Psorinum therapy – homeopathy for cancer?

January 31, 2011

A quick look at another paper doing the rounds


There is an update to this blog post that follows the original post


These papers [1], [2](pdf) have recently been pimped around twitter by various homeopaths, apparently as proof that a homeopathic remedy can cure cancers, including the very nasty pancreatic cancers. Paper 1 (published in a sensible-looking oncology journal) is just an abstract from a meeting, and paper 2 (published in Evidence-Based Complementary and Alternative Medicine) is the actual paper with all the juicy details – but they essentially detail the same study.

Taken on face value, the results are pretty amazing, with 5-year survival rats of around 40% for patients with stomach, gall bladder pancreatic and liver cancers (paper 2, table 3).

Compare these with current 5 year survival rates for stomach and pancreatic cancers of roughly 12% and 2% respectively.

So, if kosher – these results would be a fantastic addition to the arsenal in the war on cancer.

But…

… the studies were conducted without any controls whatsoever. The mind boggles. Why bother going to the effort of a 5 year study, and not including a control arm? Whether it be an ‘untreated’ arm, a placebo arm or a comparison against current best practices and therapies, a control arm would have increased the viability of this study no end. Even if they failed to recruit any more patients, and just split the patients into to two randomised groups with 20-odd patients in each arm, the power and impact of the study would be massively enhanced. To not control anything is just a massive fail.

This massive fail is then compounded by a failure of peer-review at eCAM. Did the reviewers not ask themselves where the controls in this study where? However, this was published in eCAM and this is clearly labelled as a prospective study – maybe I am being too harsh.

However, for those totting this paper as evidence for homeopathy curing cancer,  let’s make this absolutely clear: the only conclusions that can be drawn from this study are that the study is ultimately a waste of 5 years and is utterly meaningless in it’s current form. It should have been designed properly 5 years ago, and it should have contained some sort of control arm, and should have been properly randomised and blinded.

The authors are clearly aware of this and allude to it themselves in the final sentence of the paper:

“…randomized double-blind clinical trial, detailed molecular, pharmacokinetics,and pharmacodynamics studies should be conducted for further scientific exploration of this alternative cancer treatment to determine if it can be integrated into the mainstream oncology.”

However….

It is perhaps telling that in this final sentence in the paper, that the authors mention “detailed molecular, pharmacokinetics,and pharmacodynamics studies.” That use of the word ‘molecular’ is the only appearance of the word molecular or derivatives thereof in the entire paper, maybe unsurprising given that this is a homeopathic study.

The wonder remedy that the researchers are testing out is ‘Psnorium’ – a homeopathic remedy made from the fluid from scabies blisters (yuck) – that apparently has indications for a large number of symptoms, including, “generalities; sensitive; to pain” – well, that rules out the ~48 people on the planet that suffer from CIPA, then…

Of more note to people with an interest in molecular mechanisms (myself included), is the fact that the dilution factor used in the study is only 6x. So, 1 in 1,000,000.

Wait a minute! That’s cheating! There is an outside chance that Psnorium 6x actually has “something” in it!

Let’s assume for a minute that the results are genuine, and Psnorium 6x has had an effect on these cancers. The fluid from scabies blisters will likely contain serous fluid – but depending upon the exact contents of the blister it could contain all manner of biochemical goodies.

Given that scabies blisters are apparently intensely itchy, there may be some histamine around. The fact that the scabies mite (a foreign object) has penetrated the skin, means that some sort of immune response will have been mounted, and therefore it is inconceivable that scabies blisters would not contain some cytokines or chemokines. Was the remedy prepared from crusted or normal scabies? Because patients with crusted scabies secrete higher levels of cytokines IL-5 and IL-13, and lover levels of IFN-gamma than normal patients [3]. Other studies have shown that scabies mites, or extracts thereof alter secretion levels of a whole range of cytokines:

Active mites on the surface of the HSE induced secretion of cutaneous T cell-attracting chemokine, thymic stromal lymphopoietin, interleukin (IL)-1alpha, IL-1beta, IL-1 receptor antagonist (IL-1ra), IL-6, IL-8, monocyte chemoattractant protein-1, granulocyte/macrophage colony-stimulating factor, and macrophage colony-stimulating factor.

So, biochemically speaking, scabies blister fluid likely contains some very interesting molecules, some of which may have an effect on cancer cells. Oral administration of Interleukins has been shown to have physiological effects in some studies, and cytokine therapy is an avenue being explored in the fight against cancer.

<Insert vaguely witty sub-heading here>

Let’s assume that the DBRCT has been done properly, and it shows a clear, statistically significant effect in cancer patients. What next? Would it be the killer blow that shows that skeptics have been wrong and homeopathy works? Sadly not – because of the likely presence of actual molecules of something. That being said, if there is an effect to be seen, it does at least give us the possibility of conducting an interesting experiment to test homeopathy:

  • Take the scabies blister fluid.
  • Give one-third of it to a homeopath, get them to make up their remedies as usual, with all the serial dilutions and succussion.
  • Give another third to a competent postgraduate student. Get them to make a 1 in 106 dilution of it, but without the homeopathic rituals like succussion.
  • Give the final third to a well-equipped, well-staffed biochemistry lab. Get them to fractionate the fluid by HPLC or FPLC, and then test the fractions for biological activity in a suitable assay, and identify the molecules present are responsible for the effect, (assuming it’s not some arm-wavy, unsubstantiated guff about the vital force or EM fields) they will presumably isolate one or more fractions that contain the molecules responsible for the therapeutic effect. These molecules could then be purified for trial in patients.

If only the homeopathic remedy recapitulates the results of the DBRCT, then homeopathy works. Elseif, science works, and someone just got lucky feeding diluted extract of scabies blister to cancer patients.

Simples.


UPDATE

A blog post at Anaximperator that I was alerted to by a pingback is well worth a look as it contains a rather interesting graph from the conference presentation that was not included in the publications –

“Psorinum+Allopathy+Homeopathy” does not look significantly different from “Psorinum+Allopathy”. “Psorinum+Homeopathy” comes a distant 3rd. The authors of the study apparently didn’t think to include an “Allopathy” or “Homeopathy” alone group. Looking at this, I would suggest that psorinum gives little, if any, benefit above and beyond the conventional treatment that patients were receiving. You will note that the only group without conventional/allopathic treatment fared significantly worse than those groups receiving it. As the anaximperator author wryly observes –  “It appears that conventional treatment is necessary for homeopathy to work.” 😉

Advertisements

Canadian Homeopaths plan astroturf-war

January 13, 2011

A quick note about something that popped up on my radar…


The logo of Marketplace (TV series)

Image via Wikipedia

This website (and just in case – a freezepage ) reveals that the Canadian Society of Homeopaths are planning a response to a forthcoming CBC show, Marketplace, which is running a documentary on Homeopathy. Without seeing the show (it aires on Friday, Jan 14, 2011),  it seems that the Canuck homeopaths are assuming that it puts homeopathy in a negative light (I wonder why?) and they want to get the message out so any interested parties can watch it. Fair enough.

However, their list of actions (sent out via e-mail to their members) reveals that they are also planning to bombard the Marketplace show’s blog with pro-homeopathy comments:

4. Be prepared to leave a comment on the CBC and Marketplace website immediately after the programme airs. Go to and check out the comment function right now. Sign up now to create a user’s account so that there will be no delay when you are ready to send your comments. Once the programme has aired, you can leave a comment by clicking on the title, which will take you to a summary page concluding with a link “Share your comment”. This leads to a comment box, which requires that you sign in. CBC monitors and reviews all messages so you may want to read the Submission Guidelines page before planning to send your comments.

5. Know what you are going to say so that you can post a response without delay. Choose to focus on a single point per comment, elaborate on it, and conclude with a strong, affirming statement. Often the most effective messages are short, concise, and to the point. Send as many of these as you can

They want to get their points in quickly (“leave a comment on the CBC and Marketplace website immediately after the programme airs”) but have perhaps failed to spot that unlike the Grauniad in the UK, the comments on the Marketplace blog are listed most recent first – so the early comments will soon be pushed off the bottom. They also request that their followers post as many short, concise comments as they can – essentially spamming up the comments board.

In point 7, the CSoH also warn members about falling into the same trap that UK homeopaths have fallen into regarding homeopathic for malaria vaccines.

In the second point 7, they go into full-bore, “la-la-la-I can’t hear you” mode.

la la la - I can't hear you!

How we all react to this criticism will determine how much traction this story maintains in the coming weeks and months. We urge you to be calm, be polite, be underwhelmed. Take the moral high ground. Convey that this Marketplace programme is no more than a mild irritant for homeopaths who are providing an important service in your community. It is disappointing that the CBC journalists chose to ignore the reality that is the basis of homeopathy, but that doesn’t affect what we know to be true.

The strength in homeopathy is that it works. We practitioners know it works because we see it every day in our patients and they obviously know it works because they refer their family and friends to homeopathy and they keep coming back when they get ill. Nay-sayers can say “it aint so” until they are blue in the face, but that doesn’t change the fact that homeopathy does work, even if we still don’t know how it works. Full stop. End of discussion. Let’s say what needs to be said to set the record straight and then get back to doing the important work that we do with homeopathy.

Any Canadian sceptics out there may want to keep an eye on how this astroturfing campaign proceeds 😉