Homeopathy is The One Quackery To Rule Them All.

There, I’ve started off this post the way I start off most posts about homeopathy, with a statement of just how enormous a pile of pseudoscientific (or rather prescientific) quackery that it is. You’d think that in 2015 no one would believe that diluting a substance (with vigorous shaking between each serial dilution step, of course, in order to “potentize” it) makes its effects stronger or that water has some sort of mystical “memory” that remembers the therapeutic substance but forgets all the other impurities, chemicals, and urine with which the water has been in contact over the millennia. Still, homeopaths and naturopaths (all of whom are trained in homeopathy) continue to prescribe little magic sugar pills that have been soaked in the water remaining after a homeopathic remedy has been serially diluted to the point where there’s almost no chance (other than perhaps through contamination of the surfaces of the flasks used to do the dilutions) that there’s even a single molecule of the original remedy left. Such is unreason in 2015, the same as it was over 200 years ago when Samuel Hahnemann dreamt up homeopathy.

What is even more depressing is that there are actual people in medical academia, real doctors, who think there might be something to homeopathy even though its precepts violate multiple well-established laws of physics and chemistry and its other law declaring that “like cures like” has no basis in physiology or medicine. Every so often, I come across articles by such Very Serious People that make their way into actual reputable medical journals. So it was that Mark Crislip (Crissslippppp!) sent me just such an article by Moshe Frenkel, Clinical Associate Professor at the University of Texas Medical Branch, former chair of the Clinical Practice Committee of the Society of Integrative Oncology, former medical director of the Integrative Medicine Program at M.D. Anderson Cancer Center, director of an integrative oncology service in The Institute of Oncology in Meir Medical Center in Israel, and founder and director of Integrative Oncology Consultants. In other words, he’s a former academic who formed his own consulting practice but is still a heavy hitter in the world of academic “integrative oncology.” We’ve met Dr. Frenkel a few times before here, including in posts about his recommendation based on anecdotes of the Feldenkrais method and, perhaps most memorably (at least I like to think so) his study in which he and his colleagues sprinkled the magic water on breast cancer cell lines and misinterpreted probably ethanol toxicity as selective toxicity of homeopathic remedies on breast cancer cell lines. It was a study that Rachael Dunlop also deconstructed in a most excellent fashion. Perhaps the most depressing thing about the study is that it came out of a lab at M.D. Anderson. My deconstruction of that particular study also provoked some of the most hilariously dumb responses I’ve ever had to any post of mine.

So Dr. Frenkel is a believer in homeopathy. This much is clear. Indeed, he’s even “earned” his very own entry in the American Encyclopedia of Loons. Yet, somehow, he managed to publish a brand spankin’ new article justifying the potential use of homeopathy in oncology. His commentary appears in Current Oncology Reports, which, while by no means top tier, is a relatively decent journal (Impact Factor 2.891) not generally known for woo. Yet, here Frenkel publishes an article entitled Is There a Role for Homeopathy in Cancer Care? Questions and Challenges.

Whenever an article’s title is a question, a general rule of thumb is that the answer to the question is no. In that tradition, I was half tempted to let Frenkel ask this question and then answer simply, “No.” Unfortunately, there’s a lot more quackery to deal with; so let’s dig in.

Frenkel starts his article out, as is mandatory for articles by believers about “complementary and alternative medicine” (CAM) or, as it’s now more commonly called “integrative medicine,” with an appeal to popularity, touting how patients with cancer commonly use CAM to “improve their quality of life, to gain a sense of control, and to participate actively in their care.” (One notes that he doesn’t say anything about “to treat their cancers” or “to get better.” Among these, he notes meditation, acupuncture, homeopathy, yoga, and diet. Of course, two of these things are not like the others. For instance, yoga is a system of exercise. Diet and exercise can be science-based methods to assist treating cancer patients. Similarly, meditation might potentially be science-based, although it’s difficult to study. In marked contrast, acupuncture and especially homeopathy are pure quackery. This is a common strategy among CAM apologists, to mix science-based and potentially science-based modalities that have been “rebranded” as being somehow “alternative” and therefore CAM with modalities that are pure quackery, as though they are both equally legitimate. Frenkel thinks this is just damned unfair:

Homeopathy has grown in popularity with the public but is viewed with skepticism by medical academia and is still excluded from current conventional recommendations. Homeopathy is practiced extensively in Europe, Asia, Middle East, and South America to treat functional disorders and minor ailments.

And:

In Europe, homeopathy is used during and after cancer treatments. A survey of close to 1000 cancer patients in 14 European countries revealed that 36%of cancer patients were using some form of complementary medicine. In the surveyed countries, cancer patients often used homeopathy with herbal remedies as the main CIM therapy [6].

In the UK, a questionnaire-based study revealed that homeopathy was one of the mainly used CIM therapies by cancer patients [7].

Approximately 34 % of patients treated in a French cancer department reported using CIM; of these patients, the majority (42 %) used homeopathy [8].

In Germany, cancer patients (both adults and children) tend to use homeopathy in addition to conventional treatments. Homeopathy, as a matter of fact, is the most frequently used CIM treatment among German adults and children with cancer [9, 10].

To which my response is a big yawn. As I like to say, large numbers of people belief in ghosts and hauntings. It doesn’t make ghosts and hauntings real, nor does the popularity of homeopathy in some parts of the world mean that homeopathy is an efficacious treatment for anything.

Even so, having established (or attempted to establish) the popularity of homeopathy, Frenkel next moves on to try to argue that it is also efficacious. A lot of what he writes are the same tired old defenses of homeopathy that I’ve deconstructed ad nauseam right here on this very blog and on my not-so-super secret other blog. It’s still worth discussing some of them again plus one that I somehow missed having discussed in detail, namely a Swiss report on homeopathy released in 2011, which Frenkel exults about:

The Swiss report carefully reviewed the evidence from randomized double-blind and placebo controlled clinical trials testing homeopathic medicines, they also evaluated the Breal world effectiveness^ as well as safety and cost-effectiveness [15]. The report also conducted a comprehensive review of preclinical research such as botanical studies, animal studies, and in vitro studies with human cells. After assessing the evidence from basic science research and high-quality clinical studies, the Swiss concluded that homeopathic remedies seem to induce cellular effects as well as changes in living organisms. The report also mentioned that 20 of the 22 systematic reviews of clinical research, testing homeopathic medicines, detected a trend in favor of homeopathy. The authors concluded that homeopathic treatments should be reimbursed by Switzerland’s national health insurance program, and the Swiss government followed this recommendation [15].

There’s just one problem. It’s a terrible report. Critics almost immediately pointed out (as well they should have) that the Swiss report consisted of a poorly done analysis of the existing evidence. Indeed, David Martin Shaw even characterized it as research misconduct, noting that the writers of the report didn’t even do an online review of the literature because “just searching online would not have been sufficient to supply a representative overview of homeopathic research.” They also included “expert contacts and scanning of bibliographic references.” As Shaw discussed, this is a highly suspect research strategy because any high quality research would be available online via the usual databases such as PubMed.gov and other online sources. More importantly, the “expert contacts” almost certainly suggest biased sources (i.e., homeopaths and naturopaths, the latter of whom also use homeopathy, with perhaps other believers in homeopathy).

Shaw also notes that the authors based “their conclusion that homeopathy is effective on four trials that are all more than a decade old and have been comprehensively exposed as weak, flawed studies (see reference 3 for details of the trials) [3]. The authors also tried to redefine how one determines whether a treatment is safe and efficacious by emphasizing “real world effectiveness,” which, as I’ve pointed out time and time again, is putting the cart before the horse. You can’t look at real world effectiveness until you’ve established efficacy in clinical trials, because design and interpretation of pragmatic studies designed to look at real world effectiveness assume that efficacy has already been established in randomized clinical trials. Both David Shaw and Steve Novella quote a damning passage from the Swiss report:

If homeopathy is highly likely to be effective but this cannot be consistently proven in clinical trials, the question arises of what conditions are needed for homeopathy to show its effectiveness and realise its potential, and what conditions threaten to obscure this?

Shaw expressed surprise that the authors of the Swiss report would be so bold as to come out and say that they are seeking to prove that homeopathy works and looking for conditions under which they can achieve that. As Novella notes, they are assuming that homeopathy works, but are frustrated by the fact that high quality clinical trials uniformly fail to detect efficacy. In any case, Frenkel fails to note that an Australian and British report found exactly the opposite conclusion as the Swiss report. They both concluded that homeopathy doesn’t work detectably greater than placebo. So has a Cochrane review on homeopathy used to treat the adverse effects of cancer treatment, concluding that there is “no convincing evidence for the efficacy of homeopathic medicines for other adverse effects of cancer treatments.” It did note that there were small studies that suggested that topical calendula and Traumeel S mouthwash might have efficacy preventing acute dermatitis during radiation therapy and chemotherapy-induced stomatitis, respectively, but this is weak at best. For one thing, calendula is not truly homeopathic, as it’s not diluted at all, and the tiny Traumeel S study has never been replicated with a larger number of patients.

Frankel also cites poorly done animal studies of homeopathic remedies, including a study of his own that I’ve discussed before, namely the one that demonstrated that the alcohol diluent in homeopathic remedies is toxic to breast cancer cell lines. It was a study so flawed that it took a tag team of Rachael Dunlop and myself to take it down. The rest of the evidence presented consisted of the usual panoply of favored studies of homeopathic remedies, such as best case series of the sort Nicholas Gonzalez used to con the NIH into funding a study of his protocol for pancreatic cancer and survival data in case series with no controls other than historical data.

Frenkel concludes erroneously:

Limited research has suggested that homeopathic remedies appear to cause cellular changes in some cancerous cells. In animal models, specific homeopathic remedies have had an inhibitory effect on tumor development. Studies of homeopathic remedies combined with conventional cancer care show that these remedies improve quality of life, reduce symptom burden, and possibly improve survival in patients with fatal disease. In vitro studies, animal studies, and clinical interventions that combine homeopathy with conventional cancer care suggest that homeopathy might improve the well-being of patients and might affect the progression of cancer and patient survival. These findings warrant comprehensive clinical studies to determine the effects of homeopathy on cancer and patient survival. Although additional studies are needed to confirm these findings, given the low cost and minimal risks and the potential magnitude of homeopathy’s effects, in certain situations, one might consider the use of homeopathic remedies as an additional tool to integrate into cancer care.

Let’s just say that the studies enumerated by Frenkel in his review, as is the case of pretty much every “positive” study touted by homeopaths, do not show what he thinks they show. Certainly, when coupled with the utter implausibility of homeopathy from a scientific standpoint, these studies do not show that homeopathy “works.” As I like to say, equivocal results + an incredibly high degree of scientific implausibility = negative results.

I could have saved Frenkel a lot of time and effort right after the title of his paper by telling him the answer is no. The sad thing is, this is a doctor who was once the chief of “integrative medicine” at one of the two most respected cancer centers in the US and is still well-regarded within academia—I mean quackademia. This should tell you much of what you need to know with respect to what we are up against in fighting the infiltration of pseudoscience into medicine.

Comments

  1. #1 herr doktor bimler
    August 3, 2015

    Homeopathy is practiced extensively in Europe, Asia, Middle East, and South America to treat functional disorders and minor ailments.

    You may read this as an appeal to the Argument-by-popularity cognitive error, but to me it looks more like a heads-up to fellow-practitioners: “Look at all the money you could take in with these righteous scams, if it weren’t for those interfering laws!”

    Frenkel evidently espouses the ethical philosophy that if the rubes *can* be duped, then it’s your ethical duty to dupe them

  2. #2 Narad
    August 3, 2015

    My deconstruction of that particular study also provoked some of the most hilariously dumb responses I’ve ever had to any post of mine.

    Stepping into the proper Wayback Machine….

    “Five centuries ago, uncannily similar words were addressed by Luther to Copernicus, who had presented his heliocentric theory: “this fool who wishes to reverse the entire science of astronomy.” Isn’t it ironic to find the sceptics caught in the unenviable position of the Church of those times, which relentlessly persecuted anyone who dared oppose its authority and threaten its power, and systematically used brutal repression in lieu of scientific argumentation.”

    Did anyone see the movie Tron?

  3. #3 has
    August 3, 2015

    “Is there a role for homeopathy in cancer care?”

    If/When I get cancer I wish to conduct a single-arm unblinded trial into the efficacy of punching a homeopath to feel better. Expect positive results.

  4. #4 zebra
    August 3, 2015

    Orac:

    …with an appeal to popularity, touting how patients with cancer commonly use CAM to “improve their quality of life, to gain a sense of control, and to participate actively in their care.” (One notes that he doesn’t say anything about “to treat their cancers” or “to get better.”

    and then

    …nor does the popularity of homeopathy in some parts of the world mean that homeopathy is an efficacious treatment for anything.

    Well, actually, it does, if the “anything” is the negative feelings experienced by the patient as described above.

    You have, as far as I can tell from your writings, completely failed to refute the argument about “real world” or practice v trials. Except of course, by defining efficacy as being determined only by trials.

    If people are buying magic water, or being motivated to practice yoga by the spiritual aspects, and so on, then in fact the market is providing a real-world trial of efficacy. It makes people feel better, and it doesn’t require special new laxatives, and they don’t end up OD on heroin when they can’t get the prescription.

    Doesn’t sound that bad to me.

  5. #5 Helianthus
    August 3, 2015

    @ zebra

    then in fact the market is providing a real-world trial of efficacy.

    *sigh*
    it depends on what is the endpoint being evaluated.
    If it is the ability of the merchant to sell its products, well yes, market results will show that homeopaths are good at selling themselves.

    It makes people feel better

    Ah, I see. Your endpoint is to make people “feel” better. You define efficacy as “people are happy after using this product”.

    I believe Orac’s endpoint is more about evaluating if the treatment is making people do better.
    Actually, more precisely: It’s about evaluating if the treatment is doing that is written on its lid: to successfully treat cancer.

    tl;dr: efficacy is about delivering on promises.

  6. #6 Narad
    August 3, 2015

    You have, as far as I can tell from your writings, completely failed to refute the argument about “real world” or practice v trials.

    I must congratulate Z. for making some progress, no matter how imperfectly formed.

    Take the next step! Imagine that those scare quotes are actually your ears.

  7. #7 Eric Lund
    August 3, 2015

    And where were the editor and referees on this paper? Of course a competent referee should have been able to pick this paper apart, as you just did. But at most journals the corresponding author is encouraged, if not required, to suggest potential referees for the paper, and of course authors will tend to suggest friendly reviewers. That’s where the editor comes in: it’s his job to select the actual referees, and if he is using only the referees suggested by the corresponding author he is falling down on the job. At some journals (particularly the ones that practice triage) the editor himself may serve as a reviewer. The editor and reviewers are supposed to spot things like studies that don’t conclude what the author says they conclude, biased viewpoints in the literature search, and relevant studies that the authors did not cite.

    Granted, sometimes bad papers slip through. I have read several papers in my field to which my reaction, as with this paper, was, “How the #^*@ did that get past the referees?” But nothing as egregious as this.

  8. #8 herr doktor bimler
    August 3, 2015

    one that I somehow missed having discussed in detail, namely a Swiss report on homeopathy released in 2011, which Frenkel exults about

    It was dealt with in one of the comment threads, however, after D. Ullmann heralded it as a lot of things which it wasn’t.

    http://scienceblogs.com/insolence/2012/05/03/nccam-i-say-we-take-off-and-nuke/

  9. #9 zebra
    August 3, 2015

    Helianthus #5

    …with an appeal to popularity, touting how patients with cancer commonly use CAM to “improve their quality of life, to gain a sense of control, and to participate actively in their care.” (One notes that he doesn’t say anything about “to treat their cancers” or “to get better.”

  10. #10 ChrisP
    August 3, 2015

    My understanding of the Swiss homeopathy report was that it was a chance for homeopaths to convince the Swiss government with their best evidence. There was a partner report done properly that showed homeopathy was of no value.

    This seems to be situation normal for homeopathic arguments. They only work when being delivered by homeopaths to other homeopaths. Other people think they have been diluted to the point where they have no substance left.

  11. #11 douq millar
    August 3, 2015

    Do people like Frenkel know their studies are trash and will be demolished by observant critics like you, but they assume most readers (doctors) will not be critical readers and thus their message, though totally flawed, still sinks in? I just wonder why they publish trash that is so easily discounted – are they stupid or is the motive to still try to fool some of the people some of the time?

  12. #12 has
    August 3, 2015

    Zebra@4: Don’t you have a Hollow Earth to be off spelunking, or something?

  13. #13 Lighthorse
    August 3, 2015

    @Eric Lund

    Only handful of papers? While I don’t know your field, I can’t say the same for my own, which is largely focused the medical role of plants. If asked, I would say that, over the past 40 years, in one journal and the next, the peer-review process has greatly deteriorated. For a time, I wondered if it was just that my knowledge had increased, but that hypothesis has long since bit the dust, only to be replaced with disgust.

    In the case of the paper at hand, I suspect that the editors were blind-sided by a subject they knew little if anything about.

    In the 1990s, a leading medical journal in the U.S. published a study on a plant widely marketed as a dietary supplement. Nearly every paragraph was riddled with falsehoods, misspellings, and egregious errors not supported by facts. Wondering how it managed to slip through, I put to the question to a colleague. As far as I could make out, any letters to the editors to decry the paper were either discounted or rejected. In our final analysis, we concluded that either the editors were aware of the faults and deliberately allowed it to be published to defame the authors and slight the subject of their paper, or had placed their trust in reviewers who were not up to the task. Today, I would say that it may well have been the latter, combined with what was then emerging as a popular subject certain to garner attention.

  14. #14 Lighthorse
    August 3, 2015

    @doug miller

    In the field of “integrated medicine” or CAM, in the last 40 or so years, I have rarely seen like-minded participants criticize the work of their fellows.

  15. #15 Eric Lund
    August 3, 2015

    Other people think they have been diluted to the point where they have no substance left.

    There is some merit to this viewpoint.

  16. #16 Eric Lund
    August 3, 2015

    @Lighthorse: I don’t have firsthand knowledge of my field all the way back to the mid 1970s, but having referees asleep at the switch has been an occasional problem in my field since my grad student days. I would think that earlier examples would have suffered the deserved fate of being completely forgotten within a few years of publication, which seems to be the case with the older examples in my field–and I am in a field where it is common for papers to acquire citations 10-20 years after publication. There are certainly stresses on the peer review system–among other things, it suffers from what economists call a perverse incentive, in that people who routinely do a bad job of it don’t get called on as much–but IME that leads to spurious rejections as much or more than spurious acceptances.

    As for the specific case you cite, a functioning journal should have a comment-and-reply mechanism, which deals both with cases like that and more run-of-the-mill scientific controversies where scientists think the claims in a paper are not completely junk but overstated. The more prestigious the journal, the more likely it is to have such a system in place, although journals that focus exclusively on reviews do not always have this mechanism. (Unfortunately, the nature of review journals is such that they tend to have higher impact factors than other specialty journals in the same field, for obvious reasons.) Of course the editor has discretion here, but a journal that does not allow comments on research articles is not a healthy journal.

  17. #17 jonnybdead
    iowa
    August 3, 2015

    @zebra
    #9

    I dont think you realize that you are helping him prove his point and not yours.

    The argument you have is an age old one. This is very much a slippery slope. Yes in some cases it may be harmless. The person may get the benefit of real treatment for their symptoms, and the benefit of CAM to treat their emotions. Thats all that CAM treats. However, it often goes the other way and some people will move just to CAM. When that happens the person can experience an extremely painful death. This has been pointed out by Orac and others many times.

    Like i said…slippery slope.

  18. #18 has
    August 3, 2015

    Lighthorse@14: Prof Ernst has some timely observations on this very point. Short version: the CAM review process is nothing but a BYOC (“Bring Your Own Critics”) gravy train whose sole function is to separate alternative “researchers” from their hard-scammed cash. No surprise to anyone here, of course, but it’s nice (i.e. scary) to see some numbers attached to this growth industry in medical research fraud.

  19. #19 c0nc0rdance
    August 3, 2015

    Homeopathy, The One Quackery To Rule Them All.

    With apologies to Tolkien:
    “One Woo to rule them all, One Woo to find them,
    One Woo to bring them all and in the darkness bind them”

    I was just at the dentist. She shares an office with her sister, who apparently is an “alt-med friendly” family physician. Poster in the waiting room read “Homeopathic hCG”. Scanned details; apparently this product has not been approved to treat or diagnose disease, the standard Quack Miranda Warning.

    How does a physician reconcile themselves to offering admittedly non-treatments in the guise of treatments? How many people thinking they are getting human chorionic gonadotropin are in fact paying their physician to be lied to? How does that reconcile with medical ethics?

    Also, didn’t the FDA ban the sale of this product way back in 2011?

  20. #20 Denice Walter
    August 3, 2015

    So patients can use CAM “… to gain a sense of control and to participate actively in their case”.

    That’s the attraction of woo-meisters as I see – to
    convince people who feel powerless to believe ( wrongly) that they’re now in control whilst they wait out for the real meds to kick in ( if SBM is allowed) or until either time or chance smiles upon them ( without SBM) or they die and stop complaining.

    One of the idiots I survey says that “a belief system” is what REALLY cures- not the meds, woo or hand waving ( although he’d not express it exactly that way)- perhaps it primes the qi or suchlike ( seriously, they think along these lines-‘ it invokes the healer within’,’ changes the energy’)

    Jonnybdead is right: it treats emotions- which can be useful but usually some sort of bait and switch or lying is involved.
    There are more realistic, honest ways to treat emotional discord – even without meds.

    I think in woo-paganda, the doctor is set up as an agent of control -a dictator who needs to be ousted quickly because people resent the power that he or she represents -even if control is truly outside the doctor’s power as well.

    Then, the person feels ’empowered’ and free- although he or she may be unwittingly REALLY doing nothing but hoping and relying upon magic. The woo-meister is then associated with this feeling of escape and freedom and rewarded by adulation and prompt payment.

    That’s why articles or broadcasts usually include a rant against the ‘powers-that-be’, medical dictatorships, police states, illuminati, governmental and corporate servitude, the media and other forms of oppression that call for immediate liberation at the hands of the wise, benevolent alt med specialist. Other aspects of this ruse involve tales about economic, social or physical disaster approaching (really!- fires, earthquakes, floods, tsunamis, gang wars, real wars, stock market crashes, food shortages) – situations of outside control wherein the woo-meister can jump in with saving advice or extremely necessary survival products ( flashlights, ‘Survival Stuff’- a food replacement, e-courses on raising vegetables at home etc).

    That’s what they’re selling as they oppress their marks with misinformation and high prices.

  21. #21 zebra
    August 3, 2015

    jonnybdead 17,

    OK, let’s speculate about a different hypothetical individual:

    What if someone continues conventional, unpleasant, treatment by virtue of having the emotional/subjective issues helped by “woo”, and so lives instead of giving up and dying?

    My point is that Orac makes no scientific case for his position, if the discussion is about real-world practice.

    I’m sure we can find anecdotes like you suggested, and I’m sure we can find ones like what I suggested.

    But Orac has been honest in pointing out that European results, with less expenditure, are at least as good as US results. (The minions don’t seem to listen to their fearless leader about that, apparently.)

    So, we have an interesting question, if in fact all those Europeople are using CAM, and all the US people are getting higher rates of “scientific” tests and interventions.

    Of course, neither Orac nor the minions wish to discuss this question. How might such real-world data suggest a more formal research project?

  22. #22 Denice Walter
    August 3, 2015

    I couldn’t have wished for a better example of woo pandering to fears concerning external control than that which Mikey writes today at Natural News-
    News Flash!- Everyone is out to get black people- especially the CDC, Planned Parenthood and the Democrats!

    But there are a few enlightened white people like him on their side. And the other idiot ( same spiel).

  23. #23 Eric Lund
    August 3, 2015

    The Dunning-Kruger is strong in our troll du jour.

    You don’t have to be a medical expert to recognize that clinical trials are a best-case scenario for testing whether a prospective treatment will work. If you have ever done software development or testing, or you are familiar with the fundamentals of engineering, you have direct experience with the closest equivalent in that field to a clinical trial. In particular, you know that often, something that works on paper or in the lab will fail to work in real world situations, because real world patients/users will not always follow the protocol, or will find a way to screw something up that the designers did not anticipate.

    Corollary: Just because something works in a clinical trial doesn’t mean it will work in the real world. But the inverse does hold: if it fails to work in a clinical trial or the equivalent, it certainly won’t work in the real world. So we don’t (or shouldn’t) waste time and resources investigating a prospective treatment plan further if it fails to produce significant results in a clinical trial. And if flaws in a treatment which has passed clinical trials show up in real-world application, we modify or withdraw the treatment, as appropriate–unlike woo-pushers, who tend to blame their failures on people failing to follow the protocol exactly.

  24. #24 Vicki
    August 3, 2015

    I have another hypothetical individual for zebra: the honest doctor who believes that homeopathy will deal with the psychological problems and get their patients to return in order to have their other problems treated.

    Why hasn’t this person done studies and published the results? Where is the evidence that cancer patients who use homeopathy live longer or are more likely to have their cancer cured than those who don’t?

    Orac noted in the article you’re attacking that homeopaths talk about quality of life but not about how long their patients live or about cures. if one of them had found that radiation plus homeopathic Berlin wall, or surgery plus homeopathic marigold, had a better outcome than the radiation or surgery without the homeopathic nostrum, they should publish. Either they have no such evidence, or they are consciously and deliberately withholding that information, and harming cancer patients who don’t walk into their specific practice.

  25. #25 Becca Stareyes
    August 3, 2015

    Zebra @ 21

    You don’t find it a major ethical problem to for doctors to recommend* something that they know doesn’t do anything clinically because it might make the patient feel more in control? Especially if they have to promise that it might have a clinical effect (lying to a patient)?

    Orac notes that things like yoga, diet and maybe meditation might make patients feel better, but they can be presented as ‘this won’t kill cancer cells, but might help you manage stress from having a scary disease where treatment is pretty unpleasant.’

    * I’m not talking about a doctor being ‘it won’t hurt you to do that, but I don’t think it will help you’.

  26. #26 zebra
    August 3, 2015

    #23,24,25

    But Orac has been honest in pointing out that European results, with less expenditure, are at least as good as US results. (The minions don’t seem to listen to their fearless leader about that, apparently.)

    So, we have an interesting question, if in fact all those Europeople are using CAM, and all the US people are getting higher rates of “scientific” tests and interventions.

    Of course, neither Orac nor the minions wish to discuss this question. How might such real-world data suggest a more formal research project?

  27. #27 Anders Gustafsson
    Europe
    August 3, 2015

    That the European healthcare system is more cost-efficient has everything to do with being more proactive and nothing to do with CAM. After all, the curse of Hahnemann only affects a couple of countries.

  28. #28 zebra
    August 3, 2015

    Becca Stareyes 25,

    If I have scientific evidence that believers in homeopathy will deal with the stress of conventional treatment better if they drink what is “clinically” nothing but water with a funny label, I would think it unethical to not suggest that such an individual do so.

    Would you also find it “ethically” necessary for a doctor to tell a religious patient that “prayer is a useless bunch of crap that does nothing but make you feel more in control”?

  29. #29 sadmar
    It's always about language
    August 3, 2015

    “Efficacious”, “treatment” and “anything” all have different possible meanings. Orac uses them more narrowly, zebra more expansively. Let’s say Orac means ‘homeopathy has no effect whatsoever on any bio-physical infirmity’ and zebra means ‘cancer patients using homepathy receive “spiritual” benefits that improve their quality of life’. If we can establish that zebra is correct, then Orac could have been careless in the use of overly general language to make a more specific point. Or he could be evidencing an sbm tendency to just not want to touch psychological aspects of ‘care’ (as opposed to ‘treatment’). However, we know where Orac is ‘coming from’ and it’s not a major challenge to parse the distinction.

    For sake of argument, lets say it’s true that “Cancer patients use homeopathy to improve their quality of life and to gain a sense of control, although it does not treat the cancer itself or help their physiological condition get better.” That would indeed be efficacy for something, and doesn’t sound all that bad.

    But that’s not what Moshe Frenkel is saying. The quotes Orac has pulled all reveal a sophistry elegantly constructed to conflate ‘treatment of physiological disease’ and ‘improving spiritual quality of life’. Let’s skip the stats on the popularity of homeopathy “to treat functional disorders”, as that popularity may be the product of some other sort of ‘efficacy’ entirely, and, well, we know it doesn’t treat disorders (I yawn along with the blinking box,)

    Frankel ties “seem to induce cellular effects” to “a trend in favor of homeopathy”. Nope. There’s no proof the second results from the first. He ties “appear to cause cellular changes” to “improve quality of life, reduce symptom burdon…” Nope, the second are psych effects, not due to altered cancer cells. He almost makes a point that would be valid if removed from his physiological claims: “in certain situations, one might consider the use of homeopathic remedies as an additional tool to integrate into cancer care,” – the key term here being the use of “care” rather than “treatment”, but he’s back to an unwarranted conflation by using “remedies”. Sorry, Moshe, homeopathy don’t remedy nuthin’!

    So, basically, Frenkel is trying to bamboozle the reader by framing the question as ‘care’ in the title and trying to claim physiological efficacy in abating the spread of cancer in the body text. There might be a role for homeopathy in cancer care: just as there is a role in cancer care for comfortable beds and blankets, decent tasting food, nights out at the movies, other stuff that “”improve quality of life, and reduce symptom burdon.” Sbm, after all, offers lots of care that is merely palliative. Nothing wrong with people feeling better if the doctors can’t make them be better. And if that’s the product of some ritual that tweaks brain chemistry rather than swallowing a chemical analgesic, I don’t see the difference.

    But an oncology journal publishing a ‘research’ paper trying to convince medical professionals homeopathy actually attacks cancer cells? That stinks. Hmm, where’s that smell coming from? A Springer ‘Pay to Play’ journal, with an editor in chief from Cancer Treatment Centers of America, section editor for Evolving therapies from The Cleveland Clinic. and section editor for Integrative Care from Cancer Treatment Centers of America. Stacked deck, much?

    I’ll suggest that sbm-ers only aid BS like Frankel’s paper by not being clear enough that their critique of woo is limited to it’s claims to physiological medicinal benefit. I think sbm-ers should allow that there might be some instances where woo has utility in delivering psychological support, or at least that studying it in the proper way might lead to developing other effective and less problematic forms of psychological support, but then they could certainly add, ‘but we’re not going to be able to talk about that to any productive end while all this BS about vitalistic woo-ha-ha actually curing disease is getting peddled, so let’s get back to reality and try to help our patients endure their pain without legitimating every quack in the phone book.’

  30. #30 jonnybdead
    iowa
    August 3, 2015

    @zebra

    The fact of the matter is that CAM is not real. Not a one! The majority of them were used in the 1800’s or before. Of course they dont work, we had no medical knowledge then. We now have real medicine. We should not be trying to use the “comfort factor” that the pseudoscience brings with it. If any of those people knew it was not real…if wouldnt comfort them at all. They are only comforted because people are lying to them and saying that it is real. The incorporation of woo into real science will hurt it way more than it could ever help it.

  31. #31 jonnybdead
    August 3, 2015

    @zebra
    #28
    That is a straw-man. please do not use logical fallacies here. They have no use to this crowd. It just hurts your case.

  32. #32 zebra
    August 3, 2015

    sadmar 29,

    With respect to your final paragraph: SBMers would do better to avoid mirroring the wooers behavior as you describe above– which is to conflate the “integrated” approach with Woo Gone Wild.

    Unless they can present scientific evidence that outcomes are worse because there’s an acupuncture session thrown in with the conventional medicine, they are still dodging my question.

  33. #33 Eric Lund
    August 3, 2015

    there might be some instances where woo has utility in delivering psychological support

    You do realize that this is essentially what the placebo effect is, right?

  34. #34 zebra
    August 3, 2015

    Eric Lund,

    “You do realize that this is essentially what the placebo effect is, right?”

    Psychological support is the placebo effect?

    Gotta get the message out to all those psychiatrists and psychologists.

  35. #35 jonnybdead
    iowa
    August 3, 2015

    @zebra

    you really need to stop using logical fallacies to try to make points where you have no substance. Its annoying a hell.

    Lying to someone by saying that a treatment works, when it is just a sugar pill, and getting a result. Yes that is placebo.

  36. #36 Calli Arcale
    http://fractalwonder.wordpress.com
    August 3, 2015

    My point is that Orac makes no scientific case for his position, if the discussion is about real-world practice.

    You miss *his* point, which is there is no scientific case to support the use of homeopathy. So, you feel he does not have a scientific case, but are okay with the lack fo science for homeopathy? Or what?

    See, the thing with homeopathy is that any subjective effect is only observable if the patient is actively misled about the stuff’s effectiveness — whether by the doctor, or by advertisers, or whomever, someone has to trick them into thinking this stuff works before they’ll start thinking it does. Forget the slippery slope of people maybe quitting their insulin if they start thinking homeoatphy works: I’m WAY more worried about the slippery slope of allowing physicians to mislead their patients. We already give advertisers way too much room to do that. Let’s not make the problem worse, okay?

    And if you want an example of the distinction between perception and effect, just look at asthma meds. I hate taking my albuterol, but the stuff definitely works. I’d love an alternative that didn’t make me all jittery. A trial of an alternative inhaler showed that patients had just as much subjective improvement as if they used albuterol — but their actual lung function was not improved at all. And that kind of thing can turn deadly much more quickly than, oh, forgoing chemo in favor of juicing or whatever.

    But seriously, what this is ultimately about is honesty. I’m not sure why you have a problem with that. Let’s forget the paternalistic approach, where it’s okay to mislead patients, or play to their superstitions, if it just gets them to stop complaining. Let’s actually treat them like grownups and be honest with them.

  37. #37 zebra
    August 3, 2015

    Calli Arcale 36,

    So, putting aside the endlessly repeated bit about asthma, which has nothing to do with what I am talking about…

    Let me re-post the thing which everyone is trying to avoid:

    “But Orac has been honest in pointing out that European results, with less expenditure, are at least as good as US results. (The minions don’t seem to listen to their fearless leader about that, apparently.)

    So, we have an interesting question, if in fact all those Europeople are using CAM, and all the US people are getting higher rates of “scientific” tests and interventions.

    Of course, neither Orac nor the minions wish to discuss this question. How might such real-world data suggest a more formal research project?”

    Where’s the honesty in the US system?

  38. #38 Denice Walter
    August 3, 2015

    OT but it’s already late and the apropos thread has become troll-ridden

    AoA announces a weighty tome:
    Vaccine Whistleblower: Explaining Autism Research Fraud at the CDC
    by Kevin Barry
    Forward by RFK jr
    Preface by Boyd Haley
    Published by Skyhorse
    available soon!

    Kev, Esq, dissects 4 recorded phone conversations “legally acquired” between Thompson and Hooker, is ‘co-president’ of EBCALA ( remember them?) and has a son with regressive autism.

    Commenter Tony Bateson – of Oxford- chimes in about his inability to find unvaccinated people with ASDs-
    Hey Mr, I have two for you:
    Stagliano’s youngest and O’Toole’s son ( Prof of TMR- antibiotics did it!/ a common belief at TMR -btw-)

  39. #39 Anna M.
    August 3, 2015

    What percentage of those European homeopathy users actually understand what homeopathy is? If they’re kept in the dark as to what it really is (not herbal medicine) and they’re given that magic water in a trusted setting such as a hospital along with proven treatments, it wouldn’t surprise me if they convinced themselves it was useful in some way. But it wouldn’t be right.

    It wouldn’t help me in the slightest because I know it’s utter BS. But if I had been uninformed before and then later on found out the reality of homeopathy, I’d be furious.

  40. #40 sadmar
    August 3, 2015

    Eric:
    Essentially? Yes.

    ‘And where were the editors on this paper?’ I told you: at Cancer Centers of America, and possibly The Cleveland Clinic. If you think a questionable paper has appeared in a journal, you might think to use the Google to see who the editors are, what affiliations they have, and check what kind of work they do and publications they may have (if you’re ambitious). In the case of Current Oncology Reports, you’d see there’s an Editor-in-Chief who oversees 17 ‘Section Editors’ each responsible for some subset of the larger field of oncology – most defined by sub-specialty: Breast, Head and Neck, Gastrointestinal, Lung. Sarcomas, Leukemia, Lymphomas, Melanoma etc. My having a Section and Section Editor for Integrative Medicine, the journal placates the Alties by giving them a chunk of turf from their own, but also quarantinines it from the other Sections. I’d guess most oncologists just check the articles addressing their own sub-specialty – which could be pretty decent if the journal has a respectable impact factor – and just ignore the stuff that isn’t directly relevant to their practice, including uttering a quick “bah!” as they skip over the ‘Integrative’ stuff.

    A better question might be “where was Springer in setting up an editorial system for an oncology journal that reserves a spot where woo can go to get a very friendly reception”? I think we have a pretty good guess…

  41. #41 Calli Arcale
    http://fractalwonder.wordpress.com
    August 3, 2015

    I brought up the asthma example because it speaks precisely to your confusion about the difference between appearance and results. That you object to being reminded of it speaks volumes.

    Zebra, others have already pointed out what you’re overlooking by comparing American to European results. You’re pretending that all else is equal with respect to health care, but it very definitely is not. Europeans have vastly greater access to health care than Americans do, on average, which correlates with less need for interventions for reasons that really shouldn’t be at all surprising — they’re managing chronic conditions better and addressing problems while they’re still small enough to not require hospital stays and/or surgery.

    So back to your interesting question — where is the honesty in deliberately ignoring this critical difference?

  42. #42 zebra
    August 3, 2015

    Calli Arcale,

    How do you know what I am “ignoring”?

    You have given no indication that you even know what I am talking about. Do you know what I am referring to with respect to Orac’s honest reporting? Can you tell me what it is you think I am suggesting by the question?

  43. #43 jonnybdead
    August 3, 2015

    @zebra

    Here is a better question. Why? Why would we research what a sugar pill does. We already do that in placebo research. Why would we wast money? The fact is people who buy in to this dont know how it is ment to work. If you told them that it is so diluted that there may not even be one atom of the “toxin” in it, most would not use it.

    How would putting sulfur or any other of those elements in your body help you anyway? Its like the person had no medical knowledge….thats right they didnt. It is only through deception that this is still a thing anyway. People selling snake oil….that is all.

  44. #44 herr doktor bimler
    August 3, 2015

    patients with cancer commonly use CAM to “improve their quality of life, to gain a sense of control, and to participate actively in their care.”

    Martin Seligman has a lot to answer for, what with the whole ‘positive psychology’ movement and his promotion of self-delusion as a desirable trait.

  45. #45 sadmar
    August 3, 2015

    @ jonnybdead

    As argument, ‘slippery slope’ is a logical fallacy, simply assuming without proper warrant that one thing leads to another and another and another. A ‘slipper slope’ thesis may be a valid claim, but of if the rhetor meets the burden of proof in establishing why that pattern must necessarily be the case. If you say, “It often goes the other way and some people will move just to CAM” you’ve already negated the slippery slope. Some people move to CAM-only, but others do not. Sometimes it may NOT ‘go the other way’. Thus, the end result depends on some other conditions beside simply stepping on square one. In the absence of those conditions, or in the presence of countervailing conditions, no slope – no slip.

    As I’ve pointed out above Frenkel is a disingenuous crap artist. He IS claiming homeopathy can treat the cancer itself and help people actually get well. Zebra though, is framing a hypothetical based on one sentence of Frankel’s which Hellanthus abstracted from the text and objected to on general principle. The claim then is ‘homeopathy could have a place in cancer care IF it helps patients improve their quality of life, etc. etc.” — or, ‘there’s significant value to feeling better if you aren’t better, when you can’t get better by any means known to science.’

    Now, it counters that argument not at all to point out that sometimes this may have (or has had) negative unintended consequences, unless the conditions that produced those effects are always the case. All zebra has to do is point to one reasonable conterfactual.

    What you want to do, jbd, it seems to me, is move the discussion off the plane of the hypothetical and absolute into the real and conditionally pragmatic. So just concede the abstract point ‘homeopathy could help some cancer patients deal with their pain’ – as you’ve basically already done – and move on to real-world arguments about why that’s a poor choice for achieving that end (of which there are plenty) – with the understanding that it’s not a open-and-shut case, and the arguments will go back and forth, but you’ll be able to mount a strong and valid case if you do your homework.

  46. #46 sadmar
    August 3, 2015

    hdb #44:

    True that.

  47. #47 JustaTech
    August 3, 2015

    Zebra, you’re giving me headache. To respond to your not-question @42, I will tell you what I think your question @21 was.

    To paraphrase: “Cancer outcomes in Europe are just as good as in the US and cost less. People in Europe use CAM and people in the US use ‘scientific’ tests. Is there a causal relationship here?”

    I hope I have your question correct. The answer is probably no, because people in Europe are using CAM (homeopathy) *in addition to* SBM to treat their cancer. Not in place of.

    The issue of costs is not related to CAM but rather related to how health care is delivered and paid for, which is very different in the US compared to European countries.

  48. #48 Old Rockin' Dave
    Running down a dream, and now I'll need to wash the car.
    August 3, 2015

    Q: “Is there a role for homeopathy in cancer care?”
    A: Yes. Comic relief.
    To wit:
    HOMOEOPATHIST, n. The humorist of the medical profession.
    – Ambrose Bierce, The Devil’s Dictionary (1911), p. 139

  49. #49 ChrisP
    Australia
    August 3, 2015

    If I have scientific evidence that believers in homeopathy will deal with the stress of conventional treatment better if they drink what is “clinically” nothing but water with a funny label, I would think it unethical to not suggest that such an individual do so.

    But you don’t.

    So the argument is mute.

  50. #50 zebra
    August 3, 2015

    JustaTech,

    I give you credit for at least trying.

    Are people in the US in these “integrated” settings (the actual topic of the post) using CAM “in place of” SBM?

    See you tomorrow if you answer.

  51. #51 Calli Arcale
    http://fractalwonder.wordpress.com
    August 3, 2015

    zebra:

    How do you know what I am “ignoring”?

    Well, I admit I’m being generous. It’s possible you have actually noticed this egregious difference between the two groups being studied and decided just to straight up lie about it in hopes we’re too stupid to catch on. Maybe you really do think that if you just don’t admit that this serious difference between the two groups exists, it won’t invalidate your conclusion. But you would be wrong, if that really is the case, and you’re not just ignoring this difference.

    You have given no indication that you even know what I am talking about. Do you know what I am referring to with respect to Orac’s honest reporting? Can you tell me what it is you think I am suggesting by the question?

    You are saying that we are ignoring that Europeans have better health results with greater use of CAM, and asking us whether it’s honest to ignore that. But we are aware of that, and several of us have explained why your conclusion (that the CAM is responsible for the better health results) is erroneous.

    So, tell me. How is that honest?

  52. #52 Calli Arcale
    http://fractalwonder.wordpress.com
    August 3, 2015

    PS: when a person fails to make their point clear, it does not reflect well on them when, instead of attempting to engage and clarify, they instead shift the burden to their audience, and start blaming them for not understanding.

  53. #53 sadmar
    August 3, 2015

    @ jonnybdead

    You just straw-manned zebra in #43, by reframing his position as ‘we should research what a sugar pill does’. We all know the sugar pills themselves do nothing. Yet, we all know that the ‘ritual’ of following a prescription (for anything) does ‘something’. So what we’re talking about is researching placebo effects in a different way.

    Zebra observes that (allegedly) placebo-slinging Euro-oncology is achieving similar results to the (allegedly) sbm-confined Amer-oncology, and says that bears study. Well, maybe, or maybe not, depending on how ‘results’ are defined and measured. Here we must acknowledge the difference between ‘integrative’ and ‘alternative’. If Euros are getting sbm-plus-woo, folks here are getting sbm-minus-woo, and the physiological health results are similar: that’s just what we’d expect. On the other hand, if we’re talking about results confined to measures of perceived “quality of life” and “reduced symptom burden”, then if sbm-plus-woo, does about the same as sbm-minus-woo, we’ve just shot down one argument for adding woo to sbm as an emotional palliative.

    The doesn’t end the discussion though, as the aggregate stats may hide more than they reveal. The giant pink elephant in the room is “homeopathy combined with conventional cancer care improves quality of life and reduces symptom burden.” OK, show me! Give me evidence that this is in fact true for some population of a significant size. Get a good sized field of cancer patient test subjects who are inclined to accept a proposition that homeopathy is beneficial, but aren’t committed to a belief that it has definitive magic curative power. Divide them into two groups, the only difference in treatment over the course of the study being the addition of homeopathy to one of them — otherwise identical sbm programs. Do a thorough personality profile on each subject. After (x) number of months, assess patients’ perception of quality of life and symptom burden, and material evidence of quality and life and symptom burden – their activity levels, their interactions with family and friends, how able they are to get out and do stuff. Break it down into different categories and put it all graphs. If the material quality-of-life graphs show the same distributions of everything between the got-piacebo and no-placebo groups — pffft, so much for homeopathy as psych palliative. My guess would be that wouldn’t happen though, and some cluster of the got-piacebo group, (not necessarily all or the majority) would indeed have the highest scores on the material-benefit-from-psyhcological-outlook measures.

    Where you would go from there (again IF) I’d think ought to be fairly obvious…
    1) Go to the personality profiles, and do follow-up interviews, to try to figure out WHY and how some patients benefited from this particular form of placebo theater more than others.
    2) Run additional studies from the same sort of sample population using some different ’emotional support modalities’ (I’ll call ’em ESMs) as adjunct to the physiological sbm treatments: acupuncture, reiki, CBT, yoga, TM, peer prayer conferences, spiritual counseling by clergy… whatever. IF any of those yield material results significantly different from the baseline sbm-only graphs, unpack the ‘for whom’ ‘why’ ‘how’ etc. My hypothesis would be that the results will be all over the place. ESM-1 might be widely but only mildly helpful. ESM-2 might be much more helpful, but only with one smaller subset of the test group, while another subset actually does worse with ESM-2 than no-ESM, but responds well to ESM-3. ESM-4 might do nothing, and ESM-5 might make pretty much everybody more miserable… For example, we might find Christians do better with peer prayer groups, previously cheerful secularists do better with CBT, ex-jocks do better with yoga, yada yada yada…
    3) Take all that data and devise new ESMs – targeted to specific categories of patients – without any of the baggage of a history of ‘miracle cure!’ claims, and then see how well they do…

    OK, segue back to the real-world… There would certainly be arguments against undertaking any such research program, including arguments that any knowledge that could possibly be gained wouldn’t warrant the expenditure of finite resources to get it. But that’s not ‘testing sugar pills is a waste of time’.

    Does this make sense to you, jbd?

  54. #54 Johnny
    127.0.0.1
    August 3, 2015

    When people start talking about using SCAM alongside SBM, my mind goes to this – http://xkcd.com/836/

    If the homeopaths were working for free, didn’t interfere with real treatments, and providing their wares for the cost of materials, I wouldn’t mind them offering “a sense of control” to anyone. But once they start trying to make money on something that works on same principle as, and just as well as, mommy kissing your boo-boo, they step over the line of acceptable behavior.

  55. […] Is there a role for homeopathy in cancer care? I think you know the answer to that question… – Still, homeopaths and naturopaths (all of whom are trained in homeopathy) continue to prescribe little magic sugar pills that have been soaked in the water remaining after a homeopathic … For instance, yoga is a … […]

  56. #56 Moon
    August 4, 2015

    @Zebra
    “You have given no indication that you even know what I am talking about.”

    Yeah, probably cause you’re going on about some weird “minions” and plaster the thread with logical fallacies. IOW, if you’re full of shit, don’t blame anyone else.

  57. #57 Harobed
    Australia
    August 4, 2015

    “Homeothapy is practiced extensively in Europe, Asia, Middle East and South America…….”
    In Europe, Homeothapy would be used as an adjunct by those misguided people who seem to believe that “magical water” really work. In other parts of the world, I would imagine that a few medical practitioners exist in amongst a vast population, so the use of quackery is marginally preferable to no medical follow up. At least it appears as though someone cares.

  58. #58 Harobed
    Australia
    August 4, 2015

    Homeothapy would be used in Europe by those misguided people who believe it works as an adjunct to chemotherapy. In parts of Asia and South America, where there are traditional healers, there are very few medical practitioners to vast populations. It is in these places that it wouldn’t be hard to imagine that local “naturopaths” would be the people called upon to help the sick. They may not cure their patients, but would make those people feel cared for.

  59. #59 Lighthorse
    August 4, 2015

    According to Wikipedia contributors:

    “India has the largest homeopathic infrastructure in the world, with low estimates at about 64,000, but going as high as 300,000 practising homeopaths. In addition, there are 180 colleges teaching courses, and 7500 government clinics and 307 hospitals which dispense homeopathic remedies.”

  60. #60 Helianthus
    August 4, 2015

    @ Harobed

    Homeothapy would be used in Europe by those misguided people who believe it works as an adjunct to chemotherapy.

    I also question the “extensively used” part, because the French physicians me and my family got were usually not that much woo-prone, aside from the occasional prescription for a multi-vitamin supplementation. I mean, it’s not like the whole French population is treated with homeopathy as a primary approach.

    There was a similar poll in the US a few years back, with big numbers of CAM adepts as a conclusion, except that exercise, meditation, massage… were considered “CAM”. The actual parts of true magical water were only a fraction of the whole. I suspect the actual number of homeopathy followers are much closer in both side of the ocean than Mr Frenkel would like us to believe.

    On the other hand, French TV features maybe as many ads on homeopathy and multi-vitamins packs, than on mainstream drugs, if not more (due to local laws limiting advertisement for pharma drugs). I suspect aggressive advertising may account for higher use more than actual drug efficacy.

  61. #61 Lighthorse
    August 4, 2015

    @Helianthus #58:

    Homeopathy in France:

    http://www.ncbi.nlm.nih.gov/pubmed/25921648

  62. #62 Helianthus
    August 4, 2015

    @ Lighthorse

    Thanks.

    So a bit more woo-prone than I was thinking – almost all general practitioners did prescribe homeopathy at one point or another -, but accounting for 10% of the patients and 5% of drugs prescriptions.
    Um, it’s only reimbursed homeopathic nostrums. I should mind adding the over-the-counter stuff.

    May I use the 10% number and still nitpick it’s not exactly “extensively used”? At least, not that differently than in North America.

  63. #63 zebra
    August 4, 2015

    Calli Arcale 51, 52

    PS: when a person fails to make their point clear, it does not reflect well on them when, instead of attempting to engage and clarify, they instead shift the burden to their audience, and start blaming them for not understanding.

    several of us have explained why your conclusion (that the CAM is responsible for the better health results) is erroneous.

    Sorry, I haven’t figured out a way to anticipate and prevent people like you from suffering delusions. I never said any such thing.

    And, until you wrote that, I had now way of knowing that’s what your delusion was, right, so I had to ask.

  64. #64 zebra
    August 4, 2015

    Harobed,

    Recent NYT article:

    http://tinyurl.com/n9qeywo

    Some interesting information about the issues your raise.

  65. #65 zebra
    August 4, 2015

    sadmar #53,

    What “zebra is saying” first is that Orac is not doing much better than the person he is criticizing when it comes to sophistry and slippery conjunctions.

    Then we can get into what I think of as forming hypotheses (not drawing conclusions, that distinction apparently being too difficult for most minions) from the information we have.

    First, is homeopathy “The One Woo That Will Turn US Healthcare Into Mordor” if it is used in conjunction with conventional medicine?

    Meh, I hypothesize “not so much”. Why? Well, I would have to assume that if homeopathy has a negative effect when it is used in Europe, then the US system is even worse than we thought. Which violates Ockham’s Razor, FWIW. And for those who haven’t been following, yes, I’m talking only about the physical outcome with respect to the underlying condition.

    Now, what I would be interested in discussing is your research design, where you distinguish between perception and “material evidence”.

    Are you suggesting that someone giving a positive report is the obverse and moral equivalent of a malingerer? Isn’t it a bit “paternalistic” to dismiss such claims? This is a difficult area, I know, but I still think my “market” approach has merit and is much simpler.

  66. #66 gaist
    August 4, 2015

    First, is homeopathy “The One Woo That Will Turn US Healthcare Into Mordor”

    Nice straw-man you got there. Does it do any tricks?

    Well, I would have to assume that if homeopathy has a negative effect when it is used in Europe,

    Why would water or sugar in pill form have negative effects, if it doesn’t replace actual treatments? The fact that makes it ‘woo’, is all the promises that it would do something.

    yes, I’m talking only about the physical outcome with respect to the underlying condition.

    Do you have any evidence that homepathy would improve physical outcomes? Actual evidence? Does anybody?

  67. #67 Eric Lund
    August 4, 2015

    I should mind adding the over-the-counter stuff.

    I don’t know what French or EU laws apply to labeling and presentation of homeopathic OTC products, but some US drugstores have homeopathic remedies on the same shelves as real medicines for the same symptoms, and if that is also true where you are, that may contribute to the apparent rate of homeopathy usage, from people who don’t realize they are buying a homeopathic product.

    I’ve told this story here before, but I once almost bought a homeopathic product. I was in San Francisco and had run out of throat lozenges, so I went into a local Walgreen’s to buy some more. At first I couldn’t find anything similar to what I usually get, but found something else that looked like it might be suitable. There were even name-brand and store-brand versions of the product, as is common in the US (the store brand is almost always cheaper but is usually the same or similar quality–in some cases a store brand will be made at the same factory that produces the name-brand stuff). So I took one of the store-brand packages off the shelf, intending to take it to the cash register and buy it, and only then noticed the words “homeopathic remedy” which were inconspicuously printed on the package. I put it back, looked a little more, and found the kind I usually get–which not only contains an actual active ingredient but was about four times cheaper than the store brand homeopathic remedy.

    I have to wonder how many people who wouldn’t intentionally buy a homeopathic product have done so inadvertently, as I almost did. I’m sure it’s not zero.

  68. #68 Helianthus
    August 4, 2015

    @ Eric Lund

    some US drugstores have homeopathic remedies on the same shelves as real medicines for the same symptoms

    At least in France, there is a higher level of segregation between pharma drugs and all the “comfort” stuff, be it cosmetics, homeopathy, essential oils, slim diets, detox cures, diapers… The former is on the shelves behind the pharmacist’s counter or in the back-room, and you have to ask the clerk for things as commonplace as aspirin or paracetamol. Everything else is on shelves on the customer side.
    So I guess there is less chance of grabbing homeopathy remedies by mistakes.
    Actually, I think that, in some officines, even some of the homeopathic stuff is behind the clerk’s counter; you have to ask for it. It would make sense for the products being reimbursed by assurance.
    OTOH, having homeopathic nostrums being treated same as drugs is likely having the same effect as them being on the same shelf: making people believe homeopathy provides real treatments.

  69. #69 Gray Squirrel
    August 4, 2015

    Pardon the digression but:

    Red alert!

    Anti-vaxers have started a recall effort against California State Senator Richard Pan, he who co-authored SB277 that doesn’t allow antis to turn their kids into walking vectors in public schools.

    This is apparently now at the stage where they can start taking signatures. They need a total of 36,000 signatures in Yolo County and Sacramento County, to qualify for the 2016 ballot.

    I’d call this “all hands on deck!” time, because if the wackos succeed at this, it is going to have a serious chilling effect on elected officials in other states trying to duplicate California’s success.

  70. #70 Calli Arcale
    http://fractalwonder.wordpress.com
    August 4, 2015

    Oh good grief, Zebra. Did I strike a nerve, there, since you completely ignored my substantive reply, instead focusing on insulting me for pointing out that if one is misunderstood, it’s more productive to clear than up than to lambast others for not reading your mind correctly.

    So, I am forced to conclude your definition of honesty is different from mine.

  71. #71 JustaTech
    August 4, 2015

    Zebra @50: “Are people in the US in these “integrated” settings (the actual topic of the post) using CAM “in place of” SBM?”

    I don’t know. Probably not, since it’s “integrated”. It also doesn’t make any difference to their treatment, since it doesn’t work.

    And no, I won’t answer you tomorrow, because I’m going to busy making cancer treatments.

  72. #72 Roadstergal
    YOLO - so vaccinate, to make it as long as possible
    August 4, 2015

    #69 – what can be done by pro-vax Californians who aren’t in Yolo or Sacramento counties?

  73. #73 Lighthorse
    August 4, 2015

    @Eric Lund: “for polio, measles, whooping cough”: http://www.cbc.ca/news/homeopathy-a-cure-or-a-con-1.1769564

    Meanwhile, I continue to be amazed at the “remedies” homeopaths offer. In my in-box today, I read that some homeopath in Europe has a “proving” of “LSD” and claims she identified a case in which “LSD is indicated isopathically as well as constitutionally.”

  74. #74 Lighthorse
    August 4, 2015

    @Eric Lund:

    Homeopathy in Canada and claims of curing cancer:

  75. #75 Gray Squirrel
    August 5, 2015

    Roadstergal @ 72: And also anyone outside California:

    First thing I suggest is to send a _postcard_ to State Senator Pan’s office in Sacto, saying something like “I supported SB277, I support you, and I oppose the recall. How can I help? Please put me on your mailing list. (signed, and print name, and phone number, email address, and postal address)”

    The use of a postcard means that his staff will see the text on it before they see that you’re not from their counties, and that increases the likelihood that they’ll decide to add your name & contact info to their database for supporters, and you’ll get email or postal mail when the time comes.

    Of course the obvious is to donate to whatever campaign they may run to fight this, but I haven’t heard of a committee being set up for that yet.

    In general, postcards are a great way to send simple & straightforward messages to elected officials. Print clearly so it’s easy to read. Practice on an equivalent sized piece of paper first, so you can be sure your message will fit. The postage cost is minimal and the format ensures it’ll be read. (Remember: one side of a postcard is for nothing but the recipient’s address and your return address, and the other side only is for the written message.)

  76. […] “foot detox” bath. As regular readers know, homeopathy is, as I like to say, The One Quackery To Rule Them All, and “foot detox” baths are a scam. Not surprisingly, segments of the autism biomed […]

  77. #77 sadmar
    August 6, 2015

    @ zebra:

    Are you suggesting that someone giving a positive report is the obverse and moral equivalent of a malingerer?

    No.

    “Assess patients’ perception of quality of life” was a poor choice of words. I didn’t mean the patients’ day-to-day ‘perception’: I meant the perception expressed in the course of giving a self-report – what a patient says at that moment under the condition of being quizzed. And there’s nothing to really ‘assess’ there, just ‘record’. Mentioning ‘perception’ first was also a poor choice, since it’s not even necessary to the study, the purpose of which is to investigate the conditions under which some people may indeed receive improvements in quality of life and reductions in burden-of-symptoms by participating in placebo theater.

    The self-report part is really just ‘frosting’ investigating the nature and accuracy of self-reports. There could be two levels of psychology at work, and I’m just curious about the second: I can imagine reasons patients would report a quality-of-life condition different from what they’re actually experiencing day-to-day, and I just wondered how prevalent that might be.

    No aspect of my hypothetical study would be intended to make moral judgements about any of the participants, individually or collectively. The idea is just to gather more detailed information on how/when/why/for-whom certain forms of placebo theater might be helpful, and how/when/why/for-whom certain forms of placebo theater might be have no effects, or even negative effects.

  78. #78 Krebiozen
    August 6, 2015

    sadmar,

    I can imagine reasons patients would report a quality-of-life condition different from what they’re actually experiencing day-to-day, and I just wondered how prevalent that might be.

    I suspect this is a major part of what is called the placebo effect; patients are likely to report feeling better because they want to please the doctor or therapist. I wonder particularly if those who choose altmed may exaggerate the benefits because they know it is controversial and feel defensive. If this is true we may end up paying for something that doesn’t even result in patients feeling better, just in them saying they do.

  79. #79 zebra
    August 7, 2015

    Sadmar (and Krebiozen)

    I hadn’t expected a reply and just noticed your comments.

    But anyway, the point of my “market” approach is that by definition, there is some benefit to the patient, since the patient is engaging in some transaction to receive the treatment.

    Unless you have some objective test, I wonder how much information you can garner. Maybe my back will hurt the same, but I will mind that it hurts less, as the saying goes. So I will be able to touch my toes after drinking the Magic Water.

  80. […] there a role for homeopathy in cancer care? I think you know the answer to that question, Respectful Insolence am 3. August […]

  81. #81 Thinking outside the box
    New Zealand
    September 3, 2015

    I can’t believe people’s ignorance. The Philosophy needs to first be studied and understood. Secondly, Homeopathy is an art and not just a science. I have seen some AMAZING things changed and cured on all levels for many many people and animals using what you call “Magic Water” (There’s nothing magic about it.). I’ve seen a 5 year old Autistic child who could not comprehend a word or speak, until 6 months after treatment with the same remedy. Called his mum “MUM” for the first time ever. Remedies are also made up in high percentage alcohol (which holds the memory of the potensized substance), not just water.
    The reason the Homeopathic remedies cannot be measured is because it is ENERGY.
    Homeopathy is an Energy Medicine.
    This Energy resonates with the individual persons Energy (on all levels) If the remedy is prescribed and not all symptoms disappear, and only some on a couple of levels do, then this is a close remedy, but not close enough (as in the Simillimum) Therefore, the patient needs a different remedy or the same remedy in a different potency. Sometimes it can take the Homeopath time to find the simillimum, but that’s okay because the treatment is safe and works gently to help the body to heal naturally. Anything foreign like Pharmaceutical drugs are only going to cause either suppression or nastier symptoms down the track…and don’t get me wrong, there is a place for allopathic medicine, but if there is a natural way, then I’d rather pay a trained Homeopath than feed The BIG FAT GREEDY PHARM companies 🙂

New comments have been temporarily disabled. Please check back soon.