Rung Five

What to avoid: proven to backfire, or tested and didn't hold up

Kept out of the rankings. First, things with evidence of harm. Below them, popular ideas that were put to a fair test and failed.

Evidence of harm

  • Replacing standard treatment with alternative medicinePatients with curable cancers who chose alternative medicine alone had 2.5 times the risk of death within five years; more than 5 times for breast cancer and 4 times for colorectal cancer.
  • High-dose vitamin E (400 IU a day)Raised prostate cancer risk by 17% in the 35,000-man SELECT trial.
  • Beta-carotene pills for smokersTwo large trials (ATBC and CARET) found more lung cancer, not less, in smokers taking beta-carotene supplements. Food sources are fine.
  • Apricot seeds, laetrile or amygdalinRelease cyanide in the body. A Cochrane review found no reliable evidence of benefit and called the balance of risk clearly negative.
  • Metal-containing Ayurvedic formulasSome contained lead or mercury at levels 100 to 10,000 times acceptable limits.
  • Ashwagandha with existing liver diseaseCase series describe herb-induced liver injury; three patients with prior liver disease died of liver failure.
  • Giloy (Tinospora) with liver diseaseLinked to liver injury in 43 people at 13 Indian hospitals; four with existing liver disease died.
  • Antioxidant pills during chemotherapyIn 1,134 women in a breast cancer chemotherapy trial, taking vitamins A, C or E, carotenoids or CoQ10 both before and during treatment was linked to about 41% higher recurrence risk (borderline significance). Iron and B12 were also linked to worse outcomes; multivitamins were not.
  • St. John's wort during cancer treatmentIn a small crossover study it cut levels of the active form of the chemotherapy drug irinotecan by 42%. The National Cancer Institute warns it can make some cancer drugs work less well.
  • Black salve and other corrosive skin pastesSold to "draw out" skin cancer, these bloodroot and zinc chloride pastes destroy healthy tissue, leave scars and can leave cancer behind.
  • Gerson therapy and coffee enemasReviews found no anticancer effect. Repeated coffee enemas have caused deaths from fluid and mineral imbalance, and serious infections.
  • Panchakarma purging and bloodletting during treatmentAyurvedic enemas, laxatives and induced vomiting can cause infection and dangerous mineral imbalances, and bloodletting is risky when blood counts are low.

Tested, didn't hold up

  • Pomegranate extract for rising PSAA large placebo-controlled trial found no difference in PSA doubling time, because PSA slowed in the placebo group too.
  • Selenium pills to prevent prostate cancerNo benefit in SELECT.
  • Green tea extract (EGCG pills) for men at high riskA one-year randomized trial did not significantly reduce prostate cancer diagnoses. Drinking green tea is fine.
  • Metformin added to hormone therapy in non-diabetic menNo overall survival benefit in the STAMPEDE trial of about 1,900 men, though it eased metabolic side effects.
  • Extra vegetables alone to slow early prostate cancerThe MEAL trial raised intake to 7 or more servings a day for two years; progression was unchanged.
  • Large monthly or yearly vitamin D dosesInfrequent big doses did not lower cancer deaths in pooled trials; daily dosing did.