Black Salve BS

Historically, people weren’t always careful in the sun.

Summer is fast disappearing in the Northern hemisphere and with it, the sunshine. Which is sad, as we all love a bit of sun, don’t we? Even if it doesn’t always love us, particularly those of us with fairer skin. Sunburn is no fun, but these days we also understand that it’s worse than a couple of days of painfully peeling skin: too much sun exposure can cause cancer.

Unfortunately there’s a whole generation – indeed more than one – who didn’t grow up with parents constantly slathering on the factor 50 (easy-to-use transparent sunscreens with very high SPFs didn’t appear on the market until the 1990s). For some sunburn was a regular part of summer, and those people need to be particularly vigilant for changes which might signify something nasty is going on.

On the plus side, these types of cancer are very treatable, and the outlook is hopeful. Often, the growth can be removed by surgery or even cryotherapy with very little scarring. Even the most dangerous kind of skin cancer, malignant melanoma, has a ten-year survival rate of around 90% with appropriate treatment.

But there’s the key: appropriate treatment. If you notice changes in your skin, especially a mole which is changing in colour or shape, you must see a qualified doctor as soon as you can.

What you should absolutely not do is visit the Black Salve page on Facebook (which I am not linking to for reasons which will be come obvious). This page, so Facebook tells me, is followed by nearly 17,000 users. It features a cheery cover photo of a family holding a canoe over their heads, and its profile picture is a pretty white and yellow flower.

Sanguinarine is a toxic salt extracted from the bloodroot plant. It’s infamous for its ability to destroy animal cells.

It’s all very suggestive of a homely, traditional remedy. The sort of thing your grandma had in her medicine cabinet. Very safe and “natural“. But while black salve might be a traditional remedy, it is anything but safe. Most preparations contain bloodroot, a source of the toxin sanguinarine, which kills animal cells.

Applying bloodroot to the skin destroys tissues and causes the formation of a large, black lump of dead flesh. Eventually this mass, called an eschar, falls off, leaving varying degrees of damage behind (internal use is also not recommended: consuming bloodroot can cause vomiting and loss of consciousness).

Bloodroot is easy to buy. Back in May this year the Good Thinking Society reported that eBay had removed “listings for dangerous cancer ‘cure’” following an investigation. Those listings were for black salve, and this was, of course, very positive news. Except for one thing: whilst listings for black salve were removed (and remain absent), listings for bloodroot were not. At the time of writing, a quick search reveals several bloodroot preparations still for sale.

At the time of writing, bloodroot is easy to find on eBay. The listing confirms that this is prepared from the “rhizome of certified organically grown Sanguinaria conadensis plants”.

Why is this such a bad thing? Because it’s easy to find recipes for making homemade black salve with bloodroot online, and using such mixtures can have truly horrific consequences. Last year the story of a woman who applied it to a basal cell carcinoma on her nose was widely reported. The black salve paste she used did so much damage that she ended up with a large hole in her nose through which she could actually draw air. Photos and video are available online (be warned: it’s gruesome).

Many patients turn to black salve as an alternative to what they imagine will be disfiguring surgery to treat their cancer. But, as in this woman’s case, the paste can do so much damage that far more extensive, reconstructive, surgery is ultimately needed.

Black Salve usually contains bloodroot and, sometimes, zinc chloride – another skin irritant.

It won’t surprise anyone to learn that dermatologists don’t recommend black salve. It can do enormous damage to the surface of the skin, resulting in scarring and a high risk of infection, and it does kill cancer cells along the way. But there is no guarantee that all of the cancerous cells deep within the skin will be destroyed. As a result, patients who’ve attempted to cure themselves may end up with cancerous tissue hidden, and growing, beneath a scar.

In fact, exactly this happened to an otherwise healthy 76 year-old woman in 2006. Her case is described in detail in the journal Dermatology Practical Conceptual – in summary, she refused surgery on a small melanoma on her leg. Instead, she bought black salve on the internet and applied it. A few years later the cancer had spread to her lungs, liver and lymph nodes.

Some people even recommend using black salve on breast cancers but this is, if possible, even worse. It’s highly unlikely that the salve will reach the entirety of a tumour which is beneath the skin. It is likely to do some horribly painful and disfiguring damage along the way, though.

Black salve is particularly popular in Australia, which of course has some of the highest rates of skin cancer in the world. But it’s available in the UK too. One online “herbal medicine” site is openly selling various formulations at prices ranging from £25-£100. Ironically, they describe their “Herbactive” product as “chemical free” (it isn’t, nothing is) and then go onto boast that it “now has a stronger concentration of bloodroot”. Fantastic.

They also sell a product which contains zinc chloride along with bloodroot. They claim zinc chloride is safe. It isn’t. It’s well-known to be a skin irritant, and should never be left in contact with skin.

The Black Salve Facebook page is full of anecdotes and testimonials, but light on evidence.

The Black Salve Facebook page is packed full of anecdotes and testimonials from people who claim to have used these mixtures safely. It’s all interspersed, of course, with the usual “Big Pharma” conspiracy theories. Namely, that the “truth” is being suppressed because there’s “no money in it for the pharmaceutical [industry].”

The irony is that reconstructive surgery is incredibly expensive, and the antibiotics, painkillers and other drugs that are inevitably needed to treat black salve victims aren’t free, either.

Given that Facebook’s community standards page states that: “We remove content, disable accounts and work with law enforcement when we believe that there is a genuine risk of physical harm or direct threats to public safety.” one has to wonder why the Black Salve page is still there. People are actually posting pictures of physical harm. What more does Facebook need?

Please, don’t be tempted to use black salve, or anything containing bloodroot. If you think you have a skin tumour see a properly qualified doctor and follow his or her advice.

It might literally save your life.


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No, ketchup does not cause cancer

ketchup and coke

Do these things really cause breast cancer? (Spoiler: no)

Less than two days into the new year, and I’d already found what might well be one of the silliest health headlines of the year. What is it I hear you ask? Well, it was in a national newspaper on New Years Day, and it was this:

Sugar found in ketchup and Coke linked to breast cancer

This, to borrow a favourite line from an online greetings card company, had me rolling my eyes so hard I could practically see my brain. Why? Because even without reading any further, I knew immediately that it was the equivalent of saying, “too much of thing found in most stuff might cause cancer!”

But let’s not be one of the 70% of users that only read the headline, let’s dig a little further. The newspaper article, which in fairness isn’t too bad – it’s just a bit of a silly headline, alludes to work carried out the University of Texas’ MD Anderson Cancer Centre. If you click on the link I’ve added back there, you’ll see that MD Anderson’s headline was:

“Sugar in Western diets increases risk for breast cancer tumors and metastasis”

Note, they just say ‘sugar’, not sugar in two apparently randomly-selected foodstuffs. The researchers divided mice into four groups, fed some a diet high in sucrose (more commonly called table sugar – in other words, the stuff in the sugar bowl) and compared them to others fed a low-sugar, ‘starch-controlled’ diet. They found that the high-sugar diet lead to increased tumour growth, particularly in mammary glands.

I’ve covered forms of sugar before but still, here’s a quick reminder before we go any further: this is a molecule of sucrose:

Saccharose2

Sucrose

Sucrose is made of two ‘bits’ joined together: one unit of fructose and one unit of glucose.

157px-Alpha-D-Glucopyranose

Glucose

These two molecules are what chemists call isomers. They contain the same number and type of atoms, just joined up differently. They’re both sugars in and of themselves. Glucose is used directly by cells in your body for energy. Fructose, on the other hand, is trickier. It has a lower glycemic index than glucose, in other words, it doesn’t raise your blood sugar as rapidly as glucose, but this doesn’t mean it’s healthier. It’s metabolised almost exclusively in the liver and, long story short, invariably ends up being converted into, and stored as, fat.

179px-Beta-D-Fructofuranose

Fructose

Fruit is high in fructose, and fructose tastes very sweet to us (sweeter than either glucose or sucrose). This is nature’s way of telling us, and other animals that might eat the fruit, that it’s high in nutrients. From the plant’s point of view, it’s an incentive to eat the fruit and, ahem, spread the seeds around.

Humans have, of course messed around with this perfectly sensible survival mechanism by stuffing all kinds of easily-available and not particularly nutrient-rich foods with fructose, and herein lies the problem. Co-author of the paper that started all this, Lorenzo Cohen, Ph.D., professor of Palliative, Rehabilitation, and Integrative Medicine, said “we determined that it was specifically fructose, in table sugar and high-fructose corn syrup […] which was responsible for facilitating lung metastasis and 12-HETE production in breast tumors.” Notice that he mentions fructose in table sugar; this is because, once you eat sucrose, it breaks down into units of glucose and fructose.

The article goes on to suggest that sugar-sweetened beverages are a significant problem, so was the newspaper wrong to pick on Coke? It’s a popular drink after all, and a standard can of Coca-Cola contains approximately 35 grams of sugar (which might come from either sucrose or high fructose corn syrup mainly depending on where you buy it). The guidance for adults is no more than 30 grams of sugar per day, so a single can of regular Coca-Cola would take you over that limit, and it’s very easy to drink two or even three cans without giving it a second thought.

sugar

Soft drinks and fruit juice both contain a lot of sugar

However, the same goes for pretty much any non-diet soft drink.  Pepsi, for example, has a similar amount. Lemonade can be even more sugary, with some drinks hitting 40 grams per 330 ml can. Ginger beer might well be the worst; there are 53 grams per 330 ml in Old Jamaica Ginger beer for example. Fruit juice is no better, with many juices containing 35 g of sugar per 330 ml, although at least fruit juice might contain some other nutrients such as vitamin C.

So really, I’d say it’s a bit unfair to single out Coke in a headline like this.

What about the ketchup (note they didn’t pick a specific brand here, just generic ‘ketchup’)?

Well, ketchup IS high in sugar. It contains about 24 grams of sugar per 100 grams. But hang on, 100 grams of ketchup is quite a lot. A more realistic serving size of a tablespoon is only about 15 grams, which works out at about 3.5 grams of sugar. Still quite a lot, but probably a drop in the ocean compared to all the sugar in cake, bread, drinks, fruit juice, breakfast cereals and the tubs of Roses and Quality Street you scoffed over Christmas. Unless you make a habit of drinking ketchup by the bottle (apparently some people do) this is frankly a ridiculous foodstuff to pick on.

I imagine that someone did a quick search for ‘foods that contain fructose’ and picked Coke because, well, everyone knows that Coke’s bad, right? So that sounds credible. And ketchup because we all sort of suspect it’s probably not that healthy, but it hasn’t been the subject of a health scare recently so that makes it stand out. Great clickbait, bad science.

mouse

Mice are not people

Plus, let’s be absolutely clear, the study was in mice. Mice are not people. While a study that shows an effect in mice is an interesting start, and may well be good reason to conduct more studies, quite possibly in humans, it’s not proof that this mechanism exists in humans. Humans have, after all, evolved to eat a very different diet to mice. There might well be a link, but this doesn’t prove it, and even if a link does exist we certainly can’t say anything about the significance or size of it from this research.

I’m not a dietician, but I’m going to go out on a (fairly sturdy) limb here and say that cutting back on sugar will not do you any harm and is likely to be a jolly good thing. Let’s also be clear that sugar in fruit juice, agave, honey etc is still sugar and is no healthier than table sugar. Eating too much of the sweet stuff is almost definitely bad for your waistline and, as we all learned as children, bad for your teeth too – something which is often overlooked but really shouldn’t be, poor dental health having been linked to other serious health problems including diabetes and heart disease.

ketchup on bread

Maybe cut back on the fried ketchup sandwiches

But, and here’s my big problem with the newspaper’s headline, none of this means that Coke and ketchup directly cause breast cancer which is how, I fear, some people will interpret it. Cut out sugary fizzy drinks by all means, and perhaps ditch the ketchup sandwiches (especially fried ones), but please don’t worry that the occasional dollop of red sauce is going to kill you. I’m pretty certain it won’t.

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A small edit was made on 6th January to clarify that pure fructose isn’t used as an ingredient in Coke, but rather high fructose corn syrup.