Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski. That Orac has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 30 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: oracknows@gmail.com

Recently, I came across a news story describing two cancer patients treated by naturopaths in New Zealand. Both died, one almost certainly unnecessarily, the other after enduring more suffering than she likely had to. These tragic cases and others reminded me of why it is so appalling that so many physicians are “integrating” naturopathy into “integrative medicine.” In reality, they are integrating quackery into medicine.

After nearly 13 years of blogging, I thought I’d seen it all. Then former naturopath Britt Hermes let me know that there is a naturopath in Utah offering stem cell treatments. My face is raw from the double facepalming.

Trolling the antivaccine trolls

Craig Egan is a man with a mission. He’s trolling the antivaccine trolls to promote science, and he’s been very successful at it.

Yesterday, I wrote about how right-to-try and an unethical offshore vaccine trial are part of free market fundamentalists’ attack on the FDA. Here’s another example, the “right to choose medicine.”

I’ve discussed so-called “right-to-try” laws, which promise to speed experimental drugs to terminally ill patients, but which in reality are about weakening and bypassing the FDA. Now über-Libertarian Peter Thiel is trying a new tactic to bypass the FDA by organizing an offshore clinical trial of a new herpes vaccine based on dubious science and not overseen by an IRB to protect patients. Both right-to-try and this trial are different fronts in the same fundamentalist free market war on FDA regulation.

There was a rumbling in the antivaccine underground a week ago about a recent ruling by the Vaccine Court compensating parents of a child who died of sudden infant death syndrome (SIDS). In a confused and scientifically highly flawed decision, the Special Master Thomas Gowen didn’t rule that vaccines cause SIDS, but did rule that they contributed to SIDS in this one case. Soon, the message will be that vaccines cause SIDS. They don’t. The Vaccine Court screwed up.

Tooth Fairy science is the study of a phenomenon before having actually demonstrated that the phenomenon actually exists. I can’t think of a better example than trying to construct an elaborate mapping system of body parts and organs to the surface of the external ear for purposes of sticking needles in them to heal and relieve pain (auricular acupuncture). Yet that’s what’s just been published.

American antivaccine activists have contributed to a massive measles outbreak among the Minnesota Somali immigrant community by spreading Andrew Wakefield’s misinformation. In the wake of the harm they’ve caused, they’re not apologetic. They’re doubling down.

In January, Robert F. Kennedy, Jr. bragged about having met with President-Elect Donald Trump about chairing a presidential commission on vaccine safety. In the intervening eight months, no commission has materialized, but, if you can believe his account, Kennedy has been meeting with government officials to promote his antivaccine views at the behest of the Trump administration. As long as that continues, pro-science advocates can’t afford to rest easy.

By definition, alternative medicine has not been shown to be effective or has been shown to be ineffective. Thus, alternative medicine is ineffective against cancer and can best be represented as either no treatment at all or potentially harmful treatment. It is thus not surprising that cancer patients who choose alternative medicine have a higher risk of dying from their cancer. A new study confirms this conclusion yet again.

California’s new law that eliminates personal belief exemptions has been a success, increasing vaccine uptake after just one year. That isn’t to say that there aren’t problems. One potential problem is the increasing number of medical exemptions, likely fueled by doctors willing to write letters of support for them based on reasons that are not science-based.

Antivaxers fear and detest vaccines, but one of the types of vaccines they fear and detest the most is the HPV vaccine, such as Gardasil and Cervarix, which have been blamed for everything from sudden death to premature ovarian failure to autoimmune diseases. A couple of Mexican “researchers” from a cardiology institute try again with a “critical review” of HPV vaccine safety that lacks anything resembling critical thinking.

Naturopaths are fake doctors who fancy themselves to be real doctors, so much so that they call themselves “physicians” even when explicitly barred from doing so by law.

In March, it was widely reported that a young woman named Jade Erick had died suddenly of a hypersensitivity reaction while undergoing an infusion of intravenous curcumin ordered by a naturopath named Kim Kelly to treat her eczema. The FDA investigated and found egregious problems with the injectable curcumin used. This tragic incident serves to demonstrate how dangerous a combination naturopaths and dubious compounding pharmacies can be.

There’s one phenomenon I’ve never been able to figure out, namely antivaccine pediatricians. For a pediatrician, to be antivaccine is a profound betrayal of everything learned in medicine and a betrayal of patients. Here’s another antivaccine pediatrician, one I have never encountered before. Special bonus quack points: She’s a homeopath, too.

Much of the belief system that undergirds antivaccine views is rooted in superstition. That’s why it’s not a coincidence that antivaxers frequently speak in terms of contamination due to vaccines as a cause of autism and all the other conditions for which antivaxers blame vaccines and ritual purification in the form of “detoxification” as the treatment. These beliefs very much resemble religious beliefs, and antivaxers project them onto pro-science advocates.

Correcting antivaccine misinformation is hard. Real hard. Another study shows us just how hard.

On July 3, an antivaxer named Kent Heckenlively posted a WhiteHouse.gov petition demanding a five year moratorium on childhood vaccines. It failed. Did that stop Mr. Heckenlively? Of course not, and this time he has help from über-crank Mike Adams, who is whining about being “censored” by Facebook over it. The hilarity continues to ensue

Eleven years ago, Abraham Cherrix and his parents chose quackery over science-based medicine to treat his cancer, and Cherrix was one of the earliest cases of teens who chose quackery to treat a life-threatening disease that I discussed in depth. Recently, I learned that Cherrix is still alive. The reason? He finally realized the error of his original decision and underwent chemotherapy and a bone marrow transplant.

So-called “right-to-try” is a cruel sham that holds out the mostly false hope of survival to terminally ill patients and their families. In return, all they have to give up is patient protections and agree to pay to be guinea pigs to test a drug company’s product. The product of an ideology that uses the terminally ill as shields to hide the ideological motives behind the law, which are to hobble the FDA, right-to-try is a terrible idea. It’s bad for patients, but it just passed the Senate and could well become the law of the land when the House reconvenes in September if it isn’t stopped.

Many are the stories of those who have embraced quackery to treat their cancer. Few are followup stories when such a person realizes she’s made a mistake and returns to conventional therapy. This is one such story, but you’re unlikely ever to see the media outlets that touted Carissa Gleeson’s choice of quackery to treat her cancer run the story of her having changed her mind and saved her life with real medicine.

I recently took a review course in general surgery to prepare for my board recertification examination in December and realized just how much the standard of care had changed in the decade since I last recertified. Then I learned that laetrile is still a thing. If there’s one thing that demonstrates the difference between alternative medicine and real medicine, it’s how no alternative medicine treatment ever goes away, no matter how often it’s shown not to work. Ever.

Dr. Aviva Romm, one of Goop’s doctors, tried to distance herself from Goop’s pseudoscience. It didn’t go well.

Whenever vaccine uptake falls to a level below that needed to maintain herd immunity, the risk of outbreaks of vaccine-preventable diseases climbs. It doesn’t take that dramatic of a decline. Here’s a study that shows how a small decrease in vaccine uptake can lead to a large increase in disease.

Although it’s not uncommon for there to be conspiracy theories about police shootings, it is unusual for such a conspiracy theory to touch upon topics covered right here on this blog. Sadly, it’s happened in the wake of the police shooting of Justine Damond in Minneapolis.