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"CAM-Cancer" is the name of a project entitled "Concerted Action for Complementary and Alternative Medicine Assessment in the Cancer Field" (CAM-Cancer). Originally funded by the European Commission (EC) within the Framework 5 Programme, it is now hosted by the National Information Center for Complementary and Alternative Medicine (NIFAB) at the University of Tromsø, Norway.
Written by Edzard Ernst and the CAM-Cancer Consortium.
Updated November 1, 2011

Homeopathy in cancer

  • Abstract and key points
  • What is it?
  • Does it work?
  • Is it safe?
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Abstract and key points

  • Treatment with highly diluted substances based on the similia principle
  • The evidence for homeopathy in oncology is not convincing
  • There are few risks associated with homeopathy

Homeopathy is a system of medicine based on the similia (‘treating like with like’) principle. It usually entails taking highly diluted remedies by mouth. Homeopaths claim to treat the individual patient holistically such that the body is stimulated to heal itself. Homeopathy is thus advocated for all human conditions, in oncology mostly for palliative and supportive care.

A systematic review of 8 controlled clinical trials of homeopathy for the prevention or treatment of adverse effects of cancer treatments concluded that the evidence is not convincing.

There are no serious direct risks associated with homeopathy but there are indirect risks, if homeopathic preparations are used in place of conventional cancer treatment.

What is it?

Homeopathy is a system of medicine based on the similia (‘treating like with like’) principle. It usually entails taking highly diluted remedies by mouth.

Scientific name

Homeopathy (or homoeopathy)

Ingredients

Homeopathic remedies are frequently made from natural substances, e.g. plants or minerals, but in principle they can originate from any material (e.g. Berlin Wall remedy) or even non-material sources (e.g. X-ray remedy).

Application and dosage

Homeopathy is defined as “a therapeutic method using preparations of substances whose effects when administered to healthy subjects correspond to the manifestation of the disorder in the individual patient”.1 In other words it is based on the similia principle which states that “substances may be used to treat disorders whose manifestations are similar to those which they will themselves induce in a healthy subject (Similia similibus curentur = ‘let like be cured by like’).1

Homeopathic preparations are produced through a process of serial dilution and succussion/shaking (potentisation) of the “mother tincture”. Preparations are available in a range of dilutions, from low dilutions where the original substance is measurable, to extremely high dilutions in which it is unlikely that a single molecule of the original substance remains. Homeopathic potencies are designated by a number and a letter. The number refers to the number of successive serial dilutions to which the starting material has been subjected. The letter refers to the scale used, the decimal (D or X) and centesimal scales (C) being those most widely used. In the decimal method a 1 in 10 dilution is used at each stage while in the centesimal method a 1 in 100 dilution is used in successive stages.1

They are usually prescribed on a highly individualized basis; ideally, the totality of the patient’s complaints should match the “drug picture” of the remedy which has been defined in so-called “provings”, i.e. homeopathic pathogenetic trials. These are studies which test a substance at a non-toxic level on healthy volunteers to determine the symptoms it provokes and which, according to the similarity principle, it may be used to treat.2

Today, there are several variations of homeopathy as described above e.g. isopathy (homeopathically diluted remedies derived from the causative agent of the disease itself), or homotoxicology (illness is understood as the body’s inability to effectively cope with its burden of toxins), or complex homeopathy (combination of two or more homeopathic medicines in a standard mixture), or clinical homeopathy (one or more single remedies for standard clinical situations).1

History/Providers

Homeopathy was developed by the German doctor Samuel Hahnemann (1755-1843) and became popular, first in Europe, then also in a wide variety of countries around the world, especially in the US, India and South America. When more and more effective pharmacological treatments were discovered, the popularity decreased. Recently, it has experienced somewhat of a renaissance in parallel with the growing interest in CAM.

Today homeopathy is practised both by doctors, other health professionals and by lay homeopaths (or “professional homeopaths”). The former two groups are statutorily regulated by their professional bodies, while the latter are often not regulated. In the UK, for example, anyone regardless of background can currently practise as a homeopath. Homeopathic preparations can be prescribed by a homeopath during a consultation but can also be purchased from health food shops, some pharmacies or online suppliers.

Claims of efficacy

Homeopaths believe that homeopathic remedies stimulate the body’s own healing powers (vis medicatrix naturae), i.e. the inherent ability of an organism to overcome disease and disorder and regain its health.1 Therefore, Hahnemann viewed homeopathy as a “cure all”.2 Today it is mostly advocated as a treatment or prevention of chronic conditions and often administered as an adjunctive treatment.3

Mechanism of action

No biologically plausible mechanism of action is known. A 2007 systematic review of in-vitro research on high potency effects found that “no positive result was stable enough to be reproduced by all investigators”; however “even experiments with high methodological standard could demonstrate an effect of high potencies”.4 The fact that homeopathic preparations “may exhibit specific physiochemical properties”5 does not mean that a mechanism of action has been identified.

Alleged indications

In oncology, homeopathy is mostly used as palliative and supportive care to improve quality of life, to ease or prevent the adverse effects of treatments, or to alleviate or prevent the symptoms of the cancer.

Prevalence of use

This depends crucially on the country and the setting. For instance, homeopathy is popular in France 6, Italy 7 and Germany 8. Some European centres are specialized and use homeopathy for the majority of cancer patients. Elsewhere, it would not be used at all or only very rarely.

Legal issues

Non-doctor homeopaths are in many countries not regulated by statute. In some countries, they are not officially allowed to practise but usually this is not enforced. In some countries, e.g. the UK, it is illegal for homeopaths to claim they can cure cancer.

Costs and expenditure

Homeopathic remedies tend to be relatively cheap. A consultation with a homeopath can last up to 1 hour and therefore is more costly.

Homeopathy is a system of medicine based on the similia (‘treating like with like’) principle. It usually entails taking highly diluted remedies by mouth.

Does it work?

Systematic reviews

A systematic review of systematic reviews of homeopathy conducted in 2002 concluded that there is no evidence from systematic reviews that homeopathy is effective beyond placebo for any condition.9 A 2009 Cochrane review was aimed at evaluating “the effectiveness and safety of homeopathic medicines used to prevent or treat adverse effects of cancer treatments”.10 The authors found 8 controlled clinical trials: three studied adverse effects of radiotherapy, three studied the adverse effects of chemotherapy and two investigated menopausal symptoms due to breast cancer therapy. One rigorous study of Calendula extract ointment (n=254) suggested benefit for the prevention of radiotherapy-induced dermatitis compared to controls treated with trolamine.11 Another small (n=32) yet rigorous study found that Traumeel S mouthwash (a complex homeopathic remedy) was better than placebo for chemotherapy-induced stomatitis.12 The other trials were either methodologically weak or had negative results. Neither of the two positive studies employed high dilutions; thus their effects might be explicable through the pharmacological properties of their ingredients.

Narrative reviews

An overview of the literature concluded that “specific anti-tumour effects [of homeopathic remedies] have not been shown in any controlled clinical research to date…”.13

Clinical trials

A recent prospective cohort study compared cancer patients who had opted for homeopathic treatments as an adjunct to conventional cancer therapies to patients who had chosen to have conventional care only.14 Matched pairs were formed of patients with the same cancer type and prognosis. Encouraging effects in terms of fatigue and quality of life were noted after three months. It is unclear, however, whether the outcome was caused by the treatment or by selection bias.

Is it safe?

Adverse effects

Highly diluted remedies are unlikely to cause serious adverse effects. The most serious risk is indirect: if homeopathic remedies replace conventional cancer treatment, this can cause adverse outcomes including premature deaths. In this context, it is important to realise that, according to one German survey 14, cancer patients seek homeopathic treatments much more frequently from providers who are not physicians than from physicians.

Contraindications

None known

Interactions

None known

Warnings

Do not use as a replacement for conventional cancer treatment.

Other problems

None known

Citation

Edzard Ernst, CAM-Cancer Consortium. Homeopathy in cancer [online document]. http://www.cam-cancer.org/layout/set/print/CAM-Summaries/Other-CAM/Homeopathy-in-cancer. November 1, 2011.

Document history

Last udpated and revised in November 2011 by Edzard Ernst.
First published in June 2010, authored by Edzard Ernst.

References

  1. Swayne J. International dictionary of homeopathy. Churchill Livingstone, Edinburgh. 2000.
  2. Ernst E. The heresy of homoeopathy. Br Homeopath J 1998; 87:28-32.
  3. Spence DS, Thompson EA, Barron SJ. Homeopathic treatment for chronic disease: a 6-year, university-hospital outpatient observational study. J Altern Complement Med 2005; 11:793-798.
  4. Witt CM, Bluth M, Albreacht H, Weisshuhn TE, Baumgartner S, Willich SN. The in vitro evidence for an effect of high homeopathic potencies. A systematic review of the literature. Compl Ther Med 2007; 15(2):128-138.
  5. Baumgartner S, Wolf M, Skrabal P, Bangerter F, Heusser P, Thurneysen A et al. High-field 1HT1 and T2 NMR relaxation time measurements of H2O in homeopathic preparations of quartz, sulfur, and copper sulfate. Naturwissenschaften 2009; 96:1079-1089.
  6. Thomas-Schoemann A, Alexandre J, Mongaret C, Azibi S, Dauphin A, Goldwasser F et al. [Use of antioxidant and other complementary medicine by patients treated by antitumor chemotherapy: a prospective study]. [French]. Bulletin du Cancer 2011; 98(6):645-653.
  7. Clerici CA, Veneroni L, Giacon B, Mariani L, Fossati-Bellani F, Clerici CA et al. Complementary and alternative medical therapies used by children with cancer treated at an Italian pediatric oncology unit. Pediatric Blood & Cancer 2009; 53(4):599-604.
  8. Langler A, Spix C, Edelhauser F, Kameda G, Kaatsch P, Seifert G et al. Use of homeopathy in pediatric oncology in Germany. Evidence-Based Complementary & Alternative Medicine: eCAM 2011; 2011:867151.
  9. Ernst E. A systematic review of systematic reviews of homeopathy. Br J Clin Pharmacol 2002; 54:577-582.
  10. Kassab S, Cummings M, Berkovitz S, Van Haselen R, Fisher P. Homeopathic medicines for adverse effects of cancer treatments. Cochrane Database of Syst Rev 2009; 2: CD004845.
  11. Pommier P, Gomez F, Sunyach MP, D'Hombres A, Carrie C, Montbarbon X. Phase III randomized trial of Calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer. J Clin Oncol 2004; 22:1447-1453.
  12. Oberbaum M, Yaniv I, Ben-Gal Y, Stein J, Ben-Zvi N, Freedman LS et al. 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 2001; 92:684-690.
  13. Frenkel M. Homeopathy in cancer care. Alternative Therapies in Health & Medicine 2010; 16(3):12-16.
  14. Rostock M, Naumann J, Guethlin C, Guenther L, Bartsch HH, Walach H et al. Classical homeopathy in the treatment of cancer patients--a prospective observational study of two independent cohorts. BMC Cancer 2011; 11:19.
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The present documentation has been compiled by the CAM-CANCER Project with all due care and expert knowledge. However, the CAM-CANCER Project provides no assurance, guarantee or promise with regard to the correctness, accuracy, up-to-date status or completeness of the information it contains. This information is designed for health professionals. Readers are strongly advised to discuss the information with their physician. Accordingly, the CAM-CANCER Project shall not be liable for damage or loss caused because anyone relies on the information.