Homeopathics and Cancer

[UM Review RN]

Does anyone have information about how homeopathic pharmacognosis works on cancer patients?

Do you think this kind of treatment is effective?

[TiredMD]

It is therefore my opinion that we don't know as much as we think we know. We should not close our minds to all alternative therapies just because some have not been proven to work.

Agreed. But I still argue that we shouldn't accept any treatment until it has been proven to be safe, and to work.

[Josh L.Ac.]

Agreed. But I still argue that we shouldn't accept any treatment until it has been proven to be safe, and to work.

So at what level/degree of evidence to you say "hey, this is worth recommending to my patients?"

Do you need a few well-controlled studies, a Cochrane Systematic Review, or a large number of small studies? Or does it need to be accepted as "standard of care" before you recommend it?

[TiredMD]

So at what level/degree of evidence to you say "hey, this is worth recommending to my patients?"

Interesting and difficult question. My three major criteria can probably be summarized as follows:

1) The treatment must be demonstrated to be safe and efficacious. For pharmaceuticals or medical devices, FDA approval for specific indications is my gold standard. In cases where the FDA has not addressed it, at this level in my training I tend to rely on the opinions of my staff attendings. Once I am in practice on my own, it will likely come down to my sum-total interpretation of available literature. No, it wouldn't take a Cochrane review (since they take so damn long to come out anyway), but neither would I ever rely on two or three small studies of 30 patients published from a group in Poland. Critical evaluation of available medical literature is, in my mind, the number one quality of a competent physician.

2) For a specific patient, it should be the best of all available options. Yes, some herbs have been shown to be moderately effective for certain illnesses. But unless there is evidence that it is superior to other, more commonly utilized therapies, there is no particular reason to recommend it. Or if there are specific contraindications or prior treatment failure with common therapies.

3) It has to be available in standardized, regulated forms and quantities. This is the difficulty with "herbal medication". No FDA oversight means it is difficult to know what patients are actually getting, and if the person giving it to them really knows what the hell they're doing. Prior to licensure of accupuncturists, any jacka$$ could pass themselves off as a practitioner, and who knew if they were even washing their needles? I couldn't live with myself if (back in those days) I said "sure, give accupuncture a try" and some poor mother of two ended up with hep C.