Respectful Insolence

Another Christmas is over, and we’re settling in to that strange week between Christmas and New Years when, or so it would seem, most of the world isn’t working except for retail. I’m half taking the week off from work in that I don’t plan on going into the office if I can possibly avoid it, but will be starting up a couple of grants for the February/March NIH cycle and dealing with a couple of nagging issues left over from before the holidays. Regular readers might have noticed that ScienceBlogs had a bit of a glitch beginning sometime in the early morning hours of Christmas morning and not ending until yesterday sometime. In essence, although you could read the blogs, you couldn’t comment, and all the bloggers were locked out of the Movable Type back end. Since that provided me an excellent excuse to take a day off from blogging, I did. I was still recovering from the food and wine coma of the last two days anyway and probably didn’t have anything coherent to say, if I ever do.

But what should await me this morning when I decided to take a look and see if ScienceBlogs were fully up and running again? It’s something I had hoped to be able to ignore until 2012, having blogged enough about it over the last month or so. I’m referring to the “brave maverick” cancer doctor Stanislaw Burzynski and his Burzynski Clinic. Read the links for the full, Orac-ian deconstruction of what Burzynski appears to be doing, but the brief version is that he uses what he calls antineoplastons, which he claims to have originally isolated from urine back in the 1960s and 1970s but now synthesizes chemically, to treat cancer. It turns out that these antineoplastons are nothing more than the metabolic products of a real drug, phenylbutyrate. This is a drug that was initially used to treat urea cycle disorders but has also shown (very) modest promise in treating some forms of cancer and that these days Dr. Burzynski appears to be switching over to using off-label phenylbutyrate but still calling it “antineoplastons” and charging outrageous sums of money to his patients. In addition, these days, seeing a profit opportunity, he’s jumped on the genomic bandwagon–incompetently–and started offering what he calls “personalized, gene-targeted therapy,” which, when looked at more closely, is really nothing more than a simplistic use of a commercially available test to pick out a witch’s brew of chemotherapy, targeted therapies, and antineoplastons phenylbutyrate, put together with little or no thought to synergistic toxicities or whether they interfere with each other’s actions or not. All of this, he sells as being “not chemotherapy” (it is; it’s just incompetently administered chemotherapy) and “natural” (it’s no more natural than taxol, which was originally derived from the bark of the Pacific yew tree and turned into a chemotherapy drug). Through all of this, Burzynski has tried, through his PR flack, to silence bloggers who criticize him and thereby protect the lucrative cult of personality he’s built around his name. Now, it appears that there is another aspect of Burzysnki’s practice I need to comment on, as mentioned on Pharyngula (crossposted here) and Furious Purpose, and that’s physicians who send their patients to Burzynski.

By way of background, I’ve noted before that there is a particularly disturbing aspect of Burzynski’s practice. That’s how his patients, convinced that Burzynski can save them (or, if they’re parents, that he can save their child) will, understandably go to extreme lengths to raise the often hundreds of thousands of dollars Burzynski charges to apply his science-y-sounding woo to cancer. It is not at all uncommon for these families set up charities designed to raise money, or, as I put it a couple of years ago, to harness the generosity of kind-hearted strangers to pay for woo. In fact, it was a couple of high-profile cases, one involving U.K. performer Peter Kay, who did two charity concerts for a Burzynski patient, that originally brought the attention of the skeptical blogosphere on Burzynski. More precisely, it was the reaction of one Marc Stephens, who claimed to represent the Burzynski Clinic and in that claimed capacity issued legal threats against bloggers, that brought the attention (and wrath) of the skeptical blogosphere down on Burzynski. In any case, I thought that that was the worse aspect of Burzynski’s activities, that he seemingly encouraged his patients with terminal cancer to go to such lengths to raise money, the better to enrich himself. There is now, however, another aspect that could be at least as disturbing. I haven’t made up my mind yet, because I don’t know if what I’m learning about this aspect of Burzynski’s activities. If what PZ and Furious Purpose write is accurate, then Dr. Teo is about as unethical as it gets. However, I suspect things are not as simple as what is being written.

Meet Dr. Charles Teo, a neurosurgeon currently in Australia. Apparently, he has a history of funneling patients to Burzynski, although it’s not clear at all to me whether it’s Dr. Teo who promotes Dr. Burzynski or whether he’s just working with patients who have decided to go to Dr. Burzynski. For example, here is one patient description cited:

After much research and the help of many friends we discovered Dr Charles Teo from Prince of Wales Private Hospital in Sydney, who performs surgery on inoperable brain tumors. Dr Teo is a neurosurgeon who has pioneered a method of minimally invasive brain surgery and has successfully performed around 5000 operations. Dr Teo has offered to operate on David and at this stage the operation is scheduled for Friday, 20th September 2002. David, with the support of his family will fly to Sydney on Wednesday, 18th September 2002.

This process is not a cure, however, it is designed to relieve the pressure by reducing the size of the tumor, he will need further treatment to kill off any remaining pieces of the tumor. The treatment being researched at the moment is antineoplastons treatment which is administered by the Burzynski Clinic in Houston, USA.

One notes that this is from 2002 and 2003 and that it is not at all clear from the description above that Dr. Teo suggested that this family go to visit Burzynski or that this patient is evidence of Dr. Teo taking advantage of dying patients.

In all fairness, this case is a bit more damning:

However, Braydon’s mother Zoe Cobb hoped the Sebastopol toddler could begin treatment soon at the Burzynski Clinic in Houston, Texas.

“We’ll talk more about it with Charlie (Dr Charles Teo) this afternoon,” Zoe said. “We’re just off for the MRI scans now.”

The Burzynski Clinic, named after founder Stanislaw Burzynski, specialises in individual cancer treatments.

Zoe said they had discussed taking Braydon to Texas with Dr Teo, who said he felt it would be a good option for the four-year-old.

However, before you decide, take a look at this video:

And this one as well:

There is a type of surgeon who represents the true “brave maverick” in that he is highly skilled, highly confident, and willing to take on seemingly “hopeless” cases. Surgeons like this will often, as described above, operate on patients who have either been operated on before by other surgeons who couldn’t fix what was wrong or been turned down by other surgeons as “inoperable.” Of course, “inoperable” is not a hard-and-fast word in that what is inoperable to one surgeon might well be operable to another. It’s also a very fine line in that this is an area where science- and evidence-based medicine collide with personal surgical skill. There are surgeons out there who are just so good that they can physically do with their hands what other surgeons, talented and experienced as they might be, cannot. Alternatively, they are far less risk-averse than the typical surgeon in their specialty and are therefore willing to attempt things that other surgeons won’t, such as the resection of “unresectable” brainstem tumors. Where daring ends and recklessness begins is a very fuzzy line with surgeons such as these. When they fail, they fail spectacularly, but when they succeed sometimes the result is the patient described in the video above. Surgeons such as these might very well cause a lot of complications and unnecessary suffering through aggressive–even reckless–pushing of boundaries. However, they also push the envelope (which Dr. Teo even says explicitly that he is trying to do in the second video), which can lead to advances in surgery and can sometimes save patients thought to be unsavable. Where the balance between the harm and good done by such surgones lies is, again, not a trivial thing to figure out.

It probably doesn’t help that Dr. Teo has other aspects of the “brave maverick” doctor. For example, if you search for his name plus “cell phone cancer,” you’ll find a plethora of articles and videos featuring Dr. Teo warning against the dangers of cell phones as a cause of brain cancer:

Brain cancer surgeon Charlie Teo has urged people to put mobile phones on loudspeaker, move clock radios to the foot of the bed and wait until microwaves have finished beeping before opening them.

The controversial Sydney specialist told a Melbourne fundraiser that although the jury was still out on mobile phones and other forms of electromagnetic radiation, we should not take risks.

“Even though the jury’s not in, just to err on the side of safety I would try and limit the amount of electromagnetic radiation that you’re exposed to,” he said.

“The American government, for example, recommends that all electrical appliances should be put at the foot of the bed and not the head of the bed.

Then there’s this video:

At around the 3:35 mark, Dr. Teo is featured saying unequivocally that he believes mobile phones can cause brain cancer. Later, the reporter engages in a blatant bit of fear mongering by noting that mobile phones use microwaves and you wouldn’t think of putting your ear up next to a microwave oven.

The stupid in that video, it burns brightly, rather like what would happen if you put metal in a microwave oven.

So, we can see that Dr. Teo is not a very good judge of epidemiology or basic science. Yes, I’ve refused to concede on many occasions that a link between cell phones and cancer is physically impossible, as some physicists have unwisely done based on a Cancer Biology 101 understanding of cancer, but I do consider it incredibly implausible that there is such a link. Maybe not homeopathy-level implausible, but almost. Also, as I (and others) have pointed out time and time again, not only is a link between cell phones and cancer incredibly implausible based on what we know about physics and biology, but the epidemiological evidence is overwhelmingly against such a link existing. There’s no convincing evidence for an increase in the incidence of brain cancers and no good evidence that the laterality of brain tumors correlates with the side of the head people hold their phones to. In brief, there is no good reason, based on prior plausibility informed by basic science or on epidemiological evidence, to think that mobile phone radiation causes brain cancers.

But Dr. Teo believes it does, which makes me think it’s not all that much of a stretch to think that he would be susceptible to the fancy-sounding blandishments of a charlatan like Dr. Burzynski.

And that’s why I think that what’s more likely to be going on here is something way more nuanced than what PZ and Furious Purpose think. Subject to change as more information comes in, I reject, based on what I’ve been able to find out thus far, the contention that Dr. Teo is operating on patients with inoperable brain cancer in order to make money off of them. Certainly neither PZ nor Furious Purpose have made a convincing case for that. A far more likely explanation is that Dr. Teo is one of those “cowboy surgeons” who will operate on risky patients that other surgeons won’t. When he agrees to operate on someone with an “inoperable” brain cancer, from what I can tell he almost certainly believes that he can do what other surgeons can’t: Remove the tumor and possibly cure the patient. It appears that, often enough, he’s right. Based on what I’ve been able to find out, unless there is more information that I’m not aware of, I have little choice but to say that I consider it at best highly irresponsible (and–dare I say?–most unskeptical) and at worse downright scurrilous to leap to the conclusion that Dr. Teo is intentionally operating on inoperable brain tumors just to make money and then funneling patients to the Burzynski Clinic, as PZ claims here (and here):

Teo is an Australian surgeon who has a brilliant scheme for anyone with a bit of surgical skill and a complete lack of conscience. He performs surgery on inoperable brain tumors in kids dying of cancer, and then ships them off to the Burzynski clinic in Texas to get injected with urine and die.

You’ve got to admit, marshaling the resources of a hospital, opening up a child’s skull, and diddling about with a knife inside without killing them is an amazing feat of impressive showmanship, sure to make devastated parents think something is being done worth $20-60,000 — even if there is no evidence at all that poking a glioblastoma with a pointy object offers any therapeutic benefit at all. I wouldn’t be at all surprised to learn that Teo is actually a very skilled surgeon. The problem is that brain surgery is not a panacea, and sometimes it is a totally inappropriate approach to deal with some cancers.

Or as Furious Purpose claims here:

From reading the stories of those desperate parents of children with inoperable brain tumours, I must conclude that Dr Charles Teo may deliberately choose to operate on children with tumours he knows these kids will die of, because current medical science has no cure to offer them. He then removes the tumour or at least some of it for what is said to be between 20000.- and 60000.- dollars for the surgery at Prince of Wales Hospital in Sydney and the high dependency care required afterwards, and he then recommends to the parents for their child to have additional treatment with “antineoplastons” at the Burzynski clinic in Houston, Texas. Treatment that is not FDA-approved, that has not been shown in trials meeting current scientific standards to be effective, and that is given only in exchange for exorbitant sums of money, and may be refused if the money is not forthcoming.

Charles Teo and Stanislaw Burzynski appear to be making money from the desperation of parents of dying children. Teo seems to be offering hope through surgery when there is none, and he then seems to be referring those same desperate folks for more false hope, and more expenses, to the Burzynski clinic in Houston.

Nonsense! Neither Furious Purpose nor PZ has anywhere near enough evidence to justify accusing Dr. Teo of something so vile and despicable.

It’s far more likely that Dr. Teo’s just an aggressive surgeon who thinks he’s doing his best for his patients by trying to remove tumors that other surgeons consider unresectable. Again, there’s a fine line between being surgically aggressive and surgically reckless, and there’s also insufficient evidence in the public record for me to judge whether Dr. Teo has crossed that line.

The second part of the accusation against Dr. Teo is a bit trickier. Is Dr. Teo funneling patients to Dr. Burzynski after having operated on them for in essence no reason? We only have two cases to go on, one of which doesn’t describe Dr. Teo as saying anything about the Burzynski Clinic or antineoplastons, the second of which quotes Dr. Teo as saying that he felt it would be a “good option” for his patient. Whether Dr. Teo suggested it or the patient’s parents latched on to the Burzynski Clinic and Dr. Teo gave his blessing is not known. From what we know, at best we can conclude that Dr. Teo’s grasp of science is not the greatest and that he’s prone to dubious science, as evidenced by his enthusiastic embrace of the “cell phones cause cancer” pseudoscience making the rounds. It’s quite possible that he’s similarly prone to being impressed by bad science and pseudoscience like that promoted by Dr. Burzynski. If that’s true, it’s bad. Very bad. However, it might not be true. We only have two cases that we know about over 8 or 9 years to go on, and Dr. Teo operates on hundreds of patients a year. These two cases could easily be outliers.

It’s clear that Dr. Teo is a controversial figure. He’s wrong on mobile phones and cancer. He also seems to have a bit more of the flamboyant showman in him than is good for a surgeon to have, a point that several of the stories I’ve cited make, and he definitely seems very cocky, perhaps more so than is necessary to be a neurosurgeon. (After all, it takes a certain amount of cockiness to have the confidence in yourself that you can crack open someone’s skull and remove part of his brain without leaving him permanently disabled.) It’s also pretty clear to me that Dr. Teo is the type of surgeon who pushes the envelope, perhaps bordering on recklessness at times. If that’s the case, he should be called out for subjecting patients to operations that can’t help them. However, I’m not convinced that that’s the case. In fact, it is not in the least bit clear to me that Dr. Teo is the sort who operates on patients whom he knows he can’t cure in order to make money, and I wish I didn’t have to point that out. When it comes to whether there’s any sort of relationship between Dr. Teo and Dr. Burzynski, I can only conclude that it’s possible–likely, even–that Dr. Teo is a bit too credulous about Burzynski’s results but that there is nowhere near enough evidence that I’ve been able to find to conclude that Dr. Teo and Dr. Burzynski have some sort of relationship in which Dr. Teo sends patients Dr. Burzynski’s way after operating on them. If there is such a relationship, then I would condemn Dr. Teo in the strongest possible terms–but I need a lot more convincing than either PZ or Furious Purpose has provided before I can come to a conclusion.

Comments

  1. #1 Anj
    December 27, 2011

    I would be interested to know what Dr. Teo’s colleagues think of him. If Dr. Teo really can do what other surgeons can’t – are they interested in learning how? Does Dr. Teo make an effort to document his techniques so others can learn from them?

    If you really can create better outcomes, then people who are in the field usually notice and want to learn how they can improve their outcomes as well. Sometimes this interest and scrutiny reveal unsupported claims.

    I would be interested in learning more about Dr. Teo.

  2. #2 Orac
    December 27, 2011

    It’s actually a bit more complicated than that. Surgeons are humans, too, which means that they don’t always take kindly to it when another surgeon disagrees with them and then goes and removes a tumor that they said couldn’t be removed. It makes them look bad. So, although I’d like to think that all of us could put aside our resentment at being shown up, not all of us can. Of course, that’s assuming Dr. Teo can do what he claims he can do, which would require looking at his outcomes in great detail to see if his rate of complete resection is higher than other surgeons and what his survival rates are. This is not an easy analysis, because it has to be adjusted for all sorts of things.

  3. #3 peter barton
    December 27, 2011

    Very interesting thesis on Dr Burzinsky. Like you I remain skeptical though at present a patient I know to be incurable,(peer reviewed) has an inoperable tumour shrunk by 36% in just 6 weeks. Yes it could be happen chance but even UK Oncologists are curious. We must have facts on this treatment and its success/ failure and this can only happen when the authorities are able to scientifically examine the results. This has gone on for far to long and shames science.

  4. #4 Dangerous Bacon
    December 27, 2011

    Dr. Teo (quoted above): “The American government, for example, recommends that all electrical appliances should be put at the foot of the bed and not the head of the bed”

    Oh…really? How did I miss that announcement? Anyone have an official source, before I race to disconnect my clock radio and move it to the foot of the bed (I’ll need to buy a new end foot table as well)? Or would it be enough to wear one of those old-fashioned deep sea-divers’ helmets to bed to protect myself from the electromagnetic radiation?

  5. #5 Tim Farley
    December 27, 2011

    Thanks for the measured reaction. I think we’ve had too many of these mob-like reactions in the skeptic community of late, one of these days its going to come back and bite somebody in the form of a libel lawsuit. Some of the Twitter conversations where Burzynski critics are directly shouting at current patients are becoming quite distasteful.

    As skeptics we need to be careful about going in the direction the evidence is leading us, but no further along than it currently merits.

  6. #6 Richard
    December 27, 2011

    @Dangerous Bacon:
    I think the real solution is going to be a Faraday cage built into a Snuggie, or for the more fashion conscious among us, a onesie. Of course, that still leaves the head exposed, so perhaps a gimp hood with the faraday cage wiring would need to be added to the ensemble.

  7. #7 @superzac
    December 27, 2011

    Thanks for injecting some common sense. I read the article from PZ and it was so flimsy it made me apoplectic. Cudos

  8. #8 lilady
    December 27, 2011

    Dr. Teo may be a good, possibly a great, neurosurgeon. He does however, some “odd” opinions about brain tumor prevention. From his website, the “Neuroendoscopy Centre For Minimally Invasive Neurosurgery”:

    “What causes brain tumours?

    The short answer is that no-one knows why brain tumours occur. There are many theories, some of which are scientifically sound, others being nothing more than speculation. Here are some of those theories. Please remember that no definitive cause has been found and therefore we should not draw any firm conclusions based on non-factual information:

    Genetic Arguments for this theory are mostly based on the close association between some congenital syndromes and brain tumours. There is a condition called neurofibromatosis(NF) that is characterised by multiple soft tissue tumours. The abnormal chromosome has been localised to chromosome 22 and 17. Those with NF1 may suffer from tumours anywhere along the visual tract and those with NF2 get tumours of the vestibular nerve. Also, some people with brain tumours have an over-expression of certain growth factors (PDGF) and cancer genes (proto-oncogenes) and a depletion of tumour suppressor genes. These genes and growth factors are found in many people without cancer.

    Ionising Radiation Ironically, radiation that is given in limited doses to treat patients with malignant tumours, may also cause malignant brain tumours when given in higher doses.

    Electromagnetic Radiation The Scandinavians first alerted us to the adverse effects of very low frequency EMR. They showed quite conclusively that people who lived close to high tensile electrical wires were at greater risk of developing cancers, including brain tumours. To extrapolate this data to other electrical appliances may be over-reacting but it is generally accepted that one should try to limit exposure. Mobile phones emit EMR. More info.

    Immunosuppression The scientific community accepts unequivocally that the immune system plays an important role in the genesis and control of any malignancy. The relative importance is disputed. Some people with brain tumours do have deficiencies in their immune system, but the majority are not immunosuppressed. Dr Teo is a strong believer in the importance of keeping the immune system primed. This can be done with exercise, a diet rich in anti-oxidants, positive thought, reduced stress and laughter.”

    Is he joking, or what?

  9. #9 Anj
    December 27, 2011

    ….
    pondering the effect of being a surgeon who becomes known for saying “Yes, I can!” when other surgeons decline to operate.

    Certainly it can result in the patients who have the choice of certain death without surgery seeking that “Yes, I can!” surgeon out for treatment. How does one judge the results? Is “I gave them a better chance they would have without surgery.” an adequate defense if the outcomes are relatively poor?

    Are there any historical precedents for cutting edge techniques (that were later widely adopted) being developed outside of academic institutions (the usual venue) or the military (another known venue)?

  10. #10 warthog
    December 27, 2011

    It seems pretty likely that parents who were desperate enough to keep looking after first and second opinions said “this is inoperable” would also shop around for cancer treatments that were out of the mainstream.

    There are alternative possibilities here.

  11. #11 Aegis
    December 27, 2011

    I think this can be pushed a little further honestly. As a doctor in Australia I know a bit about teo (although I am not a neurosurgeon).

    As you could probably expect his media presence and his challenge to established practice (i can do better) make him… unpopular … among a fair proportion of neurosurgeons. He is often in thee media suggesting, implicitly, that many patients that other neurosurgeons let die could be saved if the surgeons just had the skill and cajones. Unsurprisingly surgeons do not like people who do this.

    He also showboats further, for example he sold a rich guy access to watching him operate, which certainly pissed off a wider set of the medical profession.

    The point I am trying to make is that teo is under a lot of scrutiny. He is not well liked in the medical fraternity, and in his speciality in particular. There are a lot of people who would probably get some pleasure in taking him down a peg.

    He hasn’t been taken down a peg. I suspect this means that the evidence for his surgery outcomes is at least debatable, if not clearly in his favour. It is oblique evidence, true, but probably compelling.

    I have no relationship to teo at all, and to be honest I think his brand of ‘pushing the envelope’ is verging on unscientific, but I totally agree that there is no evidence for the claims made, and he probably is doing what he thinks is right. He is at least doing it well enough to not get closed down, despite fairly strong opposition

  12. #12 Orac
    December 27, 2011

    Actually, of all the things I’ve read about Teo, his having sold access to watching him operate is probably the one thing I can point to as being pretty damned unethical to have done. As for the rest, one wonders if, because he’s not liked by his colleagues because of his brashness and—let’s face it—his basically insulting them by basically accusing them of not being as good as he is, it’s quite possible that he has sympathies for other “brave mavericks” like Burzynski. However, given Teo’s idiocy with regards to the cell phone/cancer link, it’s also quite possible that he’s not particularly discriminating on a strictly scientific basis. In any case, even though Teo sounds like a first class tool, there’s no evidence that I could find to back up PZ’s or Furious’s accusations against him.

    I’m very, very disappointed in PZ. I don’t know Furious; so I don’t know enough about him to have formed an opinion to be disappointed.

  13. #13 8
    December 27, 2011

    For the sake of accuracy it’s worth pointing out that Burzynski seems to be using mainly oral phenylbutyrate for most cancers, but intravenous mixtures of phenylacetate/phenylacetylglutamine for brain timours, based on what I can gather from patient blogs. PB is broken down in the body to make PA/PAG.
    The fact that the medical community in the US, UK and beyond don’t know the true identities of antineoplastons (or have linked it to the peer-reviewed literature about PA/PB- which does show hints of efficacy in some brain tumours) is most unfortunate, especially as PB is allowed to be prescribed off-label for brain tumours in the US. At the very least, Burzynski’s behaviour as a doctor and a scientist is misleading the medical and scientific community, and at worst – if PA/PB do have any efficacy in brain tumours at that stage – denying the truth about these relatively cheap off-label drugs to any patients who are not able to afford his fees. Something still doesn’t add up here.

  14. #14 David
    December 27, 2011

    lilady @8: “Dr. Teo may be a good, possibly a great, neurosurgeon. He does however, some “odd” opinions about brain tumor prevention.”

    Actually, except for the EMR stuff, most of what he posted is mainstream. And the EMR stuff is rooted in real science. The problem I see with it is that he doesn’t reference the refuting evidence. And in any event, he very strongly prefaced the material by saying it included speculative ideas.

    Thanks, Orac. Great post.

  15. #15 Irene
    December 27, 2011

    Cancer and cell phones? Let’s ask xkcd:
    http://xkcd.com/925/

  16. #16 DLC
    December 27, 2011

    Granted, two data points to not make a good curve. However, Dr. Teo has some disturbing symptoms about him. I’ll note that in reply to PZs post about it, I ask if Dr Teo knows what a quack Burzynski is or if he would care if he knew.
    I’m not so generous as you, Orac. A man I would trust to bore a hole in my skull has to not be a damned fool.

  17. #17 Aegis
    December 27, 2011

    By the way, here is a greater than 1hr long talk directly with Mr Teo. From memory he discusses a lot of what is covered here (although not anything about use of other ‘therapies’ such as the antineoplastons).

    http://www.abc.net.au/tv/bigideas/stories/2010/12/02/3082876.htm

    download or stream links on the page

  18. #18 Aegis
    December 27, 2011

    sorry, his section is about half an hour, not over 1hr. It starts at about 20 minutes in, but really it is pretty different from the impression PZ gives.

    Orac in particular should find a lot to like in that talk I think, although the idea of pushing boundaries outside the evidence base is somewhat worrying. He is a very compelling speaker though.

  19. #19 Aegis
    December 27, 2011

    I just rewatched that talk … pretty amazing Q+A at the end. If the talk is unavailable in US I can download it and up it somewhere, let me know

  20. #20 Orac
    December 27, 2011

    Granted, two data points to not make a good curve. However, Dr. Teo has some disturbing symptoms about him. I’ll note that in reply to PZs post about it, I ask if Dr Teo knows what a quack Burzynski is or if he would care if he knew.

    I’m not so generous as you, Orac. A man I would trust to bore a hole in my skull has to not be a damned fool.>/blockquote>

    Even if what you said is true, doesn’t it bother you that PZ and Furious both accused Dr. Teo of operating on children for profit even though he knows he can’t save them? Even if Dr. Teo has a bit of a soft spot for Burzynski’s woo (which, I note, an assertion that has not been convincingly demonstrated), it goes way beyond the pale to accuse someone of, in essence, medical malpractice and fraud based on such flimsy evidence.

  21. #21 thinline
    December 27, 2011

    Thanks, I read PZ’s post and it annoyed me, as did some of the comments (particularly the moron saying he should have his medical license revoked). They obviously know enough about Teo from one speculatory post to come to that conclusion (blindly following the leader whaaaaat?). Granted, as an Australian I probably hear about his exploits more often than in the States. He is very controversial, but the blogs by PZ (what kind of headline is “Charles Teo has a lucrative racket”?) and Furious Purpose are just stupid. Thanks for taking a measured approach.

  22. #22 Orac
    December 27, 2011

    Yeah, I was originally going to mention the comments after PZ’s post but thought this was getting too long. There was one that I remember in particular where the commenter said something along the lines that Teo of this:

    The barbaric part of me would argue for Mr. Teo to get the same “treatment” he’s been perpetrating on others, or perhaps a pair o’ hand-amputations. Couple that with demolishing (with fire) the Burzynski “clinic.”

    The stupid, it burns.

  23. #23 Orac
    December 27, 2011

    BTW, Martin at Furious Purpose appears not to be backing down. In fact, he’s digging himself in deeper::

    I have not questioned Dr Teo’s ability to perform brain surgery, he seems to have developed a micro-invasive technique that is quite renowned and successful, and I’m sure he is an excellent surgeon. But all I need is one case, and I have mentioned two, where Dr Teo has recommended an unproven treatment with a urine-derived substance in a clinic that charges tens of thousands of dollars for the privilege and that, unlike any public health service, should you not fork out the money, may refuse to treeat you at all. One case is enough to show that Charlie Teo is, at best, of questionable morals. At worst, a doctor who operates on inoperable tumours for shitloads of money, and then refers his suffering clients to a known quack for some more milking.

    Martin has, of course, shown nothing of the sort. In the first case, the patient doesn’t mention whether Dr. Teo recommended Burzynski or not. In the second case, Teo says something that could well be simply supporting his patient after the decision was already made. Ill-advised? Yes, if that’s what he did. It doesn’t say there that Teo advised the patient to go there. The family just said that Teo “agreed” it was a “good option.”

    As for “operating on inoperable patients,” come on. Even as a nonsurgeon should realize that what is “inoperable” to one surgeon is sometimes operable to another. Martin has no evidence whatsoever to justify an accusation that Yeo is operating on “inoperable” brain tumors for boatloads of money as though he were doing so from either recklessness or lack of ethics. Dr. Teo thinks these tumors are operable. He says so many times himself.

    Martin’s post was not skepticism. It was not supporting science-based medicine. It was leaping to a conclusion based on inadequate evidence.

  24. #24 warthog
    December 27, 2011

    http://www.abc.net.au/radionational/programs/sundayprofile/dr-charlie-teo-neurosurgeon/3001370

    That’s a transcript that lets him discuss the ethics of having people observe the surgery; I don’t know if his views have changed, I don’t know anything about the person that observed, and I don’t think it clears up everything about the problem. But it does give his reasoning and I think the transcript is worth a skim. (My own thoughts probably don’t apply and won’t shed light.)

    And if this is true:

    http://www.voiceless.org.au/About_Us/Voiceless_Council/Charlie_Teo.html

    “Charlie dedicates 3 months every year to pro bono work in developing countries, for which he has been recognised with awards from Rotary International, including the Paul Harris Fellowship, and as a finalist in the NSW Australian of the Year awards in 2003 and 2009. Dr Teo founded the Cure for Life Foundation in 2003, which is now the largest funder of brain cancer research in Australia and which supports the Neuro-oncology wing of the Lowy Cancer Centre.”

    If that is true I think it very hard to paint him a mercenary, and all descriptions of his being motivated by money over humanity need to be reassessed.

  25. #25 warthog
    December 27, 2011

    http://www.cureforlife.org.au/About_Us/

    Oh, ouch.

    And looking under “research” it appears that the money is going to science-based initiatives; I don’t have the background to fully assess it, but what is familiar looks pretty solid. So however much he may, personally, buy into woo, he’s still supporting both scientific research and rehabilitation efforts for children (that’s the last entry under “previous grants and fellowships” in the “research” tab.)

    It doesn’t list what those are. But if he is trying to provide any kind of charitable support to child patients who have passed through his hospital, it blows the claim that he’s sending them to Burzynsky out of the water.

  26. #26 Tom Brons
    December 27, 2011

    Burzynski has been harassed for years. Cancer is one of the biggest money-makers for Big Pharma. End of story. Treating patients for months is much more profitable than curing them. ALWAYS HAS BEEN !!! Sheeple is stupified and blind and Big Pharma Criminals finance Reserchers so they DON’T FIND any cures : swine flue (manufactured), bird flue (manufactured) … vaccines = BIG BUSINESS.

  27. #27 novalox
    December 27, 2011

    @tom brons

    Thanks for your unbridled and unchecked stupidity in your posts. You have successfully made yourself look like a fool with your conspiracy theory mongering and ad hominems.

    Thanks for giving me a laugh at your unintentional humor.

  28. #28 lilady
    December 28, 2011

    @ David: I do find a problem with Dr. Teo’s posting of the Scandinavian study…when multiple studies have disproved the effects overhead low emission EMR and the use of household appliances and cell phones, see:

    NCI Fact Sheet: Cell Phones and Cancer Risk

    Also, Dr. Teo’s explanation of the immune system and cancer is very simplistic and this statement, “Dr Teo is a strong believer in the importance of keeping the immune system primed. This can be done with exercise, a diet rich in anti-oxidants, positive thought, reduced stress and laughter”…puts the blame on the patient for his cancer. Where are the studies that “suggest” that decreasing your stress level, keeping “good thoughts” and laughter reduce your risk of brain cancers?

    As far as I can see, there is little or no evidence that Dr. Teo is referring patients to Burzynski. The articles that allege that this is the case are based on the flimsiest of evidence and an example of very poor journalism.

  29. #29 Douglas Kennedy
    December 28, 2011

    where is the proof that Dr Burzynski’s therapy is effective?
    Any research done to date?

  30. #30 Peridolius
    December 28, 2011

    Oh, Tom Brons, don’t make me have to send a coded message to Lord Draconis. He’ll be most displeased that you’ve discovered their Sooper Seekrit™ Eeeeeeevil® Plans to hide all those totally natural, side effect-free, practically free cancer cures. Funny how the Big Pharmers let their own family members die rather than let us know that they have Teh Kurez.

    OT: I hope that the birds and swine make sure to keep their flues clean. It’s wintertime and I’d hate for any of them to asphyxiate.

  31. #31 lilady
    December 28, 2011

    @ Peridolius: It would be a pity to have swine or bird *flues* during this holiday season.

    BTW, I’ll be using my Big Pharma filthy lucre to refurbish and retrofit with a wood-burning fireplace insert, my daughter’s fireplace. She should have gotten her seasonal *flue* shot. FLUES IS BIG BUSINESS!!!

    *SpellCheck is useless for this troll

  32. #32 rorschach
    December 28, 2011

    Hi Orac, if there was indeed any sloppy research, it was all mine and not PZ’s since he got the story from me. I looked hard but couldn’t find more than the 2 documented instances online where a Teo surgery followed a Burzynski visitation, however, you might want to keep in mind that Burzynski’s phase II “research” on antineoplastons was done on patients with brain stem gliomas, the exact same clientele that Teo operates on when other neurosurgeons won’t, because of the risk of complications, and the fact that removing all of the tumour is simply not technically possible most of the time, thereby merely delaying the inevitable for a little while.
    Is it ethical to cause a family to go broke for their child to live 6 weeks longer ? I don’t know the answer. A neurosurgeon knows the odds of a child surviving a particular neoplasm, as does a surgeon like yourself when you operate on someone’s breast tumour. Teo makes a living on operating on those who choose to want to prolong their or their loved one’s lifes for as long as possible. It’s legitimate, just a service he provides for a certain kind of clients, sure, but is it the best advice he could give, don’t you think that playing with the hopes of families of dying people, and sending them broke for a little bit more time is at least a tad bit iffy ? I think it is. And sending them to Burzynski after surgery, or, should my assertion that he does and has done so prove to be false, to not state clearly that it is a waste of money to do so, is in my view highly questionable.

  33. #33 Moderation
    December 28, 2011

    Color me shocked that PZ Myers would make inflammatory statements without all the information. Used to read him daily and at times he had some great posts, but I began to realize he was consistently as much about generating heat (clicks) as light on a subject. It is important not to overstate the evidence against Dr. Teo, regardless of his poor grasp of basic science as it applies to cell phones and cancer.

  34. #34 Dangerous Bacon
    December 28, 2011

    “Sheeple is stupified and blind and Big Pharma Criminals finance Reserchers so they DON’T FIND any cures”

    One of the constants in alt-med alt-reality is that the people who are loudest about mainstream conspiracies (and confident that they are too smart to be fooled) are themselves the easiest to fool by quacks who present themselves as victims of the system.

    You’d think all that “skepticism” would exist right across the board, on mainstream med and woo alike. What works against that is it’s hard to exist in a complete vacuum. There’s an overwhelming urge to trust someone. And besides, somebody must be called on when you get sick (self-treatment goes just so far).

    “Funny how the Big Pharmers let their own family members die rather than let us know that they have Teh Kurez.”

    Not to mention how the Big Pharmers commit suicide themselves rather than take advantage of the cheap safe woo cures that exist. They’re suicidal sociopaths, all of them.*

    *this presumes that there isn’t a network of sooper-secret woo clinics where the Big Boys go for colloidal silver and zapper cures, the existence of which has been totally concealed to this day.

  35. #35 bob dok
    December 28, 2011

    When you see Brain cancer reduction of 35% for short period of time in hopless case like this one http://www.hopeforlaurafund.co.uk/ you just can’t dismiss with this nonsens crap.Not just has been managed to stop growing,but has reversed in size.I belive that you are too biased to see with clear eyes.Simply with this you maybe just had stoped last chance for someone life.When established science havn’t what to offer,what is the point to attack alternatives.It is simple logic that cure is out of the mainstream science up to date and it is in all other uncharted waters.Research for this treatment is in phase 3 and hopefully we will get proper results.Up to then leave proper research to run its course.

  36. #37 Sauceress
    December 28, 2011

    Better late than never they say.
    I’ll take this opportunity to show my gratitude to Orac for all of his posts on Burzynski.
    Especially..
    -When “personalized gene-targeted cancer therapy” really means “making it up as you go along”

    -What Dr. Stanislaw Burzynski doesn’t want you to know about antineoplastons

    -Dr. Burzynski and the cult of personality of the “brave maverick cancer doctor”

    Excellent job Orac. Many Thanks.

  37. #38 Militant Agnostic
    December 28, 2011

    bob dok

    Up to then leave proper research to run its course.

    Proper researchers do not charge experimental subjects tens of thousands of dollars to participate in “clinical trials” – quite the opposite. Proper researches don’t sell conventional chemotherapy drugs to experimental subjects at highly inflated prices. Proper researchers publish their results in the peer reviewed literature. Proper researchers do not threaten their critics with litigation.

  38. #39 Pareidolius
    December 28, 2011

    Bob Dork,

    If you used spell check or even your space bar, you might have greater success in getting others to listen to you. As it was I had to get out my Illiterate – English/English – Illiterate dictionary to decipher that word salad. Once you’ve mastered grammar, you can work on the whole critical thinking/citations thing.

  39. #40 Silvia Chamlee
    December 28, 2011

    Wow, you know nothing of Dr. Burzynsky ‘s program. You write from a place of complete ignorance, there is no science in your words just a crumbling tower of protecting old science and medicine that is as ancient as the dinasuars.

  40. #41 herr doktor bimler
    December 28, 2011

    You would think that a defender of Burzynski who is sufficiently well-acquainted with his research to point out the ignorance of his detractors could at least spell his name correctly.

  41. #42 Todd W.
    December 28, 2011

    @Silvia Chamlee

    Perhaps, since you presumably know of the science of Dr. Burzynski’s program, you could point to studies that show the effectiveness of any of Burzynski’s treatment protocols. Some caveats: the study should have a robust number of subjects to be able to reach a meaningful conclusion as to effectiveness (too small a subject population = shaky or inconclusive results) and which includes a control group. The study should be published in the medical literature in a peer reviewed journal; the more respected the journal, the better. Studies performed by someone not connected with Burzynski would be best.

    You don’t need to provide links, but at the very least provide the authors names, title of the article, journal in which it was published and publication date. Alternatively, the PubMed ID number would suffice, as well.

  42. #43 warthog
    December 28, 2011

    medicine that is as ancient as the dinasuars.

    Dinosaurs practiced science-based medicine?

    Did they have rocketships too? That’s the only thing that could make that cooler.

  43. #44 Matthew Cline
    December 28, 2011

    @warthog:

    Dinosaurs practiced science-based medicine?

    Did they have rocketships too? That’s the only thing that could make that cooler.

    On the contrary, the only thing that could make it cooler would be if the dinosaurs were also ninjas.

  44. #45 Narad
    December 28, 2011

    On the contrary, the only thing that could make it cooler would be if the dinosaurs were also ninjas.

    With flying cars that unfold from suitcases, which they use to get to the rocket ships. Think, people.

  45. #46 Julia
    December 28, 2011

    With all the wild-ideas chronicled by RI this year, it seems strange that the Puffinton Toast is hosting this article: “Worst Scientific Claims Of 2011″ http://www.huffingtonpost.com/2011/12/27/whale-sperm-orgasmic-feet-topbad-science-list_n_1171912.html —Is “buffet-style” the new way to serve-up science reporting?

  46. #47 Militant Agnostic
    December 29, 2011

    After reading the posts of the various grammatically challenged Burzinski supporters and hearing of the attempts by the not-a-lawyer at libel intimidation, I am beginning to wonder if there is an internet conspiracy to make Burzinski look ridiculous. However, my paranoia levels are unusually high due to a black helicopter* that was flying overhead throughout my lunch hour pole walk around the scenic storm water runoff pond.

    *I later found out that the police had arrested a sexual assault suspect in the neighborhood the helicopter was circling over after the suspect had rammed a police car and eluded the police when they initially tried to arrest him at his workplace.

  47. #48 warthog
    December 29, 2011

    Matthew @ 44:

    They can’t be ninjas. We found them. And then they went extinct.

    Or did they?!

  48. #49 Phoenix Woman
    December 29, 2011

    The irony of Silly Silvia’s comment at #40 is that it closely followed Orac’s comment at #36 in which he demonstrates that he knows, all too well, what Stanislaw Burzynski does:

    http://scienceblogs.com/insolence/2011/12/on_leaping_to_conclusions.php#comment-6202094

  49. #50 Norm
    December 30, 2011

    Orac, you still lying to your readers about this guy? Are you going to court soon with Barrett for lying and fraud too?

    The only people fooled by the woo are the fucking morons that believe anything this hack doctor writes in his blog.

    Enjoy your propaganda woo readers!

    There is not one thing in this blog that is true – written like a perfection tin foil hat conspiracy theorist.

    He doesn’t even know what “gene-targeted therapy” is!

  50. #51 norman
    December 30, 2011

    And lastly, anyone that says “changing your diet” has no effect on diabetes – really? Guys, this Orac guy is your woo master. Woo-woo!

  51. #52 miss b.
    December 31, 2011

    rorschac furious purpose says:’if there was indeed any sloppy research, it was all mine and not PZ’s since he got the story from me.’

    only goes to show wot a has-been myers now is;}

  52. #53 Narad
    December 31, 2011

    Oh, look, OracIsGod (etc.) reverted to its “Norm” identity. How inventive.

  53. #54 Matthew Cline
    January 2, 2012

    Quoth Norm:

    Are you going to court soon with Barrett for lying and fraud too?

    Quoth Narad:

    Oh, look, OracIsGod (etc.) reverted to its “Norm” identity. How inventive.

    Interesting. Tim Bolen has been claiming for a while that Orac is going to be added to the the DDI v Barrett lawsuit. Might Norm be a Bolen sock?

  54. #55 Norman10
    January 15, 2012

    From the Disclaimer:

    “In addition, Orac has been funded over the last decade by institutional funds, the Department of Defense, the National Cancer Institute, and various cancer charities. For the first time ever, in 2011 Orac received a little bit of pharmaceutical money in the form of a seed grant.”

    Therefore any and everything Orac says, especially pertaining to Burzynski is like a terd falling into our soup. All words are suspect, as he is literally PAID to lie about Burzynski.

    Enjoy your bliss, jackasses. Orac is a lie, a fraud, a whore.

  55. #56 Lawrence
    January 15, 2012

    Hmmmmm….publicly funded research for the betterment of his patients vs. charging hundreds of thousands of dollars for treatments with little or no proof that they actually help….I wonder who’s really the liar (hey look, I can spell!), fraud, and a whore.

  56. #57 novalox
    January 15, 2012

    @norman10

    Thanks for your utter stupidity. I had a good laugh at your ignorance and foolishness.

  57. #58 Thomas
    January 15, 2012

    Norman: If you really believed that Orac was paid to lie about corrupt old Dr. B., you wouldn’t bother to post here – since you’d expect your post to be deleted. So you’re a liar. Is Dr. B paying you to “support” him like this?