Dermatologists across America are witnessing an alarming trend.
More and more people are self-treating their cancers with a powerful cell-killing substance bought online. They say this topical paste is doing enormous harm and disfiguring patients.
On his TV show last year, Dr. Oz described this touted cancer remedy as "downright frightening" and "dangerous."
And yet many others praise the treatment, crediting it for clearing up their skin cancers. These folks are usually self-taught fans of alternative medicine. They mean well. And it is a fact that many patients are satisfied with the results.
But I know from personal experience that there are some problems with these salves. And BTW, there are several different OTC topical preparations.
The one Dr. Oz was slamming is called Black Salve. So let’s start with that. . .
Used by conventional and alternative practitioners
The use of salves, pastes or escharotics (substances that penetrate deep into the tissues) applied topically for cancer treatment is thought to go back at least 2,500 years to an arsenic paste described in Indian literature.
They were also mentioned by the Persian physician (and all-around genius) Avicenna in the 11th century and in the medicinal and scientific writings of Hildegard of Germany in the 12th century.
In the 19th century, a number of US doctors used salves. One in particular was Dr. J. Weldon Fell, one of the founders of the New York Academy of Medicine. He was recognized among his peers for the formula he created. It was considered highly effective.
Although zinc chloride - a caustic agent - was first used to treat cancer in England in 1815, it wasn't until 1858 that Dr. Fell combined it with a powdered form of the herb Sanguinaria canadensis, better known as bloodroot (pictured below).
He credited Native American tribes for his knowledge of the anti-cancer properties of bloodroot. But we needed to wait over a century before lab studies would confirm that alkaloids in bloodroot contain properties that work against cancer in a number of different ways.
Dr. Fell would coat a cotton cloth with the escharotic and place it over the tumor, changing the dressing daily. When the tumor developed into a slough of dead tissue or scab (also called an eschar), he would make incisions into it to insert more paste.
In his 1857 book, Dr. Fell said that two years after treatment, 80% - 90% of patients suffered cancer recurrence with surgery alone. This dropped to 30% in patients where the salve was used as part of the treatment.
In the first half of the twentieth century, Harry Hoxsey - who was not a doctor and was the subject of a relentless campaign to put him out of business by the medical authorities - included salves made from bloodroot and zinc chloride as one of his herbal cancer remedy protocols. This was passed down from his grandfather, a veterinarian, who used the same formula in the previous century to treat horses with tumors. (Hoxsey also advocated a more famous formula you take by mouth, for all types of cancer.)
Hoxsey’s topical formula is the combination used today in Black Salve (also known as Cansema or Compound X), but sometimes other herbs are included in the formula such as chaparral, goldenseal, galanga, graviola and red clover.
The high cure rates of Dr. Mohs
Dr. Frederic Mohs, a surgeon from the University of Wisconsin, invented a technique for treating some types of skin cancer, particularly basal and squamous cell carcinomas. These are less serious cancer lesions than deadly melanoma. He used his treatment on his first patient in 1936.
Traditionally, skin cancers required removal of much healthy tissue surrounding the tumor with a wait of several weeks for pathology reports.
But with chemosurgery, as Dr. Moh's technique was originally called, the practitioner applies a paste made up of zinc chloride, bloodroot, and the mineral stibnite. This slowly cauterizes or "fixes" the cancerous tissue.
Within a day, a thin layer of tissue can be removed without bleeding or pain to be examined immediately under a microscope. This is repeated until no cancer can be seen. The technique allowed for complete removal of the tumor with minimal loss of healthy tissue.
Mohs wrote in 1978 that using this method - the fixed tissue technique - he achieved a five-year remission rate of 99.3% with 9,351 patients.
Over time this approach was replaced by the fresh-tissue method, now called Mohs micrographic surgery. This doesn't require the use of a salve.
Mohs paste for melanomas
Dr. Norman Brooks from the Skin Cancer Medical Center, Encino, California not only believes the use of the paste is just as valid today, but recommends it for melanomas.
Most experts do not – certainly not for home treatments. So the following should be seen in the context of treatment by an expert, not on a do-it-yourself basis. . .
Writing in Dermatologic Surgery in June 2017, Dr. Brooks tells of Dr. Mohs’s achievement in increasing survival by 53% over three decades using chemosurgery compared to conventional surgery. And these were for advanced, mainly very thick, deeply invasive melanomas. In spite of this dramatic improvement in outcome, its use is not widely accepted for this purpose.
He also writes that "vaccine-like anti-melanoma immunity may be stimulated." The paste stimulates total body immunity and resistance to any further growth of the melanoma. He first published this systemic immune response effect in mice in 1998.
A melanoma breakthrough
If Dr. Brooks’ theory of immune modification holds up, this could be one of the most important discoveries in the history of cancer.
To understand what he’s saying, you need some background on melanoma. This is a deadly, highly invasive form of cancer that metastasizes like crazy. If you have metastatic melanoma, your condition is deeply serious. If I found I had just one melanoma lesion that had not metastasized, I would be worried.
Fortunately, it’s a pretty rare cancer. In the United States, there are about 10,000 deaths per year from this disease, compared to 67,000 deaths from breast and prostate cancer and 155,000 from lung cancer. Nearly 1.2 million Americans are living with melanoma, meaning this cancer IS survivable, albeit dangerous.
Most of the topical salves are recommended, if at all, to treat much less serious basal cell carcinomas. This disease does not metastasize. In fact, most of the time it’s not much more serious than a pimple. So when you hear the claim “salve cures skin cancer,” it’s not such a big deal. Yes, a topical salve can wipe out a basal cell carcinoma (BCC).
Melanoma IS a big deal. Dr. Brooks appears to be a reputable doctor, publishing in a highly respected medical journal. So the news that a topical salve is this successful is important.
And the immune response is the big news here. The data he cites indicate that the five-year survival rate is higher among patients whose melanomas are removed with Dr. Mohs’s technique compared to those whose melanomas were removed with conventional surgery.
As far as the naked eye can tell, both methods are simply cutting out the lesion – one with a chemical, one with a knife. Why do those who use the chemical survive at a higher rate?
Dr. Brooks believes it may be because the Mohs herbal/zinc chloride formula stimulates the immune system somehow – in effect, vaccinating the patient against a recurrence of the disease.
Exciting news, if it can be confirmed
Dr. Brooks told a meeting of dermatologists in 2010 that chemosurgery "not only kills the tumor locally but stimulates total body resistance and immunity, supporting the idea that surgery actually enhances melanoma tumor growth and metastatic spread. That's why I believe it's so important to use zinc chloride when treating melanoma."
Ken Gross, MD, who has authored a textbook on Mohs surgery, described Mohs paste as "a tried and true compound that does what it's purported to do.
"If you look at it from a perspective of what can I do that won't hurt my patients, probably helps them, and won't interfere with definitive modern therapy, I would say Mohs paste is a shining example."
Patient experience
In 2016 a research team from the University of Utah carried out a survey of 340 adults attending dermatology clinics in the state to find out their opinions of Black Salve.
Of the 23 patients who had used the salve, 17 had not talked to their doctors about the treatment, but relied on the experience of friends or relatives. About half had used it for cancer or a precancerous lesion while the rest used it for warts or other benign growths.
The most common reason given for using it was to avoid the pain, scarring and cost of surgery.
61% reported they were either satisfied or very satisfied with the treatment. Less than 9% were unsatisfied or very unsatisfied.
17 out of the 23 were unaware of any potential side effects from its use.
Should you use black salve?
The formula containing zinc chloride and bloodroot has been used for over 150 years to treat cancer.
A review published last year by a research group from Australia concluded that "Black Salve does appear to cure some skin cancers, although the cure rate for this therapy is currently unknown." But they warned it couldn't be relied on to be specific for tumors. It may harm normal tissue as well.
Because zinc chloride is a caustic agent, it will eat away at the tumor. This may be very painful. When the scab falls off, it can leave a big hole. While some of the tumor may be destroyed, cancer cells may still lie underneath where they can spread into the body, particularly in melanoma. Infection, scarring, disfigurement and a worse cancer outcome may be the end result.
This is the side of the story presented on the Dr. Oz show, although judging from the Utah survey, negative experiences apply to a small minority of patients. Nonetheless, these can be serious.
According to Dr. Brooks – who, you will recall, advocates the treatment -- "These are very hazardous substances that people can get hold of easily over the internet. Zinc chloride paste is a very powerful compound."
Ingrid Naiman, an expert on salves and author of Cancer Salves: A Botanical Approach to Treatment, agrees: "Zinc chloride is a highly antiseptic caustic that is somewhat more readily absorbed by malignant tissue than by normal tissue, though it is often reactive with healthy as well as morbid tissue.
"In the right hands, escharotics constitute an important option for cancer patients...but the products sold today [Bloodroot escharotics] are aggressive."
From the information we’ve been able to gather, I think this is a valid approach under a doctor’s care. A dermatologist who is trained in Mohs micrographic surgery can be found from the American Society for Mohs Surgery, although only a small number may still favor the original technique.
I don’t think it’s a good idea as a self-treatment – mostly because of my own experience with another skin cancer salve. . .
In an interview a few months ago, we talked to Dr. Adiel Tel-Oren, an international expert on skin cancer who has developed a new approach to treatment. He told us, “I’ve seen all those over-the-counter products like the black salve, Curaderm and others, and I’ve seen people who walk around without a nose because they put it on their nose, and ended up destroying it. It ate up their nose. And they put it in other places. It’s horrible.”
My own experience with self-treatment
I have a history of basal cell carinomas and I’ve long since lost count of the number of BCC lesions snipped away by dermatologists. It took me awhile to finally get around to trying the salves, but I was told by people I trust that they are safe and effective.
About a year ago, I used Curaderm to remove two BCCs. Curaderm is not formulated from bloodroot. It uses a different herbal ingredient, solasodine glycoside derived from eggplant. This substance is toxic to cancer cells and harmless to healthy cells (the makers say) when used in the concentration in Curaderm.
The product is recommended only for BCCs and other fairly harmless lesions, not for melanomas.
Curaderm contains two other ingredients, salicyclic acid and urea, which are intended to burn away dead tissue so that the eggplant extract can get at the live cancer cells.
The directions are to clean and dry the wound, apply a thin layer of Curaderm, and cover with a bandage – twice a day, every twelve hours. The makers warn that the wound will get larger at first and that this might be alarming (it did, and it was).
Eventually the lesion starts to get smaller and this indicates the cancer is dying away. The directions say to continue use until all live cancer cells have been destroyed. The first problem I had is that it was hard to tell when this has occurred.
It’s possible I used the salve a little bit too long. But I didn’t want the cancer to bounce back after I’d gone to so much bother to get rid of it. And it was some bother!
A big, nasty wound. . .
The other problem I had is that the process took weeks, during which time there was a large, open and fairly deep wound which I thought posed a major infection hazard.
This might all be worthwhile if the procedure left no scar, and that’s the reason I waited a year to write about my own experience. I wanted to be able to relate to you whether this procedure would scar or not. A year later, the skin is smooth in both the regions I treated and the discoloration has faded, but there is still clearly a scar.
I have plenty of surgical scars from BCCs that were cut out with the knife, so I was really hoping this approach would be scar-free. It isn’t. And others who have tried Curaderm tell me the same thing. The Curaderm scar is about as bad as a surgical scar, although the skin is smooth and you don’t have the puckering of the skin that is left after surgical stitches heal.
I would rate the Curaderm treatment effective and pretty safe. It’s been recommended by luminaries such as Dr. Mercola and Dr. Jonathan Wright. But next time I need to have a BCC removed I think I’ll just do surgery. This was too much bother and, in my opinion, involves too much infection risk. And after all the bother, I still had scars.
Best regards,
Lee Euler,
Publisher
References:
- http://www.cancersalves.com/pdf/CS-Introduction.pdf
- https://www.skincancer.org/skin-cancer-information/mohs-surgery/evolution-of-mohs
- https://journals.lww.com/dermatologicsurgery/fulltext/2018/02000/Mohs_Melanoma_Chemosurgery_Simplified_to_a_Single.34.aspx
- https://drive.google.com/file/d/0BxEga3L2RntVU2x0UHhmeFFaQW8/edit
- http://www.jaad.org/article/S0190-9622(15)02372-5/fulltext
- https://www.hindawi.com/journals/ecam/2017/9184034
