When Do You Just Keep Your Mouth Shut?

My mother is currently renting a small holiday apartment in a nearby town here in Germany, so that she can both escape the Italian summer heat, and do some much needed exercises in the thermal baths in the area. When I was visiting her this weekend, her landlord stopped by for a chat. He almost immediately informed us that he has metastatic cancer, with a tumor in his brain, as well as many small masses in his lungs, lymph nodes, and other places throughout his body. I was, of course, devastated to hear this. I doubt he has much longer to live, and it was really sad to find out that such a nice (albeit quite odd) man was going through something so terrible.

But then the conversation took a turn that made me very uncomfortable indeed. My mother asked him if he was doing any treatments, and he informed us that he was doing Gerson Therapy. “Oh! I’ve heard of that! It’s supposed to be really good!” my mother exclaimed. “There’s a Gerson clinic in Hungary right? And in Mexico! Maybe you should think about staying some time at the clinic!” Uh-oh. A cancer treatment my mother has heard of, is enthusiastic about, and is only done in Hungary and Mexico? Quackery alert. He then proceeded to tell us that the bulk of the therapy consisted of drinking gallons of juice made from nettles, dandelion leaves, apples and carrots. Oh dear.

Well, a quick internet search a few hours later confirmed my suspicions that this is, of course, yet another woo-based “naturalistic” cancer quackery, and my heart sank for the man. However, it got me thinking, at what point do you keep trying to dissuade people from falling into pits of alternative medicine garbage, and at what point do you keep your mouth shut?

I have posted before about the potential harm of perpetuating the placebo effect. If I were a doctor, and a patient of mine asked me about Gerson therapy, I definitely would not encourage them to do it. However, when it comes to casual conversation between acquaintances, or even between friends and family, it can get far harder to draw the line.

This man was clearly not forgoing science-based medicine completely. He had regular visits to the oncologist, and had already had at least three operations to remove some of his lymph nodes. What most likely happened was that his doctors explained that there was little more they could do, and so he decided to buy Gerson’s books and try this diet in parallel with his medical visits. He said he felt better, he has lost a lot of weight and has more energy, so the placebo effect does seem to be working on him, as he is also full of hope that this therapy will at least prolong his life. On the other hand, he told us about all the food he is not allowed to eat which he misses, but that giving up cake and alcohol and such things are a small price to pay if this treatment actually does save his life.

This is the sticky part for me. On the one hand, I don’t want to shit all over this man’s hope. Maybe living the last year or two of his life with hope and promise is the happiest way he could be spending this time. On the other hand, how much are his sacrifices costing him, when they will do nothing to save him from cancer? Would he be happier not denying himself the cakes he loves so much, or the holidays he’s not taking, rather than living his last days within a ten minute radius of a toilet for fear of wetting or soiling himself?

At what point do you just shut up and smile? At what point do you stop arguing, stop fighting for reason and science?

For me, there is a hard line when it comes to doing harm. If he were not seeking real treatment at all, I would have said something, even if he thought me interfering and arrogant in doing so. I simply can’t have a clean conscience if I don’t at least try to inform someone who is forgoing medicine for nettle juice. However, if there is nothing that person can do, if all possible medical treatment has been exhausted, and there is nothing left but to wait out the inevitable?

In this case, I did not say anything. I do not know this man at all, and it is not up to me to decide how happy he will be living a lie, or not. I think that, if he were a close friend or family member, I would try to convince them not to go for woo, but I wouldn’t insist if they had their mind set on it. When it comes right down to it, everyone has the right to decide how they want to live out their last days. Of course, in an ideal situation, they would make that decision fully informed, rather than based on lies and empty promises. However, there is a great wide world of information on the internet, and I really do think that some people are simply chasing a happy delusion. Some people really do prefer the feeling of hope to the harsh reality of truth. As I have mentioned before, I am not one of those people, but it really is not up to me to judge how other people find comfort.

What about you? Where do you stand on the fight against woo? Would you have spoken up, in this case?

Bad Science Reporting BullShit-O-Meter… Activated!

Recently, a post about the anti-cancer effects of ginger was cropping up on my feed quite a bit, and it caught my attention. I was immediately inclined to call bullshit on the whole thing, not only because the source was Earth, We Are One, but the all-caps title STUDY SHOWS GINGER IS 10,000X STRONGER THAN CHEMO (ONLY KILLS CANCER CELLS) was telling of an alt-medicine crapfest in itself.

However, not all alternative medicine ideas are equal. Sometimes they spawn from complete garbage (homeopathy, I’m looking at you), while other times they are simply exaggerating and twisting a small grain of truth into something it’s not, and sometimes that small grain of truth can be interesting. So, where does this article fall in the scale of bad science reporting, I asked myself? I am nothing but diligent in these matters, so I looked into it.

Of course, unsurprisingly, the so called studies were not linked in the post, but rather they quoted davidwolfe.com as their source. Sigh, OK, let’s take a look at it. Before my screen was overcome by popups asking me to subscribe to this and that, I managed to glimpse a few titles on the homepage, including 6 Things You Need To Know If You’re Friends With A Leo, and Press THIS Point on Your Belly to Remove Pounds of Toxins From Your Colon. Oh dear, it’s one of those sites. This might be an interesting fountain of silliness for future posts, but for now I’m on a mission to find the article in question.After using the search engine to find the article, I can immediately see that EWAO blatantly plagiarized the entire thing, from the title to the images and the text, except this version of the article actually links to the studies! And they’re real papers! Score one for David Wolfe! Color me impressed.So, what do the studies actually say? [Read more…]

What Is The Harm Of The Placebo Effect?

An article posted by Cara Santa Maria about banning homeopathy for pets got me thinking about a recent conversation I had with my father about the placebo effect, specifically when it came to homeopathy. While it is well known in the scientific and skeptic community that homeopathy is garbage, and takes full advantage of the placebo effect and anti-modern medicine marketing for its success, my father took the stance that there is an inherent benefit of “prescribing” placebos to patients under certain conditions.

His reasoning was this: if you have a patient that is suffering from insomnia, which is not due to a hormonal imbalance but rather due to an unaddressed anxiety or stress, and a sugar pill helps that patient to sleep at night, isn’t that better for their health than taking potent sleeping aids? Similarly, if a sugar pill helps someone with a generalized anxiety disorder feel more relaxed, or relieve a tension headache, or help a hypochondriac wait out a common cold they are convinced is deadly pneumonia, isn’t that better than giving that person the pharmaceutical counterpart to the homeopathic remedy? While he agrees that placebos are harmful in the context of an ulcer, or cancer, or other conditions in which a patient thinking they feel better will only make them wait for proper treatment and worsen their condition, he posited that using placebos in certain contexts could do a patient far more good than going straight for the heavy duty drugs. After all, sugar pills and drops of distilled water, while being useless cures also carry no side effects, so if plain water helps the condition, why expose the patients to the inevitable side effects, however minor, of drugs with real active ingredients?

While this reasoning has some merit on it’s face, it also ignores some serious downsides to this approach, especially when it comes to homeopathy.

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What Happens When You Combine Media Frenzy and Block Research

Stem cell research in the US has been both promising and crippled. The potential outcomes of what could one day be possible with stem cells has been the focus of a media frenzy for the past two decades, leading most lay people to believe that we have already figured it out by now, and that all you need to do is inject some stem cells at the site of an injury and voila! Magic happens!

At the same time, stem cells have been the focus of great ethical controversy, one that stems from religiosity and scientific ignorance, leading to the crippling of the progression of stem cell research in many parts of the country (and the world, for that matter), particularly during the Bush Administration, which means that the scientific research lags far behind the expectations of the public. This is a very dangerous combination.

 

Patients seeking stem cell therapies for achy joints or shoulder injuries no longer need to hop a plane to Mexico or China. More than 550 clinics around the U.S. offer unproved interventions for sports injuries and conditions including autism, multiple sclerosis and Alzheimer’s disease.

This vast stem cell market has boomed in recent years, particularly for orthopedic applications such as easing joint pain or for facelifts and other cosmetic procedures. In one frequently advertised regimen a patient might have adult stem cells harvested from his own fat tissue and injected at an injury site, purportedly to speed recovery. Professional athletes including football stars Peyton Manning and Chris Johnson have reportedly used stem cell injections to help them get back onto the field.

Yet there is a darker side to the promise of these treatments. There is little systematic data about patients’ long-term outcomes—positive or negative—and in most cases there is no scientific evidence that these costly procedures work. Many of these cellular therapies may not do much of anything but there is also the serious risk that recipients of cell injections could develop serious complications “including blood clots or dangerous immune reactions,” says Paul Knoepfler, a stem cell researcher at the University of California, Davis, School of Medicine

 

These clinics are trying to circumvent the law, by claiming that they are eligible for an FDA approval exemption. That should be a red flag right there, and another one is the fact that they advertise directly to the public, and also profess to be able to treat children with cerebral palsy and autism. Desperate parents have always been a fountain of cash for con artists (Burzynski clinic, anyone?)

Skeptics need to be wary of these kinds of places, even more so than you odd alternative medicine retreats that claim that meditation and talking to dolphins will clean out your shakras and cure your lower back pain, or whatever such nonsense. These clinics have the facade of genuine science to hide behind, and rely on ignorance of current scientific progress to dupe patients into believing that these treatments are safe, effective and have been around for ages. The stem cell media frenzy has only helped them along in this regard.

Bad scientific reporting bears a large part of the responsibility as well, of course. But we also need to not fear pointing out this quackery just because, in different contexts, we happen to fully support stem cell research. This kind of quackery is far too dangerous to ignore.

 

 

Bad Science: When There Is No Science At All

Note: this is a post from the old blog, but one that I think can spark an interesting discussion. Also, I am aware that National Geographic has been sold out, but this post was written well before that.

rhinoI have to admit I do enjoy National Geographic. Sure some of the articles can be a little wishy-washy, but the pictures are stunning and it definitely keeps my attention and keeps me company far more than any “women’s” magazine ever would (no, I could give a shit if those are Angelina Jolie’s real boobs, and if she has an eating disorder it is none of my business). This month, however, when flipping through I came across an article that bothered me called Rhino Wars.

rhinowarsThe article talks about the illegal trade in rhino horn from Africa to Asia, where it is rumored to have medicinal properties ranging from fever reducing properties to a cure for cancer. Despite the lack of scientific peer-reviewed evidence, many people believe in this and even doctors suggest it as a possible treatment for cancer.

Because of this demand, poachers have driven all five species of rhino onto the Endangered Species List, selling the horn for up to twice its weight in gold. This has also led to entrepreneurs trying “rhino farming”, where they keep the animals alive and sever their horns two-three inches above the base, which ensures its re-growth within a few years (unlike elephants, rhinos can survive perfectly well without their horns). While it doesn’t seem like an optimal solution, the argument for rhino farming is that it makes for competition for poachers (who kill the rhino before severing its horn) and is a good way to ensure the species’ survival. However, there is one big glaring problem that this NatGeo article completely fails to mention:

What about the millions of people that are duped into paying a fortune for something that most likely doesn’t work?

This is where the lack of science becomes incredibly bad science. A search through the literature on this subject has led me to only two studies, from the 1990s, on the effects of rhino horn on hypothermic rats. OK, so it seems as though they have been published in an actual journal with an actual Impact Factor, which is a good start. Unfortunately I cannot access the full article in order to take a good look at their methods, but here is an excerpt from one of the abstracts:

Intraperitoneal administration of an aqueous extract of rhinoceros horn at 5 2.5 and 1 g/ml, showed a significant antipyretic effect in rats with hyperthermia induced by subcutaneous injection of terpentine oil. Similar assays with extracts of the horns of saiga antelope, water buffalo and cattle at 5 g/ml also caused a significant drop in fever

Let’s say for the sake of argument that this is true, and that this effect translates over to humans. So rhino horn reduces fever, so what? So does paracetamol. We already have drugs that do this. Also notice that cattle horn has the same effect. Well, if you have to use some kind of horn, why not use one from an animal that is already farmed and has the same effect?

Here’s the problem, I cannot find a single peer-reviewed paper on the effects of rhino horn on cancer treatment. So what the hell are we waiting for?!

Although I highly doubt that rhino horn will have anti-cancer properties, I have explained again and again that not thinking something likely is no reason to not investigate it. There are doctors that are suggesting this, there need to be studies done. If one, two, three studies are done that show no health benefits, these results need to be plastered in these doctors’ faces and all over the news, only that way can we have any hope of educating people and getting them to devote their efforts to other, tried and tested treatments, possibly saving lives. You want to save the rhino and decrease poaching? Start by decreasing the demand.

And what if these studies demonstrate that rhino horn actually does have an anti-cancer effect? Well great! We can start looking for the active ingredient in the rhino horn so that it can be purified in the lab.

If it turns out that rhino horn does aid in cancer treatment then maybe I’ll be in favor of expanding and trading from rhino farms, at least until scientists are able to identify and replicate the compound that has these medicinal properties. But, until then, I think that rhino farming is a terribly flimsy band-aid over this festering problem.

By supporting rhino farming you are supporting financial interests in keeping the rhino horn trade alive. You may decrease the poaching and black market trade a little, but you are supporting people that do not want it to get out that rhino horn doesn’t have the medicinal benefits people think, because that would hurt sales. I know that there are going to be people that believe in traditional medicine no matter what, but to think that education could not make a huge dent is ridiculous. You only have to look at the past hundred years to see how this is not the case.

The fact of the matter is that, while NatGeo is right to point out the lives of rhino’s that are being saved, they fail to make the more obvious point. It is not just rhinos that are losing lives in this “war”, it is countless sick, desperate humans that are losing their lives as well.

Bad Science: Urine Therapy

Note: post from the old blog, slightly edited. The first of a new segment to come: bad science. Any suggestions for things you know, or suspect of being bad science are welcome in the comments section.

I get asked a lot of questions about strange alternative therapies quite often, and this is one that has been on my radar for a while now. People who drink their own urine for therapeutic reasons. Gross right? Well, yes, but that’s hardly the reason why I’m going to call it out now. My father drank a cup of horse blood every day for two weeks after a terrible car crash left him very dangerously anemic in order to get his iron levels back up, and that’s pretty disgusting too, but that doesn’t mean it didn’t work. I’m going after urine therapy for the two most important, fundamental reasons:

1. It doesn’t make any sense
2. There is no scientific evidence for it

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