Homeopathic medicines for adverse effects of cancer treatments

Kassab S, Cummings M, Berkovitz S, van Haselen R, Fisher P

Published Online:

March 16, 2011

Homeopathic medicines are used by many patients with cancer, usually alongside conventional treatment. Cancer treatments can cause adverse effects, and one of the reasons patients use homeopathic medicines is to help with these symptoms. This review looked at whether these medicines could help patients with problems caused by cancer treatments. Eight studies with a total of 664 participants were included in this review. Three studied adverse effects of radiotherapy, three studied adverse effects of chemotherapy and two studied menopausal symptoms associated with breast cancer treatment. Two studies with low risk of bias demonstrated benefit: one with 254 participants demonstrated benefits from calendula ointment in the prevention of radiotherapy-induced dermatitis, and another with 32 participants demonstrated benefits from Traumeel S (a complex homeopathic medicine) over placebo as a mouthwash for chemotherapy-induced stomatitis. These trials need replicating. Two other studies reported positive results, although the risk of bias was unclear, and four further studies reported negative results. The homeopathic medicines used in all eight studies did not seem to cause any serious adverse effects or interact with conventional treatment. No cancer treatments were modified or stopped because of the homeopathic interventions.

Abstract (click to read)

Background:

Homeopathic medicines are used by patients with cancer, often alongside conventional treatment. Cancer treatments can cause considerable morbidity and one of the reasons patients use homeopathic medicines is to help with adverse effects.

Objectives:

Evaluate effectiveness and safety of homeopathic medicines used to prevent or treat adverse effects of cancer treatments.

Search strategy:

The following were searched up to November 2008: Cochrane PaPaS Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; CINAHL; BNI; CancerLIT; AMED; CISCOM; Hom-Inform; SIGLE; National Research Register; Zetoc; www.controlled-trials.com; http://clinicaltrials.gov; Liga Medicorum Homeopathica Internationalis (LMHI, Liga) conference proceedings; reference lists of relevant studies were checked; and homeopathic manufacturers, leading researchers and practitioners were contacted.

Selection criteria:

Randomised controlled trials (RCTs) of homeopathic medicines in participants with a clinical or histological diagnosis of cancer where the intervention was aimed at preventing or treating symptoms associated with cancer treatments. All age groups, and all stages of disease were included.

Data collection and analysis:

Two review authors independently assessed studies for inclusion and two review authors extracted data. Three review authors independently assessed trial quality using the Delphi List and the Cochrane Collaboration's tool for assessing risk of bias. Disagreements were resolved by consensus. Where available, data were extracted for analysis.

Main results:

Eight controlled trials (seven placebo controlled and one trial against an active treatment) with a total of 664 participants met the inclusion criteria. Three studied adverse effects of radiotherapy, three studied adverse effects of chemotherapy and two studied menopausal symptoms associated with breast cancer treatment.

Two studies with low risk of bias demonstrated benefit: one with 254 participants demonstrated superiority of topical calendula over trolamine (a topical agent not containing corticosteroids) for prevention of radiotherapy-induced dermatitis, and another with 32 participants demonstrated superiority of Traumeel S (a proprietary complex homeopathic medicine) over placebo as a mouthwash for chemotherapy-induced stomatitis. Two other studies reported positive results, although the risk of bias was unclear, and four further studies reported negative results.

No serious adverse effects or interactions were reported attributable to the homeopathic medicines used.

Authors' conclusions:

This review found preliminary data in support of the efficacy of topical calendula for prophylaxis of acute dermatitis during radiotherapy and Traumeel S mouthwash in the treatment of chemotherapy-induced stomatitis. These trials need replicating. There is no convincing evidence for the efficacy of homeopathic medicines for other adverse effects of cancer treatments. Further research is required.

This record should be cited as:

Kassab S, Cummings M, Berkovitz S, van Haselen R, Fisher P. Homeopathic medicines for adverse effects of cancer treatments. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD004845. DOI: 10.1002/14651858.CD004845.pub2

Assessed as up to date:

January 20, 2009

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Primary Review Group:

Pain, Palliative and Supportive Care Group

PEARLS - Practical Evidence About Real Life Situations (click to read)

Clinical question:

How effective are homoeopathic medicines used to prevent or treat adverse effects of cancer treatments?

Bottom line:

Compared with trolamine, calendula ointment reduced the incidence of acute dermatitis of grade two or above in women undergoing radiotherapy for breast cancer in 1 clinical trial (NNT* 5 [CI 3 to 11], 254 patients). There is no convincing evidence for the efficacy of other homoeopathic medicines for adverse symptoms and skin reactions related to radiotherapy. Two small studies were positive but both had an unclear risk of bias. Based on a single, small trial, 1 particular homoeopathic combination (Traumeel S - a proprietary complex homoeopathic medicine) showed promise in the treatment of chemotherapy-induced stomatitis. High quality trials to date provide no evidence for the efficacy of homoeopathic medicines over placebo in women with breast cancer suffering from menopausal symptoms. The homoeopathic medicines did not seem to cause any serious adverse effects or interact with conventional treatment. No cancer treatments were modified or stopped because of the homoeopathic interventions. *NNT = number needed to treat to benefit 1 individual.

Caveat:

It is difficult to draw firm conclusions because of the paucity of evidence, clinical heterogeneity and lack of repetition of the included trials. The calendula ointment used in the study was prepared according to the German Homeopathic Pharmacopoeia and so the results may not apply to topical preparations of calendula extracts prepared by different methods.

Context:

Complementary therapies, including homoeopathic medicines, are used by many patients with cancer, usually alongside orthodox treatments. A systematic review of 26 surveys from 13 countries reported that up to 64% of patients with cancer (average 31.4%) used complementary therapies at some stage of their illness.

Cochrane Systematic Review:

Kassab S et al. Homeopathic medicines for adverse effects of cancer treatments. Cochrane Reviews 2009, Issue 2. Article No. CD004845. DOI: 10.1002/14651858. CD004845.pub2. This review contains 8 studies involving 664 participants.

Authored by:

Brian R McAvoy

Cochrane Primary Health Care Field

Health topics:

Cancer > Palliative and supportive care > Complementary & alternative therapy

Complementary & alternative medicine > Cancer > Palliative and supportive care

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Homeopathic medicines for adverse effects of cancer treatments

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