With Permission from Manfred Mueller and www.TheHomeopathicCollege.org
INTRODUCTION TO HOMEOPATHIC CANCER TREATMENT
Dr. Moshe Frenkel, founder and director of the Integrative Medicine Clinic at MD Anderson Cancer Center in Houston, Texas, recently observed1 that patients with cancer commonly use complementary and integrative medicine including homeopathy. According to Dr Frenkel, homeopathy has grown in popularity with the public but is still viewed with skepticism by medical academia and is still excluded from conventionally prescribed treatments. In recent years, homeopathy has been used widely in cancer care in Europe and many other countries worldwide. The global increased use of homeopathy in cancer care raises the question if there are any measurable benefits for cancer patients. In a 2015 commentary entitled “Is There a Role for Homeopathy in Cancer Care”, Dr Frenkel explored the evidence related to the benefit of homeopathy in cancer care.
Frenkel pointed out that limited research suggested that homeopathic drugs appear to cause cellular changes in some cancer cells. In animal models, several homeopathic medicines showed an inhibitory effect on certain tumor development. Some clinical studies of homeopathic remedies combined with conventional care have shown that homeopathic remedies improve quality of life, reduce symptom burden, and possibly improve survival in patients with cancer. The findings from several lab and clinical studies suggest that homeopathy might have some beneficial effect in cancer care. Dr. Frenkel concluded that further large, comprehensive clinical studies are needed to determine these beneficial effects. Although additional studies are needed to confirm these findings, given the low cost, minimal risks, and the potential magnitude of homeopathy’s effects, this use might be considered in certain situations as an additional tool to integrate into cancer care.
In two previous reviews in 2007 2 and 2012 3 published in The American Homeopath, we had called for making homeopathic cancer treatment more available, for very similar reasons. It has been five years since our last review was published. In the present review we summarize the most recent studies on homeopathic cancer treatment published, beginning in 2013. As in the previous reviews, the evidence shows that patients, not physicians, are the primary impetus for the increasing call for homeopathic cancer treatment worldwide. In the countries where homeopathic treatment is available, treatment is often provided in the absence of good professional references on homeopathic cancer drugs. To remedy this situation, in our recent book4 Homeopathic Cancer Drugs, we compiled data from more than 200 books covering over 2 centuries of homeopathic cancer therapies, making for the first time a comprehensive clinical reference work available to practitioners working in our field.
For the present review we selected recent research studies conducted in institutions across the world that investigated the efficacy of homeopathic drugs for the treatment of multiple cancers, their safety, their ability to counter side effects from conventional cancer therapies, or their capacity to improve the quality of life in cancer patients. We noticed that many more studies of this kind have been conducted on homeopathic cancer treatment than in any previous five-year period. While we welcome this in light of our past calls for increasing research, it has substantially increased the scope of the current paper. In our present random walk through research published in global peer-reviewed medical and scientific journals over the last five years, we let the evidence speak for itself.
PREVALENCE OF HOMEOPATHY IN CANCER CARE
Homeopathic cancer treatment has become almost commonplace in Europe. According to the public record, patients in Tuscany, Italy, routinely demand homeopathic and other therapies complementary to conventional cancer treatments. A 2017 study5 found that homeopathic treatment can reduce side effects and cancer-related symptoms, including hot flashes from surgery, chemotherapy, and radiation treatment. Researchers concluded that integration of evidence-based complementary treatments such as homeopathy allows for an effective response to the demand coming from cancer patients and combines safety and equity of access in public health care systems.
The Region of Tuscany Health Department was included as an associated member in WP7 “Healthcare” of the European Partnership for Action Against Cancer (EPAAC), initiated by the EU Commission in 2009.The principal aim was to map centers across Europe prioritizing those that provide public health services and operating within the national health system in integrative oncology (IO).
Researchers used6a cross-sectional descriptive survey design with a questionnaire regarding integrative oncology therapies to be administered to all the national health system oncology centers or hospitals in each European country. They identified these institutes by convenience sampling, searching on oncology websites and forums and be analyzing the official websites of these structures to obtain information about their activities and contacts.
Information was received from 123 (52.1 %) out of the 236 centers contacted until 31 December 2013. Forty-seven out of 99 responding centers meeting inclusion criteria (47.5 %) provided integrative oncology treatments, 24 from Italy and 23 from other European countries. The number of patients seen per year was on average 301.2 ± 337. Among the centers providing these kinds of therapies, 33 (70.2 %) use fixed protocols and 35 (74.5 %) use systems for the evaluation of results. Thirty-two centers (68.1 %) had research in progress or carried out until the deadline of the survey. The complementary and alternative medicines (CAMs) more frequently provided to cancer patients were acupuncture 26 (55.3 %), homeopathy 19 (40.4 %), herbal medicine 18 (38.3 %) and traditional Chinese medicine 17 (36.2 %); anthroposophic medicine 10 (21.3 %); homotoxicology 6 (12.8 %); and other therapies 30 (63.8 %). Treatments are mainly directed to reduce adverse reactions to chemo-radiotherapy (23.9 %), in particular nausea and vomiting (13.4 %) and leucopenia (5 %). The CAMs were also used to reduce pain and fatigue (10.9 %), to reduce side effects of iatrogenic menopause (8.8 %) and to improve anxiety and depression (5.9 %), gastrointestinal disorders (5 %), sleep disturbances and neuropathy (3.8 %).6
Reducing the Use of Cancer-Causing Hormone Drugs
Negative publicity in the UK about menopausal hormone therapy (MHT) (or hormone replacement therapy; HRT; in the United States), has led to increased use of complementary and alternative medicines (CAM), including homeopathy, and other non-pharmacological interventions (NPI) for menopausal symptom relief among UK postmenopausal women. The negative publicity was due to reports that they can induce cancer and heart disease. In a recent study 7 one in four postmenopausal women reported using CAM therapies/NPI for menopausal symptom relief, with lower use reported by older women. Higher levels of education and previous MHT use were positive predictors of CAM/NPI use.
Significant Use of Homeopathic Cancer Treatment in a UK Hospital
The UK is one of a few countries that actually have homeopathic hospitals. A new survey8 conducted to improve quality and outcomes of their hospital used Measure Yourself Medical Outcome Profile (MYMOP2) as a tool to assist clinicians in setting the treatment goals across a wide range of diagnoses and other complaints in routine clinical practice at the Bristol Homeopathic Hospital. A total of 198 patients with a wide range of complaints attended one to five consultations with 20 homeopathic doctors. Diagnostic categories were most commonly neoplasms (16.7%), psychological (13.9%) and genitourinary complaints (12.3%), with 66.7% suffering from these problems for at least one year. The three symptoms that bothered patients the most were pain, mental symptoms and tiredness/fatigue.
Homeopathy Most Use CAM in Cancer Patients in France
The overall clinical significance of improvements found in the survey was at least moderate. A repeated measures ANOVA test also showed statistically significant improvements (p<0.001). According to the researchers the study demonstrates that when patients with long-term conditions come under homeopathic care their presenting symptoms and wellbeing often improve. Offering a low cost high impact intervention to extend the range of choice to patients and to support self-care could be an important part of the National Health Service.
The first study in France on non-conventional medicine (NCM) use in patients two years after cancer diagnosis was based on data obtained in a 2012 survey of a representative sample of 4349 patients. Non-conventional treatments used were homeopathy (64.0%), acupuncture (22.1%), osteopathy (15.1%), herbal medicine (8.1%), diets (7.3%) and energy therapies (5.8%). In nearly half of the NCM users, cancer diagnosis was one of the main factors which incited patients to use unorthodox therapies. Apart from the NCM users’ socioeconomic profile, the results showed that impaired health was a decisive factor. The researchers concluded that opting for unconventional approaches was therefore a pragmatic response to needs which conventional medicine fails to meet during the course of the disease. They concluded further, that better information of patients and caregivers is needed to allow access to these therapies to a larger population of survivors.
Positive Effects – Homeopathy/CAM Used on Children/Adolescents with Cancer
Children and adolescents with cancer in Switzerland frequently use complementary and alternative medicine (CAM). Swiss researchers recently investigated how and why.10Childhood cancer patients treated at the University Children’s Hospital Bern, Switzerland, between 2002-2011 were retrospectively surveyed about their use of CAM. Out of 133 patients (response rate: 52%) 53% had used CAM (mostly classical homeopathy) and 25% of patients received information about CAM from medical staff. Those diagnosed more recently were more likely to be informed about CAM options. The most frequent reason for choosing CAM was that parents thought it would improve the patient’s general condition. The most frequent reason for not using CAM was lack of information. Of those who used CAM, 87% perceived positive effects. The researchers recommended that since many pediatric oncology patients use CAM, patients’ needs should be addressed by open communication between families, treating oncologists and CAM therapists, which will allow parents to make informed and safe choices about using CAM.
Another French study11 used a parent questionnaire to collect information about the use of complementary and alternative medicine (CAM) on 50 children treated for malignant diseases. Most of parents (48%) used one or more CAM for their child in the context of cancer. The most used type of CAM was homeopathy, dietary supplements and aromatherapy. The most frequent goal for CAM use was to limit the side effects of conventional treatment (75% of parents). For 87.5% of users, the CAM was effective. Physicians were not aware of this use for 33.3% of users, in spite of the fact that the family physician was the main source of information for this use. Most of parents (48%) needed more information about the CAM and they bought their medicines in a pharmacy. The use of oral CAM in this survey was common. For most parents, this use was effective and appreciated because they generated fewer side effects than conventional treatments. However, doctors were not systematically informed of this use. This is problematic because some CAM such as herbal supplements could potentially cause interactions with cancer treatments. More information about CAM is necessary in pediatric oncohematology.
Reducing Chemotherapy Side Effects with Homeopathy & CAM
About 50% of cancer patients in Germany use complementary and alternative medicine (CAM). Women with breast cancer use CAM more frequently than others. A recentstudy12 linked a questionnaire to the largest internet portal for cancer patients in Germany. The questionnaire addressed attitudes towards CAM, disclosure to the oncologist, sources of information, and objectives for the use of CAM. 80 patients with breast cancer took part in the study, 61 currently using CAM. Most frequently used CAM methods were selenium supplements, relaxation techniques, prayer, vitamin C supplements, and meditation. Satisfaction was highest with relaxation techniques, vitamin C, homeopathy, yoga and Chinese herbs, lowest with mistletoe and acupuncture. 70% of participants did not think their oncologist took time to discuss CAM. Only 16% believed that their oncologist was well informed about CAM. 46% relied on naturopaths and non-medical practitioners concerning CAM. Objectives for the use of CAM were to reduce side effects of conventional therapies, to boost the immune system, and to become more active.
Researchers assessed the prevalence of use of CAM in European patients with early-stage breast cancer, and the motivations and predictive factors for its use, as well as patients’ information needs over a three months period. 69 out of 184 responders (37.5%) reported using at least one CAM. CAM use was associated with younger age (p = 0.03) and higher education level (p < 0.001). Pharmacological substances (e.g., homeopathy, phytotherapy) were the most commonly used (79.7%) before physical means (42%) and dietary methods (31.9%). A total of 65.8% of users felt that these treatments have demonstrated evidence of efficacy and 74.8% that they were not associated with side effects. The main goal for use was improvement of treatment-related symptoms (28.3%); secondary goal was increasing the general health status (20.5%). Patients reported high needs for information on CAMs. CAM use was associated with mild differences in secondary adverse events reported by patients. The authors of the study concluded that since breast cancer patients are common users of CAM concomitantly to their conventional cancer treatments they should be investigated regarding their current consumption of CAM. Furthermore, they need advice evidence-based data on these treatments and potential interactions with on-going treatments.
Homeopathy and CAM Used in Pediatric Cancer Patients
Although complementary and alternative medicine (CAM) is widely used in the Dutch pediatric population, research on the use of these therapies in the pediatric oncology population is of mixed quality. In a multicenter survey,13scientists investigated the prevalence of CAM use, possible determinants of use, and parental attitude towards communication and research on CAM therapies. The prevalence of CAM use in the past 12 months was assessed by using a questionnaire based on the European guidelines on CAM research, filled out by parents of children visiting pediatric oncology outpatient clinics of six academic hospitals in the Netherlands. The questionnaire consisted of 26 questions on the child’s clinical status, CAM use, and attitude towards communication and research on CAM therapies. One hundred and twenty-two of 288 respondents (42.4 %) reported CAM use. The most frequently used categories were homeopathy (18.8 %) and dietary supplements (11.5 %). Female gender and parental CAM use were significant predictors for the use of CAM (p < 0.001). Only one third of the parents had discussed CAM use with their pediatric oncologist. More than 80 % of the respondents identified a need for information about CAM from their pediatrician and 85.7 % was positive towards research on CAM. Half of the parents were interested in participating in future CAM trials.
The researchers concluded that with more than 40 % of parents of Dutch pediatric oncology patients providing complementary and alternative medicine to their child and with lacking evidence on efficacy and safety of most CAM modalities, there is a clear need for high-quality research in this field. This study shows that most Dutch parents have an open attitude towards CAM research and that almost half of the parents would consider participating in future CAM trials, paving the way for research on CAM and aiming for its evidence-based use in pediatric oncology.
The use of complementary and alternative medicines (CAM) in patients with cancer is now well recognized. However still very little is known about the use of CAM in children patients with advanced cancer during the end-of-life period. Australian researchers interviewed14 96 parents of children who had died of cancer in Melbourne, Australia between 1996 and 2004 to establish the prevalence of CAM use during the end-of-life period. They explored factors affecting the use of CAM and determined the perceived efficacy of CAM use and its effect on the overall experience of end-of-life care.
Thirty percent of parents caring for a child with cancer reported using some form of CAM during the end-of-life period, with 44% of these families using more than one type. The most common therapies used were organic foods, faith healing, and homeopathy. There was a strong correlation between open discussion about treatment alternatives with the treating physician and parental use of CAM. The majority (78%) of respondents felt CAM use had benefited their child significantly and most felt it had not caused additional suffering.
In Australian cancer centers, a significant number of children with cancer are administered CAM during the end-of-life period and most families in this study had found it beneficial. Researchers concluded that the main focus should continue to be on open and honest communication between caregivers and families in order to provide the best possible holistic care.
Homeopathy Improves Quality of Life in Cancer Patients
A group of German scientists15studied systematically whether homeopathic care is of benefit to cancer patients. They conducted a prospective observational study with cancer patients in two differently treated cohorts: one cohort with patients under complementary homeopathic treatment (HG; n = 259), and one cohort with conventionally treated cancer patients (CG; n = 380). For a direct comparison, they formed matched pairs with patients of the same tumor entity and comparable prognosis. Main outcome parameter were change of quality of life (FACT-G, FACIT-Sp) after 3 months. Secondary outcome parameters were change of quality of life (FACT-G, FACIT-Sp) after a year, as well as impairment by fatigue (MFI) and by anxiety and depression (HADS).
The researchers found a significant improvement in quality of life as well as a tendency of fatigue symptoms to decrease in cancer patients under complementary homeopathic treatment. They concluded it would take considerably larger samples to find matched pairs suitable for comparison in order to establish a definite causal relation between these effects and homeopathic treatment.
Patient Satisfaction High with Homeopathy in Cancer Patients
Homeopathy is a frequently used complementary and alternative medicine (CAM) treatment in Germany. Another group of German researchers investigated results16 comparing responses of homeopathy users and users of other forms of CAM, or non-homeopathy-users (NHU) in pediatric oncology (PO) in Germany. They examined the differences between these two groups (usage, associated demographic characteristics, previous experience with CAM). 186 (45.2%) of the 367 CAM users were exposed to homeopathy. The treatment duration amounted to a median of 601 days for homeopathy users and 282 days for NHUs. Parents with p (127; 76.5%) also used homeopathy for their child’s cancer. Nonmedical practitioners played a considerably greater role as source of information than did treating physicians. The majority of homeopathy users received their prescriptions from nonmedical practitioners (56%; 29.4% of NHUs). Homeopathy users communicate more frequently with their physicians about the CAM-use (77.7% versus 65.2%) and recommend CAM more often than non-homeopathy-users (94% versus 85.6%). Homeopathy is the most frequently used CAM treatment in PO in Germany. Homeopathy users sustain treatment and therapies considerably longer than NHUs. Most families who had used homeopathy before their child was diagnosed with cancer also used homeopathy for the treatment of their child’s cancer. Compared to other CAM treatments, patient satisfaction with homeopathy appears to be very high.