Artemisinin-Is It a Useful Drug for Cancer Treatment in Dogs?

A couple of readers have asked about a purported cancer therapy agent called artemisinin. This is a compound derived from a plant and used for a variety of purposes in the system known as Traditional Chinese Medicine. It is sometimes recommended outside of this system as an herbal therapy for cancer, with the usual claims of dramatic benefits and virtually no risk of side effects. As we’ll see, the truth is more complex and more interesting than such simplistic claims.

What Is It?
A number of compounds have been identified in the plan known most commonly as Sweet Wormwood. Artemisinin is the most widely studied of these and the one most often claimed to have medicinal benefits. The usual forms in which the drug is given is as a dried herb or infusion (steeping the plant in water like tea).

It has been claimed to have benefits in treating cancer and fungal or parasitic infections in pets. It is also widely used, in conjunction with other drugs, in treatment of malaria in humans.

Does It Work?
There is no question that artemisinin has been useful in the treatment of malaria. Like any effective medicine, of course, it has been shown to have side effects (relatively low rates of nausea and vomiting, rare allergic reactions and possibly liver damage), and there is now evidence that malaria is developing resistance to artemisinin-based therapy.

The evidence for use in cancer therapy is not nearly as convincing (see also this review). There are a number of in vitro and lab animal studies showing potentially useful effects on cancer cells. However, this has been true for most cancer therapies that have gone on to be failures in actual clinical trials, so all it establishes is the possibility the drug might be useful, not that it actually is.

The next level of evidence is the case report, which is simply a formalized, published version of the anecdote. There are some case reports showing improvement in human cancer patients with use of artemisinin and related compounds (e.g. 1, 2). However, as with all anecdotes, these reports are subject to enormous risk of bias and confounding, and it is not appropriate to draw conclusions about the safety and efficacy of artemisinin from them. At most, they suggest the possibility that further, controlled testing is appropriate.

There isn’t much in the way of such evidence in humans. One clinical trial combining the compound with chemotherapy for lung cancer patients found no difference in terms of short, medium, or long-term survival. Some difference was seen in the rate of disease progression, but the reality and clinical relevance of this is doubtful, and the source is pretty questionable since it is a Chinese alternative medicine journal, and such journals appear to never publish negative results.

There is, similarly, virtually no clinical trial literature in veterinary species evaluating artemisinin as a cancer therapy. A clinical trial investigating the related compound artesunate as a therapy for lymphoma in dogs has recently been published:

J.N. Bryan, D. Tate, S.M. Bechtel, K. Choy, L. Donnelly, K. Fitzpatrick, B.K. Flesner, B. Fowler, B. Gallis, C.J. Henry, C. Herrera, M. Jabbes, K.A. Selting, T. Sasaki. Randomized, blinded, placebo-controlled trial of artesunate with doxorubicin for B-cell lymphoma of dogs. J Vet Int Med. 2014;28(4):1362.

Artemisinin has described anti-cancer properties. Artemisinin can down-regulate VEGF, HIF-1alpha, and survivin in cancer cells, causing apoptotic death. Artesunate, a water-soluble derivative, has better oral absorption in dogs than artemisinin. The hypothesis was that oral artesunate is tolerable with doxorubicin and results in longer disease-free interval (DFI) than doxorubicin and placebo in dogs with stage 3a or 4a B-cell lymphoma.

Twenty-one qualifying dogs were randomized (blinded) to receive artesunate 20 mg/kg or equivalent placebo. Dogs received study drug alone for 72 hours, then received 30 mg/kg doxorubicin q.3 weeks for three doses with study drug. Thereafter, lymph node measurement, CBC, chemistry profile, and urinalysis were monitored monthly until disease progression. Differences and DFI were compared by Mann-Whitney and Kaplan-Meier logrank tests. Significance was set at P ? 0.05.

Artesunate alone did not cause clinical remission (P = 0.1347). Artesunate induced no biochemical toxicosis. One dog experienced progressive disease following doxorubicin; all others experienced a complete response. Artesunate caused no greater neutropenia or thrombocytopenia following doxorubicin (P = 0.6234 and P = 0.2311). DFI was not different between groups (70d for placebo and 122d for artesunate, P = 0.967). Dogs receiving artesunate had higher nucleated red blood cell counts (median 272nRBC/100WBC artesunate and 9nRBC/ 100WBC placebo, P = 0.0142). Red cells displayed poikilocytosis and basophilic stippling in artesunate-treated dogs.

Artesunate did not cause remission as a single agent, nor improved DFI in dogs treated with doxorubicin. 20 mg/kg artesunate caused evidence of heme stress in treated dogs. Artesunate was otherwise well tolerated with doxorubicin. Artesunate cannotbe recommended as a therapy for B-cell lymphoma in dogs.

This trial, like that reported in humans, found no evidence that artesunate improved survival used in conjunction with chemotherapy, and it did not appear to have any beneficial effects used alone.

Another uncontrolled clinical trial in dogs was identified some possible toxicity as well as some possible benefits, but was the heterogeneity of patients and treatments make any firm conclusions impossible.

So far, the clinical trial evidence does not strongly support the preliminary in vitro and lab animal studies or case reports that suggested these compounds might have benefits in cancer patients. This is not unusual, since the vast majority of drugs fail to become useful treatments in actual patients even when they initially look promising in pre-clinical studies. More research may help clarify the value, if any, of artemisinin in cancer therapy.

Is It Safe?
A number of potential risks to artemisinin have been reported in humans and other species. Generally, side effects have been mild and rare in humans, with low rates of vomiting and other GI symptoms reported. There have been concerns about neurologic toxicity, including hearing damage, but it is not yet clear how significant this risk really is. In the context of malaria treatment, where there are clear benefits, the risks appear to be small enough in most cases (other than pregnant women and, possibly, young children) to justify use. However, the risks in cancer patients have not been established.

In dogs, there have not been safety studies in cancer patients either, however there is stronger evidence of risk with artemisinin use. One study of various forms and routes of administration found anemia, neurotoxicity, and changes in mitochondria. Other studies have also found significant toxicity at high doses (see also this study). However, other studies using different forms and dosages have not reported adverse effects.

Bottom Line
There is clear clinical trial evidence that artemisinin is useful in the management of malaria in humans, though there are some concerns about it losing its efficacy. Side effects are reported, but they are usually mild and uncommon.

There is some pre-clinical evidence (in vitro studies and lab animal studies) suggesting artemisinin and related compounds might have some benefit in cancer treatment. This is supported by a few uncontrolled case reports in humans. However, the limited clinical trial evidence does not generally support any real benefit for actual patients, human or canine. More research is needed to clarify whether there are circumstances in which the drug might be helpful, but it is by no means a reliable, proven cancer therapy.

Pre-clinical trials in dogs have found some potentially significant risks, which seem to be greater than those seen in humans. Some of these, such as changes in red blood cell production, have also been seen in the limited clinical trials done in dogs, but others have not.

Overall, there is enough evidence to support further controlled clinical research but not to use the treatment in patients outside the context of appropriate clinical trials designed to assess safety and efficacy.

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39 Responses to Artemisinin-Is It a Useful Drug for Cancer Treatment in Dogs?

  1. pankaj shah says:

    The report looks biased against use of Arteminisin for treatment of cancer.Wonder why no clinical trials have been taken although invitro results were published in 2007.Probably it is that the drug industry donot want this treatment to come into fore as they will huge revenue for their stupid chemotherapies & for which they charge unusually high charge.The whole idea is that chemotherapies donot improve survival rates or conditions but dont take other medicines.

    Funny world of pharma companies.

  2. skeptvet says:

    By “biased,” of course, you mean I disagree with your view. This article reviews the evidence. The fact that the evidence isn’t very good is not a bias on my part.

    As for the claim that the lack of studies can be blamed on Big Bad Pharma so we can move on and use these kinds of unproven products anyway is a cop out.
    For one thing, if the research isn’t done, then we don’t know if the product is safe and effective, so it’s no good just saying, “Well, we can’t do the research so let’s just trust the anecdotes.”

    More importantly, herbal remedies are a $30 billion/year business in the U.S. alone. Companies are making tremendous profits selling unproven healthcare products because the law allows them to. The herbal remedy industry spends a far lower proportion of revenue on research than the much maligned pharmaceutical industry because they are not properly regulated. The money and incentives ARE there to study these things appropriately, but the political will is lacking to require this industry to put its money where its mouth is.

  3. Skeptdoc says:

    “In the context of malaria treatment, where there are clear benefits, the risks appear to be small enough in most cases (other than pregnant women and, possibly, young children) to justify use. However, the risks in cancer patients have not been established.”

    Is this not a value-laden statement? Statistically, is not the level of risk what it is? If risk is “small enough” to justify its use in malaria treatment then surely it remains “small enough” to justify its use in cancer treatment?

    Is it not appropriate to compare the “mild and rare” risks of vomiting/GI symptoms associated with artemisinin and the symptoms and risks associated with radiation and chemotherapy? If not, why?

    Furthermore, the one study you cite, in which “Dogs received study drug alone for 72 hours, then received 30 mg/kg doxorubicin…” [note: a chemotherapy drug] “…q.3 weeks for three doses with study drug” does not allow you to claim that the study drug alone was ineffective, since no dog received only the study drug. This appears to be a study the design of which is incapable of establishing the clinical efficacy of the study drug alone.

    Finally, the study drug artesunate may not be equivalent to artemisinin, it being a synthesised preparation of dihydroartemisinin reacted with succinic acid anhydride in basic medium, with pyridine as base/solvent, sodium bicarbonate in chloroform and catalyst DMAP (N,N-dimethylaminopyridine) and triethylamine in 1,2-dichloroethane.

    I would be interested in reading a properly designed study that compares artemisinin with doxorubicin in the treatment of B cell lymphoma. Are you aware of any?

  4. skeptvet says:

    “In the context of malaria treatment, where there are clear benefits, the risks appear to be small enough in most cases (other than pregnant women and, possibly, young children) to justify use. However, the risks in cancer patients have not been established.”

    Is this not a value-laden statement? Statistically, is not the level of risk what it is? If risk is “small enough” to justify its use in malaria treatment then surely it remains “small enough” to justify its use in cancer treatment?

    Of course ther eis subjectivity in the weighing of risks and benefits. Any decision about whether or not to use a treatment must balance risks and benefits, and in the absence of definitive high-level evidence this always means invoking other considerations, including how much uncertainty about risks and benefits is tolerable before one makes the decision to employ an intervention. In general, if the urgency to act is great, more uncertainty is tolerable than if it is not, but this is always a subjective judgment that must be made through discussion between client/patient and clinician.

    My reading of the literature on artemisinin in humans (and granted that is not my field of practice) is that for malaria the benefits are well-established and the risks are reasonably well-known and relatively small, therefore it seems reasonable to use the therapy. In the context of cancer, the benefits and risks are both largely unknown, which to me seems to argue for a more conservative approach. If interventions with better data establishing risks and benefits are available, these should be preferred. If there are no options for which the uncertainty is lower, certainly artemisinin use may be justified, but it has to be clear that this is a desperation roll of the dice, and proper informed consent must be obtained.

    It is also important to be wary of extrapolating from one population to another. Malaria patients and cancer patients are often different in many relevant respects, so if the evidence suggests mild GI symptoms are the risks in malaria patients, we cannot simply assume the risks will be the same in the cancer population. Therefore, it is not a question of comparing risks of GI symptoms form artemisinin with those from chemoTx, because the risks for chemoTx are known but those for artemisinin in the cancer population are not.

    …” [note: a chemotherapy drug] “…q.3 weeks for three doses with study drug” does not allow you to claim that the study drug alone was ineffective, since no dog received only the study drug. This appears to be a study the design of which is incapable of establishing the clinical efficacy of the study drug alone.

    Well, part of the issue here is an ethical problem. It would not be ethical to treat dogs with lymphoma with artesunate alone compared to placebo because there are already established effective therapies for canine lymphoma. You cannot ethically deny a known effective treatment in a clinical trial of an unproven treatment.

    In this study, the compound did not induce remission when given alone for 72 hours. Since existing therapies generally do induce remission within this timeframe, it can at least be concluded that it is not going to be as quickly effective as existing therapies. Whether it would induce remission if given longer before established therapies were added is an open question, but one that it seems unethical and perhaps not worthwhile to try and answer. The study also shows that addition of this therapy to chemoTx did not improve outcomes. So at least based on this there is not yet any reason to use the compound. More research is certainly appropriate, but it will also have to work within similar ethical boundaries.

    A comparison of the agent to doxorubicin has not, as far as I know, been published. Such a study could be done, though again clients would have to understand that they were taking a chance on an unproven agent and choosing, for at least some period of time, not to employ agents with known risks and benefits. I have been involved in some such research, and most clients will not choose to do this unless they simply cannot afford established therapy, which raises still more ethical questions. So it’s not a simple matter, but I think more research could be done.

  5. John Seville says:

    Unfortunately I have had 3 dogs with cancer in the last eight years. Two of my dogs about 8 years ago developed cancer at the same time, one with oral Squamous, the other with metastatic breast cancer. Both were treated by the book with surgery, chemo and even Cyberknife radiation, at great expense, but I did not care about the money, I cared about my dogs. Unfortunately neither survived dying 2 month apart. Fast foward 5 years, another of my dogs develops metastatic breast cancer. My first thought was go to the oncologist I had the first time, but then I said, why? He did not help my dogs with his conventional treatment, any they went through hell with the chemo, so I decided to go a different route. After researching I found a vet that used other methods in treating cancer, basically nutrition, Chinese herbals and Artesunate. My dog never suffered through the treatments, there were plenty of capsules to give every day, around 30, the diet involved home cooked meals and a on/off cycle of artesunate. It has been almost 2 years since diagnosis, it’s been a lot of work, but my dog is still here. The breast tumor nor the lung met show up on x-rays for the last several months and the doctor feels she is in remission. We have no intention of stopping anything we have been doing along the way. She is a 11 yo English Mastiff and this treatment with Artesunate has saved her life. There were times when I could feel the tumor had digressed in size after a nightly treatment.

    Biggest problem with these treatments is rarely does one know how to use it properly. Most of these trials I have read do not use it properly, so they do not achieve good results or any results. The same would go for the chemo agents they use, if not used properly, not only can they not be effective, they can kill you, at least the artesunate will not kill you if used improperly. Oncology needs all the help it can get, remission rates are really dismal and so is quality of life. I tried the conventional methods and failed, but succeeded with the unconventional methods.

  6. skeptvet says:

    Just a few reminders of why testimonials like this aren’t, unfortunately, very reliable or helpful.

    Medical Miracles: Should We Believe?

    Testimonials Lie

    Alternative medicine and placebo effects in pets

    Placebo effects in epileptic dogs

  7. c. l. says:

    What do you think about this study? It appears quite new though small scaled.
    A Randomised, Double Blind, Placebo-Controlled Pilot Study of Oral Artesunate Therapy for Colorectal Cancer
    http://www.sciencedirect.com/science/article/pii/S2352396414000346

  8. skeptvet says:

    It was generally well-designed and reported, but it was a little odd in its focus. The outcome had nothing to do with the health or survival of patients but with microscopic characteristics of the tumors once resected. The assumption was that tumors taken out surgically from patients getting placebo would show very few cells with markers of cell death (< 7% with signs of apoptosis)m whereas those tumors from patients given the drug would show more signs of cell death (>60% with signs of apoptosis). This would be interesting if it were born out, but it wouldn’t necessarily tell us if there would be an actual benefit to patients. More a proof of concept than a proff of actual effect.

    As it worked out, this primary outcome did not show any difference between placebo and artesunate, since there were high and similar levels of apoptosis in samples from both groups:

    55% of placebo recipients and 67% of artesunate treated patients achieved the primary outcome (patients in whom the proportion of apoptotic cells was > 7%). In designing this trial, it was assumed that only ? 1/11 patients receiving placebo would have > 7% of tumour cells displaying apoptosis. The unpredicted higher baseline values in placebo recipients precluded detection of an artesunate effect in the primary outcome.

    So the trial showed the drug didn’t do what the authors thought it would do, and if it had it might or might not have had any relevance to clinically important outcomes like survival, so I’m not sure this trial says much at all about the usefulness of the drug for cancer treatment. There were a few secondary outcomes measured, but again nothing that bears directly on health or survival.

  9. c. l. says:

    While the primary outcome is not expected but the secondary outcome shows some difference it made if can be replicated? It did seem to show that Artesunat decreased the express of a Ki67. As a number of studies have shown over the years, the expression of Ki-67 is a factor of poor prognosis for survival in different types of cancers. And in this study, it is consistent with it too.
    ==============
    Artesunate does not restore apoptosis in tumour cells in our study, but rather decreases the expression of a Ki67. Ki67 is also an important marker of prognosis in CRC unlike CD31, which is increased in expression.
    =============

    Findings

    20 patients (artesunate = 9, placebo = 11) completed the trial per protocol. Randomization groups were comparable clinically and for tumour characteristics. Apoptosis in > 7% of cells was seen in 67% and 55% of patients in artesunate and placebo groups, respectively. Using Bayesian analysis, the probabilities of an artesunate treatment effect reducing Ki67 and increasing CD31 expression were 0.89 and 0.79, respectively. During a median follow up of 42 months 1 patient in the artesunate and 6 patients in the placebo group developed recurrent CRC.

    Discussion

    Artesunate has a very high probability (0.97, calculated with an informative prior in Bayesian analysis, Fig. 2b) of effect on Ki67 staining of tumour cells. This is consistent with a high probability of artesunate effect on Ki67 staining of fibroblasts (0.84; Table 2). Ki67 is a marker of tumour cell proliferation whose upregulation is associated with a poorer prognosis in colorectal cancer. Other markers of tumour biology were also affected by artesunate, although with lower probabilities (for example, 0.79 probability for increased CD31 expression). In one case (Fig. 4b) there was a ~ 75% fall in circulating CEA levels after 2 weeks of artesunate treatment alone.

    Survival Analysis
    During a median follow up of 42 months, there were 6 recurrences in the placebo group and 1 recurrence in an artesunate recipient. Fig. 4 illustrates results from a Cox’s proportional hazards model. The hazard ratio of first disease recurrence is 0.16 (95% CI (0.02, 1.3)) in the artesunate group compared with placebo. The survival beyond 2 years in the artesunate group is estimated at 91% (95% CI (54%, 98%)) whilst surviving the first recurrence in the placebo group is only 57%(95% CI (28%, 78%)). A full sensitivity analysis for patient CRC21 is given in Supplementary Table 1 and suggests that if this patient was in the artesunate group without recurrence at 3 years, then a p-value for an artesunate effect on survival would be p = 0.07 (95% CI 0.02, 1.21).

  10. c. l. says:

    Quickly searching on google, there were some previously published results that showed something similar relating to Ki-67’s decrease:
    ==========
    Artemisinin at concentrations of 10 and 50 mum slowed the growth of embryoid bodies (Fig. 2A) and decreased the expression of the proliferation-associated antigen Ki-67 (Fig. 2B) (n = 3), although no cytotoxic effect, as evaluated by the lethal cell dye Sytox-Green, was observed (data not shown).
    ==============
    The expression of p53, Epidermal growth factor receptor (EGFR), and antigen Ki-67 as a cellular marker of proliferation, as well as the number of blood vessels stained by the CD31 antibody decreased, whereas the expression of transferrin receptor protein 1 (CD71) increased.
    ==========
    human-colorectal-carcinoma-and-inhibits-hyperactive-Wnt/beta-cat
    Artesunate (ART), a remarkable antimalarial agent, also inhibited the growth of human colorectal carcinoma. As determined by MTT assay, flow cytometry analysis on apoptosis and indirect immunofluorescence analysis on the proliferation-associated marker Ki67, ART suppressed the proliferation and promoted the apoptosis of colorectal cancer cells in a dose-dependent manner.
    ===========
    (I provided links for each of the quoted text above but the website thinks it was too spammy)..
    It seems the lack of further studies with this is likely due to the lack of financial incenvitives of making big money from this. This study being designed in such a way (odd) as you said is probably because it is cheaper and easier for a double blind study with limited funding.

    From the same author in the study in a later writing:
    http://theconversation.com/could-leading-anti-malarial-be-used-as-an-experimental-treatment-for-bowel-cancer-34893

    The choice of studies to carry out in patients is often driven by commercial interests, as these studies are much more challenging and expensive than laboratory experiments. Perversely, a cheap drug for one condition may not be developed further for another use, even if it is effective, if industry lacks financial incentives.

    Several encouraging types of information emerged. Artesunate reduces the Ki67 protein, a marker of how quickly tumour cells are multiplying, by about half. This is especially important because we already know that an increase in this marker in tumour tissues is a sign of poor outcome.

    Artesunate also shows direct anti-tumour effects when another marker of cancer progression, carcinoembryonic antigen, goes down without any other treatment. The chances of the tumour coming back may also be reduced by artesunate when patients are followed up for some years, although because our study was a relatively small one, we must remain cautious about this conclusion.

    Forward thinking

    Where do we go from here? We have a much clearer idea about the design of a bigger study with artesunate and bowel cancer – and we would like to do this as soon as possible, funding permitting. It may be that artesunate could also show promise for other cancers. These results also provide support that experimental use of drugs in well-designed studies can open new approaches to manage difficult conditions.

    As for patients who feel they need treatment for their bowel cancer now and can’t wait for more results? This is best left between the patient and their oncologist, until the evidence accumulates to decide if and how artesunate could become a standard of care.

  11. skeptvet says:

    The paper is open access, so people can read the details for themselves. At the moment, it provides some interesting evidence concerning potential mechanisms whereby artesunate might be useful in one type of cancer in humans, but there’s a long, hard road between that and clinical use.

    As for patients who feel they need treatment for their bowel cancer now and can’t wait for more results?

    This implies that there are only potential benefits, no risks. But previous studies with far less treatable cancers have shown that even with the least treatable disease, untested therapies can make life worse for patients.

    Gonzalez Regime for Pancreatic Cancer: Even Worse than We Thought

    This study of artesunate was done in patients already receiving the standard of care, which can be very effective. I agree that patients need to make decisions in consultation with their doctors since it is the rare individual not in science or medicine who is able to identify and critically evaluate the literature for themselves, and we have a natural tendency to grasp at straws even when we end up doing more harm than good.

  12. S Barker says:

    What about this article? It talks about the high levels of iron present in tumors, cancer cells, and malaria cells. Artemisinin or a combination of derivatives called “Artemix” has been successful in killing cancer cells – namely breast cancer. It also states that Artemisnin should be given with antioxidents and D-3.
    [Artemesinin and Canine Cancer in Dogs Naturally Magazine]

  13. skeptvet says:

    This is yet another example of making the thoroughly unjustified leap from what a substance does to cells in culture to giving it to patients. The overwhelming majority of medicinal compounds tested that do something useful in cell culture turn out not to be safe and effective medicines for actual patients because living organisms with real disease are enormously more complicated than cells in a test tube. Research like this suggests artemisinin might be useful, it does not show that it is useful. We cannot simply skip over clinical trials and all the other steps in moving from a good idea to a truly useful medicine without endangering patients.

  14. S Barker says:

    So you’re saying I shouldn’t give my 100lb Rottie-mix who will have his cancerous toe removed any Artemisinin to try killing off any newly forming cancer since it might be dangerous as it is not conclusive. Ok. We’re going back to homemade food (rice, split peas, lentils, carrots and either mackerel or ground turkey with Gold Seal vitamins and yogurt). What else can I use to keep the immune system at a high functioning level? Thank you.

  15. skeptvet says:

    And since proponents like to post anecdotes, even though I find them unreliable I feel obliged to point out that they cut both ways:

    http://mobile.news.com.au/national/victoria/father-says-anti-malaria-drug-prescribed-as-alternative-cancer-treatment-nearly-killed-him/story-fnii5sms-1227246907848

  16. John Seville says:

    I somehow forgot I had responded to the post of using Artesunate for my dog’s cancer, so took a look to see if skeptvet had responded. It is really laughable how you grasp as any straw to debunk the possibility that something other than mainstream medicine can work. FYI, the cancer fighting ability of artemisinin and derivative has been documented by 2 scientists at Washington State University, Prof Lai and Singh. Both have worked on Arte for a number of years and have documented cures for various forms of cancers including the biggie, osteosarcoma. I suggest you contact them and ask for copies of their work so you can finally admit you were wrong on this one. BTW, my dog is 12 now and still in remission as per the oncologist who has been treating her, who by the way now also implements Artesunate into his treatment of various cancers. He is one of the most respected oncologists in the country with a state of the art facility, Dr Gerald Post of the Veterinary Cancer Center in CT. Contact him also, since you seem to have a lot to learn on the subject of Artesunate and cancer. One more point, Artesunate has also been found to be possibly more effective than Valcyte against viral infections, especially Cytomegalovirus. My Immunologist uses it and there are plenty of abstracts in Pubmed to document this. Seems like you will be eating a lot of crow on this one! Ignorance is not, not knowing , but refusing to admit not knowing. Good luck in researching this one, you may even start using it yourself if you value the health of the pets you treat.

  17. skeptvet says:

    You sure have a lot of anger about anyone with the temerity to point out that anecdotes aren’t evidence. And you do not seem to have read my article, since I never say artesunate isnt’ effective, only that there isn’t much evidence yet to show whether it is or not. There is one trial, cited in the article, showing no benefit for dogs with lymphoma, and an in vitro/uncontrolled case series in dogs with solid tumors showing some possible benefit. That’s it. So as I say in the original article, it is worth further study, but it is not appropriate to use widely without proper monitoring and testing. It has far less research behind it than most pharmaceuticals, and yet those still turn out to have unanticipated problems once they go into general use, and there is not reason to believe a chemical like this should be any different. Every treatment needs to pass the same scientific tests for safety and efficacy, and it isn’t appropriate to skip over those just because you firmly believe in it.

    If further research validates the efficacy of artesunate or artemisinin for some cancers, I will be thrilled and happy to use it. I won’t be “eating crow” since I have never claimed it doesn’t work. And if it turns out not to be a safe and effective therapy in future research, what will you do? Will you continue to believe it saved your dog no matter what the research says? How open is your mind on the subject?

  18. louise says:

    http://www.telegraph.co.uk/wellbeing/health-advice/pill-cancer-tumour-bowel-health-drugs-cheap/

    You may be interested in the above article which provides information about the larger clinical trial now underway to follow up Prof Krishna’s pilot study in relation to Artesunate and Bowel cancer.

  19. skeptvet says:

    Thanks. We’ll just have to wait for the results and the published reports to see what comes of this.

  20. KarenLS says:

    Two data points. In 2002 I read an article about the research at U of WA on artemisinin and canine bone cancer. I happened to have a dog who had been diagnosed with advanced bone cancer. I contacted the researcher to find out where to obtain artemisinin and what the dosage should be to give it a try. A newfoundland whose entire front leg looked like swiss cheese on the x-ray lived another seven months before it metastasized to lung cancer and we had her euthanized. She shouldn’t have lasted a month. She was 9 1/2 when she passed. Fast forward several years and another newfoundland had bone cancer in her rear leg. Again contacted the researchers for updated information. I obtained artemisinin and its two derivatives. She too lived another seven months. While these are certainly not “cures” they are very suggestive of movement in the right direction. When the first began bearing weight on the cancerous leg and I ran out of the artemisinin I stopped the treatment. What if I had continued the treatment? We’ll never know because I did not have the funds to take her back for periodic x-rays and other tests. Same goes for the second one. If someone had contacted us to do the follow on testing I might have agreed…. we just could’t afford it on a “let’s see what is going on” basis.

    However, having observed the response of these two dogs I know that if I was diagnosed with cancer the first thing I would do is order artemisinin and its two derivatives and begin taking them while waiting for the human diagnostic process to laboriously wend its way to a firm diagnosis and treatment plan. If it didn’t work then no harm, no foul. If it did work then the human medical community would scratch their heads or just add on to the already beneficial result. My name is in the dictionary under skeptic but I have personally lived these two data points so I am willing to pursue the possibilities.

  21. skeptvet says:

    These are anecdotes, not data points. I have seen plenty of cases in my career who have done just as well without artemesinin, so neither your anecdotes nor mine say anything about whether or not it is beneficial or safe. Only controlled research can tell us, and in the meantime we are guessing. It is natural to want to “do everything” in these cases, but unfortunately I’ve seen patients harmed by untested alternative therapies, so there is potential risk as well as potential benefit to this approach.

  22. Judy Maji says:

    We have a rescue dog living with us for over a year {rottweiler} that we have grown to love, recently she was diagnosed with bone cancer and i would love to find something in holistic medicine that would possibly heal her. She a very warm and gentle dog to everyone and is worth the time and effort. The rescue group does not have the funds to help on an expensive level and we have some limitations. Sunny is only 5 years old.
    I have been giving her a small amount of tumeric and the vet has been giving her Rimadyl chewable 100MG { 11/2 tabs once a day} and Gabapetin 600MG {1’2 a tablet twice a day}

  23. CNM says:

    “And since proponents like to post anecdotes, even though I find them unreliable I feel obliged to point out that they cut both ways:

    http://mobile.news.com.au/national/victoria/father-says-anti-malaria-drug-prescribed-as-alternative-cancer-treatment-nearly-killed-him/story-fnii5sms-1227246907848

    Potentially a side effect of treatment, but not an indication that treatment failed.

  24. Mary Anne Whitonis says:

    Mr. Seville, Where is the best place to purchase those products and their derivatives? I have a dog recently diagnosed with histiolytic sarcoma and they tell me that this is resistant to chemotherapy drugs. I read the study by the doctors at the Washington State University and they say that those products you mentioned pretty much cured a dog with osteosarcoma. Wow!

  25. Mary Anne Whitonis says:

    I know one thing. I know that animals lived for years after the treatment with Artemisia and iron loading and than iron supplementation. I know that I am told over and over again that traditional chemotherapy will not work on histiocytic sarcoma. There is no other game in town other than holistic which I am doing with a doctor from Hawaii who had several clients with multiple lung tumors that he has kept going for two years now. And, the other game in town is the Artemisia and its other compounds. I think it is sad that people and animals can die when there is something that can work. An extra year or several years is an eternity to a cancer patient and until any of us are in that position we are not in a position to judge to tell them to wait until something is approved. Who among us wouldn’t take the chance if we thought it could give us more time on this Earth with those we love. I also think that my time is precious and unlike others I don’t feel it is necessary to be a “topper” or a last work person. It doesn’t do anything for me in my life. But, I know one thing. I have very serious disorders medically. I see doctors from Johns Hopkins, Thomas Jefferson and Geisinger Hospital and the one thing these world class experts have in common is their humbleness and their willingness and eagerness to get a consensus with other colleagues. I find my life is save with people who don’t think they are not capable of making a mistake or of learning something even though they are 1 of 3 people who treat people like myself with my problems. People who think they can do no wrong are the people that cause harm to others and sometimes even worse. And when I encounter anyone like that in any type of medical community I run from them like my hair is on fire!!! I don’t trust my life or the life of anyone I love with their care. They are the people who usually make the most mistakes and unfortunately the majority of us the last time I checked, only have 1 life and than it’s lights out permanently. So, say what you will about holistic medicine. I know it works. I know that integrated medicine is the way of the future in every way. And, I know that if something works, people and animals shouldn’t have to lose their lives especially if they are willing to sign off to the risks involved. Now I have serious health issues and a very sick dog and I simply can’t afford the time to be wasting on this site or any other on a regular basis. I am also a graduate of a graduate program in the sciences so I am not just some housewife frau. But, good luck to providing some good information to people but keep an open mind for the sake of all of our lives, humans and animals.

  26. Sarang Kulkarni says:

    I think oncologists should be more open to the natural medicine and they should believe apart from the chemo there are certain things which can be beneficial, as prof Lai said cancer cells and malaria bacteria have most of things common so if artemisinin is potent antimalarial drug then it must be potent anti-cancer drug. Yes i agree that no medicine has 100% cure rate but still if we have a medicine which is hope for targeted therapy i think health professionals must come forward and should start working on such type of medicines

  27. skeptvet says:

    Sorry, but your logic doesn’t make sense. Malaria is caused by a parasite, not a bacterium, and there are no similarities between them that make it likely the same drugs would work for both. Heck, even cancer isn’t one disease but thousands of different diseases, and each responds differently to treatment. It’s not a question of being “open” to new treatments. I’m open to anything that can be shown to work by rigorous scientific testing. However, it is dangerous and not in the best interests of patients to experiment on them with treatments that haven’t been through such testing.

  28. G says:

    Thank God Skeptvet is in science and not business or in any field needing a strong sense of understanding people’s emotions or a field dealing with decision making without sufficient evidence before doing so. With that said, Skeptvet is saying (although in a dry and devoid of empathy way which is why people are getting annoyed with you) that he cannot know for certain (without putting your dog through a controlled trial) whether your dog was absolutely without a doubt cured from this herb (or not). And so he is simply saying that if he had more controlled studies to go off of, his opinion would be shifted (whether for or against, based on the study). Right now, his opinion is that there isn’t enough evidence either way. He is trying, through his extremely logical way, to help you see that even if a dog’s tumor disappeared, without isolating the variables (dogs diet, other supplements so on) it’s hard to know the exact cause behind the tumor disappearing – and it’s hard to know what was coincidence vs. cause. Was it the diet? Was it that the owner stopped using hormone creams at night and petting their dog thus causing hormonally sensitive tumors to develop? (Not saying that that’s what happened.) Was it the herb? You will never know for certain, is his point. And thus because you cannot know for certain, you cannot then make the leap in logic and say that you know the herb caused improvement. My point of posting this is that I can see the care in which he is trying to display by expressing his logic even if he’s responding in ways the are devoid of….something important. But I also can see why everyone is really annoyed with him because he just doesn’t seem to be flexible without exhaustive evidence. For example, I have a feeling that even if one controlled study proved in favor, he would want several controlled studies to verify – which again is what is needed in order to bring more certainty to the conclusion. And we outside of science (although I have a partial science background but am in business) would never go through such rigor because in doing so, we’d actually fail at our jobs (with standards like these, he would fail at our jobs). Because most of our jobs take a level of guessing with limited information under time pressure, and the better guessers we are under time pressure, the better we are at our jobs – we don’t have time for controlled studies on every decision. And people who cannot be swayed either way without overwhelming evidence are often bad at making solid decisions under limited amounts of data points. I once had a boss who was so overly logical she failed at her new job. She was once in a field that supported her logical talents, but decided to do a career switch for some dumb reason, and then was faced with the business of PEOPLE (like customers and non-scientific co-workers) not data that could be fully isolated and studied. And because she couldn’t trust people’s abilities to assess a situation (without excessive data points), she would reject their perspectives, even when they were correct. And because she was now in a field that required fast decisions on limited data, she could never make decisions on time or would make horrible decisions if forced to do so under time pressure. And she was always assuming that the emotions of people made them illogical and irrational and thus their data was not to be trusted – yet she failed to see that just because they weren’t saying things in a hyper logical way, they could still be correct, whether it made sense to her or not. Her failure was that she failed to trust the non-logical people around her, the very people she needed to trust, and if she did, she could actually get to the answer she was searching for much more quickly. But because she isolated herself from non-proven data points (because she failed to have intuition about people and their given assessments), she rejected people’s inputs and it actually took her way too long to get to the correct information and business opportunties often passed her by. Anyway, I post this to help you understand why you’re annoying and angering people on this thread. Consider it a gift from someone who is just as good at understanding people as you are at understanding scientific studies. But I also post this to help people understand that you are not trying to annoy them or anger them, but simply cannot change your perspective until you have an overwhelming amount of data from controlled studies. He will never ever believe you, so don’t waste your time with stories of your pets being healed. And yes, your pets could have been healed by this herb (or not), but he won’t trust any evidence outside of controlled studies, so it doesn’t matter. And, that’s okay because this world needs his talents as much as it needs yours. But they clash when it comes to things needing a sense of intuition on limited data (data that has not been vetted by controlled studies), which is what we have here. I’ve enjoyed reading everyone’s posts. It’s helped me make better decisions for my dog. Enjoy and have a good day!

  29. skeptvet says:

    Wow, what an enormous straw man you’ve set up to knock down! Unfortunately, since I’ve been a successful vet in private practice for over 15 years, working with people effectively all day every day, your Spock-like caricature of me really doesn’t hold up. If you think you have to make the best decision possible under constraints of time and with imperfect information in your job, you should try practicing clinical medicine some time! 🙂

    And in addition to caricaturing me personally, you have pretty seriously misrepresented what I actually say on this blog. Acknowledging uncertainty and the limitations of the evidence isn’t the same as saying we can’t act on the available evidence. Uncertainty simply puts our balancing of risks and benefits in context. Unfortunately, some people do feel that recognizing the limits of personal experience and observation is somehow pedantic or demeaning. People get angry because they want certainty, hope, and validation, and they dislike being told that their experiences don’t justify the certainty they want. Life is full of nuance, ambiguity, and uncertainty, and the folks who don’t want to recognize that aren’t scientists striving for better information, they are people who want an anecdote that supports their hopes or beliefs to be enough. So while I appreciate your attempt at “balance,” mildly supercilious as it is, I think you’ve misinterpreted my message and the nature of the attacks made against it.

  30. Janel says:

    My dog was diagnosed with a maste cell tumor on host front paw. My vets said they would not be able to remove it efficiently because of tight space of paw. I opted out of surgery and have been trying other means to heal the cancer. I have been considering trying Artemix which is a combination of the artesunate artemisinin and artemether. My dog is a French bull dog he was 28 lbs. in your statement above you said it has to be given in the right way do you have any advise on how to administer or suggestion

  31. lisa says:

    Artemisinin must be taken at least 30 days out from chemotherapy. So the one study you quote us the one that proves that chemotherapy prevents artemisinin from doing its job. Logically based on one study that is easy to see. If your readers read ALL the published studies, they will see the benefit of artemisinin in cancer treatment.

  32. skeptvet says:

    Any evidence for your claim?

  33. Mary says:

    Check out treatment of veterinary sarcoma with iron uploading. German trial that cured 4 animals stage 3 and stage 4 cancers.
    I have done holistic protocol for 1 and half years since dogs lobectomy for hystiocytic sarcoma.

    Cancer has returned and tumor can’t be removed. So I am trying artemissin compounds. Also now planning on doing artemesia annua they used in study and same iron brand used in German study. There is nothing else to try so I am trying it. I’ll let everyone know.

    Thanks,
    Mary anne

  34. skeptvet says:

    Any published papers you can suggest?

  35. Norm Vigus says:

    From purist perspective, rigorous scientific studies and investigation is a good thing, I don’t have a problem excepting this. I used to work in research fields, managing and directing studies, although not into this area of work. However, one thing I did stumble over on many occasions is this Ivory scientific towers structure; the almost immovable establishment, like politics or any other arena, they turn out not to be as purist or unbiased as they would like to believe themselves to be! The fact is money and politics, often can, and do significantly influence how studies are conducted and there results. Even statistic, we know the are lies, and more lies, and statistics. Big Pharma has a significant financial interest in their Patented approaches which do earn them billions a year, and from a pure financial perspective it’s not doing them any favors someone coming up with some ( so called crack pot) natural remedies for what eve condition, as they cannot patent it. After all NO one can argue Big pharma’s primary goal in life is to earn money and lots of it. Thus when some lab often sponsored by these mega corporations come up with so called failed studies, can they be really trusted to deliver a truly scientific purist finding? It’s alike bitter Apricot seeds B17 or laetrile, go the the UK NHS and read their so called findings on it. can be highly toxic has little or no evidence for positive treatment in cancers. But, should readers choose to take it, do NOT take more than 2 or 4 seeds a day or it can kill. I know this is complete and utter garbage 2 to 4 seeds a day are completely and utterly harmless. I have take 25 seeds at a time in the past, and know many other who have done the same, with zero ill effects. Now, a respected prestigious organisation like the NHS to come out with such bunkum, leads one to question their loyalties, does it no? As they should know better than embark on such ludicrous storylines!

  36. skeptvet says:

    Science is not an academic exercise for “purists.” It’s the reason we mostly get to live past childhood now. And while financial bias is a real issue, that doesn’t magically mean that making stuff up without scientific evidence is reliable, or that we can simply ignore any research we don’t like if it seems to fit someone else’s agenda. It’s fine to be critical of industry, but when only anecdotes, personal experience, or blind faith is offered to support the alternative, that is just a step backwards away from real, useful knowledge and back to stumbling around ineffectually in the dark.

    Life Expectancy

  37. Gwen Ferry says:

    I think you are not looking at the right scientific studies on Artemisinin. Perhaps you could take a look at these ones, both with humans and animals where it is found to work beyond expectations.
    Here is a video worth listening to: [link removed]

  38. skeptvet says:

    Sorry, youtube videos aren’t the sort of evidence I take very seriously. If there are published research studies that aren’t accounted for in the reviews I cited, please cite them and I’ll take a look.

  39. Nancy Westrell says:

    I really appreciate your empirically based approach. Sorry that other folks don’t get it. I can understand their desparation – my dog has reached the end of the line for chemotherapy options for transitional cell carcinoma. People keep suggesting “natural” remedies for her, including artemisin. I declined one chemotherapy agent, because the research suggests very low chance of helping this kind of tumor, plus very high incidence of side effects that will make her last 6 months miserable. I think we should judge “natural” treatments with the same criteria as pharmaceutical options.

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