 Worldwide attention was drawn to the possible value of aloe after the Second World War when skin burns of victims of the atomic bombs on Japan were evidently successfully treated with aloe vera gel, but you don't really know for sure until you put it to the test. Today, most radiation burns are caused by doctors giving radiation treatments for cancer. This can cause severe, painful, scarring skin reactions that can interfere with the therapy, yet sadly we are yet to come up with good prophylactic skin treatment measures to prevent this radiation-induced skin toxicity. Enter aloe vera gel, used on skin burns for centuries. So a randomized double-blind placebo-controlled trial was performed aloe vera gel versus a placebo gel, and no benefit was found. After the completion of the study, though, many involved clinicians felt that the patients participating in the trial had less skin inflammation than normal across the board, suggesting that maybe the placebo gel was helping too, so to their credit they actually ran a second experiment to see if aloe was better than nothing. And once again, aloe peered have no effect at all. In both trials, the severity scores were virtually identical, meaning aloe vera gel simply didn't work. What about an even larger trial? Hundreds of patients randomized to aloe vera gel, or just plain skin lotion, not only during the radiation treatments, but extending for two weeks afterwards, the skin lotion placebo worked even better in terms of reducing skin peeling and pain, and so yet again, aloe failed. And indeed, if you do a systematic review of all such studies, there's simply no evidence suggesting aloe is helpful. Head and neck cancer patients suffer the additional burden of radiation damage to the lining of their mouth and throat, and aloe didn't seem to help with that either. OK, so aloe may not help with cancer treatment, but how about helping with the cancer itself? In a petri dish, aloe inhibits the proliferation of human breast cancer cells, cervical cancer cells, and lung cancer cells. So is aloe vera a natural cancer soother? Unfortunately, in vitropotency, meaning like petri dish studies, often fail to translate to the clinic because the compounds aren't bioavailable enough to build up to test tube levels within the tumor in the body. So while some studies suggest an anti-proliferative effect on cancer cells in vitro, evidence from clinical trials is currently lacking. Until 1998, 50 patients with advanced untreatable cancer were treated with melatonin, which they thought might boost anti-cancer immunity, or melatonin with about 20 drops of an aloe extract twice a day, which they made by soaking one part aloe leaves to nine part 40-proof alcohol. And the aloe group appeared to do better, nearly twice as likely to either have a partial response or early some stabilization, and the most important outcome, improved survival. Here's the survival curve. So for example, six months out, 80% of the aloe group were still alive. Whereas more than half of the non-aloe group were dead. The researchers conclude that melatonin and aloe may be recommended in patients with very advanced untreatable cancers, since it didn't seem to cause any bad side effects and seemed to help. We don't know if the aloe would help on its own, though, and a subsequent study by the same group muddied the waters further by adding a third component to tincture of myrrh as well. But the main problem with these studies is that they weren't randomized. So if sicker patients were intentionally or unintentionally placed in the non-aloe control group, that could explain the apparent aloe benefit. The problem is there's never been any randomized studies of aloe for advanced cancers until now, or at least 2009, which we'll cover next.