Respectful Insolence

So chemotherapy does work, after all

One thing I’ve learned over the years is that there is a palpable hostility in the “alternative” medicine world towards chemotherapy. Many are the times I’ve posted examples, including rants by Mike Adams, cartoons, and a post about what I like to call the “2% gambit” that claims that chemotherapy only contributes 2% to survival in cancer. Basically, that last gambit uses and abuses a rather mediocre study whose design almost seemed intended to minimize any detected benefit from chemotherapy. On second thought, strike the word “seem.” It was pretty much designed to minimize any apparent benefit from chemotherapy, as it left out chemotherapy-responsive tumors without a good justification and didn’t look at ten year survivals, where chemotherapy effects are often more apparent.

Sadly, it’s not just the alt-med cranks who harbor a hatred of chemotherapy. There are otherwise rational people, some of them doctors even, who don’t like chemotherapy at all either, for example, Reynold Spector, who blighted Skeptical Inquirer with a depressingly nihilistic view of medicine, which earned him a heapin’ helpin’ of some rough and ready not-so-Respectful Insolence. I get it. I do, believe it or not. I understand why chemotherapy is one of the easiest aspects of science-based medicine to demonize. There’s no doubt about it; chemotherapy is toxic. Depending upon the specific drug, it can make your hair fall out, induce vomiting, result in immune suppression, and occasionally result in death. However, when weighed against the prospect of dying from cancer, the side effects, while extensive, can be considered in many cases to be an acceptable risk considering the alternative. Still, the toxicity of current cancer treatments clearly fuels the burgeoning alternative medicine cancer cure industry. People are afraid of chemotherapy and are thus susceptible to promises that they can be cured of cancer without chemotherapy.

That’s one reason why I’m always interested in studies that try to look objectively at the efficacy of chemotherapy in decreasing mortality from cancer. A doozy of just such a study was published yesterday. You’re not likely to see it on Mike Adams’ site, Joe Mercola’s site, or any other alt-med site, except in order to attack it or lie about it, which is why I can’t resist this little pre-emptive strike in which I discuss the study.

Basically, what I’m referring to is a large meta-analysis that appeared in The Lancet yesterday as an E-pub ahead of print. Funded by Cancer Research UK; British Heart Foundation; UK Medical Research Council, this study was carried out by the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) at the Clinical Trial Service Unit at the University of Oxford, United Kingdom and entitled Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100 000 women in 123 randomised trials. Before I discuss the meta-analysis itself, I think it’s worth briefly noting exactly what the EBCTCG is:

400,000 women in 400 randomised trials
Every five years, CTSU brings together updated data on each woman randomised into all trials of the treatment of operable breast cancer. The EBCTCG process was initiated in 1983 and the first cycle collected data for hormonal and cytotoxic therapy in 1985 [6a, 6b]. The collaboration was extended in the 1990s to all aspects of early breast cancer management [7a - 7f] and its results informed the year 2000 NIH consensus development conference on the treatment of early breast cancer [8]. The 2005 report on chemotherapy and endocrine therapy [9a] shows the substantial effects on 15-year survival of the chemotherapy regimens (such as about 6 months of FAC or FEC in women aged <70) and hormonal regimens (such as at least 5 years of tamoxifen in women with ER+ disease) that were being tested in the 1980s. The 2005 report on surgery and radiotherapy [9b] shows that treatments that substantially improve local control have little effect on breast cancer mortality during the first few years, but definite effects by 15 years.

Results from the fifth cycle are emerging (ER-poor [10a], DCIS [10b], aromatase inhibitors [10c], endocrine therapy [10d], radiotherapy after breast-conserving surgery [10e], chemotherapy [in preparation]) while the sixth (2010-2012) cycle of data collection is in progress.

It’s really quite an incredible effort, looking as it does at patient-level data for so many women in so many clinical trials. I sometimes say about meta-analyses the prototypical complaint about meta-analyses, namely that the quality of the output is critically dependent on the quality of the input. In other words, “garbage in, garbage out.” However, the inclusion criteria for the EBCTCG are actually pretty stringent. More importantly, the EBCTCG has access to unpublished data and patient-level information. As is explained here, this is very important as a means of avoiding bias as much as possible:

Where there are several trials that address similar, although not necessarily identical, questions, it is possible to obtain estimates of the differences between treatments by combining the data from them. This approach is much more precise than the estimates given by any individual trial. Inevitably, trials with extreme results tend to receive more attention than those with more moderate results. This produces a natural tendency for unduly selective emphasis on those trials or subcategories of patients where, by chance alone, the results are misleadingly positive or misleadingly negative. Most such biases can be avoided by appropriate combination of the results of all trials that address similar questions. This combination cannot be done satisfactorily from published data alone (Stewart and Parmar 1993), and the inclusion of unpublished as well as published data is necessary to avoid bias. Furthermore, the information available from the published trials is not sufficient to allow a uniform analysis of all the available data with appropriate stratification for factors that will affect survival such as age, time since diagnosis, or nodal status. Thus, analysis based on individual patient data is necessary.

The EBCTCG also goes to great lengths to try to include data from every randomized trial ever published, or an unbiased subset of them, in order to try to minimize selection bias that all too often results from too rigid selection criteria used for meta-analyses. All in all, it’s an enormous effort.

The name of the EBCTCG means exactly what it says, too. Basically, by “early” the EBCTCG means early stage breast cancer; i.e., breast cancer that can be cured by surgery alone. By concentrating on this subset of breast cancer the EBCTCG is able to concentrate on what factors impact survival in conjunction with surgery. The study that was published yesterday was thus designed to estimate the effect of adding various chemotherapy regimens to breast cancer treatment on survival. There are two common chemotherapy regimens for breast cancer. The first, commonly known as ACT, consists of Adriamycin (doxorubicin) and Cytoxan (cyclophosphamide), given together for several doses, followed by a taxane, such as paclitaxel. The other common regimen, more often used in Europe than here in the U.S., is known as CMF and consists of cyclophosphamide, methotrexate, and 5-fluorouracil.

Overall, this meta-analysis involved over 100,000 patients involved in 123 randomized trials over 40 years, and the authors made these comparisons: (1) taxane-based versus non-taxane-based regimens (data for 33 trials, begun in 1994-2003); (2) any anthracyclinebased regimen versus standard or near-standard CMF (20 trials, begun in 1978-97); (3) higher versus lower anthracycline dosage (six trials, begun in 1985-94); and (4) polychemotherapy versus no adjuvant chemotherapy (64 trials, begun in 1973-96, including 22 of various anthra cycline-based regimens and 12 of standard or near-standard CMF). Several meta-analyses were performed, which produced five main findings:

  1. Standard CMF and standard 4AC (ACT without the “T,” which is an older chemotherapy regimen used before taxanes were developed) were roughly equivalent in efficacy. Both of the roughly halved two-year recurrence rates and resulted in a proportional decrease in recurrence over the next eight years by approximately one-third. Overall, breast cancer mortality rates were reduced proportionally by 20-25%.
  2. Regimens were lower chemotherapy doses per cycle were less effective.
  3. Regimens with a lot more chemotherapy than the old standard 4AC (but not so nasty that they required stem-cell rescue) were somewhat more effective. They further decreased breast cancer mortality by 15-20%. the most prominent of these regimens is 4AC plus four cycles of “T” (a taxane), which became the standard of care for node-positive breast cancer after taxanses were developed.
  4. In all chemotherapy comparisons, the ten year overall mortality was reduced because there was not very much excess mortality due to causes other than breast cancer during the first year.
  5. In all meta-analyses looking at taxane-based regimens or anthracycline-based regimens (doxorubicin is an anthracycline), the proportional reductions in early recurrence, any recurrence, and breast cancer mortality were more or less independent of age, nodal status, tumor size, or even estrogen receptor status.

This latter finding is actually somewhat surprising, because more recent trials suggest that ER(+) tumors, although sensitive to antiestrogen therapy such as Tamoxifen, are less sensitive to chemotherapy than ER(-) tumors. Yet according to the findings of this meta-analysis, ER(+) and ER(-) tumors, the reduction of approximately one-third in mortality due to breast cancer due to modern chemotherapy regimens like ACT is the same. The autnors conclude:

While awaiting the results of these new trials, it appears that ER status, diff erentiation, and the other tumour characteristics available for the present meta-analyses had little eff ect on the proportional risk reductions with taxane-based or anthracycline-based regimens. The more effective of these regimens offer on average a one-third reduction in 10-year breast cancer mortality, roughly independently of the available characteristics. The absolute gain from a one-third breast cancer mortality reduction depends, however, on the absolute risks without chemotherapy (which, for ER-positive disease, are the risks remaining with appropriate endocrine therapy). Although nodal status and tumour diameter and differentiation are of little relevance to the proportional risk reductions produced by such chemotherapy (and by tamoxifen therapy), they can help in treatment decisions as they are strongly predictive of the absolute risk without chemotherapy, and hence of the absolute benefit that would be obtained by a one-third reduction in that risk.

One aspect of this trial that needs to be emphasized is that there were very few trials of patients with ER(+) tumors with favorable histology. These are the sorts of tumors that probably do not benefit much, if at all, from chemotherapy and can be effectively treated with estrogen-blocking drugs. There are a number of clinical trials right now looking at this very question, using signatures based on a number of genes to classify tumors as high, low, or intermediate risk. The Oncotype DX assay produces one such signature.

The bottom line is that, contrary to what you will hear from cranks and alt-med supporters who believe in “alternative” cancer cures, in the case of early stage breast cancer, chemotherapy saves lives. In women with breast cancer, it decreases the risk of their dying from breast cancer by approximately one-third. This is nothing to sneeze at, as it means thousands upon thousands of women who would have died but did not, thans to chemotherapy. This study simply represents yet another in a long line of studies, another strand in the web of evidence, that support the efficacy of chemotherapy in prolonging the lives of women with breast cancer. It’s not perfect, and it has a lot of potential complications, but it works and in many cases it’s better than the alternative.

While it’s true that chemotherapy decreases a woman’s risk of dying from her breast cancer, the vast majority of women do not individually benefit from chemotherapy. That decrease in risk is based on populations and probabilities. We can’t predict in advance whether chemotherapy will help in an individual patient with an acceptable degree of accuracy, only apply probabilities based on population data. In order to save that one-third, we have to treat most women, who segregate into three groups: those who would have done well without chemotherapy, who are treated unnecessarily; those who would do poorly regardless of chemotherapy, who are also treated unnecessarily; and those for whom chemotherapy is the difference between life and death. What would be far more effective (and far more desirable) would to be able to identify in advance which women would do poorly without chemotherapy but are likely to respond to chemotherapy. Fortunately, with the emerging era of genomic medicine, we are finally developing the tools necessary to identify these women. When that happens, we’ll finally be able to make sure that only the women who can be saved by chemotherapy are the women who receive chemotherapy. I’m hoping that day is not too far off.

Comments

  1. #1 Darwy
    December 7, 2011

    My sister’s breast cancer was ER(+), however she was already Stage 4 when it was found & removed. She went through standard chemo and responded reasonably well; her tumors went from 5 cm down to less than 1 (they were present on the ovaries and liver). But when she switched over to Tamoxifen during the pause in standard chemo, they came storming back larger than before. All in all, she went 18 months with the disease before we lost her Dec 21st 2005.

    It’s hard to believe it’s been nearly 6 years already. It still feels like yesterday.

  2. #2 herr doktor bimler
    December 7, 2011

    I can’t say I’ve known anyone who opted for a course of chemotherapy and later announced “Oh that was a mistake — I wish I’d never had the therapy and lived for that extra 6 months / 2 years / 30 years and counting”.

  3. #3 Clay
    December 7, 2011

    It’s too bad that Steve Jobs wasn’t a reader of your blog. It might have led him to a wiser course.

  4. #4 Jojo
    December 7, 2011

    I was the primary caregiver for my mother as she went through chemo this summer. I understand why people are so afraid of chemo. It was very hard on her, and made her very sick. I would not wish that experience on even my worst enemy.

    However, it was worth every additional day that she may get to spend with my 5 year old son. It makes me feel a little better knowing that research continues to support the treatment she went through.

    It’s funny, I found and continued to read Respectful Insolence for all of the Anti-vax debunking and snark. However, everything I learned about breast cancer here really helped me emotionally when my mother was diagnosed with breast cancer. So, thanks Orac, for providing an education and comfort in addition to great entertainment.

  5. #5 Dianne
    December 7, 2011

    I’ve seen a lot of people get chemo for a lot of different cancers. I’ve also seen responses ranging from “I feel SO much better! When can I have more!” to “You mean that’s it? I got all worried about side effects for nothing!” to “That was horrible! I don’t care if I die-I just don’t want to go through that again.”

    Chemo isn’t homeopathy-it’s active, dangerous drug. But it doesn’t necessarily lead to the “puking your guts out and wanting to die” scenario that people who want to sell you “natural” treatments pretend. Quite a lot of people find it tolerable and it can improve quality of life as well as extend life expectancy and improve cure rates.

  6. #6 palindrom
    December 7, 2011

    Dianne @5 — Homeopathy enthusiasts over at the Wretched Hive (Huffington Post) occasionally point out that their treatments have no side effects. As far as I’m concerned, that’s the only one of their claims that’s credible. Problem is, the adjective “side” isn’t really necessary.

    On another point, I was following one of the links above (“better than the alternative”) and read about the Daniel Hauser case, which happened before I tuned into all this. As far as I could tell, in the end the boy was treated and declared cancer-free a year later. I hope that’s accurate, and that he’s still OK! It’s so rare that those gnarly “mom knows best” things actually do end well.

  7. #7 Shelby
    December 7, 2011

    Er, sorry, but there’s a bit of a typo in there. Instead of “hair fall out,” you put, “hear fall out.”

    Otherwise, another great article. :) I’ve, too, have heard a lot of people say that chemotherapy is BS and is much too dangerous. I wonder how effective their alternative medicine is if they get cancer themselves.

  8. #8 Orac
    December 7, 2011

    You do realize, don’t you, how much spelling/typo Nazis irritate the crap out of me, even when they’re telling me I wrote a good post.

  9. #9 g724
    December 7, 2011

    Yo Orac- Apologies for the digression but: Do you have any interest in going after outrageous veterinary quackery? Someone I frequently run into on another blog reports she has run into an individual who has been engaging in blatant fraud re. health care for horses in boarding stables. “Activating their DNA,” remote “healing” by whatever magical nonsense, faked claims of cures for various diseases of horses, secret knowledge and huge fees for “service” included, and last but not least, discouraging people from getting their horses vaccinated or going to real vets. Where should someone go to turn in a blatant veterinary quack?

  10. #10 Prometheus
    December 7, 2011

    I think that one of the reasons lay-people are so susceptible to the outdated “alt-med” canards about cancer therapies being terrible and ineffective (they once were, about fifty years ago) is that the science is so nuanced and detailed. It doesn’t have a good punch line, a slogan or even a beat you can dance to.

    Most people expect to hear – “We found a cure for cancer!”, because so many people still believe that “cancer” has a single cause and should respond to a single treatment The “War on cancer” rhetoric hasn’t done the field of oncology any favors, as it (at least early on) promised more than could be delivered.

    A number of “alternative” cancer therapy promoters have claimed on this ‘blog that their treatments are “natural”, not to mention safe, effective and free from side effects. Yet, to a one, their supporting “data” are only testimonials or – at best – open-label uncontrolled “studies” with no indication of how many were treated to get the number of “successes”.

    Anecdotes such as testimonials are fine if you’re looking for a good mechanic or plumber, but they can be (and are) deceptive. For example, I had a great uncle who was diagnosed (in 1972) with pancreatic cancer and went on to live for eleven years after diagnosis, finally dying at the age of 73. His only “therapy”? Jack Daniels whiskey.

    Now, does that mean the folks in Lynchburg, Tennesee can claim that their product is an effective treatment for cancer of the pancreas? Probably not. More likely, he was misdiagnosed. I don’t think that even the “alt-med” crowd is so far from reality that they’d believe whiskey is effective for treating cancer.

    Still, people – especially people who have cancer or loved ones with cancer – want a “cure” for cancer that doesn’t involve the unpleasantness of current therapies and – even more importantly – doesn’t involve probabilities.

    I think what often scares people most about cancer – even more than the prospect of surgery, radiation or chemotherapy – are those damned probabilities. You know, stuff like “the five-year survival of people with stage X disease treated with regimen ABC is 65%”.

    People have become so used to modern medicine being so safe and effective, so used to hearing things like “gorillacillin is effective in 99% of all infections…” and “the risk of serious adverse side effects is 1 in ten million” that they are often shocked to their core when they hear their chance of being alive in five years being given odds that seem more appropriate for Los Vegas than modern medicine. They want a treatment that is effective and permanent; and so do we all, especially oncologists and cancer researchers.

    However grim current cancer therapies might be – and there is reason for great enthusiasm, given the strides being made every year – they are still better than doing nothing at all or, worse yet, trying some “alternative” therapies. Remember: what happens to “alternative medicine” when it is proven to work? It becomes just plain “medicine”.

    Prometheus

  11. #11 Irene
    December 7, 2011

    Uh-oh. Zombie Hitler is going to get really, really pissed off at this comparison of Nazis with mere typos!

  12. #12 Dr. Brocco Lee
    December 7, 2011

    “So chemotherapy does work, after all.”

    That it works or doesn’t work are really generalizations. Sometimes it does sometimes it doesn’t, what the heck, sometimes it even kills you before the cancer does. Sometimes it makes the symptoms go away but not the root of the problem, and soon after it returns. Chemotherapy is a treatment that merely addresses the symptoms. When it works it only takes away the tip of the iceberg.

    Of what use is to undergo chemotherapy and surgery if your diet is not balanced and full of poison devoid of nutritional value? …not to mention exposing yourself to carcinogens by other means.

    Alternatives
    ————

    A mini documentary by David Triplett in which he documents his treatment of melanoma using cannabis (flower) oil. He was advised by his doctor to undergo “chemotherapy” though the use of some toxic creams and after researching he found an alternative which got rid of the cancer without chemo nor surgical removal.

    http://www.youtube.com/watch?v=JPm0Jq9bj98

    Another documentary that is really interesting is “Forks over Knives” which explore studies on cancer of different populations and the links to diet.

  13. #13 Jojo
    December 7, 2011

    Shelby @7 It also would have been helpful if you didn’t have a typo in your post complaining about a typo.

    “I’ve, too, have heard…”

    Isn’t there an internet law about all comments complaining about typos always containing typos?

  14. #14 Calli Arcale
    December 7, 2011

    Jojo — that would be Muphry’s Law (yes, spelled like that).
    http://en.wikipedia.org/wiki/Muphry%27s_law
    “If you write anything criticizing editing or proofreading, there will be a fault of some kind in what you have written.”

    Palindrom — “Homeopathy enthusiasts over at the Wretched Hive (Huffington Post) occasionally point out that their treatments have no side effects. As far as I’m concerned, that’s the only one of their claims that’s credible.”

    And even that’s not always true. There was a recent uptick in infants admitted to ERs with atropine poisoning not too long ago. It’s unusual, and it was traced to the use of homeopathic teething drops. The drops were supposed to contain absurdly diluted belladona (nightshade). Problem is, it wasn’t absurdly diluted; there was enough there to cause atropine poisonings. Fortunately, despite its reputation, atropine is a fairly well understood chemical (it even has legitimate medical uses) and poisonings are treatable. This was apparently an accident; however, Zicam is a known example of a faux homeopathic remedy — though it meets the legal definition of a homeopathic remedy (it’s in the homeopathic pharamcopeia), 2X Zinc is really not very dilute at all, and can cause loss of smell.

    Homeopathy *should* have no side effects. This leads people to be a bit less cautious with it than perhaps they should, as manufacturers may make mistakes, and as the term can and is misused (irony, there) by con artists wanting to evade FDA scrutiny.

  15. #15 Narad
    December 7, 2011

    Do you have any interest in going after outrageous veterinary quackery?

    You could try running it past SkeptVet.

  16. #16 puppygod
    December 7, 2011

    Of what use is to undergo chemotherapy and surgery if your diet is not balanced and full of poison devoid of nutritional value? …not to mention exposing yourself to carcinogens by other means.

    Because it can save your life / extend your survival chance / improve your quality of life? You do realize that at time when you consider chemotherapy it is usually many years too late to prevent cancer by lifestyle changes?

    And regarding lifestyle changes, there is very interesting article at BBC about cancer causes: http://www.bbc.co.uk/news/health-16031149

    Unsurprisingly, tobacco and diet are listed as major offenders.

    Alternatives

    Anecdotes are not data, show us hard facts not propaganda… Actually, I’m not going to bother with addressing that. Just read comments in almost any other thread.

  17. #17 palindrom
    December 7, 2011

    My pet duck is sounding kind of hoarse. I think I’ll take him to a quack veterinarian.

  18. #18 ChemoMan
    December 7, 2011

    BL@12
    Have you got any more of those fantastic sciency youtube clips you could put up as citation?

    So Chemo works huh. No surprise here, millions of us knew this already because it has worked for us. 3 years and 6 months for me now and I am bloody grateful to big Pharma for giving me the chance, all you alties can go and stick coffee up your arse. I also hope Morgan G, Ward R and Barton M of ‘The contribution of cytotoxic chemotherapy to 5-year survival in adult malignancies’ fame took note of this study, it certainly was intellectually sound and honest which is more than can be said for that sad study.

    Thanks Orac much appreciated

  19. #19 Nonsense on Stilts
    December 7, 2011

    Thank you, Orac, for this review. I will pass the link along to a number of my colleagues. The alt world always fails to mention the diseases where chemotherapy is the ONLY cure. Advanced Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma, advanced testicular cancer, and acute leukemia are all cured by chemotherapy. There is no substitute. Chemotherapy is hard and it is toxic, but modern supportive care reduce vastly reduce the side effects and risks. Vomiting is rare now. The incidence of serious, life-threatening infection has been drastically reduced. Most of my patients tell me that their chemo treatments were not as difficult as they feared. Thank you for being a clear, intelligent voice in defense of modern medicine and oncology.

  20. #20 terric
    December 7, 2011

    Palindrom I think I love you.

  21. #21 Neil
    December 7, 2011

    ha ha ha ha ha.. oh gee.You guys really do live in a box together don’t you. And I can’t understand how you think you are a writer Orac. You have very little time for another’s point of view, unless of course two letters appear before the surname, then a bit slack can be given hey? So my point of view is a piece of shit but if a well respected surgeon with over 40 years experience says something, no problem because these people are classified as ‘rational’.

    You need a shower, hug a tree perhaps to find something in you – ‘your heart’ to find some love somehow. In fact, here is something that you will not believe – that hugging trees is actually good for you, but you wouldn’t know because it’s alternative!!

    Once again I got bored after your first section as you have no respect for humanity.You dissect people in two parts like surgery.

    There should be no alternative and conventional. There should be Medicine that works and medicine that doesn’t.

    And as I said previously, if you were confident with yourself and truly believed what you were doing is right, you wouldn’t even mention alternative medicine, but you are clearly afraid of it because even you and your family use it otherwise you would be dead by now. Just what do you actually classify as alternative? Organic food? Massage? Essential oils, Uncontaminated water? Organic vegetable juice? If you are truly against alternative (or whatever you want to call it) then have the guts to live off everything else but – so, for breakfast I would like you to have 16 panadols with tap water; lunch, some toxins and medications of your choice and for dinner some osteo-eze. You are not allowed to exercise like me, because this is alternative isn’t it? And stop depleting what bees are left in the world will you please by not having any honey ever again,this is alternative – leave it for the caring people of the world who understand about health. Even though bees are smarter and more important than your medicines you would not know about this, because it’s alternative!!

    I see above a one Dr Brocco Lee has also mentioned ‘Forks over knives’, but just don’t watch it – it’s alternative!!! It will probably save millions of lives, but it’s alternative!!!

  22. #22 Sarah
    December 7, 2011

    My uncle had liver cancer due to a horrible habit of drinking in his earlier years. Because of chemotherapy, his symptoms lessened and he was able to see his two sons off to college, even though it was from the hospital. Although I do understand that chemotherapy can be considered putting “toxins into one’s body” I think that the loss of hair and sometimes the queasy feelings (in which my uncle often complained about) were worth it, because he was able to live an extra year, when doctors claimed that 7 months was the limit.

  23. #23 Andreas Johansson
    December 8, 2011

    And regarding lifestyle changes, there is very interesting article at BBC about cancer causes: http://www.bbc.co.uk/news/health-16031149

    Articles like that always annoy me. OK, too little fruit and veg increases the risk of cancer. So how little is too little? Is it a linear function where the more fruit the better until you explode? Or is there an adequate level above which increased consumption has no effect? Or what?

  24. #24 puppygod
    December 8, 2011

    @22 Andreas Johansson

    Articles like that always annoy me. OK, too little fruit and veg increases the risk of cancer. So how little is too little? Is it a linear function where the more fruit the better until you explode? Or is there an adequate level above which increased consumption has no effect? Or what?

    It’s a popular news article aimed at general public. Of course they are not going into details. There is a link to the original report at the bottom of the article. You can find there excerpts like this:

    The advice from the Department of Health (2005) is to increase the average consumption of a variety of fruit and vegetables to at least five portions per day, corresponding to 5 × 80 or 400 g per day. In this section, we estimate the population-attributable fraction (PAF) of these five cancers (and of all cancer) that results from consumption of fruit and vegetables lower than this target.

    Just two mouse clicks away.

  25. #25 Seti
    December 8, 2011

    I’ve had chemo, and really it wasn’t too bad. I know that for some people it’s worse, but there’s a lot the medics can do to damp down the worst symptoms, and taking care of yourself, resting and eating the right stuff (for you) helps.
    I really think we need to shout about this, and also how curable cancer is now. People still have a huge fear of it, and lazy journalists always use the word “gruelling” to describe chemo (really – I’ve never seen another adjective attached to it!) OK, it’s no picnic, but who ever promised you a rose garden?

  26. #26 MI Dawn
    December 8, 2011

    OK, where the heck did “neil” come from? He obviously forgot HIS meds when he posted.

    @Neil: I’ll say this in short words, because obviously Orac’s technological terms are too tough for you.

    Eating well (lots of fruits and vegetables, decrease fats, watch proteins, increase fiber, etc) are NOT alternative. Any normal doctor recommends this because IT IS A PART OF DOCUMENTED, RESEARCHED PROOF THAT IT HELPS.

    Exercise, stopping smoking, drinking in moderation are ALSO not alternative. I don’t know what kind of doctors YOU go to, but I’ve never been to a doctor who didn’t recommend these things because they are NOT alternative medicine.

    However: There is very little proof that “organic” foods are better than the same foods not labeled organic. Filtered water is not better than most municipal waters (of course, exceptions may occur with water line breaks, but then at least the municipality warns the people to use bottled water/boil water until the supply is tested and found safe again.)

    Massages are nice. I like massages, and essential oils often smell nice. They don’t cure anything except maybe muscle tension. Still not alternative unless you’re claiming they cure all sorts of health problems.

    Alternative medicine are treatments that have not been proven effective against the disease state they are claimed to cure/treat. Or they go against all logical sense, like homeopathy (Avogadro’s number, anyone?). Or they claim to cure things they can’t, like chiropractors curing diabetes by spinal manipulation. Theraputic touch. Reiki. THOSE are alternative medicines.

    As the saying goes: do you know what we call alternative medicines that are tested and proven to work? Scienced-based medicine! Anecdotes aren’t data. Scientific PROOF will change anyone’s mind here. Orac says that, we all say that. Give us proof something works, and “allopathic” medicine will accept it.

  27. #27 Vicki
    December 8, 2011

    Neil:

    In saying that there should be no alternative, only medicine that works and medicine that doesn’t, you are telling Orac something he has told us many a time. But I suppose that’s not surprising, given that you boast of having gotten bored partway through reading the post you comment on. If you looked around here a bit, you’d know that one of Orac’s objections to “alternative” medicine is that its promoters won’t define what it includes, and move the boundaries for rhetorical purposes.

  28. #28 MI Dawn
    December 8, 2011

    Darn. Wrote a long response to Neil that hit moderation. Oh well, I know Orac will release it when he can…

  29. #29 Svlad Cjelli
    December 8, 2011

    Alle Ding’ sind Gift. ¯\_(ツ)_/¯

  30. #30 Lawrence
    December 8, 2011

    Yes Neil, there is medicine that works (backed by published studies, replicated results, etc) and crap that doesn’t – which “woo-docs” call alternative medicine.

    If what they did was proven to work, it wouldn’t be “alternative” it would only be medicine. Obviously, you’ve glossed over or just ignored the fact that diet & exercise has been a part of the modern medical practice for quite some time.

  31. #31 MikeMa
    December 8, 2011

    I think Neil’s objection is that, in the absence of functional alternatives, diet and exercise appear higher on the wooist’s list of recommendation. Maybe if we could somehow elevate the idea of diet and exercise, Neil would be happier with SBM.

  32. #32 Edith Prickly
    December 8, 2011

    What’s that I smell? Ah, it’s another organic vegan brain-fart from our newest altie troll! Really Neil, it’s like someone ordered you from an alt-med stereotype catalog. There isn’t a single idea in that post that hasn’t been flogged to death previously by other crunchy granola types who believe that the right diet can magically protect you from all illness and misfortune.

    The reality is that there is nothing “alternative” about the notion that following a healthy diet and exercising is good for you. As Orac has written many, many times, that’s been standard medical advice for decades and is supported by plenty of reliable research. Alties have co-opted the advice on diet and exercise and then taken it to absurd extremes, mostly to sell unnecessary vitamin supplements and dubious “immune-boosting” treatments to credulous people. If you can cite some credible research showing that diet works better than chemotherapy for treating cancer, please share it. Youtube videos don’t count.

  33. #33 Dianne
    December 8, 2011

    The basic problem with recommendations concerning diet and exercise is this: people won’t follow them. If we had a drug with a compliance rate as poor as that of most diet recommendations, we’d abandon it as hopelessly poorly tolerated. Even for extreme cases such as diabetes, where an immediate benefit can be seen, it’s virtually impossible to get people to be really compliant with diet. Hence, the search for better tolerated treatments. Like, say, statins or metformin. Neither is perfect, but you can get people to actually take them. Which makes them far more helpful than recommending diets that people simply can’t follow.

  34. #34 flippertie
    December 8, 2011

    I had 7 monthly sessions of chemo, followed by remission, followed by more chemo, and then a huge dose to entirely kill off my bone marrow before a transplant.

    It was a nasty scary experience, but I’m alive. It was toxic and it damaged me, but I’m alive. It was traumatic for me and my family, but I’m alive. My wife has a husband, my daughter a father, my parents a son, siblings a brother.

    When I went in for the transplant I signed a waiver saying I knew there was a 1 in 4 chance the drugs would kill me. But that’s better than a 100% chance that the leukaemia would in a slightly longer time frame.

    It changed my life. I’m a slower, physically damaged, more accepting person than I was before it happened. But among the few things that still get me worked up to boiling frustration and anger are well meaning idiots who preach that cancer is cause by ‘self hate’ or repressed anger’ some similar platitude, and those who tell me I would have been better off trying natural cures, diets and treatments which wouldn’t have been so hard on my body.

    Sure chemo’s harsh – but it works, and it’s a lot easier than it was a generation ago, and it’s only going to get better. Sure it’s harsh and it kills some people – but they wouldn’t be taking it if they had other plausible choices – they were dying anyway. Sure it’s harsh – but so’s dying early.

    Cancer’s hard and forces hard choices, but I’m glad I chose chemo and a couple of decades more life (insha’allah ;-) over natural foods, reiki, and an inscription reading “1963 – 2006″

  35. #35 Andreas Johansson
    December 8, 2011

    It’s a popular news article aimed at general public.

    I’m part of the general public (at least as far as medicine and health are concerned). If it leaves me confuzzled, I figure it probably so leaves most people.

  36. #36 chris
    December 8, 2011

    Am I alone in doubting everything? Alt med is rubbish; and I’ll believe in chemo when I see the huge “CURE FOR CANCER” headline on the front page of the Times. There are too many ways to nudge the results in the tests. For-profit pharma knows them all.

  37. #37 Dianne
    December 8, 2011

    I’ll believe in chemo when I see the huge “CURE FOR CANCER” headline on the front page of the Times.

    Been there. Done that. Don’t you remember angiogenesis inhibition? Hailed in the popular press as the cure for cancer. It’s not. It’s another useful tool, but not the cure for cancer. Which is unsurprising since it would be a lot more surprising if anything were THE cure for the multiple diseases that go under the heading of “cancer.” There will never be A cure for cancer any more than there will ever be A cure for infectious disease: it’s simply not a single problem with a single solution. So don’t believe the popular press’ declaration of a cure any more than you believe the alties. Or Merck’s for that matter.

    And yes there are ways to manipulate results, but if you really think that imatinib is no improvement over hydroxyurea for CML or that cisplatin does nothing to help cure testicular cancer then you just don’t understand science at all. You’ve gone past skepticism and all the way to denial in your “doubting everything”.

  38. #38 ChemoMan
    December 8, 2011

    chris @36

    You will believe in Chemo if you are ever diagnosed with Lymphoma

  39. #39 Vicki
    December 8, 2011

    Chris:

    That’s like saying you don’t believe in seatbelts because they haven’t completely eliminated deaths in car crashes, and ignoring that the automobile death rate is down significantly even in absolute numbers, and moreso per capita or per million passenger-miles.

    More seriously, I doubt that you doubt everything. At least, I hope you have sufficient confidence in consensus reality to eat sometimes, drink sometimes (water is good), and sleep sometimes (though “eat when hungry, drink when thirsty, sleep when tired” may be difficult). If you have no confidence in any health advice, eat what tastes good. You may not take any drugs, prescription or over the counter, but you probably will use a bandage if you cut yourself.

  40. #40 Chris
    December 8, 2011

    I am personally amazed that people, like chris, still think cancer is just one disease, or that will be one treatment for all of its forms.

  41. #41 TBruce
    December 8, 2011

    Am I alone in doubting everything?

    No, there’s lots of stopped clocks around.

  42. #42 Dianne
    December 8, 2011

    You will believe in Chemo if you are ever diagnosed with Lymphoma

    Or die. There are people out there who chose “die”. If Daniel Hauser had been a bit older he would have been one of them.

  43. #43 Andreas Johansson
    December 8, 2011

    Am I alone in doubting everything? Alt med is rubbish; and I’ll believe in chemo when I see the huge “CURE FOR CANCER” headline on the front page of the Times.

    You doubt everything but would believe obvious journalistic exaggeration? Please grow whatever organ produces consistency.

  44. #44 Nicole
    December 8, 2011

    My aunt has stage 4 colon cancer. Generally regarded as treatable, not curable. She is in chemo to try and help prolong her life by staving off the progression of the cancer. I don’t know what I’d do in her situation- I don’t know if I had cancer that was most certainly terminal if I’d pursue treatment or paliative care or something inbetween. But I do know that I would make an informed decision, one free of woo and snake oil, as well as overly optimistic projections, which many people do not have the option of. I also know that I would make sure to receive the standard of care regarding cancer screenings, unlike my other aunt who is refusing to have a colonoscopy and instead relying on herbs and prayer.

  45. #45 Marie
    December 8, 2011

    Hey folks I am another chemo, radiation, bone marrow transplant survivor (oh yeah also got a new drug via a clinical trial THANK YOU BIG PHARMA you got me in enough remission to get a transplant!) I just want to tell you that I feel fine. None of it was really that bad. As a matter of fact, I am catching up on my scans that aren’t related to my cancer(lymphoma) such as a mammogram. I had one today and it hurt like hell. Much worse than any pain I had as a transplant patient. Seriously. Even a bone marrow biopsy wasn’t that bad. My point is that pain is so individualized. I hate hearing alt med folks who have never had chemo talk about how bad it is. Really?? not for me.

  46. #46 Neil
    December 8, 2011

    @Mi Dawn

    You sound very normal.

    I love the bold part first. If this was true, and you feel so strongly about it, why isn’t nutrition more involved in a Medical Doctors training AND recommend it more to patients? Here is one example of god knows how many – My mother has recently had bowel cancer – not one word about what she eats by her oncologist, not even after her operation! That’s because it is has nothing to do with the food obviously! Ah, yes, I always knew the colon was heavily involved in lifting weights and eye vision, nothing to do with nutrition.

    As for the rest of your report, you haven’t got a clue about health.Water is more powerful than you will know, and more powerful than most medical doctors understand about – only a teeny weeny bit of the planets water is safe for drinking, yet it appears all clear for you to drink. There is a huge disparity between even public water supplies in the world, much of Europe has been against fluoride and so on and so on. If it was safe, why are so many experts against it. You are short on facts big on opinions.

    If you are like a lot of people looking for this ‘proof factor’ all the time you are going to go to your grave unchanged. This is because every person on this planet is different, they are unique. What works for one may not work for another.

    The only people who go forwards in this world and get through the clutter of information/ material wealth around them are those who are proactive and not reactive; they discover things, they learn about things, they practice things, and ahve a go at things. The last time I checked no one ever achieved anything great sitting on their ass on the sofa. The biggest problem is most people have been conditioned and brainwashed – they are a closed shop.

    Do you think it is possible for a human being to survive without not drinking or eating anything for many many years. Is this healthy? I can tell you that it is true, and this person exists, but humanity has brainwashed themselves to limit their ability to the possibilities.

  47. #47 Narad
    December 8, 2011

    Oh, great, a breatharian.

  48. #48 lilady
    December 8, 2011

    @ Narad…It gets worse. The breatharian has all sorts of conspiracy theories…I think Neil is hitting the bottle again.

  49. #49 The Very Reverend Battleaxe of Knowledge
    December 8, 2011

    Oh, great, a breatharian.

    I first learned about them from the Taoist version in one of Barry Hughart’s novels—but they were an object of ridicule even there.

  50. #50 lilady
    December 9, 2011

    The Very Reverend Battleaxe of Knowledge…Yesterday, in the wee hours of the morning he went off on a rant against Orac and I cautioned him about drinking. It’s all about anti-intellectualism, “natural medicine” and our snarky comments.

  51. #51 herr doktor bimler
    December 9, 2011

    Water is more powerful than you will know, and more powerful than most medical doctors understand about

    Is this leading up to an announcement that Brawndo contains electrolytes?

  52. #52 herr doktor bimler
    December 9, 2011

    the Taoist version in one of Barry Hughart’s novels

    I yield to none in my admiration for “Bridge of Birds”.

  53. #53 Narad
    December 9, 2011

    I can tell you that it is true, and this person exists, but humanity has brainwashed themselves to limit their ability to the possibilities.

    C’mon, Neil, is it Jasmuheen, HRM, Koot Hoomi, or some crank of your own devising that is too potent even to speak of before the brainwashed masses?

  54. #54 adelady
    December 9, 2011

    “I don’t know if I had cancer that was most certainly terminal if I’d pursue treatment or palliative care or something inbetween.”

    Something in between works wonders for some. A friend has managed to spin out nearly 10 years. Yes, I’ll have this treatment because …. I want to see my daughter married, then the other daughter, then a grandchild, then a holiday!, then another grandchild.

    She really looked as near death as her doctors warned her she was each time. Several episodes of rush to the hospital because this time really looks like ‘it’.

    But she did all the things she wanted to do. Just one step, treatment, procedure at a time.

  55. #55 Neil
    December 9, 2011

    Anyone interested to answer questions with intelligence without arrogance.
    1) Why do you feel nutrition is not an integral part of a medical doctors training?
    2)What do you think of Henry Gadsden’s( former head of Merck) comments many many years ago when he said that he wanted make drugs available for even healthy people.
    3)Is there really ‘bad cholesterol’?
    4) Vitamin C was successfully used by Medical Doctors many many many years ago to treat diseases? Why not now?
    5) If you were in charge to significantly improve human health in the USA in one year via a government funded program and you had only two choices – which would you choose? a)Selectively position 1 million new orthadox medical Doctors throughout the USA OR b)selectively position 200,000 Naturopaths, 200,000 Nutritionists, 200,000 health Educators in schools, 200,000 Professional Fitness trainers, 200,000 truck drivers delivering organic food to peoples homes every week.

  56. #56 Todd W.
    December 9, 2011

    @Neil

    1) I don’t know what doctors you go to, but my doctor does bring up diet and nutrition at every checkup.
    2) I don’t know enough about the quote or its context, so cannot answer.
    3) Yes.
    4) Perhaps because they realized that much of what they observed was coincidence, and that vitamin C wasn’t actually a wonder drug after all.
    5) I’d probably go with option b, with the change that instead of naturopaths, I’d have real medical professionals. Also, while organic food may be better as far as farming practices go, I haven’t seen any evidence that it is necessarily healthier than food grown in a different fashion, so I wouldn’t place that restriction on things. I’d also replace nutritionists with dietitians. If those changes in option b aren’t allowed, then I’d go with a.

  57. #57 Neil
    December 9, 2011

    Todd – zero from 5.
    1)x Thats not what i asked you
    2)x
    3)x Its a myth
    4)x insufficient
    5)x Again, thats not what was asked. You had 2 options, not the option of changing things to suit yourself. Besides your health strategy has not improved the health of the USA because there it is nothing different than the current system. All you are doing is adding more Doctors and waiting for people who are sick to visit them. Option B is proactive and can only improve the state of health of the population. Einstein did say, keep doing what you have always done and you will keep getting the same results.

  58. #58 LW
    December 9, 2011

    “1) Why do you feel nutrition is not an integral part of a medical doctors training?”

    That should be more reasonably asked of you, Neil. There are a number of people who comment on this site, in addition to Orac himself of course, who are medical doctors (not me, I hasten to add). They don’t “feel” whether nutrition was an integral part of their education; they know that it was.

    You “feel” that nutrition is not an integral part of a medical doctor’s training because you, so far as I can tell, have never met a medical doctor and know nothing about them except the rumors whispered by your alt-med chums.

  59. #59 Viking Warrior Princess
    December 9, 2011

    @ Neil
    “3)x Its a myth”
    and I presume that you can back this up with adequate references? And just to remind you YouTube and HuffPo references are worth diddely squat.

  60. #60 TBruce
    December 9, 2011

    1) Why do you feel nutrition is not an integral part of a medical doctors training?

    It is.

    2)What do you think of Henry Gadsden’s( former head of Merck) comments many many years ago when he said that he wanted make drugs available for even healthy people.

    Businessman being a businessman. You obviously hate businessmen. What are you, a communist?

    3)Is there really ‘bad cholesterol’?

    LDL. LOL. (Couldn’t resist)

    4) Vitamin C was successfully used by Medical Doctors many many many years ago to treat diseases? Why not now?

    It worked very well to treat scurvy. Ask the British Navy. It still does, except that scurvy is extremely rare except in the severely disadvantaged. Was there something else you had in mind?

    5) (long question deleted)

    Neither – option 1 would produce an oversupply of doctors, which is not a good thing. (however, you could send a few of ‘em up to Canada, we’re pretty short of them)
    – option 2 would produce an oversupply of naturopaths, which is also not a good thing. One naturopath, however, is an oversupply.

    Yes, I flunk. I’m honoured.

    P.S. Einstein didn’t say that. He also didn’t say the CORRECT form of the quote which is: Insanity is doing the same thing over and over again and expecting a different result. It’s from AA or NA.

  61. #61 Todd W.
    December 9, 2011

    Subtext is clearly lost on Neil. And his grading assessment? Who’s the one being arrogant? I mean, I did the best I could answering poorly formed questions, especially the last one. Two untenable situations. It’s like if I asked him would he rather be cemented into the pavement in front of an oncoming big rig or stuck on the ledge of a skyscraper with no way to get down but to jump.

    Perhaps Neil has played “Would you rather…” a few too many times.

  62. #62 MI Dawn
    December 9, 2011

    @ Neil: thanks for the compliment, I guess. I can’t say why your mother’s oncologist didn’t discuss diet with her; why don’t you ask him? Maybe he did and she didn’t remember. Maybe he figured her primary doctor would so he didn’t need to. Maybe he just doesn’t care (some doctors don’t).

    Yes, water is important. No one here denies water is important, and that it needs to be as free as possible from bacteria, heavy metals, etc. but just because you get water from a “pure” source does not mean the water is pure. As far as fluoride in Europe – true, they don’t put it in water, because they put it into salt there. They still get supplements.

    I really don’t know what you know about medical training. Every medical program I have met graduates from teaches nutrition. Nutrition is usually integrated into the modules, rather than being 1 specific course. So, no, most doctors don’t have a “course” in nutrition, it’s taught along with other pieces. So I don’t “feel nutrition isn’t an integral part of medical training” when I KNOW it is an integral part of medical training.

    2)citation needed, please, so I can read the comment in context before answering.
    3)I believe that some studies have shown this to be true, but studies are still ongoing. At this time, I will go with yes.
    4)please tell me when this was. My grandfather practiced for many years and I never knew him to use vitamin c (except to treat scurvy). He also recommended a little extra (about 500 mg, IIRC) in winter to decrease the incidence of colds but stopped doing that when more research showed it really had no effect.
    5) get rid of the naturopaths and I’ll choose selection b. Make it nurse practitioners or physician assistants or whatever. But I want someone who doesn’t believe in quack treatments. (and yes, to my shame, I do know many nurses who believe in quack treatments….)

    If I ever get diagnosed with cancer, I’ll make a decision regarding treatment based on research. I’ll definitely use conventional treatments if they’ve been proven effective. I would consider going into a research trial. I might try to improve my diet in some ways (add more fruit/veggies, decrease red meat). But I wouldn’t go to some quack clinic.

  63. #63 T-reg
    December 9, 2011

    That was not a question intended for fact finding or clarification. It was a rhetorical tool being used with the intention of mocking the posters on this thread.

    Neil, do you actually have any idea what is taught in med school? Judging from the fact that you “feel” (not “know“) that “nutrition is not an integral part of a medical doctors training”, I’d say that you are not really aware of what is taught in med school.

    By “bad” cholesterol, did you mean “evil” cholesterol? If so, then yes, it is a myth.

    What a “businessman” whishes to do for his business has usually no bearing upon what a medical doctor practices.

    Anyone interested to answer questions with intelligence without arrogance.

    It’s ironic how your response to those answering your questions is filled Arrogance and shows little intelligence. Are you trying to get some ‘yang’ for your ‘yin’ to ‘harmonize’ your ‘qi’?

  64. #64 Dianne
    December 9, 2011

    1. It is.
    2. Don’t know exactly what he said or the context, but given that life inevitably ends in death, I’d say that there are situations in which “healthy” people might benefit from drugs.
    3. I can’t top TBruce’s answer. If you have some evidence that high levels of LDL are not detrimental to health, please present it.
    4. Yes, vitamin C has been successfully used to treat…scurvy. It doesn’t work in virtually any other context. Also get with the program. The miracle vitamin of this decade is D not C.
    5. Ick. None of the above. The US is adequately supplied with doctors so option A is out and option B could only worsen health on the population level.

    Naturopaths are a danger to public health. Organic food often isn’t (a food can be labelled “organic” and still have been exposed to a number of different “natural” pesticides and herbicides) and even if it is, there’s not much evidence that organic food is in any way better. Also, get with the program, again. Local foods are the hot new trend in crunchy nutrition so your truck drivers won’t be needed.

    If I were in a position with a mandate to improve public health, I’d work on ensuring adequate supplies of critical drugs, including generics and getting decent health insurance for everyone. If I were specifically asked to reduce obesity and related nutritional problems, my first move would be to increase the minimum wage and reduce working hours so that people have time, energy, and resources to buy good food, cook it, and engage in exercise and active recreational activities. That seems to me more likely to help than a bunch of nutritionists giving advice that people can’t follow.

  65. #65 T-reg
    December 9, 2011

    @^

    *wishes

    filled *with*

  66. #66 puppygod
    December 9, 2011

    If you were in charge to significantly improve human health in the USA in one year via a government funded program and you had only two choices – which would you choose? a)Selectively position 1 million new orthadox medical Doctors throughout the USA OR b)selectively position 200,000 Naturopaths, 200,000 Nutritionists, 200,000 health Educators in schools, 200,000 Professional Fitness trainers, 200,000 truck drivers delivering organic food to peoples homes every week.

    This is actually pretty tricky question. I can’t help but wonder whether 200k health educators and 200k fitness instructors, if properly trained, could not only balance the detrimental effect of 200k naturopaths and 200k nutritionist, but increase the net effect on general population health. After all properly educated and fit youth would eventually left 400k quacks without job anyway.

    The problem are truck drivers. Compound effect of direct delivery and organic farming would be devastating from ecological point of view.

  67. #67 Denice Walter
    December 9, 2011

    @ Neil:

    A while back, I asked two fellows who supported alternative medicine a question- neither answered. Perhaps you will.

    You have strong views: how did you come to support them? What were the influences that were formative? It could be books, websites, a particular writer/ teacher, studies, or personal ( family) experiences. Beliefs and attitudes don’t just *happen*: they are formed over time being intricately inter-woven with our experiences. As an example, I could say that my own ( opposing) views were formed through undergrad courses I took, family history, and working with seriously ill people.

    If you support something it might be interesting to understand from whence those attitudes originated. That’s true for *all* of us, despite our varying ways. Thank you in advance.

  68. #68 Krebiozen
    December 9, 2011

    Neil,
    If you think ‘bad cholesterol’ is a myth, you really need to look at some reliable sources of information. I suggest you read Daniel Steinberg’s ‘An interpretive history of the cholesterol controversy’ in the Journal of Lipid Research, it’s available free on-line. Part 1 is here.

    Go on, prove to us that you are one of those people who “learn about things”. When you have read all five parts (you may have to learn some medical terminology as well I’m afraid) do feel free to come back and explain why you still believe that LDL cholesterol is a myth and is not connected to cardiovascular disease.

  69. #69 Prometheus
    December 9, 2011

    Neil (#55):

    “Anyone interested to answer questions with intelligence without arrogance.[sic]“

    In this case, the arrogance appears to be in Neil’s answers, but I’ll have a go at it.

    “1) Why do you feel nutrition is not an integral part of a medical doctors training?”

    Ah! A trick question! Nutrition is part of modern medical education, but it is part of courses titled “Physiology” and “Biochemistry”. As has been pointed out already, almost every real physician asks their patients about (and, sad to say, lectures them about) their diet, exercise, etc.

    What Neil really means is “Why doesn’t medical education teach the nonsensical belief that ‘proper nutrition’ can prevent and cure all diseases?” The answer to that question is “Because it’s a fantasy.”

    “2)What do you think of Henry Gadsden’s…”

    I have no idea what he meant by that – why don’t you ask him?

    “3)Is there really ‘bad cholesterol’?”

    Another trick question! The cholesterol molecule is the same whether it is part of a LDL or HDL agglomeration. However, scientific research has found that people with elevated LDL levels are more likely to have atherosclerotic disease, so the popular press has – in its usual way – taken to calling that “bad cholesterol”.

    “4) Vitamin C was successfully used by Medical Doctors many many many years ago to treat diseases? Why not now?”

    Unless Neil is referring to the treatment of scurvy with vitamin C, the reason vitamin C has fallen “out of fashion” is that scientific research – that bane of fantasy – has shown that vitamin C doesn’t treat or prevent anything apart from scurvy.

    “5) If you were in charge to significantly improve human health in the USA in one year via a government funded program and you had only two choices…”

    This is a strange choice – add a million extra real doctors in a country where access to a physician isn’t a problem (although paying for medical care is) or add 400,000 fantasy-based practitioners (naturopaths and “nutritionists”; a “dietician” is a medically trained specialist in nutrition, a “nutritionist” can be someone who printed up their “certificate” at home) plus 200,000 school health educators and 200,000 fitness instructors.

    Do we really need a bunch more “practitioners” advising people to waste their money on herbal remedies and dietary fads? And do you really think that kids in school don’t already know that they should eat fewer crisps and hamburgers and more fruits and veggies? Or that they should put down the Xbox and get out for a run?

    Let me pose an alternative choice:

    Which would improve the health of the nation more: a million more real doctors or a million fewer fantasy-based naturopaths, chirpractors, homeopaths, acupuncturists and nutritionists?

    Prometheus

  70. #70 Interrobang
    December 9, 2011

    Both my mother and a good friend of mine are currently undergoing chemo (breast cancer and uterine/very early pancreatic cancer respectively*). Aside from that they’ve both lost (most of) their hair, and a few other minor side effects, they’re both fine. My mother’s tumour has shrunk radically, and my friend’s oncologists are actually talking about “permanent remission.”

    I’m tremendously grateful, because I’m not looking at having to attend the funerals of both my mother and one of my best friends in the next little while, especially since I’m only a few years out from having to attend the funerals of my dad’s best friend, both my grandfathers, and my great-aunt, as well as losing my beloved old cat to lymphoma, all within the same 8 months… I’m only now feeling recovered from that, and it’s been almost two years since I had to have Nero put down.

    __________
    * When they did the surgery on the uterine tumour(s), they found she had a completely different and very early-stage cancer on her pancreas, and resected that, too. In a sense, you could argue that being diagnosed with uterine cancer saved her life, since they were able to catch the pancreatic cancer long before it would have become apparent otherwise.

  71. #71 Anton P. Nym
    December 9, 2011

    Regarding Neil’s “just asking questions” post:

    1) Why do you feel nutrition is not an integral part of a medical doctors training?

    I don’t, because it is.

    2)What do you think of Henry Gadsden’s( former head of Merck) comments many many years ago when he said that he wanted make drugs available for even healthy people.

    I hold no opinion because I don’t know the context, or even if your summary is an accurate description what was actually said by Gadsen.

    3)Is there really ‘bad cholesterol’?

    Sort of, in that “bad” cholesterol is an oversimplification but it’s close enough to get the general point across.

    4) Vitamin C was successfully used by Medical Doctors many many many years ago to treat diseases? Why not now?

    We have a lot less scurvy now. Seriously, though, “vitamin therapy” is best used to correct dietary shortfalls, and we have a lot fewer now with the advent of enriched flour and iodised salt. Any other use of vitamin C, particularly the megadose fad of latter years, just makes your urine darker.

    5) If you were in charge to significantly improve human health in the USA in one year via a government funded program and you had only two choices – which would you choose? a)Selectively position 1 million new orthadox medical Doctors throughout the USA OR b)selectively position 200,000 Naturopaths, 200,000 Nutritionists, 200,000 health Educators in schools, 200,000 Professional Fitness trainers, 200,000 truck drivers delivering organic food to peoples homes every week.

    Neither, as both are sorely wrong-headed. (Though as a Canadian I’d like to have more doctors… we do have a slight shortfall, particularly in family practitioners and ED staff.) If you changed “naturopaths” to “primary care physicians” and changed “organic food” to “healthy and nutritionally-balanced food” the latter option would be better and probably cheaper than the mess you Yanks have today… but it’s dirty-dirty-soshulizm so there’s no risk of that coming true.

    — Steve

  72. #72 lilady
    December 9, 2011

    I am in awe with all the many testimonials offered on this blog about survival from serious cancers. Best wishes to you for continued good health.

    @ Interrobang: Your mom’s “case” reminds me of Supreme Court Justice Ruth Bader Ginsburg. She underwent treatment (excision, radiation and chemo) for colon cancer in 1999 and during a follow-up abdominal CT or MRI…February 2009, a small resectable pancreatic tumor was found which was excised. After she had her first child in 1955, her husband Martin was diagnosed with testicular cancer. They were both in law school at the time and she cared for her child, her husband, took class notes for both of them and was on the Harvard Law Review.

    Martin fathered another child with Ruth, they celebrated their 56th wedding anniversary and he died June, 2010.

  73. #73 Narad
    December 9, 2011

    I see Neil hasn’t ponied up his breatharian yet. Here’s another question for you Neil: Why didn’t a “Forks over Knives,” whole-foods, vegan diet of 25 years’ standing prevent my best friend from being diagnosed with colon cancer at age 40 and succumbing so quickly that he didn’t even have a chance to *start* chemo?

  74. #74 Neil
    December 9, 2011

    Narad – Vegans can still be totally unhealthy and eat crap. A vegan simply means in a basic sense someone who has elected to not eat animal products, not necessarily nanna’s apple pies. Being a Vegan also does not have anything to do with avoiding stress, trauma, violence, being a child molestor etc.

    I have also rarely met an adult who says ” I eat poorly and need to improve”. The average person I meet who thinks they eat ‘quite well’ or ‘quite healthy’, is interesting because when I open their fridge and look in the pantry, I would only eat about 5% – 10% of what I see. The entire philosophy of eating including the food pyramid has completely mislead people down the wrong path.

    Denice Walter – My interest is purely as a Health and Fitness specialist is to determine what is the best habits for life of disease free and disability free longevity. I ampersonally what some people may classify as ‘middle aged’- I am never ill including all my travels except India for 1 day, have no health insurance, never go to a MD, and I performed in front of 100 million people in 2011.

    I vist many Countries, cultures and talk with the people; my own practice on myself and others( the only real way to test theories), Dr Colin Campbell( China Study), A mountain of books on the Brain; Marcia Angell MD; Dr Andrew Weil MD; Human Evolutionary studies, biology; Dr Joe Kosterich MD, Dr Bruce Lipton; Dr William Howard Hay MD ………………………….and so on.
    Then what I do is what Bruce Lee said ” Adapt what is useful, reject what is useless and add what is specifically your own”.

  75. #75 lilady
    December 10, 2011

    “My interest is purely as a Health and Fitness specialist is to determine what is the best habits for life of disease free and disability free longevity. I ampersonally what some people may classify as ‘middle aged’- I am never ill including all my travels except India for 1 day, have no health insurance, never go to a MD, and I performed in front of 100 million people in 2011.”

    And Neil, what if you get hit by a car and need care in a hospital trauma center? Do you have enough money to pay for your care…or are you just going to plead poverty and have taxpayers foot the bill?

    It seems to me that I would know about a person who performed in front of 100 million people in 2011. Elvis Presley performed in front of 2.5 million people during 800 or so individual performances over several years in Las Vegas…and he made the headlines with that paltry number.

  76. #76 Dianne
    December 10, 2011

    I am personally what some people may classify as ‘middle aged’- I am never ill

    So say a number of people just before they drop dead of a heart attack or loose their ability to talk to a stroke or develop a cancer related DVT. Just because you feel fine doesn’t mean that you’re perfectly healthy. Hypertension, diabetes, high cholesterol, and early cancers, among others, have no symptoms. Perhaps you’re just fine-I certainly hope so-but perhaps you’re not. A “perfect” diet and exercise program won’t protect you from everything.

  77. #77 Neil
    December 10, 2011

    Lilady – Envy, one word for you.

  78. #78 Neil
    December 10, 2011

    Dianne. brilliant! I may be better off believing I feel like shit and I am gonna die. Glad I am not your friend. Negativity destroys lives and people do have the ability to look after themselves. I am a big boy, but thanks anyway.

  79. #79 lilady
    December 10, 2011

    Neil- bullshit, one word for you. You better stop hitting the bottle.

  80. #80 Militant Agnostic
    December 10, 2011

    Narad @69
    A raw food vegan diet didn’t prevent Bif Naked from getting breast cancer. I heard her interviewed about a year ago and she gave full credit to the surgery and chemo for beating it. Pinetop Perkins, the oldest person to win a Grammy award ate a Big Mac, fries and a diet Sprite every day and lived to be 96, 3 years longer than Linus Pauling.

    Niel @70 – Bruce Lipton – really? The guy is more full of shit than Joseph Smith and L Ron Hubbard combined. The only question is whether he is underpants on the head crazy or a con man. I was subjected to a DVD of a talk by him once and I heard him utter several outright falsehoods before I stopped watching in disgust. In one case he was trying to make a point about how some map drawn by Germans showed more land area in the northern hemisphere than in the southern hemisphere when the land areas in the south and north were really equal. Except there actually is more land area in the Northern hemisphere than in the Southern hemisphere and this is what drives the Milankovich climate cycle.

    Someone who tells easily detected falsehoods like that is a classic bullshitter who counts on his audience being ignorant fools. No wonder Neil admires him and since he makes similar easily dis-proven bullshit claims such as appearing 100 million people in a year. Unlike the marks Neil takes advantage of, the regulars on this blog are not innumerate. That shit won’t fly here.

    lilady @71 – and Elvis is still alive :)

  81. #81 TBruce
    December 10, 2011

    Neil:

    You performed in front of 100 million people in 2011? You realize that to do that, you would have to bring in an audience of about 300, 000 every night in 2011. Why, that’s unbelievable – in the true sense of the word.

    Did you give them the same idiotic quiz that you gave us? I hope for your sake that you didn’t give them that lame-ass misquote that you attributed to Einstein. I hope for my sake that you did. I always enjoy a good belly laugh.

  82. #82 Militant Agnostic
    December 10, 2011

    I have comment in moderation regarding one of Neil’s influences is champion bullshit artist Bruce Lipton who is either underpants on the head crazy or a con man. That is not an exclusive or.

    Neil @73 – Unlike the marks you seek to fleece, the regulars here are not innumerate, so we know your claim of appearing before a 100 million people in a year is risible.

  83. #83 lilady
    December 10, 2011

    It would be possible for Neil “to perform” in large venues.

    There is the May Day Stadium that seats 150,000..in Pyongyang North Korea or the Yuba Bharati Krirangan Stadium that seats 120,000..in Kolkata India. It would just be a matter of Neil performing 2-3 shows daily for a year, to perform in front of 100 million people.

    Then there is the late Pope John Paul II, who perhaps during his entire 27 year papacy “appeared” before 100 million people. His biggest “draw” ever was the 1 million people who saw his funeral in Rome.

    @ Militant Agnostic: I think we are dealing with a drunken underpants on the head poster here.

  84. #84 Prometheus
    December 10, 2011

    Neil (#74):

    “I performed in front of 100 million people in 2011.”

    Oh! So, you’re that cute gecko who does all the car insurance commercials? That explains a lot.

    Seriously, Neil – if you’re going to lie, could you at least make your lies a bit less obvious? We’re not the ones sniffing paint in your parents’ basement – you are.

    Prometheus

  85. #85 Neil
    December 10, 2011

    Ever heard of TV, he he.
    Some of you people are serious freaks who belong in a cave together mulling over your latest cocktails of toxic poisons, because you can’t talk maturely. As I have already said on this site you have no respect for another persons view and you have far from convinced me about the many rumours left, right and centre about the conventional medical field about it’s level of arrogance and ignorance.

    I knew Mr Lipton would make you freak just to see your arrogance fly again – it’s going way over the moon and back 50 times over.

  86. #86 Neil
    December 10, 2011

    Well done Steve for being one of the only mature responses with sensible answers on this site so far.

  87. #87 Travis
    December 10, 2011

    I have been on TV before*. I think I am going to include that appearance on my CV. I am sure people will be impressed when I tell them I have appeared in front of over 100 million people and will believe me even when I am unwilling to pony up the evidence of this. My credibility will skyrocket!

    * A provincial curling final on a local cable channel. I am a star.

  88. #88 Neil
    December 10, 2011

    TBruce, hey thanks for breaking that down for me, I never did that before, but thats pretty impressive 300,000 a night. I guess that’s why I have been asked back to go again to various countries in 2012.

  89. #89 Neil
    December 10, 2011

    @ TBruce- hey hang on a moment. I don’t even drink but I don’t believe that is right, 300,000 a night ha ha.

  90. #90 lilady
    December 10, 2011

    Neil believes in Lipton’s theory of mind over matter (healthy thoughts can change your genetic make-up). I suspect Neil, while under the influence, has magical thinking about his make-believe career on TV and appearing before another 100 million people in other countries in 2012.

    Neil, if you are going to imbibe, stick to the better booze…that other swill that you lap up is giving you delusions.

    Try looking up wet brain or Wernicke-Korsakoff syndrome and confabulation. Your “healthy diet” and your knowledge about other natural products will not cure your terminal bullshititis.

  91. #91 Travis
    December 10, 2011

    lilady,
    Does Lipton’s theory also posit that these healthy thoughts will cause other people to believe you when you make these grandiose claims? Maybe change their genetic make-up as well? I just cannot think why anyone would think others would be impressed or even interested in some random internet person’s claims to fame unless this mind over matter business also changes the genetic code of the audience in order to make them more gullible.

    I was once the King of Spain!

  92. #92 herr doktor bimler
    December 10, 2011

    Some of you people are serious freaks who belong in a cave together mulling over your latest cocktails of toxic poisons,

    I believe that the canonical wording is “Gathered together in a cave grooving with a Pict”.

  93. #93 Travis
    December 10, 2011

    I guess the drugs might help.

  94. #94 herr doktor bimler
    December 10, 2011

    The average person I meet who thinks they eat ‘quite well’ or ‘quite healthy’, is interesting because when I open their fridge and look in the pantry, I would only eat about 5% – 10% of what I see.

    Certainly Neil is a cheap guest, but there is something sinister and stalkerish about breaking into the houses of average people in order to open their fridges and look in their pantries.

  95. #95 lilady
    December 10, 2011

    @ Travis: A close friend whose mother had a host of psychiatric disorders, used to cycle off her medications. We knew that her mom was off the meds when she would haul out the gaudy crucifix and drape rosary beads around her neck. She would talk gibberish about her given name “Verna” and trick around with with variations…such as “Venerable”, etc. At times she would plumb the depths of paranoia about thought control by the government. Then too, there was the rambling incoherent theft of all her imaginary money. She said she was the Queen of Romania.

    “Certainly Neil is a cheap guest,”…and a cheap host as well. I bet I could tempt him with a thick porterhouse steak rather than an ersatz tofu burger…especially if he is imbibing or off his meds.

  96. #96 Travis
    December 10, 2011

    lilady,
    People thinking they are Jesus, Napoleon and many other famous people are often used as a joke to describe the mentally ill and sadly I guess there is some truth to it.

    To be honest I was not thinking of psychiatric disorders at the time though, I just needed a silly claim and the Moxy Früvous song King of Spain popped into my head. I guess this might not be well known outside of Soviet Canuckistan.

  97. #97 Narad
    December 10, 2011

    Narad – Vegans can still be totally unhealthy and eat crap. A vegan simply means in a basic sense someone who has elected to not eat animal products, not necessarily nanna’s apple pies. Being a Vegan also does not have anything to do with avoiding stress, trauma, violence, being a child molestor etc.

    Yah, I expected about as little.

    See, Neil, all of your moronic shit falls apart in this case. I realize that you probably would luuurve to go all Hamer, but given that you are trying to actually flog homebrew, dollar-store shtick, I am left in the position of breaking it to you that the fellow to whom I refer was far more intelligent than you could ever aspire to be. Your weird-ass apple-pie, child-molesting diversions are of precisely no interest, and I would go so far as to suggest that your public persona is, as Richard Burton mentioned in passing to the proprietor of Blake Tours in John Huston’s take on Night of the Iguana, “a big, fat, zero.”

    Now, don’t take this personally. It’s certainly true that I gave you the opportunity to stick your idiot foot into your idiot head and be left to suffer the perplexity of figuring out which is which, but let me be clear: I’m quite sure that there will never come a day upon which zikhrono livrakha is appended to invocations of your time on the planet.

  98. #98 Antaeus Feldspar
    December 10, 2011

    The average person I meet who thinks they eat ‘quite well’ or ‘quite healthy’, is interesting because when I open their fridge and look in the pantry, I would only eat about 5% – 10% of what I see.

    It seems Neil is still under the delusion that we believe him to have the correct answers. Me, I’d be more alarmed if some idiot who actually believes in breatharians approved 100% of my food choices.

  99. #99 Mephistopheles O'Brien
    December 10, 2011

    200,000 Naturopaths

    As soon as someone can show that naturopaths do something better than a real doctor, maybe. So far, it appears that natoropaths are cheaper to produce than doctors, but I know no other advantages. Perhaps someone could share?

    200,000 Nutritionists

    “Nutritionist” is a vague, unregulated term not subject to professional qualifications in most places. As such, before I hired them, I’d like to know what they were intended to do, how they were trained, what science they would back their work on, etc.

    200,000 health Educators in schools

    Always in favor of getting more good information taught in schools.

    200,000 Professional Fitness trainers

    Does anyone out there really believe there’s a shortage of fitness trainers, or that lack of same is the cause of illness? Anyone?

    200,000 truck drivers delivering organic food to peoples homes every week.

    Based on something I heard on Science Friday some time back, there’s some evidence that some organically grown foods (I rarely eat inorganic food, as I like carbon) do contain higher amounts of certain nutrients than some foods not grown using “organic” methods. However, is it really the case that people aren’t eating enough fruits and vegetables (particularly organic ones) because they’re not being delivered to the door? How about decent, reasonably priced markets in so-called “food deserts”? How about less expensive “organic” produce? And don’t forget the CO2, nitrogen oxides, ozone, and fine particulates being generated by all those extra trucks.

  100. #100 TBruce
    December 10, 2011

    @ TBruce- hey hang on a moment. I don’t even drink but I don’t believe that is right, 300,000 a night ha ha.

    300 000 x 365 = 109, 000,000.

    Can you get anything right?

  101. #101 Anton P. Nym
    December 10, 2011

    @86: Neil, you do realise that I was *not* agreeing with you, right?…

    For the record I’d like to slightly ammend one of my answers, in that I had a thinko and forgot my Dara O’Brien (dietitian::nutritionist as dentist::toothiologist) while responding. I’d definitely like to see registered dietitians instead of self-appointed food gurus in your proposed plan of eebil socialised healthcare plan.

    And while breatharians certainly behave as if they have chloroplasts in place of neurons, I don’t believe, nor do I see any trustworthy evidence at all, that anything remotely resembling a human being can subsist on nothing but the ambient atmospheric conditions to stoke the Krebs cycle and support anabolism.

    — Steve

  102. #102 TBruce
    December 10, 2011

    Of course, I spot the typo one second after I press the “post” button. The total is 109, 500, 000.

    Remember, I said “about 300 000″. To be precise, 274,000 a night for a year would give you
    100, 010, 000. Close enough?

    Anyway, about the tone of our answers, here’s a quote for you:

    You’re only young once, but you can be immature forever.

  103. #103 Neil
    December 10, 2011

    I am touched by your feelings. I must leave you now my little religious fanatics – I feel sorry for you that you are bound by a religion that disempowers you as humans to be a free spirit. I have no religious teacher, no sponsors, no drug sales reps, and no licences to practice only a certain way – no way, I am free as a bird.

  104. #104 Vicki
    December 10, 2011

    Numbers aside, the number of people who have watched Neil on television is completely irrelevant to the validity of any of his claims. If you think audience size proves truth, you have to accept everything said by Barack Obama, George Bush, and Vladimir Putin, even when they disagree with each other.

  105. #105 Gray Falcon
    December 10, 2011

    Neil, do you know what evidence is?

  106. #106 Mephistopheles O'Brien
    December 10, 2011

    …I am free as a bird.

    Cuckoo? Or is this a Lynyrd Skynyrd reference?

  107. #107 Denice Walter
    December 10, 2011

    @ Neil:

    Thank you for your response. I am not here to de-construct but to offer food for thought.

    Ideas like Lipton’s ( yes I’ve heard him on radio) are attractive because it would be wonderful if they were true. People would be in control of what happens to them. Of course there is a partial basis for them in reality: if you are motivated by belief you might conceivably change what you *do* ( e.g. diet, exercise) which *might* affect outcomes. I am also a middle-aged person who doesn’t get ill. I play tennis, I eat relatively well. These actions are no guarantee. Also by looking purely at my own experiences ( lots of elderly family members who lived to extravagant ages despite rather awful diets), I might not believe in dietary restrictions at all. I do for other reasons, such as data.

    I am very critical of what I believe to be true: I counsel people about changing their lives and more informally, manage money for myself and others. Often I am confronted by variables for which I have no real data and others I may not even be aware of – an uncomfortable position because my advice will affect others’ lives… and my investment income. My solid ground has to be numbers not beliefs.

    We can all fool ourselves: thinking that we have more control or knowledge than we actually do. Research data edges out more of the uncertainty – true for doctors, counsellors, or investment advisors. I survey alternative medicine and often hear/ read many things that I wish were true: it would be great if niacin could cure serious mental illness, if cancer were to be eradicated by diet, and if people could live lives unhampered by disability and decline.

    However, when I seek out data, I either find none, badly done studies, or un-related material being touted as “proof”. Then I am told that the *reason* these hypotheses are rejected by the mainstream is because of a conspiracy – usually by the drug companies ( and who ever called them “blameless” or “perfect”?). If alternative approaches were effective the evidence would easily show up in data: there *is* data about diet and health that SBM accepts- it is more subtle than what natural health advocates believe. There *is* data about how attitudes affect outcomes but it’s not what Lipton professes.

    At any rate, fitness and diet are important but they’re not the whole ball of wax. Remember that those who promote theories contra SBM often are motivated by fame and money because *people* tend to *like* those things. If you don’t trust the medical establishment, governments, and the media why trust someone just because they *agree* with you?

  108. #108 LW
    December 10, 2011

    I *too* have no religious teacher, no sponsors, no drug sales reps, and no licences to practice only a certain way (or at all). Therefore the rest of you are compelled to believe every word I type. Especially if I pontificate about topics that I know nothing about, like claiming that people can live without eating or drinking.

  109. #109 Denice Walter
    December 10, 2011

    Oh f-ck!

    And I have a long, sincere comment to Neil in moderation. At least, he did answer my query *unlike* the other two.

    Because I survey alt med, I am very familiar with Lipton: he presents a very attractive idea – belief changes physiology. In a way, alt med is all about “working on yourself”- transforming yourself. People like this stuff because it short-circuits reality-based evidence.Our human ability to plan and self-regulate makes self-improvement** an option for us that other animals aren’t as likely to consider.

    Needless to say, alt med has tried to corner the market.

    ** and isn’t it one of the several hells of the Tibetans ( demi-gods)?

  110. #110 LW
    December 10, 2011

    TBruce, your initial estimate of about 300,000 was actually a very good estimate. Remember he claimed that he “performed in front of 100 million people in 2011″ — note past tense. He made that claim on Dec 9, at which point there were still twenty-two days left in 2011. Therefore, the proper denominator isn’t 365; it is 343 (I have generously assumed that he performed on Dec 9). That means the average number per day is 291,545. However, I’m inclined to doubt the precision (understatement), so the number should be rounded, as you did, to about 300,00.

  111. #111 LW
    December 10, 2011

    Oops, dropped a 0 before the final period.

  112. #112 lilady
    December 10, 2011

    Not to worry folks…Neil will be back later. He doesn’t have the intellectual capacity to understand basic science, no less subjects that go beyond a six-year-old’s inquisitiveness about how things work in the real world.

    Here is a case of a paranoid conspiracist lacking in education about health maintenance who is drawn to Alt/CAM “practitioners” who appeal to his no-existent rational thinking processes…they present information that appeals to his Luddite view of the world.

    Furthermore, he has a sense of great inadequacy and goes into attack mode, when confronted with internet bloggers and posters who actually know what modern medicine and health maintenance is all about.

    Just another conspiracy-minded, totally uninformed troll who is out of his league and whose great career in television is only in his mind.

  113. #113 Prometheus
    December 10, 2011

    Neil (#85):

    “Ever heard of TV, he he.”

    So, if you’re not the gecko who sells car insurance, where would we have seen you on TV? Some cable-channel infommercial about juicing, exercise equipment or “dietary supplements”? Doing a “perp-walk” into a federal courtroom? One of those “call police if you see this man” news flashes?

    No matter – being on the TV doesn’t equate to either veracity or validity, as even a casual examination of advertisements and political statements will confirm. Bernie Madoff has “performed” in front of nearly a billion television viewers and I wouldn’t trust him enough to buy a bag of crisps from him.

    Prometheus

  114. #114 TBruce
    December 10, 2011

    No, not the gecko. He is, after all, a rather pleasant little reptile.

  115. #115 ArtK
    December 10, 2011

    @ Neil

    I have also rarely met an adult who says ” I eat poorly and need to improve”.

    You must know a lot of stupid people. From your posting, that’s not surprising.

    I am never ill

    You could be lucky in the DNA lottery; you could be deluding yourself and have some undiagnosed conditions; or, you could be right about your lifestyle keeping you healthy. Or, it could be a combination of the three. Your assertion of good health and assumption that your lifestyle is responsible are just that, an assertion and an assumption. Not evidence.

    and I performed in front of 100 million people in 2011.

    And I have a blue ribbon from the L.A. County Fair for “tablescaping.” So there! When I was in college I appeared on national television many, many times — as a member of the band. Neither fact makes me any more or less qualified to pontificate on diet and exercise than your claim of appearing before 100 million. Bob Smith probably appeared before 100 million over his career, but I’m not going to take health advice from him on that basis.

    In other words, color me unimpressed by your “credentials.”

  116. #116 epador
    December 11, 2011

    The problem with quoting loudly:

    30% reduction in mortality (or 30% extension of life expectancy)

    is avoiding stating the original risk of mortality (or life expectancy) in as large print if at all to the patient when the PARQ is completed before the patient starts treatment.

    In my 17 years of giving patients chemotherapy, I always tried to make this information clear to the patient before starting treatment. Very rarely would someone balk at receiving an accepted treatment, yet many of my colleagues felt the risk of scaring the patient away from treatment was too great to be truly honest with them.

    I appreciate your head nod to this issue at the end of the post, but note you seem to avoid doing the math for us.

    Hypothetical Numbers that are not all that far from adjuvant treatment for early breast cancer:

    If you have a 30 % risk of death without treatment, and a 33% reduction with treatment, then you have about a 10% chance of benefitting from the treatment, and still a 20 % chance of dying after the treatment. As long as the risks of treatment aren’t exceeding the benefit, it is still reasonable, considering the alternative. If the patient goes into treatment understanding this, they will have both a better appreciation for good results, and if there is a recurrence, have a chance for realistic and balanced disappointment.

    I haven’t read the study, but did they due QOL numbers too?

  117. #117 Delurked lurker
    December 11, 2011

    Denice Walter @ 107

    Thanks for that

    Like a breath of fresh airian :)

  118. #118 Rosalind Klass
    December 11, 2011

    Hi all,
    I think there is always two side to an argument, there are people who swear by alternative meds, others dont. Cancer is a really serious disease and the worse when doctor tells you that you have 6 months to live without chemeo and 12 months to live after chemeo. It takes a really positive person to say let’s go for treatment.
    However I do not believe that taking Zeolite or Oxy3 etc will help cure cancer. I truly believed that if there is a supplement that is proven good for your body, I will try it because if it is good, it will give your body a better chance of fighting the disease, that is not to say you reject chemeo as advised by your doctor. I think the oncologist could be a little more sympathetic and give you a bit more encouragement and ask you to do all the good things to help your body fight the disease, but they don’t do they?
    they see you as one of the unfortunate soul and explain to you the treatment they are going to give you and it is YES or NO from you.
    I am all for chemeo, so far still the known treatment that can at least help to prolong life a little (statistics)however do seek any other alternatives that might help to give your body a better chance of fighting. Do not get alternative believing that it is going to cure the disease only if you are lucky.
    So I am going to get Zeolite (not from quacks like http://www.cancerfightingstrategies) but need a little more research before I am confident that this product is good for the body and Essiac (again not until I read more about it) so perhaps Onrac can help me here.
    Again let me say please do accept treatment from your oncologist if possible (as there are statistics to prove) however do seek other help, best of all, change your lifestyle by eating more healthily and take more exercises, prepare yourself mentally and be positive (very positive) I likened it to going to a battle with cancer, send positive message to your soldiers in your body and ask them to fight for survival and if everybody is positive, just maybe you might survive for a lot longer.
    I am not trying to smart just voicing my feelings.

  119. #119 Chris
    December 11, 2011

    So, Ms. Klass, you are going to consume a bunch of minerals from soil that is full of aluminum. Now try to convince the “aluminum is evil” folks who are telling us aluminum adjuvants are dangerous on the article that comes just before this one.

  120. #120 Vicki
    December 11, 2011

    Rosalind,

    The thing is that a lot of supplements aren’t “proven good for your body.” They are assumed to be good for your body, and then when people try to measure how good, the effect is nonexistent, or in some cases the supplement even appears to be harmful.

    Supplements have their uses, but mostly in cases of specific dietary shortages or difficult producing or using certain substances. That’s vitamin C for scurvy, vitamin D for rickets. It’s iron or B-12 for people who don’t absorb them from food efficiently. It doesn’t mean everyone needs multivitamins, or that more is necessarily better. I drink orange juice and eat a variety of fruit and raw vegetables; a vitamin C pill would be a waste of money for me.

  121. #121 Denice Walter
    December 11, 2011

    @ Rosalind Klass:

    Essiac tea/ Flor Essence has *not* been shown to be of any benefit in the treatment of cancer when tested ( see Quackwatch) but that does not stop alt med proselytisers from broadcasting its merits when compared with SBM treatments ( like chemotherapy). Why do you think that is?

    Either they sell supplements or books that trash SBM and this product ( even if they don’t personally sell it) is part of the argument they present *against* the consensus, just like they quote the “successes” of Drs Gonzalez and Burzinski. In short, they are also selling a world view as well as promoting themselves as alternative thinkers ( using alternatives to actual thinking).

    About supplements and cancer, there is the possibility that supplements might *interfere* with the SB therapy or *augment* the growth of cancer ( several posts about this at the Science Based Medicine blog- Orac’s friends).

    Alt med advocates often ask you to believe *them* and dismiss the scientific consensus ( doctors, journals, government, media) because those organisations all have an *agenda*, *ulterior motives*, and *conflicts of interests*.
    Whereas *I* ask: why believe *them*?- they also have agendas, ulterior motives, conflicts of interest ( they are *competitors* with SBM for the public’s health care money) _plus_ they aren’t well educated and to people who are, it is painfully apparent. Sometimes I don’t know whether to laugh or cry.

    Use the search box at top right to search for Orac’s many discussions of cancer therapies.

    @ delurked lurker: sorry to disappoint you. Next time I’ll try harder.

  122. #122 lilady
    December 11, 2011

    @ Rosalind Klass: Real chemotherapy (the stuff that works) can often stress major organs of the body…that is why prescribing oncologists monitor liver and renal function with frequent blood tests.

    So, are you going to mess up your chances of a remission or cure, by adding an aluminum-laced “supplement” that “appeals to you” then blame chemotherapy for not effecting a cure?

    Silly woman.

  123. #123 Neil
    December 11, 2011

    Fear not Rosalind. Not all Medical Doctors are religious fanatics as represented by those who have no respect for your opinion or simple facts that have been proven over and over again through independent studies, and not paid for by the type of people who reply to you who would sell out our neigbourhoods to pay for another BMW. It does not matter what you say, we are beneath them, but the good news is, things are changing, and this is why they are so pissed – they don’t like change and something that works better than themselves in an effort to improve humanity.

    Ask yourself this. There is island where you had to live the rest of your life. One half of the population on one side live where people were largely free of most diseases, active, joyful, full of spirit and life. On the other side is life as you know it today.It’s not really that scientific is it?

    Just yesterday I had a second sound therapy session using sound bowls, gongs, didgeridoos etc in a purpose built facility. There is much research at the moment behind the effectiveness of this type of healing for even, cancer, in a few key centres in the world. But of course our little religious freaks will think nothing of the sort, as you will see in their reply. As already mentioned they have little respect , not even for ancient ancestors of the land who know about many aspects of health and healing that they would never understand or want to understand due to their religion.

  124. #124 Gray Falcon
    December 11, 2011

    Neil, the only one you worship and respect is yourself.

  125. #125 Narad
    December 11, 2011

    Not all Medical Doctors are religious fanatics as represented by those who have no respect for your opinion or simple facts that have been proven over and over again through independent studies, and not paid for by the type of people who reply to you who would sell out our neigbourhoods to pay for another BMW. It does not matter what you say, we are beneath them….

    Wow, that was fantastically clumsy. The problem, of course, Neil, is that Rosalind hasn’t actually received anything even vaguely resembling the scorn that you have most richly and promptly earned.

    Now, who’s that Mysterious Breatharian of Unspeakable Power again?

  126. #126 lilady
    December 11, 2011

    @ Gray Falcon: I told you “Neil” would be back…he has a lull in his busy schedule of “performing in front of 100 million people on T.V.”…or is it all in his wet brain?

  127. #127 adelady
    December 11, 2011

    Didgeridoo? Sound therapy?

    Okaaay. Being Australian I thought I’d check this one out. The first page of google hits tells us a lot about the real benefits of playing a didgeridoo, not listening to the sound of someone else playing it. Great for reducing snoring, general health and fitness, breath control, stress, respiratory disorders. So far, so as expected.

    Then, oh my goodness! the next page of hits.
    “Didgeridoo Sound Therapy & Sound Healing is not an Aboriginal Australian tradition or practice, though love and respect is given to them for sharing this amazing instrument with the world.” Appears at the bottom of a page claiming that having a didgeridoo played – by someone else – while it rests on your body gives the same wonderful results as conventional ultrasound therapies.

    We can also be treated to “Clearing of Emotional and Energetic Stagnation” by, once again, someone else playing the instrument and not by learning to do it ourselves (and getting better sleep and better breathing as a result).

    Need I point out that there’s a great deal of attention paid to the all too familiar ‘vibrations’ and ‘harmonics’ but I daren’t ask what the benefits of “Quantum Manifestation” might happen to be. Apart from completing a line on my Woo BS Bingo card.

    I’m sure indigenous Australians will be thrilled with the “love and respect” offered by this crowd. (The only positive thing I noticed was that all the piccies of people playing the instrument were men, not women. So that shows *some* respect for cultural values.)

  128. #128 The Very Reverend Battleaxe of Knowledge
    December 11, 2011

    Yeah, “sound therapy” is a beaut, all right. You thought aromatherapy was the silliest thing you’d ever heard of, didn’t you? At least that actually involved contact between a few molecules of something and some part of your body (the olfactory bulb of your brain). Hell, that puts it ahead of homeopathy, come to think of it. But some sound waves hitting your eardrum…wow! Just wow.

  129. #129 Narad
    December 11, 2011

    With a little more effort, Neil could hit the Darrell Brann trifecta.

  130. #130 Neil
    December 11, 2011

    Narad ho ho ho. In amongst your desperation to try and piss me off because I have stuck a hatred chord in you, the reality is, I can’t sink to your level of lowness. You are very proficient at sitting on your ass, being an expert in grammar for which I am no match. But my skills that has me travelling the world along with serving humanity makes people like you fantasize at people like me because you don’t have the guts to do what I do; of which you still have no clue, other than all your wild guesses, similar to your 21st century scientific voodoo that just spills out relentlessly.

  131. #131 ArtK
    December 11, 2011

    @ Rosalind

    I think there is always two side to an argument

    Sometimes there are even more than two. Don’t fall into the trap of false equivalence. Even though there may be multiple sides, not all sides are equally valid.

    People are very good at fooling themselves — very intelligent people can be mislead by a lot of things. Science is a mechanism we have for determining which sides are valid and which are invalid in an objective, unbiased way.

    Just because someone “swears by alternative med,” it doesn’t mean that it actually works. In almost all cases, things in alt med are “proven” through anecdotes and personal experience. But that’s extremely unreliable.

  132. #132 Gray Falcon
    December 11, 2011

    I’m sure indigenous Australians will be thrilled with the “love and respect” offered by this crowd.

    Neil’s spirituality appears to be some cobbled-together bits stolen from other cultures, while ignoring the parts of those cultures that would disapprove of his arrogance and selfishness.

  133. #133 alison
    December 11, 2011

    There is much research at the moment behind the effectiveness of this type of healing

    Citations, please. If this stuff is so good at what’s claimed for it, I’d expect to see it published. After all, as I think someone else has already pointed out to you, Neil – treatments that can be shown to work become part of modern medicine. Treatments that have no evidence of efficacy – not so much.

    And… As already mentioned they have little respect , not even for ancient ancestors of the land who know about many aspects of health and healing that they would never understand or want to understand due to their religion.

    Which ancient ancestors would these be? Until fairly recently the average lifespan was around 40… Seems to me those promoting didgeridoo ‘healing’ don’t show a lot of respect for the ancestors either, as they’re nicked a part of an indigenous culture for their own purposes & I bet aren’t paying royalties either.

    Like Narad, I’m still waiting to hear more (including some identifying details) about your supposed Breatharian :-)

  134. #134 herr doktor bimler
    December 11, 2011

    Seems to me those promoting didgeridoo ‘healing’ don’t show a lot of respect for the ancestors either, as they’re nicked a part of an indigenous culture for their own purposes & I bet aren’t paying royalties either.

    This is standard procedure for indigenous cultures. Once the colonists have stolen their land and resources and all they have left are their cultural intangibles, you can be sure that some douchebag will find a way of laying claim to those as well.

  135. #135 Neil
    December 11, 2011

    Art K. So which person/ study/ whatever is going to give you the green light that a certain alternative treatment works?

    Rosalind and any other people who seek the truth out there:
    There is no cure, each person must find their own pathway to spiritual enlightenment. You will never ever ever ever ever ever ever get humanity to agree on all treatments – impossible. And those enlightened individuals on the planet know ‘evidence based medicine’ is inadequate. Even 2 typical medical researchers scarcely agree on most phases of every subject. Now if Medicine is not sure why, why should the laymen not feel all at sea regarding his/her own condition?Buy Dr William Howard Hay’s classic ‘A new Health Era’, a former courageous Medical Doctor who speaks the truth.

  136. #136 herr doktor bimler
    December 11, 2011

    similar to your 21st century scientific voodoo that just spills out relentlessly.

    “Voodoo” as a pejorative term? I am SHOCKED to see such disrespect for Haitian spiritual traditions.

    Yeah, “sound therapy” is a beaut, all right. You thought aromatherapy was the silliest thing you’d ever heard of, didn’t you?
    *Bagpipe* therapy makes a kind of sense. You feel so much better when it stops.

  137. #137 Narad
    December 12, 2011

    You are very proficient at sitting on your ass, being an expert in grammar for which I am no match.

    Grammar? Why would I bother with your grammar when there’s a boiling crater of semantic lava in front of my nose?

  138. #138 Narad
    December 12, 2011

    There is no cure, each person must find their own pathway to spiritual enlightenment.

    Is “spiritual enlightenment” different from the rather trivially obtainable regular Enlightenment? (A sturdy dose of LSD and playing with yourself while whistling Dixie should take care of this, if I recall the immortal wisdom of Art Kleps properly.)

    The simple fact of the matter is that you’re really pathetic as far as gurus go. I mean, come on:

    Rosalind and any other people who seek the truth out there

    Real enlightened-master-guru-audience-of-100-million-hey-baby-I’ll-tell-you-when-you-can-sniff-my-didgeridoo types don’t need to scrounge around for marks that seem to have already departed.

  139. #139 lilady
    December 12, 2011

    Maybe “Neil” “performs” in front of 100 million each year discussing the Hay diet. I bet he sells little chemistry kits to determine which foods are acidic and which foods are alkaline.

    William Hay who died in 1940 claims to have cured himself of Bright’s disease with this “diet”. Here is what Neil’s hero had to say about smallpox:

    Dr. William Howard Hay Addresses the Medical Freedom Society
    June 25, 1937,

    “I have thought many times of all the insane things that we have advocated in medicine, that is one of the most insane- to insist on the vaccination of children, or anybody else, for the prevention of smallpox, when , as a matter of fact, we are never able to prove that vaccination saved one man from smallpox. Naturally not. When you have protected anybody, as we denote protection in medicine, you have at the same time destroyed your evidence. If that man doesn’t take the disease against which he is supposed to be protected, how can you ever know he would have taken it if he hadn’t been protected? We have destroyed the evidence…..”

    (Source whale.to)

  140. #140 Cath of Canberra
    December 12, 2011

    I’ve just now stumbled on this stark statement of what can happen when you don’t treat cancer. It’s heart-wrenching.

    Some here may remember the Penelope Dingle case – she died in 2005, the coronial report handed down in 2010; it’s her own words here.

  141. #141 The Very Reverend Battleaxe of Knowledge
    December 12, 2011

    Besides, isn’t “sound therapy” what they used on Noriega when he was holed up in the Vatican Embassy?

  142. #142 Delurked lurker
    December 12, 2011

    Hi Denice Walter

    I really did like your post, virtually free of vitriol and a nice change from the average red faced rants we get here from BOTH sides. Sorry if my clumsy attempt at humor confused the issue.

    Thanks again…really :)

  143. #143 lilady
    December 12, 2011

    @ The Very Reverend Battleaxe of Knowledge: It is said that U.S. forces used Van Halen rock music at the Vatican embassy to get Noriega to surrender. I think I prefer Van Halen over didgeridoo…even though Neil claims dodgeridoo is therapeutic.

    BTW, Noriega was extradicted from France after spending time in prison and has just arrived in Panama…facing a long stretch in their prison system. Hmmm, will he actually survive or will we next here of him due to a sudden unexplained death?

  144. #144 Militant Agnostic
    December 12, 2011

    Neil BSA*

    Even 2 typical medical researchers scarcely agree on most phases of every subject.

    I thought scientists were part of a dogmatic religion.

    Isn’t it hilarious that Neil accuses us of arrogance while he claims to be in possession of the TRUTH.

    *Bullshit Artist

  145. #145 MrPeach
    December 12, 2011

    I was diagnosed with advanced prostate cancer a little over a year ago. I had a PSA of 242, and complete cancer involvement in all of 12 samples.

    I was lucky enough to get into a trial of early chemotherapy followed by hormone treatment. The chemo was rough, though I seldom had nausea after the first treatment thanks to anti-nausea drugs. I lost almost all of my hair (all over) and I looked like hell (as evidenced by a photo my cousin had taken halfway through treatment). I was hospitalized halfway through with neutropinic fever for a week. I would still do it again without a second thought.

    At this point my PSA is down to 0.03 and my oncologist at Dana Farber is quite positive about my prospects.

    I cannot say if the chemo helped. What I can conclude is that any cancer I had which was susceptible to chemo is likely gone, and all I have to deal with now is the hormone sensitive cancer – which is well under control.

    What the future holds for me I cannot say, but I remain thankful for being able to get onto this trial and for how my cancer has reacted.

    I find myself getting extremely angry at anyone who would suggest trying “treatments” that have no science behind them. Woo merchants are killers as far as I’m concerned when they substitute their fantasy treatments for those that have been proven to work (if only for some).

    I’ve lost a lot – my mucous membranes are still not functioning correctly, my testicles have shrunken to tiny marbles and sex is a thing of the past. But I’m alive and may be for a while longer – being able to see my grandkids grow up is all I can ask for at this point, and I may just be able to do that. Thank you science for that.

  146. #146 lilady
    December 12, 2011

    @ Mr. Peach: Thank you for sharing your “testimonial” as others have done on this blog.

    I can only imagine the outrage you and others who have undergone prolonged treatment for cancer must feel, when you read some of the downright ridiculous posts about alt/CAM cancer treatments.

    (Sipping my soda now) and, toasting you for your continued progress and good health…you really are a peach of a guy.

    lilady

  147. #147 Lawrence
    December 12, 2011

    I love how Neil thinks “evidence-based medicine” is inadequate….how else are we supposed to figure out what works without “evidence” that it does?

  148. #148 Neil
    December 12, 2011

    Lawrence – having trouble reading your own data of deaths from Doctors, mishaps, cock ups, blunders………….? Yep, many people have their evidence thanks. Have you got some evidence based data to confirm the USA is excessively overfat? I am still not sure yet.

  149. #149 Lawrence
    December 12, 2011

    Well Neil, a hell of a lot of people seemed to have died before modern medical care – including, you know, plagues, mass disease outbreaks, modern sanitation, etc….so, pointing out flaws in what we do today, well yeah, nothing is going to be perfect, but at least we continue to learn and improve – a heck of a lot better than wishful thinking.

  150. #150 Krebiozen
    December 12, 2011

    Damn those doctors who force people in the developed world to become obese and suffer diseases of affluence. They should be prising burgers out of the hands of fat people in junk food outlets, not wasting their time treating the sick. /sarcasm

  151. #151 Denice Walter
    December 12, 2011

    @ Delurked lurker:

    Well, thanks then.
    I truly believe that some of our detractors ( and silent lurkers who are currently on the wrong side of the fence- and it *is* wrong) are *reachable* if you can get them to think about these issues. So far my score is not at all good ( Jake, Blackie, Neil) *but* perhaps some day what I said will resonate with them….
    I am a remarkably even-tempered person : vitriol is merely a rhetorical device and sarcasm is a family tradition. However, I do like making fun of things.

  152. #152 Calli Arcale
    December 12, 2011

    Neil:
    Yes, doctors and other medical professionals (please don’t forget nurses and such) do make mistakes from time to time. Sometimes these mistakes are fatal, though it can be difficult to judge whether anyone should be blamed in many cases — there is such a thing as an honest mistake. And dishonest mistakes. There is an ongoing series on this blog about Dr Burzynski, who appears to be exploiting the clinical trial system to practice essentially without oversight, using chemotherapy drugs in ways likely to cause considerable grief for the patients and for little to no gain.

    This is all true.

    But does that mean you should try to treat advanced colon cancer purely by changing your diet? Of course not. That medical professionals make mistakes does not mean that naturopaths don’t, and that chemo is not always beneficial does not mean that dietary interventions ever are. You can’t just refute A in order to prove B (forgiving, of course, that “doctors sometimes make mistakes” doesn’t prove “you shouldn’t try chemo” — that would be a non sequitor).

    Chemo *works*. It’s usually very potent medicine, though, and thus it is *dangerous*. This means one should have a healthy respect for it and sift through the options carefully. Have a doctor who doesn’t want to talk diet and exercise? Get a different one. Most doctors would be overjoyed to find a patient who doesn’t grouse when lectured about their diet and exercise. Have a doctor who won’t listen to your concerns or offer multiple choices (or at least fully explain why he/she doesn’t feel there are more than two choices in a particular circumstance)? Again, get a different one — that’s a mark of an incompetent doctor, and you don’t want to be treated by an incompetent doctor.

    Seriously. Do not judge the profession by its worst examples, and be an advocate for yourself. There are usually more than two options; it’s not just “chemo” or “do nothing”. I’ve known a few people diagnosed with cancer; most of them were given several choices, and their oncologists patiently discussed the pros and cons of each. (The oddball case is my grandfather, who, as a former general surgeon over the age of 90, self-diagnosed as “probably pancreatic cancer” and decided he really didn’t want to deal with biopsies and surgeries and chemo; he was ready to go, and opted for hospice. Had he been a younger man, he probably would’ve chosen differently. He would have agreed vehemently that a proper diet and good exercise is important, but he would have disagreed about not seeing doctors. He was a big believer in the annual physical and routine screening — catch problems while they’re still small, whenever possible.)

    And about the “appearing before 100 million people” thing…. I’m not going to doubt it. What would be the point? It could be true or it could be exaggerated; it doesn’t matter. You’re a person, same as anyone else, and just as worthy of expressing an opinion. It doesn’t make your argument any more right, nor any more wrong.

  153. #153 Edith Prickly
    December 12, 2011

    @Cath in Canberra – thank you for sharing that, even though it is absolutely appalling. What a stark illustration of the real dangers of believing an alt-huckster’s claims.

    I read through a few older posts about that case and it’s interesting that she doesn’t mention the role her husband played in encouraging her to seek alternative treatment in the first place – it sounds like she was originally looking for help with infertility? I can’t believe he let it go on so long when she was suffering that kind of pain.

  154. #154 Denice Walter
    December 12, 2011

    @ Krebiozen:

    Ha! I listen to an idiot perpetually rant about how the corporations** conspire to poison/ fatten/sicken the People with ” burgers, pizzas, fries, sodas, coffee, candies, cakes” while the dieticians’ associations and governments stand idly by, *enabling* them.

    Last I looked, it seems that the People *like* to eat those tasty treats: must be some reason that creatures who evolved while nearly starving on the savannah or in a frozen wasteland should uh… *prefer* calorie dense foods, laden with carbohydrates and fat.
    I doubt that visions of alfalfa sprouts and acai berries dance in our heads.

    **PharmaFastFoodMedia

  155. #155 ArtK
    December 12, 2011

    @ Neil

    Art K. So which person/ study/ whatever is going to give you the green light that a certain alternative treatment works?

    It’s not one particular person and not one particular study. Part of the scientific process is independent replication. One high-quality study is interesting. Multiple studies independently producing the same or similar results is much more compelling.

    Your question highlights a big difference between science-based medicine and the alt-med community. The alt-med community are happy to adopt a “treatment” based on the testimony of one or a few people; SBM, not so much.

  156. #156 ArtK
    December 12, 2011

    Sound therapy with a didgeridoo? No wonder I feel good after listening to the Wicked Tinkers. And here I thought it was because I liked loud, raucous Celtic music.

  157. #157 Calli Arcale
    December 12, 2011

    Denice:

    Last I looked, it seems that the People *like* to eat those tasty treats: must be some reason that creatures who evolved while nearly starving on the savannah or in a frozen wasteland should uh… *prefer* calorie dense foods, laden with carbohydrates and fat.

    One big thing the conspiracy theorists tend to forget is that the corporations “conspiring” to fatten us are made up of people, and in many cases, they promote yummy food not because they are evil but because . . . well, it’s yummy. They like it too. The chefs who devise brainburgers and mountainous cheesy fries are not laughing evilly behind our backs as we trudge towards a lifetime of hardened arteries. They’re making these things because they like to eat them too.

  158. #158 herr doktor bimler
    December 12, 2011

    the corporations [...] are made up of people

    So corporations are Soylent Green?

  159. #159 Denice Walter
    December 12, 2011

    @ Calli:

    Right. As the solstice fast approaches the bustling financial and cultural capitols of NY and London** where it will be cold, dark, and probably damp, people have money in their pockets and appreciate cultural diversity in the form of ethnic restaurants and creative dessert ideas imported from Southern or Central Europe – not to mention products supplied by Tanqueray, Absolut, and Johnny Walker. I am proudly evolved from this tradition.

    ** as well as Minneapolis, Seattle, and Toronto.

  160. #160 Neil
    December 12, 2011

    MY GOODNESS Calli, A HUMAN that I could speak with around a camp fire! Calli, if I could see you now I would hug you and give you some flowers, hoping, and highly assuming that you are a woman, and I would even give you one of my home made organic juices.
    Yes, Chemo works. Bet you never thought I would say that did you? I have never said that it didn’t, some/many assumed that I am a whacko alt med freak with no regard to conventional treatment. I open my mind to possibilities, I am a great believer of possibilities and common sense, which can often perform higher than the ‘scientific’ community.
    I am also a great believer that the big problem with communicating in written form can be very easily misunderstood. And yes, I have been reading ORAC’s article on Burzynski,and should be finished by 2014( ha). It is at times difficult for me to understand as I am not medically trained.

  161. #161 Lawrence
    December 12, 2011

    Unfortunately Neil, it shows…..

    As far as common sense, well, that has been in fairly short supply in the woo-community…

  162. #162 Neil
    December 12, 2011

    Unfortunately Lawrence, you are a dickdead. But I would even give you a drink as well, thats of course, after you wake up off the floor.

  163. #163 Lawrence
    December 12, 2011

    Nice one Neil, did you think of that one all of your own?

    Given your beliefs, I’m surprised you’d even consider taking a drink – isn’t that supposed to be bad for you?

  164. #164 lilady
    December 12, 2011

    Neil…wanna expand on your TV performance career? I’m interested in what type of person/demographic composes the 100 million people who see your performances every year.

    @ Lawrence and Calli: I would be very leery of Neil’s “homemade organic juices”.

  165. #165 Narad
    December 12, 2011

    Yes, Chemo works. Bet you never thought I would say that did you? I have never said that it didn’t, some/many assumed that I am a whacko alt med freak with no regard to conventional treatment.

    So, you’re a whacko alt med freak with passing regard for conventional treatment on the side with your massively inflated* ego? How novel.

    * Not massive enough to answer direct questions, of course.

  166. #166 Neil
    December 12, 2011

    Lilady – ah, no. Privacy thanks.For now anyway.
    Narad – glad to see you are still trying to piss me off.
    Seeing as though you asked me, I will ask you. You don’t believe in nutrition, sound, Lipton, Didgeridoos, Naturopaths, organic food, meditation, ancient healing etc etc. That kind of narrows it down to bad luck/ genes. If it is bad luck/ genes would this be the same for everyone?
    At least this may get you to write with some dignity rather than your loser dead shit comments all the time about me that people don’t want to read.

  167. #167 Gray Falcon
    December 12, 2011

    Neil, please debate us, not the people you think we are.

  168. #168 Narad
    December 12, 2011

    Narad – glad to see you are still trying to piss me off.

    Quite frankly, I haven’t the slightest interest in your moods. If you could get around to ponying up your breatharian, then we could proceed, probably after a hearty laugh, to whether or not you are in fact guilty of the usual magical-blowhard blame-the-victim routine regarding the anecdote that I related.

  169. #169 Denice Walter
    December 12, 2011

    Here are a few reasons I find myself suspicious of alt med proselytisers’ claims:
    - when they discuss a topic I have formally studied ( in life or social sciences) it just doesn’t line up with what I have learned. If I investigate SB research that has been done recently to compare- still seems out of synch: e.g. Wakefield contra neuro-development; meds for SMI. Important parts are missing or un-related material is added.
    - sometimes alt med offers a new treatment that they predict will soon be the *ne plus ultra* in medicine, e.g. CoQ10 for heart disease- a “cure” suggested to my father in the mid-1990s; well, he’s dead 10 years and still no breakthroughs on this front. Similarly, topics about immunity and cancer.
    - research design/ statistical analyses leave much- make that *everything*- to be desired.

    I doubt that those who talk about this studied anything vaguely resembling that which I did. Sometimes the basics are very wrong. Either everything I studied is amiss or else these experts *aren’t* experts outside of their own estimation.

  170. #170 alison
    December 12, 2011

    You don’t believe in nutrition, sound, Lipton, Didgeridoos, Naturopaths, organic food, meditation, ancient healing etc etc.

    Neil, science doesn’t work on the basis of belief. It operates on evidence. If you (or anyone else) could provide solid, incontestable evidence that sound/didgeridoos etc actually achieve what’s claimed for them, then they would be accepted. This evidence does not include testimonials or hearsay.

  171. #171 Cath of Canberra
    December 12, 2011

    Some kinds of cancers can be prevented; some can have the odds lowered with sensible precautions; and some are just sheer bad luck, whether genetic or random. And of course not everybody is the same genetically or in luck. Duh. Why would you even ask?

    There’s plenty of good evidence that eating fruit, veg and fibre is beneficial, especially against digestive system cancers, and this is utterly regardless of whether the fruits & veggies are “organic” or not. Juicing is probably a bad idea, though, since it removes the fibre.

    Other good cancer preventatives: don’t smoke. Don’t drink too much alcohol (implicated in oral cancers, damnit). Don’t eat huge amounts of red meat, smoked or salted meat. Have an HPV vax if you are young enough. Wear sunscreen. Don’t go round inhaling coal dust or asbestos or pesticides. Don’t drink water containing benzene or arsenic.

    Didgeridoos are, unremarkably, absent from that list. I’d say they are probably good for you in other ways, like meditation and exercise. I’m not aware of exercise helping to prevent cancer, although it’s very good for you in other ways.

    Naturopaths, however, are always best avoided. Likewise positive thinking gurus (Liptonite or other), whose practices may seem harmless but usually end up with victim blaming when it fails to work. And “ancient healing”? Seriously? Well, that obviously worked soooo well for the ancients, who died at an average of 40-50ish. I’ll give that one a miss.

  172. #172 Cath of Canberra
    December 12, 2011

    Hey Orac, my posts seem to be going to moderation. Is it because I’m using a different nym now, maybe? No links.

  173. #173 Chris
    December 12, 2011

    Neil:

    You don’t believe in nutrition, sound, Lipton,

    No, I don’t like Lipton tea, I much prefer Red Rose tea.

  174. #174 Neil
    December 12, 2011

    Alison. I understand but I would not agree with you that it is always reliable and trustworthy. We have plenty of evidence for many things in human wellness, yet we are going backwards in many ways, forwards in others. Something called ‘control’ sometimes gets in the way of common sense it appears.

  175. #175 lilady
    December 12, 2011

    Neil…I don’t want to intrude into your “private world”…but just between the two of us…are you having visual hallucinations? Did you “google” Wernicke-Kosakoff Syndrome and “confabulation”?

    We are all waiting for you to discuss breatharians. Inquiring minds want to know!

  176. #176 Neil
    December 12, 2011

    Isn’t it about now that you start on your healthy soda drinks?

  177. #177 Gray Falcon
    December 12, 2011

    Neil, do you understand why we need solid evidence? Look up “bloodletting” and you’ll know why.

  178. #178 novalox
    December 12, 2011

    @neil

    Evidence, please. We’re all waiting.

  179. #179 Narad
    December 13, 2011

    Something called ‘control’ sometimes gets in the way of common sense it appears.

    Well, sure.

  180. #180 Calli Arcale
    December 13, 2011

    Neil:

    MY GOODNESS Calli, A HUMAN that I could speak with around a camp fire! Calli, if I could see you now I would hug you and give you some flowers, hoping, and highly assuming that you are a woman, and I would even give you one of my home made organic juices.

    Yes, I am a woman, though sometimes I like to say I’m a Time Lady rather than a human. ;-) (My nickname comes from the Doctor Who RPG. I started out on the Internet playing that, and it sort of stuck.)

    I’m glad we have some common ground. I think most people have far more common ground than they realize. Personally, I’m a great believer in conservative medicine — when possible, use the least therapy that will do the job, whether that be surgical, some sort of exercise, drugs, some combination of the above, or whatever. Consequently, I am reluctant to try something that doesn’t have evidence behind it. That seems like common sense to me, but I realize common sense isn’t actually that common — our own natural, human prejudice has us think that whatever *we* think is sensible is actually what most people think is sensible (and in our moments of greatest arrogance, what is actually true), but of course that’s not really so. You, for instance, put common sense above science, while my “common” sense tells me that science is more reliable than my own prejudices. So obviously there is difference in opinion.

    See, the thing is, just because something conforms to our prejudices does not mean it is true. It means it is satisfying, of course. But we should be suspicious of this. Things that are satisfying tend to cloud our judgement, and we believe things which are not true and not even adequately proven. (This is the purpose of the null hypothesis; if your data fits your hypothesis *and* the null hypothesis, your hypothesis is probably wrong even though the data fits it — the null hypothesis lets us tell if the experiment would’ve come out that way anyway.)

    You said to others:

    Seeing as though you asked me, I will ask you. You don’t believe in nutrition, sound, Lipton, Didgeridoos, Naturopaths, organic food, meditation, ancient healing etc etc. That kind of narrows it down to bad luck/ genes. If it is bad luck/ genes would this be the same for everyone?

    That’s a false dichotomy. If it’s not stuff you can do, it’s just genes and luck? Not true, and the data bears that out. It’s *both*, to varying extents, at different times. Genes are a factor in many cancers. Environmental factors are important in many cancers. And then there is the unknown — a great many of the factors remain unknown, though work continues. Luck? Yes, that’s surely a factor — carcinogenic substances can trigger mutations, but they don’t always, or the mutations aren’t functional enough to survive to become a malignant tumor, or they aren’t able to evade the immune system, or they don’t get that nasty immortality mutation. So environmental and genetic factors stack the odds — as far as medical science can tell, after that it’s a crapshoot. I would bet that as more research is done, we’ll find that the amount due to chance is smaller than we presently think, but is still significant — after all, cancerous mutations are somewhat random, evolution is involved (seriously), and that means there’s going to be an element of chance, inevitably.

    But that doesn’t mean diet and such don’t have anything to do with it. They do. They’re just not the whole picture. Healthy, hearty people who eat right and do all the “right” things can still get cancer. And people who eat junk and sit on the couch all day can live to get hit by a bus at 85. There are no guarantees. It still makes sense to exercise and eat well. Stack that deck. ;-)

  181. #181 lilady
    December 13, 2011

    Your heroine of the Australian breatharian movement “Jasmuheen” a/k/a/ Ellen Greve, has been roundly criticized for encouraging several young women to starve themselves to death…with notes left besides their bodies found in the bush…praising the no food and no liquids “breatharian diet”.

    Jasmuheen also exists on herbal tea and chocolate biscuits”…some breatharian, eh.

  182. #182 T-reg
    December 13, 2011

    @Neil:

    some/many assumed that I am a whacko alt med freak with no regard to conventional treatment

    Our assumption may have something to do with your opening statements on this thread – you ask questions, requesting intelligent answers rather than arrogance. When someone answers you without arrogance, you show them your own arrogance and deride them. That’s precisely what almost every alt med fanatic does.
    Besides, the way you argue here is also signature alt med style – only assertions and anecdotes, no proof.

    I open my mind to possibilities, I am a great believer of possibilities and common sense

    Part of the scientific process is to have an open mind to possibilities. However, we don’t stop there. We take it further from there to test whether the possibilities are consistent with reality. This testing is done in ways which are designed to minimize the chances of error. If any of the propositions are found to be inconsistent with reality, they are rejected.

    If you have been following this blog for some time, you would notice that posters here often acknowledge their mistake when presented with proper proof. When you are asked for proof here (or anywhere in the scientific community) it is usually with the intention that if adequate proof is provided, your view will be accepted. Sadly, the “proof” presented for almost all such wild claims tend to have glaring errors many of which are often easy to spot if you apply common sense.

    Just to illustrate how rigorous the scientific method is: The reason why Double blind studies are done is to not only account for the placebo effect, but also to avoid the bias of the observer which may interfere with the observations. This bias includes that for the treatment as well as that against the treatment

    As already mentioned they have little respect , not even for ancient ancestors of the land

    Many ancient cultures used to practice human sacrifice in order to please the gods for good health and prosperity. I don’t think there is any reason to respect such practices. A point which I’d like to use to drive home to you that just because ancient cultures practiced something doesn’t make it a valid practice. They were humans too and they could be wrong too.

  183. #183 lurker
    December 13, 2011

    Very thankful for Alt. Med and SBM- I really don’t know why they are so hostile
    to what they call woo. They claim profit motive..well….
    at least it hasn’t killed people as Merck’s infamous Vioxx with $2.5 billion
    in sales in 2003 alone.

  184. #184 Lawrence
    December 13, 2011

    Hmmmm….well, there was that guy out in AZ that forced people inside a sweat hut for hours under the guise of “spiritual healing” and caused several people to either die or require immediate actual medical attention….

  185. #185 tütüne son
    December 13, 2011

    Very thankful for Alt. Med and SBM- I really don’t know why they are so hostile
    to what they call woo. They claim profit motive..well….
    at least it hasn’t killed people as Merck’s infamous Vioxx with $2.5 billion
    in sales in 2003 alone.

  186. #186 Renate
    December 13, 2011

    There are so many examples of people dieing from various forms of alt med, one could make a very long list. Natural doesn’t equal harmless.

  187. #187 Calli Arcale
    December 13, 2011

    lurker (and the linkspammer who plagiarized you),

    My grandparents were both on Vioxx. They were devastated when it was pulled from the market; of all the things they took for their pain, it was the most effective with the least discomfort. I’m not entirely comfortable with the decision to pull it. I wasn’t entirely comfortable with the decision to pull Seldane either, years ago; I used to take that for my allergies, but the manufacturer voluntarily withdrew it after it was found to cause deaths in a few people taking very high doses of intravenous antibiotics in the hospital. Eventually, they came out with a safer alternative, Allegra. I take Allegra now; I like it. It works. But it’s a freakin’ horse pill compared to Seldane, because you need twice the dose for it to be effective. And it’s more expensive. (Terfenadine, Seldane, is essentially a metabolic precursor of fexofenadine, Allegra. giving fexofenadine instead relieves the strain on the liver that will also be processing those antibiotics and whose capacity will become exceeded at very high doses of one or the other.)

    I’m not entirely convinced the right thing was done with Vioxx. I *am* convinced, however, that Merck behaved dishonestly and deserved to lose a lot of business for it. My main problem is that they didn’t suffer overmuch. The patients who too Vioxx suffered, and continue to suffer.

    But is that important? Not really. We’re not talking about Vioxx. We’re talking about cancer treatment, and how chemo compares to alternative treatments.

    I personally do not care where a treatment comes from, philosophically, as long as there is evidence for its safety, side effects, and efficacy; I need that information to decide whether or not to accept my doctor’s recommendations, because it’s crucial to the risk/benefit analysis. Well, that’s not entirely true — I do care where the treatment comes from insofar as I care that it is obtained ethically. For instance, I will never try bear bile or rhino horn to treat my cancer, no matter what evidence someone gives me — I’d honestly rather die than contribute to those particular horrors. Especially the bear bile. I don’t think I could live with myself, knowing how it is obtained. (That said, I’d be fine with its synthetic equivalent, provided there was evidence.)

    We don’t have problems with medicine that comes from “out of the box” thinking. But by definition, alternative medicine is that which cannot be accepted by mainstream medicine due to a lack of evidence. So folks here have a problem with it on the grounds that it is massively oversold. If you object to Merck’s shameful behavior with respect to Vioxx, you should be appalled by what goes on in alternative medicine. Merck lied about their research, but at least they did the research. The people who sell traditional chinese medicine do not really have any idea whether or not it is safe, beyond the knowledge that people have been using it for a long time and they haven’t heard of anybody dying of it yet. That’s a very low bar.

    And people do get hurt by “woo”. Most of the time, it’s by delaying proper treatment (how many people have we read about here who went from an easily treatable cancer to a massive and definitely terminal metastatic cancer between the time of first diagnosis and the time they finally gave up on whatever alt med they were trying and went to an oncologist?) but sometimes its direct. Lawrence already mentioned the guy in AZ. There was the spate of atropine poisonings from babies given homeopathic belladonna drops. Ayurvedic medicine is famous for its use of lead as a medicine. (There was a big to-do about someone finding that ayurvedic medicines imported from India were contaminated with lead; apparently they didn’t dig far enough to know that it’s not contamination — it’s supposed to contain lead.) Chiropractic has caused deaths due to vertebral artery dissection. Even acupuncture has caused deaths; the most common adverse side effect is infection at the needle site (which is complicated by the fact that so many acupuncturists are germ theory denialists) but some particularly enthusiastic practitioners have actually punctured lungs and other internal organs. Supplements are poorly regulated, and commonly differ in potency from what is on the bottle; Gary Null famously ODed (but survived) on Vitamin D because the supplement he was taking had a rather drastic manufacturing defect — something like a 100-fold overdose. Intentional megadosing is usually harmless (the body’s usually pretty good at dumping the excess, meaning the main result is generally expensive pee), but can sometimes lead to serious illness or even death, especially if it’s a child. Natural remedies can be harmful too; St John’s Wort is a popular natural antidepressant (and it has some effect, though when tested, OTC supplements have varied so widely that it’s unlikely to get much clinical benefit) but it interacts with a lot of drugs — including antibiotics and birth control pills, reducing their effectiveness. For the diet-fixes-everything folks, consider that grapefruit is infamous for the number of drugs it interacts with. And then there’s the insanity of chelation therapy, an alternative use of a mainstream treatment for heavy metal toxicity. That has claimed lives, due to acute hypocalcemia.

    Use what has evidence in its favor. If you don’t require evidence, you are playing a game of chance, with your life at stake.

  188. #188 lilady
    December 13, 2011

    Still waiting for Neil to provide information about his “breatharian” claims. It makes one wonder if any of his “claims” are true.

    I see “lurker” is back with the same tired arguments…yawn.

  189. #189 herr doktor bimler
    December 13, 2011

    lurker (and the linkspammer who plagiarized you)

    I’m not seeing much difference between one spammer and another.

  190. #190 lurker
    December 13, 2011
  191. #191 Dianne
    December 13, 2011

    I really don’t know why they are so hostile
    to what they call woo. They claim profit motive..well….
    at least it hasn’t killed people

    Check out the website whatstheharm.net before making this sort of statement. Woo kills.

  192. #192 JR in WV
    December 15, 2011

    Neil,

    My wife just spent 8 weeks and 1 day in hospital, starting with pneumonia and septic shock. I took her to the ER, and the second time they asked her for her birthday, she said 1913. In two minutes she was in a treatment bed in the ER, had a CT scan of her head to be sure she wasn’t having a stroke, was put on a ventilator, and had multiple antibiotics administered to slow the effects of the infection.

    They administered steroids, blood pressure meds to fight the shock, and she wound up in MICU for 2 weeks, where a team of doctors and nurses saved her life. Since I was quiet and helpful, and alone, they allowed me to be with her 24 hours a day, my choice. I spent 16 or 18 hours at a time holding her, rubbing her foot, and telling her I loved her, and that she was getting better each day.

    Sometimes I wondered what her outcome would be, and called a doctor friend who helped me cope with the unknown. Survival rate for septic shock is under 40%, so the fact that we just had soup together means she beat the odds. My Dr buddy told me not to gamble any more (I never have, really) ’cause I just used up all my luck on her.

    Later in her recovery, she had a collapsed lung, and they put in a chest tube right there in the hospital room. After the air leak (that’s what causes a lung to collapse, an air leak) didn’t heal up, the surgeon told us he wanted to repair her lung surgically, sutures and surgical glue, 20 or 30 minutes.

    We were together in pre-op with a nurse anesthetist when they wheeled her away, and I went to the surgical waiting room, which was full of families waiting to hear what the news was about their ill loved one. I waited nearly 4 hours, way past 20 or 30 minutes.

    The surgeon came in, and was exhausted. He told me when he slid the video camera in, part of her left lung was necrotic, like mushy bread crumbs, completely unexpected, a shock to everyone around my wife. He had to work without having a plan prepared, using his 30-odd years of experience and his good judgement. He removed all the damaged tissue, coated everything with antibiotics, all done through two tiny incisions an inch long. At the end, he put in 2 chest tubes through the incisions he used for the surgery.

    I was surprised to learn that there is no diagnostic test to identify necrotic tissue (dead and rotting) in the body.

    She had a long recovery in the hospital, and after some discussion between doctors, she was allowed to come home with a chest tube, as her lung was still leaking air. We had an appointment with her surgeon for 3 weeks later, and that’s when he removed the tube.

    One of the surgeon’s prescriptions for my wife was 2000 mg of vitamin C daily. She’s taking 500 mg tablets, 4 a day. No surprise, our family doctor told both of us to take vitamin B6 and vitamin D regularly.

    She is on a medley of other medications to control her heart rhythm, blood pressure, fat levels in her blood, etc. She’s been given handouts on heart healthy diets, has a physical therapist visit twice a week to supervise an exercise program.

    The physical therapist asked us to use fresh fruit and yogurt with protein powder in a blender to make smoothies to be sure she gets enough protein and fruit. We always had fresh fruit in the fridge, but we’re going through a lot more of it now.

    This was all the result of plain old medicine, done very well, at a hospital with great outcome results, the best in the US in some areas, right here in W. Va.

    Neil, if you aren’t getting this kind of advice from your doctor, you need a better doctor. Maybe one with board certification in family practice, like our family doctor.

    Good luck, if you do get sick. Nothing beats good medical care.

  193. #193 Neil
    December 16, 2011

    Hi Jr

    Thank you very much for taking the time to write, and hopefully you read this. I wish you and your wife well and manage to enjoy another Christmas together as you sound like one of these classic wonderful couples who have probably been together for many many years.

    I am one of the lucky people who personally know some fantastic progressive medical professionals. In my profession I have been fortunate to meet a huge diversity of health professionals and have opened my eyes immensely.

    I am keen to learn about longevity. Do you have any tips?
    I wish you and your wife the best for the future.
    God bless.

    Thanks again.
    Neil