Respectful Insolence

Bizarrely enough, Suzanne Somers has been a common topic of discussion on this blog since the very beginning. Indeed, in one of my earliest substantive posts, way back in December 2004 when I had just started this blog on Blogger, I used her as an example of how misleading breast cancer testimonials can be. At the time, I only knew Somers as a breast cancer survivor who had decided to turn to “alternative” therapy. What she really meant was that she had undergone surgery and radiation but had decided not to undergo chemotherapy, opting instead for mistletoe extract

I also explained at the time that the reason “testimonials” for “alternative” medical therapies for breast cancer often sound convincing is that people don’t understand that in early stage breast cancer surgery is 90% of the cure. Radiation reduces the risk of local recurrence in the breast from about 1 in 3 to under 10%, and chemotherapy only reduces the risk of systemic recurrence (recurrence of the cancer anywhere in the body) by around 3%. Of course, the benefit of systemic therapy increases as an absolute percentage the nastier the tumor. As tumor stage increases, the relative benefit of chemotherapy increases–at least until Stage IV, metastatic disease, where the disease has become incurable and only palliation remains. Of course, in these cases, the woo-prone almost always attribute their survival more to the “alternative” therapy than any of that old-fashioned nasty “cutting” or “burning,” and Suzanne Somers appeared to be no exception.

Another characteristic of the woo-prone is that, well, they are woo-prone. Too much woo is never enough for many of them, and that certainly seemed to apply to Suzanne Somers as well. Her next misadventure was becoming enamored of so-called “bioidentical” hormones, which in reality are nothing more than female hormones synthesized to be chemically identical to the hormones normally produced in the body. Indeed, Suzanne Somers became the poster girl (actually, “girl” may not be an appropriate description of a 62 year old woman) for these hormones. But there was more to “bioidentical” hormones than just the hormones. Somers, like many of their advocates, attributed almost mystical properties to them, taking huge quantities. She seemed to view them as some sort of “fountain of youth” that would keep her appearance young and luscious forever–or at least until she dropped dead of old age, as all of us who manage to survive long enough without first dying of some other cause cause will do some day. She took it even farther than that, too, in that she postulated that hormone levels could be measured in the saliva and a cocktail of “bioidentical” hormones could be whipped up at a special pharmacy to replace exactly what hormones she was supposedly deficient in. Ultimately, her advocacy went straight into quackery in that she made claims that postmenopausal women should really have the estrogen levels of a 20-year-old.

As an aside, I can’t resist interjecting here how strange I find it that advocates of “natural” therapies don’t see anything incongruent about claiming that their therapy is based on “nature” as they pump themselves full of synthetic hormones. But that’s just me.

In any case, for a breast cancer survivor to pump herself full of estrogen is a very bad idea indeed. We know Somers’ tumor was estrogen receptor positive, meaning that estrogen could stimulate it to grow. Indeed, I’m guessing that her doctors probably tried to persuade her to take an estrogen blocking drug such as Tamoxifen or Arimidex daily for five years after her surgery, particularly if she was refusing chemotherapy. In actuality, estrogen blockade produces more bang for the buck than chemotherapy for patients with early stage estrogen positive tumors, and it’s a lot less toxic. Of course, the beneficial effects of estrogen blockade and chemotherapy are additive; so the best odds are associated with using both. Indeed, a breast cancer survivor who takes massive quantities of estrogen to “rejuvenate” herself is playing Russian Roulette with her life, plain and simple. That Somers has been lucky enough thus far not to have a recurrence of her breast cancer is just that–luck–and nothing to do with any of her health regimens. Worse, she made millions selling books advocating “bioidentical” hormone therapies and since her breast cancer treatment has diversified into a veritable cornucopia of “anti-aging” treatments that she hawks at her website Ageless-Diva.com.

I guess all that bioidentical hormone woo wasn’t enough for Somers, though. Once again following the premise of the woo-prone that too much woo is never enough, it appears that Suzanne Somers has decided that some new pseudoscience is necessary to–shall we say?–rejuvenate her business. But what? What would be the perfect complement to her existing portfolio of pseudoscience? What new technology that actually has a great deal of promise on a scientific basis but is still in its–excuse me–embryonic form? What technology has been abused again and again by charlatans and quacks in the quest for anti-aging, cures for blindness, or even as a “cure” for autism?

Yeah, baby! We’re talking stem cells! Except this time instead of embryonic stem cells we’re talking adult stem cells:

Successful Actress, Author, Businesswoman and Medical Advocate to Assist NeoStem in Public Awareness Program

07-29-08

NEW YORK, July 29, 2008 /PRNewswire-FirstCall via COMTEX/ — NeoStem, Inc. (Amex: NBS) has announced an alliance with Suzanne Somers to create a multi-year awareness program to help educate the public on the increasing importance of adult stem cell collection and long term storage. Ms. Somers has authored 17 books to date focusing on healthy living and anti-aging medicine and is a number 1 New York Times bestselling author. In her latest book Breakthrough, Ms. Somers explores cutting-edge science and delivers a smart, proactive review of the newest treatments for breakthrough health and longevity.

Because Suzanne Somers knows so much about biology and science. Yes, if I were forming a startup company to offer a legitimate, science-based therapy or service, Suzanne Somers is definitely the first person I’d approach to be my spokesperson. Who could instantly give my product more scientific cred than Suzanne Somers, I ask? Indeed, if I wanted to learn about the latest breakthroughs in stem cell biology and therapies, Suzane Somers is clearly the go-to person whose book I’d read first. If this press release is any indication, it looks as though we’re in for a long fall of infomercial hell featuring Suzanne Somers:

“Stem cell therapy is the most exciting new breakthrough in medicine. It gives me great peace of mind to know that my own stem cells will be banked as bio-insurance for me. Now I am prepared for my future as the beneficiary of medical benefits while I am alive.”

This adult stem cell public awareness program is expected to be launched in September of 2008. The timing of the campaign was designed to coincide with the establishment of new stem cell collection centers in certain major metropolitan areas. Ms. Somers is scheduled to have her stem cells collected at the new location of the California HealthSpan Institute in San Diego, so that they are available to her for her use in the future as physician confidence in adult stem cell therapy grows. In addition to distributing the filming of Ms. Somers’ own adult stem cell collection, NeoStem may feature her in print, TV and online promotions. Ms. Somers has become a supporter of adult stem cell research and the potential of using one’s own stem cells as part of a conventional therapy to treat disease and reverse tissue damage.

As I said, infomercial and commercial hell. Be sure to be very careful about watching late night TV. But what, exactly, is NeoStem? This is what its press release states:

NeoStem is developing a network of adult stem cell collection centers that are focused on enabling people to donate and store their own (autologous) stem cells when they are young and healthy for their personal use in times for future medical need. The Company has also recently entered into research and development through the acquisition of a worldwide exclusive license to technology to identify and isolate VSELs (very small embryonic-like stem cells), which have been shown to have several physical characteristics that are generally found in embryonic stem cells.

I see several problems with this service. First, there is no data that banking stem cells when you’re healthy is any better as far as their function goes than just harvesting them at the time they’re needed. In hematopoietic malignancies, like leukemias and lymphomas, stem cells are routinely harvested. It’s true that autologous stem cell therapy doesn’t work as well for leukemia in older people, but it’s not because the stem cells don’t work. It’s because it’s much harder to get older patients into a durable remission. Indeed, stem cells isolated after combination chemotherapy work just fine. Another problem is that we have no idea how long these cells can be stored with full activity. The company claims that “only 3%” die off every 20 years, but that doesn’t necessarily mean that the cells surviving are as functional as stem cells isolated and used immediately.

Here’s another problem:

Advances in technology now allows NeoStem to increase the number of stem cells in the peripheral blood. The process is called mobilization, which involves 2 injections of a medication that temporarily causes your stem cells, which reside in your bone marrow, to the peripheral blood.

Once you have completed mobilization the next step is apheresis a painless and safe procedure (similar to donating blood) which separates and collects, through a sterile, closed and disposable system, your stem cells from your peripheral blood.

In other words, they pump people full of Neupogen®, which is human granulocyte colony-stimulating factor (G-CSF) manufactured through recombinant DNA technology. It’s a hormone used as a drug, and it’s not without potential risks. For example, here are some potential, albeit uncommon, adverse reactions:

True, most of these adverse events are generally only seen with long term use of Neupogen®, but if you consider that there is no good science to suggest that harvesting and banking stem cells now is any better than doing it at the time they’re needed then why take even that small chance? It’s all risk, albeit small, for, as far as I can tell, no defined benefit.

Rick Lewis, blogging at blog.bioethics.net, while lamenting how he’s been scooped writing a book about stem cells, points out a number of other problems:

Suzanne must know something that I don’t. Said she in the news release, “Stem cell therapy is the most exciting new breakthrough in medicine. It gives me great peace of mind to know that my own stem cells will be banked as bio-insurance for me. Now I am prepared for my future as the beneficiary of medical benefits while I am alive.” Odd. When I left the International Society for Stem Cell Research (ISSCR) annual meeting in June, all I could think about was how much more we need to learn about how stem cells and their descendants talk to each other as they sort themselves into developmental pathways, and then reawaken to replenish and heal tissue.

Exactly. Particularly disturbing it this full-color, glossy brochure aimed at physicians and designed to sell NeoStem’s services. It concludes:

Collection and storage of adult stem cells is a joint process. By offering your patients access to NeoStem’s adult stem cell collection and banking services, you provide a unique opportunity for them to invest in their own health. In addition, your practice can collaborate with NeoStem to open an adult stem cell collection center in your area. For information about this exciting opportunity, please ask about our physician collection center program at 1.888.STEM BANK.

I’m sorry, but in the absence of a lot more evidence, selling this service to physicians and offering in essence to sell franchises of NeoStem’s centers to physicians strike me as profoundly unethical. Think about it this way, as well. A while back, I heard about similar services that harvest umbilical cord blood for stem cell isolation from babies. Looking into it, I saw that they charged several hundred dollars a year to store the blood, and I would expect that NeoStem probably charges at least in the same ballpark for its services. Even if it works exactly as described, the very concept strikes me as an extremely expensive “insurance policy” against an event that is very unlikely to happen, namely that the “insured” develops a disease requiring stem cell transplant for which his or her own stem cells can’t be harvested and used. Otherwise, as I said before, there’s no reason to bank stem cells; they can almost always be harvested when needed, except in the cases of certain malignancies, for which autologous stem cell transplant is not possible and donated stem cells are required.

The bottom line is that it’s important to realize that not all woo is mystical or magical, (like reiki) or complete pseudoscience (like homeopathy). A considerable amount of it is often the misapplication of science that is simply not ready to be used in patients yet. Stem cells represent just such woo. Other than already defined uses in hematopoietic and a few other malignancies, there is no science- and evidence-based use for them as yet that has accumulated sufficient data regarding efficacy and safety. Of course, I could be snarky and point out that the fact that Suzanne Somers is NeoStem’s spokesperson should tell you all you need to know about the service, but I won’t.

OK, I lied. I couldn’t resist. It’s just too easy, and, my pseudonym notwithstanding, I am human after all.

Comments

  1. #1 I am so wise
    August 5, 2008

    Perhaps it is time to drop the civil pretense and starting labeling the people who use this nonsense and those who promote it in harsher, but more accurate terms, like dumb ass and fraud?

  2. #2 Samia
    August 5, 2008

    Stupid question– what’s the difference between radiation and radiation therapy?

  3. #3 Diora
    August 5, 2008

    In theory, people should have enough common sense not to get medical advice from a movie star. If they do – well, there is no cure for stupidity.

    In good old days some 25 years ago there was a commercial where an actor playing a doctor on a daytime soap opera (a genre where they sometime manage to bring people executed via lethal injection back to life via open heart surgery) started his pitch for some OTC drug with words “I am not a doctor, but I play one on TV”. Which to everyone with common sense immediately disqualified him from giving medical advice… Movie stars’ giving medical advice (or any opinion on a scientific subject) always reminds me of this commercial.

  4. #4 AnnR
    August 5, 2008

    I guess when you get your stem cells back you get to skip the part that cancer patients go through where they obliterate your bone marrow?

    I find this disgusting because plenty of people who’d be more than happy to just be living regular OLD lives go through this in an attempt to be here for a few more years, and she’s making it out for vanity.

  5. #5 Phoenix Woman
    August 5, 2008

    When I read this:

    Her next misadventure was becoming enamored of so-called “bioidentical” hormones, which in reality are nothing more than female hormones synthesized to be chemically identical to the hormones normally produced in the body. Indeed, Suzanne Somers became the poster girl (actually, “girl” may not be an appropriate description of a 62 year old woman) for these hormones. But there was more to “bioidentical” hormones than just the hormones. Somers, like many of their advocates, attributed almost mystical properties to them, taking huge quantities. She seemed to view them as some sort of “fountain of youth” that would keep her appearance young and luscious forever–or at least until she dropped dead of old age, as all of us who manage to survive long enough without first dying of some other cause cause will do some day.

    I knew I would soon be reading this:

    In any case, for a breast cancer survivor to pump herself full of estrogen is a very bad idea indeed.

    Doubleplusungood.

    We know Somers’ tumor was estrogen receptor positive, meaning that estrogen could stimulate it to grow. Indeed, I’m guessing that her doctors probably tried to persuade her to take an estrogen blocking drug such as Tamoxifen or Arimidex daily for five years after her surgery, particularly if she was refusing chemotherapy. In actuality, estrogen blockade produces more bang for the buck than chemotherapy for patients with early stage estrogen positive tumors, and it’s a lot less toxic. Of course, the beneficial effects of estrogen blockade and chemotherapy are additive; so the best odds are associated with using both. Indeed, a breast cancer survivor who takes massive quantities of estrogen to “rejuvenate” herself is playing Russian Roulette with her life, plain and simple. That Somers has been lucky enough thus far not to have a recurrence of her breast cancer is just that–luck–and nothing to do with any of her health regimens.

    The sad thing is that she doesn’t care if she dies five years from now with a body that’s mostly malignant tumor, so long as her skin doesn’t sag.

  6. #6 biopunk
    August 5, 2008

    Samia,

    I don’t think that your question is stupid, rather it is pivotal to understanding woo.

    The simplest definition of radiation would be the way energy travels through space or matter. Radiating from a source, traveling in waves, etc.

    Radiation therapy is the use of ionizing particles to harm the healthy tissues surrounding and supplying nutrients to the tumour, in an attempt stop it’s growth. This is usually done in two ways: teletherapy or brachytherapy.

    Brachytherapy is the implantation of radioactive materials in the body in or around the tumour. This is usually cesium, radium, iridium or gold.

    Teletherapy is the focusing of the radiation on the tumour from a source outside the body, like an X-ray.

    So I think the common scenario runs something like this: Woo-ers equate crystals (or whatever) as an energy source, that energy “radiates”, and is focus-able by the “healer” and telepathically “sent” to the tumour and “heal” it without any of the nasty side effects of radiation therapy.

  7. #7 Agrippina
    August 5, 2008

    Slight correction: “Rick Lewis” is Ricki Lewis, Ph.D., a woman :)

  8. #8 Rev Matt
    August 5, 2008

    Of course if she does have a recurrence of breast cancer she will naturally blame the failure of the surgery+radiation treatment and completely ignore the intervening decade or so of SCAM treatments she used.

  9. #9 BB
    August 5, 2008

    Paid a shiva (mourning) call last night to the brother of a woman who died of ovarian cancer. other callers were wowed that the deceased was into woo (after the cancer became incurable). I of course come off like the Grinch for pointing out that pursuing woo can be deadly (Gilda Radner comes to mind).

  10. #10 Samia
    August 5, 2008

    biopunk, thanks for the answer. I am sad now. Crystals. Wow. I thought maybe Orac was talking about two different kinds of *actual* radiation therapy or something. I think it’s safe to say Suzanne Somers is insane.

  11. #11 khan
    August 5, 2008

    Ultimately, her advocacy went straight into quackery in that she made claims that postmenopausal women should really have the estrogen levels of a 20-year-old.

    Why would anyone want those stupid hormones back? It is delightful to be rid of them.

  12. #12 Dangerous Bacon
    August 5, 2008

    Orac is just jealous. He only wishes he’d written _one_ book that “explores cutting-edge science”, never mind 17 like Suzanne Somers.

    Now there’s a Renaissance woman.

  13. #13 Rogue Epidemiologist
    August 5, 2008

    “The sad thing is that she doesn’t care if she dies five years from now with a body that’s mostly malignant tumor, so long as her skin doesn’t sag.” Phoenix Woman

    Well… FWIW, malignant neoplasms tend to be extra firm, which might give her breasts extra perkiness!

    hey! where am i going? and why am i in this handbasket?

  14. #14 Mind Body Shop
    August 5, 2008

    My greatest joy comes from knowing how a skin care regression session can change a person’s life. Sometimes the feedback comes years after a session took place.

  15. #15 Missy Miss
    August 6, 2008

    A friend-of-a-friend2‘s husband traveled to Mexico recently to get stem cell injections for a vision problem. They were delighted to discover that stem cells don’t have a blood type, so you can use anyone’s for anyone!

  16. #16 Temporis
    August 6, 2008

    The hormone and stem-cell woo sounds similar to the ancient alternative medicine practiced by one Elspeth Bathory.

    I suppose we should just be glad Ms. Somers isn’t kidnapping young virgin girls and bathing in their blood.

  17. #17 Niobe
    August 6, 2008

    Ooh Orac can you visit the mind body shop spam a few posts up, it’s fabulous friday fodder.

  18. #18 kate corwyn
    August 6, 2008

    Whilst I am vehemently anti-woo I am also disappointed by some of the sentiments expressed here. Clearly it is idiotic for a woman with an estrogen-sensitive cancer to take extra estrogen, however for those of us without that risk factor estrogen replacement can be the difference between good quality of life as opposed to suffering from hot flushes, night sweats, incapacitating joint and muscle pains, severe memory problems, dysphasia, dyslexia (go read about the mental disruption of menopause that some women experience and imagine what it’s like to become almost unable to read), absence of libido and more. It’s not just a skin treatment as some of you suggest.

  19. #19 Phoenix Woman
    August 6, 2008

    I see the trolls have checked in.

  20. #20 sophia8
    August 6, 2008

    “hot flushes, night sweats, incapacitating joint and muscle pains, severe memory problems, dysphasia, dyslexia (go read about the mental disruption of menopause that some women experience and imagine what it’s like to become almost unable to read), absence of libido and more. “
    Kate, very few women suffer all those problems. I’ve been through the menopause, as have many of my women friends. None of us had anything like that severity and number of symptoms. I’m afraid you’re sounding like the stereotype of a pharma shill: “Buy these pills or you’ll have all these horrible symptoms!”
    Like that poster above, I’m happily estrogen-free!

  21. #21 Kim
    August 7, 2008

    Money. Pure and simple. Money to take the cells, money to store the cells, money in franchises…geeze!

    I guess the “Thigh Master” wasn’t selling anymore….

  22. #22 Thomas
    August 10, 2008

    My sister had breast cancer.

    I’ve had colon cancer.

    We both followed respectable medical wisdom and did what we needed to do, instead of going to the quack shops, and we are both still alive with no relapses.

    Some things aren’t fun. Oh, well, they are still more fun than being dead.

    Not all medicine is perfect but it’s a lot better than clueless hippy “science”.

    I put hippy “scientists” in the same category as holocaust deniers and people who don’t realize all government, when boiled down to it, comes from the barrel of a gun in some fashion.

    Reality deniers should be a category we could label people and then build institutions for them so they don’t pester intelligent people. Be sorta like a zoo with tie-dye and macrobiotic snacks.