Psorinum therapy – homeopathy for cancer?

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.” 😉

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23 Responses to Psorinum therapy – homeopathy for cancer?

  1. From the 2011 study: “The participants’ eligibility criteria included (i) histopathology/cytopathology confirmation of malignancy, (ii) inoperable tumors, and (iii) no prior chemotherapy or radiation therapy.”

    Apparently clinical trial eligibility in India works the opposite way it does here. Oh, you’re previously untreated? Here’s a wildly speculative alternative to current chemotherapy!

  2. Dana Ullman says:

    Yeah…don’t ya HATE those “wildly spectulative therapies” that have absolutely astonishingly good results with people in stage 3 or stage 4 (!) cancers, including pancreatic, stomach, gall bladder, and liver cancer???

    By the way, this “sensibly looking oncology journal” has a 17.9 impact factor.

    In light of these 155 cases, either you have to realize that this homeopathic drug may have a truly profound effect OR homeopaths have truly magical capabilities that are amazing…but heck, I bet you don’t want to see these good results yourself or with your family. Instead, you’d much rather undergo chemo and radiation and die early.

    As for the “control group,” are you kidding? There were millions of people in the control group…and we KNOW what results they experienced.

    And by the way, there was a 2nd trial on lung cancer too…with equally impressive results…but heck, let’s STOP these incredible treatment immediately before others hear about it.

    Continue doing “ostrich therapy” and keep your head in the ground! Peace out…

    • xtaldave says:

      1) Re: Sensible looking oncology journal
      That was a conference abstract, Dana. I realise that you might not know this, but conference abstracts are mostly not peer-reviewed by the journal itself. So the high impact factor & peer-review ethic of that journal can’t really be applied to this work, especially when the full paper is published elsewhere. Real scientists would cite the paper Dana, and not the conference abstract, ok?

      2) “I bet you don’t want to see these good results yourself or with your family.”
      Dana – I’d love to. I spent 3 years working in a major UK cancer research institute, and I know that these cancers are bloody horrible. I also know that cancer patients can be desperate, and giving false hope by pimping uncontrolled observational studies in this way is insanely cruel.

      3) “There were millions of people in the control group…”
      I suspect you know that is bullshit. You cannot cite “all cancer sufferers everywhere” as an appropriate control, especially when the patients were allowed to continue conventional treatment at the same time.

      4) “there was a 2nd trial on lung cancer too…with equally impressive results…”
      … and equally control-free.

      5) Let’s imagine that the boot is on the other foot. Lets say that these exact same studies suggested psnorium causes cancer. You’d be all over it whinging about the lack of controls, or maybe you’d actually spin it as evidence of a homeopathic effect. I know how much you like to accuse people of double standards. Take a look in the mirror sometime.

      6) Don’t you agree that repeating this study with appropriate controls would be the more scientific approach to this therapy? If I was Chatterjee, and I could repeat this with the appropriate controls, I’d be ordering suitable molecular biology kit to find out what the active ingredient is, and getting myself a damn good patent lawyer.

      7) “Peace out” ???? Grow the hell up. You’ll be 60 later this year.

  3. Dana Ullman says:

    Hey Dave…First, the only different thing about the patients in this study is that they did not use chemo or radiation AND they were given this specific homeopathic medicine. We all know what results to expect from everyone else who uses conventional treatment and who does not use THIS homeopathic medicine…and it seems that you would rather that people use conventional treatments and die sooner. Wow, how compassionate of you…

    And thanx for verifying how little you know about homeopathy. The dose used in these studies IS a “molecular” dose…and there are plenty of homeopathic mediciens that are used in the 6X potency.

    Please simply show me ANY case series report that has similar results as those in these homeopathic studies. THAT IS YOUR CHALLENGE. Show us all! I’m now waiting…

    • xtaldave says:

      “We all know what results to expect from everyone else who uses conventional treatment and who does not use THIS homeopathic medicine…”
      You cannot say that this is the case in this control-free study. The authors of the study certainly don’t say that:

      “The limitation of this study is that it did not have any placebo or treatment control arm; therefore, it cannot be concluded that Psorinum Therapy is effective in improving the survival and the quality of life of the participants due to the academic rigours of the scientific clinical trials. This study also cannot rule out the effects of the implemented allopathic and homeopathic supportive measures in the observed results.”

      In your obvious and overwhelming excitement at finding a positive study to wave at your critics, you are imbuing the paper with more significance than even the authors do. Hardly academically and scientifically rigorous…

      And yes, I know that not all homeopathy is beyond 1023, and in those cases where there is a chance of an active ingredient being present, I have absolutely no trouble with the plausibility or ‘prior probability’ if you will, of the remedy. That does not excuse those remedies from being properly tested in methodologically sound DBRCTs. Psnorium hasn’t been properly tested yet – I know it, the authors know it – and yet you refuse acknowledge that fact, merely because it suits your rhetoric.

      Let’s assume that when Psnorium is tested the results are positive – we can then have some fun conducting the little ‘science versus homeopathy’ experiment I outlined in the blog post. *IF* the homeopathic remedy is effective and the non-homeopathic remedies are not, I will doff my cap to you and admit that you are right, and that homeopathy works.

      Until that day, I am afraid that uncontrolled small scale observational studies like this are not going to convince anyone (apart from people like yourself who have already made their minds up) that psnorium therapy or indeed homeopathy in general is effective.

      And by the way – stop trying the “reverse burden of proof” gambit. You always do it and it is utterly pointless. Let us not forget that it is you who are pushing this study as proof, and not me.

  4. Dana Ullman says:

    I am still WAITING for you to cite ANY controlled or uncontrolled trial of using any conventional drug to treat any of the above cancers in stage 3 or 4 that are similar to those in this study.

    Just show me…and us…and stop with the theorizing and excuses.

    And that is so funny that you ask me to stop requesting a burden of proof. You don’t have the proof, so you don’t want to show it. Not surprised.

    The bottomline is that either Psorinum is an impressive drug OR homeopaths emit some special magic. Which is it? The other possibility is that these 155 patients just happened to be lucky. Ok, if THAT is your logic, please just show us any other time in history where 155 (or so) patients with these serious cancers just happened to get the results noted in these studies. Just show us.

    • xtaldave says:

      The bottomline is that either Psorinum is an impressive drug OR homeopaths emit some special magic.

      You simply cannot say that. At the risk of repeating myself (and the authors of the paper) yet again:

      “The limitation of this study is that it did not have any placebo or treatment control arm; therefore, it cannot be concluded that Psorinum Therapy is effective in improving the survival and the quality of life of the participants due to the academic rigours of the scientific clinical trials. This study also cannot rule out the effects of the implemented allopathic and homeopathic supportive measures in the observed results.”

      Until the study is repeated properly, the data simply do not support your fawning, blustering, overblown conclusions.

  5. I just visited Dr Chatterjee in Calcutta.
    I met the patients myself, checked their X-rays and medical records. Ten cases were also checked meticulously by the NCI in Washington. As far as I know, no other research team has ever even been close to these results on these very heavy types of cancers.
    With these results in mind, it would in conventional terms be considered unetical to perform a double-blind study, and withdraw one treatment group the possibility of Psorinum treatment.

    I do not agree that this study has no value because it does not contain a control group, as these results has never been obtained previously in the history of medicine before. If my mother had cancer, knowing the preliminary results of psorinum, I would give her psorinum and rather not let her enter a double-blind placebo controlled study.

    My idea is to make a study on using Psorinum for cancer prevention. Give it to a large number of cancer-free people, and see if there will be a difference in the risk of developing cancer.
    That would not be considered unethical, and if the preliminary results are true, it is very likely that it can heal 90% of early caners, if iot can heal 20 % of the most sevre stage 4 cancers.

    • xtaldave says:

      Hi Mikael, thank you for your comment, and thank you for the extra information. If, as you say, these cases have been double checked by an external agency, this can only be a good thing.

      As I noted in the original post, I also found no evidence of any results in pancreatic cancer as encouraging as this.

      In criticising the lack of a control arm in this study I am doing no more than the authors themselves do in the discussion of the paper. They conclude that a double-blind, properly controlled study would the next logical step in building the evidence base for psnorium therapy.

      However, if such a trial was considered unethical (I am not au fait with Indian clinical trial guidelines), then a straight comparison with current best practise – a blinded (if feasible) superiority-type trial would seem to be a sensible compromise between the need for a properly controlled trial, and any ethical considerations that might apply.

      Your concerns regarding ethics do make the assumption that it is the psnorium therapy is the effective agent – something that cannot be concluded from the current study due to it’s lack of controls.

      FWIW, I think that your idea for a cancer prevention trial seems like a good one, and, as long as it is properly controlled and blinded, should make for some interesting results! I await the paper with great interest.

      Good Luck!

    • Dr Samrat Mukherjee says:

      Hi Mikael and Dave
      I am myself a Postgraduate Homoeopathic physician in India and my father is suffering from moderately differentiating hepatocellular carcinoma with very high AFP. My father is 72, hypertensive, dyslipidemic, diabetic and on anticoagulants. Recently he has undergone Permanent pacemaker implantation also. Considering all these factors I have to keep my father on conservative therapy. Homoeopathy was the treatment of choice. The unbiased observation is that my father is responding quite well to the Homoeopathic medicines (Hydrastis MT – 1 tsf bd and Cholesterinum 3x 2 tabs od ). 3 months post therapy CT abdomen shows status quo condition of the tumor size, without any metastatis, the AFP level is status quo, the LFT which showed hyperbilirubinemia and an altered A:G ratio has come down to normal. Symptomatically my father had severe anorexia which has improved, and he also c/o Right upper quadrant pain which is no more now. I contradict what Dana says and is going to apply this Psorinum therapy heartily on my father. At least it is better to provide a peaceful and painless death to such terminally ill patients with the so called “IDIOTIC, BULLSHIT PLACEBO THERAPY” than to prolong and make their life more unendurable with the “ULTRAMODERN, HIGHLY TECHNOLOGICAL, SCIENTIFIC!!!!!!! AND LOGICAL !!!!!!!! MODERN MEDICINE”.
      ————————————————— Sam

  6. Richard says:

    The original blog makes a point that some folks perhaps are losing sight of in their blinded defence of ‘homeopathy’ vs ‘hard science’.
    The study could be better done (the list of other homeopathic and allopathic treatments used for symptom relief makes this cohort desperately complex, at best) and despite the lack of a control arm, the results are impressive enough to suggest that treatment of these cancers with Psorinum could be worthy of follow-up.

    However this only shows that there is something in Psornium that may help in treatment of these tumours. This is not necessarily suprising given the well known role the immune system has in attacking tumours and in high concentrations of immune modulators (cytokines, growth factors, even lymphocytes) likely to be found in Psornium. One such molecule, interferon, is alrady used as a chemotherapeutic against melanoma, renal cancer and several others. The idea that this study ‘proves’ homeopathy works is at best misguided. As the blog posters suggests, a comparison between Psornium prepared ‘homeopathcally’ vs the same mixture prerpared in a lab would be an interesting one.

    Many drugs are found in nature. For example Taxol, a widely used chemotherapy agent is found in yew tree bark and chewing the bark may provide some dose, but by extracting the taxol, analysing it’s structure and synthesizing it you get a much more effective drug. This shows there is a place for science in taking such ‘folk remedies’ and extracting biological mechanism and using that knowledge to enhance treatment. The homepathic community should have respect for, and seek to help, medical science for the good of all, rather than dismissing it altogether.

  7. Claire says:

    Hi,

    My father has an advanced pancreatic cancer and I was very impressed with that paper. Does anyone knows if psorinum has any kind of important side effects or contraindications? Is there any particular aspect in the preparation of the drug? I’m thinking in trying that, why not?

    • xtaldave says:

      Hi Claire,

      This blog does not and cannot offer specific medical advice – regarding treatment, I can only recommend that you seek the advice of a suitable medical professional.

      My best wishes for you and your father.

      Dave

  8. Arunodoy Mittra says:

    Some hope is better than no hope. All the very expensive drugs, called ‘scientific’ has limits in containing progression of Cancer and then the patient succumbs filling in data sheets of Oncologists. May be Psorinum 6x is being tried on patients having least of hope and also have no capacity to afford therapies costing $ 5000 per month.
    A.Mittra, a M.R.C.C patient about to go for 2nd line treatment after Sunitinab malate.

  9. […] We are told that psorinum is an alcoholic extract of scabies, pus cells. Such an extract may indeed contain biological active substances. This is explained in a blog post here. […]

  10. magufo says:

    And that’s what Dave did not answer me. There active ingredient in a 6X dilution?
    Well, homeopathy even manages low dilutions, so the criticisms of the document are only relevant to the issue of controls, but not that they should not be active.
    This reflects the double standards of pseudo skepticism.

    • xtaldave says:

      Magufo, I am slightly confused. You have not commented on this post previously. Are you referring to another post or comment? Perhaps you should make it clear what you are replying too?

      And Magufo, you will find that my approach to homeopathic remedies not diluted beyond 10^23 has been consistent throughout all my discussions, both with you and others.

      Here for example, https://xtaldave.wordpress.com/2010/10/02/scientific-evidence-for-homeopathy-2/#comment-1197

      And I will state again what I have stated numerous times.

      If a homeopathic remedy is not diluted to a point where there are no active ingredients left, then I have no problem with that being a plausible remedy. However, the efficacy and safety of that remedy still need to be demonstrated to the necessary standards of scientific and medical evidence.

      I fail to see how this is double standards – this is an entirely rational and fair position to take. If you do not think so, kindly explain why.

      • Magufo says:

        Reember this:

        “Homeopathy: there’s nothing in it”

        View here: http://www.1023.org.uk/

        This campaign says 10:23.

        Not that such skeptics are actually the science charlatans and liars?

        Understand now, that is a double standard?

      • xtaldave says:

        You are making a literal interpretation of a Public awareness campaign strap line as a logical point in a debate?

        Anyway, after the Nelson’a fiasco, we know some remedies come with all-natural, soothing shards of broken glass… :-).

        There’s definitely something in them.

  11. magufo says:

    You go out with me Nelsons example: is that all homeopathic industries have the same problem?
    I mean as a 6D remedies still contain a substance.

    Moreover 10:23 campaign lies, distorts and is an act of astroturf, clear and concise by the Sense About Science. Uhh … sure is that “no interest” … ah but “I did not say that” …. it is sad that the skeptical movement (pseudo skeptic) fall into such unscientific practices and conservative.

  12. […] 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. […]

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