Every week, another patient asks Skyler Johnson, MD, the same question: Can ivermectin treat my cancer?
His answer never changes.
"It's not been shown to be effective in actual cancer patients," said Johnson, a radiation oncologist at the University of Utah Huntsman Cancer Institute in Salt Lake City.
Widely discredited as a COVID-19 treatment, ivermectin now is promoted in some online circles as a cancer therapy despite lacking clinical evidence, and some states have made it easier to obtain. Additionally, HHS Secretary Robert F. Kennedy Jr. claimed in a post on X that the FDA suppressed the substance as part of a "war on public health."
Those factors create a growing challenge for oncologists like Johnson, who must navigate conversations with patients swayed by unsupported viral claims.
On platforms like Substack and X, accounts with thousands of followers push ivermectin as a cheap alternative for patients distrustful of "profit-driven oncology." An X post shared thousands of times falsely claims cancer is a parasite that ivermectin can kill, an assertion Johnson said predates the pandemic.
"I just feel like we're in some kind of disinformation epidemic," said Samyukta Mullangi, MD, MBA, an oncologist at Tennessee Oncology near Nashville.
Google searches for ivermectin spiked in January to their highest level since the pandemic. That surge coincided with actor Mel Gibson's Jan. 9 appearance on Joe Rogan's podcast, where he claimed multiple friends used ivermectin and other drugs to beat stage IV cancer. "This stuff works, man," Gibson said, without citing credible evidence.
The episode, viewed more than 11 million times on YouTube, prompted the Canadian Cancer Society to denounce the actor's comments as "dangerous, cruel, (and) irresponsible" misinformation.
"The main harm is that some patients will think this is a treatment for their cancer and choose it over the actual evidence-based recommended treatments," said Celeste Bello, MD, MSPH, a hematologist, medical oncologist, and senior member in the malignant hematology program at the Moffitt Cancer Center in Tampa, Florida. "This delay may result in damage to organs and possibly result in the patient not being able to get the evidence-based recommended treatment due to the disease becoming too advanced."
While ivermectin has proven effective against some conditions in humans, neither COVID-19 nor cancer are among them.
It is used to treat river blindness and other parasitic infections, and it earned its two discoverers a Nobel Prize in 2015. Topical versions treat lice and rosacea, and veterinarians administer it for parasitic infections in animals.
But multiple studies failed to produce credible evidence that it helps against COVID-19. The ACTIV-6 study found no significant difference in symptom relief, hospitalization rates, or emergency department visits between patients with mild-to-moderate cases who took ivermectin and those who took a placebo.
Preclinical studies suggest ivermectin may be effective against some cancer cell lines in high doses, Johnson said. In a 2021 study, mice given ivermectin and anti-PD-1 monoclonal antibodies showed higher rates of cancer cell death and T-cell infiltration of breast tumors.
"For sure, there is something to it, but as in many things in life, it is way more complicated than people are making [it] out to be," said Peter P. Lee, MD, a co-author of the study and chair of the immuno-oncology department at City of Hope Comprehensive Cancer Center near Los Angeles. He pointed to early research that suggests "promise" if combined with immunotherapy drugs.
"To think that all you have to do is take it and that's it, it's not enough," Lee said. "And in all of our studies when we give ivermectin alone, it's just not enough."
A phase I/II study that Lee and colleagues presented at this year's American Society of Clinical Oncology meeting tested ivermectin with immunotherapy for metastatic triple-negative breast cancer. Eight patients were evaluated: one had stable disease, one had a partial response, and six saw their cancer progress.
Those results underscore how much research remains, doctors said.
"A compound has to go through a lot of steps before it can go from the lab bench to a human," Bello said. "I think a lot of people don't understand this process, and that's where the mistrust starts."
Some states have responded by making ivermectin easier to obtain. Laws in Arkansas, Idaho, and Tennessee allow for its over-the-counter sale. In at least a dozen other states, similar bills have been proposed.
Doctors worry that easier access could lead patients to hide ivermectin use, risking harmful drug interactions.
"I worry that even when patients ask me my thoughts about it and I say, 'I don't think there's good data,' they're going ahead and taking it anyway, because it's easy to access, and then just not telling me," Mullangi said.
Growing access and misinformation make those conversations more critical. Those discussions typically cover a wide range, Johnson said. Some patients are curious. Others are skeptical of the pharmaceutical industry.
"Try to reiterate that we're on the same team, that we have the same goals," to identify why patients are interested in ivermectin, Johnson said. "Leverage that to build a relationship around trusting what I'm discussing with them."
Motivational interviewing techniques can help uncover why patients believe what they do, Johnson said. A physician can ask the patient to rate their confidence in an ivermectin treatment on a scale of one to 10, then follow with questions about the selection, he said.
"You'll ask, 'OK, how come you're not a 10? How come you're not 100% certain that ivermectin's the right thing?' And when you ask these types of questions, you can get to some really interesting places as to why patients believe the things that they do," Johnson said.
Another key relates to a vow Johnson makes to those asking about ivermectin.
"I can promise you that if this medication is proven to work in cancer patients," Johnson said, "I will be the first to recommend it to you."
https://www.medpagetoday.com/hematologyoncology/othercancers/116308
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