Clark Stanley claimed that his snake oil cured almost all evils. He sold them for fairs in several North American cities at the end of the 19th century. In the labeling of his ointments he enumerated the bonanzas of his oil: it was good for a bruise, lumbago, a sore throat or an animal bite, among other sorrows. "Immediate relief. It's good for everything a liniment should be good, "read the prospect. But, in truth, it was not good at all. Stanley was one of the great bastions of charlatanism. In fact, the expression snake oil in English (snake oil) is still used today to mention something deceptive or of a quality or benefit difficult to verify. At the congress of the European Society of Medical Oncology (ESMO, for its acronym in English) held two weeks ago in Munich that term was also used to present a paper on the risks of pseudotherapies.
"The characteristics of the pseudosciences They are: bizarre theories, abuse of science, use of fallacies and false claims, "Dr. Edzard Ernst, of the Peninsula Medical School (United Kingdom), was speaking during his presentation at the ESMO congress, which this journal was invited by the company Roche. The doctor, expert in the study of alternative medicines, shelled, sarcastic, the partial results of some scientific studies that supposedly validated the efficacy, for example, of homeopathy, a discipline with 200 years of life and that It has not yet been able to demonstrate any healing potential beyond the placebo effect. European oncologists warned that alternative or complementary therapies are not always safe and are not free of risks.
During the congress, a study was presented that analyzed, precisely, the use of alternative therapies in a group of patients with sarcoma. The researchers included in the group of this alternative or complementary medicine a kind of vitamin supplements, homeopathy, acupuncture, yoga, tai chi and some special diets (vegans, for example), among others. 15% of the patients included in the study used some of these therapies during their illness and 24% admitted to resorting to naturopathic treatments assiduously. The majority claimed to use these therapies to strengthen the immune system and the body, to "leave nothing unattended" or to "reduce tension and stress," among other explanations.
The researchers detected, however, a low perception of the risk that these practices can pose, some of which may interact with conventional treatment and reduce the benefit of medical therapy. 60% of patients admitted, in fact, that the information about the safety problems of these alternative treatments was insufficient, but they also did not show concern about the risks. "When we looked at the sources of information about these unconventional practices, oncologists only accounted for 7%," says Dr. Peter Hohenberger, supervisor of the study. The Internet is the main source of information for 43% of the patients consulted in the study.
"What you have to promote is that there is more information, that patients are aware because this can be harmful," says Dr. Tabernero
"When he receives chemotherapy, the patient asks about the side effects and you have to explain everything that can happen. On the other hand, the knowledge that patients have of the side effects, of how it has been concluded that these treatments can be effective or not, is null. In a serious country like Switzerland, where the patients demand a lot, in the part of the medicines they knew everything and in the part of alternative medicines, they did not know anything, neither the mechanism of action by which the vitamin C and the D, the hyperproteic diet, it worked. There is a lack of knowledge, and what we can do is promote this knowledge, "says Dr. Josep Tabernero, president of ESMO and head of the Vall d'Hebron Institute of Oncology (VHIO) in Barcelona.
The oncologists insisted that Not everything natural is innocuous. "Patients tend to believe that supplements or herbs are generally safe, but they are not without risks. In daily practice, if you do not know what your patient is taking as an alternative medicine, the risk of drug interactions can increase significantly. It has an impact on clinical outcomes, "warned Dr. Markus Joerger of the Cantonal Hospital in Sant Gallen, Switzerland.
Interactions between treatments
In line with the possible interactions between drugs, the scientific congress also hosted the presentation of a retrospective study that measured the pharmacological interferences of alternative therapies with conventional therapies. The research, also in patients with sarcoma, included 202 patients who underwent chemotherapy or tyrosine kinase inhibitors between 2014 and 2018. Scientists detected 18% of important drug interactions. "We know from previous research that one in three outpatients with cancer is susceptible to possible drug interactions," said Dr. Audrey Bellesoeur of the University of Paris Descartes (France), lead author.
The researchers found more interactions in those patients who were receiving tyrosine kinase inhibitors and, of all the detected interference 29% were associated with alternative medications. "The risks of interactions with non-conventional medicines are the same as for other shared medications: mainly, greater toxicity and loss of efficacy of cancer treatments. However, we often have less information about the composition of these products and their risk of toxicity or interaction when used in combination with other agents, "said Bellesoeur.
Tabernero admitted that, as a scientific society, they have little room to maneuver to combat the risks posed by some pseudotherapies. "What you have to promote is that there is more information, that patients are aware because this can be harmful. We do not have any executive power. What we can do is educate, promote knowledge ", argued the president of ESMO. Tabernero refuses, however, to criminalize all non-conventional therapies. "This does not mean that all alternative medicine is not favorable. Acupuncture in some patients works wonders to control pain, anxiety … But acupuncture does not cure cancer. But it helps to bring the disease better and all this must be integrated. You have to be receptive, but always with evidence. We have to look for the evidence, because if not, we are lost, "he warned.