all.

As said, one core principle is that the effect of a remedy gets stronger the more the remedy is diluted (and shaken vigorously: “succussed”). From present-day knowledge, we know that nothing else in nature gets stronger when diluted – or succussed, and most homeopathic remedies are so diluted that not even a single molecule of the original substance can be found.  Sometimes homeopaths use a lesser degree of dilution, which means that the remedy may contain minute amounts of the original substance.

Nowadays many homeopathic remedies are administered as pills. At some point in the manufacturing process, a drop of water (the diluted and succussed remedy) is dripped onto the pill, which is then left to dry. Today we understand that when the pill is dry, the water has evaporated.

But the absurdities don’t stop there. Through a process called grafting, the acquired capabilities of the dried sugar pills can be transferred to other dry sugar pills; all that is needed is physical contact between a dried sugar pill, and the sugar pills that are to acquire the same capabilities.

Could homeopathy still work?

Many “absurd” ideas have been accepted in the past after passing fair tests. Could this happen to homeopathy too? Actually, homeopathy failed many fair tests. It has been tested so extensively that it is fair to conclude that there is evidence of absence, not just absence of evidence.

Is the homeopathic remedy Psorinum an effective cancer treatment?

No, it’s not.

Let’s take a closer look at Psorinum – and the evidence that is supposedly accepted by ASCO. What we will look into is this published paper  and the presentation given at the ASCO conference in 2009.

The 186 patients in the study had been diagnosed with inoperable cancers of the stomach, gall bladder, pancreas or liver. The patients also had various types of supportive treatments, both conventional and in the form of various homeopathic remedies. Ten  of them dropped out of the study and opted for conventional treatment instead.

We are told that psorinum is an alcoholic extract of scabies: pus cells. Such an extract may indeed still contain some minute biological active substances. This is explained in a blog post here.

We are also told that the remedy used was a “6x-dilution”. This means that the psorinum was in a 1 to 1ooo.ooo dilution. So this remedy may actually have contained some biologically active substances. The patients ingested the remedy, but it is not clear if they drank it, or took pills. Again – a dried pill is a pill where the water has evaporated.

Tumour response was evaluated using CT-scans, and the patients were followed up via personal meetings, phone calls, and emails. One of the things they were asked was whether they had been taking any other conventional or investigational cancer treatments. If they answered yes, they would no longer be offered the homeopathic treatment.

A significant number of the patients experienced shrinkage of their tumours, and 5-year survival rates were approximately 40%. Such figures are indeed impressive. But was it really the Psorinum therapy that was working?

Well – we do know that there are long-term survivors of these types of cancer through conventional medicine. And the only way we know that these patients did not receive any conventional or other experimental treatment is, that they told the researchers so.

There is an interesting graph that is not in the printed article, but only in the oral conference presentation:

This is a way to illustrate survival statistics. The higher the graph, the more survivors. Allopathy is the term homeopaths use for conventional treatment. So the yellow curve represents those who had psorinum and conventional as well as homeopathic treatment. The green curve represents those who had psorinum and conventional supportive treatment, and the magenta represents those who had Psorinum and homeopathic supportive treatment.

The yellow and the green curves are really not all that different. We really can’t tell if the small difference is statistically significant. But the magenta curve is definitely different from the others. It appears that conventional treatment is necessary for homeopathy to work.

There is one important question that can’t be answered from the data: How would these patients have fared on conventional treatment (or allopathy if you will) alone? This is because the researchers never bothered to include a group that had conventional treatment only.

The hypothesis that homeopathy shortened the lifespan of this group of patients is just as valid as the hypothesis that it prolonged it.

If we take the absurdities of homeopathy and the qualified research into account, odds are however, that it didn’t do a damn thing.

What else could be wrong with the study?

As we said, these survival statistics look impressive. So it is reasonable to ask ourselves if there could be anything in the study, that would make it more impressive than it really is.

We can’t know for sure, because the whole dataset isn’t available. But there are some other possibilities that aren’t all that far fetched.

1) Perhaps some of the patients didn’t really have cancer.

The only thing we are told about age distribution is that the patients were between 18 and 86 years old. With the exception of liver cancer, these cancers are rare in people younger than 40. Elderly people without cancer will most likely live longer than people with cancer, but it is not all that implausible, that they would die of old age within the observation period.

The diagnoses were based on either biopsies or fine needle aspirations. According to the study design, none of them were operated, so what we need to take into account here is the possibility of false positive biopsies/fine needle aspirations. Fortunately false positive biopsies are rare, but they do occur. See for instance this study.

2) Another thing we can ask is how reliable the stagings were. The stage is a way to describe how advanced the cancer is. The higher the stage, the more advanced. The most advanced stage is stage 4, where the cancer has spread to other locations. The lower stage, the longer expected lifespan. Cancers do not progress at the same speed. Some cancers grow slow while others grow faster.

We are told that some of the cancers were stage 2 and 3 cancers. Stages are defined differently for different cancers. Since none of them was operated, we only have the radiologic examinations. So what we have to take into account is the possibility of radiologic overstaging. This is a review of radiologic staging of stomach cancer. The researchers went through all publications they could find were radiologic staging was compared to the pathoanatomical stage found in the subsequently surgically removed tissue. In all of these studies, overstaging by CT-scans was found in up to 28,4 % of the cases. So overstaging is a distinct possibility in a study like this one.

3) Was the tested treatment the only one used? The homepoathic treatments used are described in details. The so called “Allopathic supportive treatments” less so. Also the information that they did not receive any other treatments was not based on chart reviews. It was based on information given by the patients during interviews. What would you answer, if you really wanted to try psorinum alongside conventional/experimental treatment of a cancer with a poor prognosis?

So what about all the fuss?

The thing is that there is a big difference between presenting data in a peer reviewed research paper and at a conference. In a peer reviewed paper, the submitted paper has been read by a group of “experts” chosen by the editor. The job of these reviewers is to check if the paper is relevant for the journal and if the study design and results warrant the conclusion that the authors draw from it. Based on their assessment, they may recommend that the paper is published or that changes will have to be made.

An abstract for a conference presentation is also reviewed, but only to check if the study is relevant for the conference. No attempts are made to check if the conclusions are consistent with the study design/results. Here is the abstract from which ASCO accepted the presentation. Not easy to spot that this is about homeopathy. And it is not easy to spot why (based on the data) the conclusion that

Psorinum therapy is effective in treating stomach, gallbladder, pancreas, and liver cancers….

is just as valid as our suggestion  that:

Psorinum therapy reduces the efficacy of conventional supportive treatment of  stomach, gallbladder, pancreas, and liver cancers….

Or the more likely conclusion

Psorinum therapy has no effect on stomach, gallbladder, pancreas, and liver cancers….

So a presentation at an ASCO conference does not mean an endorsement by ASCO.

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20 responses to “Homeopathy For Cancer, Endorsed by ASCO?? Not Really

  1. Pingback: Psorinum therapy – homeopathy for cancer? « Anomalous Distraction

  2. xtaldave August 22, 2012 at 2:57 pm

    Hi,

    Great post – I was really interested to see the graph from the ASCO presentation – my original hunting around didn’t uncover this. I have amended my blog post to link to your post and included an update regarding the “survival functions” graph.

    Keep up the good work,

    Dave

  3. jli August 22, 2012 at 3:12 pm

    Thank you Dave. The credit for finding the presentation with the graph really should go to Beatis. Your post is great too. I would like to encourage people reading this post to follow the link to Dave’s post.

  4. Acleron (@Acleron1) August 22, 2012 at 6:51 pm

    A good and clear explanation of this work, well done. To use a poster session at a conference as an advertising stunt is pretty despicable.

    Having taken your advice to read xtaldave’s post I see an all too depressing and common trait from homeopaths. The frequency of poor trials when as in this case a change to the protocol would give a higher power is such that I have to conclude that homeopaths know their nonsense doesn’t work.

  5. ramlall June 18, 2013 at 6:26 am

    Are you by any chance funded by the MNC drug companies? Just a hunch.

  6. ramlall June 18, 2013 at 6:31 am

    I have seen and felt how Homeopathy works,almost instantly, in several cases of physical ailment. Maybe not in other cases, but even if it did in ONE single case, it disproves in one shot the entire arguments against it.How did that ONE case got solved?No use giving a round about answer of maybe this or maybe that worked.Delve deep and try finding the truth instead of debunking anything which comes up against the conventional system. That’s like having a more scientific approach.Be a sceptic, not a disbeliever.

  7. beatis June 18, 2013 at 7:28 am

    @ramlall

    How did that ONE case got solved?

    Which case?

  8. JLI June 18, 2013 at 2:46 pm

    Are you by any chance funded by the MNC drug companies? Just a hunch.

    No – I work in a taxpayer financed health care system. Writing for this blog is something I gladly do for free in my spare time. I don’t own the blog, but even if I did, I wouldn’t have any expenses. You can open your own blog if you will – for free.

  9. JLI June 18, 2013 at 2:52 pm

    I have seen and felt how Homeopathy works,almost instantly, in several cases of physical ailment.

    If I was a conspiracy nut, I might conclude that you are payed by big suppla (BS).

    How did that ONE case got solved?No use giving a round about answer of maybe this or maybe that worked.

    You haven’t really provided evidence that such a case even exists.

  10. ramlall June 18, 2013 at 7:31 pm

    People like you SHOULD not be convinced and wasted time upon- not “cannot be”. Its pathetic.You deride Homeopathy in a manner which almost implies that you are paid by the MNC’s lobby.The day Homeopathy gains worldwide recognition, you’ll start writing for that system!! I know where you stand. It’s all money, honey.Even if an evidence was given right in front of your eyes,the greenback wouldn’t let you see it, would it?

  11. JLI June 18, 2013 at 7:40 pm

    Homeopathy has been subjected to fair tests and failed them. It doesn’t matter what you or I think about homeopathy. If it fails fair tests, it has to be discarded as useful treatment of real diseases.

  12. ramlall June 19, 2013 at 6:17 am

    Tests by who? And under what conditions? It’s like saying that your religion is bad because My Christ says so! What about the hundreds of patients consuming these medicines and getting cured,each day,right before our eyes,even as I write? You can fool some men for all time but not all men for all time. And Homeopathy, had it been a fraud, would not have survived for centuries. Aren’t there Allopathic medicines which also fail/aggravate the situation? One medicine may cure cancer but makes the heart fail! If any Allopathic doctor sits for a test under Homeopaths even he is bound to fail all tests. Remember, a bullet kills no doubt, but even a knife can be used to achieve the same purpose.That doesn’t mean the knife has failed the bullets test or vice versa. Talk to thousands of Homeo patients and you can form your opinion outside your one sided laboratory.

  13. JLI June 19, 2013 at 9:17 am

    Tests by who? And under what conditions?

    The studies are out there in the open. It took me less than a minute to find this one.
    The study was done by people who really wanted to know if it works or not. It included Two qualified experienced non-medical homeopaths (each with 15 years experience, classically trained) who prescribed individualized homeopathic treatment at each visit mirroring normal practice.

    It is unknown if the participating homeopaths remained so after the study results that conclusively demonstrated, that the remedies did not work.

    had it been a fraud, would not have survived for centuries.

    Doing wrong isn’t necessarily fraudulent. Sometimes it is well meant ;-). Bloodletting survived for centuries. It did so because at least one patient got better after this procedure – just as at least one person got better after trying homeopathy. This was not effects of bloodletting/homeopathy.

    Aren’t there Allopathic medicines which also fail/aggravate the situation?

    Yes- Nobody denies that. But the relevant issue here is the risk-benefit balance. There is a good balance between risks and benefit in conventional treatment of cancer. There is no benefit of homeopathy as cancer treatment.

  14. Sunjay Somani June 19, 2013 at 12:47 pm

    That proves beyond any doubt that all the thousands of Homeopaths round the world are quacks and wasting their own and patients time. All the Homeopathic Medicine manufacturers are actually selling only sugar coated pills which are being taken by the “foolish” millions as just a pass time. If two Homeopaths could not prescribe a medicine which can cure,a particular disease because of their ineptitude, it necessarily follows that all the Homeopaths all over the globe have to be fools of the same order as they are.Not “just as at least one person got better after trying Homeopathy” but millions are still getting better and will so in future as well.The facts are there in every home.

  15. JLI June 19, 2013 at 8:40 pm

    Well Beatis. Homeopathy might be of some use after all. My friend “Tink” came up with this: http://tinypic.com/view.php?pic=1775si&s=6

  16. beatis June 20, 2013 at 5:37 am

    That is soooo weird!

  17. beatis June 20, 2013 at 2:41 pm

    @ Sunjay Somani:

    You seem to know an awful lot about homeopathy! :mrgreen:

  18. ashish maheshwari August 11, 2013 at 6:43 pm

    I don’t read from any cancer survivors who might have taken psorinum therapy if it took it and if it did help them. so I don’t know what to make of it. and I need to look at alternates as my mom cannot be treated with chemo / allopathically. please help with

  19. JLI August 12, 2013 at 11:07 am

    Sorry to hear about your mom. You and her have my deepest sympathy.

    I understand perfectly why you want to find an alternative when conventional treatment is unable to deliver a cure.

    In an ideal world nobody would exploit people who are in the awful situation that your mother is in. But the world isn’t ideal. There are lots of people who have become very rich by selling false hopes. If any of these alternative therapies really worked, they would become conventional treatments immediately. But since they don’t work, they really aren’t alternatives. Often times they aren’t even providing better quality of life.

    Even though a cure isn’t possible, there are still ways to relieve symptoms and make it as comfortable for her as possible.

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