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Thankyou to Professor Bewley and colleagues for their comments.
We agree with many of the concerns raised and want to point out it is
essential to read and interpret this article for what it is - a case
report. As has been rightly pointed out, it is therefore only anecdotal
and is the lowest grade quality of evidence.
Our intention in writing this article is merely to point out a
Our intention in writing this article is merely to point out a
temporal association between taking curcumin and the patient's disease
entering a quiescent and stable phase. But this is prone to many
confounding factors and like any case report, has severe limitations. The
only conclusion that can be drawn from this case is that further studies
are needed to establish whether curcumin is indeed beneficial for myeloma.
The media response has been disproportionate and regrettable. We
believe the article did use cautious language but for further clarity:
In no way do we endorse the use of curcumin in Myeloma, either in
addition to and especially not in place of established therapy. There is
insufficient evidence to support this, doing so can be potentially
dangerous and it can come at significant financial cost to patients.
The article should not be removed as we maintain there is still an
important observation to be noted - but this needs evaluation in the
context of a clinical trial.
Case report should be withdrawn
HealthWatch UK is a charity that promotes ‘science and integrity in medicine’, values we might all expect to be shared by the BMJ and all its subsidiary journals. Accordingly, we ask you to think again about the Publishing Executive’s response (1) to the e-letter submitted by our colleague Les Rose (2) regarding a report by Zaidi et al. (3) about curcum...
HealthWatch UK is a charity that promotes ‘science and integrity in medicine’, values we might all expect to be shared by the BMJ and all its subsidiary journals. Accordingly, we ask you to think again about the Publishing Executive’s response (1) to the e-letter submitted by our colleague Les Rose (2) regarding a report by Zaidi et al. (3) about curcumin as a treatment for myeloma.
We regard the response as unsatisfactory because:
1. Zaidi et al. had little regard for the extensive published research on the medicinal chemistry of curcumin. Their conclusion made a clear case for the clinical use of curcumin in myeloma, when it would have been far more appropriate to call for rigorous clinical trials. The BMJ was wrong to say the language they used was ‘cautious’.
2. Zaidi et al. failed to respond to Rose and their use of citations of research by a discredited investigator was not commented upon (1). This should have been detected both by reviewers and editors and should have been put right.
3. It is poor judgment for BMJ Case Reports to deny responsibility for claims in other media – especially when our complaints to the BBC were rebutted by the justification that this was a peer-reviewed publication. Journal executives must know that such claims will be amplified by the lay media, especially when they are unusual and thus newsworthy. Indeed, journals often issue press releases for this purpose. Editors therefore have an obligation to ensure that peer review is rigorous and claims in published papers are made responsibly.
4. While case reports have a role in medicine, they are no more than a suggestion of where proper research should next be carried out. It is not appropriate even to suggest that a treatment should be prescribed on the basis of anecdote.
For all these reasons, HealthWatch UK considers that this report should be withdrawn and an editorial should be published explaining the reasons.
Susan Bewley, Professor of Women’s Health, Kings College London, Chair of HealthWatch UK
Nick Ross, writer, campaigner and broadcaster
Roger Fisken, consultant physician (retired)
On behalf of the Board of Trustees of HealthWatch UK.
BMJ approached the authors for their comments, but did not receive a
response. This case was reviewed by two external peer reviewers prior to
publication. It uses cautious language throughout and correctly offers no
definitive conclusions. BMJ Case Reports is not responsible for claims
made in other media.
I am the Publishing Executive for BMJ Case Report...
I am the Publishing Executive for BMJ Case Reports
Zaidi et al conclude that "Dietary supplements, such as curcumin, may
be beneficial for some myeloma patients". This is on the basis of their
single case report; in other words it is an anecdote. In contrast, the
medicinal chemistry of curcumin has been studied in depth for many years.
Nelson et al conclude that, despite over 120 clinical trials, no
beneficial effect has been observed (1).
I am wondering about h...
I am wondering about how rigorous was the peer review of this case
report. Did the reviewers evaluate what was the more likely explanation,
in the light of the published literature?
I note that Zaidi et al cite a review by Aggarwal et al in 2009 (2).
Several papers from this author were withdrawn in or about 2012 as
possibly fraudulent (3), casting doubt on his authority. I do not think
this oversight reflects well on the authors of the present case report, or
on its reviewers.
This case report has recently attracted substantial attention from
the lay media. Exaggerated claims have been made on national radio. Yet
there is good evidence that cancer patients who rely on alternative
treatments such as plant extracts have worse outcomes (4). Was it really
responsible of the BMJ to publish this report in its present form?
1. Nelson KM, Dahlin J, Bisson J et al. The Essential Medicinal
Chemistry of Curcumin. J Med Chem. 2017 Mar 9; 60(5): 1620-1637.
2. Aggarwal BB, Harikumar KB. Potential therapeutic effects of
curcumin, the anti-inflammatory agent, against neurodegenerative,
cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases.
Int J Biochem Cell Biol 2009;41:40-59.
3. Ackerman T. M.D. Anderson scientist, accused of manipulating data,
retires. Houston Chronicle, March 2, 2016 Updated: March 4, 2016.
http://bit.ly/2AHTN20 (accessed 8th Jan 2018)
4. Johnson SB, Park HS, Gross CP et al. Use of Alternative Medicine
for Cancer and Its Impact on Survival. Journal of the National Cancer
Institute, Volume 110, Issue 1, 1 January 2018
I have had smouldering myeloma for nine years but have not required treatment.