Britt Marie Hermes is a former naturopath who had the requisite intellectual and moral integrity to realize and admit to herself that her chosen profession was a pseudoscientific fraud. Further, rather than just sulk away and go on with her life, she decided to share what she learned with the world, in the hopes of mitigating the damage caused by her former profession.

Of course, no good deed goes unpunished. For her trouble she has been harassed and legally threatened. She was recently sent another cease and desist letter from Colleen Huber, for a post in which she explains why she thinks Huber is cybersquatting on domains with Hermes’ name:

The Wix account of BrittMarieHermes.com is registered with an email address at the domain natonco.org, the official website for the Naturopathic Cancer Society and a non-profit organization in Tempe, Arizona run by naturopathic cancer “doctor” Colleen Huber, NMD and her surrogate Hazel Chandler. The organization raises money for cancer patients who desire to use, but cannot afford, expensive alternative cancer therapies such as intravenous vitamins, mistletoe injections, and special diets, which is then funneled to Huber’s clinic Nature Works Best and others.

Huber is a naturopath who treats cancer with “natural” therapies. She makes some extraordinary claims, without the evidence to back them up. Huber and her clinic treat cancer with IV therapy and diet. Their website states:

The intravenous nutrients are tailored specifically to each patient’s condition and chosen for their targeted, time tested, and research-documented anti-cancer, or tumor fighting effect. The nutrients we use are different for each patient, but some of nutrients used may include a combination of Vitamin-C, Sodium Bicarbonate, DMSO, in addition to many others. Before we have done a full workup we cannot know which of these nutrients may be used for your treatment, if they are used at all. These treatments are made specifically for each patient, their type and stage of malignancy and may be used exclusively or as a supplement to chemo and radiation.

They specifically state that they do not treat their patients with chemotherapy or radiation. Further, they appear to discourage standard treatment as evidenced by this statement on their website:

Your best opportunity is to begin the natural treatments before the conventional treatments (chemo, radiation, etc.) sicken and weaken you and ultimately strengthen the disease. Many of the patients who opted for only natural treatments never even got sick and saw no side effects.

So in their view chemotherapy strengthens the cancer. Meanwhile they recommend implausible treatments that are not evidence-based. David Gorski has already done an excellent job reviewing the literature on vitamin C and cancer – bottom line, it doesn’t work.

Baking soda (sodium bicarbonate) treatment for cancer is based on the fact that solid cancers often exist in an acidic environment. Mouse studies suggest that treatment with an alkalinizing agent may reduce the ability of solid tumors to metastasize. There are, however, no clinical trials showing that it actually works in humans. A 2017 paper discusses the problem:

However, a concern in translating these results to clinic has been the presence of counter ions and their potential undesirable side effects (e.g., hypernatremia).

I found one preliminary clinical trial registered at clinicaltrials.gov, which was completed in 2015, but there are no published results. I wonder if they are still crunching the numbers after two years, or if this is an example of the file drawer effect.

This is an excellent example of pseudoscience in medicine. Start with a semi-plausible idea, such as countering the acidic environment of solid tumors. This is a bit simplistic, and I would guess that simply giving an alkalizing agent like baking soda would not work, but it is enough of a justification to do some serious research. Perhaps it will lead to a more nuanced treatment. The basic and animal research has had mixed results, with positive effects in some tumors but not others. Concerns about serious side effects are also raised. At best these results are preliminary and point the way to a modified approach and perhaps justify preliminary human trials.

However, we are still a decade of research away from definitive clinical evidence that can be used as the basis of evidence-based treatment. Most possible treatments at this state will ultimately fail. But this preliminary data can give the impression that one is being scientific and evidence-based – just a misleading impression.

What about the notion that sugar feeds cancer? This is also not based on any clinical science, just a handwaving notion that cancer cells are hungry. As a Cancer Research UK review states:

There’s no evidence that following a “sugar-free” diet lowers the risk of getting cancer, or boosts the chances of surviving if you are diagnosed. And following severely restricted diets with very low amounts of carbohydrate could damage health in the long term by eliminating foods that are good sources of fibre and vitamins.

The Mayo Clinic also states:

Sugar doesn’t make cancer grow faster. All cells, including cancer cells, depend on blood sugar (glucose) for energy. But giving more sugar to cancer cells doesn’t speed their growth. Likewise, depriving cancer cells of sugar doesn’t slow their growth.

I could not find any published study supporting the claim that reducing sugar in the diet improves cancer outcome. But I did find this study that looked at glucose levels in diabetics with cancer, and found:

Higher glucose and HbA1C levels in diabetes patients with incident cancer are not associated with worse overall survival following cancer diagnosis. Among insulin-treated patients, higher glucose levels may be associated with improved survival.

Again, the notion of starving cancer cells by depriving them of sugar is overly simplistic. The problem is that all healthy cells need energy too. The goal of cancer treatment is to find a way to harm cancer cells only, or at least significantly more than healthy cells. Depriving all cells of carbohydrates doesn’t cut it.

So, in keeping with what I find to be the general approach of naturopathy, Huber’s cancer treatment is a hodgepodge of barely plausible treatments not based on convincing clinical research, but that can be marketed to the public as “natural.” She simultaneously scaremongers about established effective treatment. In my opinion, the term “quack” fully applies here.

But the real howler comes from Huber’s published “study” in which she claims:

However, our success rate of 93% in steadfast patients following all protocols as recommended, from Stage I through early Stage IV (Table 5) is unprecedented and unequalled in both conventional and natural medicine in all clinics that report their results in detail as we do in this paper.

Sounds impressive – better results than any other clinic treating cancer, including those using conventional therapy (with the caveat that this includes those clinics who report their full results). But let’s take a look at Huber’s data more closely.

Many patients voluntarily left our practice, against our advice, primarily for financial reasons, while still having cancer. Of the remaining patients, 175 either went into confirmed, complete remission, which we define by no evidence of cancer remaining in the body on imaging, or have remained in good to excellent wellbeing, as determined retrospectively by prolonged stable health of at least 6 months after leaving our care and needing no other physician supervised cancer care, and as confirmed by annual telephone conversation with either the patient or a family member. Those patients in remission stayed in our care an average of 3.7 months; those who left, 2.7 months, (this data last measured in 2010). Eight additional patients went into remission after leaving our clinic, and while being treated at a different clinic, and it is unlikely that our treatments were the decisive factor in that remission. We were still treating 22 patients at July 1, 2014 plus giving ongoing maintenance treatments to some of those who are still in remission. 44 died while still our patients. Of those 44, 12 died after a significant dietary dispute with us. That is 32 patients died although they received our treatments and complied with our requested diet. 22 more were killed by hospital procedures and/or chemotherapy and/or radiation side effects while still our patients. 45 total patients chose to have chemotherapy while having our treatments. Yet, of the 175 who went into remission, only 12 had chosen to have chemotherapy while having our treatments. Stages 1, 2, 3 and early Stage 4 patients at start of treatment had much better outcomes than late Stage 4 patients in general.

Those familiar with cancer research may immediately notice when reading through this paper the distinct lack of survival curves, which is a standard way of tracking how patients do with cancer treatment. There is also a clear lack of any proper controls. There is no comparison of patient with similar cancers and stages with conventional or any other treatment.

But the biggest problem, which even a non-expert might notice, is the clear bias in the way the patient outcomes are tracked. Patients who left the practice for whatever reason were not counted. There is a known bias in which patients who do well with a treatment stick with it, and those who do not do well stop the treatment or seek other alternatives. It is highly likely that those patients whose cancer progressed while getting treatment tended to not follow up, and so are not counted. Patients who did well would be more likely to stick around and be counted.

This factor alone makes Huber’s numbers worthless. Any clinic can look good if you track outcomes this way. Since she is mixing patients and treatments in a clinical setting, the best method for tracking outcome would likely be an intention-to-treat analysis, in which all patients who begin treatment are counted. These patients should be compared to matched controls who present to a standard cancer clinic.

Huber’s numbers are simply not scientific. They are useful only for self-promotion and convincing customers that her treatments are effective, when the best science available does not support that claim.

This sloppy and worthless paper is apparently what passes for science in the naturopathic world. What this suggests (along with a great deal of other evidence) is that if you go to a naturopath you are likely to be treated with implausible treatments that are not based on reliable scientific evidence, but marketed as “natural” and presented as superior to science-based treatments.

Hermes criticism, in light of this, seems completely justified. Huber has apparently chosen to fight back not with facts or logic, but with legal thuggery.

Posted by Steven Novella

Founder and currently Executive Editor of Science-Based Medicine Steven Novella, MD is an academic clinical neurologist at the Yale University School of Medicine. He is also the president and co-founder of the New England Skeptical Society, the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society. Dr. Novella also contributes every Sunday to The Rogues Gallery, the official blog of the SGU.