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CHAPTER 17 Integrative Oncology 335

contain a different colored “hit pill” among the regular pills; how- Contrary to conventional medical pharmacotherapeutic meth-
ever, the contents of this pill do not specifically appear on the label, odology, homeopathic lore asserts that remedies are more power-
ful as they become more dilute. As difficult as homeopathic theory
although some suspect that it may contain either a concentrated
VetBooks.ir dose of notoginseng or the more troublesome herb, aconite, which is to believe, the remedies are as easy to administer as sugar pills
because, for many remedies, the pills are just that: lactose tab-
has both cardiotoxic and neurotoxic effects.
That there is no formal “recipe” for Yunnan Baiyao and the fact lets impregnated on the outer surface with a diluted homeopathic
that some manufacturers still refuse to disclose their ingredients mixture. Most remedies are available over the counter. Although
means that many unknowns persist with currently available prod- most states consider the practice of homeopathy on animals as
ucts and caution is warranted. part of veterinary medicine, clients can and do self-prescribe and
Despite the many questions regarding the contents and manu- self-administer the medication to their animals. Several do-it-
facturing quality of Yunnan Baiyao, some research has emerged yourself books on veterinary homeopathy are available.
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that may validate its hemostatic potential. For example, a pro-
spective, randomized, double-blind, placebo-controlled study How Does Homeopathy Work?
on Yunnan Baiyao for human patients undergoing bimaxillary First, there is the question of whether homeopathy does, in fact,
orthognathic surgery found significant reduction in intraoperative work. Most systematic reviews and meta-analyses find that the
blood loss when Yunnan Baiyao was administered preoperatively effects of homeopathy resemble the strength of placebos. The ben-
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for 3 days. No thrombolic events or other side effects were noted efits seen in humans receiving homeopathy may be due to the
during this short-term administration. A prospective study of the lengthy interviewing process itself rather than the homeopathic
effects of oral Yunnan Baiyao on thromboelastographic param- remedies per se. 104 Currently, there is no repeatable, rigorous evi-
eters in apparently healthy dogs showed that the product was well dence that homeopathy works for veterinary patients. Similarly,
tolerated and increased the strength of blood clotting. 99 there is no rational mechanism of action.
On the other hand, a 2017 report of the effects of Yunnan In human homeopathy, evidence for the incorporation of
Baiyao on blood coagulation in beagle dogs found no clinically homeopathy for symptom control in cancer patients is weak and
significant effects on the coagulation parameters under study. 100 burdened with methodological flaws, uncontrolled trials, and/or
Additional indications in the future may arise for cancer treat- small subject numbers. Positive benefits shown in smaller studies
ment because of the cytotoxic effects of notoginseng, 101 which also frequently disappear when the study is repeated with larger num-
exhibits the capacity to specifically sensitize tumor cells to ionizing bers and controls.
radiation. An in vitro analysis of Yunnan Baiyao on canine heman- The most reliable benefit from homeopathy may be its placebo
giosarcoma (HSA) cell lines revealed a dose- and time-dependent effects on the client (i.e., bolstering a feeling that they are doing
HAS cell death by means of caspase-mediated apoptosis. 101a That something safe and supportive for their animal with cancer). This
said, high doses of notoginseng could also be toxic to bone marrow false sense of assurance could work against the animal’s best inter-
stem cells. 102 Furthermore, a retrospective case-controlled study ests if it delays meaningful diagnosis and effective care, as illus-
of Yunnan Baiyao administration in dogs with right atrial masses trated in a human study on the effect of antecedent use of CAM
and pericardial effusion did not show a significantly delayed recur- in delaying medical advice sought for breast cancer. 105
rence of clinical signs or improved survival. 103
In summary, although Yunnan Baiyao may reduce the risk of Can Homeopathy Cause Direct Harm?
bleeding, one must weigh the strength of its anecdotal acclaim Scrutiny of homeopathic claims is growing in both human and
against the unknowns regarding dosage, purity, and long-term veterinary medicine. Serious adverse events and deaths in children
benefits or risks. consuming homeopathic teething pills finally came to light as a
US FDA investigation became public into homeopathic products
Homeopathy that had a 10-year track record of serious adverse effects. 106 As
it turned out, dilutions assumed to be safe were not. Similarly,
Homeopathy constitutes an alternative type of health care based concerns are mounting in the veterinary community about the
on an irrational premise that the more dilute a remedy is, the dangers of homeopathy for animals, whether due to intrinsic tox-
more potent it is. Homeopathic remedies are produced with low icity of improperly produced remedies or the ethical infractions
to extremely low concentrations of the substance from which it of treating animals with substances indistinguishable from pla-
was derived. This means that the amount of active pharmacologic cebo. 107 Owing to its unlikelihood of helping and risk of harm,
ingredients in the solution may range from a weak extract of plant, homeopathy has no place in cancer care for animals.
animal, or mineral contents to barely undetectable amounts. That
said, even small amounts of toxic substances, especially when Massage
ingested over long periods of time, can still induce injury or death.
Homeopathic practitioners claim that they prescribe their Massage incorporates several methods of hands-on, low-force
remedies to stimulate an individual’s natural healing response. techniques that target restrictions and pain, mostly in the soft tis-
According to homeopathic principles and the “like cures like” sues of the body. The benefits that massage may hold for can-
doctrine, a natural substance that causes symptoms of illness in cer patients encompass quality of life, control of postoperative or
a healthy person can, when prepared correctly, cure that same postprocedural pain and stress, and support of improved mobility
set of symptoms in an unhealthy person. Thus when selecting a and functional recovery after amputation.
remedy for a patient, the homeopath determines which substance Cancer and its standard control measures can make people and
would most closely cause an identical “symptom picture” if given animals physically uncomfortable. A 2011 study of patients with
in larger quantities. She or he then recommends the homeopathic metastatic bone cancer, reported in the journal Pain, found that
dilution to alleviate those issues based on the aforementioned “like “[T]he reduction in pain with massage was both statistically and
cures like” principle. clinically significant, and the massage-related effects on relaxation