Respectful Insolence

Dr. Rashid Buttar is a quack. There, I’ve said it. It’s my opinion, and there’s lots of evidence to support that opinion. As you know, I seldom actually invoke the “q-word.” Indeed, for the longest time after I started blogging I tended to go out of my way to avoid using it, even to the point of being a bit ridiculous, but in Dr. Buttar’s case I now have little choice but to make my opinion of him plain.

I’ve noticed before that, as far as antivaccination cranks and the mercury militia go, when it rains it pours, and stories about such lunacy seem to come in waves. Weeks can go by without my coming across any antivaccination stories to blog about, and then suddenly I’ll find myself blogging about vaccines and/or autism every day for days in a row. The other day, I mentioned that Dr. Buttar is presently facing charges of unprofessional conduct, oddly enough not for his use of chelation therapy to treat autistic children, but rather for his treatment of patients with cancer. Naturally, this has made him a bit cranky. In an interview with the Charlotte Observer, he’s now lashing out at the North Carolina Medical Board:

Armed with complaints from Kenny and three others, the state board accuses Buttar of unprofessional conduct for departing from prevailing medical practice by treating patients with experimental, ineffective therapies and charging “exorbitant” fees.

A public hearing is set for Feb. 20, after which the board could reprimand the doctor or revoke, suspend or put limits on his license.

Buttar, 41, who has tangled with the board before, denies wrongdoing and vows to retaliate.

“I’ve been itching for a fight,” he said. “I’m going to make this into a huge thing. … I told the (state) legislature that the medical board was a rabid dog, and they needed to put it down.”

A “rabid dog”? More like a three-legged Chihuahua. I find it incomprehensible that the North Carolina Medical Board has taken so long to bring Dr. Buttar up on charges.

Dr. Buttar, as you may recall, has been a bit of a bĂȘte noire on this blog since very early in its history, not long after I first became interested in claims by antivaccinationists that mercury in vaccines causes autism. Although what Dr. Buttar is most famous for is his “transdermal” chelation cream (Buttar’s butter, as we skeptics have sometimes called it), he’s also prone to serious scientific delusions and has been known to come up with some truly bizarre protocols to treat autism (with rumors that Dr. Buttar’s armamentarium of woo even included urine injections to “boost the immune system”), all the while charging exorbitant fees. I knew all about Dr. Buttar’s autism quackery, but I hadn’t looked into his cancer quackery before. I had been meaning to do a post about it, but somehow in the two years or more since I learned of Dr. Buttar’s proclivities to treat cancer using chelation therapy and other dubious methods. (Believe it or not, he even appears to have an AirEnergy Machine that he uses, a machine that I featured a while back in Your Friday Dose of Woo.) Certainly, he was very confident, even cocky, when speaking to patients about “curing” their cancers:

After learning that his adrenal cell cancer had returned following surgery, Jeffrey Kenny sought help from Buttar in early 2004. “He said it didn’t matter what kind of cancer anybody had, he could cure it,” Stephanie Kenny said. “He kept reiterating he had a 100 percent success rate.”

And another patient’s statement:

Messina, who did not meet Buttar, said his aunt told him the doctor “treated every type of cancer the same” and bragged about his 100 percent success rate. Two weeks before she died, in November 2004 at age 52, “she just flat-out told me, `I wish I’d never gone to this Dr. Buttar,’ ” Messina said. “She felt that her cancer got a lot worse.”

As I’ve said before, if anyone claims that he can treat a usually fatal cancer with 100% success, run, don’t walk, out of his office. If anyone states that he treats every type of cancer the same, kick that person (if male, in the unmentionable area) before running away, the better to make sure that there is little chance of his catching you should he decide to pursue. That little bit of advice aside, it is instructive to see what sorts of things Dr. Buttar says on his website about cancer:

The standard method of treating cancer is comprised of a combination of chemotherapy, radiation and surgery. However, according to the conventional, traditional medical literature, 75 to 95 percent of all cancers are related to some type of toxicity which results in damage to the immune system. Also, 42 percent of all cancer patients die of malnutrition. Yet, how many doctors treating cancer address nutrition or help repair the immune system? Learn the 5 step treatment approach Dr. Buttar uses in repairing the immune system in conditions such as cancer and AIDS. Then reach your own conclusion.

Dr. Buttar doesn’t know what he is talking about. I’d love to know where he got that figure of 75-95% of cancers being due to toxins damaging the immune system. In reality, the causes of cancer are complex, involving damage to DNA, interplay with the immune system, angiogenesis, and hereditary factors, the exact mix of which depends upon the specific cacner. Moreover, it’s not true that oncologists don’t address nutrition. It’s a very important factor. And it’s really ridiculous to claim that oncologists aren’t interested in the immune system. It’s also hard not to mention that Dr. Buttar is starting to sound a bit like Hulda Clark, at least in claiming that he can cure both cancer and AIDS.

If you dig around, you’ll see that Dr. Buttar seems to blame nearly every ill known to humankind on “heavy metal” toxicity, with no evidence to back up his assertions. Naturally, there are lots of testimonials there, but, as I’ve pointed out before, testimonials are almost completely worthless in determining whether a treatment works. But what does Dr. Buttar’s treatment actually involve? It’s a veritable cornucopia of unproven and dubious therapies:

Chelation is one of more than 35 intravenous infusions Buttar offers as part of his approach to boost patients’ immune systems and detoxify their bodies so they can heal.

While chelation (pronounced key-Lay-shun) is approved by the Food and Drug Administration for lead poisoning, it is widely criticized by mainstream doctors when used to treat patients with cancer, heart disease, autism and other chronic illnesses.

But Buttar believes most patients with cancer also have high levels of heavy metals, such as mercury, and other toxins, such as pesticides, because of environmental exposure.

“Chelation works for the right things,” he said. “It’s not a panacea. But it works phenomenally well for chronic disease.”

Buttar’s practice also has two hyperbaric oxygen chambers — and more on the way. The treatment, which floods the body with oxygen, is commonly used to accelerate wound healing. But Buttar uses it to fight cancer because, he says, cancer cells can’t thrive in an oxygen-rich environment.

He acknowledges most of his treatments have not been proven by standard means, such as controlled clinical trials. But he said they have been effective in his practice over 10 years.

“Effective in his practice”? Note how Dr. Buttar does not define what he means by that. For example, what is the five year survival of his patients for various cancers at specific stages? What is the objective response rate (tumor shrinkage rate) for different kinds of tumors? In other words, what is his evidence that what he is doing is effective? Does he have randomized, double-blinded studies? Does he even have a well-controlled case series compared to historical controls (a weak form of medical evidence, but at least something)?

Nope.

Of course, that doesn’t stop him from charging huge sums of money for his “services”:

Buttar’s therapy for cancer patients ranges from $40,000 to $60,000 for two months, he said, and he doesn’t accept insurance. He said 70 percent of his patients are from outside North Carolina, including 30 percent from other countries.

But it can be even worse than a mere $60,000 for Dr. Buttar’s ministrations. For example, the Cajun Cowboy, a prostate cancer sufferer who made the mistake of trusting Dr. Buttar before becoming disillusioned and moving on to other questoinable therapies, spent over $150,000 at Dr. Buttar’s clinic. His conclusion:

My conclusions are that, Dr. Buttar is a good Doctor, but alas so far, my prostate cancer has just not been affected by this treatment. I have spent close to $150,000.00 dollars and had very little to show for it. One of the things Dr. Buttar and other natural cure Doctors assert is that surgery is so much more expensive, well I beg to differ. I have spent about $10,000 dollars of the above 150 thousand just in having the mercury amalgams removed from my teeth, then a copula root canals and too much pain to even mention!

Later, he dropped the part about Dr. Buttar being a good doctor:

Now as far as Dr. Buttar goes read what is said about almost every modality that he practices at:

QuackWatch.org

Now I new what was on this site before I went to Dr. Buttars and I new you had to take it with a grain of salt but for me, most of their opinions concerning Dr. Buttar’s treatment may be true! What I can say for sure is that they did not work for me after over $150,000.00 dollars and two years of treatment!

Dr. Buttar’s regimen is also very onerous for sick and debilitated patients to follow, as the Cajun Cowboy documented. The number of pills, patches, and supplements that Dr. Buttar administers to patients with is truly astounding. I always find it rather odd how alternative medicine advocates complain about how many pills conventional doctors subscribe, but then “alternative” doctors like Dr. Buttar (or Dr. Nicholas Gonzalez of the coffee enema fame) frequently surpass all but the most onerous “conventional” therapies, without the benefit of the therapies prescribed being evidence-based. Also integrated into Dr. Buttar’s “integrative” treatments is ozone therapy (which would be a good name for a rock band, if it weren’t so horrible to see desperate patients falling for such woo on such a regular basis). Not surprisingly, this regimen of pills and ozone therapy is supplemented as well by that quackery of quackery, coffee enemas. I often wonder why these regimens are so complicated. I’ve speculated that it allows the “alternative” doctor an “out” if the patient doesn’t get better, simply because it can always be claimed that the patient failed to follow the regimen properly.

But that’s just the cynic in me.

What’s really frustrating is to see how the media treats “maverick doctors” like Dr. Buttar, even when they enrich themselves so blatantly on the backs of desperate patients. The article in the Charlotte Observer article has an overall tone of present him in essence as a controversial iconoclast who might or might not be a quack, even going so far as to finish the story with testimonials about the supposed effectiveness of Dr. Buttar’s methods. (Obviously the journalist had no clue that testimonials do not represent convincing evidence for the efficacy of a therapy.) It’s that old false “balance” that journalists can’t seem to break out of. No matter how obvious it is that someone (like Dr. Buttar) is a quack (in my opinion), no matter how obvious it is that Dr. Buttar’s therapies are utterly without foundation or support in science (more than just my opinion), the “other side” has to be presented as if it has some sort of scientific validity. From my perspective, the only “rabid dog” that needs to be neutralized so that it can’t endanger anyone else is Dr. Buttar. At the very least, let’s hope that the North Carolina Medical Board behaves more aggressively towards his medical license than a 13-year old toothless toy poodle with a limp. Dr. Buttar and his medical license need to be parted from each other forthwith.

Comments

  1. #1 mark's tails
    December 10, 2007

    What’s so scary is how long this guy has been out there doing this kind of stuff. 100% cure rate, ofcourse, after a few months the patients just don’t show up anymore so they must be cured.

  2. #2 notmercury
    December 10, 2007

    JB Handley started his son on Buttar’s cream at an extremely young age yet no public outrage at being ripped of by this slime. Not to mention all of the parents who lost a bundle thanks to Generation Rescue’s free advertising for Buttar and his useless chelator. I’m sure JB will personally reimburse all of those parents.

    Dr. Buttar is on record as stating that he can only help autistic kids before a certain age. Once they are beyond that magic window of opportunity, he can still help them but they will probably end up flipping burgers for the rest of their lives. Nice.

    I’d like to see Rasheed flipping burgers in prison, maybe a side of tossed salad for nutritional value.

  3. #3 Alan Johns, M.D.
    December 10, 2007

    “Just because no one complains doesn’t mean that all the parachutes are perfect.” a wise man

  4. #4 notmercury
    December 10, 2007

    “But Buttar uses it to fight cancer because, he says, cancer cells can’t thrive in an oxygen-rich environment.”

    What about this claim? I read that some tumors include hypoxic regions but would HBOT have an impact on that and might it even stimulate angiogenesis to some degree?

  5. #5 Faithful Reader
    December 10, 2007

    Sorry to be OT, but I have a hideous cold. I heard a story on NPR the other day about autism and the “fever effect”– http://www.npr.org/templates/story/story.php?storyId=16956039

    I wanted to know what Orac thought or know about this as I had not heard of it before.

    This is the first blog i started reading– now I am a ScienceBlogs addict.

  6. #6 Lexin
    December 10, 2007

    I often wonder why these regimens are so complicated.

    I have no evidence for this at all, but after dealing with an elderly mother (the Aged Parent I call her, she’s 82 and she has a wide variety of illnesses) for a very long time now, I suspect that the complexity of the treatment gives the sick person some illusion of being able to control what’s happening. It would be interesting to see research on the matter.

    I know the Aged Parent seems never happier than when she’s deciding what particular item of her diet upset her this time or when dealing with a complex variety of pills which have to be taken in particular order and spaced a certain number of hours apart. And this is conventional medicine; in general I’ve managed to keep her away from medical woo.

  7. #7 daedalus2u
    December 10, 2007

    Here is a link to the actual paper.

    http://pediatrics.aappublications.org/cgi/content/full/120/6/e1386

    I will be putting up an analysis of this on my blog in the next few days. I think it is exactly consistent with my low NO hypothesis of ASDs (discussed on my blog).

  8. #8 HCN
    December 10, 2007

    It is also discussed here:
    http://www.autismvox.com/fever … Long story short, kids act differently when they are sick. So what?

    Orac can’t really be expected to comment on EVERYthing, can he?

  9. #9 isles
    December 10, 2007

    Lexin, I would add the thought that the complicated nature of a woo regimen gives the “prescriber” an excuse for why it doesn’t work. He or she can always say that if the protocol had been followed to the letter, it would have worked.

  10. #10 Nat
    December 10, 2007

    The larger, longer or more elaborate a placebo treatment protocol is the more likely it is to ‘work’ (subjectively that is). Ben Goldacre repeats this frequently.

    The patients really has to buy into the treatment/s in these rigourous behavioural regimines. They have plenty of psychological investment in feeling/getting better before you even start to calculate the actual effects of the treatment/s.

    So, if I were a quack, I’d employ very onerous treatment regimes (and charge through the roof for them). Luckily, I have scruples.

  11. #11 Sastra
    December 10, 2007

    I’ll add to Lexin’s, isles’, and Nat’s comments on why the regimen by pointing out that alternative medicine quacks seem to share some similarities with phony paranormalists. In The Full Facts Book of Cold Reading, Ian Rowland says that rituals are often an important part of the cold reading repertoire for astrologers, psychics, tarot card readers, etc.

    According to Rowland, a complicated series of steps to follow helps to re-enforce the belief system, impose the authority of the ‘expert,’ inhibit awkward responses, and promote the desired sheep-like cooperation.

  12. #12 HCN
    December 10, 2007

    Faithful Reader, if you are curious about the fever study check this out:
    http://photoninthedarkness.com/?p=137

  13. #13 Calli Arcale
    December 12, 2007

    In my experience, there is an unconscious tendency in most people to find things to be more impressive if they are complicated. Plus, complication makes for a good smokescreen, and not just because the quack can claim you didn’t do it right. If it’s sufficiently complicated, it can make people think they are not smart enough to understand it, which makes them unable to effectively question it.

  14. #14 Macnerdzcare
    December 17, 2007

    That is why i trust mainstreatm science not these alternative stuffs.

  15. #15 Enemy_of_Enemas
    December 21, 2007

    Regarding the comments about equating coffee enemas with crockery, the last time I looked both coffee and enema bags were available otc without a prescription. The coffee at the local grocry store or starbucks, and enema bags at the drug store.

    Sorry, but I just don’t see the wisdom in mobilizing a swat team to arrest the sad joe in line to buy his enema bag and coffee at the supermarket. This is a little bit ludicrous. As far as the law goes, every citizen has a constitutuinal right to self administer any kind of enema they decide on, tap water or, yes, even coffee enemas or anything else they think will help get rid of the bricks in there.

    So in conclusion, it is now clear that any internet bully who would deny a citizen his constitutional right to the enema of his choice is himself a quack.

  16. #16 HCN
    December 21, 2007

    Reading comprehension check: Dr. Buttar did not only prescribe coffee enemas, and other useless crap. He overbilled, and made promises he could not keep (basically lied about how effective the treatments were).

    Plus the Medical Board of North Carolina is not a “SWAT team”.

    If you want to push coffee up your bum, that is your perogative. It is a waste of perfectly good coffee.

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