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Homeopathy for Primary and Adjunctive Cancer Therapy*

DANA ULLMAN, MENACHEM OBERBAUM, IRIS BELL, AND SHEPHERD ROEE SINGER

KEY CONCEPTS

Homeopathy is a medical specialty that recognizes symptoms as adaptive responses of the organism to endogenous and exogenous factors. This system of medicine utilizes drugs that have undergone a specific pharmaceutical process of serial dilution with vigorous shaking, which homeopaths have found stimulates the healing process. Each drug is selected according to the “law of similars,” with the intention of initiating a healing process by stimulating the body’s own adaptive capacities.

Clinical research exists to support the biological activity of homeopathic preparations, as well as their efficacy, in a number of clinical indications. However, this research often lacks sufficient replication or corroboration, and thus must be considered as yet inconclusive.

Individual studies have shown that homeopathic medicines can be used to mitigate the adverse effects of chemotherapy and radiation treatment, though this research also requires replication and corroboration. However, due to the widely recognized safety of homeopathic medicines, there appears little risk in employing these drugs in conjunction with conventional anticancer treatment.

The historical and international experience with homeopathic medicines in a wide variety of acute and chronic illnesses, combined with a growing body of scientific evidence and a benign safety profile, would suggest a place for homeopathic treatment in an integrated medical approach to cancer treatment.

Though far from conclusive, much headway has been made in homeopathic cancer research in recent years. The bulk of this effort resides in the realm of basic science; however, anecdotal evidence and limited clinical trials offer hope that homeopathy may indeed be of value in cancer prevention, treatment, mitigation of conventional cancer therapy side effects, and in palliative care. Some case reports and case series even claim cancer cures. Independent replication of the more exceptional claims is notably lacking. In spite of these encouraging preliminary findings, existing evidence and ethical considerations place homeopathy at this point as an adjunct to conventional cancer therapy, not in its lieu, save where conventional therapy is ineffective or futile. With these caveats in mind, we proceed to review “the best in homeopathic anticancer research.”

Homeopathy employs an entirely novel paradigm and therapeutic arsenal in comparison with conventional medicine. The approach to cancer treatment illustrates this philosophical rift. Western medicine tends to view cancers as a localized disease (which may metastasize and develop systemic properties), while homeopathy views cancer (and other diseases with seemingly local manifestations) as a local expression of underlying system-wide illness or “disorder.” Conventional medical treatments, including surgery, radiation, and chemotherapy, seek to exterminate the rogue cancer cells. By contrast, homeopathic medicines, along with other holistic approaches, purport to augment the individual’s resistance and empower the body to reestablish its own health.

Definitions

Homeopathic medicine: Homeopathic medicine is the application of specially prepared nanodoses (described in the following paragraphs) of a plant, mineral, animal, or chemical substance to treat the similar syndrome of symptoms that it is known to cause in overdose.

Homeopathic medicines, also termed “remedies” are made through a process of serial dilution with vigorous shaking in between each dilution. Water soluble medicines are repeatedly diluted by a factor of 1:10, 1:100, or 1:50,000, in double-distilled water in glass vials. Mineral substances are initially triturated and diluted with lactose powder. In most countries, homeopathic medicines are recognized as drugs—usually over-the-counter—that have a long history of safety, thereby permitting their use without a doctor’s prescription.

When a medicine has been diluted 1:10 six times, it is termed 6X (X = Roman numeral for 10). When it is diluted 1:100, it is termed 6C. According to Avogadro’s number, in all probability, there should be no remaining molecules of the original medicinal substance after it has been diluted 1:10 twenty-four times (24X) or 1:100 twelve times (12C). Homeopathic medicines include both pre-Avogadro number doses and post-Avogadro number doses.

Nanodoses: The prefix nano derives from Latin and means dwarf; today, the prefix is used in nanotechnology or the nanosciences, which explore the use of extremely small technologies or processes, at least one-billionth of a unit, designated as 10^–9, though our use of the word nanopharmacology and nanodose draws from its modern usage, suggesting “very small and very powerful.”

Hormesis: Hormesis is the term for generally favorable biological responses to low exposures to toxins and other stressors. The wide variety of scientific researchers who have experimented with and explored hormetic effects have only evaluated the effects the pre-Avogadro number doses (Calabrese, 2005).

The Homeopathic Approach to Cancer

Homeopathy is a branch of holistic medicine first conceived by the German physician, translator, and chemist Dr. Samuel Hahnemann at the turn of the 19th century. The central tenet and basis for this form of medicine is the law of similars. This purported law of nature dictates that a patient with a given syndrome of disease can be effectively treated by giving a medicine that would create a similar syndrome in a healthy individual (Hahnemann, Organon §26).

The premise underlying the law of similars is that symptoms of illness are adaptations and defenses of the entire organism—mind and body—in response to stress, infection, or toxic exposures. Rather than using pharmaceutical agents to inhibit or suppress specific symptoms or biochemical processes, homeopathic medicines (remedies) are tailored to the unique body–mind syndrome of the patients.

This principle of using “like to treat like” is both ancient and modern. Hippocrates asserted that, “By similar things disease is produced, and by similar things, administered to the sick, they are healed of their diseases.” More recently, the principle of similars may be observed in the modern medical applications of immunization and allergy desensitization, though homeopaths use much smaller doses of medicines and prescribe these medicines with greater individualization of treatment. Homeopaths assert that it is no coincidence that radiation causes cancer, and many chemotherapeutic drugs are themselves carcinogenic.

Though the law of similars is the sine qua non of homeopathy, the field is actually best known for its use of submolecular doses. While a widely accepted explanation for such activity is still lacking, nonlinear dose–response relationships are well documented in conventional pharmacology–toxicology literature as the phenomenon of hormesis (Calabrese & Baldwin, 2001; Calabrese, 2005). In this response, an agent, which may be radiation, a toxin, or chemotherapeutic drug, causes an effect at a given dose but attenuates or reverses that effect at a different dose. Though hormesis is more likely to occur at doses below the lowest observed adverse effect level for a given agent, homeopaths use even smaller, more potentized doses. Homeopathic medicines may include dilutions in which no material amount of the original medicinal substance remains, and which are prepared through a well-defined process of serial dilution and succussion.

Of additional relevance to biological homeopathic remedy effects are animal and in vitro data demonstrating experimentally measurable effects of increasing duration from homeopathic remedies administered at increasingly higher, ultra-dilute doses (potencies) (Sukul, Bala, & Bhattacharyya, 1986; Witt, et al., 2007). As noted earlier, a tenet of homeopathy is state dependency. That is, the direction of response to a given remedy depends on the condition of the host at the time of taking the medicine (a remedy can cause symptoms in a healthy individual, but relieve the same symptoms in a sick individual). Consistent with this claim, Bertani et al. (1999) showed in animals that a homeopathically prepared mixture of mineral remedies worsened carrageenan-induced paw edema when given prior to the experimentally induced injury but attenuated the edema when given after the injury had been established (Bertani, Lussignoli, Andrioli, Bellavite, & Conforti, 1999).

The use of extremely small, often submolecular, doses in homeopathic medicine, was in fact an afterthought of Hahnemann’s, in an effort to minimize the side effects of “physiological” doses. For over 20 years after Hahnemann developed the system of homeopathy, he only used material doses of medicines, until he and his colleagues began experimenting with even higher dilutions of their medicines and discovered more longlasting results requiring less frequent dosing. While not common in homeopathic practice, the possibility of employing “crude” doses is not inconsistent with homeopathic theory. Basic science studies increasingly indicate that succussion (vigorous shaking), juxtaposed with serial dilution, is essential to the preparation of active homeopathic remedies, and is key to activating persistent measurable changes in the physical chemistry and material science solvent properties (Elia & Niccoli, 1999, 2004; Elia, Napoli, & Germano, 2007; Rao, Roy, & Hoover, 2007; Rey 2003; Roy, Tiller, Bell, & Hoover, 2005).

Hahnemann practiced medicine in the early 1800s, but had a deep and radical understanding of cancer causation. He recognized that there was a genetic component to cancer, and understood the contribution of diet and chronic poisoning to the development of many cancers. However, Hahnemann also attributed great importance to past experience and mental and emotional states in the development of cancerous and precancerous conditions (Hahnemann, 1828). Indeed, most homeopaths today accept the centrality of mental symptoms to selection of the best-acting homeopathic medicine and their use in evaluation of the healing process.

In recent years, many environmental exposures have been associated with cancer. That smoking is a pervasive carcinogen can now be doubted by only the most cynical. Likewise, the carcinogenic effects of certain environmental pollutants are no longer subject to serious debate (asbestos, diethylstilbestrol (DES), radon). The carcinogenic effects of additional environmental exposures are now the subject of heated debate (dietary pesticides, low-frequency electromagnetic fields). However, homeopathic theory adds to this debate the concept of individual susceptibility. Indeed, for many if not most cancers, no environmental exposure is implicated, and the person is left with his/her genetic disposition (eg., breast cancer and BRCA-1). Though unproven, homeopathy aspires to decrease individual susceptibility, be it from genetic, environmental, or other causes.

Concurrent with his general abhorrence of local and cursory therapies, Hahnemann invoked the term “suppression” to describe yet another possible factor contributing to deep pathologies. Homeopathy theorizes that symptoms of acute illnesses represent the organism’s innate “best choice” defense mechanism and that suppression of this response, by strong pharmaceuticals or other means, reduces the overall integrity of the defenses, risking transmuting minor ailments into deeper and more serious pathologies, including cancers.

Modern complex systems and network science offers a rational basis for the concept of suppression. That is, every body part plays some role within the larger system; the organism as a whole. Systems biologists view the human being holistically as an indivisible, integrated, interdependent, and interactive complex system or network of component parts (http://www.systemsbiology.org/Intro_to_ISB_and_Systems_Biology/Systems_Biology_-_the_21st_Century_Science, accessed November 24, 2007). As numerous conventional (Barabasi & Bonabeau, 2003; Coffey, 1998; Goldberger et al., 2002) and CAM researchers (Ahn, Tewari, Poon, & Phillips, 2006; Bell, et al., 2002b; Bell & Koithan, 2006; Hyland & Lewith, 2002) have noted, because of the indivisibility and interconnectedness of subsystems within the person as a network, change in one local subsystem or part necessarily leads to changes distally throughout the rest of the network across levels of organizational scale (Vasquez, et al., 2004).

The nature of the change is nonlinear (i.e., the size of the output is disproportionate to the size of the input) and multiscale (i.e., manifest across different levels of organizational scale, large or global and small or local). The degree to which other parts of a network (organism) will change their behavior depends in a complex manner on the initial state of the organism (thereby accommodating the potential for state-dependent, bidirectional effects of the same agent), the role of the initially affected part within the organism as a whole (e.g., brain is more crucial to survival than a toe), and the strength of the functional interrelationships it has with remaining parts of the system (Brandt, Dellen, & Wessel, 2006). Endogenous (genetic, biochemical, nutritional, age, sex, biorhythm) and environmental individual difference factors that interact with the organism will affect whatever changes actually manifest.

In a biological system, treatments that effectively block functioning at one level of scale, that is, suppress expression of function (dysfunction) at a specific body part or local subsystem level, will have multiple hard-to-predict distal effects on other functions throughout the rest of the organism both globally (organism level) and locally (other body part or subsystem levels). The rest of the larger system must and will adapt to changes in the ability of any one of the parts to perform its customary role.

Thus, in systems biology, suppressive local treatment must inevitably produce major or minor clinical consequences by imbalancing other functions to a greater or lesser extent in the rest of the organism. Empirically, there are documented examples suggesting that the nature of the adaptations that the rest of the organism makes in response to effective local suppression may lead to serious emergent adverse clinical outcomes in other, arguably more important body parts, for example, increased risk of cardiac disease in certain patients treated with Cox-2 inhibitor drugs or lymphoma in patients treated with tumor necrosis factor alpha suppressing drugs for local inflammation of arthritic joints; type II diabetes mellitus in certain patients treated with newer generation antipsychotic drugs; or Clostridium difficile-associated diarrhea in patients treated with antibiotics and proton pump inhibitor drugs.

To understand the homeopathic approach to cancer treatment, we must first clarify that homeopathy does not purport to treat “cancer,” but rather “people with cancer.” This is not mere sophistry. Homeopathy aspires to affect an inanimate “vital force,” (the homeopaths’ term for the organism’s overall immune and defense system), by prescribing for the totality of symptoms (Hahnemann Organon, Aphorism 7), of which the cancer is but a part (see also Milgrom, 2002). Some consider homeopathy the ultimate “holistic” medicine, because it involves all levels of the individual—local, physical-general, emotional, and mental—in treating all maladies. In addition to this broad biologic approach, homeopaths also assess the person’s social and physical environment in search of “obstacles to cure.” Prescription is based upon the totality of a person’s physical and psychological characteristics, with the aim of inducing a curative reaction.

It would be prudent to reiterate that cancer is a deep and serious pathology, and no rigorous proof replicated by multiple independent researchers currently exists to support the contention that homeopathy alone can cure cancer. However, based upon our own professional experience, we believe it is reasonable to recommend homeopathy as an adjunct to conventional medical treatment for cancer, particularly in cases for which the efficacy of conventional treatment is limited, and as treatment for side effects and peripheral issues that arise during conventional cancer treatment.

Homeopathic Mechanisms of Action-1

Scientists at several universities and hospitals in France and Belgium have discovered that the vigorous shaking of the water in glass bottles causes extremely small amounts of silica fragments or chips to fall into the water (Demangeat, et al., 2004). These silica fragments or chips may help store the information in the water or possibly change the structure of the water, with each medicine that is initially placed in the water creating its own effect on water structure (Anick & Ives, 2007).

Homeopathic Mechanisms of Action-2

Microbubbles that are created by vigorous shaking may burst and thereby produce microenvironments of higher temperature and pressure. Several studies by chemists and physicists have revealed increased release of heat from water in which homeopathic medicines are prepared, even when the repeated process of dilutions should suggest that there are no molecules remaining of the original medicinal substance (Elia & Niccoli, 1999; Elia, et al., 2007; Rey, 2003).

Homeopathic Mechanisms of Action-3

Recent spectroscopic analyses have successfully differentiated one homeopathic medicine from another and one sub-Avogadro homeopathic potency from another (Rao, et al., 2007).

The Homeopathic Treatment of Cancer Patients

The evidence in support of the use of homeopathy as a primary treatment for cancer patients is generally weak, often conflicting, and inconclusive. Milazzo et al. (2006) recently reviewed the efficacy of homeopathic treatment in cancer and concluded that there was insufficient evidence to support the clinical efficacy of homeopathic therapy in cancer care. We proceed to present some of the more promising homeopathic research.

Curing Cancer

A remarkable study on Indian patients with brain tumors was performed in conjunction with the M.D. Anderson Cancer Center at the University of Texas. Fifteen patients diagnosed with intracranial tumors, nine of which were gliomas, were treated orally with Ruta graveolens (garden rue) diluted to 1/10¹² (6C) and Calcarea phosphorica (Calcium phosphate) 1/10³ (₃D)1. Eight of nine glioma patients showed complete regression of tumors. These patients were receiving no conventional anticancer therapy (Pathak, Multani, Banerji, & Banerji, 2003).

Four articles appearing in a single edition of Integrative Cancer Therapies demonstrate intriguing results of homeopathic treatment of prostate cancer. Sabal serrulata (saw palmetto) is the most popular complementary treatment for prostate pathology ranging from benign hyperplasia to carcinoma.

Jonas et al. (2006) injected 100 Copenhagen mice with a standardized dose of MAT-LyLu rat prostate cancer cells. From day 2, animals were given 100 μL daily of one of four homeopathic remedies in rotation (Thuja occidentalis 1000C, Conium maculatum 1000C, and Sabal serrulata 200C, and Carcinosin 1000C) or control water by oral gavage. Tumor volume was measured every 4 days. Animals treated homeopathically had a 23% decrease in tumor incidence, and significantly longer overall and tumor-free survival, as compared with controls. Tumor volume among tumor-bearing animals was 38% lower in the homeopathically treated group, and tumor weight was 13% lower than in the control group. In an attempt to elucidate mechanisms for this phenomenon, proliferating cell nuclear antigen (PCNA) was measured in tumor tissues of the two groups. There was a 6% reduction in PCNA-positive cells in the homeopathy-treated group as compared to control. Terminal deoxynucleotidyl transferase mediated D-uridine triphosphate nick end labeling (TUNEL) assay of tumor tissues demonstrated a significant 19% increase in apoptotic positive nuclei in the homeopathy-treated group as compared to control. Cell viability and apoptosis gene expression were not affected, as measured by MTT assay and rAPO-1 multiprobe, respectively. The authors concluded that, in this model, homeopathy slowed progression of cancer and reduced cancer incidence and mortality. However, the mechanism remains obscure.

Whereas this study did not elucidate specific antitumor activities of any one of the remedies under study, MacLaughlin et al. (2006) went on to investigate the specific activity of the individual homeopathic components. They assessed the in vivo antiproliferative effects of homeopathic preparations of Sabal serrulata, Thuja occidentalis, Conium maculatum, and Carcinosin, in nude mouse xenografts, and in vitro, on human prostate cancer as well as human breast cancer cell lines. Mice were inoculated subcutaneously with either PC-3 human prostate or MDA-MB-231 human breast cancer cell lines on both sides of the abdomen, and then treated daily for 5 weeks with either homeopathic Sabal serrulata (SS 200 CH) or homeopathic multitreatment (MT) including all four aforementioned remedies in series. Two control groups were employed, one without treatment and one with homeopathically prepared water. Tumors were measured with a caliper and mice were weighed weekly. Prostate tumor xenograft size was significantly reduced in Sabal serrulata–treated mice compared to untreated controls (P = 0.012). No effect was observed on breast tumor growth. Additionally, homeopathic multitreatment did not affect tumor size.

In the in vitro part of this experiment, androgen receptor–negative human prostate cancers DU-145 and PC-3, and human breast cancer MDA-MB-231 cell lines were treated with a variety of treatment regimens and potencies and measured for cell proliferation using crystal violet protein stain and for cell viability using MTT both at 24 and 72 hours after treatment. Treatment with Sabal serrulata in vitro resulted in a 33% decrease of PC-3 cell proliferation at 72 hours and a 23% reduction of DU-145 cell proliferation at 24 hours (P < 0.01). However a range of potencies of Sabal serrulata had no effect on breast cancer cell lines, suggesting the specificity of Sabal serrulata for prostate cancer cells. These findings remained robust after correcting for multiple comparisons (Amri H, personal communication).

In two studies directed at elucidating the cellular mechanism of these apparent anticancer effects, Thangapazham (2006a, 2006b) investigated the effect of various homeopathic medicines (including Sabal serrulata) on cell proliferation using the MTT assay, and on mRNA levels for apoptotic genes using RiboQuant multiprobe set rAPO-1. Homeopathic medicines showed no significant effect on growth and viability in three cell lines. These results would appear to conflict with the findings of MacLaughlin et al. (2006).

Symptom Management and Quality of Life in Cancer Patients

Homeopathy is frequently employed adjunctively to improve quality of life in cancer patients. To evaluate the efficacy of homeopathy in symptom control and its impact on mood and quality of life in cancer patients, Thompson and Reilly (2003) studied 100 consecutive patients at a cancer research clinic in the United Kingdom. Of 100 patients enrolled in the study, 81 had breast cancer, 39 had metastatic disease, and 9 had refused conventional cancer treatment. Patients were given a 60-minute consultation and a homeopathic prescription, followed by four to six follow-up visits over a period of 3 to 12 months (mean—6.7 months.) Up to three symptoms characterized by the patient as problematic were chosen as basis for comparison. As a baseline measure, the patients were asked about the effect of these symptoms on daily life and their overall sense of well being. Additionally, patients completed the Hospital Anxiety and Depression Scale, as well as the European Organization for Research and Treatment in Cancer Quality of Life Questionnaire (Core 30). These measures were taken again at follow-up visits. At conclusion of the study, patients completed a final assessment questionnaire asking about satisfaction with the homeopathic approach. Fifty-two patients completed the protocol. Satisfaction with treatment in this group was high, with 75% of these patients scoring 7 or higher on a 0–10 scale. Symptom scores for fatigue and hot flushes improved significantly during the study, as did the three primary symptoms the patients experienced. Further, the mean depression and anxiety scores also improved significantly, while the pain index showed a trend towards improvement. The study also found that 59% of the patients who completed the study measured an improved quality of life.

This study’s major limitations are its high drop-out rate and lack of a control group. However, it does seem to indicate a high level of satisfaction with homeopathic treatment and impressive rates of improvement in fatigue and hot flushes, at least among the 52% of patients who completed the study.

The same researchers conducted an observational study of 45 women with breast cancer who were being treated with homeopathic medicines as they were being withdrawn from estrogen usage (Thompson & Reilly, 2003). The most common presenting symptoms were hot flushes (38), joint pain (12), and fatigue (16). Each woman was prescribed an individually chosen homeopathic medicine. Forty women (89%) completed the study. The effect on “daily living scores” (the primary end-point of this study) showed significant improvement (P = 0.001). Significant improvements in anxiety (P = 0.013), depression (P = 0.039), and quality of life (P = 0.05) were also demonstrated, as were hot flushes, fatigue, and mood disturbance scores. It should be noted that 49% of the referrals came from the local oncology center, that 32 (55%) of the women were taking tamoxifen, and that 21 (48%) had undergone adjuvant chemotherapy. Twenty (44%) of the women were on other medications (11 on antidepressants and 3 on clonidine).

In a similar study, Jacobs et al. (2005) compared the efficacy of homeopathy treatment (both individualized remedies and a homeopathic “complex2”) with placebo in the treatment of hot flushes in menopausal breast cancer survivors. They found no difference in the hot flush severity score (primary outcome), but did find a statistically significant improvement in general health score (SF-36) in both homeopathy groups (P < 0.05) at 1 year.

Certain homeopathic medicines may be of use in reducing the side effects of radiation treatment. Clinical research suggests that homeopathic remedies may be beneficial in providing protection from side effects of radiation. To study the effect of homeopathic treatment on radiation-induced dermatitis, Balzarini et al. (2000) randomized 66 women undergoing post-surgical radiation therapy to either Belladonna 7C and X-ray 15C or placebo. Outcome was measured using a composite index of total severity score. This score evaluates breast skin color, warmth, swelling, and pigmentation. They found homeopathy superior to placebo in improving total severity during recovery, as measured by a composite score. There was a trend toward improvement during treatment, but this did not reach statistical significance.

The herbal and homeopathic ointment Calendula officinalis (marigold) was found significantly better than triethanolamine salicylate (Trolamine, the current standard of care) in preventing radiation-induced dermatitis. (Pommier, 2004) Two hundred fifty-four women receiving postoperative radiation treatment for breast cancer were randomized in a single-blind manner to receive either Calendula ointment or Trolamine. Calendula is commonly used in homeopathy, and in this study was given at herbal (crude) dosages. The ointments were applied to the breast after the first radiation session and twice or more daily, depending on the occurrence of dermatitis and pain. The incidence of acute dermatitis of grade 2 or higher was significantly lower (41% vs. 63%; P < 0.001) in the Calendula group. Patients given Calendula had fewer interruptions of radiotherapy because of skin toxicity (9 vs. 12 patients), and they had less radiation-induced pain (P = 0.03). Calendula was slightly more difficult to apply, but the overall satisfaction with its use was greater than with Trolamine.

Schlappack (2004) studied 25 patients who were treated homeopathically for radiation-induced itching. Fourteen of these patients had developed itching during postoperative radiation and 11 after completion of radiotherapy. A single dose of an individually selected homeopathic medicine diluted to 1/10⁶⁰ (30CH) was given in the clinic. Patients used a visual analogue scale (VAS) of severity of itching at baseline and at follow-up. Patients were evaluated at a median of 3 days (range: 1–27 days) after administration of the homeopathic medicine. In total, 14 of the 25 patients (56%) responded to the intervention. Nine of the remaining patients were prescribed a second medicine, to which seven responded. Altogether 21 of 25 (84%) patients improved under homeopathic treatment. The VAS measurements before and after homeopathic treatment showed a reduction from a median of 64 mm (range: 20–100 mm) to 34 mm (range: 0–84 mm). The most frequently effective medicine was fluoric acid in homeopathic dilution (Schlappack, 2004). This study lacked a control group; however, the prescription and represcription design of the study reflects the real-life trial and error conditions under which many homeopathic prescriptions are made.

Stomatitis is another troublesome and often treatment-limiting side effect of cancer therapy. It has been purported that the homeopathic medication Traumeel S may reduce the severity and duration of chemotherapy-induced stomatitis in patients undergoing bone marrow transplantation. Thirty patients between the ages of 3 and 25 years who had undergone allogeneic (n = 15) or autologous (n = 15) stem cell transplantation were randomly assigned to receive either Traumeel S or an indistinguishable placebo. Patients were instructed to rinse their mouths with their allocated medication five times daily for a minimum of 14 days or until all signs of stomatitis were absent for at least 2 days. At treatment conclusion, mean stomatitis scores were lower in the homeopathy group than in the placebo group (P < 0.01). Five patients (33%) in the Traumeel S group did not develop stomatitis at all, as compared to one patient (7%) in the placebo group (P = 0.01). Stomatitis worsened in only seven patients (47%) in the Traumeel S group compared with 14 patients (93%) in the placebo group (P = 0.001) (Oberbaum, 2001). This study suggests that a homeopathic medication is superior to placebo in preventing and treating stomatitis in stem cell transplantation patients.

In addition to clinical studies testing the efficacy of Traumeel S in humans, laboratory research also indicates that this homeopathic medicine may affect the behavior of immune cells, lending credence to Traumeel’s anti-inflammatory effects. T cells, monocytes, and gut epithelial cells were treated with Traumeel S and exposed to PHA-, PMA- or TNF. Secretion of IL-1β, TNF-α, and IL-8 was measured over a period of 24 to 72 hours. Traumeel S was found to inhibit pro-inflammatory mediators IL-1β, TNF-α, and IL-8 by 54% to 70% as compared with untreated cells. The effect was paradoxically inversely dose related, countering claims that the effects of this remedy may be cytotoxic in nature (Porozov, 2004).

Conclusion

Until recently, most clinical studies relating to the homeopathic treatment of cancer patients had been of low quality and relegated to publications outside the mainstream medical literature. Recent years have seen a quantum leap in both the quantity and quality of research. Despite this fact, a critical mass of research has not been reached that would allow firm conclusions to be drawn. Judging the state of homeopathic cancer-related research against the hierarchy of study methods for clinical decision making (Guyatt, et al., 2000), we conclude that homeopathic research still has a long way to go. Most of the research we present is at the level of basic science, with promising, though not definitive, evidence in favor of homeopathic remedies in certain animal and cell models of cancer. The observational and controlled study data are also encouraging, though not universally positive, in support of homeopathic remedies as adjunctive cancer care and for palliation. Randomized and blinded clinical trials exist demonstrating the efficacy of homeopathy in treating side effects of cancer therapy, but to date these suffer from either small sample sizes, inadequate controls, or borderline statistical significance. One small but remarkable study demonstrated apparent cure of glioma in eight of nine cases using homeopathy alone (Pathak, et al., 2003). We would await indubitable reproduction of these results before drawing overly optimistic conclusions.

The field of homeopathic research in cancer treatment requires independent replication studies with larger sample sizes, as well as investigation of individual variations in responsiveness to distinguish potentially good versus poor responders, a pressing concern for much of complementary and alternative medicine (CAM) research (Bell, Baldwin, & Schwartz, 2002a; Caspi & Bell 2004a, 2004b). Until further evidence of the efficacy of homeopathy in cancer treatment becomes available, patients should be warned of the danger of opting for homeopathic treatment in lieu of proven conventional therapies. However, homeopathy may be a useful adjunct in treating cancer treatment side effects, and may improve patients’ moods and quality of life. Many homeopaths balk at prescribing homeopathically for patients receiving conventional cancer therapies, particularly those as aggressive as radiation or chemotherapy. However, we believe integration of these therapies should be encouraged. Homeopathy may be of benefit to cancer patients, even in conjunction with aggressive cancer protocols. Moreover, homeopathic remedies historically do not interact adversely from a pharmacodynamic or pharmacokinetic perspective with conventional cancer treatment drugs, in contrast to some nutritional and botanical supplements.

In summary, the literature we have reviewed does not offer convincing evidence to support the contention that homeopathy is currently a reasonable alternative to conventional cancer therapy. However, from an integrative medicine perspective, the evidence favors further testing of homeopathy as one component in an overall cancer treatment program, including prevention or mitigation of chemotherapy and radiation therapy side effects and support of patient well-being during these stressful life events. Until the body of researchers allows different conclusions, we believe homeopathy’s place in cancer therapy must be as an adjuvant, rather than alternative, to conventional cancer therapies.

REFERENCES

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MacLaughlin BW, Gutsmuths B, Pretner E, Jonas WB, Ives J, Kulawardane DV, et al. (2006). Effects of homeopathic preparations on human prostate cancer growth in cellular and animal models. Integrative Cancer Therapies, 5, 362–372.

Milazzo S, Russell N, & Ernst E. (2006). Efficacy of homeopathic therapy in cancer treatment. European Journal of Cancer (Oxford, England, 42(3), 282–289. Oberbaum M, Yaniv I, Ben-Gal Y, et al. (2001). A randomized, controlled clinical trial of the homeopathic medication Traumeel S^® in the treatment of chemotherapy- induced stomatitis in children undergoing stem cell transplantation. Cancer, 92(3), 684–690.

Pathak S, Multani AS, Banerji P, & Banerji P. (2003). Ruta 6 selectively induces cell death in brain cancer cells but proliferation in normal peripheral blood lymphocytes: A novel treatment for human brain cancer. International Journal of Oncology, 23(4), 975–982.

Pommier, P, et al. (2004) Phase II randomized trial of calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer, Journal of Clinical Oncology, 22, 1147–1453.

Porozov S, Chalon L, Weiser M, et al. (2004). Inhibition of IL-1beta and TNF-alpha secretion from resting and activated human immuncytes by the homeopathic medication traumeel S. Clinical & Developmental Immunology, 11(2), 143–149.

Schlappack O. (2004). Homeopathic treatment of radiation-induced itching in breast cancer patients. A prospective observational study. Homeopathy: The Journal of the Faculty of Homeopathy, 93(4), 210–215.

Thangapazham RL, Rajeshkumar NV, Sharma A, Warren J, Singh AK, Ives JA, et al. (2006b). Effect of homeopathic treatment on gene expression in Copenhagen rat tumor tissues. Integrative Cancer Therapies, 5, 350–355.

Thompson EA & Reilly, D. (2002). The homeopathic approach to symptom control in the cancer patient: a prospective observational study. Palliative Medicine, 16(3), 227–233.