Regular readers know that my clinical specialty is breast cancer surgery, and that I am a breast cancer researcher as well. In the before time (i.e., before the COVID-19 pandemic) I used to write frequently about breast cancer and breast disease. In the nearly four years since the novel coronavirus first caused the epidemic in Wuhan China that ultimately spread to the rest of the world and was declared a pandemic by the World Health Organization in March 2020. So it was interest, amusement, and alarm that greeted my discovery of the Philadelphia Homeopathic Clinic and its page on the Homeopathic Treatment for Breast Fibroadenoma.
Longtime readers, of course, know that homeopathy is quackery, which is why there’s a very good reason that I frequently like to refer to homeopathy as the “One Quackery To Rule Them All” (apologies to J.R.R. Tolkien). Yes, I know that there are other forms of quackery that are contenders for that title, such as reiki and other forms of “energy medicine,” but homeopathy is still the champion. That’s why, for newbies, I always like to include a brief explanation (with links) of why.
When I first learned what homeopathy really is, I was gobsmacked. Indeed, most people are blissfully unaware of the magical principles of homeopathy, such as the law of similars (i.e., “like cures like,” the principle that states that, in order to relieve a symptom, you should use an herb, medicine, or other compound that causes the symptom) and the law of infinitesimals (which claims that diluting a remedy makes it stronger). And don’t even get me started on homeopathic “provings,” in which healthy people take the substances used in homeopathic remedies and then report their findings. I’ve discovered that even most physicians are unaware of the true precepts of homeopathy, with most of them thinking it’s just herbal medicine.
Although the law of similars is without a basis in science, biology, or physiology, and homeopathic provings result in some truly hilariously ridiculous nonsense, it is the law of infinitesimals that best illustrates the utter absurdity of homeopathy. Here’s the idea. This law states that, to make a remedy stronger, you dilute the remedy. And, wow, do homeopaths ever do that! A typical homeopathic remedy is 30C, with “C” signifying a 100-fold dilution. So a 30 C homeopathic dilution is equal to thirty 100-fold dilutions or (10-2)30, or a 1060-fold dilution. Those of you with a chemistry background will notice right away that this is an incredibly large number compared to Avogadro’s number, which is 6.022 x 1023 and is the number of molecules in a mole of a chemical. So, even if one starts with a mole of a substance (whose weight equals its molecular weight in grams), the resulting 30C dilution will dilute it over 1036-fold beyond the number of starting molecules. In other words, it’s incredibly unlikely that there will be a single molecule of starting substance left, other than potentially any that might “carry over” between serial dilutions sticking to the glassware. How do homeopaths explain this? They claim that water has “memory” and that it “remembers” contact with the active ingredient.
As is usually the case whenever I write about homeopathy, I like to include this clip of Richard Dawkins from Enemies of Reason. Whatever other failings Dawkins has (and there have been many over the last decade), in this case he explains the ridiculousness of The One Quackery To Rule Them All in two minutes:
Now, on to the homeopathic treatment of breast fibroadenoma. For those of you not familiar with the condition, fibroadenomas are benign breast tumors that are very common, particularly in younger, premenopausal women. They tend to be smooth, oval, rubbery masses that frequently change in size with the hormonal shifts that occur during the menstrual cycle. Similarly, although they are often painless, they can be painful, with the level of pain fluctuating with changes in hormone levels during the menstrual cycle. As for size, fibroadenomas can be stable in size but sometimes grow rapidly; after menopause, they frequently regress with the huge decrease in average estrogen levels that occurs then.
In most cases, no specific treatment is needed for a biopsy-proven fibroadenoma, other than watchful waiting, with repeat imaging and physical examination every 6 months for a couple of years, in order to make sure that the fibroadenoma is not growing. If the fibroadenoma is growing, we do generally recommend excision. Also, in general, we usually obtain needle biopsies of fibroadenomas in order to prove that they are benign, although back in the day we would sometimes just diagnose them based on how they appear on physical examination, mammography, and ultrasound. We do intervene if they are particularly large, if they are growing rapidly, or if they are causing so much discomfort or pain that the patient would like them removed. Interventions can include surgical removal or cryoablation (freezing) of the fibroadenoma.
There is, however, one clinical situation in which fibroadenoma removal is mandatory, and that’s when there is a suspicion that the tumor is not a fibroadenoma, but rather something called a phyllodes tumor, which can be either benign or malignant. Phyllodes tumors and fibroadenomas are often nearly indistinguishable clinically, with suspicion for a phyllodes being aroused by a very large tumor, a very rapidly growing tumor, or features on biopsy that suggest phyllodes. (Phyllodes often can’t be diagnosed by needle biopsy alone, although needle biopsies do often show features that are suggestive of, but not diagnostic for, phyllodes tumor and thus raise the suspicion that a lesion is a phyllodes tumor rather than a fibroadenoma.) While phyllodes tumors, even malignant ones, generally have an excellent prognosis with simple surgical excision that includes a margin of normal tissue, they do need to be taken seriously. I have myself cared for one patient in my 20+ year career who actually ended up dying of recurrent metastatic malignant phyllodes. To say that this outcome messed me up is an understatement, even though I know it’s rare. For months after I learned of her stage 4 metastatic diagnosis, I second-guessed myself in almost every clinical decision until I was finally able to accept that what happened hadn’t been my fault.
So let’s look at what the Philadelphia Homeopathic Clinic—which, hilariously, dubs homeopathy the “medicine of the future” rather than what it is, a 227-year-old form of vitalistic quackery invented in by a German physician named Samuel Hahneman—has to say about the homeopathic treatment of fibroadenoma. In fairness, most of the clinical information at the beginning of the article is more or less correct, although we rarely use tamoxifen or raloxifene, both drugs that block the action of estrogen, to treat fibroadenomas. They do, however, correctly mention watchful waiting, surgical excision, and cryoablation as options for dealing with fibroadenomas. Then, of course, they can’t resist saying:
It is important to discuss the potential risks and benefits of each treatment option with your healthcare provider to make an informed decision about your care. In some cases, a combination of conventional and homeopathic treatments may be recommended to manage fibroadenoma effectively.
No, no, no, no! There are no cases where a “combination of conventional and homeopathic treatments” would be appropriate for a fibroadenoma; homeopathy should never be part of treatment of fibroadenomas—or any disease or medical condition.
After a typical quack blurb on how homeopathy is “holistic approach to healing” and “emphasizes treating the whole person rather than just the disease or condition” (yawn), the homeopaths at this clinic try to convince you that homeopathy is becoming more popular to treat fibroadenomas:
Homeopathy is gaining popularity in the treatment of fibroadenoma because it offers a natural, safe, and non-invasive treatment option that aims to address the underlying causes of the condition. Homeopathy is aware that fibroadenoma can result from a variety of causes, such as hormonal imbalances, stress, and emotional trauma.
By using highly individualized remedies tailored to each patient’s specific needs, homeopathy aims to support the body’s natural healing mechanisms and promote long-term healing.
While I can’t necessarily disagree that homeopathy, at least remedies diluted over around 11C or 12C (which are indistinguishable from the water used to dilute the homeopathic remedy) are “safe” in the short term, such remedies are most definitely not safe in the long term, particularly for fibroadenomas in which there is a possibility of phyllodes tumor. While this situation is, admittedly, uncommon—thankfully!—given that homeopathy provides no benefit, being essentially no treatment, even the small possibility of harm due to an untreated phyllodes tumor is too much risk.
So how do homeopaths treat fibroadenomas? Let me start with the one that made me, as a breast cancer surgeon, cringe with alarm:
Calcarea Fluorica is the most effective homeopathic remedy for treating fibroadenoma of the breast, where the nodes are as hard as a rock. This medicine has a strong ability to break down these solid lumps in the breast. Many women have experienced favorable outcomes when using Calcarea Fluor to treat their breast fibroadenomas. The complex nodes become less prominent, and with the help of homeopathy, they can eventually dissipate altogether.
Let’s put it this way. If a woman has a breast mass and has axillary lymph nodes that are “hard as a rock,” it’s breast cancer that’s spread to the axillary lymph nodes, until prove otherwise, and you should never, ever mess around with homeopathy. But what is Calcarea Fluorica, anyway? It’s just calcium fluoride:
The remedy Calcarea Fluorica, also known as Calcarea Fluorata, is derived from calcium fluoride. It is one amongst the 12 biochemic medicines in homeopathy. When calcium fluoride is potentized according to homeopathic formula which is a process of arousing medicinal powers of crude substance, it is converted into a very beneficial homeopathic medicine Calcarea Fluorica. Among the various health concerns that it can treat well, the most prominent ones are hard lumps/knots, extra bony outgrowths (bone spurs) and varicose veins.
And, supposedly, it’s good for “female problems” (ugh, I cringed when I read that):
If we talk of women problems, then the foremost complaint for which it is most importantly indicated is hard knots in the breasts. It is a top-grade medicine to dissolve hard knots/lumps in breasts. It can be given to manage cases of prolapse of uterus. In such cases, its use is considered when there is bearing down and dragging pain in uterus and thighs.
No! “Hard knots in the breast” need to be evaluated to determine if they are or are not cancer! Also, remember that “potentized” means serially diluted, with shaking between each dilution, until the remedy is diluted so much that it is indistinguishable from water, at which point fluoride wouldn’t even be good—contrary to what homeopaths claim—to prevent dental caries anymore, although homeopaths claim it’s good for bone spurs, backache, goiter, varicose veins, and even rectal complaints. Truly, homeopathy is magic. Indeed, calcium carbonate (e.g., Calcarea Carbonica) works too.
Let’s look at another:
Scrophularia Nodosa is particularly beneficial for fibroadenoma and other breast tumors. This medicine is also effective in treating tenderness, swelling, and redness of the breasts due to tumors. It is also used to dissolve cysts in breasts. Scrophularia Nodosa has been proven highly effective in treating all kinds of tumors in the breasts. Its decisive action on breast tumors makes it a reliable homeopathic remedy to get rid of tumors. Fibroadenoma of the breast can be effectively treated with Scrophularia Nodosa. This homeopathic medicine is also used to treat other breast tumors, such as cysts, nodules, and indurations. It is used to reduce the size of breast tumors and the symptoms associated with them. Scrophularia Nodosa is an effective homeopathic remedy for treating breast fibroadenoma. In addition, it can also be used to treat other tumors in the breast, such as cysts, nodules, and indurations. This homeopathic medicine is a safe and reliable option for treating fibroadenoma of the breast.
I swear, this homeopathy website reads as though it were written by AI.
In any case, Scrophularia Nodosa is derived from the figwort plant, to which medicinal properties have been ascribed, specifically that it’s good for the throat disease scrofula, all based on the doctrine of signatures. What is the doctrine of signatures? Glad you asked! It’s an old doctrine dating back to Galen that states that herbs resembling various parts of the body can be used to treat ailments of those body parts. Looking at the plant, I can see how it might be thought to resemble the ducts and lobules of the breast, but even that’s a stretch. In any case, homeopaths seem to think that this herb, diluted to nonexistence, is “highly effective” treating breast disorders. So, apparently, are a lot of other plants and herbs diluted into nonexistence; that is, if you believe the Philadelphia Homeopathic Clinic.
As a clinician, I couldn’t resist taking a look at the “case studies,” starting with this one:
Julia, a 35-year-old working mother, was diagnosed with multiple fibroadenomas in both breasts. She didn’t want to undergo surgery and opted for a natural approach. Her homeopathic treatment plan included a combination of homeopathic remedies and dietary modifications. She was prescribed Phytolacca, Conium, and Calcarea Fluorica to treat her symptoms. Additionally, she was advised to reduce her caffeine intake and increase her intake of fresh fruits and vegetables. Within three months, Julia experienced a significant reduction in breast pain and tenderness. A follow-up ultrasound revealed a decrease in the size of the fibroadenomas.
One thing about this anecdote stands out. Can you guess what it is? It’s the recommendation that Julia reduce her caffeine intake. Caffeine, as you might have guessed, worsens the symptoms of fibrocystic condition and fibroadenomas, and cutting out caffeine is always among our first recommendations for women with fibroadenomas is to reduce their caffeine intake or eliminate caffeine from their diet altogether. Chances are, decreasing caffeine intake almost certainly did way more for this woman than anything these quacks offered her.
The next one made me laugh even more:
Rachel, a 42-year-old woman, was diagnosed with a fibroadenoma of 2 cm in her right breast. She experienced occasional pain and discomfort in the affected breast. Rachel opted for both conventional and homeopathic treatments. She underwent a lumpectomy to remove the fibroadenoma and started homeopathic treatment to prevent further occurrences. She was prescribed a combination of Bellis perennis and Silicea to support healing after surgery and prevent any recurrence. Within six months, Rachel’s follow-up ultrasound showed no evidence of any fibroadenoma.
So let me get this straight. A surgeon removed her fibroadenoma, and her pain disappeared? And the homeopaths attributed this to her homeopathy and the reason why her fibroadenoma never recurred? How convenient! While fibroadenomas can recur after excision, usually this only happens if the fibroadenoma is incompletely excised. The vast majority of women who have a symptomatic or growing fibroadenoma removed will not have their tumor recur, no adjuvant quackery required.
The authors even include a published “case report” of a fibroadenoma disappearing after homeopathic “treatment.” This case involved a woman who had had a fibroadenoma excised, after which it recurred and was excised, and then recurred again. It is not clear, however, whether these were recurrences or new fibroadenomas in the same breast. The reason I make this distinction is because it’s common for women prone to fibroadenomas to develop more than one of them. Most likely, her last fibroadenoma just regressed, as fibroadenomas not infrequently do. It’s all very thin gruel to make claims for the efficacy of homeopathy.
I’ll conclude by looking at the final “cautions” made about homeopathic treatment in the article:
While homeopathic treatment for fibroadenoma is generally safe and non-invasive, it is essential to take certain precautions and follow safety guidelines to avoid adverse effects. Here are a few things to keep in mind:By following these precautions and safety guidelines, you can ensure that your homeopathic treatment for fibroadenoma is safe and effective in promoting natural and holistic healing.
- Always consult a qualified homeopathic practitioner before starting any homeopathic treatment for fibroadenoma.
- Never self-diagnose or self-medicate with homeopathic remedies, as this can lead to ineffective or harmful treatment.
- Disclose any pre-existing medical conditions, medications, or allergies to your homeopathic practitioner to avoid any possible interactions.
- If you experience any unusual symptoms, discontinue the treatment immediately and seek professional medical advice.
- Keep homeopathic remedies out of reach of children and store them in a cool, dry place as directed.
I love the part about consulting a “qualified homeopathic practitioner” because it made me chuckle out loud. At least the part of seeking “professional medical advice” if you experience “unusual symptoms,” is not wrong. The only change I would make is to remove the conditional “if” and just say: Seek professional medical advice.
Truly, homeopaths are so wrong that they don’t know they are incapable of knowing how wrong they are, and homeopathy remains The One Quackery To Rule Them All.
22 replies on “Homeopathic quackery vs…a fibroadenoma?”
I was also involved in the care of a patient who died of a phyllodes tumor. In that case, the breast ruptured during attempted mastectomy. Unfortunately, that surgeon did an axillary dissection. I was involved at another hospital when another surgeon was plucking recurrences out of her chest wall and axilla as they came up.
I know that I am in the minority, but I prefer low grade and high grade over benign and malignant for phyllodes tumors because the low grade/benign ones are no less malignant than other low grade sarcomas or even basal cell carcinomas.
My brain hurts after reading this.
Nice photomicrograph.
I learned the same lesson working in the women’s clinic during training. We sent a mass that was measuring about 5 cm for mammo and Bx, by the time I saw her four weeks later and got path, the thing was about 12 cm. Path was “Suspicious for Phyllodes”
I remember, naively, thinking: “I thought these were supposed to be benign??”
If memory serves, maybe Orac can correct me if this sounds off, I think this thing had been seen on screening mammos for years but hadn’t changed until then…
My guess is a couple of things. First, we get ultrasound-guided core biopsies of essentially all solid breast masses, even if they look like fibroadenomas, in which case we want to prove that they are benign and safe to watch. This mass sounds as though it had never been biopsied and was probably a phyllodes all along. Second, we usually recommend surgical excision of larger fibroadenomas. The cutoff varies by surgeon, and there’s argument in the literature over the appropriate cutoff, but mine is usually between 3-4 cm. The reason is that the larger fibroadenomas are more likely to hide a phyllodes tumor. Finally, there is such a thing as a giant fibroadenoma that can grow rapidly like this. On rare occasions, they get so big that a mastectomy is needed to remove them.
If water has a homeopathic memory, then what is the role of flush toilets?
Even the purest water will always have some other substances dissolved in it, even if it is only a couple of hundred thousand molecules of minerals leaching from the glassware used. Yet those substances, present at far higher concentrations than the homeopathic base material after just a couple of serial dilutions, are somehow never ‘potentized’. Which means that the water knows which substances the homeopath wants to have potentized.
So water not only has a memory, it has telepathic abilities!
Wait a minute – those who practice homeopathy commonly preach against water fluoridation (one homeopathic group calls fluoridated water “poison for the whole family”), yet think calcium fluoride is a terrific homeopathic drug?
One website offers a homeopathic water fluoridation detox formula, in doses ranging from 12C to 10M,. Curiously, the 10M and the 12C cost the same: $20 for a vial despite vastly different potencies.
“As we work our way towards the M scale, we are utilising high dilutions indeed. Still with marked action on the physical the millesimal delves into the state of the psyche and spirit. M potencies resonate with the deepest levels of a person’s terrain – back through one’s history and family history. These are the potencies that we think on when dealing with the high vibrations of trauma, shock and inherited ancestral family patterns however are also called for with great effect in acute situations. An M given at the right moment can quash the intensity of an acute and even avert an emergency situation however working in this scale is best prescribed under the supervision of a professional Homeopath.”
http://formandheal.com/blog/2021/3/16/depth-over-strength
This stuff ain’t for amateurs.
@ Dr Bacon:
re “..trauma, shock and inherited ancestral patterns..”
Woo guru Null insists that people are affected by events that transpired up to ” seven generations” ago ( oh, where did I hear that figure before?) so arguments your parents or ancestors had are still damaging you today.
Prospective parents should de-tox physically is well as spiritually to clear their future child’s psyche.
If this were true, I imagine that the Middle East and Europe would be populated with multitudes of damaged individuals. And North America, China, Japan, India as well as former colonies around the world.
Who knew?
I have always felt that homeopaths should develop a “cure” for toe fungus. Since there are standard medical treatments a blinded study could be performed with little harm to the patient.
A. In one of his book Dr. Offit said “there is a limited quantity of water in the world. You don’t want it to remember where it’s been.” (I am paraphrasing from memory, but it struck me as a good caution about homeopathy.
B. Given the lack of oversight of homeopathic remedies, I don’t know if we can really say they’re short-term safe. Won’t that depend what’s actually in them, and that would be highly dependent on the care taken by the (relatively unregulated) manufacturers?
In a sort of related vein: W. C. Fields has a lot of quotes about water attributed to him, but one of the funniest is
There have been a number of recalls of homeopathic drugs due to microbial contamination.
https://www.fda.gov/drugs/information-drug-class/homeopathic-products
Other problems include the presence of significant quantities of heavy metals.
http://researchgate.net/publication/15368404_Heavy_metal_intoxication_from_homeopathic_and_herbal_remedies
The major problem with homeopathic drugs continues to be their use in lieu of treatments that are actually effective.
As an aside: Orac notes correctly that it can be difficult to distinguish fibroadenomas from phyllodes tumors, which have a greater tendency to recur and sometimes behave in a malignant fashion. Pathologists are helped in this differential diagnosis by getting relevant clinical information (i.e. size of lesion, growth rate), which often isn’t provided to them.
The process of homeopathy, which involves dilution, could be significant in better comprehending the allergy cascade and its effects on solid tumors. To explain briefly, continual disruption of the tumor microenvironment can be achieved by maintaining specific IgE antibody production during targeted degranulation. In simpler terms, once a planned allergic response to an antigen is achieved, future exposure to said antigen, using the homeopathic process, could sustain cytotoxic inflammation in the tumor microenvironment.
@ Orac,
The concept of the allergy cascade in cancer immunotherapy is still in its early stages. In my opinion, the homeopathic process (dilution effect) could be a useful tool to safely stimulate forced immunity and hinder the growth and spread of solid tumors. Better results can be obtained when a tool is used properly.
https://www.alleamit.com/
What
The
Hell?
I was going to comment that homoeopathic potions have no active ingredient in them and there for are completely unlike things that contain active principles. But then I thought better gratifying MJD’s search for attention.
You comment is apt as well.
MedicalYeti writes,
“What The Hell?”
MJD says,
I know, I’m sorry, I shouldn’t have gotten so technical. Just SIMPLY saying that there may be beneficial dilutions of antigens at parts per million and possibly parts per billion.
For heaven’s sake, MedicalYeti. Can you quantify the use of ‘What The Hell’ in that I’m not familiar with such a metaphysical-based phrase?
So, your idea is that allergic reactions are a good thing, and you want someone to test this by repeatedly giving patients pure water with different words on the label?
Have you managed to ignore everything Orac said about homeopathy, and specifically that there is no active ingredient? If there’s nothing there, dividing that nothing by ten, or a thousand, or a million will still leave you with nothing. Multiplying that nothing by any number you like will also leave you with zero.
So…Lick a piece of calcite or fluorite?
That’s essentially it?
Riiiiiiiiight.
In other woo-fraught news…
Naomi Wolf Substack:
interviews a German neuro-scientist who speculates that spike proteins in viruses or vaccines damage part of the brain that manages autobiographical memories in effect turning people into zombies. Wolf has observed this widespread phenomenon herself and wrote about it.
Steve Kirsch Substack:
gave a speech at his MIT venue proclaiming proof that vaccines killed millions based on analysis of whistleblower data from NZ and US.
I imagine if millions died – esp in NZ- someone would notice while the US could hide it much better.
What’s wrong with these people?
So would that be a cause of long covid? Though I’ve never heard of someone getting long covid from a vaccination.
As you’d expect, Kirsch’s NZ claims were promptly demolished by vastly more knowledgeable people like Prof. Jeffrey Morris.
https://twitter.com/jsm2334/status/1730584510511653010
Hilariously, some of his putative allies in antivax-land (including a certain Substacker who’s infested the RI comments section) have attacked Kirsch’s conclusions. A few of them even think he fell into a trap set by vaccine advocates to make him look bad. 🙂
We all know that Scrofula can be healed by King’s touch.
I’m just wondering that now we have Charles III on the Throne and given his love of homeopathy, will he recommend it?
Or move back a few hundred years and treat the condition by traditional methods?
This blog post brilliantly dismantles the absurdity of homeopathic quackery when confronted with real medical issues like fibroadenomas. The author skillfully exposes the lack of scientific basis behind homeopathy, emphasizing the importance of evidence-based medicine in addressing health concerns.