Respectful Insolence

Cancer research explained briefly

One reason I (and most people involved in cancer research) don’t like the frequently used term “cure for cancer.” The reason is simple. Embedded within this term is the assumption that cancer is just one disease, when it is most definitely not. Rather, it is many diseases affecting many organs, each with its own mechanism of pathogenesis and each often requiring different treatments. For example, for “liquid” tumors arising from hematopoietic organs, the treatment usually consists primarily of chemotherapy, sometimes with radiation therapy in the case of lymphomas, while “solid” tumors often require surgery as the primary treatment. Different tumors are driven by different oncogenes, different environmental influences, and different biochemistry. They have different growth characteristics, complications, and organs to which they prefer to metastasize. Even with in the same cancer (breast cancer, for example, my specialty), the biological behavior of the cancer within different patients can vary widely, from indolent tumors that grow slowly and may take years to metastasize to highly aggressive tumors that grow rapidly and metastasize widely. That’s why there is no such thing as “a cure for cancer.” There are cures for cancers, and, hopefully, there will be more cures for more cancers over the remaining years of my career.

All of this is my typical roundabout way to introduce perhaps the best simple explanation of this I’ve ever seen. Surprisingly, it’s a cartoon to which a commenter referred me. Here is a panel (click to see the whole cartoon):

i-c40f8bc020f70be0aa8ec1f3170a4ab6-cancer.gif

This cartoon, and the fact that cancers represent a protean foe, with many faces and many abnormalities, should help explain why the frequent complaint that we haven’t “made much progress” in the 37 years since Nixon’s declared “war on cancer” in general demonstrates a lack of understanding that (1) there is no “war on cancer” there are “wars on cancers” and (2) just how difficult this battle is. I hope to contribute to the development of such cures, but have no illusion that I’m likely to provide any major breakthrough. Rather, I hope that my contributions, modest, great or small, add to the body of knowledge about cancer that one day leads to cures.

Comments

  1. #1 happeh
    May 30, 2009

    You know Orac? This blog talks on and on about how conventional medicine knows best and alternative medicine is quackery. The blog talks about how stupid patients are and what idiots they are. These patients are idiotic and stupid of course, because they do not obey or agree with the western or conventional medicine doctor.

    What is missing from the blog, is any honest treatment of why patients would avoid or not trust conventional medicine doctors. This blog conveniently never mentions that conventional medicine can be taken apart by someone who wants to, just as easily as this blog takes apart alternative medicine.

    Today there is a news story that says:

    “Surgery is no longer the best treatment option for most patients with advanced colorectal cancer that has spread to other organs, a new study suggests.”

    What this story is saying, is that those conventional doctors who know everything, have been cutting pieces out of the behinds of people with colorectal cancer for years for no reason at all.

    All of that surgery was unnecessary. All of the pain experienced by the patient was unnecessary. All of the mental suffering from fear of the surgery was unnecessary. The cost of the surgery was unnecessary.

    You Orac, and your fellow doctors, clearly do things that are unnecessary. If I wanted to be mean and rude, I could say that you were butchers and quacks for convincing trusting uneducated people to allow you and your fellows to cut pieces off of them like they were a steak.

    What guarantee can you give Orac, that in 20 years I will not be reading a story that says, “20 years ago chemotherapy was thought to be the best treatment for cancer, but now we know that only hastened the death of the patient, and did not cure the cancer”.

    If you are an honest scientist and medical professional, you cannot give me that assurance.

    People who do not trust conventional medicine are clearly justified in their opinions by historical events in the medical community. Hiring thugs with guns to force your medical treatment on people who do not trust you is criminal.

    You are taking away their freedom of choice as a human being, and forcing something on them you think might be beneficial, but could just as easily turn out to make them sick, kill them, or just plain be unnecessary like surgery for colorectal cancer.

  2. #2 D. C. Sessions
    May 30, 2009

    And despite the complainers, we have made progress. Someone I know was diagnosed a year ago with multiple myeloma [1]. Sam Walton was dead by this point in his disease, but the gent I know is in full remission and looking at going back to work. Not out of the woods yet, but …

    [1] One of those that’s always found in an advanced state, because it’s under the radar for nearly forever.

  3. #3 e.d.
    May 30, 2009

    Happeh obviously does not understand how modern medicine works. Anyone who does knows that modern, science and evidence based, medicine is never 100%, they call it “practicing medicine”, as it is a constant learning experience. Modern medicine is a cost/benefit analysis. Modern medicine is taking what didn’t work and learning from it. Modern medicine is taking what is “kind of working”, learning from it, and improving it.

    Modern medicine is about thinking, critically and logically, which can be tiring and overwhelming to an individual not “given”/educated to the sciences or mathematics.

  4. #4 shannon
    May 30, 2009

    I think the issue here is that sure, the conventional medical practitioners may not be perfect, but at least they have some direction. I don’t really trust alternative practitioners because I have no way of knowing how they have tested their practices or whether they just bought a diploma somewhere and are now trying to cure cancer.

    Also, with conventional doctors, if it isn’t their area, they can refer you to someone, but I find with alternative treatments that if they have one small success in one area, all the sudden that treatment is considered right for every area, and when dealing with non self limiting illnesses, I believe that is dangerous.

  5. #5 Dave W.
    May 30, 2009

    happeh @#1:

    The fact that scientific conclusions have changed in the past is not predictive that any particular conclusions we have now will change in the future. In other words, that things have changed in the past doesn’t mean that they’ll change in the future.

    To suggest otherwise is to undermine your own ability to “know” anything. To demand a [i]guarantee[/i] that our knowledge won’t change is to deny reality (as you know). Citing the lack of enduring knowledge as a reasonable [i]justification[/i] for not trusting evidence-based medicine is to claim that it’s rational for the denial of reality to be a basis for making health-care decisions.

  6. #6 RebeccaF
    May 30, 2009

    What this story is saying, is that those conventional doctors who know everything, have been cutting pieces out of the behinds of people with colorectal cancer for years for no reason at all.

    Oh, happeh and his reading comprehension… No, what that study is saying is not that surgery was unnecessary and that it didn’t help. It is saying that we know have methods that are even better than surgery for this specific type of cancer in that specific type. That’s a good thing, a sign of progress, not a sign that

    All of that surgery was unnecessary. All of the pain experienced by the patient was unnecessary. All of the mental suffering from fear of the surgery was unnecessary. The cost of the surgery was unnecessary.

  7. #7 HCN
    May 30, 2009

    Just a reminder that Happeh showed up after his website was featured as a Friday Dose of Woo:
    http://scienceblogs.com/insolence/2009/04/your_friday_dose_of_woo_the_worldwide_wa.php

    Just ignore him.

  8. #8 Confuseddave
    May 30, 2009

    “Surgery is no longer the best treatment option for most patients with advanced colorectal cancer that has spread to other organs, a new study suggests.”

    What this story is saying, is that those conventional doctors who know everything, have been cutting pieces out of the behinds of people with colorectal cancer for years for no reason at all.

    Am I the only one who thinks that this is logically garbage? It is no longer the best way to treat cancer, therefore it has never been the best way to treat cancer is a bit of a logical leap, to me. I also suspect that, when you look at the evidence, you’ll find that what is actually new here is that the proportion of individuals for whom surgery is the best option has stopped being a majority. I don’t know who you’re referring to, but I wouldn’t trust any journalist to interpret that shade of meaning correctly. Which is, of course, what this whole problem is all about.

  9. #9 Arnold T Pants
    May 30, 2009

    Happeh, you fail to understand how progress is made in medicine. This study is a refinement of how a particular cancer is treated at a particular stage, and it examines two possible approaches that could be used for that treatment. By comparing outcomes in a number of cases, an investigator might see a significant difference between outcomes of the two treatments, and sometimes the prevailing treatment is shown to not be the best treatment. With sufficient reproduction of the results, treatment guidelines could then change. This is how science works. It is an iterative process of reevaluating what we do and think.

    What is ironic is how charlatans accuse the scientific establishment of being incompetent when discoveries are made that change thought or practice. Perhaps would like it better, Happeh, to just cling to a belief and never change it, never refining our understanding of the world.

    You also to understand the nuance involved, Happeh. The study does not say that surgery is never indicated in colorectal cancer. It doesn’t even say that surgery is never indicated in stage IV metastatic cancer. Just because a study shows that in some cases treatment A is associated with better outcomes than treatment B does not mean that treatment B is worthless. In another type of cancer, or another presentation of the same cancer, treatment B might well be better than treatment A. And even if treatment B is no longer used because treatment A is better in all cases, that is not to say that treatment B was ineffective or worse than non-treatment.

    And feel free to shove it with your histrionics about surgeons being evil people because they resect tumors. If you had a cancerous mass obstructing the lumen of your colon, you’d probably be pretty grateful to the surgeon who removes it.

  10. #10 Ramel
    May 30, 2009

    At number one we have a rant fron the nutjob who gave us “masturbation will cause a person to become crippled and blind in one eye”. That qualifies as an epic credibility fail. He even gets an encyclopedia entry at http://www.sciforums.com/encyclopedia/Happeh

  11. #11 kythyria
    May 30, 2009

    Today there is a news story that says:
    “Surgery is no longer the best treatment option for most patients with advanced colorectal cancer that has spread to other organs, a new study suggests.”
    What this story is saying, is that those conventional doctors who know everything, have been cutting pieces out of the behinds of people with colorectal cancer for years for no reason at all.

    *facepalm*
    What this headline is saying, is that the study suggests some other treatment is more effective than surgery. And that previously nobody had any real evidence that anything was better.

    As for the ridiculous assertion that there was “no reason” for surgery, there was a reason: it was the best known treatment at the time. Saying otherwise is like saying there’s no point in wearing a wide hat in a rainstorm because umbrellas work better.

    What guarantee can you give Orac, that in 20 years I will not be reading a story that says, “20 years ago chemotherapy was thought to be the best treatment for cancer, but now we know that only hastened the death of the patient, and did not cure the cancer”.

    How about the guarantee that WE ALREADY KNOW CHEMOTHERAPY WORKS, and what for, so that headline will never appear, although one saying that a better treatment has been discovered may appear.

    Of course, a quick search of this blog indicates that you are one of the woo-meisters Orac devoted time to skewering.

  12. #12 Scientizzle
    May 30, 2009

    Here’s Happeh’s colorectal cancer story. A modicum of reading comprehension reveals this quotation:

    93 percent of advanced metastatic colorectal cancer cases…did not present the complications that failure to remove the primary tumor were expected to cause. Advances in chemotherapy that do a better job at shrinking both the primary colon tumor and the metastases are thought to be responsible for this change.

    Surgery is not, nor was not ever generally “unnecessary,” Happeh. Chemo has just gotten so much better that surgery may now be more readily avoided. This is great news on so many levels!

    What this also highlights is that cancer docs around the world will take this information and adjust their treatment protocols appropriately to maximize risk-benefit calculations for treatment options. Future research will almost certainly revisit this topic to make sure the altered treatment plan is properly successful. Science-based medicine will constantly update treatment protocols based on new information and treatment options.

    Alternative medicine doesn’t do this. Ever. Quite the opposite, even: advocates point to studies like this and say doctors are clueless sadists who do their bidding on behalf of Big Pharma marketers. They might even say things like doctors…clearly do things that are unnecessary…[they are] butchers and quacks for convincing trusting uneducated people to allow [doctors] to cut pieces off of them like they were a steak.

    What then does AltMed offer? Often, claims of unreasonably high success rates, emotional attention, demonization of modern medicine, anecdotal evidence, and implausible or demonstrably false mechanisms of action. (If uncharitable, this list could be read as: lies, patronization, lies, very poor evidence, and denial of reality.)

    Happeh, with his batshit crazy rantings, is clearly too far down the rabbit hole. But his lies here deserve to be pointed out for those that may be on the fence…

  13. #13 Orac
    May 30, 2009

    oday there is a news story that says:

    “Surgery is no longer the best treatment option for most patients with advanced colorectal cancer that has spread to other organs, a new study suggests.”

    What this story is saying, is that those conventional doctors who know everything, have been cutting pieces out of the behinds of people with colorectal cancer for years for no reason at all.

    All of that surgery was unnecessary. All of the pain experienced by the patient was unnecessary. All of the mental suffering from fear of the surgery was unnecessary. The cost of the surgery was unnecessary.

    Wrong, wrong, wrong.

    Here is an actual news report about the study:

    http://health.msn.com/health-topics/colon-cancer/articlepage.aspx?cp-documentid=100239505

    What it found (which is a retrospective study, with all the attendant problems with retrospective studies, and would need to be replicated) is:

    Immediate colon resection (surgical removal) following diagnosis of stage IV metastatic colorectal cancer had previously been the standard procedure, followed by chemotherapy several weeks after the operation. Surgery was thought to guard against symptoms and complications from the primary tumor, which chemotherapy was thought not to affect.

    However, “if the colon tumor is not causing obstruction, perforation or bleeding we’ve found these patients are best treated with chemotherapy. By moving straight to chemotherapy, patients can avoid the risk of surgical complications and can start treatment for all sites of disease without delay,” study author Philip Paty, a surgical oncologist at Memorial Sloan-Kettering Cancer Center, said in a news release issued by the center.

    Actually, this is a bit overblown in how it states that resection of the colon primary had always been the “standard” procedure when a patient with metastatic colorectal cancer is diagnosed. It hasn’t. If the tumor causes obstruction or bleeding, it’s a no-brainer. The primary tumor was generally resected to stop the complication, and after recovery the patient would start chemotherapy. However, in the case where the patient’s tumor doesn’t cause obstruction or bleeding, then it’s a bit of an overstatement to say that we always recommended resection of the primary tumor first. It was actually more of a case-by-case basis, depending on the individual patient. Moreover, given the development of the ability to stent open obstructions, practice has been evolving away from immediate surgery anyway, because we can temporize using colon stents to stent open most obstructions while the patients undergo chemotherapy.

    In any case, though, this article does not say, as our wank-happy woo-meister claims, that all those patients who underwent surgery didn’t need to. To say that is to say that we should somehow have already “known” that chemotherapy first would be better, which we didn’t (and, quite frankly, still don’t for sure, this study notwithstanding). Moreover, the chemotherapy available even just a decade ago is nowhere near as good as the new chemotherapy regimens for colorectal cancer that we have available now. In brief, chemotherapy works a lot better now for colorectal cancer.

    But what Happeh should really look at is who did the study: A surgical oncologist! In other words, a surgeon did a study and found that surgery was not better. Wow! Apparently his conflict of interest in wanting to promote more surgery didn’t stop him from reporting a study that is likely to lead to his doing less surgery in patients with metastatic colorectal cancer.

  14. #14 Liz
    May 30, 2009

    My grandmother was diagnosed with Stage 4 colorectal cancer in 1986. She was dead within 4 months.

    My Aunt was diagnosed with stage 4 colorectal cancer in 2004 and is still alive today.

    She is dying, now, this time for good, but it is mostly because she decided to be very wishy-washy with her treatments (they would work, but she didn’t like feeling like crap, so she would wait 6-8 months between sessions, then do it again when the tumors grew back and scared her) and stop chemotherapy all together in favor of herbal tinctures and “lymph cleansing” which consists of someone taking all the money a dying woman with 5 soon to be orphan children has and waving an ultraviolet light over her body.

    We all wonder what would be now, if she had simply been more aggressive with her treatment, but it is a moot point as she is about to be admitted into hospice. The lesson is:

    Modern medicine = people living for YEARS longer than they should, even with horrible diagnoses.

    Herbs & Quackery = rapid tumor growth and more metastases and death. (For the record dying of cancer is way worse than the discomfort of chemotherapy.)

    You ARE curing us. You are giving people a chance at living for longer than nature would allow them otherwise. We’re all going to die eventually, but giving people a few more years with their kids, an opportunity to live on, do things they really want to do before they die, another year to be alive.

    Thank you.

  15. #15 Clare
    May 30, 2009

    “Small aspects of sub-problems of a complex phenomenon”: there’s the nub. Of course it would be nice if the remedies to complex diseases (or problems … my daughter recently did an internship in a research lab working on a “small aspect” of morphine tolerance) could be found simply and quickly … “magically” I’m tempted to say. The woo-meisters conveniently forget that until medical research could proceed on a truly scientific basis, effective treatment (as opposed to “treatment” that only pretends to be effective) was a hit or miss affair. The sadists, in my view, are not the doctors and the researchers, but the quacks who promise so much on the basis of so little.

  16. #16 e.d.
    May 30, 2009

    I emailed a similar question once, about breast cancer, to you, Orac. Given the varying presentations of breast cancer, there’s more than a likely chance that there’s more than one “breast cancer gene” with more than one way to misfire?

  17. #17 Kayla
    May 30, 2009

    What an inspirational post!

  18. #18 T. Bruce McNeely
    May 30, 2009

    Speaking of malignant tumors, is there a cure for Happeh?

  19. #19 Arnold T Pants
    May 30, 2009

    @16- There are many genes that can mutate and predispose one to cancer, and there are several in breast cancer. BRCA-1 and BRCA-2, notably. The mechanism section of Wikipedia’s cancer entry is a good place to look for more info.

  20. #20 Rogue Medic
    May 30, 2009

    happeh,

    You demonstrate a typical logical fallacy.

    “Surgery is no longer the best treatment option for most patients with advanced colorectal cancer that has spread to other organs, a new study suggests.”

    You assume that because a treatment is found to be no longer the best treatment option, that the treatment is ineffective. That is not even what the headline suggested, but you misinterpreted the headline that way. Did you read the story, never mind the study it describes?

    If you want to find treatments that are ineffective, you need to look at alternative medicine. They never need to improve their treatments, because none of their treatments are effective. If patients treated with quack treatments get better, it isn’t because the voodoo was effective. If these victims of fraud get better, it is in spite of the snake oil – not because of it.

    What this story is saying, is that those conventional doctors who know everything, have been cutting pieces out of the behinds of people with colorectal cancer for years for no reason at all.

    Please provide a direct quote of any of the researchers making that suggestion.

    You Orac, and your fellow doctors, clearly do things that are unnecessary. If I wanted to be mean and rude, I could say that you were butchers and quacks for convincing trusting uneducated people to allow you and your fellows to cut pieces off of them like they were a steak.

    Again, where is any quote from any of the researchers that finding a better treatment for this one type of cancer means that the previous best treatment was ineffective?

    You did not understand what the point of this post was. Did you even read the post?

    Why would anyone think that you were not trying top be rude. You also succeeded in demonstrating your ignorance.

    What guarantee can you give Orac, that in 20 years I will not be reading a story that says, “20 years ago chemotherapy was thought to be the best treatment for cancer, but now we know that only hastened the death of the patient, and did not cure the cancer”.

    The use of chemotherapy for the type of cancer Master Hauser has, is 90% effective. That is an especially effective form of chemotherapy, but there is evidence of this effectiveness. That will not change in 20 years, except that there will be more evidence of the effectiveness of chemotherapy. There will be changes in chemotherapy to more effective forms of chemotherapy. There may be some changes from chemotherapy to other treatments, because the other treatments are found to be more effective for that specific type of cancer. These are improvements in care, not signs of ineffectiveness or signs of harm.

    If you are an honest scientist and medical professional, you cannot give me that assurance.

    If you are an intelligent person, you realize that is not even close to true.

    Let’s use a nice simple example, that even happeh might understand. I own a car that is capable of accelerating from 0 to 60 miles per hour in about 10 seconds. A sports car might accelerate to from 0 to 60 miles per hour in about 5 seconds. the sports car is better at acceleration.

    Does that mean that my car does not accelerate?

    Does that mean my car’s acceleration is so bad that it is negative (harmful)?

    happeh, if we believe you, these would be reasonable conclusions about my car. My car accelerates adequately for my needs. happeh, you may not be able to understand this.

    How did you, happeh, start your comment?

    What is missing from the blog, is any honest treatment of why patients would avoid or not trust conventional medicine doctors. This blog conveniently never mentions that conventional medicine can be taken apart by someone who wants to, just as easily as this blog takes apart alternative medicine.

    You demonstrate a level of incompetence that is fortunately rare.

  21. #21 Donna B.
    May 30, 2009

    I’m currently in a state of disagreement with my sister who expects doctors to promise a degree of certainty of a cure for the options my Dad has in treating his NSCLC.

    She’s driving me nuts with this attitude and is now furious that part way through my Dad’s choice of radiation over surgery (he’s 86 years old) his doctors are saying that concurrent chemotherapy might increase his chances for a longer survival. She has balked at every suggestion made by every doctor because of side effects or recovery time and rates of possible recurrence. I think she’s also on the verge of driving my Dad and few doctors nuts.

    While I can understand confusion over various treatment recommendations because we have been told many things that cannot all possibly true at the same time, I do not understand the feeling that the doctors are malicious and are not giving us the best advice they have at that time. I wouldn’t expect any two doctors to totally agree on something more than I would any two lawyers.

    Well… maybe I can understand that somewhat. In general, the public has been led to believe that doctors, medicine, and science can do things that aren’t possible yet. Frankly I blame sensationalist journalism that touts each discovery made in “Small aspects of sub-problems of a complex phenomenon” as a cure.

    Doctors say “we can help that” and people hear “we can fix (or cure) that”.

    I think the general population, even (perhaps especially) the better educated, have expectations from medicine that are not rational.

  22. #22 Donna B.
    May 30, 2009

    http://www.phdcomics.com/comics/archive.php?comicid=1174

    I should have just linked to that comic instead of writing a comment.

  23. #23 happeh
    May 30, 2009

    Happeh, the way you’ve “proven” that surgery for colorectal cancer is ineffective in certain cases, is by citing a scientific medical paper. You can’t cite the findings of conventional medicine to rebuke the validity of conventional medicine. The very fact that we do so much research means that we recognize and admit that we do not yet (and probably never will) know all the answers, and that many issues require further investigation. But what we’ve determined so far, based on use of the scientific method, puts us in a much better position than a movement that spurns updated data, and that believes that modifying assumptions or conclusions is a sign of weakness. The alternative to conventional medicine is to doggedly and perpetually defend baseless beliefs, without any curiosity toward the most updated body of knowledge.

  24. #24 adina
    May 30, 2009

    Sorry, I accidentally wrote my name as Happeh, when I intended only to address Happeh.

  25. #25 Lisa J
    May 30, 2009

    a) Happeh scares me when I’m not laughing my butt off at him. What is most frightening is the possibility that someone might take him seriously…

    b) Great news! They believe they can be effective without surgery. That should actually make woo-meisters happy, since everyone KNOWS that when you cut into a tumor you immediately metastasize it into the rest of the body and any attempt at removing a tumor results in death… just ask the woomeisters who counsel cancer patients to avoid surgery and biopsies to stage their cancer because it will kill them faster…

  26. #26 DebinOz
    May 31, 2009

    I was honoured to have Mary-Claire King, the genetic epidemiologist who discovered some of the breast cancer genes, on my PhD orals committee at UC Berkeley.

  27. #27 Chris
    May 31, 2009

    DebinOz, I got to see a talk by Mary-Claire King a while ago. She is a great speaker, you were so lucky! (she mentioned that the name “BRCA” was not only for “BReast CAncer”, but also “BeRkeley, CA”)

  28. #28 Matthew Cline
    May 31, 2009

    Well… maybe I can understand that somewhat. In general, the public has been led to believe that doctors, medicine, and science can do things that aren’t possible yet.

    I remember this one man who blamed scientists for his lover dying of AIDS. His basic reasoning was “Scientists can accomplish anything. Therefore, the reason they haven’t cured AIDS yet is either because they’re too lazy to get off their asses to do it, or they want people to die of AIDS”.

  29. #29 Pablo
    May 31, 2009

    In other news, the Catholic Church no longer supports the American Cancer Society because the ACS supports embryonic stem cell research.

    So much for the “culture of life.” Now, it is the cancer patients who they don’t care about.

  30. #30 Dacks
    May 31, 2009

    Just listened to a provocative idea by a cancer researcher (can’t remember the name) on the most recent Nature podcast: http://feeds.nature.com/~r/nature/podcast/current/~3/4EzBZvHBw_Y/nature-2009-05-28.mp3

    He was pushing a new approach that would view cancer as a chronic disease that can be controlled, like diabetes or hypertension. His concept is that aggressive therapies can backfire by killing most cancer cells, but providing opportunities for the resistant cells to multiply rapidly after the treatment ends. The alternative, in his view, is to kill as few cancerous cells as necessary to keep the patient healthy, but to continue treatments perhaps for many years.

    It sounded intriguing, but a little scary to me. Is this a new-ish idea, and does it have any merit?

  31. #31 Orac
    May 31, 2009

    Contrary to how it’s being represented, the concept of trying to turn cancer into a chronic disease that can be managed is not new at all. Judah Folkman proposed it at least 12 years ago (possibly as long as 30 years ago), for example.

    In any case, I’m waiting for the actual article to come out (tomorrow, I think). I’m getting a bit perturbed by the hype around this.

  32. #32 DLC
    May 31, 2009

    The good thing about science-based medicine is, it changes as newer, better ways of doing things are found.
    This cannot be said for such “ancient” practices that some people want to sell.

    Orac: good piece of writing, thanks.
    RE: Dr Folkman: he was one of the big hitters in cancer research. I was hardly aware of him until you mentioned his passing on this blog. Folkman fought the good fight.
    As is a certain plastic box full of blinking lights, who shall remain nameless.

  33. #33 happeh
    May 31, 2009

    Adina – “Happeh, the way you’ve “proven” that surgery for colorectal cancer is ineffective in certain cases, is by citing a scientific medical paper. You can’t cite the findings of conventional medicine to rebuke the validity of conventional medicine.”

    Why not? If someone finds out they have made a mistake and tells people they made a mistake, why can’t I say “See. That proves they make mistakes”? They really did make a mistake. They personally admitted it.

    Adina – “The alternative to conventional medicine is to doggedly and perpetually defend baseless beliefs, without any curiosity toward the most updated body of knowledge.”

    That sentence makes no sense. You are trying to “fix” the conversation in your favor by saying the beliefs are baseless before any discussion has taken place.

    I could say “Alternative medicine tries to wake up conventional medicine to reality, but the focus of conventional medicine on profit means that they will not listen”.

    I am guessing that you and your fellows would object to my stating your side in the debate as “Conventional medicine is focused on profits”, because I am “fixing” a negative image of conventional medical people in the minds of the audience.

    Let’s have a more honest discussion where what is right wins. Let’s put aside all the games and tricks used for winning a debate.

    This is about the health of human beings so we want the right information to win. We do not want someone who wins by games and tricks to win the debate, with the result being improper health care information being disseminated world wide, and the resultant suffering that improper health care information will cause.

  34. #34 Arnold T Pants
    May 31, 2009

    Happeh, should we have the unbiased, untheatrical, entirely scientific debate at your blog “Doctors R Stoopid?”

  35. #35 Arnold T Pants
    May 31, 2009

    Correction- the name of the blog is “SCIENTISTS R STOOPID.”

  36. #36 Dedj
    May 31, 2009

    “If someone finds out they have made a mistake and tells people they made a mistake, why can’t I say “See. That proves they make mistakes”? They really did make a mistake. They personally admitted it.”

    If that was what had actually happened, then fair enough.

    But like it or not the statement:

    “We did it wrong”

    is not directly equatable with the statement:

    “We did it well enough, but now we can do it better”

    This is not a correct/incorrect situation, as you have already been informed. Please stop treating it as such.

  37. #37 happeh
    May 31, 2009

    It is very difficult to discuss things with certain types of people because they want to play word games.

    Orac says – “In any case, though, this article does not say, as our wank-happy woo-meister claims, that all those patients who underwent surgery didn’t need to.”

    If this discussion is going to be based on pedantry, then my use of the word “all” does give you the victory. I should have said “many” or “a large majority”. I felt I was among reasonable people who would overlook exact wording and see through to my meaning.

    Orac then says – “To say that is to say that we should somehow have already “known” that chemotherapy first would be better, which we didn’t”

    You didn’t because you had to test to find out. Just like you do not know that alternative medicine does not work or that my claims are untrue, until you have honestly and throughly tested them.

    For instance. Everyone here seems to think my claims about masturbation cannot be true, because some men hundreds of years ago said masturbation does not cause any health problems. Why do you and the other scientists here believe the work of pre industrial age men who claimed that masturbation causes no harm to the human body?

    Modern scientists do not believe those primitve men who claimed that bleeding patients is an effective medical treatment. So why do you trust those same primitive men when they tell you masturbation causes no ill effects?

    You scientists contradict yourselves. You want to claim to be an authority on what is and is not right, but then you want to make excuses when it turns out you are wrong like “To say that is to say that we should somehow have already “known” that chemotherapy first would be better, which we didn’t”
    ——-

    RogueMedic – I would truly like to deal with the points that you have made out of courtesy to you. Your position is so based on word twisting and pedantry that I cannot do it. Here is an example of why I cannot deal with you.

    “What this story is saying, is that those conventional doctors who know everything, have been cutting pieces out of the behinds of people with colorectal cancer for years for no reason at all.

    Please provide a direct quote of any of the researchers making that suggestion. ”

    It is clear from my writing, that I am putting my interpretation of the conclusions of the study in my words. You know your demand for a quote of the researchers saying the same thing I did cannot be fulfilled, because I wrote my own interpretation of the conclusions of the researchers.

    Discussions with people like you lead to nothing but headaches. You do not want to discuss. You want to hold people down and suffocate them with your nit picking demands.

    Why would I consent to that?

  38. #38 Dedj
    May 31, 2009

    “It is clear from my writing, that I am putting my interpretation of the conclusions of the study in my words.”

    And it is clear, from reading the original story, that your interpretations of the conclusions do not match up with the actual conclusions.

    Again:

    “Doing it better”

    does not equal

    “We did it wrong”

  39. #39 Richard Eis
    June 1, 2009

    -It is clear from my writing, that I am putting my interpretation of the conclusions of the study in my words.-

    Your interpretation fits your agenda to be as naive and as possible. Congratulations. The rest of us have long since had you figured and you are only deluding yourself.

  40. #40 RebeccaF
    June 1, 2009

    For instance. Everyone here seems to think my claims about masturbation cannot be true, because some men hundreds of years ago said masturbation does not cause any health problems.

    No, I think that your claims about masturbation cannot be true because many men and women throughout the past centuries have not only said it does not cause any health problems, but demonstrated that it does not do so.

    Have any more lies you want to tell?

  41. #41 razzmataz
    June 1, 2009

    So, I’m wondering if you are familiar with CaBIG and their (and NCI’s) audacious goal of curing cancer by 2013?

  42. #42 Rogue Medic
    June 1, 2009

    RogueMedic – I would truly like to deal with the points that you have made out of courtesy to you.

    happeh using the word truly. Should I take the bait, as Charlie Brown does with Lucy? What about courtesy? happeh has repeatedly made it clear that happeh only uses courtesy as a ploy to mislead.

    Your position is so based on word twisting and pedantry that I cannot do it. Here is an example of why I cannot deal with you.

    “What this story is saying, is that those conventional doctors who know everything, have been cutting pieces out of the behinds of people with colorectal cancer for years for no reason at all.

    Please provide a direct quote of any of the researchers making that suggestion.”

    It is clear from my writing, that I am putting my interpretation of the conclusions of the study in my words. You know your demand for a quote of the researchers saying the same thing I did cannot be fulfilled, because I wrote my own interpretation of the conclusions of the researchers.

    We do understand that you are putting your twisted spin on the study. You have misrepresented it to the point that your statement is either completely delusional or an outright lie. The sad thing is that nobody can be sure which pathetic life you lead.

    There is nothing in the study to support your claim. You cannot cite anything from the study that is a criticism of surgery as dangerous. At least not without misrepresenting what the study actually says.

    My position is so based on word twisting and pedantry? No. That is your field.

    Discussions with people like you lead to nothing but headaches. You do not want to discuss. You want to hold people down and suffocate them with your nit picking demands.

    If you get headaches, perhaps you should try conventional medical cures.

    I do not wish to hold anyone down, but to help them to improve their understanding of science. You only preach the stifling quackery that ignores science. Science may nit pick, but science is the way we learn. Perhaps I should not use the word we when communicating with you. Perhaps even the word communicate is a mistake.

    Why would I consent to that

    Why take the chance at having to defend you lies? The anti-science frauds that you promote are busy making a fortune selling their snake oil to the people you deceive. You are nothing but a con artist pushing ineffective pseudo-drugs.

  43. #43 Chris
    June 1, 2009

    Have any more lies you want to tell?

    happeh using the word truly. Should I take the bait, as Charlie Brown does with Lucy?

    Do not feed the troll.

    razzmataz:

    So, I’m wondering if you are familiar with CaBIG and their (and NCI’s) audacious goal of curing cancer by 2013?

    Hmmm… looking at their webpage, http://cabig.cancer.gov/, I only see an information/communication system. Where is that goal stated? I put “2013″ into the search box and there were no results.

  44. #44 Agoraphobic Kleptomaniac
    June 1, 2009

    @Happeh-37:

    Orac says – “In any case, though, this article does not say, as our wank-happy woo-meister claims, that all those patients who underwent surgery didn’t need to.”

    If this discussion is going to be based on pedantry, then my use of the word “all” does give you the victory. I should have said “many” or “a large majority”. I felt I was among reasonable people who would overlook exact wording and see through to my meaning.

    And, yet, somehow… you’ve turned a screed about pedantry into a pedantic issue?

    Orac didn’t need to say “all” to make his point that you are wrong. The article doesn’t say, “MOST OF those patients who underwent surgery didn’t need to.” It also doesn’t say “SOME OF those patients who underwent surgery didn’t need to.”

    It simply says that going into a straight Chemo Regiment is better than operating when the growth is not bleeding or causing obstruction. What about this point is so impossibly hard for you to understand????

    Just like you do not know that alternative medicine does not work or that my claims are untrue, until you have honestly and throughly tested them.

    Put up or shut up. Until you bring a study that shows that claim, alternative medicine will be just that, alternative.

    Honestly, I’d cheer if they had studies showing that a few vitamins or Ionic water could cure cancer, but somehow, I don’t think you’ll reply to this post with anything but complaints about how mean everyone is to your silly arguements.

  45. #45 Chris
    June 1, 2009

    Put up or shut up.

    Don’t count on it. Stop feeding the troll.

  46. #46 happeh
    June 1, 2009

    “Put up or shut up. Until you bring a study that shows that claim, alternative medicine will be just that, alternative.”

    This is what is wrong with modern scientists. All of you young children have been trained that without a study, nothing exists.

    Did you know they built something called a Hadron collider for billions of dollars? The collider was built to look for a THEORIZED particle called a Higgs Boson.

    Nobody knows if these really exist. But real scientist who can think and theorize have theorized the possibility of this boson, and they have spent billions of dollars to prove the existence of this boson.

    All without a study proving that a Boson exists.

    Those people are real scientists. They can visualize and imagine something that they do not necessarily know or believe is true. Then they can work to prove or disprove the theory.

    You people are children. You cannot visualize or imagine something unless a study has given you permission. You will never invent or create anything on your own. The people who taught you to never believe or think anything unless it was study approved have ensured that.

  47. #47 snerd
    June 2, 2009

    Alternate Happeh:

    Fools! FOOLS! You called me mad, I, the greatest mind of our time, if not of all time? I’ll show you! I’LL SHOW YOU ALL!
    Bwahahahahaha! etc

  48. #48 Obvious troll is obvious
    June 2, 2009

    Happeh != Large Hadron Collider physicists.

    Just for the record…
    Not even close.

  49. #49 Kaethe
    June 3, 2009

    Thanks for the cartoon. I may repost it on my blog to explain to people what I do.

    While I absolutely agree that finding a cure for cancer ain’t going to happen, I am hopeful. We are making great strides in targeting therapies based on not just staging, but genetics. And I anticipate that many more vaccines will arise to prevent specific cancers. How much cooler it would be to eradicate cervical cancer, than to merely cure it.

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