Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 1998; 3: 143
Health-care, particularly treatment for cancer, is an emotive issue. The recent history of the ‘di Bella cure’ provides a classic illustration of how easy it is to let hope and emotion produce an almost unstoppable bandwagon travelling in the wrong direction: some simple scientific observation at the outset would have saved tears and recriminations. In this story, sceptics will identify every single element common to any promotion of nonsense, from anecdote to zealotry.
Di Bella, a former temporary professor of physiology at the University of Modena, Italy, devised a cancer ‘cure’ based on somatostatin, bromocriptine, melatonin and various vitamins. When questioned at scientific meetings about its effectiveness, he was reluctant to divulge figures, claiming that “the results speak for themselves”. His novel therapy was based on a new therapeutic concept, quadrilogy, which he said he had derived by means of a backward logic process. In radio broadcasts, he claimed that he had been prescribing this therapy successfully for 25 years, and that it was effective against all cancers without any adverse effects. His anecdotal evidence was supported by personal testimony from an assistant who said it was effective in 90% of cases. Di Bella’s supporters paraded his scientific credentials, including 21 Medline-listed papers. Not one of them was about cancer.1 Two scientific reports (by the Italian National Oncology Commission and the Pharmacology Commission of Italy) concluded there was no scientific basis to support the therapy. Di Bella’s supporters scorned these reports as prejudiced responses, typical of the conservative medical establishment.
Di Bella continued to gain media exposure, invariably favourable. He described his results to the European parliament, also claiming that he had successfully treated Alzheimer’s disease, multiple sclerosis, and retinitis pigmentosa with somatostatin. In Italy, a local judge weighed up the (legal, not scientific) evidence and decreed that the health service must provide the treatment for patients, at a cost of approximately £20 per person treated per day. With further media exposure, public support grew into a frenzy and a public demonstration in Rome attracted 10,000 supporters.
The Italian health minister was forced to convene a panel of international experts to review di Bella’s case histories and to supervise 10 clinical trials. Di Bella was consulted in detail in the planning of these trials and gave his signed agreement to their design. The first interim report has just been published.2 The notes of the 3,000 patients he had treated were reviewed: 1500 did not have cancer at all. Of the remaining 1500, four showed evidence of improvement but they had also received other treatments. Reporting on 4 of the 10 trials under way, the panel found that “There were no signs of tumours shrinking or responding to treatment in any of the patients”. Moreover, 30% of the patients in these trials experienced adverse effects, including moderate to severe nausea and vomiting, diarrhoea, abdominal pain and somnolence.
Di Bella’s motives are not the issue here: he may have been sincerely trying to help sick patients, or he may have been a charlatan. The disaster here is the empty wallets and dashed hopes of desperately ill people, and the waste of limited public health-care resources. There was no attempt at even the simplest observational study with an objective review of results. Even when such a review was conducted by the Commissions, it was rejected out of hand by di Bella’s supporters. It is remarkable how often the public seem to assume that the medical profession is not interested in successful new therapies! A moment’s thought reveals this to be the exact opposite of the facts. A glance at the recent history of similarly miraculous ‘cures’ shows that we seem to be dealing with a repetitive pattern of events - events which in the end turn out to be to the disadvantage of vulnerable patients. When will we learn the lesson?
