04/09/2016

Isolates, Herbs and Formulations in Breast Cancer Care

Yesterday, I spent 3 hours at Cape Town's Mount Nelson Hotel listening to Dr Weber on the subject of isolates, herbs and formulations in breast cancer care.  I am not a homeopath and have never attended a lecture on the subject before.  I found it fascinating.

Dr Weber, the CEO of Panaxea, a company which "provides our practitioners with the most efficacious natural remedies available"  He is based in Australia and is a visiting professor at Tianjin
University.  His talk was based on the content of his book "Botanical Oncology:isolates" which was published in 2014.  He went through 220 slides and it would be an impossible task to even begin to summarise all the information presented. Nearly all the slides had a least one reference cited.

His talk was a mixture of traditional Chinese medicine, evidence based medicine and translational research. The different approaches were applied variously to different subtypes and stages of breast cancer.   I found it difficult to follow.  It is perhaps because I am not au fait with many of the concepts (eg phlegm which in traditional Chinese medicine apparently refers to interstitial fluid).  What bothered me was the lack of clinical outcome data.

When a drug is being developed, it has to go through at least 3 phases:
When a drug is being considered for use for cancer treatment, the oncologist wants to know whether or not the administration of the drug will lead to improved outcome (There has been a lot of criticism about the pharmaceutical companies.  Amongst other issues, they often do not publish the results when a drug is shown not to work and do not always take account of patient side effects).  Herbal products fall outside the current legislation omitting the need for outcome based studies, and controlled trials do not have to be conducted before they are marketed.

In a short three hours, an amazing number of products were discussed (I think, over 100) but survival data was given on only 90 patients: half of whom had received "herbs" or JLBSHJ formula.  All of the rest of the data was anecdotal.

Western medicine does not always get it right and there is an increasing demand from patients for Complementary and Alternative Medicine.  Dr Weber urged oncologists to engage in more dialogue with integrative oncologists.  I am encouraged by his commitment to "research and evidence based medicine" and am sure as the evidence for the usage of isolates, herbs and formulations in the management is produced, a more integrated approach will result.



11 comments:

  1. A study by Li et al., was published in 2013 in PLoS ONE on controlled clinical studies. Here is the abstract and it is an open source journal if you wish to see the entire article. As I said on Saturday, I believe the way forward in treating any cancer and especially breast cancer is to open the dialogue between biomedical oncology and those of us in complementary medicine that are committed to an evidence-based approach. There are biases on both our sides hover, given the dominance of the biomedical model, we in CM need to work harder to make the meeting fruitful. It will be a difficult dialogue but in the end the patient will benefit.
    Daniel
    Traditional Chinese Medicine in Cancer Care: A Review of Controlled Clinical Studies Published in Chinese
    A total of 2964 reports (involving 253,434 cancer patients) including 2385 randomized controlled trials and 579 non-randomized controlled studies were included. The top seven cancer types treated were lung cancer, liver cancer, stomach cancer, breast cancer, esophagus cancer, colorectal cancer and nasopharyngeal cancer by both study numbers and case numbers. The majority of studies (72%) applied TCM therapy combined with conventional treatment, whilst fewer (28%) applied only TCM therapy in the experimental groups. Herbal medicine was the most frequently applied TCM therapy (2677 studies, 90.32%). The most frequently reported outcome was clinical symptom improvement (1667 studies, 56.24%) followed by biomarker indices (1270 studies, 42.85%), quality of life (1129 studies, 38.09%), chemo/radiotherapy induced side effects (1094 studies, 36.91%), tumor size (869 studies, 29.32%) and safety (547 studies, 18.45%). Completeness and adequacy of reporting appeared to improve with time.

    Xun Li, Guoyan Yang, Xinxue Li, et al. Traditional Chinese Medicine in Cancer Care: A Review of Controlled Clinical Studies Published in Chinese. PLoS One. 2013; 8(4): e60338. doi: 10.1371/journal.pone.0060338

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    1. I think what Dr Edge was meaning was that from her perspective there needs to be "clinical outcome data" for any specific herbal medication discussed. i.e. this herbal formula achieved this result in this trial with these patients. The above cited reference gives evidence for the general efficacy of Chinese herbal medicine. Dr Edge stated that if an oncologist gives a patient a drug then they want to know what the expected outcome will be. Is this level of evidence available on any of the 100 different panaxea products discussed ?If not then Dr Edge's statement on this blog is entirely correct.

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  2. Evidence based medicine should incorporate all evidence, not only clinical trials. Hundreds, perhaps even in some cases thousands, of years of self-evidently safe and efficacious usage of some traditional (herbal) treatments is no less evidence than any lab study - as Dr Weber points out, the future appears firmly pointed to trans-speciality and trans-system collaboration with respect to improved patient outcomes and reduced morbidity and mortality rates for many disease conditions, not only cancer. Chris Erasmus, Publisher, Odyssey Magazine

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