Look into my eyes…

thankyou for the trouble you set into sharing it with me. great blog

Thanks Kat – that’s a great discussion. I find the whole issue of placebo effects fascinating. I’d highly recommend Dylan Evans’ book on the subject: http://www.amazon.co.uk/Placebo-Mind-Matter-Modern-Medicine/dp/0007126131

I’ve been meaning to read that for a while, I also find the whole area really interesting.

Controlled – well, just about. But I was still argue that the aromatherapy trial was nevertheless much less robust than this one.

What I really like about this hypnotherapy trial is that those in the control group spent equal time talking with a psychologist as those in the hypnotism group. They even used the same psychologists to meet with both groups. There seems to have been a real effort to isolate the cause of any improvement. As far as possible, this implies that it really was the hypnotism that had the additional impact on outcomes, rather than being a placebo effect.

By contrast, in the aromatherapy trial, one group received aromatherapy massage, while the other received “usual supportive care alone”. It’s impossible to tell just from the abstract what that supportive care consisted of, but to make the trial even close to being valid, the care given to the control group would need to be equal in time to that spent on the massage. Even then, it doesn’t guarantee that the aromatherapy had anything to do with it. A previous, smaller trial in a hospice setting suggested that massage with inert carrier oils only was as effective as with fragranced aromatherapy oils: http://snurl.com/1rdcb One trial relying on inhalation rather than massage even found that the use of fragranced rather than plain carrier oils actually increased anxiety: http://snurl.com/1rdd1

That’s a good point, and I agree that when doing trials for complemetary therapy, it’s important to think about the control. The placebo effect is incredibly strong. There’s an interesting debate about this going on at the BadScience blog, run by Dr Ben Goldacre, where he discusses some new results in acupuncture.
http://www.badscience.net/?p=540

Thanks for your comment. Actually, Professor Ramirez’s aromatherapy trial was controlled:
http://blog.cancerresearchuk.org/scienceupdate/?p=7 There were two arms of 100 patients each, one group got aromatherapy massage while the others didn’t.

With regard to acupuncture, you may be interested to know that Cancer Research UK is funding Professor Lesley Fallowfield down at the University of sussex to carry out a controlled trial of acupuncture for relieving the side effects of radiotherapy for head and neck cancer. There is some evidence that acupunture can help with the side effects – severe dry mouth caused by damage to the salivary glands – as current drug treatments aren’t very effective. so this trial will put acupuncture to the test in a controlled trial setting.

There’s also a bit more about acupuncture and cancer on CancerHelp UK:
http://cancerhelp.cancerresearchuk.org/about-cancer/treatment/complementary-alternative/therapies/acupuncture

Interesting stuff – and it’s good to see that there was an effort made to have a proper control group, unlike in the trials on aromatherapy that you blogged last month.

On the subject of complementary medicine, there were some interesting reports this week about the use of acupuncture for controlling back pain (though sticking needles into random bits of the body had as good an effect as “proper” acupuncture points). What’s the situation with using acupuncture in the realm of cancer? I seem to recall reading somewhere that there’s some evidence it can have good effects on controlling pain.