When you spot something that’s of concern, it can be worth spending a couple of minutes filling in a report, or noting it publicly via social media. Little actions such as these are greater than no action; they do add up, and can be the starting point for greater change.
This week, I went and had a minor procedure to remove a lesion after having a skin cancer check performed. It’s highly unlikely that the lesion is a potentially problematic one, but that can’t be completely ruled out unless it’s sent to pathology and examined.
This experience had me thinking about skin cancer and alternative medicine… namely, Black Salve.
For those of you not familiar with Black Salve (also known as ‘Bloodroot’ or ‘Cansema’) it is a herbal preparation which proponents claim can “draw out cancer cells” when applied to the skin.
Black Salve preparations typically contain zinc chloride, and chaparral – also known as creosote bush, and bloodroot – the extract of which is called sanguinarine, an ammonium salt which attacks and destroys living tissue.
Black Salves are corrosive substances, classified as ‘escharotics’. Escharotics are substances which cause tissue to die and slough off. Black Salve proponents believe that when this escharotic destroys tissue, it is somehow targeting cancer cells – and that when scabs form and fall off, the cancer is being removed from the body.
This is sadly very wrong – there is no mechanism by which black salve can mobilise and destroy cancer cells in a targeted manner; the salve merely damages tissue, healthy or not.
Use of Black Salve can result in ulceration, infection, skin damage, deep tissue damage, and muscle damage. If you are feeling not too squeamish and want to see the extent of damage Black Salve can cause, Google Black Salve and have a look at either the Google image search tab, or the Black Salve Facebook page. Be warned though, you’ll see people with huge ulcers, large scabs, and people who have literal holes in their faces and large areas of tissue missing from arms, necks, and breasts. It’s fairly disturbing, frankly – both that people believe that they’re doing themselves good by using Black Salve, and that they feel that damaging themselves in this way is less traumatic than going to a doctor, being examined, and undergoing evidence based cancer diagnosis and treatment.
And here’s another thing which is troublesome – many users of Black Salve hear of it via word of mouth – from other Black Salve users, naturopaths, and other alternative medicine proponents. Some decide to use Black Salve after a diagnosis from a GP – my own skin cancer doctor has had people ask him about its use, much to his dismay – while others self-diagnose skin cancers, or act on the opinions of unqualified people online.
There is a reason we have doctors who are specially trained in skin cancer detection and treatment, and pathology labs who conduct histological examination of tissue samples. Diagnosis of skin cancer is by no means as simple as looking to the opinion of somebody unqualified to do so.
Of course, do keep a close eye on your own skin, but make an appointment with a GP or skin cancer clinic if you notice anything unusual or concerning – and speak with them about how regularly it would be appropriate for you to have your skin checked by a professional.
Two in three Australians will be diagnosed with skin cancer by the time they are 70, so this is really worth keeping on top of – to find out more about reducing risks and screening, there’s a lot of useful information on the Cancer Council’s website.
Back to Black Salve. Self or internet diagnosis and the use of Black Salve don’t allow for accuracy. Some lesions and skin spots are benign and don’t require any treatment at all. Conversely, those that do need their progression assessed – Black Salve can leave behind cancerous cells. The use of Black Salve can lead to pointless injury, and a false sense of having cancer treated.
Why do people choose to use Black Salve? Well.. mistrust of evidence based medicine is a factor, alongside the belief that Black Salve is somehow ‘safer’ because it is ‘natural’. As with many other dangerous beliefs, getting accurate information into the public sphere can help, but it can also further polarise those who are heavily invested in the belief – there’s a substantial number of Black Salve adherents who believe that Black Salve is a cure for cancer being suppressed by Big Pharma, the goverment, Lizard People and what have you.
Publicising the dangers of Black Salve is one way to reduce its use; another is via regulation. This is a difficult one, as while the TGA have deemed it ‘unlisted’ on the Australian Register of Therapeutic Goods, there is no effective ban on Black Salve products.
The TGA has, however, issued an alert recommending people do not use Black Salve and associated ineffective cancer cures, which is useful, as we can then report those selling Black Salves or products recommending their use (such as the notorious DVD “One Answer to Cancer”) to the TGA.
In 2013, the TGA responded to a complaint made regarding the Australian Vaccination Network’s promotion of Black Salve and sale of the One Answer to Cancer DVD, citing several breaches of the Therapeutic Goods Act 1989. The TGA ordered the removal of any promotion of Black Salve from the AVN’s website, and that a retraction be posted, including a link to the TGA’s consumer alert on its use.
Personally, I would like to see regulatory agencies come down harder on dangerous products such as Black Salve, but their consumer alert can be useful when approaching third parties.
The night before my minor procedure, I decided to have a quick look online to see whether I could find anybody selling Black Salve in Australia. Unfortunately I didn’t have to look too hard – there were several listings on ebay for Black Salve, posted by sellers based in Australia.
I filled out reports for each one on their item pages, then decided to have a go at contacting ebay publicly via Twitter, with a polite tweet:
I didn’t have a great amount of confidence that anything would come of it, but thought it worth a try nonetheless.
The next morning, I awoke to a reply from ebay’s Australian account:
And a few more listings did appear, from the same sellers, with words slightly changed in order to try and evade detection and deletion. I sent links to them back to ebay via Twitter, and they promptly deleted these also. When I let ebay know how much I appreciated their help, the person handling their Twitter account replied,
I suppose for most people, the images of Black Salve use speak for themselves… and I feel very fortunate that I happened to come across somebody in a position of power to virtually get it off the shelves who was eager to assist when making a complaint.
Such people are out there. We don’t always find them (or they can’t always act) when trying to alert businesses, organisations, or dare I say government run health websites to dangerous misinformation or products they’re involved in the promotion of – lobbying against quackery is often a more time consuming and complicated process than a couple of ebay forms and some tweets.
It really is worth taking that first step though – whether it results in a small and immediate success or is the beginning of a greater campaign. And if you don’t feel that larger scale complaints, lobbying and publicising are your thing, get in touch with other skeptics, let them know what’s going on, and see whether they’re inspired to take action.
There are days when I feel rather overwhelmed by the amount of dangerous quackery out there, and helpless to do much about it. I’m acquainted with some people who accomplish amazing things; medical researchers, doctors and nurses, journalists, SAVN and the Good Thinking Society, and individuals who utilise their expertise and passion to expose and formally complain about charlatans, quacks, and dangerously misled proponents of woo. I’ve had the privilege of meeting great activists and educators, dedicated communicators, those who engage with the media, the public, and with bodies creating policy, and their efforts completely blow me away.
Over the past few years that I’ve been involved with skepticism, I’ve become convinced that we can all be doing something useful. Whether it’s as simple as sending a complaint to an e-commerce website, engaging politely on social media with those in a position to help stop quackery being spread, sharing evidence based information when somebody makes an inaccurate claim, letting people know that David Avocado Wolfe makes some very dangerous claims about medicine and suggesting they stop sharing his memes on Facebook, publicly or financially supporting campaigns run by other skeptics.
Many great skeptical triumphs which have helped diminish the proliferation of woo began with a single person noticing something was wrong, perhaps discussing it with other skeptics, and acting upon it. That said, don’t discount the tiny triumphs – they definitely add up. If there’s a chance that an action you could take may bring about any measure of good, please consider going ahead with making that complaint or politely engaging with somebody. It may well be worth it.