Cutting, poisoning, and burning naturally

Not too long ago, a reader asked me about black salve, and then not too long later I saw a commenter mention black salve. It occurs to me that, in all the years I’ve been doing this blog and my other blog, I don’t think I’ve ever actually written about black salve, except in passing. So I searched the blog, and my memory appears to be correct about this. I really haven’t written much about black salve. It’s been mentioned several times, but I haven’t really dedicated a post to it, even though that wretchedest of wretched hives of scum and quackery,, has promoted black salve in the not-too-distant past. But what is this mysterious black salve?

In brief, it’s a caustic substance. Usually, it’s derived from bloodroot, but it can also be made from zinc oxide or various herbs. The claim that you will hear from advocates of black salve make is that it somehow “draws out the cancer” if you either apply it as a paste over a tumor, such as a skin cancer, cancerous lymph nodes, or a soft tissue cancer such as a sarcoma. Most commonly, you see it used for melanoma. It can even work sometimes. Unfortunately, it’s how black salve works that is problematic. Even its proponents admit that it’s nasty. For example, look at this description of The Indian Herb, which is a different name for black salve:

The Indian Herb is a perfectly balanced vitamin and mineral substance which is not harmful to the body in any way. It balances metabolism and any blood disorders. It is a dark, semi-liquid paste. The herbal paste may be taken orally or applied directly to surface tumors and cancers.

Indian Herb is not a gentle healer. In most reported cases, it is a relentless substance which hunts down and penetrates all abnormal tissues. Pain, swelling, and sometimes fever is associated during its use.

No kidding! You will see. The problem is that it also “penetrates all normal tissues, too.” It is completely nonselective.

You will often hear proponents of alternative cancer cures lambaste conventional, science-based medicine as “cut, poison, burn.” Keep that in mind a second as I describe what black salve does. Basically, if you place it on the skin, black salve burns. It’s highly caustic. It is, in essence, a “natural” version of “cut, poison, burn,” because it burns and poisons the skin, which then forms an eschar, which is a thick, dry scab on the skin composed of—you guessed it!—burned epidermis and dermis. Black salve, in essence, works by producing a second or third degree burn, a second degree burn being a burn that extends into the dermis (the layer of the skin below the external-most layer, the epidermis) and a third degree burn extending completely through the dermis. If you have a melanoma or other skin cancer that does not extend deeper than the dermis, then black salve can indeed burn it away. However, in doing so, it also burns away a lot of normal surrounding skin. Compared to a surgical excision, with the skin edges nicely approximated, that leads to a lot of scarring and deformity. Even in the unusual cases in which black salve can actually get rid of a skin cancer, it’s a profoundly stupid way to go, because it’s imprecise, might not get the whole tumor, and leaves potentially horrendous scars. Quackwatch has an article on black salve that shows a woman with her nose and the entire middle section of her face burned off as a result of a naturopath using black salve on her.

So when black salve seems to work, it does so in a much less precise manner, with far more tissue destruction leading to severe scarring than a decent surgeon would ever allow. However, what about the other claim that it “draws out the cancer”? For instance, I have heard of black salve being used to treat breast cancer, cancerous lymph nodes, and sarcomas, all of which could be palpated or seen through the skin. A reader sent me an example of this a few days ago, and I decided I should discuss it. Be aware, however, that some of these pictures might be too disgusting for some readers; so don’t say you haven’t been warned. If you’re not up to the task of looking at these pictures, then don’t click on the links. It’s the story of a young woman named Lisa. Lisa now has stage IV melanoma, and her basic story is recounted here.

Basically, back in 2000, Lisa developed a mole that was eventually excised and found to be a stage I melanoma. Nearly nine years later, she noticed a lump under her arm, which turned out to be a lymph node with melanoma in it. She underwent an axillary dissection (removal of all the axillary lymph nodes) and was found to have only one out of 18 lymph nodes involved with tumor. She underwent radiation therapy, and the combination of radiation and surgery left her with a shoulder with limited range of motion. She also underwent a month-long course of adjuvant interferon (which is actually rather short). Then in February 2010, she was found to have tumors in her spleen and pelvis. It was at this point that an acupuncturist turned her on to the first of many “natural” cures for her cancer. I don’t know if this acupuncturist turned her on to black salve, but she discovered it, and wrote a blog post about using it. She also went on a clinical trial of ipilimumab, which was approved by the FDA in 2011 to treat advanced stage melanoma. So, as of early 2011, Lisa reported:

Currently my scans are mixed….some areas went away completely, other remained the same, and 2 got slightly larger. I decided to step up my “A” game and really start researching and doing whatever I had to in order to make this melanoma go away. If other people did it I could totally do it. And this, my friends, is what the remainder of my blog will be about.

So in May 2012, Lisa described her use of black salve. Basically, she had developed a tumor under left arm. (Her axillary dissection was on her right.) This tumor was consistent with melanoma in her lymph node. So she decided to try to draw out the tumor using black salve. As I said before, she published pictures, which don’t bother me (but, then, I’m a surgeon) but might be disturbing to some of you. Click on the link and scroll with care. These picture document the burning of the skin, which continued deeper and deeper, to the point where chunks of necrotic skin and lymph node were falling off of her. One picture in particular shows a large area of black, burnt eschar involving most of the skin under her arm. Eventually, as they often do for burns, the eschar started to lift leading to a raw, denuded area, which is, of course, how full thickness burns heal. The dead skin falls off, leaving the underlying tissue exposed, which then heals in from the inside out, both at the bottom and in from the edges of the incision. In essence, Lisa gave herself a big, disgusting, open wound. Even Lisa writes at one point that it was “nasty as hell” and “I don’t have to explain to you how painful this was.” Of that, I have no doubt.

Worse, the black salve failed to get rid of the tumor:

With much thought, research, consulting, and contemplation, I decided to go for surgery. The lymph node swollen underneath (that was new with the use of salve) freaked me out. However, the way it was explained to me by holistic docs and Fred was that the lymph system was backed up due to trying to get rid of this cancerous tissue. Due to the lymph being blocked the fluid was building up in my lymph system causing the lymph nodes to becomes inflamed (not necessarily cancerous). That definatly put my mind at ease. So anyways, yesterday I had whatever was effected taken out. Dr Beg agreed to just take out what was wreaking havoc and maintain as much tissue and mobility that he can. The surgery was in and out…took about three hours. I have a small drain to get rid of any excess blood. Tomorrow I will go to Dr. Beg and get the drain removed and a bandage change. Pathology reports in about a week to see what exactly were in those bastards.

Here’s a hint. A surgery that takes three hours is not really “in and out,” unless by “in and out” Lisa meant that they sent her home the same day. I can do a modified radical mastectomy (a mastectomy and axillary dissection) in less than two hours. What this suggests to me is that it was not a simple matter to excise this cancerous lymph node and required considerable skill and patience, most likely because of the tissue necrosis and scarring, which likely required considerable debridement of nonviable tissue.

In any case, I can only imagine the horror Dr. Beg likely felt when he saw what his patient had been doing. He is, after all, a real surgical oncologist who practices evidence-based medicine. On the other hand, I have to give him props for persuading Lisa to let him excise the nasty, cancerous mass and talking her into letting him do more if he found more. He must have a highly understanding and nonjudgmental bedside manner. Let’s just put it this way. Lisa went to Cancer Treatment Centers of America, which wasn’t woo enough for her:

Okay, so I went to Philadelphia to the cancer treatment center of america and as much as I wasn’t impressed I don’t want to say the place was horrible. After two solid years of doing hardcore holistic and integrative approach, an offering of being blasted with chemo with a side of a little acupuncture and reiki is not my idea of holistic or integrative treatment.

As for the surgeon, he recommended that she undergo an axillary dissection (I had to read between the lines of Lisa’s account), which was probably appropriate when a lymph node in the axilla is involved with melanoma, although in the case of someone with stage IV disease, where surgery would not be curative, I’m not sure that it would be absolutely necessary. In fact, to me it’s rather odd that CTCA would offer the more radical surgery than the surgical oncologist not practicing at an institution like CTCA that is steeped in woo and selection bias. Besides, sometimes you are forced to do only as much as the patient will let you, and getting that ugly, necrotic mess from under Lisa’s arm resected was more important than oncological “purity.”

I also find Lisa’s case a bit confusing after having read several of her blog entries. For instance, she had a splenectomy, and it’s not entirely clear whether she actually had tumor in her pelvis (or her hip, as she refers to it). The reason this matters is that stage IV melanoma can sometimes be cured (or at least long term remissions induced) with surgery. If the melanoma tumors can be completely removed, there is a small chance for cure. Lisa had her spleen removed, getting rid of that tumor, and she also had that tumor under her arm removed. If she didn’t really have tumor in her pelvis (which couldn’t be removed surgically), then it’s possible that the surgeries to remove her tumors might have cured her. (I left out a part where apparently tumors were seen on one ultrasound of her liver and not on another.)Certainly the black salve and other “alternative” treatments she pursued have not. Even if she did have cancer in her pelvis, melanoma is a notoriously fickle cancer, which can have highly variable behavior. Naturally, I hope Lisa’s situation is the former and not the latter, because in the former case she might have a chance at long term survival. Perhaps at some point I’ll go over this case in more detail, as the sheer number of quackeries and the rationale for them are huge. (There’s even live blood analysis and a discussion of how the meridians of the teeth affect the meridians of the body!) This time around, I was more interested in the black salve.

Whatever the reason for Lisa’s continued survival, I wish her well and hope she continues to do well. However, I also hope that she never again uses black salve, which clearly didn’t help her and, to me at least, equally clearly harmed her. It’s a brutal, nasty treatment that is even nastier and more brutal than even a typical warped Mike Adams fantasy about how horrible conventional treatments are. There’s no reason ever to use it unless you like being badly burned, both figuratively and literally.