The testimonial of Hollie Quinn: The Huffington Post promotes breast cancer quackery right before Breast Cancer Awareness Month

I hate The Huffington Post. I really do.

Why, you ask, do I hate HuffPo so? I hate HuffPo so because of its history from the very beginning of its existence of promoting the vilest forms of anti-vaccine quackery and pseudoscience. It's because, over the last couple of years, not content with being the one-stop-shop for all things antivax on the Internet, right up there with Whale.to, Mercola.com, and NaturalNews.com, HuffPo branched out very early into quantum quackery, courtesy of Deepak Chopra. Just search for "Huffington Post" and "Deepak Chopra" on this blog and you'll discover how many times I've blogged about this over the last five years. Search all of ScienceBlogs using the same search terms, and you'll see that I'm not alone in having castigated HuffPo for giving voice to Choprawoo and its assault on medicine, neuroscience, physics, astronomy, molecular biology, and evolution. I hate HuffPo so because over the last five years, it has continually sought out and explored new forms of woo, in particular, virtually every major form of quackery in existence. Examples include homeopathy, the Beck Protocol (which is a trifecta plus one of pure quackery including blood electrification, colloidal silver, magnetic pulsing, and ozonated water). I hate HuffPo so because, not content with its war on medical science and with trying to rival NaturalNews.com and Mercola.com, being the "mainstream" voice of the anti-vaccine movement, and promoting New Age pseudoscience and mumbo-jumbo as personified by Deepak Chopra, HuffPo started into other areas of pseudoscience, including Robert Lanza's biocentrism and even intelligent design creationism, the latter example proving that even a liberal rag like HuffPo can't resist pseudoscience, no matter how much associated with the religious right. Crank magnetism in action, indeed.

I especially hate HuffPo so for publishing posts like this one over the weekend, entitled One Woman's Story: Saying No to Conventional Cancer Treatment. I hate it so because I view this to be exactly the sort of deceptive post that can lead a woman to forego effective therapy for breast cancer and die. Yes, HuffPo continues to be a potential killer with its promotion of quackery. When you, my readers, started sending me the link to this story on Sunday, it outraged me enough that I nearly put aside the grant I was working on in order to have a post ready by Monday. I even did a few searches and found out some things that were to form the basis of this post. Fortunately for my sanity (and the completion of a draft of my grant), I decided to wait a day before writing this.

Let's take a look at HuffPo's latest atrocity against medical science, shall we?

The post begins:

What would you do if you were diagnosed with breast cancer during your first pregnancy at the age of 27?

A few months ago I received a book in the mail with the inscription "This all began with you..."

"YOU DID WHAT?: Saying No to Conventional Cancer Treatment" is a book written by Hollie and Patrick Quinn about navigating through the shock and the fear of a breast cancer diagnosis at a very young age and during her pregnancy with their first child. It is the story of the many courageous and intelligent choices they made along the way. They said no to chemotherapy, radiation and hormones, the standard care of the day in the best oncology centers nationwide. They said YES to an evidence based Integrative Alternative Cancer Care model and are living well to tell their tale with two healthy children in tow!

Do you recognize this particular variety of "alt-med" cancer cure testimonial? This sort of thing goes way, way, back to the very beginning of this blog, where in one of my first posts ever (back in December 2004!) I took on a very similar form of cancer cure testimonial, using Suzanne Somers and Lorraine Day as examples. Since then, I've periodically revisited just this type of "testimonial" for "alternative" cancer cures, be it from Suzanne Somers or women like Kim Tinkham, although Hollie Quinn's story is most like Suzanne Somers, as you will see.

Now, you may think I'm an utter cad for criticizing a woman with breast cancer, my being a breast cancer surgeon and all. A fair enough criticism--to a point. The reason such "testimonials" irritate me so is that I spend my clinical time trying to save women from death from breast cancer and my research time trying to think up better ways to prevent women from dying from breast cancer. Anything that interferes with that calling does not meet with a favorable response from me. So, while I can feel a lot of sympathy for what Ms. Quinn must have gone through being diagnosed with breast cancer at age 27 while pregnant with her first child (I've taken care of a few patients just like that, one of whom was actually a 26 year old and an illegal immigrant), while I can comprehend how she could misunderstand breast cancer biology so profoundly leading her to write the sorts of claims summarized in the HuffPo post by Dr. Chilkov and expounded upon in Quinn's book, I can't let them go unanswered, particularly Dr. Chilkov, who is a practitioner of traditional Chinese medicine:

Patrick and Hollie are two highly intelligent and well-educated people. Upon hearing the devastating diagnosis and the recommended toxic chemotherapy treatment, they decided to take a few months to systematically learn and understand the molecular biology of breast cancer and the cancer treatments recommended to them. They also researched alternative and natural cancer treatments thoroughly and rationally. I know. I watched them do it.

Hollie and Patrick decided to embark on an unconventional and alternative path. They chose to radically change their diet and lifestyle and to use botanical medicines and nutritional supplements and Chinese medicine (herbal medicine and acupuncture) in a very systematic and thoroughly researched manner. They sought the care and guidance of health care professionals experienced in this approach. They did not do this on their own. They were incredibly organized and disciplined. They fully understood the risks and benefits of their choices. Their eyes were wide open.

Needless to say, this took an enormous amount of courage, self-discipline and self-trust. This was not a New Age fantasy with rose-colored glasses or magical thinking. They took a very pragmatic approach. These two young parents with a newborn in their arms, made a very serious science-based study of ALL of their choices.

Actually, what the Quinns did was to make a choice that increased the odds of their new child becoming motherless. Yes, the choice was that stark, that misguided, and that potentially disastrous. That Ms. Quinn was fortunate not to suffer the consequences of her choice with it does not make it a good choice any more than surviving a car crash in which you didn't wear your seatbelt made not wearing your seatbelt a good choice. It was a monumentally poor choice that Ms. Quinn has until now been fortunate enough not to pay for with her life. Dont' get me wrong, though. I sincerely hope that Ms. Quinn never pays for her choice with her life. Her child deserves no less. Unfortunately, Ms. Quinn seems utterly oblivious to the fact that, even eight years later, she is not out of the woods yet. Breast cancer recurrences can occur as late as 10, 15, 20 years later or more, particularly for estrogen-responsive tumors such as the one hers appears to have been. That being said, even though I wish no evil on Hollie and hope that she lives a long and happy life to see her daughters grow up and possibly even produce grandchildren for her, I also can't abide seeing videos promoting her book without investigating:

Whenever I see a video or testimonial like this, I ask: What is the history? So I did something very simple. I went to Amazon.com and looked at the book page for You Did What? Saying 'No' To Conventional Cancer Treatment. I then used Amazon's "Search Inside This Book" feature and looked for terms like "surgery," "lumpectomy," and "lymph nodes." Guess what I found out? Ms. Quinn had definitive curative surgery for her tumor! She underwent a partial mastectomy and sentinel lymph node biopsy. On p.25, it reads:

Less than two weeks later, Hollie had a lumpectomy, along with a sentinel lymph node biopsy, in order to start to gauge the spread of the cancer through her lymphatic system. It was the last conventional medicine we accepted, and, despite the relative success in "curing" cancer, even this intervention is one that Hollie now says she wouldn't do if she had a chance to do it all over again.

In a comment on HuffPo, Hollie states:

I was diagnosed with a very aggressive Stage 2 breast cancer, which had begun to spread to my lymph nodes. I did undergo a lumpectomy and sentinel node biopsy before rejecting the rest of conventional treatments (chemo, radiation, and hormone therapy).

And, on p. 32 of her book:

For her part, Hollie now says that if she could do it all over again she wouldn't have had her tumors removed surgically--the only conventional treatment she had--but would have enjoyed the empowering experience of watching traditional medical wisdom melt the lumps away.

And if Hollie had done that there would be a good chance that, eight years later, her daughter would be motherless, having not enjoyed the very un-empowering experience of the decline of her bodily functions. It's also funny that Ms. Quinn's surgery was mentioned neither in her promotional video nor by Dr. Chilkov in her HuffPo post.

What this means is that Hollie underwent the first part of conventional therapy for breast cancer, making the title of her book inherently deceptive. She did not "say no to conventional therapy." She said no to chemotherapy and radiation therapy. There's a huge difference. As I have explained time and time again, surgery is the primary curative modality for breast cancer that has not metastasized beyond the lymph nodes under the arm. Chemotherapy and radiation add to surgery by decreasing the risk of recurrence. Chemotherapy decreases the risk of systemic recurrence (i.e., in the rest of the body), while radiation therapy decreases the risk of local recurrence (i.e., in the breast). If Hollie had said no to surgery, as she says she would now do if faced with the same decision, it is highly unlikely that she would currently be doing as well as she is now. In fact, it is quite likely that she would either have died of metastastic disease or developed cuirasse disease, which is in many ways a fate worse than death. That's how women died of breast cancer before we had effective therapies.

So, from what we can find out, Hollie had a stage II tumor. That means it was either large enough to have reached the threshold to be considered stage II (2 cm in diameter) and/or there was involvement of the axillary lymph nodes (the lymph nodes under her arm). I tried but couldn't find a description of the size of the tumor by searching the book; but I did find this passage in her book (p. 34):

In her lymph nodes, Hollie had what is called a micrometastasis. This means that there were microscopic cells that had begun to spread to the lymph nodes. According to all the doctors, the mere presence of any cancer cells in lymph nodes meant that the cancer was now in the circulatory system and could spread anywhere (i.e., metastasize to other parts of the body). And we agree with this point.

Here's something you need to know about this story to have this story make sense. It was 2002 when Hollie was diagnosed and underwent her therapy for breast cancer. In 2002, the sentinel lymph node (SLN) biopsy in breast cancer was still a relatively new procedure. Accrual to the NSABP-B32 trial of sentinel lymph node surgery had just wrapped up, but, because of the decreased morbidity of SLN compared to the old procedure (axillary dissection, which involved removing all the lymph nodes under the arm), SLN had already taken over as the standard of care before all the evidence was in that it was as effective and that it didn't result in harm due to an increased risk of dying or having a recurrence in the axilla. Because the single or handful of lymph nodes harvested during SLN biopsy are subjected to much greater scrutiny by pathologists than the 10-35 lymph nodes typically removed in an axillary dissection were, more and more pathologists found, rather than larger metastases, microscopic tumor deposits in SLNs. In 2002, breast cancer surgeons and oncologists honestly didn't know what the significance of micrometastatic disease to the lymph nodes was. Based on our previous paradigm, we assumed it had to be bad, and based on our past experience we chose the most conservative course, namely recommending removal of the rest of the lymph nodes for micrometastatic disease and treating them as enough to bump a patient from stage I to stage II if there wasn't any other feature of the primary tumor do justify doing so. This may very well have resulted in stage migration, or, as it's commonly known, the Will Rogers phenomenon.

By the time I had to give a talk regarding the management of the axilla in the era of SLN biopsy, I reviewed the literature regarding SLN biopsy. Then, in June I attended the ASCO Meeting in Chicago, where results of the NSABP-B32 and ACOSOG Z0011 trials of SLN biopsy were reported. Basically, what they showed is that SLN was effective and accurate and, more importantly, that in the case of micrometastases, there appears to be no survival advantage to going back and taking all the lymph nodes out. In other words, micrometastases, although they do portend a somewhat worse prognosis, are not as serious as macrometases. We know that now based on having had eight years for the data to mature and provide us with survival data. We now know that about 60% of women with micrometastases have no other lymph node metastases and that the local recurrence rate in the axilla with SLN biopsy alone is around 3%. True, the major writers of cancer care guidelines, such as the NCCN, have not yet updated their recommendations to take ACOSOG Z0011 into account. It is, after all, only one trial. However, it is likely to be the last trial that ever randomizes patients to SLN alone or full axillary dissection; so we are going to have to look at the accumulated evidence regarding the necessity for full axillary dissection after an SLN positive for micrometastatic disease and come to a consenus. My suspicion is that that consensus will be that full axillary dissection will be considered unnecessary for such patients.

There's also another confounding factor. From Ms. Quinn's description, I can't tell if she had a true micrometastasis or simply had some isolated tumor cells. There's a difference. The definition of a micrometastasis, which wasn't firmed up in 2002, is a tumor in the lymph node measuring between 0.2 and 2 mm. Anything under that is now defined as isolatd tumor cells. These days, we now treat isolated tumor cells the same as negative lymph nodes because that's what the developing evidence over the last several years tells us. In other words, it's quite possible that Ms. Quinn would be considered stage I under today's staging system if her primary tumor was under 2 cm. In other words, with surgery alone, Ms. Quinn appears to have had an excellent chance of survival. Again, chemotherapy and radiation therapy simply decrease the risk of recurrence.

Perusing what Amazon let me peruse in the book, I found a number of statements and discussions that demonstrate, more than anything else, the arrogance of ignorance and the truth of the old saying that a little knowledge is a dangerous thing. In other words, the understanding of cancer demonstrated in Ms. Quinn's book is quite superficial but that she is able to cite references in a "science-y" way to add apparent credibility to her claims. For example, there were passages about hormonal therapy in which Ms. Quinn seemed to confuse resistance to Tamoxifen, which is indeed associated with HER2-positive tumors with Tamoxifen actually decreasing the likelihood of survival. She notes that adjuvant chemotherapy doesn't work for most women, which is something I've discussed before, but fails to understand that the relative benefit of chemotherapy increases as the tumor is more advanced, up to stage III and that it is the only modality that can improve survival in triple negative breast cancer. She also writes this about radiation:

In short, the research was very clear that while there sometimes was a reduction in local recurrence with radiation there was no difference in survival. In other words, one was just as likely to be alive in five years if you did radiation, as compared to if you did not undergo radiation.

Well, yes, but the difference is that the woman gets to keep her breast! Moreover, without radiation the risk of local recurrence after lumpectomy is on the order of 1 in 3, and most of these recurrences require mastectomy to treat. Moreover, in node-positive cancer, there is an emerging body of evidence that radiation therapy to the axilla does indeed very likely improve 15-year survival in breast cancer by an average of 5.4%. There might have been an excuse for making such a misstatement in 2002 and it may well have been what her doctors told her then. In 2010, there is no excuse.

The rest of the passages I examined were full of the standard "alt-med" tropes: chemotherapy doesn't work and it's "poison"; surgery spreads the tumor (it doesn't); and that her unfeeling doctors tried to badger her into accepting chemotherapy (that may well be true). Fortunately for Ms. Quinn, it is not so surprising that she is still alive. Without further chemotherapy and radiation, she probably had roughly a 2 in 3 chance of surviving this long from surgery alone, which would have improved if she accepted chemotherapy and radiation therapy. In other words, the odds were still in her favor with surgery alone, which probably cured her, just not as much in her favor as they would have been if she hadn't "said no" to chemotherapy and radiation. Unfortunately, Ms. Quinn extrapolates that result to conclude that she would have done just as well or even better than she is doing now if she hadn't undergone surgery, that her tumors would have "melted away" from the various "alternative cures" to which she subjected herself:

For the record, I did not treat my cancer simply by changing my diet (although this is a critical element to healing). I chose an aggressive herbal oncology protocol, under the guidance of experienced practitioners. I encourage you to take a look at the book, which provides all the details about my case, but more importantly, speaks to the broader topic of the ongoing ineffectiveness and harmfulness of conventional cancer treatment today, citing extensive research.

Given how she "cited extensive research" in the parts of her book I could preview, you'll excuse me if I don't have a lot of faith in Ms. Quinn's ability to interpret the medical literature. Harsh? Yes, but. although she either doesn't understand it or won't admit it, she's promoting therapies that could lead women to decrease their odds of surviving their breast cancer, and I find that appalling. There is no good evidence that any "aggressive herbal oncology" protocol, "integrative oncology," or "naturopathic oncology" can result in increased survival for cancer patients. But it sure sells a lot of supplements, as the video on Ms. Quinn's website shows.

Unfortunately, I don't think that Quinn's going to "get it" with respect to science-based oncology, at least if her comments on HuffPo and elsewhere are any indication. For example, on the Anaximperator blog, she showed up in response to an equally harsh but less lengthy dissection of her claims than this particular bit of insolence and wrote:

Greetings! Thanks so much for sharing a small piece of the story in our book. As you rightly point out, I did have conventional surgery to remove the tumors in my breast, along with a few lymph nodes as well. For the record, we acknowledge this openly in the book. But there are a couple of important points that I'd like to add to your post here. First, the cancer was aggressive (by several measures, and by the universal agreement of the conventional oncologists), and had begun its march through my lymphatic system. As you probably know, conventional medicine holds that in cases like this, additional aggressive treatments are necessary in order to survive, and I was told repeatedly and strenuously that I would die if I didn't undergo chemotherapy, radiation, and five years of hormone therapy. I disagreed, having concluded that natural holistic medicine was a much smarter, safer route to take. Secondly, and more to your point, we cite numerous case studies in our book of patients who used the same treatment system I followed to eliminate solid tumors without any surgery. Again, we lay this out very clearly and openly in the book, so that everyone can see exactly how I arrived at my conclusions.

I couldn't find any of these case studies in the preview of Hollie's book. Dr. Nalini Chilkov, the author of the execrable HuffPo piece, not surprisingly, finds her story totally convincing and uses it to justify a number of alt-med canards, including co-opting the term "individualized treatment":

Today, the landscape of cancer treatment and diagnosis is rapidly changing. Many forward thinking Oncologists and Oncology Centers now include Alternative Cancer Care in the treatment plans of their patients. Because our understanding of cancer genetics is advancing, Oncologists are beginning to acknowledge that Cancer Care can now become more individualized and that lifestyle and diet, nutrients and botanicals and acupuncture have a place in a complete treatment approach for cancer patients.

Note that it is scientists and science-based physicians, not promoters of alt-med, who are doing the research to characterize the genetic sequences responsible for increasing cancer risk and individualizing treatment. Moreover, as I have pointed out time and time again, diet, exercise, and lifestyle are science-based interventions. Or at least they should be. Note, however, how Dr. Chilkov yokes woo like acupuncture and "nutrients" (in CAM-speak, supplements by the dozen, as shown on the preview video for Quinn's book featured on her website.

The bottom line is that we know that HuffPo is a cesspit of pseudoscience and quackery, but this post is bad even by HuffPo standards. It takes a book that is designed, despite the presence of the Quack Miranda Warning on p. vii and the reader's understandable desire for Ms. Quinn to continue to do well and raise her daughters while remaining happy and healthy, to persuade women with breast cancer that they should forego effective, science-based therapy in favor of ineffective treatments based on magical thinking, and uses it to advocate the same. But it leaves out the fact that the woman who wrote the book actually did undergo science-based "conventional" therapy for her breast cancer. She simply underwent incomplete science-based conventional therapy for her breast cancer and was fortunate enough to survive without the added risk reduction that chemotherapy, anti-estrogen therapy, and radiation therapy provide. It's such a glaring omission that even Ms. Quinn doesn't make, but Dr. Chilkov does. One wonders why.

You think I'm being too harsh on both Hollie Quinn and especially Dr. Chilkov? Women could die if they take their advice. After rereading this post, I'm not sure I was harsh enough. Certainly, it is very difficult to be harsh enough on Arianna Huffington and her misbegotten creation for promoting advice that could lead to the death of women with breast cancer who follow it. Those could be my patients. They could be our wives, mothers, daughters, or friends.

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I don't think you're being overly harsh. She's promoting her story to others. She's not just answering questions, she's actively pushing an agenda that puts the lives of others at risk.

By Gopiballava (not verified) on 27 Sep 2010 #permalink

"Ms. Quinn...conclude(s) that she would have done just as well or even better than she is doing now if she hadn't undergone surgery, that her tumors would have "melted away" from the various "alternative cures" to which she subjected herself."

This is the truly horrifying part of the article. We're not talking about her assuming a 5.4% extra risk of dying over 15 years by skipping radiation treatments. By avoiding surgery altogether she likely would have experienced aggressive tumor spreading locally and causing miserable symptoms (like an undiagnosed breast cancer that resulted in "chronic abscesses" in a case discussed at our tumor board meeting recently) and/or widespread metastases resulting in incurable disease.

HuffPo needs to grow a conscience, rather than helping lead more women down the path of rejecting potentially curative treatment.

By Dangerous Bacon (not verified) on 27 Sep 2010 #permalink

"they decided to take a few months to systematically learn and understand the molecular biology of breast cancer and the cancer treatments recommended to them. "

Ah university of google, is there anything that you can't teach us in a few months that normal idiots take years of graduate school and professional experience to learn?

I know a woman who died of untreated breast cancer and it was gruesome, to say the least. This Hollie - and her Huff-Puff reviewer - are being utterly disingenuous and that needs to be pointed out. Thanks Orac!

By NZ Sceptic (not verified) on 27 Sep 2010 #permalink

Carcinoma in situ mercenaries = surgical breast cancer oncologists.

Keep telling yourself that.

By augustine (not verified) on 27 Sep 2010 #permalink

I think you might have a typo:

Shouldn't "the single or handful of lymph nodes harvested during axillary dissection [...] removed in an axillary dissection" be "the single or handful of lymph nodes harvested during SLN [...] removed in an axillary dissection"?

One deluded person shouting loud about their survival when doing some alternative treatment proves nothing. Most of the general population don't understand risk and probability and invariably extrapolate their story to everyone.

They just can't seem to grasp the simple idea of, x% die therefore 100-x% survive, and the simple fact that they are here to write about it means that they are one of the 100-x%, no matter how small that number is.

And note, it is this very much simplified version they don't seem to grasp, there seems little point in going into the full complexities of survival proability etc

It's interesting to consider how many 'conventional' drugs are actually plant derivatives; this includes chemotherapy drugs such as vincristine and vinblastine. Perhaps renaming them 'Madagascan periwinkle extract' would make them more acceptable to the herbalists out there?

By Catherine (not verified) on 27 Sep 2010 #permalink

You were too nice. It really gets me when people claim they're using "science" and all the case studies that show how wonderful the natural treatment works. I hope, as the book becomes more available to you, you'll be able to evaluate the studies, cases and science they're claiming, and report it to us.

By AmyFromTulsa (not verified) on 27 Sep 2010 #permalink

You're right Catherine! We had an issue on a local forum where the poster wanted a 'natural' alternative to Warfarin - but was told this ghastly 'pharmaceutical' is actually derived from spoiled clover!

By NZ Sceptic (not verified) on 27 Sep 2010 #permalink

I don't think you have been too harsh.

Sadly, I have had to watch two friends die of early stage cancer, because they had been convinced that the only right way to go was alternative "medicine".

One of these women developed en curasse disease. Words fail to describe the horrors she and her loved ones had to go through.

There is ignorance that is akin to evilness. You can never be too harsh I think. Sorry.

Competition in the marketplace is always a good thing whether it be health treatments or anything else, for it provides choice which we all appreciate. However, the idea is that some health treatments are more "rational" than others or have passed a greater degree of scientific scrutiny. If this is so, it needs to be communicated in a form the public readily understand.

It is only natural that people shy away from treatments that are destructive in any way. The Hippocratic Oath means that healers will avoid using such treatments, unless no other option is available and the benefits are believed to outweigh the disadvantages.

Ultimately it is the patientâs body and they will make the final choice as to what they wish to subject it to.

I believe it is useful for those who have undergone conventional and unconventional treatments to report on their experiences to help educate those who may be considering similar options.

Excellent post Orac, and I agree totally that people should be made aware of the duplicitous claims being made in HuffPoo.

To be honest as soon as I read the title of the book I knew where this was going and what you would find.

You're not out of line with your criticism. For them to "forget" to talk about the life-saving surgery is disgusting and deceitful on their part... right up Huffpo's alley.

I am a triple negative breast cancer gal one year and a half out from lumpectomy, re-excision for clean margins, horrible bout with chemo for six months and 6 weeks of radiation, all concluding in the absolute worst year of my life. However, I'd do it all again in a New York minute. While I believe everyone has to tread the path they are most comfortable with, I left comfort behind and decided to let the true experts decide with me what was best for me. I hope that all those that follow in my footsteps do the same.

Thank you for writing this most necessary post.

By Linda McMichael (not verified) on 28 Sep 2010 #permalink

@Todd Goninon,
The problem with the marketplace is that often the best dressed get the prize rather than the best fit. We have seen numerous cases where distorted stats, star power, and fear were used to push people away from scientifically sound treatments toward woo and false hope.

I believe it is useful for those who have undergone conventional and unconventional treatments to report on their experiences to help educate those who may be considering similar options.

What makes you believe that? Such reports are simply random anecdotes, and necessarily very subject to massive bias (due to the fact that those who died can't report the fact). Accordingly, they contain effectively no usable information. The only thing such reports can do is muddy the waters and confuse people.

Only careful science can provide any reliable information. Advocating for people to take "reports" like this one into consideration is very wrong-headed.

A couple of years ago my wife and I were eating in the Cafe inside a a "natural" food store when this old guy started talking to us, telling us he was in mourning because his wife had died of breast cancer. He said they had decided to "go the natural route". Of course the "natural route" had the expected natural outcome.

Given the low quality of virtually everything made in China, why would anybody in their right mind put Chinese herbs into their body?

By Militant Agnostic (not verified) on 28 Sep 2010 #permalink

I *absolutely* hate HuffPo! I *never* read it (except what is referenced @ RI), and I'm their target audience- an East Coast Liberal ( albeit fiscally realistic). I understand Arianna has persuaded Howard Fineman ( formerly of NewsWeek; of MSNBC, currently) to head her political team and lend a shred of respectability to her project. It is so sad when a mere *fashion* magazine does better : Jenny Barnett, a 40-something mother and former editor writes about her experience with breast cancer, including detailed descriptions of her sugeries, chemo, and interactions with medical personnel, while emphasizing the importance of screening (Harper's Bazaar, Oct.2010).

By Denice Walter (not verified) on 28 Sep 2010 #permalink

Thank you for pointing out that the difference isn't just survival rates, it's that in one approach the woman gets to keep her breast.

Too many people seem to think that removing parts of a woman's body is trivial. Not "sometimes necessary for medical reasons," but unimportant enough that they won't try to help women keep as much of their bodies as possible.

Libertarian spotted @13... prepare for increased inanity.

By mikerattlesnake (not verified) on 28 Sep 2010 #permalink

@ NZ Sceptic, Beatis, and Militant Agnostic : when I was a child my uncle's wife developed "early" breast cancer and refused treatment ; she disregarded doctors'- and my family's -and choose "prayer" instead ( my atheist uncle was, of course, frantic), eventually going to NM and Mexico . The only details I was able to ferret out at the time were- "Laetrile", "life savings", and "air ambulance". Back home, she had surgery , spent several months in the hospital,and died : my uncle was devastated, surviving her by about 20 years.

By Denice Walter (not verified) on 28 Sep 2010 #permalink

Will someone define "en curasse disease" for me? Google is not being helpful. Thanks.

By Andreas Johansson (not verified) on 28 Sep 2010 #permalink

Sadly, the only thing that will stop these kinds of articles/books from being written is not the overwhelming evidence from SBM - it's a lawsuit.

Carcinoma en cuirasse is a form of metastatic cutaneous breast malignancy occurring most commonly on the chest as a recurrence of breast cancer, but it can be the primary presentation.

The google images are not pretty...

Andreas -- I think it's spelled "cuirasse". A cuirasse is a piece of armor which protects the torso (usually a breastplate and a backplate). So en cuirasse disease, from the French, means the disease is covering a lot of skin on the torso, like a piece of armor only it's killing you rather than protecting you. It sounds nasty to me. *shudders*

Regarding the original article, the first thing that struck me was the abysmal writing. Frankly, it was insulting; the writing style was similar to a first-grader's practice reading book -- simple, declarative sentences strung together. It also violated the dictum of "show, don't tell". We are told that she bravely battled cancer with alternative treatments, but we are never shown any evidence whatsoever of them. I understand the point is to get people to want to buy the book, but that doesn't mean act like you're telling the whole story, pad it out with vacuous statements, and then hope readers won't fear that the actual book will insult their reading level. I mean, I always thought Huffington Post fancied itself a source for educated readers. You'd think they shoot for at least an eighth grade reading proficiency, if not college-level, if they are really aiming at educated readers.

By Calli Arcale (not verified) on 28 Sep 2010 #permalink

Screw that, you weren't harsh enough, I think.

I can understand being scared, particularly if (as it seems) this was a wanted pregnancy. I can understand the wish to minimize the risk the pregnancy by wishing to delay chemo or radiation. What I cannot understand is choosing to a) not listen to your doctor
b) not ask questions about delaying treatment because of the pregnancy (which I have a suspicion she probably didn't do) and
c) deciding that you and some random quack you looked up know better than the person who's spent a good chunk of thier life and career STUDYING WHAT IS WRONG WITH YOU!!!

She needs to be slapped around a bit more just because she was so lucky and is now telling people to just go home and die.

By Kate from Iowa (not verified) on 28 Sep 2010 #permalink

It's this sort of thing that really got me to be more involved in skepticism. All the UFO, ghost, psychic nonsense is interesting and fun to argue about, but crap like this that affects people's health burns me up. You want to be an idiot and wreck your own health, by all means, go ahead. But if your decision and/or advice start to affect other people's well-being, then shut your damn yap. If only there were some way to hold people like this accountable for their actions.

And that's the problem, really. These twits can go about spewing dangerous advice, but if someone suffers because of it, the twit still goes merrily along their way. No penalties. Clear consciences as they rationalize away someone's death or injury.

Most of the time, they don't even have to rationalize -- after all, how are they gonna find out about those deaths or injuries?

By Calli Arcale (not verified) on 28 Sep 2010 #permalink

In other words, one was just as likely to be alive in five years if you did radiation, as compared to if you did not undergo radiation.

Not only is this dangerously misleading, it's execrably poor writing. I'd hardly need to read the book to see the intelligent but muddled thinker trying to be more sophisticated than she really knows how - it's all right here. Depressing.

Will someone define "en curasse disease" for me? Google is not being helpful. Thanks.

"Cuirasse" is the French word for armour, esp. a steel suit of armour, so a hard amour, made up of plates (in American English it is spelled "armor").
In English the word "cuirass" is also sometimes used, but this is rather obsolete as far as I know.

The term "en cuirasse" is used because the part of the body where the cancer has metastasized locally, is as it were fixated in a hard armour of cancerous tissue. Hence disease "en cuirasse".

@ Kate from Iowa,

Mrs Quinn's cancer was diagnoses when she was 38 weeks pregnant.

@ Carri Arcale,

I was too hasty & see now that you already explained. Sorry! :-)

I looked at the author's website found no mention of what happens to the proceeds from the book. Typically, people donating some proceeds from a book will trumpet that fact loudly up front (see Tony Blair). Generally, I think authors should be able to extract whatever profit they can from their creative works. But, generally, books don't goad others into needless suffering and early death. If she were donating money to cancer research, I'd cut her some slack. The conspicuous absence of any such information about charitable causes tells me that, truly in this case, charity begins at home.

Congratulations Hollie Quinn, you are profiting off the misery and death of others.

Wait, was that uncharitable? Yes, yes it was. Just like Hollie Quinn and her book of lies.

By The Gregarious… (not verified) on 28 Sep 2010 #permalink

Thanks Beatis. I now update my prior post to: she should be bitch-slapped with an OED unabridged.

By Kate from Iowa (not verified) on 28 Sep 2010 #permalink

@ Denice Walter,

That is horrible and so infuriating. All this time she could have been with her husband, her family. It always makes me so sad and angry, no matter how many times I hear about it.

Lest there be any doubt as to where the Quinns are heading, from their responses to the YouTube feedback:

"One of the things that bothers us the most about conventional medicine is the insistence that advanced cancers can't be cured. They're cured all the time, as anyone with eyes can see, and we intend to share those stories, along with lots of other info about botanical and nutritional science. The cancer category over at naturalnews.tv is rife with good news!"

Time for the Mike Adams show!

By Narad, the Man… (not verified) on 28 Sep 2010 #permalink

Thanks Beatis. I now update my prior post to: she should be bitch-slapped with an OED unabridged.

LOL! Indeed she should!

Actually, Orac, while there is no herbal treatment that cures breast cancer, you really ought to be familiar with the human trials reporting that green tea extract may substantially reduce the risk of recurrence for women who have had Stage 2 cancer, such as this woman had.

Sure, she is dead wrong to regret having gotten the curative surgery. But patients who develop that attitude get it from a combination of two influences: ignoramus alternative practitioners who sneer at every conventional treatment, and conventional physicians who imply that unless they spend their life savings on a case of chemo brain, they may expect a gruesome death. When such a prediction - which clearly implies that their surgery was not curative - is seen not to have come true, they don't conclude that the oncologist was wrong about, or deliberately underestimating, the value of surgery; they conclude that nothing he says, including the original recommendation for surgery, is to be trusted.

If I were diagnosed with real breast cancer (as opposed to DCIS), I would not hesitate for a millisecond to get a mastectomy to maximize my chances of surviving without suffering serious iatrogenic effects, particularly brain damage from chemo. I understand that some women feel differently about the relative value of their breasts vs. other organs - but some of those women are encouraged to feel differently by males in their lives, often including their oncologists. Did this woman's oncologist take the time before surgery to let her learn about the options and hear her concerns about the costs and risks of chemo and radiation, then encourage her to consider a mastectomy? Or did he/she encourage her to consent to a quickie lumpectomy because he/she believes in "sparing the breast," and just assumed that the patient could be convinced to accept every course on the menu? Hopefully, you take the former approach with your patients, but not every MD is so, shall we say, rational.

What got me was that she seemed willing to eat random herbal medicines during pregnancy/nursing. Given that (just in my small garden here) I have half-a-dozen lethal poisons, and probably a dozen or so more associated with miscarriage and serious illness, I really don't get it! OK, with folk-medicine you do have anecdotal evidence of toxicity, but we keep turning up new knowledge that isn't in the traditional pharmocopiae; I wouldn't choose to risk anything beyond culinary doses in pregnancy. On the other hand, I grew up with "don't eat anything you haven't positively identified as non-toxic" as a gardening maxim, so I've never doubted that plants can kill.

By stripey_cat (not verified) on 28 Sep 2010 #permalink

Jane,

If the trials pan out, green tea extract will find a place in the pharmacopeia alongside yew extract. Or possibly in modified form, in the same way that my doctor isn't going to prescribe/suggest straight-from-the-plant willow or poppy extracts.

The problem isn't that plants can't be effective: it's that they can, but not every plant does what someone thinks it might, or should.

And some women enjoy our breasts ourselves, whether or not any men are present (nor, for that matter, any other women: we're not all heterosexual). There are nerve endings in there.

@stripey_cat

Given that (just in my small garden here) I have half-a-dozen lethal poisons, and probably a dozen or so more associated with miscarriage and serious illness, I really don't get it!

Someone once brought a little stem of purple flowers with yellow sticking out of the centers. They thought it was very pretty. I didn't recognize them, so off to Google U. I went. I found that the plant produces very sweet berries. In the Roman era, some people would make wine from the berries and serve it to their enemies and they wouldn't be enemies any more. Any guesses?

@ Todd W.:

Belladonna?

Would that be deadly nightshade? Very pretty looking it is.

I keep forgetting the refresh button was invented long ago already.
*sigh*

It's her life, her body. We have all seen the excruciating process of dying with/of the cure. The last place you will hear about a cancer cure is in the doctor's office, unless they are the smart, open-minded ones. There is a non-profit integrative cancer support center in Canada that works with the patient and doctors to devise a plan that the patient is comfortable with, which may or may not include conventional therapies. There are stories of people who were given one year to leave, no treatment options offered, that have no evidence of disease today. And the Canadian health care system pays for it. So insecure oncologists who make a living off of extremely marginal cancer progress can huff and puff, but they are getting us nowhere.

A lot of oncologists are smart and open-minded. It's not actually a minority. But the ones you hear about are the bad ones, because people are always more motivated to complain than to compliment.

Case in point -- my grandfather. He was a physician for many years. (A general surgeon, to be precise.) When he developed symptoms consistent with pancreatic cancer at the age of 90, he gave himself the same advice he would have given a patient in the same situation -- there's treatment, but it's really not worth it. He died at home, surrounded by loved ones, in hospice care. He was frustrated at how long it took (he lived over a year past the time when he decided to die), but it took its course, and he was content when the end came.

Flip side: Patrick Swayze elected to get treatment and extend his life a few months. He knew perfectly well it would not be a cure. But for him, it was worth it. That's the thing; what's right for one person is not for another. Some would greatly prefer to rage, rage at the dying of the light. Not my grandfather. Everybody's different, and it's important to respect the significance of personal values in these decisions.

Then there's my aunt's case. She died of breast cancer at a young age. She wanted the best that medical care could provide, and she got it -- even past the point where it was doing very little good. She died in agony, letting the doctors perform painful life-extending procedures under the delusion that it could cure her. Part of the blame is hers (she was in denial) but part of it was also her doctors, who were afraid to tell her the truth. Sometimes it's hard to disappoint a person, especially when they are so earnestly optimistic. I'm not sure how well doctors are trained for that. I'm not sure how well they *can* be; this is difficult stuff.

There are indeed many practitioners (insecure and otherwise) who profit off of patients at the end of their lives, with very marginal prognoses. However, it is not merely oncologists offering extremely marginal cancer treatments. It's also quacks. In fact, the quacks have a higher profit margin. You need to be careful to apportion that sort of blame everywhere it is due, and not only with the oncologists.

(Incidentally, you may want to search for "Avastin" on this blog. There's a search box on the left sidebar. You may be interested in the discussion.)

By Calli Arcale (not verified) on 28 Sep 2010 #permalink

@Lucille, 50: Yes, it is her body and her decisions. And if her choices leave her children without their mother, well, that's her decision too. What is so wrong, and what Orac (and the rest of us) is so upset about is that she is lying to other people, telling them that it will work for them. And that will probably lead to deaths. And *that* is wrong. Lying to people about what their choices are, potentially cheating them out of years of life, not to mention thousands of dollars, is simply wrong.

By JustaTech (not verified) on 28 Sep 2010 #permalink

@50

There are stories of people who were given one year to leave, no treatment options offered, that have no evidence of disease today.

And there are stories of people who were abducted by aliens and probed and stories of people who saw angels and stories of people who were healed by prayer and stories of people who almost caught a ginormous trout. They are just that - stories.

Once she starts giving dangerous misleading advice to other people, especially for her own financial gain it isn't just her body and her life.

By Militant Agnostic (not verified) on 28 Sep 2010 #permalink

There is a non-profit integrative cancer support center in Canada that works with the patient and doctors to devise a plan that the patient is comfortable with, which may or may not include conventional therapies. There are stories of people who were given one year to leave, no treatment options offered, that have no evidence of disease today. And the Canadian health care system pays for it.

Which centre is this? I'd like to read some of these "stories". I'm also interested in finding out what my tax dollars are paying.

Yes, I am Canadian.

By T. Bruce McNeely (not verified) on 28 Sep 2010 #permalink

Good takedown, far better than I could have done.

By St Thomas (not verified) on 28 Sep 2010 #permalink

Lucille:

The last place you will hear about a cancer cure is in the doctor's office, unless they are the smart, open-minded ones.

Or they are liars. Unfortunately biology is quite complicated and there are often no set answers. The best you will get with a good honest doctor is a definite "maybe."

T. Bruce McNeely, I hope it is not the Canadian Cancer Research Group.

@45: What kind of confused plant puts both sugar and poison in its berries? Sugar implies that the plant wants the berries to be eaten (and pooped out with fertilizer) whereas poison is a protection. Both...not sure what that says evolutionarily. Wants to be eaten by a specific resistant animal perhaps?

What kind of confused plant puts both sugar and poison in its berries? Sugar implies that the plant wants the berries to be eaten (and pooped out with fertilizer) whereas poison is a protection. Both...not sure what that says evolutionarily. Wants to be eaten by a specific resistant animal perhaps?

Probably - hot peppers "want" their seeds to be eaten by birds rather than mammals (which would destroy them). Birds can't taste the heat. Another possibility is that the sweet berries were advantageous at one time, but later became a disadvantage due the advent of an animal which ate the berries and digested the seeds.

By Militant Agnostic (not verified) on 28 Sep 2010 #permalink

Well, Atropa belladonna is part of the nightshade family, which also includes potatoes, tomatoes and chili peppers. According to the almighty Wikipedia, cows and rabbits apparently can eat the plant without being adversely affected. All around, it's an interesting plant, and a good example of how the dose makes the poison, since it also has medicinal uses (atropine, anyone?).

We now return you to your regularly scheduled thread.

Chris @ 56:

I sincerely hope so too.

Cancer quackery! Eugh.

By Composer99 (not verified) on 28 Sep 2010 #permalink

". . .the quacks have a higher profit margin."

I wouldn't be so sure. I've heard that oncology is one of the more profitable specialties.

By the way, would a quack be someone who is "aggressively treating" someone's cancer while the patient's organs are failing?

While we are carefully apportioning blame, let's not assume oncologists don't belong in the "quack" category.

Being wearily familiar with the well-springs of misinformation, I , unfortunately, must convey more bad news: today Adams proudly reports that his NaturalNews.TV video network is growing by leaps and bounds "educating" the pub1ic ( see @40 above). Similarly, Null, braggadocio intact, claims the "fastest growing internet radio network" for "progressives". Both cavalierly dispense horrendously inaccurate cancer information : recently ( this month, speaking about celebrities with cancer), Adams warned patients that taking _any_ "conventional treatment" would decimate the chances that the alternative treatment would work. That it should be a "first", rather than "last" ditch attempt.

By Denice Walter (not verified) on 28 Sep 2010 #permalink

I hate the Huff and Puff post as much as you do, but not for the same reasons. I hate the left wing lunacy of the whole site. Then again, it is Hussein Obama's favorite news source. hey are so much better than Fox News - NOT! At least Fox actually asks real questions. The days of the left wing fringe elements controlling the media are gone. Thank God! Now if we could just get them all out of power alltogether.

By Medicien Man (not verified) on 28 Sep 2010 #permalink

Lucille:

I wouldn't be so sure. I've heard that oncology is one of the more profitable specialties.

Do you mind answering T. Bruce McNeely's question:

Which centre is this? I'd like to read some of these "stories". I'm also interested in finding out what my tax dollars are paying.

?

If you don't I guess we can assume it is the infamous CCRG.

[Callie Arcale: Flip side: Patrick Swayze elected to get treatment and extend his life a few months. He knew perfectly well it would not be a cure. But for him, it was worth it.]

You don't know that he extended his life at all. That is called prophetic medicine. You don't have that type of power.

By augustine (not verified) on 28 Sep 2010 #permalink

Well your tax dollars are paying for marxists to write regulations for everything from your toilet water to your healthcare. Better yet, we just learned that $800,000 of your hard earned money confiscated by our inocent government was spent to wash men's balls in Kenya. I guess we can;t have people going around having dirty balls in Africa now can we. I suppose this somehow created jobs? After all someone had to supply the water, rags, soap, and teach the Kenyans how to properly wash their balls. Yep. I guess one could speculate that this program was STIMUating? L guess the Homo Depot (name change since Home Depot went all gayist on us)supplied the buckets?

Hey Chris, did you sign up for the job of washing African balls? I heard it paid good. Did you apply lotion to the extra dried out ones?

By Medicien man (not verified) on 28 Sep 2010 #permalink

Canadians do not pay taxes in the USA.

Profitable for whom, is the big question. I think most oncologists work for clinics or hospitals rather than being in private practice, which means the profit goes mainly to the clinic/hospital, not the oncologist directly. (They are well paid, like most medical specialists. But their reimbursement doesn't necessarily track with the cost of the care. Giving a super-expensive and marginally-useful drug like Avastin probably isn't a big money-maker for the oncologist, even though it's very costly.)

The total quackery (by which I don't mean an oncologist acting too aggressively but cases of complete bunk -- I'm talking about the flat-out frauds here, and yes, they do exist) is different. There, the profit goes to the quack directly, and the cheaper they can produce the treatment compared to the more they can charge for it, the higher the profit margin. As they are not constrained by any degree of honesty in their marketing, having already taken the plunge and gone the dishonest route, they have very little incentive to use more expensive treatments.

I don't really have a problem with people using alternative treatments, as long as they aren't being misled. It's the misleading that's the problem, as others have pointed out. What makes me the angriest is the outright frauds. I've heard too many stories of a fraud saying they can cure the cancer if the patient just spends another thousand dollars, and strings the patient along until their savings are exhausted, whereupon they get dumped . . . . That should make you angry too. It should make anyone angry.

By Calli Arcale (not verified) on 28 Sep 2010 #permalink

Lucille, are you going to answer the question? Or did you switch to being some kind of off-topic troll?

@Calli Arcale

I wonder if the quacks have malpractice insurance. Not having it would save a bundle. Their "medicines" have to be cheaper: no clinical studies, no major marketing costs (thanks, Internet), etc.

I'm gonna go with more profit on the quack side.

By The Gregarious… (not verified) on 28 Sep 2010 #permalink

Since "non-profit integrative cancer support center in Canada" ... "works with the patient and doctors to devise a plan that the patient is comfortable with, which may or may not include conventional therapies", I doubt that it is the infamous Canadian Cancer Research Group. I also wonder if the only thing that is funded by Canadian taxpayer is the conventional therapies.

"Integrative" usually implies MDs supplementing what they get from the provincial health insurance plan for practicing "conventional" medicine by selling quackery on the side. The additional overhead is low and there is no limit on what they can charge.

I too am wondering if Lucille will tell us what the name of this "non-profit integrative cancer support center" is. If not, we have to conclude it is probably just a story (at least the payed for by taxpayer part).

By Militant Agnostic (not verified) on 28 Sep 2010 #permalink

Medicien Loon:

The "ball-washing in Kenya" was part of a research study on prevention of AIDS in uncircumcised men, by teaching washing and disinfection techniques after sex. I googled "$800 000 Kenya", and found the information, along with a whole lot of crude comments by your buddies.
A real waste of money, eh? After all, they're just ignorant darkies, right? Let 'em all die.

Keep showing us what a malignant little shit you are.

By T. Bruce McNeely (not verified) on 28 Sep 2010 #permalink

I've heard that oncology is one of the more profitable specialties.

You've heard wrong. Oncology, especially medical oncology, has few procedures and many expensive drugs. As a general rule, procedures are profitable (insurance companies and medicare pay relatively well for them), frequent office visits unprofitable ("just" talking to people doesn't impress insurance companies so they pay less for it), and medications are practically a dead loss for the hospital or clinic, albeit they can be very profitable for the drug company. Oncology is the field the average hospital just wishes it could get rid of without looking foolish-so they could make way for profitable sub-specialties like cardiology and GI. (Note: cardiology is expensive but IT WORKS! The mortality from cardiac disease is dropping like a stone. The mortality from cancer is dropping too, but not as impressively.)

Nalini Chilkov is not a doctor.

A British newspaper columnist (John Diamond) was diagnosed with incurable cancer and wrote about it over a period of years, till the end. He said he got a lot of encouraging letters from people who, like him, were getting radiation and chemotherapy which prolonged their lives. He got no such letters from people pushing sCAM.

Joe

I am not going to name the cancer support center in Canada because I think everyone here should be able to find it on their own and I don't want to be a part of rabid knee-jerk attack. The story that led me to "find" it myself did not name it either. There are no patient stories or testimonials on the website of this center. I think I do remember reading on their website that most of their patients utilize conventional therapies in tandem with the therapies of the center.

I am surprised at the venom directed at a woman who told her story. If you think she is lying, then don't partake. What's the big deal?

Dianne -- I wonder if the most profitable specialty (at least for the practicing specialist) is those which focus on elective procedures paid for out of pocket, and targeted primarily at the wealthy. (Not coincidentally, the same market targeted by a lot of quacks.) Cosmetic surgery (not reconstructive) and some fertility medicine comes to mind.

You make a very good point about how oncology isn't really all that profitable -- especially compared to cardiology. It's no coincidence that hospitals everywhere are adding cardiology wings and trying to position themselves as THE place to go if you have heart problems. GI, meanwhile, has developed so far that there are freestanding clinics which do nothing but GI stuff. I had my first endoscopy with a GI group based out of a local hospital. My second, with the same group, was in a brand-new freestanding facility in the suburbs that did nothing but endoscopies and colonoscopies and some minor GI procedures. They had grown to where they could fund an entire facility with just that.

By Calli Arcale (not verified) on 29 Sep 2010 #permalink

Lucille -- we're worried about her advice hurting other people. Maybe you don't mind it when people leave out critical details when advising people on matters of life and death, but I think it's reprehensible. Her life was saved with surgery, and she's trying to tell women they can beat aggressive estrogen-receptive cancer with herbs. Her advice has the potential to kill people.

You don't think we should be worried about that? You don't think we get to have our say too?

Don't worry about folks here doing something nasty to the cancer center you're talking about, unless you think possibly criticizing them in the comment section of a blog counts as "something nasty". Until then, what happens when somebody refuses to provide evidence is that people start wondering if they just made it up. Especially if they say "everybody should be able to find it on their own" -- in essence, telling people to do their homework for them. It's your argument; it's your responsibility to back it up. You don't have to, of course. It all depends on convincing you want to be.

By Calli Arcale (not verified) on 29 Sep 2010 #permalink

Callie Arcale says: "However, it is not merely oncologists offering extremely marginal cancer treatments. It's also quacks. In fact, the quacks have a higher profit margin. You need to be careful to apportion that sort of blame everywhere it is due, and not only with the oncologists."

Well said.

I am surprised at the venom directed at a woman who told her story. If you think she is lying, then don't partake. What's the big deal?

The "big deal" is the fact that trumpeting her arrogant ignorance is very likely to kill people.

Calli @76

I wonder if the most profitable specialty (at least for the practicing specialist) is those which focus on elective procedures paid for out of pocket, and targeted primarily at the wealthy. (Not coincidentally, the same market targeted by a lot of quacks.)

This is especially the case for "integrative" MDs in Canada who find the wealthy worried well much more lucrative than practicing SBM/EBM within the public health care system.

I suspect Lucille may have checked up on some of here claims about "Canadian health care system" paying for it and "conventional" treatment being optional and found out things were not as she remembered them. For one thing, health care is a provincial responsibility. The Federal Government provides partial funding through transfer payments and sets basic guidelines through the Canada Health Act. Any decision to fund woo would be at the provincial level.

I call shenanigans, especially since she hasn't even given enough information to do a Google search. She won't even tell us what province this was located in.

By Militant Agnostic (not verified) on 29 Sep 2010 #permalink

You seem unduly curious for all of your outrage, but it is in Vancouver, and the website says they take the provincial card, whatever that is.

I'm just having a little chat. Why are you guys so excited?

I'm just having a little chat. Why are you guys so excited?

Because people could die. Excuse us for not being psychopathic.

By Gray Falcon (not verified) on 29 Sep 2010 #permalink

"Because people could die." Oh, the drama.

Excuse me for finding humor in this, but people die all of the time, including with and because of conventional cancer treatments. I would welcome a new paradigm, since the old one seems very stale and ineffective.

Do you guys work for pharmaceutical companies, by any chance? How's the new patent quest going?

Lucille:

I'm just having a little chat. Why are you guys so excited?

Because you seem to support lying as a proper way to explain the risks and benefits to medical procedures. First you said "The last place you will hear about a cancer cure is in the doctor's office, unless they are the smart, open-minded ones."

And then you don't seem bothered that Hollie Quinn left out the major medical treatment, surgery, that is the most likely reason for her survival.

And since you claimed something and when asked about it, you have decided to tell us to look for it ourselves.

"Because people could die." Oh, the drama.

It's happened before. Check out the link on the sidebar for "What's the Harm?".

Excuse me for finding humor in this, but people die all of the time, including with and because of conventional cancer treatments. I would welcome a new paradigm, since the old one seems very stale and ineffective.

Hitting cancer patients over the heads with rocks is a new paradigm. The question is, does the new paradigm work? There's no evidence, that's the issue.

Do you guys work for pharmaceutical companies, by any chance? How's the new patent quest going?

And now, you've just shot yourself in the foot. Even if the answer was yes, it still wouldn't change the burden of proof.

By Gray Falcon (not verified) on 29 Sep 2010 #permalink

Lucille:

Do you guys work for pharmaceutical companies, by any chance? How's the new patent quest going?

Now exactly how is the surgery Hollie Quinn had considered "pharmaceutical"? Why do you seem to support liars?

Oh, and the Pharm Shill Gambit is old, tired and idiotic.

Lucille:

"Because people could die." Oh, the drama.

Excuse me for finding humor in this, but people die all of the time, including with and because of conventional cancer treatments. I would welcome a new paradigm, since the old one seems very stale and ineffective.

Does that make it okay to cause a person's death? People do indeed die all the time. Every one of us will die. Many of us will be undergoing medical care at the time, either palliative or a last-ditch attempt to delay the inevitable. But most of us don't want to die. People looking for alternatives to chemo generally do not want to die. A few, like my grandfather, are content with their fate. Most want to live. Lying to them, for whatever reason, is not okay.

Do you guys work for pharmaceutical companies, by any chance? How's the new patent quest going?

Ah, the pharma shill gambit.... I do not and never have worked for a pharmaceutical company. I work in embedded computing for primarily avionics platforms. The coolest project I am currently on is for a scientific Earth-observation satellite, though some have involved explody things. Definitely not pharmaceuticals. I have never been involved in any patents, and if I were, I wouldn't get a whole lot out of them; my company would hold the patent. In my specific function, I greatly doubt I will ever have reason to file for a patent. Would be kinda cool, though. A couple of my relatives have their names on patents, and there's cool factor there.

By Calli Arcale (not verified) on 29 Sep 2010 #permalink

Mind you, the real motivation most people have for posting here (including probably you, Lucille) has nothing to do with any particular agenda. Instead, it's beautifully summarized in this XKCD strip:

XKCD 386: Duty Calls

(Note: make sure to mouse-over the comic. A hidden message comes up that extends the joke.)

By Calli Arcale (not verified) on 29 Sep 2010 #permalink

Lucille - do you have any clue what happens when breast cancer is not treated with at least surgery?

By Militant Agnostic (not verified) on 29 Sep 2010 #permalink

I didn't read Hollie's book and have no idea what she said about pharmaceuticals. I'm just saying that plenty of people have died of the cure that is so vociferously defended here to the exclusion of all other possibilities.

Maybe world governments should buy up all the copies of Hollie's book, to protect the public.

Lucille:

I am not going to name the cancer support center in Canada because I think everyone here should be able to find it on their own and I don't want to be a part of rabid knee-jerk attack. The story that led me to "find" it myself did not name it either. There are no patient stories or testimonials on the website of this center.

I did find your website - there is an integrated cancer treatment center in Canada, and it's in Vancouver. The website does include testimonials (it takes more than one click to find them).

Their healing modalities do include therepeutic touch, Reiki, SHEN (whatever that is), naturopathy, and acupuncture.

What I find most interesting is that Lucille touted how they're non-profit, yet they charge $450 for their program which "provides you with powerful tools to improve your recovery and survival."

I see links for donations but no mention of how insurance might pay that $450.

Lucille, if I'm on the wrong site, please provide the right link.

@Lucille

to the exclusion of all other possibilities.

We are not against all other possibilities. We are against advice that has absolutely no basis in reality. Give us some rigorous studies showing that something works at least as well, if not better than, existing treatments, and we'll happily support the new option.

If someone sells you a car that they know (or should know) has faulty brakes, without informing you of that problem, should they be held accountable? You seem to have a "blame the victim" mentality. In the car scenario, it seems like you would say that the car seller bears no responsibility whatsoever and that if anything bad happens as a result of the bad brakes, well, it was just the buyer's fault.

@83 Lucille

Oh, the Pharma Shill gambit. How quaint. I was getting concerned, I haven't seen it in an internet discussion for two days.
All in one, a tu quoque fallacy (chemo/rad treatment is killing too), a poisoning the well (shills), and a nirvana fallacy (conventional treatment is not perfect). Plus maybe a few more who excaped my attention.

Speaking for myself, I am working in a academic lab on cancer biopsies, and we only have federal grants, not a single "Big pharma" grant. Whatever new hype drug Big Pharma comes with, I won't get a single kopeck out of it.
And yes, the quest to the next grant is difficult. Thanks for asking. Regulations and stuff to try to ensure that we are doing a good job, you know. Far from perfect, but better than the rules on the marketing of supplements. If one day CAMs quacks have as many regulations as science-based medicine, I will start taking them seriously.

These biopsies I am working on - they are bits coming from people, most of whose, for all I know, are dead now. Each of my samples come from a real person. Someone who obviously was suffering from some nasty illness. It's not some abstract topic, it's real, and it's just next door.
I don't get overworked over this. But it's just somethink like, this is a very serious matter, here is my chance to make something out of my life, to make a difference. Maybe I will manage to succeed at helping people. Just a bit.
And when an ignorant know-it-all just like you comes along and spits on my work. And now I'm just thinking, screw the humanity.

"Because people could die." Oh, the drama.

Yeah, just let people die, it's not a big deal. We have good reasons to think we could avoid some people a gruesome death - or at least limit the spread of misinformation which could result in more nasty deaths. I have seen horrific pictures of people in terminal stage of one cancer or another. A friend told me of her bed-ridden dad's death due to throat cancer, and I don't wish that on anybody. My lab secretaty is undergoing surgery this very day for something which may be uterus carcinoma. Yeah, drama. We are concerned about other people's life. Why should we care, you ask us?
Do you have any (real) argument which could show us we are wrong on this matter?

Lucille, I used to work for a pharmaceutical company. I received $1 for signing over my patent (which was a condition of my continued employment in any case).
And your point is...?

Lucille, how dense can you be?

Over and over, people here have told you the reason they find Hollie Quinn's book upsetting is that it is deceitful and fraudulent. Selling or recommending useless snake oil to people with cancer and telling them to forego effective care is, in a word, despicable.

And yet you continue to churn out statements like those in #91 that appear to be little more than rank ignorance.

No one here denies that:
- surgery, chemotherapy, and radiation therapy can be dangerous for the patient
- cancer cures are not always 'for ever' (by which I mean the remaining lifespan of the patient)

However, these treatments, unlike the quackery endorsed by the Quinns, actually work. Even you back-handedly acknowledge this in your attempt to misrepresent the mainline position here by using the term 'cure'.

By Composer99 (not verified) on 29 Sep 2010 #permalink

@ 89 Calli Arcale

Spot on. I plead guilty.

@Lucille,
You wrote:

There is a non-profit integrative cancer support center in Canada that works with the patient and doctors to devise a plan that the patient is comfortable with, which may or may not include conventional therapies.

and

There are stories of people who were given one year to leave (sic), no treatment options offered, that have no evidence of disease today.

Are these two statements related and causal, or simply in the same paragraph? Besides the testimonials you mention, is there evidence that the type of treatment this center provides is more effective than conventional therapies - either combined with conventional therapy or instead of it? If so, what are the statistics that show this (ideally showing all three scenarios - conventional therapy only, conventional and therapies provided by this center, and these therapies in lieu of conventional treatment)?
Thanks in advance.

By Mephistopheles… (not verified) on 29 Sep 2010 #permalink

Lucille:

I didn't read Hollie's book and have no idea what she said about pharmaceuticals.

And neither did you read Orac's article above. Where it is clearly outlined that her article left out the very crucial fact she had surgery. He even notes it by quoting her book:

Less than two weeks later, Hollie had a lumpectomy, along with a sentinel lymph node biopsy, in order to start to gauge the spread of the cancer through her lymphatic system.

Now to check your reading comprehensions skills it is time for a Pop Quiz: How did he get those quotes?

Maybe we need some correlary of Godwin's law for this situation, ie Orac's law: the longer any internet discussion of cancer treatment goes on the greater the probability that someone will make the pharma shill accusation. Or something like that.

I didn't read Hollie's book and have no idea what she said about pharmaceuticals. I'm just saying that plenty of people have died of the cure that is so vociferously defended here

Not something anybody denies (though you're exaggerating a bit). Yes, cancer treatments have side effects which can, in some cases, include death. However, far more people are saved.

to the exclusion of all other possibilities.

Rather an odd thing to say on a blog run by somebody who spends a large part of his time working on such "other possibilities." Really, the only thing we require is that the "other possibilities" demonstrably work. Those that do, rapidly become mainstream.

What, exactly, was Hollie's lie? I believe people are bent out of shape because she had surgery. How do they know this? Because she said it.

Again, I fully support anyone's right to pursue the treatment that they find beneficial.

A side note. . ."nonprofit" does not mean operating without money exchange.

". . .far more people are saved. . ." That is a very unscientific, and even baseless, statement.

". . .far more people are saved. . ." That is a very unscientific, and even baseless, statement.

Wrong. People die of cancer, but fewer than in the past. I recommend figure 6 for initial perusal. Yeah, heart disease is doing better, but cancer mortality is dropping too, especially for younger people. Figure 7 is interesting too: there were about 650,000 fewer cancer deaths in 1992-2005 than expected based on 1991 cancer mortality data. Hint: It's not the green tea that's causing the drop.

Inspire Health in Vancouver (www.inspirehealth.ca) sounds like the place that Lucille is touting. They offer access to the usual nonsense ("Energy Work", naturopathy, acupuncture etc.). Of course, this is not covered by the BC Medical Plan. Consultations with their MDs is covered. Nowhere on the website do they suggest forgoing surgery, radiation or chemo. They carefully state that their services are an adjunct to "conventional" (i.e. effective) therapy.

This is not exactly what the Quinns and the PuffHo are recommending.

The former is just silly, and a waste of time and money. The latter is irresponsible and dangerous.

By T. Bruce McNeely (not verified) on 29 Sep 2010 #permalink

Lucille:

What, exactly, was Hollie's lie? I believe people are bent out of shape because she had surgery. How do they know this? Because she said it.

Further proof you failed to read what Orac wrote. The HuffPo piece left out the surgery bit. Starting with the title of the piece, "One Woman's Story: Saying No to Conventional Cancer Treatment", and the title of the book. "You Did What? Saying 'No' To Conventional Cancer Treatment."

She did not say "no" to surgery, which is conventional cancer treatment. That is called lying by omission.

Would you think it acceptable if your children left our important parts of a story?

What, exactly, was Hollie's lie? I believe people are bent out of shape because she had surgery. How do they know this? Because she said it.

Her lie was one of omission, in the article Orac was quoting. She set the record straight in her book, yes, but you have to pay money for that. Please realize that responding to what you think people should be saying, rather than what they are saying, only makes you look delusional.

Again, I fully support anyone's right to pursue the treatment that they find beneficial.

If someone advertises a treatment, it has to work. It won't work just because someone feels it works, just as believing leaves are currency won't let you spend them.

". . .far more people are saved. . ." That is a very unscientific, and even baseless, statement.

1. You have no evidence.
2. We do have evidence.
3. It wouldn't help your case regardless.

By Gray Falcon (not verified) on 29 Sep 2010 #permalink

@Lucille

What, exactly, was Hollie's lie? I believe people are bent out of shape because she had surgery.

Not quite right. Regarding the HuffPo piece, people are angry that the surgery bit was left out, giving the impression that she eschewed all conventional treatment and that her current condition is due solely to the alt-med stuff she did.

Regarding Hollie herself and her book, people are angry that she is advocating that others forego all conventional treatment, including surgery, in favor of ineffective alt-med nonsense.

If the whole of the story were simply what Hollie chose to do, we'd think she was a bit off, but her body, her choice. Where the problem arises is in her advocacy to others not to seek conventional treatment. She is actively putting other people at risk. If someone is injured as a result of following her advice, then she is responsible, at least in part.

If someone wants to follow Hollie's advice, they're an idiot, but that's their decision. They can do what they want to do. However, it is absolutely reprehensible for her to be giving the advice that she is giving.

There you go. It wasn't Hollie's lie, it was the Huffington Post author's lie (according to you).

Why is advocacy a problem? You can choose to act on it however you wish. She is advocating something based on her experience; you may think she draws the wrong conclusions, but who made YOU God?

I am not making any case at all. I just don't think you are making yours.

I suggest you be very careful with your cancer statistics. All this talk about rising survival rates seems to contradict recent news stories citing studies that say survival rates have barely budged since the onset of the war on cancer begun in the 1970s.

Why would I be any more interested in viewing untreated breast cancer pictures than I would in viewing autopsies of people ravaged by chemo/radiation/surgery?

@ Lucille 104

". . .far more people are saved. . ." That is a very unscientific, and even baseless, statement.

Yes, because you know, cancer doesn't kill. Only chemo does.

You have a full body of articles at Pubmed comparing various therapies for cancer treatment. For a few of these therapies, it has been found that people die faster without the therapy compared to those receiving it. Funny enough, these therapies are the ones in use.
Just last week, Orac wrote a post about the ethics of these studies.
http://scienceblogs.com/insolence/2010/09/balancing_scientific_rigor_ve…
Because some drugs are so effective at keeping people alive, patients and physicians want the study to be stopped and the drug given to all patients, including the ones in the control arm of the study.
And just to be sure we didn't miss some long term effect or some confounding factor, there are also studies done after the release of the drug (or other therapy). Regularly, some drug is found not to have as much effect as we would like. Some, not all.
But yeah, it's unscientific and baseless.

". . .far more people are saved. . ." That is a very unscientific, and even baseless, statement.

Actually it's 100% scientific, since it's based on the various studies which show the various treatments to overall do more good than harm. You know, the ones which we require before using such a treatment - but which the sCAM crowd doesn't.

All this talk about rising survival rates seems to contradict recent news stories citing studies that say survival rates have barely budged since the onset of the war on cancer begun in the 1970s.

As they say in wiki, citation needed. Also simply dismissing statistics you don't like is unconvincing, to use the politest possible term.

@ 104:

/facepalm

By Composer99 (not verified) on 29 Sep 2010 #permalink

There you go. It wasn't Hollie's lie, it was the Huffington Post author's lie (according to you).

It's still a lie. Splitting hairs like this not helpful.

Why is advocacy a problem? You can choose to act on it however you wish. She is advocating something based on her experience; you may think she draws the wrong conclusions, but who made YOU God?

It's called evidence. If I accused you of committing murder, I would need evidence to prove what happened beyond a reasonable doubt. I don't have the "freedom" (a word you sully by using it solely for emotional weight) to have you executed based on a vague feeling. At least, not in a just system.

I am not making any case at all. I just don't think you are making yours.

Thanks for admitting the truth: That you have no point. We are making our case, you're just ignoring the evidence.

I suggest you be very careful with your cancer statistics. All this talk about rising survival rates seems to contradict recent news stories citing studies that say survival rates have barely budged since the onset of the war on cancer begun in the 1970s.

Which articles? Don't ask me to do your work for you.

By Gray Falcon (not verified) on 29 Sep 2010 #permalink

Lucille=troll

You probably own that ludicrous quack cancer clinic in Vancouver, or maybe you are Hollie's pro-quackery book editor. Trying to save your own financial gains.

Lucille @ 110:

There you go. It wasn't Hollie's lie, it was the Huffington Post author's lie (according to you).

First off, you don't have to take our word for it that the Huffington Post piece was untruthful; you can go look for yourself. Unlike you, Orac has provided links to back up what he says. Secondly, the HuffPo piece is promotional material for the book. It's true that she didn't author it, but from what she's said elsewhere, she doesn't seem to have any problems with it, and this is why: it is consistent with the message she is conveying.

She has been consistently minimizing the effect of her surgery on her prognosis. In fact, she has gone so far (in her book and other promotional material for the book) as to say that if she had this same cancer again, she would not get surgery.

She is indeed claiming, in her own words, that the alternative medicine was what cured her and that the surgery was unnecessary. This is untrue. She surgery saved her life. She just preferred an alternative course of adjuvant therapy to chemo. But for whatever reason, she wants to paint a picture where you don't need surgery, and wants to discourage other women with breast cancer from having surgery. That is irresponsible.

She is, of course, perfectly free to keep saying it. Just as we are all perfectly free to express our own opinions about the quality of her advice.

By Calli Arcale (not verified) on 29 Sep 2010 #permalink

Whatever. She didn't lie. Period. And that is what people keeping coming back to. . .she shouldn't be allowed to write such a book; if she did write a book, she shouldn't be able to make any money on it, blah, blah, blah.

I don't have cancer. I don't have to make a decision. Based on the knee-jerk hysteria I have just witnessed on this blog, if I were ever to be in a position to make treatment decisions regarding cancer, I would find this to be a very unreliable place to get information. People are so uninformed and/or lazy that they can't/won't find extremely recent news articles on the topic (I'm surprised they haven't stumbled upon them by accident).

There seems to be much solace taken in the refuted idea that Hollie lied. I find that a pathetic position to promote.

Regarding comment 116 (and similar previous remarks) - comment 95 attributed three distinct "fallacies" to Lucille's single statement suggesting that the more aggressive orthodox here might be in the pharma business. (That statement was out of line and I deplore it, though I note that it followed slurs on her character that could provoke a person to wish to retaliate.) None of you suggested that this constituted a case of fallacy abuse. Would it be acceptable to suggest that shasta just committed the same laundry list of "fallacies" in making a precisely parallel and equally unsupported statement?

Or is it that personal slanders and prating about the vast inferiority of your opponents can substitute for or support reasoned arguments only if you're on "the right side"? In this case, you really are on the right side in saying that this ill-informed woman should not be discouraging others from having curative surgery (notwithstanding Orac's rather confused argument suggesting that refusing chemo was the wrong decision, for which she just might deserve to die, even though the latest evidence says that it was probably the right decision). You don't make it obvious that you're the right side, though, when your arguments are as emotional and personal as everyone else's. Dissidents or questioners are expected to provide Internet hotlinks for every statement or be accused of inventing things from whole cloth; one poster even contemptuously referred to this demand for links as "your homework." Where are your internet links to support studies that support your case?

I happen to know that plenty of facts exist to support your side; but if this was an issue I knew nothing about, and I came here through a random web search to see two sides namecalling each other, I would probably conclude that the least shrill side was more likely to be correct. If you *really* wish the best for the uneducated masses, you might try to avoid a style of discourse that they will not find convincing. (At least, that's my opinion; your mileage may vary.)

Why is advocacy a problem? You can choose to act on it however you wish. She is advocating something based on her experience; you may think she draws the wrong conclusions, but who made YOU God?

This isn't a matter of opinion. What she is advocating is objectively, factually, false, and anyone who listens to her will increase their odds of dying from cancer by doing so.

That said, nobody's saying that she shouldn't be allowed to express her views, even though they are demonstrably incorrect. We're just saying that she's wrong, not that she should be arrested or otherwise shut up.

So, why is OUR advocacy a problem?

"Where are your internet links to support studies that support your case?"

Again, I am not making a case. I'm just exploring why people are so incensed about individuals utilizing alternative health modalities and then talking about them. I am amused that I am assumed to be profiting from them just because I am curious why this strikes such a vehement chord.

I'm curious about her. I'm curious about you. Perhaps you think her motivation is money or attention or validation. I'm more curious about you. Why are you so invested in discrediting her? I like reading about health stuff. That is why I am surprised that people are asking me to post links about the alleged failure of the war on cancer, something you should be able to view in 5 seconds without my help, and something I'm surprised people with such passion haven't already seen.

You keep saying she's been factually refuted. I am not an expert on her cancer so I will reserve judgment. You talk about choosing treatment by the odds. What if the odds are against surviving by any known means? What if a doctor told you there was no treatment and you had one year to live. That was the story I read about a person who now says he has no evidence of disease and he also had no chemo or radiation or surgery on the secondary tumors. He had had surgery years ago, was told he was clear, and had tumors pop up elsewhere years down the road, hence the grim prognosis. He gave vague information about where he went for help. I found it myself with no problem.

When I hear a story like that, I don't want to submerge it, I want to hear more. I want to hear how Hollie is doing in ten years, and how others are doing who decided on a similar path.

What, exactly, are you advocating?

@Lucille: Not to put too fine a point on it but your commentary is tedious in the extreme. You have nothing interesting, novel or well-reasoned to share. Perhaps it is time to admit that you are outclassed.

Lucille:

Whatever. She didn't lie. Period. And that is what people keeping coming back to. . .she shouldn't be allowed to write such a book; if she did write a book, she shouldn't be able to make any money on it, blah, blah, blah.

You say this right after my comment saying that she has every right to write such a book. We're not advocating suppression of free speech. Neither is Orac. You've been challenged before to back up this accusation, but you have not.

She has the right to say what she has said. You may not consider it a lie, but it's certainly wrong what she has said. And it deserves a response.

Based on the knee-jerk hysteria I have just witnessed on this blog, if I were ever to be in a position to make treatment decisions regarding cancer, I would find this to be a very unreliable place to get information.

Would you prefer a place where everybody always told you exactly what you wanted to hear, and never spoke up when they knew something wrong was said? Someplace where keeping the peace was more important than people's lives? Where "respecting people" is confused with "humoring people"? Is that your utopian ideal?

In any case, if you did have cancer, I wouldn't recommend getting your information from any blog. Talk to a specialist who can discuss your unique situation.

By Calli Arcale (not verified) on 29 Sep 2010 #permalink

Calli Arcale:

In any case, if you did have cancer, I wouldn't recommend getting your information from any blog. Talk to a specialist who can discuss your unique situation.

Or from a book where the author tells people to not undergo the treatment that possibly saved her life (surgery).

So, why is OUR advocacy a problem?

Because we are not "nice". Apparently considering lying (and lying by omission is lying) in order to promote advice that is going to cause unnecessary suffering and death to be morally wrong is not "nice". Caring passionately about the welfare of strangers is not "nice".

Lucille confuses freedom of speech with freedom from criticism - just like Christianist extremists who cry persecution when they get called on their bigoted bullshit.

By Militant Agnostic (not verified) on 29 Sep 2010 #permalink

Okay, I finally got to see the YouTube video above. if Lucille still doesn't think Mrs Quinn was lying, she needs to watch the video. Put your pride aside for a moment, Lucille. What's more important, your pride or the truth? In the video, Mrs Quinn indicates that she received no conventional medical care for her cancer. Yet her book contains evidence that she did.

Heck, the title of her book is the same statement. "You Did What? Saying 'No' To Conventional Cancer Treatment". The video is also very clear in its implication that she was cured through alternative medicine, when in fact she was cured through conventional surgery. It lies very clearly and unambiguously through omission, and in her book, though she admits she had surgery, she downplays its importance.

By Calli Arcale (not verified) on 29 Sep 2010 #permalink

@Lucille,
In your first post you stated:

The last place you will hear about a cancer cure is in the doctor's office, unless they are the smart, open-minded ones.

and

So insecure oncologists who make a living off of extremely marginal cancer progress can huff and puff, but they are getting us nowhere.

You never backed up these statements with data, and they appear to be deliberately provocative (possibly insulting). Based on these and other statements, you seem to believe there is some other, better treatment that doctors either actively suppress or simply ignore.
If you have substantial evidence to support these views, I'm sure many would be interested in seeing it.
Something to realize, though, is that diseases like cancer can follow atypical patterns - so single stories (interesting as they may be) are not proof.

By Mephistopheles… (not verified) on 29 Sep 2010 #permalink

One last thing, then I gotta go get some work done....

Lucille:

When I hear a story like that, I don't want to submerge it, I want to hear more. I want to hear how Hollie is doing in ten years, and how others are doing who decided on a similar path.

I would too, except that the path she's advocating is actually not the path she's taking. Her 10-year survival will not say a thing about how well her advocated path works, because it's not the path she actually took.

Say I won $100 million in the lottery, and then sold books saying how to become a millionaire through stamp collecting. Would you be able to judge the effectiveness of stamp collecting as a career by gauging whether or not I was rich in 10 years? Of course not, because that's not how I (hypothetical I, alas) got rich. And it would be misleading for me to imply that my wealth came from stamp collecting when in fact it came from the lottery, a notoriously poor bet.

Unfortunately, people make those sorts of conclusions all the time, so it is worth pointing out when someone's trying to imply something that isn't true.

By Calli Arcale (not verified) on 29 Sep 2010 #permalink

Lucille @ 116:

First of all, for you, the only reliable source of advice on cancer, if you should happen to get it (I hope you don't, by the way) is your GP and oncologist. Random blogs on the Internet aren't, which is why I think you'll find even Orac doesn't try to give cancer advice (despite being a breast cancer surgeon) to people, either specifically or in general.

Secondly, I really do not understand why you are having so much trouble understanding what is upsetting about Hollie Quinn's book or the Huffington Post article promoting it.

Thirdly, if Hollie Quinn is claiming that if she could do it all over again, she would forego the surgery that she actually underwent, then she is implying that the surgery that saved her life was of no effect and the 'treatments' she took afterwards were what did the trick. That implication is still a lie.

=====
jane @ 119:

shasta's comment does not appear to be defensible without further evidence (e.g. a link to a sCAM website where someone going by the handle Lucille discusses her practice at the 'integrative oncology' centre in Vancouver).

However, with regards to the tone of this blog and of its commentary, I should refer you to the name of the blog and allow you to draw your own conclusions.

By Composer99 (not verified) on 29 Sep 2010 #permalink

I'm just exploring why people are so incensed about individuals utilizing alternative health modalities and then talking about them.
...
Why are you so invested in discrediting her?

And you've been told why - because it kills people, without providing anyone any benefit (aside from the "practitioners" who get fat fees out of the process).

I like reading about health stuff. That is why I am surprised that people are asking me to post links about the alleged failure of the war on cancer, something you should be able to view in 5 seconds without my help, and something I'm surprised people with such passion haven't already seen.

You made the claim, so the burden of proving it is on you. This sort of "you should already know" is invariably a sign of a crank who HAS no evidence and is just making **** up.

What if the odds are against surviving by any known means? What if a doctor told you there was no treatment and you had one year to live.

Then you take whatever has the best odds (even if they're quite bad) of helping more than it hurts. What you do NOT do if you're rational is dive into garbage where there is no reason to believe it will do any good, but might well kill you faster.

That was the story I read about a person who now says he has no evidence of disease and he also had no chemo or radiation or surgery on the secondary tumors. He had had surgery years ago, was told he was clear, and had tumors pop up elsewhere years down the road, hence the grim prognosis. He gave vague information about where he went for help. I found it myself with no problem.

Stories are easy to find. Too bad they prove nothing.

When I hear a story like that, I don't want to submerge it, I want to hear more. I want to hear how Hollie is doing in ten years, and how others are doing who decided on a similar path.

That want is rather misguided, since it won't actually tell you anything meaningful. Only careful science can answer the question - and it has.

What, exactly, are you advocating?

That people should be offered the best scientifically supported medical care, and not defrauded by quacks touting UNsupported treatments.

@ Lucille

That is why I am surprised that people are asking me to post links about the alleged failure of the war on cancer, something you should be able to view in 5 seconds without my help, and something I'm surprised people with such passion haven't already seen.

Maybe because a full overview of the "war on cancer", as you said, with all its complexities, couldn't be done in a 5-s Google search.
Heck, I had to read more than one hundred articles when I was writing my last scientific paper. And I am a mediocre scientist, I should have read more, and more deeply. Good scientists read 20-page nebulous scientific papers every days.
OK, non-experts don't need that deep a level of knowledge to make an informed opinion, but they still need more than a few webpages.

However, I did indeed find the following link in 5 seconds. A good start to understand the issues of the war on cancer.

http://www.phdcomics.com/comics.php?f=1162

BTW, this was why I called you an ignorant in a previous post. I apologize for this, this was aggressive.
But I still think you need to read more before trumpeting the failure of conventional medicine in the war on cancer.

I want to hear how Hollie is doing in ten years, and how others are doing who decided on a similar path.

You just described the basis for a case study. Except that we need hundreds of people rather than 1 or 2, to avoid confounding factors, like age, lifestyle...
Sorry to rub this in, but you know, like in the articles on Pubmed from which we derived our baseless assumption that conventional therapies saved more than killed cancer patients.

Here is a video you may want to watch, if you want some insight into the "war on cancer" as seen by the American Association for Cancer Research. It was projected at their latest meeting. Definitely self-promotional, but all numbers are accurate. The references are at the end of the movie.

http://www.youtube.com/watch?v=3pobQRfz0No

I think the difference between me and some people here is that I've seen that the good M.D., while true to his/her training and good-intentioned, displays limitations that are successfully addressed (according to stories) in other arenas.

For example, if you are diagnosed with seborrheic dermatitis (as was someone I personally know), you will likely be prescribed some sort of topical steroid with a warning not to use it too much due to the eventual effect of thinning of skin. The GP or specialist will give you your prescription with instructions on how many times per day, etc. If you are more curious, you can ask the pharmacist for further information (and probably will get more than you got from your doctor). If you look much, much, much further, you will find that you will be far less reliant on the problematic steroid if you recognize that your skin condition is actually caused by a fungus and that there are dietary measures that are quite effective. While my experience and that of my family may be so anecdotal as to be utterly WORTHLESS, it is my experience, and I stand by it.

That is just one little story (I know it is NOTHING compared to science) where I have personally observed that a GP or specialist either didn't know the whole story or didn't have the time or inclination to tell the whole story.

A story may PROVE nothing to me or to you, but I have tried things based on stories and have been quite grateful someone bothered to tell their story.

If you want to wait for a clinical study that suits your standard, I applaud you for sticking to your principles.

Lucille @ 132:

How does any of that get around the fact that the basis of Hollie Quinn's book and the article promoting it is a deceit?

By Composer99 (not verified) on 29 Sep 2010 #permalink

For example, if you are diagnosed with seborrheic dermatitis (as was someone I personally know), you will likely be prescribed some sort of topical steroid with a warning not to use it too much due to the eventual effect of thinning of skin.

It is more likely, however, that the doc will tell you to use Head and Shoulders* and come back if that doesn't work.

*or other OTC antifungal topical treatment

BTW, I spent half an hour trying to find a news article about the alleged failure of the "War on Cancer." I did find a bunch of sories about how cancer survival rates are increasing. But no luck on a matching article. Closest that I found was a FoxNews blurb showing that survival rates had gone up, but that death rates were about the same. Perhaps you aren't aware of the difference between survival rates and death rates, Lucille?

Survival rate: the time it takes until 50% of patients with a given diagnosis have died

Death rate: percentage of total deaths each year attributable to a given cause

It is quite possible for survival rates to increase dramatically while death rates hardly budge. One way this could happen is if there are fewer deaths overall (or relative to the growth rate). Another way is if the number of diagnoses increases - like if more people are living to the age that they are likely to get cancer.

(NOTE: there is some glitch in SciBlogs. You can still post comments, but the boxes for name, email, and URL are invisible for some reason. Just click below the label text and type)

I don't know if Kevin is another science stickler, but his supposition of what the dermatologist will tell you if he thinks you have seborrheic dermatitis represents a very unscientifically-reached ERROR (based on verifiable FACT--by ME) or the dermatologist of whom I am aware is an outlier (not a LIAR, as has been attributed to Hollie Quinn--just to be clear).

I am quite aware of the semantics of survival vs. death rates, and it is hardly reassuring for the cancer patient.

It is quite possible that doctors do not have time with the demands of clinical practice and all to listen to stories, and this may very well be why the only information we get from them is what can be summarized in sound-bite fashion as clinical recommendations.

This has been very fun, in an odd sort of way. I do love stories, and have gained quite useful practical knowledge from them. Perhaps Hollie Quinn's book WOULD interest me!!

Has anyone on here read the book cover to cover? I read the Huff post article. The intensity of everyone's reactions has me curious about the book's full content.

As for the Quinn's leading people down a false path, it's my understanding we all have free will and the ability to make choices for ourselves? I know I don't make life altering decisions based on one person's or organization's opinion or research. I would like to think that is how most rational people work. Gather information and decide what is best for them in the given situation.

romeo ölmeli filminin konusu kontrol ve Aile Sing ve satıŠOâDay Isaak klan Amerikan Afrikalı orta bir savaÅ arasında kendi depoları vardır içinde. çatıÅmalar ay birkaç sonra, gerginlik söyle Chu oÄlu genç escalates ile öldürme Po, genç. Hong Kong cezaevi bir tutuklu olarak, Han Sing kardeÅi kaçar onun ölümü o öÄrenir, o korumak için yemin vardı. Oakland, aÅk düÅerse o OâDay kızı yönlendirir kendi Trish için soruÅturma

Jasmine:

Gather information and decide what is best for them in the given situation.

Just make sure the information is truthful.

@ Lucille, Jasmine

You really don't get it, don't you?

We are not complaining about Quinn publishing her story. As you say, it's her right (as much as it is our right to criticize it, though).

To resume her story,
1 - she was diagnosed with breast cancer
2 - the main cancer mass was removed by surgery
3 - then she decided to say no to conventional therapy, and looked for and followed an alternative regimen of unproven efficacy.

Could we agree on this part?

Most of us will have nothing to say to this. Specialists in oncology, like Orac, may berate her for having chosen a path which, in their professional opinion, carries higher risks. But as some people say here, her body, her choice.

The part which is infuriating us is this one:

Hollie now says that if she could do it all over again she wouldn't have had her tumors removed surgically--the only conventional treatment she had

By her own admission, her story has become now
1 - she was diagnosed with breast cancer
2 - then she decided to say no to conventional therapy, and looked for and followed an alternative regimen, which cured her.

Do you see the small difference?

She is denying that the part of the conventional treatment that she did follow, did have any positive effect. The part which is, according to oncologists, the main step in the treatment of breast cancer. Chemo, radiation, hormones are just the second part of conventional treatment.
Even for the layman, this should be obvious. How come someone could have a big lump of cancer cells removed and then say it has no link to her cure?

I am sorry, but this is misleading. I could accept the possibility that one of the alternative treatment she followed did have a anti-metastatic effect, or something (although I wouldn't bet on acupuncture or other practices which have been showed no better than placebo). If you want, try at your own risks. Who know?
But, even if assuming there is an effect, that she does is still wrong. If she tells people to forgo the surgery, she is changing the initial situation, and whatever effect of her chosen treatment may well be not strong enough to get rid of the whole tumor. And women will die for nothing.

No one seems to have addressed jane's obnoxious comment about "Orac's rather confused argument suggesting that refusing chemo was the wrong decision, for which she just might deserve to die".   Quite the contrary, jane, he said, "Don't get me wrong, though. I sincerely hope that Ms. Quinn never pays for her choice with her life."

It annoys me to see people like jane conflate an assessment of the risks involved in a course of action with a judgmental pronouncement on the moral rectitude of the person pursuing that course of action. 

Lucille yammered on and on about how remarkable it is, and how indicative of an ulterior motive, that people on this site are appalled at the possibility that innocent people will believe and act on falsehoods, and will therefore die horrible, painful, *unnecessary* deaths. Newsflash, Lucille and jane: the reason Orac wrote this post, and the reason so many commenters are on here responding to you, is because we *don't* believe that people deserve to die of cancer.    

Jasmine, you may not do this, but a lot of people do.

And when we're talking about people in state of shock or distress about a life-threatening diagnosis, we're talking about people who can be misled. Remember the first of the "5 stages of grief" is denial. If your doctor's offering you the option of losing part or all of a breast, and a friend or relative offers you this book, what will you do?

You and I might be sensible and go with the SBM recommendation. Others who are shocked, upset or already ambivalent about hospitals, surgery or doctors in general can be persuaded to "try something else". And then find that it's too late for conventional treatment when these alternatives don't work.

Personally, I'd go the nutrition and supplements route, not to avoid horrible treatments, but to give my poor suffering metabolism the best possible chance of coping better with the various insults from surgery, chemo, radio. (And I'd make damn sure my doc had the chance to advise me which to avoid and which to favour for assisting rather than impeding the effectiveness of the treatments.)

Lucille's last post provides a good example of what happens when someone does incomplete "research" and accepts only that part of it that confirms personal beliefs.

An association between fungal skin colonization and seborrheic keratosis has long been recognized in mainstream medicine and antifungal therapy has been part of the treatment regimen for a similarly extended period (one can easily find PubMed reviews on the subject going back a decade or more, and I seem to recall treatment along these lines from my med school days in the '80s). Fungal infection is far from the whole story, though, as genetic and other environmental factors play a role. Treatment incorporating anti-inflammatory, immunomodulating and antifungal therapy is currently used, not just topical steroids. Fad diets are not thought to be effective (although there are numerous altie/supplement-selling websites that harp on this).

Lucille appears to have picked out seborrheic dermatitis to demonstrate that old trope, "Medicine wuz wrong before, so it's OK to promote (my brand of woo) for (any disease). In this case, medicine has been right for a long time and woo has never come up with good treatment for the condition.

By Dangerous Bacon (not verified) on 29 Sep 2010 #permalink

Bacon. . .just telling what the good doc told my own family member. Just illustrating that all the information is not to be found in one place. Got a problem with that?

I don't have a brand. . .that is YOU.

@Lucille

The problem is that you extrapolated from that one doc to say what is most likely to happen (i.e., be prescribed steroids), when the standard of care, at least as Dangerous Bacon has shown, probably is not reflected by the experience you related. Of course, you also did not share when that story took place, so it may have been before more was known about the condition and before practice had largely changed.

So, other than the straw man argument you seem to be trying to build (i.e., that we are upset about Hollie's treatment choice rather than our real beef is that Hollie is actively advocating that people take a more dangerous course of non-treatment), what exactly is your point?

Bacon. . .just telling what the good doc told my own family member. Just illustrating that all the information is not to be found in one place. Got a problem with that?

If the information contains lies by omission, then yes! You keep demanding open-mindedness, but never stop to open your mind to one possibility: That you might be wrong.

By Gray Falcon (not verified) on 29 Sep 2010 #permalink

Jasmine's post is mind-boggling. I think Orac could do a whole post on all the misconceptions.

I guess the place I'd start is to ask, who are these single person or single organizations that she talks about? Does she not know how medical research is done, or what oncology research means? Good gravy, it's NOT a single person or organization. It's probably thousands of researchers work synergistically through hundreds of organizations.

The "single person" is more likely to be the idiotic "miricle cure" morons who claim to have THE solution to everyone's cancer.

When the American Academy of Oncological Surgeons (or whoever) comes up with recommended guidelines, that is anything but the work of asingle person or organization

As a healthcare consumer, I must say that the conventional medicine brand suffers as a result of the ridiculous statements of the posters here. I would be tempted to label the brand as unbelievably loutish, but it is important to realize that these are people who gather to commiserate about quackery, and likely see quackery almost everywhere (except in their own capsule).

Lucille, please answer this honestly:

Would Ms. Quinn still be okay if she had not had the surgery?

What "ridiculous" statements are you referring to? I haven't noticed any except from you...

Lucille's post @147 is a good example of what is wrong with how health care is provided and thought of in the U.S., and with contemporary consumer capitalism in general.

The point is not, or should not be, "hey, they've got a cool logo, and a spokesman who I liked when he was on TV." It should be what works.

"Is this treatment with a 40% chance of extending my life worth that set of side effects" is a reasonable question, and one that people will reasonably disagree on. (Different side effects are important to different people.) "Should people lie about what works?" is not merely the wrong question, it's scary. If the market encourages people to lie about life-and-death questions, or even less serious long term health questions, that does not mean lying is ethical. It means there is something wrong with the market, or with using the market for this purpose.

Too many people act as though the market is the only available tool, and try to treat every problem as if it was only a financial transaction.

@Lucille,

I've been following your back-and-forth comments with other commenters on this blog for the last few days. Mostly you've been talking past each other with very little real communication going on. I think this is because you have a very different idea of what is useful and sufficient information to make a decision from most of the other commenters, at least when it comes to medical and healthcare decisions.

So, I thought it might help if I try to explain it from a slightly different point of view. Please forgive me if this gets a bit pedantic and tends to run on into a full blown lecture.

People have been teaching each other by telling stories and learning from them for thousands, perhaps even millions, of years. It's how we learned where to find good food and avoid danger. And we still do that. We say things like, "don't go down to that part of town at night. There's a lot of crime there." or "I just ate at a new Joe's Restaurant and the food was great. You should try it."

And, for the most part, we get useful information that way. But, there can be problems. Joe's Restaurant may have great cooks and waiters on Friday and Saturday nights when they are busy and want to make sure they have the best crew to take care of lots of customers. But, if you go in on Monday night, you may get a junior cook who's still figuring out how to grill a steak without burning it and a new waitress who doesn't know what half the items on the menu are and you get a terrible meal. Or, the Joe's in Cincinnati may have a great, experienced crew and always provide good food, so when you go to Toledo you decide to try the Joe's there. But, they just opened up and have a new crew who haven't figured out how to work together and you feel like you've wandered into a bad episode of a reality tv show.

So, if major consumer test magazine is trying to give you useful advice on which restaurant chain is better, Joe's or Sue's, they need to evaluate those restaurant in different locations and at different times to see if there is a consistent difference and which is usually better.

Now for another story. Suppose your friend goes to Joe's for lunch on Monday and has a triple enchilada plate for lunch, but decides to skip the dessert. Then on the way back to work they stop at a local nutrition store and buy a bottle of Super Nutra Pills and take one with a glass of water when they get back to work. Then, on Tuesday at 11:30 you start to get hungry and ask your friend where you should go for lunch. They tell you "skip the lunch. I took one of these Super Nutra Pills yesterday and I didn't get hungry all afternoon!" So, you skip the lunch, take the pill and by 2:00 you're starving but it's too late to go get lunch. You're stuck. And, you tell another friend whose desk is next to yours that you're hungry. And, they ask what you had for lunch and you say "I just had one of these Super Nutra Pills." They will probably reply that you should have gone out and gotten some food for lunch.

Would you then tell them, "No. Super Nutra Pills are great. My friend told me so. You're being unbelievably loutish to make such ridiculous statements!" ???

By squirrelelite (not verified) on 30 Sep 2010 #permalink

LW@140: Ooh, I'm so hurt to know that I'm "obnoxious." You cut Orac's quote off early; here is the full version:

"Dont' get me wrong, though. I sincerely hope that Ms. Quinn never pays for her choice with her life. Her child deserves no less."

My, my. Does he think the loss a child suffers when a parent dies young is more severe than the loss suffered by the person who dies and thereby loses most of her adult life? Or does he think that the child did nothing to deserve the loss of a caretaker, whereas the patient's "misguided, potentially disastrous, monumentally poor" choice to refuse chemo and radiation might mean that had she died, she would have done something to deserve it?

You also don't address the larger point that he uses all this language even though he admits later in the post that it now appears "stage 2" cancers were being overtreated back then as a result of "stage migration", and that even without a mastectomy, the odds were in this woman's favor. He has to admit those things; if he stuck throughout to the premise that she must have been super-lucky not to die of her folly, that would make us wonder whether her CAM treatment might not actually suppress recurrence. But once we are told that she could have expected to be alive and well today without the CAM treatment, that makes her decision to refuse conventional treatments that could fry her heart, lungs, or brain seem like a choice a reasonable person might prefer.

Lucille@121 - If you will reread my previous post more carefully, I was asking for evidence from the crowd that was arguing with you, not from you. And I fully share the feeling that if you were diagnosed with incurable cancer, you would be better off using your last months and dollars preparing for your death than wasting them doing chemo. I find Scott's philosophy that you should pursue whatever kind of "treatment" is available, no matter how bad it is, incomprehensible.

But this is not the situation for many cancer patients. If early stage breast cancer can usually be cured by surgery alone, this is an admittedly more painful and costly analogue of getting a melanoma removed before it can spread and kill you. If you knew that you had a small melanoma, I bet you'd get it removed. Surely, if you had a gangrenous toe, you would get it amputated to save your life. I think people tend to hear "cancer" and automatically think "incurable," but that's really much too pessimistic.

@ Jane

How do you translate Scott's statement:

Then you take whatever has the best odds (even if they're quite bad) of helping more than it hurts.

into

you should pursue whatever kind of "treatment" is available, no matter how bad it is

Scott is talking about the benefit/risk ratio. Which means what you should weight the chance of getting a benefit from the treatment against the chance of getting hurt from the treatment and the chance of what will happens without the treatment. Well, it's how I interpret "helping more than it hurts".
You don't have to pursue whatever treatment etc. What you do is decide if a given treatment is worth the risk. And ideally, you decision should be done on facts, not on hearsay.

And I think Scott will agree that, if nothing of much benefit is available, then you have better save your money to prepare for your death, as you said. What Scott said was not to waste your money in unproven treatments:

people should be offered the best scientifically supported medical care, and not defrauded by quacks touting UNsupported treatments.

jane @152:

I am getting a whiff of straw from your comment.

By Composer99 (not verified) on 30 Sep 2010 #permalink

Side note on spam: the message at 137 appears to be something about a Hong Kong movie, with no connection to this thread or any other topic being discussed here. (I say "appears to" because I know no Turkish, and Google translate is fallible; of course, it may be outputting ungrammatical gibberish because the input is ungrammatical gibberish.)

@jane

LW@140: Ooh, I'm so hurt to know that I'm "obnoxious." You cut Orac's quote off early; here is the full version:

"Dont' get me wrong, though. I sincerely hope that Ms. Quinn never pays for her choice with her life. Her child deserves no less."

My, my. Does he think the loss a child suffers when a parent dies young is more severe than the loss suffered by the person who dies and thereby loses most of her adult life? Or does he think that the child did nothing to deserve the loss of a caretaker, whereas the patient's "misguided, potentially disastrous, monumentally poor" choice to refuse chemo and radiation might mean that had she died, she would have done something to deserve it?

Why do you seem like you're gunning for a fight? The reading that I got from Orac's statement was the following:

a) He hopes that she does not die; and,
b) Her child deserves to have her around, because it is tragic when a child loses a parent; doubly so if that death could be prevented.

I did not see anything in his post suggesting that if she dies, she deserves what she gets.

You'll note that that Orac also said this:

I wish no evil on Hollie and hope that she lives a long and happy life to see her daughters grow up and possibly even produce grandchildren for her

You seem to be reading a lot more ill-will into Orac's words than are actually there.

As a healthcare consumer, I must say that the conventional medicine brand suffers as a result of the ridiculous statements of the posters here.

If you're a healthcare "consumer" instead of a patient, you're doing it wrong. Healthcare is not a "consumer experience," not least of which because medicine is so complex that patients can't possibly garner enough information without expert help to make adequately informed decisions about their health -- it is not really possible for a lay person to diagnose or treat themselves in most cases (anybody who says otherwise has a bridge to sell you), and because it's not like you can exactly say "Well, I think I'll just forgo the surgery to remove my cancerous brain tumour and choose to have a tummy tuck instead." (Well, I suppose you technically could, but nobody in their right mind would.) It's not like deciding whether you're going to pick the cashmere blazer or the Italian leather boots, or stick with the wardrobe you've still got.

Further, "conventional medicine" sure as hell does not have a "brand." Christ. What a transparent piece of rhetorical knucklebones, not to mention the most weak-sauce tone trolling I've heard in a while. If you're so concerned about the impact on the "brand" of Conventional Medicine™, please, contact Conventional Medicine™'s brand manager and PR staff; I'll wait, albeit without holding my breath.

This is the problem with discussing healthcare with Americans; some of you all are so wrapped up with your for-profit healthcare paradigm that you forget that healthcare isn't really like normal market-based transactions. I don't have to worry about that, so I suspect it's much easier for me to see how different going to the doctor is to going to the mall.

By realinterrobang (not verified) on 30 Sep 2010 #permalink

ghaa, silly French, I keep adding too many 's' at the end of my words. My apologies for my poor grammar.

As for Orac's supposed desire to have death visiting Mrs Quinn. I quote you, Jane:

whereas the patient's "misguided, potentially disastrous, monumentally poor" choice to refuse chemo and radiation might mean that had she died, she would have done something to deserve it?

You know, you nailed it. But this does not make a monster out of Orac.
Put yourselves in Orac's shoes for one second. He is in real life an oncologist, a specialist in breast cancer, and here is the story of a woman who ignored the sound advice of one of his colleagues and took, in Orac's professional opinion, an unnecessary risk. How do you think he is feeling? Do you know how frustrating it is to have people ignoring you and your hard-learned knowledge and to watch them taking stupid decisions, with death as a potential outcome?

And also, you are overlooking a point. With freedom of choice comes freedom of making mistakes. So yes, if Holly Quinn had died, she will have been responsible for this, because it was her decision. Not because of some sadistic innate justice, but simply as a matter of causes and consequences.

I think an expert has the right to say "I told you so" when I ignored his advice and ran into some trouble he was warning me against. I would not like it, I may think the expert is being nasty, but I could not deny I was told.

What a paroxysm of content and comments this created and sadly much of it is rooted in an incredibly negative paradigm - fear. We should not lose sight of the fact that the treatment of Cancer by "traditional" medical methods such as chemotherapy and radiation causes suffering in its own right. It is no more irresponsible for Hollie and Patrick Quinn to have created this book than someone else creating a book stating they were cured by chemotherapy. They are telling their story, sharing their experiences, writing about what happened to them, there is nothing to be afraid of. If what they are saying is so wrong and dangerous then no-one will read the the book and if they did would absolutely not be influenced by it. I am astounded at the amount of vitriol here mounted against this book; as I said so much fear mongering.

One last point I have, Cancer is exacerbated by the way of life we have evolved or perhaps it is devolved here in the USA, which is spreading across the globe; sadly. Surrounding ourselves with carcinogens and consuming large amounts of processed food and GMO laced products. We absolutely need to look at the way of eating and drinking Hollie and Patrick Quinn and family evolved or we will extend our suffering and bring Children into our world who will have shorter life expectancies that we have.

@ Mike Brunt 158

to have created this book

Interesting choice of words. One writes a book, but one creates a story.

They are telling their story

More or less. They seem to deny in interviews that the one piece of conventional medicine that she did follow had any positive effect. See my post #139.

If what they are saying is so wrong and dangerous then no-one will read the the book and if they did would absolutely not be influenced by it.

Yes, sure. Because no-one in human history was ever influenced by a misleading report.

processed food and GMO laced products

Linked to cancer? Citation please.

Sadly, people like 158 above still bleat nonsense.
Unable to tell the difference between evidence-based medicine and random quackery and damning unspecified "carcinogens" and "GMO Food" for shortening a lifespan that is actually about 2 times what it was in 1900. Extolling the virtues of "natural life" using a machine made of materials that include those so-called carcinogens. probably while munching on an "Organic" Cavendish banana.
Dude, you seriously gotta buy me a new Irony meter.

If what they are saying is so wrong and dangerous then no-one will read the the book and if they did would absolutely not be influenced by it.

Please explain how you reach this conclusion? It seems to have no points of contact with reality; the reality is that no matter how blatantly bogus and dangerous a piece of quackery is, there are people out there who will fall for it. Or are you saying that you actually believe that the "cure for cancer" offered by the late Hulda Clark (who died of cancer) is not wrong and dangerous?? You're definitely going to have a tough time making a case for that premise.

They are telling their story, sharing their experiences, writing about what happened to them, there is nothing to be afraid of.

That would be a pretty naive interpretation even if we hadn't already determined that the Quinns are telling their story in a deceptive manner, namely, surviving cancer with the assistance of conventional treatment and then falsely claiming in their promotion of the book that the survival occurred without conventional treatment.

Are you suggesting that it's ethically defensible to lie about such important parts of one's story when other people might well be influenced by those lies in making their own life-and-death decisions?

By Antaeus Feldspar (not verified) on 30 Sep 2010 #permalink

jane and Mike Brunt, please answer honestly:

Do you think Ms. Quinn would be doing as well without the surgery she had?

@162 (Chris) yes I do believe she would be doing so well without the surgery but in reality none of us can prove that, with certainty, that she would be doing better or worse, we can say what we think or believe. Why is this thread so laced with negative comments and overly strong statements about someone who's life was threatened and who chose a path, which if wrong in such a significant way would have caused her death. Why cannot we rejoice in the fact that she is still alive, has another child and is simply writing about that experience. The Quinn's have no ulterior motives in all of this.

Chris@162 - Your comment distills mostly wordier abusive rhetoric down nicely. Why, I have already answered your question; I said explicitly that this woman's surgery was curative, and that she was wrong to discourage others from having curative surgery, and that indeed if I were in her shoes I would choose a more extensive surgery, a simple mastectomy (as preferable to chemo brain).

For those who wish to learn the art of argument by personal attack, note the character insult implied by the demand that I answer the question "honestly," and the implied premise that I either had not addressed the issue before or had dishonestly denied the value of surgery. Since it's hard to remember exactly who said what upthread, this sort of "question" is really a sly way of planting false opinions of a debater's views in the audience's mind. All the more effective for being terse and avoiding direct namecalling with nouns. Quite skillful really - props to you!

realinterrobang@156 - If you're a patient and not a consumer, I would say, you're doing it wrong. You can't learn enough off PubMed and WebMD in a couple of months to practice medicine, no. But you can certainly learn what all the options are and what expected benefits, harms, and costs are associated with each, and you can think about how those jibe with your personal values, which may not be identical to your MD's values. The way some people snarl about "University of Google," I wonder how they buy a car. Reading a couple of books by Consumer Reports giving the reported "outcomes" for various aspects of each vehicle will not make you an auto expert, but it will do you a lot better than going in and doing whatever your "expert" auto salesman says to do. If he sells Hondas, he'll tell you Honda is best for everyone; if he sells Fords, ditto. And few of them will ever admit that some people might be better off with a bicycle.

Jane - are you really comparing "expert" car salesman with MDs. If so, you really are a Dunning-Kruger champ. The fact that you think your Google education makes you a better expert on chemotherapy than a surgeon/scientist like Orac is very telling about your arrogance. If I was buying a car I would seek the advice of mechanics as to reliability and ease of repair. When it comes to my body I trust the advice of my "body mechanic" over some internet crank.

The car salesman analogy applies much better to the alt-med crowd who just happen to sell the supplements they recommend.

By Militant Agnostic (not verified) on 30 Sep 2010 #permalink

Great point - if modern life was so hazardous to our health, why do life expectancies keep going up?

Please feel free to move off the grid & refuse all modern conveniences (including modern health care) and see how long a "natural" life is.

The Quinn's have no ulterior motives in all of this.

The Quinns are selling a book. Making money off of other people's suffering, much like Hulda Clark, the people pushing laetrile, and other quacks. None of them have your best interests at heart.

@162

Why cannot we rejoice in the fact that she is still alive, has another child and is simply writing about that experience. The Quinn's have no ulterior motives in all of this.

Why should we "rejoice" at the fact that she has been spreading dangerous information that will eventually cause the premature death of other women if they follow her daft advice. As to ulterior motives - I assume she makes money from the sale of her book. Also, I am sure she has the need to convince herself that she was smart rather than lucky.

Further, if you think removing the cancerous tissue did not have any effect on your chances of survival, you are completely ignorant. By the way, humans have been genetically modifying there food for thousands of years and processing it for tens of thousands of years.

By Militant Agnostic (not verified) on 01 Oct 2010 #permalink

@168 - "spreading dangerous information" should be "spreading dangerous misinformation"

By Militant Agnostic (not verified) on 01 Oct 2010 #permalink

Mike Brunt:

2 (Chris) yes I do believe she would be doing so well without the surgery but in reality none of us can prove that, with certainty, that she would be doing better or worse, we can say what we think or believe.

Actually we do know how well she would be doing, not very. There are records of many women who have forgone surgery from the time when breast cancer was first recognized centuries ago. The outcome is not good by at least two to one.

Her chances of survival with surgery was 70%, the outcome without surgery is much less.

Some literature includes:

Ann Surg. 2005 Aug;242(2):276-80.
Patients' refusal of surgery strongly impairs breast cancer survival.
Verkooijen HM, Fioretta GM, Rapiti E, Bonnefoi H, Vlastos G, Kurtz J, Schaefer P, Sappino AP, Schubert H, Bouchardy C.
Geneva Cancer Registry, Institute for Social and Preventive Medicine, Geneva University, Switzerland.

After accounting for other prognostic factors including tumor characteristics and stage, women who refused surgery had a 2.1-fold (95% confidence interval, 1.5-3.1) increased risk to die of breast cancer compared with operated women.

Eur J Epidemiol. 2003;18(8):817-22.
Use of CAM results in delay in seeking medical advice for breast cancer.
Malik IA, Gopalan S.

CAM use was associated with delay in seeking medical advice (OR: 5.6; 95% CI: 2.3, 13.3) and presentation at an advanced stage of disease (OR: 2.2; 95% CI: 1.01, 4.6). Patients who delayed seeking medical advice more often had positive axillary nodes and stage III/IV disease. Breast cancer patients in Pakistan frequently (53%) delay seeking medical advice. Antecedent practice of CAM is widespread and a common underlying reason. The delay results in significant worsening of the disease process.

Public Health Rep. 1987 Jul-Aug;102(4 Suppl):97-9.
Women and breast cancer.
Lippman ME.
Medical Breast Cancer Section, National Institutes of Health, Bethesda, MD.

One in every 12 women will develop breast cancer; the incidence increases with age, dietary fat intake, caloric intake, height, and weight. The 10-year survival rate of breast cancer patients who refuse therapy is virtually zero.

Oops, left off an important adjective.

She would not be doing very well.

Militant Agnostic @165:

"The fact that you think your Google education makes you a better expert on chemotherapy than a surgeon/scientist like Orac is very telling about your arrogance."

Amazing - right after I called Chris out for his straw man, you claim as "fact" that I think the opposite of what I suggested in my message. The weird thing about this choice is that your message was immediately below mine (@164) so anyone can see that you are lying. For those who are interested in collecting Fallacies, your message includes a prime Straw Man Fallacy, plus an ad hominem fallacy, a tu quoque fallacy (i.e., you suggest that we should not be concerned about our doctors' having economic interests or philosophical biases because CAM providers have such interests and biases), and possibly a begging the question fallacy (because you assume as "fact," therefore as a premise, the slurs that you ought to be providing evidence for if your desire is for them to be believed by third parties). That says to me that it's time to bow out again - four fallacies in one message is just too much!

For the public, though, the Dunning-Kruger effect refers specifically to someone who thinks he is skilled at something though he is not. If someone were to think that reading a few papers on PubMed gave him enough knowledge that he could practice oncology, he would indeed be displaying this effect. However, it is not applicable, as Militant Agnostic implies, to someone who just does not have adequate trust for emdees. If it's to be preserved as a useful concept, it cannot devolve into a six-syllable synonym for "stupid [IMO]."

I also keep wanting to figure out what formal Fallacies might be involved in the often cherished though ridiculous belief that because our overall lifespans are longer than in the past, every aspect of our lives must be as healthy as it was in the past or more so, and there is no area of life in which we might possibly benefit from conditions a little closer to those in which we evolved. Fallacy of division? Chronological snobbery? Perhaps one of the super-rational denizens of this blog can answer this question for me.

What strawman?

Was it because I missed your answer before?

I also keep wanting to figure out what formal Fallacies might be involved in the often cherished though ridiculous belief that because our overall lifespans are longer than in the past, every aspect of our lives must be as healthy as it was in the past or more so, and there is no area of life in which we might possibly benefit from conditions a little closer to those in which we evolved. Fallacy of division?

Who says our overall lifespans were longer in the past? It is certainly not those arguing that it is a lie to say her surgery had no part in Ms. Quinn's continue health.

@Chris

Jane is saying that current lifespans are longer than lifespans in the past.

In general, Jane is agreeing with much of what we're all saying: the surgery was what saved Hollie a lot of pain, agony and, possibly, death. What I don't get is her argumentative tone. It seems like she wants to fight with us and is purposefully looking for buttons to press. And a few people are taking the bait.

@Todd W,

I agree. Chris probably just misread that line when she was preparing her comment.

I wonder what Jane's comment 164 would have looked like if in comment 162, instead of asking "please answer honestly", Chris had asked "please answer simply and directly". But, it's probably OBE by now.

The last several comments are also a good illustration of why I try to avoid mentioning the Dunning-Kruger effect in rebuttal arguments. It's very real and we see good examples of it every day on this and other blogs, but it's not much use in trying to respond to the claims of another commenter because it tends to devolve down to something like:

"I don't think you know as much as you think you do because I think I am more aware of complexity and subtleties of the problem we are discussing." Or something like that. Which may be true, but it doesn't do much to address the actual argument (if there even is one). FWIW :)

By squirrelelite (not verified) on 01 Oct 2010 #permalink

Thanks, Todd. I am having trouble understanding jane, which is why I have mostly been avoiding her. I most likely missed her response because I did not ask her at first, and was looking for a response from Lucille. So she agrees with the science. End of discussion with jane.

From jane

I also keep wanting to figure out what formal Fallacies might be involved in the often cherished though ridiculous belief that because our overall lifespans are longer than in the past, every aspect of our lives must be as healthy as it was in the past or more so, and there is no area of life in which we might possibly benefit from conditions a little closer to those in which we evolved. Fallacy of division? Chronological snobbery? Perhaps one of the super-rational denizens of this blog can answer this question for me.

OK, I'll bite. Which should prove that I'm not one of those super-rational beings.

I don't think that anyone here is saying that in every aspect of life, everything is better now. It's hard to prove a negative (that no aspect of our current lifestyle are worse than before).

As for myself, I don't believe this. Yes, I believe there are possibly areas in which we would benefit from being less modern. Less car use, more walks, to start with. Less meat, more veggies. Less TV/video games, more social interactions... But maybe I'm delusional.

However, we are a social species, we are accumulating and transmitting knowledge, improving our life condition via technology. Cancer treatments, to stay on topic. So on average, things are better now than in the past.

Could you be more precise, notably about these "conditions closer to those in which we evolved". Do you mean we should go back running naked in the savannah?
It's difficult to understand if I am one of these chronological snob because I don't know what you believe we are snobbing.

Chronological snobbery. I like this. Mind if I keep it?

For a different take on writing a book about your experience surviving breast cancer, has anyone read Geralyn Lucas' book, Why I Wore Lipstick To My Mastectomy?

I was having lunch at a fast food chain today which runs CNN on a wall monitor with subtitles, no sound and they were interviewing her about a gene test she had done on her daughter, Skye. I think this is for one of the BRCA mutations. Fortunately, the test came back negative.

Evidently, she was the featured speaker last Sarurday at Mather Hospital on Long Island.

http://www.northshoreoflongisland.com/Articles-i-2010-09-30-85499.11211…

She may be in the news a bit for the next couple weeks because a movie based on her book is coming out on Lifetime.

I found this article at the Mayo Clinic website on the BRCA gene test.

http://www.mayoclinic.com/health/brca-gene-test/MY00322

A search on CNN came back negative, so any article they post on this interview hasn't shown up yet.

By squirrelelite (not verified) on 01 Oct 2010 #permalink

Oops!

I noticed the movie actually came out four years ago and is out on DVD. But, it will be available for online streaming October 11.

By squirrelelite (not verified) on 01 Oct 2010 #permalink

There is a good deal of vociferous tone here which is curious to me; I will make mention of one piece of incorrect information @168

"By the way, humans have been genetically modifying there food for thousands of years" this is not correct. The modification of organisms as is referred to by the acronym "GMO" refers to the invasive as follows...

1.The scientist finds and isolates the gene with the desired genetic characteristics. This process is called mapping.
2.The scientist makes several copies of the isolated gene. The copying process is called PCR.
3.The scientist transfers the desired genes to the plant's own genes (using a piece of plant tissue). When the scientist wishes to insert the desired genes into the plant - there are 3 options. He or she can use a 'gene canon', a soil bacteria or a material called protoplast. The methods of gene insertion are called 'transformation'.
4.The scientist creates a new plant from the genetically modified plant tissue.
5.The scientist checks that the inserted genes function as expected.
6.The scientist also checks that the inserted gene appears in the plant's progeny, that is - in the seeds.
http://www.bionetonline.org/english/content/ff_tool.htm

Humans have certainly not been doing this for 1,000's of years. As many of those in this thread are well versed in progressive and methodological scientific approaches, you will find little or no testing has occurred in the evolution of GMO's.

@Mike Brunt

Humans have most certainly been genetically modifying plants and animals for millennia, though admittedly not in the fast-turn-around way that you describe, which is relatively recent.

All breeding and cultivation involves genetic modification. You select plants or animals with the trait(s) you want and breed/cultivate them with others that share those traits. This results in the selection of certain genes being passed on, while others are not (or at least, in smaller and smaller amounts). Sure, it is a lot slower than isolating a gene and injecting it into the cells of another plant/animal or using a retrovirus or some other means, but it is genetic modification nonetheless.

The bananas that we have today are most certainly not genetically the same as if the plants had been allowed to go on their own merry little reproductive way. We cultivated them to be larger, creamier and seedless. Now, the banana that you buy in the supermarket is most likely a Cavendish banana, which is a clone of all other Cavendish bananas. The problem is that now that species of banana in danger of becoming extinct. This was achieved through cultivation, not through needles, pipettes and such in a lab.

GMO stands for Genetically Modified Organism. What you described is GEO, Genetically Engineered Organism. This is what was pounded into us at a talk by the botanist whose lab was torched. Since he is now being accused of using Genetic Engineering, he has switched to it.

Mike Brunt probably has the same intellectual ability as the guys that torched the building and destroyed the rare seeds in its seed bank. He has not replied in response to the papers that women who wait or refuse treatment for breast cancer are often dead in ten years.

Obviously someone else to ignore.

One of my favorite sources on how wild plant species were modified into the modern food crops like corn, wheat and rice is the Scientific American Library book The Emergence of Agriculture by Bruce D Smith.

It talks about using genetic comparison and archaeological data to identify the wild species these plants were derived from.

http://isbndb.com/d/book/the_emergence_of_agriculture.html

I also enjoyed listening to a recent Skeptically Speaking podcast in which

University of Florida researcher Kevin Folta discusses what an expert in plant genomics thinks about the claims and controversy surrounding genetically modified foods.

http://www.skepticallyspeaking.com/episodes/71-genetically-modified-foo…

It also has some good music from Monty Harper and the "Songs From the Science Frontier" project.

By squirrelelite (not verified) on 01 Oct 2010 #permalink

Incorrect, Mike.

Humans have been genetically modifying the organisms used for food for centuries/millennia.

It's called agriculture, which makes extensive use of selective breeding, emphasizing hereditary (genetic) traits favoured by the agriculturist.

Just because it's not done by someone in a 21st-century laboratory doesn't mean it's not genetic modification

By Composer99 (not verified) on 01 Oct 2010 #permalink

Composer99, thank you! People ranting about how dangerous genetically modified foods are is one of my biggest pet peeves. Do these people think that corn just sprang up overnight with that huge ridiculous seed head? That cows ran right from the wild into a milking barn?

Not much to say in an on-topic vein that hasn't already been said. More magical thinking from HuffPo, quelle suprise.

By derelicthat (not verified) on 01 Oct 2010 #permalink

jane said: "The way some people snarl about "University of Google," I wonder how they buy a car."

Good point! When I buy a car I avoid sites like Kelley Blue Book and Edmunds, as they're mainstream and probably in league with Big Auto. What I do is visit a bunch of dealers' websites and blogs to collect anecdotes and opinions from people who have alternative views I agree with. None of that elitist snobby evidence-based hoo-hah for me!

By Dangerous Bacon (not verified) on 01 Oct 2010 #permalink

Funny, the car salesman vs MD comparison.

You understand, of course, that physicians are not permitted to dispense medication for a fee. What about naturopaths?

Who, precisely, is in this for the dosh?

It's not just that she's willfully deluded, she's also a liar.

She claims to have utterly rejected conventional medicine, when in fact the extremely conventional surgery she had is why she can write lie-filled bullshit for HuffPo.

This reminds me: Didn't Suzanne Somers also claim to have foregone conventional (aka real) cancer treatment in favor of the brand of woo she's currently hawking?

Why, yes, yes she did. Except that she actually had valley fever, which attacks people with compromised immune systems -- and considering the sixtysomething Somers gobbles steroids the way most folks eat candy, her immune system was and is almost certainly compromised.

Meanwhile, here's what happens to someone who, unlike Somers and Quinn, really did reject conventional cancer treatment: An early, painful, preventable death.

So, of our sample of three cancer patients who claim to be better at fighting cancer than somebody like Orac, we find that one really didn't have the disease, another was lying when she said she wasn't getting conventional treatment, and the one who actually did have cancer and did refuse to treat it using conventional medicine died a hideous death as cancer was allowed to riddle her body.

I believe there's another example out there in the Respectful Insolence files of a woman whose cancer may well have been dealt with during (and by) the biopsy, as it was caught at a very small, very early stage, but I can't remember who that person was. But again, the biopsy counts as conventional medical treatment, and that, rather than the subsequent woo, is what saved her.