Respectful Insolence

As a cancer surgeon, I maintain a particularly intense contempt for peddlers of cancer quackery. Although I’ve been fortunate enough not to have had to see the end results of it more than a handful of times in my career, women with bleeding, stinking, fungating tumors with widespread metastases that could have been treated if they hadn’t decided upon woo rather than good old-fashioned surgery, radiation, and chemotherapy, I’ve become aware of enough such cases and seen the dishonest marketing of quackery enough to drive me to maintain this blog and undertake other activities to promote science- and evidence-based medicine. That’s why I was happy when three months ago the Food and Drug Administration and Federal Trade Commission brought the hammer down on cancer quacks. I considered it a rare instance when the government, which usually seems utterly powerless against even the most outrageously pseudscientific quackery, an example of which I mocked yesterday.

In a bit of good news to end the week (which blog bud PalMD beat me to, although several e-mails alerted me of the action) the FTC and FDA announced that they were suing eleven cancer quacks:

The Federal Trade Commission today announced 11 law enforcement actions challenging deceptive advertising of bogus cancer cures. The FTC charged the companies with making unsupported claims that their products cured or treated one or more types of cancer. In each case, the company is charged with violating the FTC Act, which bars deceptive claims. Some complaints allege that the companies also falsely touted clinical or scientific proof for their products.

“There is no credible scientific evidence that any of the products marketed by these companies can prevent, cure, or treat cancer of any kind,” said Lydia Parnes, Director of the FTC’s Bureau of Consumer Protection.

I join PalMD’s refrain: What the hell took them so long?

The press release includes a list of the various companies and what the status of the legal action against them. The thing that strikes me about these companies is just how mundane their claims are. Anyone who’s been a regular reader of this blog or PalMD’s would be bored by them. They’re the run-of-the-mill claims of cancer cures. Indeed, one of them even sells Laetrile:

Alexander Heckman d/b/a Omega Supply – Among the products this company marketed are laetrile, which can cause cyanide poisoning when taken orally at high doses; hydrazine sulphate, which is classified by the U.S. Department of Health and Human Services as a potential carcinogen; and cloracesium, which contains celsium chloride. According to the complaint, in addition to making deceptive and false claims that these products are safe and that they effectively prevent, treat, and cure cancer, the respondents also made false claims that the products are scientifically proven to work.

I guess it’s back to the future. How “1970s.” It just goes to show that quackery never dies. Laetrile was shown to be worthless against cancer well over 20 years ago and toxic to boot; yet, in 2008 it is still being sold in the United States. To me, this is yet another argument against bypassing the preliminary preclinical work needed to justify clinical trials of “alternative” medicine modalities just because so many people believe they work and provide glowing anecdotes for their efficacy, modalities such as chelation therapy for autism, chelation therapy for cardiovascular disease, or the Gonzalez regimen for pancreatic cancer. Sometimes we hear the argument made that we should do such trials because if they are negative they will persuade those who believe in the therapy that it doesn’t work. This almost never happens. True, the use of discredited therapies does decrease (for example, laetrile use is not nearly as widespread as it was 20 years ago), but they never go away. They always come back, either through fads or promotion by quacks.

The most hilarious part of the FTC action is the letter that the FTC and FDA are ordering these quacks to send to all of their patients. Here is one such letter, excerpted:

Dear [Recipient]:

Our records show that you bought [name of products] from our website www.HerbsForCancer.com. We are writing to tell you that the Federal Trade Commission (“FTC”) has found that our advertising claims for these products were false or unsubstantiated, and has issued an Order prohibiting us from making those claims in the future. The Order entered against us also requires that we send you the following information about the scientific evidence on these products.

Very little scientific research has been done concerning the above noted products as a treatments or cures for cancer in humans. The scientific studies that have been done do not demonstrate that these products, or the ingredients in these products, are effective when used as treatments for cancer.

It is very important that you talk to your doctor or health care provider before using any alternative or herbal product, including the products named above. Speaking with your doctor is important to make sure that all aspects of your medical treatment work together. Things that seem safe, such as certain foods, herbs, or pills, may interfere or affect your cancer or other medical treatment, or other medicines you might be taking. Some herbs or other complementary or alternative treatments may keep your medicines from doing what they are supposed to do, or could be harmful when taken with other medicines or in high doses. It also is very important that you talk to your doctor or health care provider before you decide to take any alternative or herbal product, including the products named above, instead of taking conventional cancer treatments that have been scientifically proven to be safe and effective in humans.

If you would like further information about complementary and alternative treatments for cancer, the following Internet web sites may be helpful:

  1. The National Cancer Institute: www.cancer.gov/cancertopics/pdq; or
  2. The National Center for Complementary and Alternative Medicines: www.nccam.nih.gov

You also can contact the National Cancer Institute’s Cancer Information Service at 1-800-4-CANCER or 1-800-422-6237.

Sincerely,

Herbs For Cancer

The irony is delicious. I do, however, have a bit of a problem with the FTC including NCCAM as one of its recommended “sources” of information. As I and others have documented before, NCCAM funds many dubious studies, and its very purpose is not only “research,” but promotion of CAM usage through educational grants to universities and other institutions. I do not consider the NCCAM website to be consistently reliable as a source of information about “alternative” medicine. However, it is the official branch of the NIH set up to study complementary and alternative medicine (CAM).

I’m not sure that this letter is going to be all that useful. It may drive away some customers, but a large number of them will likely ignore it. They may even see it as validation of their paranoia about the government and big pharma. Oh, no! “They” got to Herbs for Cancer (the “they” being the “they” in Natural Cures “They” Don’t Want You to Know About, of course).

Naturally, the quacks are not happy:

Mary Spohn, a licensed acupuncturist in Arizona, thinks people should be free to choose alternatives to chemotherapy, radiation and surgery while fighting cancer — including natural remedies like the Chinese herbal teas that she started selling online in 2004.

Mary Spohn, a licensed acupuncturist in Arizona, thinks people should be free to choose alternatives to chemotherapy, radiation and surgery while fighting cancer — including natural remedies like the Chinese herbal teas that she started selling online in 2004.

And:

Spohn said she never claimed her teas cured anyone of cancer and that they don’t harm anyone’s health.

“The only thing it does is help the body to build up its immune system,” said Spohn, whose Web site has since shut down. “A lot of these herbs have anti-cancer properties, and that’s why I made the tea.”

Ah, yes. The usual false dichotomy: Either “conventional” therapy with chemotherapy, radiation, and surgery or “natural” remedies. It’s an argument that might have had a grain of truth to it if there were good evidence that these “natural” remedies were as efficacious as conventional cancer therapy–or that they worked at all. There isn’t, and, as far as we know thus far, they don’t. Then there’s the old “boost the immune system” claim, a common quack claim that’s utterly meaningless. It’s all topped off with the “health freedom” argument, which, when boiled down to its essence is in reality the freedom for quacks to sell whatever quackery they want and to make whatever bogus claims they wish to make to sell it:

“I’m not against chemo and radiation,” she said. “I just don’t think that should be our only choice.”

“If we lose this, then we have lost a major battle, and our only recourse will be to take drug-based modalities in treating any kind of disease. They will literally take our right away to buy a vitamin out of the store,” she said.

There goes the false dichotomy again, in an even more ridiculous form.

Perhaps the most interesting aspect of this action was brought up by PalMD. It’s one passage of the letter:

In a May 27, 2008, the FDA acknowledged that Spohn had “attempted to disclaim” some of the statements about products sold by the company, Herbs for Cancer.

The FDA noted that the site contained the message: “Disclaimer: The FTC and FDA require us to place this disclaimer here, please read. Herbs for cancer are not intended to cure, treat, or diagnose your illness.”

In the letter, the FDA told Spohn, “However, untrue or misleading information in one part of your site will not be mitigated by inclusion of such a “disclaimer.’”

How many times have you see various “disclaimers” on websites hawking various dubious “alternative” medicines and cures saying that the site is “informational” only or that this “product is not designed to diagnose or treat any illness,” usually buried near the bottom of various webpages, also usually in tiny print. If the FDA and FTC are finally getting serious, it’s truly heartening to see that they appear finally–finally!–to be attacking the very shield that quacks have held up so successfully for so long. It’s long overdue, which is why I repeat the question:

What the hell took them so long?

At least the government appears to be finally acting now. Not only is it going after some cancer quacks, but it’s launching an educational website called Cure-ious? Ask. to combat health fraud in cancer care. It’s not much, but it’s a start. At least I hope it’s a start, a real start.

Comments

  1. #1 DBH
    September 19, 2008

    Hydrazine sulphate – “a potential carcinogen” for cancer “cure”. “Like cures like” springs to mind. Are these homeopaths in disguise? They commonly quack about having a cure for cancer.

    This is absolutely delicious. I am hoping for more to come. Score 1 for rational thinking and 0 for wishful thinking.

  2. #2 DBH
    September 19, 2008

    Many apologies for the repeated comment! The server kept asking me to resubmit the post because of some error!

  3. #3 The Perky Skeptic
    September 19, 2008

    YAY!!! This is great news!!! And I had just posted on my own blog a mention of my younger brother’s diagnosis with Hodgkin’s Disease long, long ago. He was one of the lucky ones– his lymphoma was caught in an extremely early stage by an alert pediatrician, who referred him to a specialist, who referred him to St. Jude’s. How lucky he was that our parents did not succumb to cancer quackery! HOORAY for science-based medicine!!! HOORAY for the FTC sticking it to the quacks!!!

  4. #4 ateedub
    September 19, 2008

    FTC is also launching a campaign to increase consumer awareness of the “anatomy of a cancer treatment scam” and will include a public web site, banner ads, a 2 minute video, educational materials, and a consumer alert. The web site went live at 11 am EDT yesterday.

  5. #5 DonZilla
    September 19, 2008

    I HATE DUCKS! Thanks Orac for a great start to the weekend!

  6. #6 Scott
    September 19, 2008

    Good start! Next step, update the rules to acknowledge that calling something a “nutritional supplement” doesn’t make it any different and shouldn’t allow it to evade regulation.

  7. #7 FB
    September 19, 2008

    >I join PalMD’s refrain: What the hell took them so long?

    Simple: manpower, resources, priorities. There’s reason to hope that things will continue to improve though, with FDA’s recent (and, Congress-willing, future) budget increases and a hiring surge currently in full swing.

  8. #8 Kemist
    September 19, 2008

    “I’m not against chemo and radiation,” shameless quack says “I just don’t think that should be our only choice.”

    The problem is that they are, in the real world. If you want to live, that is.

    “If we lose this, then we have lost a major battle, and our only recourse will be to take drug-based modalities in treating any kind of disease. They will literally take our right away to buy a vitamin out of the store.”

    The problem, again, is that most illnesses are not caused by a deficiency of any kind, in the real world. And most people would be really interested to know that “buying vitamins out of the store” is at least a useless waste of money, at worst hazardous for their health.

  9. #9 Metro
    September 19, 2008

    In Canada we have, finally, a serious consumer protection effort on. It’s the one thing I think this government has done which was worth doing.

    Bill C-51 essentially says that peddlers of “natural health products” and the like will 1) Have to list the active ingredients on the label; and 2) Be allowed to make claims of efficacy only if they can prove them.

    There’s astroturf flying all over the place. We’ve actually had people protesting out front of local vitamin shops.

  10. #10 Savve
    September 19, 2008

    This makes me very grateful I live in a country with actual anti-quackery laws. (yes, they are actually known as quack laws!)We still have plenty of woo (homeopathy flourishes I’m afraid), but it is illegal to claim the ability to cure cancer or HIV wether by “alternative” treatment or faith healing. Any claims of ability to cure anything must be documented, and the directorate comes down hard on any unsubstantiated claims.

  11. #11 Scott
    September 19, 2008

    Savve, the difference isn’t in having such laws – the US has them too, and that’s what this case was about. They just aren’t enforced reliably here.

  12. #12 Sigivald
    September 19, 2008

    I presume it’s meant to be “cesium chloride”, not “celsium …”?

  13. #13 IBY
    September 19, 2008

    It is strange that they sent those letters to the patients, as if most of them were going to listen. Anyways, it is about time the law acted against those quacks. And oh boy is that false dicotomy typical.

  14. #14 Dawn
    September 19, 2008

    I hate to say it Orac, but you are in the wrong business. It is all about alkalizing your acidic body when you have cancer cells running rampant (you are far too acidic). However, you probably already know that and want to pay off your college loans.

  15. #15 anonimouse
    September 20, 2008

    “Health freedom” has a bad connotation, so I hear the quacks are now calling their stance “health deregulation”.

  16. #16 snerd
    September 20, 2008

    Dawn, that’s nonsense. Cancer is clearly a fungus, most probably some candida strain. You can treat it successfully with yoghurt.

  17. #17 Kemist
    September 20, 2008

    I hate to say it Orac, but you are in the wrong business. It is all about alkalizing your acidic body when you have cancer cells running rampant (you are far too acidic). However, you probably already know that and want to pay off your college loans.

    [Dr. Zoidberg] So you’ll want to try my NaOH treatment already ? It’s not costly, see, just hand me your deliiicious t-shirt and we’re square. If you throw in your deliiiicious boots, I’ll even do a nice autopsy. Zoidberg is very good at autopsies. Mmmm saponified organs… woopwoopwoopwoopwoopwoop woopwoop [/Dr. Zoidberg]

  18. #18 speedwell
    September 20, 2008

    Great. When can I sue the obnoxious fundamentalists who persuaded Mom she could PRAY her cancer away?

  19. #19 DLC
    September 20, 2008

    Dawn: You’ve got to be kidding, right ?

    Orac: Glad to know somebody is finally doing something about these criminals. Thanks for the update.