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Medical Forum / General / Nutrition / February 2007laetrile
Lack of evidence doesn't mean lack of efficacy. Nor does it support a case for efficacy. It simply means we have inadequate data for people to make a well-informed decision about whether to use an intervention like laetrile. George M. Carter *** Milazzo S, Lejeune S, Ernst E. Laetrile for cancer: a systematic review of the clinical evidence. Support Care Cancer. 2006 Nov 15; [Epub ahead of print]. Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Institute of Health and Social Care, 25 Victoria Park Road, Exeter, EX2 4NT, UK, edzard.ernst@pms.ac.uk. BACKGROUND: Many cancer patients treated with conventional therapies also try 'alternative' cancer treatments. Laetrile is one such 'alternative' that is claimed to be effective by many alternative therapists. Laetrile is also sometimes referred to as amygdalin, although the two are not the same. OBJECTIVE: The aim of this review is to summarize all types of clinical data related to the effectiveness or safety of laetrile interventions as a treatment of any type of cancer. MATERIALS AND METHODS: All types of clinical studies containing original clinical data of laetrile interventions were included. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (from 1951), EMBASE (from 1980), Allied and Complementary Medicine (AMED), Scirus, CancerLit, Cumulative Index to Nursing and Allied Health (CINAHL; all from 1982), CAMbase (from 1998), the MetaRegister, the National Research Register, and our own files. For reports on the safety of laetrile, we also searched the Uppsala database. No language restrictions were imposed. RESULTS: Thirty six reports met our inclusion criteria. No controlled clinical trials were found. Three articles were nonconsecutive case series, 2 were consecutive case series, 6 were best case series, and 25 were case reports. None of these publications proved the effectiveness of laetrile. CONCLUSION: Therefore, the claim that laetrile has beneficial effects for cancer patients is not supported by sound clinical data. > Lack of evidence doesn't mean lack of efficacy. Nor does it support a > case for efficacy. It simply means we have inadequate data for people > to make a well-informed decision about whether to use an intervention > like laetrile. > > George M. Carter There is not a total lack of evidence: http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-bitteralmond.html The evidence indicates that it may be harmful. Jeff Jeff >> Lack of evidence doesn't mean lack of efficacy. Nor does it support a >> case for efficacy. It simply means we have inadequate data for people [quoted text clipped - 7 lines] > >The evidence indicates that it may be harmful. Anything can be harmful. What the document above fails to do is to indicate whether the dosage and route of administration claimed by proponents has evidenced a risk of adverse events or side effects. However, the point is well taken that the potential for cyanide poisonng exists. And indeed, there does seem to be a paucity of evidence for efficacy. \ So anyone with a cancer that's refractory to standard of care or who doesn't wish to undergo toxic chemotherapy/radiation has little information to judge whether this intervention can be helpful. In some ways, laetrile represents a part of the indictment of privatized R&D as a method for evaluating interventions. In a system that was designed to answer important clinical questions, we'd have more data. In a system that's dependent on making huge profits, we will most likely never have data as the product is already known to be inexpensive and thus not to need to cost the lives of the poor due to an outrageous and lethal price tag arbitrarily assigned to maximize those profits. But the paper is rather poorly written, unfortunately. Thanks for sharing it just the same! George M. Carter >>> Lack of evidence doesn't mean lack of efficacy. Nor does it support a >>> case for efficacy. It simply means we have inadequate data for people [quoted text clipped - 11 lines] > indicate whether the dosage and route of administration claimed by > proponents has evidenced a risk of adverse events or side effects. There is a risk of cyanide poisoning at *ANY* dose. > However, the point is well taken that the potential for cyanide > poisonng exists. And indeed, there does seem to be a paucity of [quoted text clipped - 8 lines] > that was designed to answer important clinical questions, we'd have > more data. Yet, proponents of Laetrile can apply to NIH for a grant for proper drug trial. EDTA proponents got one for treatment of heart disease. > In a system that's dependent on making huge profits, we will most > likely never have data as the product is already known to be > inexpensive and thus not to need to cost the lives of the poor due to > an outrageous and lethal price tag arbitrarily assigned to maximize > those profits. Correct, which is why we have the NIH and universities to fund such trials, if they are found to be worthwhile. > But the paper is rather poorly written, unfortunately. Thanks for > sharing it just the same! It's not a paper. It is a webpage. Let's see you do better. Jeff > George M. Carter >>>> Lack of evidence doesn't mean lack of efficacy. Nor does it support a >>>> case for efficacy. It simply means we have inadequate data for people [quoted text clipped - 13 lines] > >There is a risk of cyanide poisoning at *ANY* dose. There may be a risk of such poisoning, but as the concentration of cyanide decreases, the risk declines. >> However, the point is well taken that the potential for cyanide >> poisonng exists. And indeed, there does seem to be a paucity of [quoted text clipped - 11 lines] >Yet, proponents of Laetrile can apply to NIH for a grant for proper drug >trial. EDTA proponents got one for treatment of heart disease. NIH has been flat funded by Bush. Perhaps some people did try and the application was rejected. I've had experience--the submission is reviewed by 2 or 3 people, maybe 4. If one of them is an a.shole, the study will not be funded. >> In a system that's dependent on making huge profits, we will most >> likely never have data as the product is already known to be [quoted text clipped - 4 lines] >Correct, which is why we have the NIH and universities to fund such trials, >if they are found to be worthwhile. I think we need better peer review, less conflicts of interest among NIH reviewers -- and massively increased funding for NIH and for pay for employees like post-docs that do the hard work. >> But the paper is rather poorly written, unfortunately. Thanks for >> sharing it just the same! > >It's not a paper. It is a webpage. Distinction noted. >Let's see you do better. Maybe I will try some day. Will you pay me? George M. Carter > Lack of evidence doesn't mean lack of efficacy. Nor does it support a > case for efficacy. It simply means we have inadequate data for people [quoted text clipped - 35 lines] > beneficial effects for cancer patients is not supported by sound > clinical data. You would think that ANY possible treatments for such a condition as CANCER would have been thoroughly studied, inside and out, until there was no doubt about its efficacy, one way or another. Especially with the extremely limited treatment options available and their not altogether stellar results. For any such possible treatment to NOT have been thoroughly investigated is blody criminal. TC "You would think that ANY possible treatments for such a condition as CANCER would have been thoroughly studied, inside and out, until there was no doubt about its efficacy, one way or another. Especially with the extremely limited treatment options available and their not altogether stellar results. For any such possible treatment to NOT have been thoroughly investigated is blody criminal." The results in the post are those from the advocates which showed they were crap research. Valid scientific studies were done seperatly and when the first few showed no effect at all no more were done. If you declare that picking your nose cures cancer and one well done studie shows it doesn't, nothingmore need be done. > "You would think that ANY possible treatments for such a condition as > CANCER would have been thoroughly studied, inside and out, until there [quoted text clipped - 10 lines] > declare that picking your nose cures cancer and one well done studie > shows it doesn't, nothingmore need be done. I beg to differ. Not only was did Laetrile not help, it was also harmful to some. So when there was an effect, it was negative. Jeff > <capm...@shipper.com> wrote in message > [quoted text clipped - 21 lines] > > Jeff Why do you trolls always talk about the science being so clear and concise but you never, ever, EVER, back it up with actual links or cites? You know why? Because you are useless trolls more interested in making noise than providing provable facts. TC > > <capm...@shipper.com> wrote in message > [quoted text clipped - 30 lines] > > - Show quoted text - Hey Jeff, is this one of those studies you were talking about? http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra ctPlus&list_uids=7033783&query_hl=6&itool=pubmed_docsum Moertel CG, Fleming TR, Rubin J, Kvols LK, Sarna G, Koch R, Currie VE, Young CW, Jones SE, Davignon JP. One hundred seventy-eight patients with cancer were treated with amygdalin (Laetrile) plus a "metabolic therapy" program consisting of diet, enzymes, and vitamins. The great majority of these patients were in good general condition before treatment. None was totally disabled or in preterminal condition. One third had not received any previous chemotherapy. The pharmaceutical preparations of amygdalin, the dosage, and the schedule were representative of past and present Laetrile practice. No substantive benefit was observed in terms of cure, improvement or stabilization of cancer, improvement of symptoms related to cancer, or extension of life span. The hazards of amygdalin therapy were evidenced in several patients by symptoms of cyanide toxicity or by blood cyanide levels approaching the lethal range. Patients exposed to this agent should be instructed about the danger of cyanide poisoning, and their blood cyanide levels should be carefully monitored. Amygdalin (Laetrile) is a toxic drug that is not effective as a cancer treatment. One of the authors: Thomas Fleming, Ph.D., Professor and Chairman, Department of Biostatistics, University of Washington, Seattle. Receives between $10,000 and $50,001 in consulting fees from GlaxoSmithKline and receives less that $10,001 per year from each of four of its competitors. (http://www.fda.gov/ohrms/dockets/ac/02/transcripts/ 3848T1.htm; accessed 2/23/05) Fleming received a consulting fee for a limited consultation with Boehringer-Ingelheim. (Circulation. 2004;109:e9004-5) Served on oncology Clinical Advisory Board for Sunesis. ("Sunesis Begins Phase I Clinical Study of SNS-595 for Cancer; Prestigious Oncology Clinical Advisory Board Established," PR Newswire, 6/28/04) Speaker on IntraBiotics' live web cast featuring a panel of experts to discuss iseganan for the treatment of oral mucositis. ("IntraBiotics to Host a Conference Call and Web Cast with a Panel of Experts," PR NewsWire, 3/18/02) **** The fact that he works for Glaxo, and Sunesis, and IntrBiotics kinda messes with his appearance of being a professional and credible "independent" researcher, doesn't it? TC >> > <capm...@shipper.com> wrote in message >> [quoted text clipped - 82 lines] > messes with his appearance of being a professional and credible > "independent" researcher, doesn't it? He was not the only researcher who conducted the study, was he? Can you provide evidence that Laetrile works? Jeff > TC > >> > <capm...@shipper.com> wrote in message > [quoted text clipped - 88 lines] > > Jeff He was one of the researchers. We don't know if he took a leadership role, do we? And he failed to declare conflicts didn't he? That, by itself, raises a red flag. You kinda missed the point there, buddy. I do not have evidence that laetrile works. I am not saying that Laetrile works. hat I am saying is that these so-called scientists don't have any evidence that it does not work. And they are prepared to make scientific calls on Laetrile effectivity in the absence of any properly conducted randomized trials. Instead of making statements about the lack of evidence to support laetrile, they should be either recommending proper trials or conducting the trials. You cannot declare that a substance is effective or not effective in the ABSENCE of data. You can declare that there is no acceptable clinically tested evidence to support its effectivenes or lack of it. but you cannot declare it effective or not effective. TC >> >> > <capm...@shipper.com> wrote in message >> [quoted text clipped - 97 lines] > role, do we? And he failed to declare conflicts didn't he? That, by > itself, raises a red flag. What conflicts was he required to declare and to whom? > You kinda missed the point there, buddy. I do not have evidence that > laetrile works. I am not saying that Laetrile works. hat I am saying > is that these so-called scientists don't have any evidence that it > does not work. First, please give a rational on why you think it should work? Does it interupt a metabolic pathway required for cancer cell survival? Does it enhance the immune system so that it can seak and destroy cancer cells? It has been suggested that industry can't be trusted because they have conflicts of interest. What makes you think that the proponents of this are more trustworthy? Some operate for-profit clinics in Mexico. > And they are prepared to make scientific calls on > Laetrile effectivity in the absence of any properly conducted > randomized trials. Instead of making statements about the lack of > evidence to support laetrile, they should be either recommending > proper trials or conducting the trials. Why? Because some quack says it works so he could make more money? The few studies that have been found suggest there is no benefit. Why do you think that more money should be wasted on this? > You cannot declare that a substance is effective or not effective in > the ABSENCE of data. You can declare that there is no acceptable > clinically tested evidence to support its effectivenes or lack of it. > but you cannot declare it effective or not effective. There is no evidence to suggest that it is effective and evidence to suggest that it isn't effective. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-bitteralmond.html http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/laetrile.html I am not wasting my time on this anymore unless you can actually suggest a reason why we should continue studies on this quackery. Jeff > TC > >> "TC" <tunder...@hotmail.com> wrote in message > [quoted text clipped - 112 lines] > interupt a metabolic pathway required for cancer cell survival? Does it > enhance the immune system so that it can seak and destroy cancer cells? Ok. You are an idiot. Or an industry food cultist. Either way, you completely fail to understand what I wrote. Go back and re-read it. TC > It has been suggested that industry can't be trusted because they have > conflicts of interest. What makes you think that the proponents of this are [quoted text clipped - 33 lines] > > - Show quoted text - >> <capm...@shipper.com> wrote in message >> [quoted text clipped - 28 lines] > concise but you never, ever, EVER, back it up with actual links or > cites? I don't know. I am not a troll. And I have not studied them. I did back up my claims with actual links. Here is an example of one I used earlier in this thread: http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-bitteralmond.html > You know why? Because you are useless trolls more interested in > making noise than providing provable facts. I see a lot of anti-vaccine people do that. You don't you provide facts that provide real evidence that Laetrile works? Not just anecdotes. But real evidence. Jeff > TC On Feb 16, 4:57 pm, capm...@shipper.com wrote: > "You would think that ANY possible treatments for such a condition as > CANCER would have been thoroughly studied, inside and out, until there [quoted text clipped - 10 lines] > declare that picking your nose cures cancer and one well done studie > shows it doesn't, nothingmore need be done. Post your proof. Show me the science that studied laetrile and found no effect at all. I expect that the studies you are referring to would be all adhering to the highest standards of modern science. Show it to me. TC Anecdote: I have a friend who was treated with laetrile for "terminal" cancer as a child. He is now in his 50s and holds the world survival record for the specific cancer (I don't know the name).... > Lack of evidence doesn't mean lack of efficacy. Nor does it support a > case for efficacy. It simply means we have inadequate data for people [quoted text clipped - 35 lines] > beneficial effects for cancer patients is not supported by sound > clinical data. > Anecdote: I have a friend who was treated with laetrile for "terminal" > cancer as a child. He is now in his 50s and holds the world survival > record for the specific cancer (I don't know the name).... The value of this anecdote is zero. Please show that this was the cause of his cure. Jeff |
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