The Temptation of Alternative "Medicine"

By Michael Edmonds 16/02/2012 22


The last couple of days I’ve been feeling a bit chesty with a bit of a cough. From experience, I know if I went to my doctor he would probably say there isn’t much he can do and that I should drink plenty of fluids, eat healthy and get plenty of sleep.

This is very frustrating. It would be much more satisfying to do something more active to shake off this cough – take a tablet or employ some sort of treatment. However, modern medicine provides no effective cure for a mild cough, and doctors readily admit this.

This is where alternative “medicine” fills the void. For those who want to feel they are actively engaged in treating their illness there are hundreds of options to pop vitamin pills, drink “magic” water and take other remedies. And for those who choose such remedies, once the illness has run it’s natural course, they may incorrectly assume their recovery was due to the remedy they selected, instead of realising it was their own body’s defenses that have fought of the disease.

And the temptation to look for alternative treatments can be much more pressing for those with life threatening diseases for which modern medicine provides no easy solutions. Such is the case of Jessica Ainscough, 26, who diagnosed with epithelioid sarcoma has embarked on Gerson therapy which involves “drinking 13 fresh organic veggie juices per day … five coffee enemas per day and a basic organic whole food plant-based diet with additional supplements.”

In such cases, I find it hard to criticize someone who is vigorously looking for a way to hang on to life. I would however suggest that anyone considering such treatments think about the following:

  • does conventional medicine provide opportunities which evidence shows is more likely to work?
  • is there any evidence that the alternative therapy might work (apart from anecdotal evidence). Remember that remission can occur naturally for a small percentage of patients with many types of cancer. For a treatment to be demonstrated to be successful, it needs to work for a greater % of patients than the natural remission rate.
  • does the alternative therapy have significant personal and financial costs? Is it worth paying thousands of dollars for supplements or undergoing 5 enemas a day?
  • is there any evidence that the therapy might cause harm? (what effect, for example, will 5 enemas a day have on the colon?
  • How will you recognize any curative effects?

Ms Ainscough has decided that the treatment has worked for her in that “I have had no cancer spread, no more lumps pop up (they were popping up rapidly before) and I can actually see some of my tumours coming out through my skin and disappearing.”

But has this observation been confirmed by a doctor? It is not unknown for patients to observe “improvements” in their condition that is simply wishful thinking.

Cancer is a terrifying disease that can push patients towards alternative “medicine” if they become frustrated with the limitations of conventional medicine. However, it is important to realise that the limitations of conventional medicine exist because they have been studied carefully. Alternative “medicines” have often not been studied at all, and repeatedly fail to provide any evidence that they work. With some therapies costing thousands and thousands of dollars and causing the patients much discomfort, it is reasonable to ask – what is their value?


22 Responses to “The Temptation of Alternative "Medicine"”

  • It’s the coffee enemas part that gets me. I can’t see how 5 of those a day can do much for your quality of life.
    What you describe sounds akin to the Gonzalez protocol that Orac wrote about a year or so back. Somehow that got to a clinical trial on patients with pancreatic cancer. It did markedly worse than the gold-standard chemo treatment in terms of both life expectancy & quality of life.

  • Alison,
    Thanks, I was trying to remember the name of that protocol. How sad that those on the protocol not only had to put up with the cost of the supplements and the discomfort of the enemas but the also ended up living for a shorter period of time than the chemo group.

    What is it with the obsession of “natural” therapies with shoving things up the posterior to make people feel “better”? What is natural about shoving coffee grinds up there?

  • The coffee enemas have, prior to the research of Dr. Gerson, shown to stimulate the liver to process toxins from the body. “Modern medicine,” i.e. those mainly supportive of pharmaceutical technology, will not discuss this matter. However, this article is showing the beginning of attention to how that there is benefit to colonic cleansing: http://www.foodmatters.tv/_webapp_516269/Colon_Hydrotherapy_-_The_Therapy_that_Even_Doctors_are_Recommending.

  • Michael, you are clearly aware that you are not “shoving coffee grinds up there” but the brewed coffee. Coffee has a vastly different result in the colon for the liver than when drank orally. You don’t have to take my word for it, however, just go do a search on “coffee enemas and liver detox.” Just because this is new to you doesn’t mean it’s hogwash.

  • Well, what’s ‘natural’ about needing to take large quantities of supplements in the form of tablets & capsules? (Rhetorical question!)

  • Elizabeth

    Thank you for clarifying that. Not sure why I thought solid particles were involved, that really doesn’t make sense does it?

    Perhaps you could clarify what the “vastly different result” is that comes from colonic application of coffee and how flushing your colon with coffee affects the liver.

    Unfortunately a “search” of coffee enemas and liver detox doesn’t really rate particularly highly with me as evidence for it’s effectiveness. I’d much rather see scientific evidence.

    I find it extremely ironic that most “detox” treatments talk about coffee as one of the substances that toxify the body yet you seem to believe that flushing coffee up people’s bums has some sort of benefit. Perhaps you can clarify how this works along with evidence to support it.

    The term “detox” is bandied around by various “therapies” for which there is no evidence that they work. Most medical professionals will suggest that the best way to “detox” the body is to eat healthily, drink lots of water and get plenty of rest. Anything else is just unsubstantiated hype.

    I’ve already had advertising standards authority complaints upheld against some detox therapies, perhaps I should widen my scope a little morer?

  • Elizabeth,

    The website you provided the link to provides no evidence that coffee enemas have any proven benefits it is just the advertising rhetoric of what seems to be a very commercially motivated site.

    And indeed it only talks about colonic HYDROTherapy which surely means flushing with water, not coffee?

    What doctors are “recommending” these sorts of therapy? There is no evidence for this rather bold statement.

    The list of “benefits” of colonic hydrotherapy also sound quite dubious. Is there any evidence to show that pounds of fecal matter get stuck for long periods of time in the colon?

  • Hi Elizabeth

    As an example of what we tend to respect here as evidence, here is an excerpt from wikipedia which provides a range of scientific references which support the idea the coffee enema show no beneifts and can cause harm

    “Some proponents of alternative medicine have claimed that coffee enemas have an anti-cancer effect by “detoxifying” metabolic products of tumors.[4] There is no scientific evidence to support any anti-cancer effect of coffee enemas.[2][5][6]

    Coffee enemas can cause numerous side effects, including infections, severe electrolyte imbalance, colitis, polymicrobial enteric septicemia and heart failure.[4][6][7][8][9][10] If the coffee is inserted too quickly or is too hot, it could cause internal burning[11] or rectal perforation.[12] The use of coffee enemas has led to several deaths as a result of severe electrolyte imbalance.[8]

    [edit] References1.^ Ernst E (June 1997). “Colonic irrigation and the theory of autointoxication: a triumph of ignorance over science”. J. Clin. Gastroenterol. 24 (4): 196–8. doi:10.1097/00004836-199706000-00002. PMID 9252839. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0192-0790&volume=24&issue=4&spage=196.
    2.^ a b Shils ME, Hermann MG (April 1982). “Unproved dietary claims in the treatment of patients with cancer”. Bull N Y Acad Med 58 (3): 323–40. PMC 1805327. PMID 7052177. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1805327.
    3.^ a b Moss, Ph.D., Ralph W. “The Cancer Chronicles” 2nd ed. Austin, Texas: 1994. (6-7)
    4.^ a b Lee, C.; Song, S.; Jeon, J.; Sung, M.; Cheung, D.; Kim, J.; Kim, J.; Lee, Y. (2008). “Coffee enema induced acute colitis”. The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 52 (4): 251–254. PMID 19077527. edit
    5.^ Cassileth B (February 2010). “Gerson regimen”. Oncology (Williston Park, N.Y.) 24 (2): 201. PMID 20361473.
    6.^ a b “Colon Therapy”. American Cancer Society. 2008-01-11. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/ManualHealingandPhysicalTouch/colon-therapy. Retrieved 2011-05-13.
    7.^ Margolin, K.; Green, M. (1984). “Polymicrobial enteric septicemia from coffee enemas”. The Western journal of medicine 140 (3): 460. PMC 1021723. PMID 6710988. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1021723. edit
    8.^ a b Eisele, J.; Reay, D. (1980). “Deaths related to coffee enemas”. JAMA : the journal of the American Medical Association 244 (14): 1608–1609. doi:10.1001/jama.244.14.1608. PMID 7420666. edit
    9.^ Keum, B.; Jeen, Y. T.; Park, S. C.; Seo, Y. S.; Kim, Y. S.; Chun, H. J.; Um, S. H.; Kim, C. D. et al (2010). “Proctocolitis Caused by Coffee Enemas”. The American Journal of Gastroenterology 105 (1): 229–230. doi:10.1038/ajg.2009.505. PMID 20054322. edit
    10.^ “Livingston-Wheeler Therapy”. Memorial Sloan–Kettering Cancer Center. 2011-05-09. http://www.mskcc.org/mskcc/html/69283.cfm. Retrieved 2011-05-13.
    11.^ Sashiyama, H.; Hamahata, Y.; Matsuo, K.; Akagi, K.; Tsutsumi, O.; Nakajima, Y.; Takaishi, Y.; Takase, Y. et al (2008). “Rectal burn caused by hot-water coffee enema”. Gastrointestinal Endoscopy 68 (5): 1008–1009. doi:10.1016/j.gie.2008.04.017. PMID 18657805. edit
    12.^ Paran, H.; Butnaru, G.; Neufeld, D.; Magen, A.; Freund, U. (1999). “Enema-induced perforation of the rectum in chronically constipated patients”. Diseases of the colon and rectum 42 (12): 1609–1612. doi:10.1007/BF02236216. PMID 10613482. edit

  • Elisabeth,

    There’s a really simple way to see if the coffee enemas have the effect that is claimed in reducing “toxins”.

    Let’s measure blood levels of the “toxins” before and after the enemas. That will show any changes.

    Unfortunately, the people advocating both Gerson and Gonzales protocols will not name the “toxins”. Could you enlighten us on the reason? Otherwise it gives the impression that they are hiding that there is no effect on “toxins”. After all, that’s what science has so far found.

  • Elizabeth, perhaps you could elaborate on where the studies showing benefit for coffee enemas are.
    I did a search on PubMed (where such studies would be expected to be collected) for “Coffee enemas liver” and got precisely three results, two of which were critical, the third was over thirty years old and questionable.

    The abstract on one is worth quoting in it’s entirety:

    “Oncology (Williston Park). 2010 Feb;24(2):201.
    Gerson regimen.
    Cassileth B.
    Source

    Integrative Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
    Abstract

    The Gerson regimen, developed by Max Gerson in the 1930s, is promoted as an alternative cancer treatment. It involves consuming fresh, raw fruit and vegetable juices, eliminating salt from the diet, taking supplements such as potassium, vitamin B12, thyroid hormone, pancreatic enzymes, and detoxifying liver with coffee enemas to stimulate metabolism. Gerson therapy is based on the theory that cancer is caused by alteration of cell metabolism by toxic environmental substances and processed food, which changes its sodium and potassium content. It emphasizes increasing potassium intake and minimizing sodium consumption in an effort to correct the electrolyte imbalance, repair tissue, and detoxify the liver. The coffee enemas are believed to cause dilation of bile ducts and excretion of toxic breakdown products by the liver and through the colon wall. None of these theories has been substantiated by scientific research. Despite proponents’ claims of recovery rates as high as 70% to 90%, case reviews by the National Cancer Institute (NCI) and the New York County Medical Society found no evidence of usefulness for the Gerson diet. An NCI-sponsored study of Gonzalez therapy, which is similar to the Gerson diet, showed that patients with inoperable pancreatic adenocarcinoma who underwent standard chemotherapy with gemcitabine (Gemzar) survived three times longer and had better quality of life than those who chose enzyme treatment, which included pancreatic enzymes, nutritional supplements, detoxification, and an organic diet.”

    To echo Michael, the concept of “Detox” as used by alternative practitioners and the general public is medically worthless. The alleged “toxins” tend to be vague and the mechanism of removal implausible.

  • western cancer treatments are a racket. most don’t die from the cancer but the treatments. surgery, radiation & chemo. a year doing one, then the next. each making you sicker. alternative therapy is not an option here. if you choose that path you are on your own. western treatments are measured and recorded… alternatives are not. the cancer money train is flying.

  • Sherry, WTF??
    Got ANY evidence of this assertion?
    I can dig up charts of cancer survival rates improving over recent decades if you like, due to what if not “western” cancer treatment?

  • And alternatives aren’t recorded?
    seems nobody told these guys:
    http://onlinelibrary.wiley.com/doi/10.1111/j.1524-4741.2006.00340.x/abstract

    “The totality of the data fails to show a single intervention that would be demonstrably effective as an ACC. The paucity and the often-low methodological quality of the RCTs are as unexpected to us as they are disappointing. Most trails had small sample sizes; thus a type II error is conceivable. But even if this were true, one would be correct in stating that to date, no effective ACC has been identified.”

    extract from:
    http://www.sciencebasedmedicine.org/index.php/the-use-of-alternative-medicine-and-mortality-from-breast-cancer/

    Or these guys:
    http://www.ncbi.nlm.nih.gov/pubmed/12565991?dopt=Citation

    Abstract:
    “This study examines the association between alternative medicines (AM) and cancer survival. A national multicentre study was carried out in Norway in December 1992 to assess the prevalence of AM use among cancer patients. One of the aims of this study was to assess the association between AM and long-time survival. In January 2001, survival data were obtained with a follow-up of 8 years for 515 cancer patients. A total of 112 (22%) assessable patients used AM. During the follow-up period, 350 patients died. Death rates were higher in AM users (79%) than in those who did not use AM (65%). In a Cox regression model adjusted for demographic, disease and treatment factors, the hazard ratio of death for any use of AM compared with no use was 1.30, (95% Confidence Interval (CI) 0.99, 1.70; P=0.056), suggesting that AM use may predict a shorter survival. Sensitivity analyses strengthened the negative association between AM use and survival. AM use had the most detrimental effect in patients with an ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 (hazard ratio for use=2.32, 95% CI, 1.44, 3.74, P=0.001), when compared with an ECOG PS of 1 or higher. The use of AM seems to predict a shorter survival from cancer. The effect appears predominantly in patients with a good PS.”

    highlighted a few relevant parts there for you.

  • western treatments are measured and recorded… alternatives are not.
    And the obvious question here is, why not? If ‘alternative’ practitioners want their ‘treatments’ to be taken seriously, then an excellent way to get recognition for what they’re doing would be to actually keep actual records of what they’re doing & how their patients respond. Preferably in a randomised controlled manner, but a series of well-documented case studies would be a good place to start. “But there’s no money for doing this” is not really a good excuse as the supplements industry is a significant player & generates a significant income for the manufacturers of the various ‘remedies’.

    You’re also doing a grave disservice to some highly skilled & dedicated doctors, nurses & scientists, Sherry, with your implication that those involved in researching & providing cancer treatments are in it only for the money. And as Darcy points out, you’re also wrong.

  • Seriously, Sherry if you are going to comment here, some actual facts would be appreciated.
    Conventional cancer treatments have been studied to make sure they work. And while some have side effects and others may not cure all cases we at least know they a worth using.
    I recently sat through an oncology consult with a friend. Over the 1 hour the doctor gave all the treatment options, the probability that each is likely to work, side effects and the various options.
    I was thoroughly impressed with the doctors knowledge, empathy and honesty.

    Most alternative therapies claim that they will work if the patient “believes” enough. Thus when the evidence proves they do not actually work they claim the patient didn’t believe enough. This is just plain wrong.

    Perhaps instead of running down treatments we know work, and the good doctors and other medical professionals who work so hard to heal patients, you should focus on trying to prove alternative therapies work.

    Of course it is rather obvious why you a unable to do this.

  • Sherry,

    Cancer is a killer disease. Without treatment, almost all people with cancer will die of the cancer.

    With treatment, about half of people with cancer will be cured of cancer. The exact proportion is slowly increasing and we do better at curing children than curing adults.

    The people you think die of chemotherapy or radiotherapy die of *CANCER*, no more, no less. Even though they die of the cancer they usually get extra life to spend with their loved ones that they would not have had if they did not receive the treatment.

    You are correct that alternative “therapy” is not an option, simply because it does not treat the cancer.

    You appear to think that chemotherapy does not work. I have two words – Lance Armstrong.

    For other modalities I would refer you to my own child. Diagnosed very late, their treatment began *after* cardiac arrest from the cancer. They started surgery after they had stopped breathing and inotropes were being used to keep their heart beating.

    Now that child is a young adult, full time university student, with a completely normal social and sporting life. Regular MRI, including this year, shows that they remain cancer free. I find it interesting that one of the earlier commenters has actually taught this young adult at university, but I don’t think that they are aware of it.

    The treatment of this child and Lance Armstrong followed guidelines, found in the peer reviewed journals, that were developed by clinicians and researchers over many years.

    No one who practices alternative therapy, CAM, integrated medicine (call it what you will) has even one case that matches either of these two, especially in the form of documentation. If alternative therapy had been tried on either they both would have died years ago. Now they both have full lives to look forward to.

    You can keep your “alternative therapy”. Let me have the stuff that works.

  • If it wasnt for alternative medicine (IV vitamin c) as for the case of the waikato farmer with swine flu then i guess that he wouldnt be alive today. Dont get me wrong the hospital did an excellent job of keeping him alive however it wasnt until he was given intravenous vitamin c that he made the turn for the better and recovered.

  • Jim,
    It is not clear that it was the IV vitamin C is what produced the change in the case you describe (although it is a possibility). One instance of using a therapy under non controlled conditions isn’t enough evidence. It would be interesting to see a more comprehensive trial run.

    With regards to “alternative” therapies vitamin C is one that sort of hovers in the middle – more research would help decide how effective it might be. Unlike other therapies which repeatedly fail to provide evidence such as homeopathy and faith healing

  • Looks like Jess’ case is a moot point as she has recently cancelled conference appearances, citing her condition becoming “aggressive” Her cancer is running its natural course, despite everything she has done.

  • She has now returned to conventional medicine after bleeding non stop from her arm pit for a year. I guess she just was not positive enough or something.