Pharyngula

I made this post a few years ago, and I’m updating it now because my family back home in the Seattle-Tacoma area has a tradition: every year they join the Relay for Life to raise money for cancer research, in honor of my sister-in-law, Karen Myers, who died of melanoma. That’s my family listed there, doing good. If anyone wants to chip in to help out, that would be nice — I’m planning to donate to my mother’s page, since I like her best, but they’re all nice people and it’s a great cause. Or if you’d prefer to donate to the one who’ll probably expend the most energy running around the track, Alex Hahn is the littlest ball of fire.

This is my sister-in-law, Karen Myers — mother to 3, shy but always cheerful, and with a wonderful laugh that you were sure to hear any time you were with her. You would have liked her if you’d known her…unfortunately, she was slowly eaten alive by an implacable melanoma several years ago. It doesn’t matter what kind of person you are; lots of good people — and you probably have known some yourself — are killed by cancer every year.

About 20 years ago, I was funded by a cancer training grant which required me to experience a fair amount of clinical training in oncology. It is not one of my happiest memories. What I saw were lots of dying people, in pain, with treatments that caused more pain — or were palliative because the patient was expected to die. Pediatric oncology was the worst, because they were dying children. I’m afraid my training convinced me to run screaming from anything clinical.

So last week, I met Beth Villavicencio, who told me she was a pediatric oncologist. The first words out of my mouth were something like, “That’s funny — you don’t look depressed or suicidal.” And she wasn’t. She looked awfully happy for someone who works with critically ill kids … so she turned me around 180°. She wasn’t miserable, because people bring dying kids to her and she saves them — she has a job where she is literally taking people who would be dying otherwise and she makes them healthy again with excellent success rates, which sounds like something that would make anyone cheerful.

How does she do that? With science. She sent me a whole stack of references on the amazing progress that has been made over the last several decades, thanks to clinical trials and evidence based medicine. Here’s one picture that says it all.

Evidence-based medicine. It works.

Those are survivorship curves for acute lymphoblastic leukemia. When the lines are plunging downwards, that means kids are dying like flies; when the lines flatten out horizontally, that means no kids are dying. Each line has a date for when the survival was measured. Look at the mid-1960s, the yellow line: 90% of the kids diagnosed with ALL would die within five years. But then look at the other curves — in the 1970s, 64% would die; in the early 80s, about half; in the late 80s, about 30%; in the 90s, about 20%; and now, about 10%. What’s going on?

We haven’t been evolving ALL-resistant kids. The medicine has been getting better. Every percentage point that those lines are pushed upwards is the outcome of hard work and clinical testing of new drugs and protocols and therapies and diagnostic tools. That’s impressive. This is how we progress.

You will sometimes hear people claim that the answer is found in the natural healing power of the body, and that doctors don’t really do anything but let nature do all the work (or worse, that treatments for cancer poison people and hinder nature’s healing power). They may also say that children are just especially tough and healthy, so pediatric cancers are relatively easy…but look at the data. When doctors don’t have effective treatments and don’t intervene, we get those yellow lines from the 1960s. We get 90%+ survival when doctors can exercise their hard-earned knowledge.

You want happy stories? Read this account of one of Beth’s patients.

It’s not just children’s cancers, either. If we want to cure adult cancers, like the melanoma that killed Karen, don’t look to magic, or wishful thinking, or ancient shamanistic wisdom, or prayer — we’ve had those for millennia, and they do nothing. What we need is more research, more doctors, more clinical trials, and more money. Unfortunately, this is what the money looks like.

It’s been drying up. Researchers are spending more time struggling to get basic funding and less time doing the work that saves lives, and more often than not, they aren’t getting funded. Often, too, the researchers who are getting screwed are the new researchers, the ones who don’t have established labs right now, which means we are short-sightedly demolishing our future research infrastructure. Good luck with that, America!

So what can we do?

We must push our politicians to invest in science, and to do so sensibly. It seems that the news nowadays is full of politicians wasting their efforts on naturopathy, homeopathy, “alternative” medicine, creationism, and other pointless exercises in pandering to useless ideological feel-good nonsense. Don’t put up with it! This is your life and health on the line, and the life and health of people you love — why are they frittering away your future on quackery? Apply the electoral pressure.

Ideally, we’d have strong, well-funded federal agencies managing the money; think of places like NIH and NSF as repositories of informed experts who disburse money rationally (usually) to address specific, important questions by qualified scientists. The first priority should be to bolster these institutions.

Alternatively, we can recruit more private donations. This has the danger that the money is more likely to go to politically prominent causes (although, to be realistic, NIH and NSF do the same thing), but in these lean times it’s what research needs. Think of it as like insurance — no, it’s better than insurance. You could sock away money and have a million dollars on hand when a catastrophic illness strikes, but it will do you no good if the doctors don’t have the tools to treat you at any cost; invest now to make it more likely that effective treatments will be available when you need them.

Donate to the American Cancer Society. One common event is the Relay for Life, a way for people to get together as a community and raise money for cancer research. Look for Relay events locally — they’re all across the country — organize one yourself, or you can donate to my family’s cause, the Relay for Life for Karen Myers, which is organized by her daughter, Rachael.

Get out there and support something that works!

Comments

#1 Sven DiMIlo
June 12, 2008

Thanks for this, PZ. I suspect nearly all of us have relatives and/or friends that have had to deal with a cancer. Father (OK) and best friend (dead) for me. In 1971, Nixon (not my favorite guy) declared a War on Cancer; in 2001 Shrub (ditto!) declared a War on Terror. I know which one I think is more important.
#2 bill r
June 12, 2008

I had the same conversation with my brother, a pediatric surgeon. He has a similar attitude. He doesn’t see the kids unless they are in dire straits to begin with, so he focuses on the one he fixes, not the ones that he couldn’t.
#3 James F
June 12, 2008

But I thought science leads you to killing people, isn’t that what Ben Stein said?

Thanks for this, PZ. It steels my resolve as a scientist not only to keep doing research, but also to keep fighting anti-intellectual nonsense.
#4 Brownian, OM
June 12, 2008

You will sometimes hear people claim that the answer is found in the natural healing power of the body, and that doctors don’t really do anything but let nature do all the work (or worse, that treatments for cancer poison people and hinder nature’s healing power). They may also say that children are just especially tough and healthy, so pediatric cancers are relatively easy…but look at the data. When doctors don’t have effective treatments and don’t intervene, we get those yellow lines from the 1960s. We get 90%+ survival when doctors can exercise their hard-earned knowledge.

Bam! Right on the head, PZ. I work as a medical geographer in the surveillance branch of my provincial cancer board and the survival curves we produce show the incredible effects of new medical interventions as they’re implemented. Whether such interventions are preventative, such as wide-ranging screening programs, or innovations in treatment, such as new medications, the numbers show that science works.

As an aside and a salvo against the current medieval romanticism of some of the religiots we get here, I ask: how come cancer survival has increased so dramatically since prayer was taken out of schools, huh?
#5 Ric
June 12, 2008

Great post, PZ.
#6 scooter
June 12, 2008

Having researched the American Cancer Society and other umbrella organizations I recommend picking your own research institution and donating directly.

MD Anderson is awesome if you like Texas Medicine.

ACS does not have a great track record for dollars donated getting into research, unless they changed their act recently.
#7 FutureMD
June 12, 2008

It’s odd that the funding goes into a freefall in 2003. What could possibly have happened in ’03 to suck up so much money that grants aren’t getting fullfilled as much? I wonder…
#8 SteveM
June 12, 2008

I know that we have made immense progress in cancer survival rates, but those two graphs just blew me away. We laugh and joke about the intelligence of the general population but I can’t believe that if more people saw these graphs (with PZ’s wondefully clear explanation) that there would be nearly as much dispute about the value of evidence based medicine. Rather than just telling people verbally that survival rates are improving, maybe showing them graphically would make more sense. I know not everyone is “visually oriented”, but these kinds of graphs are just so clear. I guess my point is that I think there isn’t enough popularization of just how much progress has actually been made in treating cancer, and maybe if that was emphasized a little more people would be more generous in funding knowing that their money is going to be effective.

and now for something completely different (but not really), those graphs really illustrate where the magic “5 year” target comes from statistically, but biologically why is it 5 years?
#9 Eric
June 12, 2008

Although I can’t contribute monetarily, I *do* support cancer research in my own way & encourage others to participate as well (although I’d suspect that if you are reading this blog, you probably do so already).

I have one desktop machine running Stanford University’s Folding@Home program 24/7. Its research will be useful in finding causes, and treatments for, certain cancers, Parkinson’s disease, Huntington’s disease, and a number of other debilitating diseases or conditions.

I have a second machine running the IBM-funded World Community Grid, also 24/7. Although the World Community Grid currently supports other very worthy applications, one of their projects is dedicated to cancer research. (Other projects include finding effective drugs for AIDS and Dengue fever. You can participate in as many or as few projects as you like.)

I’d encourage anyone who isn’t running one of these programs to go immediately to either (or both) sites and participate right away. Every little bit helps a great deal.
#10 Jeff Alexander
June 12, 2008

Unfortunately, this is what the money looks like.

You could get the same chart even with a significant increase in the amount of money available. Are new researchers getting screwed due to poor allocation decisions? If so, more money may not alleviate that problem. How are we doing with respect to total funding of cancer research?

My family’s small part: participating in the Pan-Mass Challenge.
#11 techskeptic
June 12, 2008

I wrote a similarly themed post recently.

Its all the efforts of people through the history of man that has produced every positive aspect our of our civilization.

Thank us.
#12 Dan
June 12, 2008

I think a lot of times common laypeople like me look to maybe the previous decade or two when trying to assess scientific advancements. I don’t know why we do that. Perhaps we just expect immediate results or whatnots. But the thing is, if you look back fifty years, the number of advancements and achievements are staggering.

It gives me some hope for the future. But, you’re right. The accomplishments of science don’t spring from nothing, and these cures and treatments aren’t willed into existence at the snap of anyone’s fingers. They take time. They take money. And they take science. When I give money to support research, I realize that I won’t see an immediate return on my charity, and I don’t need to, but I will help to save a life somewhere down the line. Ten, twenty, a thousand years doesn’t matter.
#13 FishyFred
June 12, 2008

Great post. One question: Did your sister-in-law marry someone with your same last name?
#14 SteveM
June 12, 2008

I’d like to add that I think these would almost be better choices for xkcd to illustrate his “Science, it works …” cartoon.
#15 Orac
June 12, 2008

It’s been drying up. Researchers are spending more time struggling to get basic funding and less time doing the work that saves lives, and more often than not, they aren’t getting funded. Often, too, the researchers who are getting screwed are the new researchers, the ones who don’t have established labs right now, which means we are short-sightedly demolishing our future research infrastructure. Good luck with that, America!

Actually, that’s just part of it. The other part of it is labs like mine. I have my first R01, but it’s ending in a couple of years. The first critical step in a research career is getting your first R01. The second is renewing it for the first time. The second step, known as competitive renewal, is also becoming increasingly difficult, meaning that young investigators who have had enough success to get their first grant are now having a lot of difficulty continuing–even to the point of having to close their labs. I’ve been sweating the renewal ever since I got my first R01, and now I am not in the least bit confident that I’ll be able to renew it when I have to apply for my first competitive renewal in the fall of 2009.
#16 SteveM
June 12, 2008

Great post. One question: Did your sister-in-law marry someone with your same last name?

Like maybe his brother?
#17 ERV
June 12, 2008

Jeff– Not to be arrogant, but were working on a revolutionary idea for cancer therapy.

Submit our proposal– comes back with no complaints, glowing reviews. Didnt get funded.

Resubmitted– comes back with no complaints, glowing reviews. Didnt get funded.

Resubmitted (third try is your last try)– we win the RO1. Funding for 5 years… until they pulled funding for our 4th year.

Does that answer your Q?
#18 Alex
June 12, 2008

Correlation doesn’t mean causation. Just because we learn more about stuff and actually apply that knowledge to try and solve problems doesn’t mean….ah hell, I can’t do the sarcasm.

I hate that fucking disease. Thanks for this PZ.
#19 ERV
June 12, 2008

Ugh, ‘pulled funding for our 5th year’.
#20 Adam
June 12, 2008

PZ: Please

1. Gimme the sources for those graphs. I want to reproduce them for my kids’ school’s next ACS event.

2. Comment on comment on comment #6.
#21 Charles Martin
June 12, 2008

Gosh, I wonder which of the two major (oh hell, let’s include Bob Barr and Ron Paul) sorry, FOUR major presidential candidates might be receptive to reversing the obvious decline in cancer research funding.

Let’s think … think … think … hmmm … I wonder …

Ponder ponder ponder …

Well, if it still isn’t blatantly obvious to you, I urge you to write their campaigns and read their position papers and find out. And then vote for that person.

Whoever they may be. Gosh, I wonder who it will be?
#22 agg
June 12, 2008

PZ, thank you for brightening my perspective on the state of cancer treatment. For a while now, I’ve been meaning to include a contribution to cancer research in my yearly budget and this seems like the perfect time to do it.

One question about the last chart though: It shows that the percentage of the R01 applications to the NIH that are funded has dropped significantly between 2003-2005. This may mean that the NIH’s budget has shrunk (as you seem to imply) but may also mean that the number of applications has gone up or that fewer applications have been approved for larger grants (like the one my job is being funded by).

Do you have any chart that would better illustrate which of these is the case?

I also seem to recall that the budgets of both the NIH and the NSF were increased by a couple of hundred million recently.

Of course, I am in no way implying that there is no need for more contributions. Just wanted to clarify…
#23 midwifetoad
June 12, 2008

I know the coffee enema as cure for cancer crowd really well. They will look at your graphs and say, “See, survival rates go up as funding goes down.”
#24 Kagehi
June 12, 2008

I hate that fucking disease.

Disease**s** Alex. Not all cancers are caused by the same things, or are effectively treated with the same techniques and medications, which is something else that the average person on the street just doesn’t get.
#25 Jeff Alexander
June 12, 2008

ERV (#17)

Does that answer your Q?

Not really but I did go take a look at the NIH website which does give significantly more detail. It appears that total funding was increasing through 2005 and then decreased in both 2006 and 2007. The big falloff in the percentage chart in 2004 and 2005 appears to be due to a significant increase in the number of applications, a decrease in the number of awards, and an increase in the average amount awarded.
#26 Rienk
June 12, 2008

I’ve seen many good researchers missing the boat on RO1 funding — which is, of course, the main source of funding for anyone in the field — since the invasion of Iraq. I’ve also seen people get the funding after initial rejection, after inserting a meaningless paragraph containing the word “bioterrorism” in the grant application. The funding percentage is dropping dramatically… and mostly because the money goes to this perpetual war.
#27 Derek K. Miller
June 12, 2008

I am one of those who is still alive because of science. Doctors discovered that I have stage 4 metastatic colorectal cancer in January 2007 (I’m 38). I’ve had four surgeries (one major), two rounds of chemotherapy (with more to come), one round of radiation, and as far as we can tell, the main tumours (there were two) are gone, and the small metastases in my lungs aren’t getting significantly bigger so far. A few decades ago, I would have been dead this far into my disease — maybe as much as a year ago.

That’s not to mention the type 1 diabetes I’ve had for 17 years. Recombinant DNA technology has created new artificial insulins that have let me manage my blood glucose quite well, even through all my cancer treatments. Less than a century ago, I would have been dead from the diabetes sometime in my 20s. In other words, without evidence-based medical research, I’d be dead twice over by now.

As it is, while I’m on medical leave from work, I feel pretty healthy, I can take my kids to and from school, I ride my bike, I’ve regained some healthy weight, and I’m able to maintain a blog, work on podcasts, see my friends, play drums occasionally in my band, and be with my wonderful wife. I still have a life. And it’s not superstition that permitted that: it’s medicine.
#28 Hank Fox
June 12, 2008

PZ, all my recent emails to you seem to be getting bounced back for some reason.

One I sent you not long back was about this same subject. I wrote a speech I wished Barack Obama would deliver, about medical research, funding and science education: http://hankfox.com/?p=180 , with a followup post on the same subject, an answer to one of my commenters: http://hankfox.com/?p=182 .

Great post on your part, by the way!
#29 Greg
June 12, 2008

PZ,

Thanks for this excellent post. I have been writing my legislators for the last 3 years about the serious problem with NIH funding. I would encourage everyone to do so. PLEASE PLEASE write your legislators and tell them NIH needs more funding and congress needs to push NIH to fund more R01s. It is largely in response to making legislators happy that NIH has wasted money in other areas.

Please tell me where you obtained that graph. I would like to get more up to date information to put in my letter to Senator Conrad.
#30 Orac
June 12, 2008

Not really but I did go take a look at the NIH website which does give significantly more detail. It appears that total funding was increasing through 2005 and then decreased in both 2006 and 2007. The big falloff in the percentage chart in 2004 and 2005 appears to be due to a significant increase in the number of applications, a decrease in the number of awards, and an increase in the average amount awarded.

Yes and no. What happened is that the NIH budget almost doubled between 1998 and 2003. Unfortunately, planning for what would happen afterward was not very good. Instead of a “soft” landing, we had a real “hard landing.” Meanwhile, since 2004, because the NIH budget has remained flat or with increases below the rate of biomedical inflation, the real purchasing power of its money has declined alarmingly. I explained a bit about what happened here; so I don’t see the need to go into a lot of detail in the comments here.
#31 pjg
June 12, 2008

PZ,

Thanks for this post. I’ve been reading for about a year now, and I think this is one of my favorites.
#32 938Mev
June 12, 2008

I put in eight years working in a radiological physics department that supported a radiation oncology department. I liked the work and helping people who were faced with a difficult life obstacle. It was a teaching and research hospital and it was very hard and demanding work. Every time I hear some crack pot criticize cancer treatment I want to slap the stupid out of them. It’s easy to take advantage of people who desperately desire some good news about a difficult situation. Those who pander the afflicted in this way are the worst among us, and there are many.

If I were running for president, my national goal would be progress in understanding and treating cancer. Adequate funding over time will have a huge impact on what we can provide to humanity in this regard.
#33 Kitty
June 12, 2008

This is not a scientific observation. This is from my life.
I am now 60 years old.

When I was 7 a nice lad (I remember his brown curly hair) stopped coming to school, the whispers – it was always whispered then – said he died of cancer.

When I was 9 my friend started to look thin and ill and stopped coming to school. It was cancer.

When I was 11 it was a bad year, one cancer, one asthma and my best friend’s sister died of a burst appendix.

At 14 another asthma and one completely unexplained – ‘after a long illness’.

During this 14 years 2 other children I knew entered the living death world of polio and the iron lung, one died the other lived out her life as a talking head until pneumonia took her at 20.

My friend’s daughter turned 16 last week. The only death she has known in her life is a single grandparent. She and her friends are not illness free but they are treated and cured by medical practices only dreamed of as science fiction when I was a kid.

So,THANK YOU all you wonderful people who work so hard in science and medicine. You will always have my support.
#34 me
June 12, 2008

Derek,
Dude, that sucks. But, you sound like you’re doing everything right, staying as healthy as you can and enjoying your life. Keep getting better!

My mother’s husband got diagnosed with throat cancer a couple of years ago (I was astounded that he went to a GP, he’s a total hippy), and then promptly started a cleansing diet, herbs, and urine therapy (gross!). He thinks he’s cured himself. He’s never been back to the GP for confirmation of this. He looks like shit, lost a ton of weight, etc. He’s a prime example of what happens to people who ignore medical science and choose alternative (non-effective superstition) medicine.

PZ, thanks for the graph, it’s good visual evidence for the increasing efficacy of medicine from a solid scientific base. I’ll print it out and show it to all my hippy friends and family.
#35 caynazzo
June 12, 2008

My PI is a pediatric oncologist as are two of the postdocs in my lab. I work at the NCI (inducing zebrafish with t-cell tumors) and so have this disconnect between what I do and its human application. And it’s no joke, everyone I talk to at the NCI feels the strain from lack of funding as we watch an endless war wage on.

However, this past Christmas I spent a few hours playing video games with some of my PI’s young patients at the NIH hospital. It was an amazing experience. Those kids are tougher than you can imagine.
#36 chris
June 12, 2008

we should really support this program….High Pinay
#37 Spinoza
June 12, 2008

Thanks for this PZ.

The distrust of medical science in the world bugs the hell out of me. I once knew someone who thought THIS: http://en.wikipedia.org/wiki/Amygdalin (Laetrile), would help them, so they went down to Mexico (from Canada…) to get it.

I knew this was foolhardy, but I wasn’t the one with the seemingly terminal cancer, so it passed.

She died quite quickly, so it’s too late for her, but if these sorts of graphs would only get more publicity, and if we could just get the public to quit fearing or distrusting modern medicine, or maybe just understand that “not this, therefore that” is a fallacious form of reasoning (in Evolution vs. Creationism, too!)…

I don’t know…
#38 Sam L.
June 12, 2008

Great post, PZ.

I’ve been doing Relay for Life at my university for the last three years, and our team has been the top fund-raiser for Relay events at all schools in the southeast. It’s a great event, and an easy way to get involved.
#39 Nightsky
June 12, 2008

A 13-year-old of my acquaintance recently beat Hodgkin’s lymphoma. Obviously a benevolent diety did it. Or–come to think of it–maybe the awesomely competent oncology staff at Los Angeles Children’s Hospital had a minor role to play.

I admit, I almost envied theists, at the time. You watch your friends go through this–their only kid has cancer–and all you can do is hang out on the sidelines and wring your hands. I contented myself with bringing food. And agitating for more science funding.
#40 NoAstronomer
June 12, 2008

While agreeing wholeheartedly with the spirit and intent of the article (I lost my bro-in-law and a family-friend recently to melanoma) there’s some chartmanship in the NIH graph.

Firstly, as Jeff points out, graphing the percentage of grants funded is not very useful and doesn’t really say anything about how much money is actually being spent.

Secondly the chart suppresses the zero in order to highlight the downturn.
#41 j h woodyatt
June 12, 2008

Please slap a “cancer” tag on this post, so the next time one of my dumbass relatives spams the entire family with the latest miracle cure bullshit, I can easily find this article and shoot it back in their faces.
#42 me
June 12, 2008

Everyone could also eat more vegetables, not smoke, drink moderately, get excercise, wear sunscreen, etc, and we’d all get alot less cancer and other diseases too. Scientific research is showing how everyday behaviours are greatly effecting our health, yet people ignore this advice too. This is not an example of buying into woo like alternative treatments for cancer, but it is an example of ignoring scientific proof.
Less money spent on tertiary healthcare could be spent on research.
#43 valdemar
June 12, 2008

A few short years ago cancer was not mentioned out loud. It was whispered about, as I remember very well from my childhood – I’m forty-six. What amazing progress in just a couple of generations, that now funding research is the issue. In the West, at least, we are no longer whispering about it as if it were a hovering angel of death.

And in a few short years, the sort of idiots who are against vaccination now – the free riders – will be able to be equally stupid and selfish about cancer prevention.
#44 Joe Dunckley
June 12, 2008

Could I have the ALL graph on a T-Shirt, please?
#45 CalGeorge
June 12, 2008

This post belongs in that list of stellar posts PZ should compile into a book!
#46 Moses
June 12, 2008

What’s going on?

More betterer prayers?
#47 Julian M Bucknall
June 12, 2008

Science. It works, bitches. (http://xkcd.com/54/)
#48 migg
June 12, 2008

Great post, thanx, PZ
Where does the first graph come from?
BTW EU grants from Framework Programmes can be given also to consortia in which there are US partners.
#49 Bad
June 12, 2008

Wait a minute: I thought Peter Duesberg had already cured cancer? And Republican Veep contender Bobby Jindal claims that he helped cure someone’s cancer in that little exorcism thing, no?.
#50 BeccaTheCyborg
June 12, 2008

Thank you for this post, PZ. I’m losing my mother to cancer now, as she’s refusing treatment, citing the miserable time she had with her last three rounds of treatment when I was younger. I might have to print this out to give her, or fill her inbox with this.

Science is improving. People are being saved by medical progress, not prayers or crystals, and cancer (and other) research needs to be funded. Money is being given to religious organizations instead of those who really need it, and it makes my blood boil.
#51 Paul Lundgren
June 12, 2008

Dr. Myers,

I mean no disrespect when I say this, but I am not involved in pushing for cancer research to the same degree as some. Instead, I am a committee member of our local National Multiple Sclerosis Society’s annual bike ride fund-raiser. My mother and her sister are both confined to wheelchairs because of that condition. Not that I haven’t worked with the ACS in the past, and there’s a good chance I will in the future. I figure that as long as I’m doing SOMETHING active to end a crippling disease, I’m leaving a noble legacy. And I also feel that the more I focus on one event in particular, the less spread-out I am and the more impact I have.
#52 Dan
June 12, 2008

My mother died of melanoma in 1982. Unfortunately I cannot support the ACS. They spend more money on political advocacy then they do on research.
#53 Bureaucratus Minimis
June 12, 2008

(Personal and OT)

Brownian,

I work as a medical geographer in the surveillance branch of my provincial cancer board and the survival curves we produce show the incredible effects of new medical interventions as they’re implemented.

I’m trying to decide on my second career and “medical geographer” sounds totally cool. What are the requirements for this sort of job? TIA.
#54 ThirtyFiveUp
June 12, 2008

I make blankies for children and adults who are experiencing some distressful situation including cancer.

Over the years I have made hundreds, mostly child size; and last year it was my turn to receive a blankie.

A very tiny DCIS discovered during a routine mammogram and quickly cut away. After a post operative biopsy, my doctor, with a big smile, told me to come back in a year.

I still hug my blankie which has many sweet messages written on the reverse to my heart. Yes, it is woo, but it comforts me.

Giving to cancer research and treatment programs is good, but also consider giving to this international charity, Project Linus. There are over 400 chapters and 2.5 million blankies have been delivered throughout the world.

http://www.projectlinus.org/
#55 LCR
June 12, 2008

Kitty’s comment (#33) brought tears to my eyes. That simple outlining of her personal experiences does more to highlight how fortunate we are to live when we do. It also makes me very, very hopeful as to the incredible discoveries science and medicine may find in the future (near and otherwise) as long as we have a society that understands the value of science and supports it accordingly. If not, we are going to have to hope some other enlightened society will share nicely with those of us stuck in the new dark ages.
#56 LCR
June 12, 2008

I wrote too soon. LOTS of these comments speak so well to not only the value of science but also to the hopeful and generous nature of so many people. Thanks for the post, PZ. After mucking through so much of the woo and creationist tripe, it is wonderful to read about what is right with the world.
#57 Longtime Lurker
June 12, 2008

Thanks for sharing your family history with us, Professor. Mom “beat” breast cancer last year, at least two friends mothers are fighting it, lost one friend to testicular cancer, and a dear friend and mentor to prostate cancer. I recently related a case where a friend of a friend delayed treatment due to lack of medical coverage, and eventually had 13 tumors removed, instead of one small mole.

Remember the slogan: “It will be a great day when our schools get all the money they need and the air force has to hold a bake sale to buy a bomber.”?

Well, maybe the Air Force should now have to conduct the Bike Rallies and 10K runs.
#58 John
June 12, 2008

If research is the goal, ACS is not a good choice. They are spending less and less on research–that’s not to say that their clinical programs aren’t important and working.
#59 Michael
June 12, 2008

Ah, it’s nice to see some good news in here for a change. The story kinda reminds me of my grandmother who had cancer in her early 50′s. We all thought it might be the end her. She got treatment, as a result, the cancer went into remission for many years. Normally the average rate for survival was 15 years. She lived 31 years after that, eventually the cancer came back in killed her in 3 days. Her doctor told her and my family she was the longest living cancer patient he had ever seen.
#60 Interrobang
June 12, 2008

I’m another person who wouldn’t be here if not for relatively modern medical technology — I was born about 2 months premature at about 900g in weight and didn’t breathe unassisted. Even though I was born around 30 years ago, I probably wouldn’t be here if I’d been born much earlier, and I certainly wouldn’t be walking (experimental surgery, at the time). Thanks to the high-priced medical talent and the beneficent government that provided it to me… (Tommy Douglas, I owe you large.)

A loss of basic research funding — especially in the US, which carries a lot of the world’s R&D (although that is changing; a lot of good medical technology is starting to come out of places like Canada and Israel, for instance), is a slow-motion disaster in the making.
#61 idahogie
June 12, 2008

Just two weeks ago I drove 4 hours to a board meeting retreat with a pediatric oncology nurse. I was surprised to hear her talk about her work cheerfully, too. She disabused me of my preconcieved notions about the mortality rate in that field.

And I am a pediatric oncology survival story myself (malignant melanoma at age 17).
#62 Navin
June 12, 2008

Oh thank you PZ for this. This post was uplifting and a well-needed antidote to the depressing article that just ran in the StarTribune about Applied Kinesiology and qigong. Evidence-based medicine works!
#63 negentropyeater
June 12, 2008

Donating to the American Cancer Society is a good thing.

But this Relay for life thing ?
Going through some of these pages and I’m thinking, why do Americans always have to be so melodramatic ?
-”Relay is a moving celebration of cancer survivorship.”
-”As a community event, Relay fulfills a need for belonging that we all have.”
I don’t know, there’s something with it that I found particularly distasteful. Call me cold and cynical, but I’ve lost half of my family to cancer, and I just don’t understand why this is necessary to get people to give more money. It’s actually sad to think that it is.

I don’t know, I just don’t understand the point of it all, this marketing, this organisation, this quasi …. religiosity in the whole thing. Maybe it’s cultural misunderstanding, afterall, I’m French, you know we can be quite rude with these things.
#64 Steve LaBonne
June 12, 2008

…unfortunately, she was slowly eaten alive by an implacable melanoma several years ago.

I’m very sorry. I know all too personally what that’s about- my dad died of melanoma when I was 11 years old.
#65 ihedenius
June 12, 2008

A start would be to cut this nonsense (121M dollar yearly).
http://nccam.nih.gov/
#66 Holbach
June 12, 2008

Good post PZ, and equally good comments from everyone who has a story or comment to relate on the heartbreak and the never ending quest to cure this most ancient of diseases. And what is foremost in the comments is the regard and determination that science and the will to apply it in it’s various mainfestations will cure or abate this most heinous of human afflictions without the need of religious interference or false hope.
#67 K
June 12, 2008

What money? People are losing their jobs and homes, giving to charity is not an option for many people.
We are caught in the ripples of a dying economy. We are at the precipice of great change. Will our society be a victim of Peak Oil along with water and food shortages or will great scientific advances be made?
#68 robhoofd
June 12, 2008

I want that first graph on a t-shirt, completely with “Evidence-based medicine. It works.” above it.
#69 Brownian, OM
June 12, 2008

I’m trying to decide on my second career and “medical geographer” sounds totally cool. What are the requirements for this sort of job? TIA.

Questions like these are always hard for me to answer, since I’ve never held a job I was ‘officially’ qualified for. (Basically, I did half a master’s in human geography, quit, and then reapplied to the organisation I’d been working for as a biostatistician before I quit to go back to school (oh yeah. Guess who has no training in biostatistics other than one undergrad course, either.)) My manager conflated geography with geographic information systems (GIS), and somebody previously had bought some GIS software that no one knew how to use. So initially, the difference between me and everyone else I work with is that I had the fortitude to turn the damn software on and give it a whirl.

My personal Rube-Goldbergian career path aside, medical geography requires a general understanding of epidemiology, public and population health and how spatial analysis, GIS, and other geographical tools and methods can augment these disciplines. Many university geography departments offer degrees in medical geography, but GIS specialists can also get work in the field without necessarily pursuing a Masters or PhD.

I’m not sure where you are located, but here is the US National Cancer Institute’s webpage about GIS: http://gis.cancer.gov/ and the North American Association of Central Cancer Registries’ GIS committe site is here: http://www.naaccr.org/index.asp?Col_SectionKey=9&Col_ContentID=281
and the CDC has a site on GIS as well: http://www.cdc.gov/nchs/gis.htm

Finally, for some info that’s not so GIS-focussed, this is the website of a friend of mine who actually happens to be a bonafide PhD’d medical geographer: http://www.science.mcmaster.ca/geo/faculty/yiannakoulias/research.html

As I noted above, I’m not the best resource for orthodox method of entries into the field, but I hope this sheds some light. If you need anything else, my email is in the link to my name in this comment.
#70 Andrey Naumov
June 12, 2008

The last chart is almost meaningless without comparing to absolute dollar amounts (and probably median amounts per funded and not funded applications) as well.
#71 Brownian, OM
June 12, 2008

Bureaucratus Minimis, I wrote a reply post about medical geography, but it’s got more than one hyperlink in it so it’s being held for moderation.
#72 PZ Myers
June 12, 2008

Actually, no, it’s very meaningful to people trying to pursue a career in biomedical research. It’s from the perspective of the scientist — it says that you are going to have to work much, much harder to get funding.

It would be just as crippling to the advancement of science if NIH funding were doubled, but grants to established programs were quadrupled, creating an almost insurmountable barrier to establishing new labs.
#73 VWXYNot?
June 12, 2008

I’ve been reading Pharyngula for a couple of years now and this is my favourite post to date. I’ve spent almost my entire career in cancer research centres (UK and Canada), and as part of my current job I see a lot of survival curves for individual clinical trials. But seeing the historical trend really puts things into perspective.

Progress requires research; research requires money.
#74 watercat
June 12, 2008

I’d like to put in a plug for saving the rainforests. Why? My son was in one of those yellow lines, dying of lymphocytic leukemia a few years before they found a cure, from a little purple flower in the jungles of Madagascar. Y’know, the ones we’re cutting down so fast. Everything’s related.
#75 Julie Stahlhut
June 12, 2008

Your post definitely hit home. I lost a 29-year-old friend to melanoma some years back, and a 41-year-old cousin to kidney cancer two years ago. My husband had a relative who died way too young of breast cancer because she spurned medicine for woo.

On a brighter note, I have a number of friends and relatives who are long term cancer survivors (in one case, 55 years!), and the oncologists I’ve met have been upbeat, optimistic people. I think that field may select for the optimistic phenotype.

The graphs tell a great story too. When we were kids, pediatric leukemias meant death. Cancer is obviously still a frightening and dangerous thing, but there’s real hope for patients now, and real success from cancer treatments — and medical research is the source of that success. (Gee, y’think someone could explain that to Ben Stein?)
#76 Mark ZZZZZzzzzz
June 12, 2008

My little brother was diagnosed with neuroblastoma at age 2 in 1972; he was dead just before his 4th birthday. Now that’s regularly curable. We have indeed come a long way in not all that long on some cancers—just not enough of them.
#77 Pierce R. Butler
June 12, 2008

Whatever happened to the “Cheerful Oncologist” blog, formerly part of the mighty sprawling ScienceBlogs empire?
#78 Richard Eis
June 12, 2008

A friend of the family just died about an hour ago. Didn’t really sink in till i started reading this and realised that if the last graph wasn’t pointing downward he might still be here.

To be honest, the largest expense i can think of around 2002/2003 was the war on terrorism. Though i wouldn’t know where to look for checking such a correlation.

Keep up the good work everybody.
#79 synthesist
June 12, 2008

As an engineer there is nothing I can do clinically to help in the search for cancer treatments, so I am doing a 65 mile charity cycle ride for the Anthony Nolan Trust (leukaemia)
http://www.blenheimpalace.com/whatson/view.htm?id=436
Given the unreliable English weather, I just hope it isn’t chucking it down with rain !!
#80 watercat
June 12, 2008

Yeah, Julie; The doctor explained my son’s disease to us by saying “It kills you.” (prick!)
While he was sick all the doctors could tell us was “They’re working on a cure; it could come any day.” Heard that about a million times, and of course I never believed them–but it turns out they were right!
It didn’t help my little guy, but I like to think he helped them with developing the cure that other kids are benefiting from now.
#81 shadowfax
June 12, 2008

the citation for the article with the Kaplan-Meier graph is:

Treatment of Acute Lymphoblastic Leukemia
Ching-Hon Pui, M.D., and William E. Evans, Pharm.D.
N Engl J Med 2006;354:166-78

I will look into seeing whether we can get it over at CafePress!

Also, today was a big day for Beth Villavicencio (she’s a friend of mine). In addition to PZ’s nice write-up, she found out today that she got a grant from St Baldrick’s Foundation for pediatric cancer research! Woo-hoo! As I personally raised $17,000 for her efforts (over at my blog, Movin’ Meat I feel pretty personally proud for her!

Woo Hoo!
#82 shadowfax
June 12, 2008

Oh, the Cheerful Oncologist signed off in January. I was sorry to see him go; I loved his writing.
#83 Martin de Boer
June 12, 2008

Great post, PZ.
Sadly, I’ve lost two close friends in the last few years dying of cancer.
My 15-year old daughter started charity (school) project a year ago to help raise money for the Dutch Cancer Society (we live in The Netherlands). She wrote a novel about a girl her own age, struck by this terrible desease (www.mytheatreofdreams.com). All profit of the book sales will go to The Dutch Cancer Society.
#84 Pablo
June 12, 2008

I am getting to the age where I am finding many of my old high school friends and classmates to be getting breast cancer. I really understand the feelings of those scientists who say, “I knew X who died from it and decided I needed to do something.”

In terms of my current contributions, while not donating to actual cancer research (although you never know what will be the benefits of our basic research), I am scheduled to donate platelets on Monday, which are typically used by bone marrow transplant patients.
#85 Nix
June 12, 2008

(Though it’s off-topic and I rarely comment I thoguht I had to here.)

Interrobang@60, snap! pretty much. 2.5 months premature due to undiagnosed twins, 993g falling to 630g 20 days post-birth, hit with pneumonia, jaundice, and a patent ductus all at the same time, 32 years ago. Survived with no problems but a huge scar and a predeliction to respiratory diseases and potbellies. Thanks be to Hammersmith Hospital for pulling me back from the brink.

I doubt there are many stories like this from people much older than us. They still got born, but they all died.
#86 David Marjanovi?, OM
June 12, 2008

they found a cure, from a little purple flower in the jungles of Madagascar. Y’know, the ones we’re cutting down so fast. Everything’s related.

Well said.
#87 Paul Burnett
June 12, 2008

I recently re-connected with my 1960 high school graduating class (in rural Illinois). In a class of 60 kids, 3 are dead of pancreatic cancer, and 1 from the previous year’s class of 50+ (and those are the ones we know of). Epidemiologically speaking, I think that’s pretty a peculiar cluster. But I don’t know how to get somebody interested in looking into it. Who would care?
#88 Matlatzinca
June 12, 2008

Thanks for the great write-up PZ. I’m glad that we could turn you around 180, and even more grateful for the excellent advocacy that you do on behalf of science research. Several people have mentioned ACS’ lobbying/political activities as a barrier to providing financial support. Please check out Shadowfax’s blog entry (#81), or else just visit the St. Baldrick’s site to find just one of the many organizations that directly support the kind of research that leads to the graphs shown above.

Oh, and PZ, you forgot to mention how cute Beth is.
(Hi love!)
#89 Fernando Magyar
June 12, 2008

re#79,

Agreed, we laymen can do things like that. My girlfriend and I, both of us past the half century mark, participated in the Kayak against cancer race organized by our dive club,www.kayuba.org, last weekend off of Ft. Lauderdale. Proud to say both she and I were among the few finishers of the advanced 12 mile course which took place in pretty rough seas and a stiff wind. I have to admit that what kept me going in the last couple of miles was the thought that however hard the going was it was still much much easier than dealing with any form of this disease.
#90 Brownian, OM
June 12, 2008

I recently re-connected with my 1960 high school graduating class (in rural Illinois). In a class of 60 kids, 3 are dead of pancreatic cancer, and 1 from the previous year’s class of 50+ (and those are the ones we know of). Epidemiologically speaking, I think that’s pretty a peculiar cluster. But I don’t know how to get somebody interested in looking into it. Who would care?

Try talking to someone at the Illinois State Cancer Registry.

Just to warn you beforehand, generalising from state- or even county-wide cancer rates to determine whether three out of sixty signifies something odd can be difficult. If you’re really concerned and you think there’s an environmental reason for the cluster, the Centers for Disease Control and Prevention (CDC) also investigate potential clusters, though I suspect they leave cancer for the state cancer registries, so check with them first. (As a side note, Illinois has gold certification from NAACCR, meaning their data are damn good.)
#91 Etha Williams, OM
June 12, 2008

Re: the grant statistics –

IIRC there was an article in Nature (I think a News & Views or an Editorial) a while back analyzing the increase in grant-seekers as a major contributer to the decrease in % grants funded. I can’t for the life of me find the article on google scholar or pubmed, though. Anyone remember this, or am I completely making it up?
#92 slim
June 12, 2008

So sorry about your sister, PZ. But thanks for the post; melanoma, especially, has a ways to go before it can be considered curable.

My grandmother died of melanoma, and so did my brother-in-law, three weeks before his only child was born. Two others in our family have had melanomas removed. We all get screened twice a year, but melanoma is ravaging, and we all know we live in its shadow (esp. since we’re all fair-skinned blonds, and grew up in FL).
#93 andy
June 12, 2008

Hi PZ – I dropped some money to help Rachael out with the relay. Thanks again for helping me out when I raised money in memory of my friend Tom!
#94 Ron Sullivan
June 12, 2008

It’s not often that a graph brings tears to my eyes, but the first pair did.

I was a nurse in the mid-1970s to the early 1980s. I worked in a major all-pediatrics hospital in the San Francisco Bay area. Nix, Interrobang, I spent some years in the NICU. Do you know how good it is to see your posts? Because we rarely got to know the long-range outcomes for our babes.

The docs had one advantage over the inpatient nursing staff: They got to see the kids who had the best chances of making it, because after those kids were treated largely on an outpatient basis. The ones who spent the most time being the most sick were the ones we got to know best, of course. Yeah, there were heartbreakers, including E. who was born otherwise healthy with liver cancer. (Sorry; I don’t remember which cancer it was.) She was a sweet baby, was in and out a lot with her equally sweet (healthy, smart, middle-class) parents before she died at about two-and-a-half.

We made efforts to meet the ALL kids who did get admitted for preliminaries because even then they had good odds and we needed good news.

When I was a kid in the 1950s, ALL was one of those soap-opera plot gimmicks meaning “ethereal wan-looking child who’s struck down suddenly and is doomed.” Now it’s a curable disease.

Watercat, I think the drug you’re alluding to is vincristine, from the Madagascar plant (IIRC) , which has another genus name lately, is it Catharanthes? I believe it’s close to the little red and pink annuals you can buy in sixpacks at the garden store.

Funny old world.
#95 DLC
June 12, 2008

In the 70s, almost everyone knew someone who had died from cancer. Now, almost everyone knows someone who has had cancer and is still alive thanks to medical research and implementation of new treatments. And on the dark side of the issue, we have con men and credulous true-believers who prey on those with serious illnesses.
As an aside: not funding the war in Iraq would not suddenly release money to be spent on other projects, as the war is being funded mainly with debt. I.E. it’s going on the national Credit Card. Your children or theirs will have to pay for it.
That said, I do support an increase in funding for research, and for new researchers.
#96 Charlie Foxtrot
June 12, 2008

Great post PZ.
My father was diagnosed with Bowel Cancer back in ’97 – had major abdominal surgery and now is kicking along just fine.
My mother was diagnosed with Breast Cancer in ’00 – had a masectomy and chemo and now is doing great.
My aunt only saw the next door neighbour who dispenses Chinese alternative medicine (who, in all fairness, did tell her to go see a doctor because she wasn’t well) and her cancer was so far gone that she didn’t live 6 months after being diagnosed, back in ’98.
I’m not just donating money when I can, but am also participating in a study where they’re looking for genetic markers across family members.(or similar, not exactly my field;)) Who knows, maybe some of you boffins out there have seen my DNA – did it wave ‘Hi’?
#97 craig
June 12, 2008

My brother-in-law was diagnosed with cancer a couple of years ago. He painted a grim picture of the diagnosis, and said he was not getting the treatment because the odds weren’t good enough, the effects too severe. While we disagreed, to various degrees we all sort of understood his choice if things were that grim.

Turns out that in his delusion he was totally misrepresenting his diagnosis. In fact, we later found out, his tumor was very small, very treatable, and his prognosis was good.

His cancer was NOT a death sentence, but his cancer combined with his other illness – religion – was.

He doesn’t have too long now. Before long he will have left a wife, four daughters from high school to 2nd grade, and a huge debt run up by relying on thieving “faith healers.”

There is a vile scumbag of a man who calls himself “John of God” who preys on the scared and sick. He has a place in Brazil, and comes to the U.S. sometimes, where he charges these scared people thousands of dollars for “healing,” sells them “crystal treatment beds” for thousands of dollars, sells them $10 or $20 bottles of water with a “John of God” sticker on them proclaiming them to be holy, etc.

Several of his trips to Brazil have left my sister’s family deep in debt.

I am not a person who hates anyone. I don’t wish anyone harm. I feel this things at least as much for my own sake as anyone else’s.

But this “John of God” scumbag better not ever find himself in my presence or he’s going to be in need of some traditional medicine. Nothing is more disgusting than a conman who targets the sick and dying.
#98 rp
June 12, 2008

This post brought back memories of a hospital room in 1964 when I was 12. I’d been in and out of the hospital several times that year (cast changes; only serious if you really can die of boredom) and several times I’d had a 5-year-old roommate who had some form of leukemia. I remember when she first was admitted – it was my first experience of adults who were terrified. And I remember the night she died. One of the student nurses hid in my room for a few minutes to talk about her and cry. I hadn’t realized how much progress had been made until this post, so thanks, PZ. And thanks to everyone who works to make cancer more treatable and less terrifying.
#99 Daniel
June 12, 2008

Nice post !!!
I am currently doing a PhD in cancer biology. My Studentship and all research in the lab that I am working in is funded by charity money. Research is expensive but substansial progress in cancer research can only be made through a lot of effort. I am very thankful to all those people donating money, organizing charity events or taking part in them. They give me the oppurtunity to do cancer research and I hope to pay it back by making at least a small contribution to our understanding of cancer.

And to answer SteveM’s question. As for most cancers it is metastasis and drug resistant relapse of the disease that actually kills the patient you can easily explain the 5 year time. If a cancer hasnt relapsed after 5 years it becomes very unlikely that it will reappear. That is why after 5 years very few people die from the cancer. Either the patient is totally cured or has already died from the disease.
#100 pablo
June 12, 2008

5 years ago i was diagnosed and treated for Hodgkin’s Lymphoma. Cure rates for some forms of Hodgkin’s are now as high as 75-80%%. While going through chemo and radiation, I decided that i couldn’t work in an office any more, so i went back to school, and now i work in a radiation oncology clinic.
#101 BA
June 12, 2008

Relay for life is an excellent cause to donate to but if you can, go to one. The honoring of the lives of loved ones by participating is so much more rewarding than the feeling you get from donating (which should also be a good feeling).

With our government dropping the ball on funding all types of research it is a critical time to donate to private organizations that fund clinical (or any sound) research.
#102 watercat
June 12, 2008

Ron #79, you’re right, it’s the rosy periwinkle, catharanthus roseus, a nice little screen saver. And, it can’t be said enough, nurses who work in pediatric oncology are saints. So to all of them who are reading this thread,

THANK YOU!
#103 SplendidMonkey
June 12, 2008

I second Pablo @#84. Giving platelets is rewarding. Red Cross donor center in Minneapolis – have a good DVD library for watching during donation, they have wonderful staff that treat you well. Say Hi to Tim for me.
#104 Dennis N
June 12, 2008

I went to the Scooper Bowl tonite. Donated to cancer research and ate myself literally sick with ice cream.
#105 jennifer
June 12, 2008

I read somewhere that doctors treating pediatric cancers organized themselves to share information, so the best treatments were known and used, the worst ones discontinued. Why can’t that be done for adult cancers? If anyone knows the answer, please don’t tell me – my mom has only been dead 15 days, and I think I need more time before thinking she could have been saved.
#106 SteveM
June 12, 2008

Daniel@99:
And to answer SteveM’s question. As for most cancers it is metastasis and drug resistant relapse of the disease that actually kills the patient you can easily explain the 5 year time. If a cancer hasnt relapsed after 5 years it becomes very unlikely that it will reappear. That is why after 5 years very few people die from the cancer. Either the patient is totally cured or has already died from the disease.

Thanks, but why 5 years and not 4 or 6 or even 1? The break in the survival curve is pretty sharply at 5 years, why there? And even as the long term survival probability has improved the “corner” remains at pretty much 5 years, why doesn’t it move out as treatment improves?
#107 Robert Thille
June 13, 2008

My Daughter and I have been raising money for the Leukemia & Lymphoma Society to fight blood cancers. If someone would like to help us out and donate in our names here are the links:
My Page
My Daughter’s Page

Thanks for any help you can give!
#108 rd
June 13, 2008

Dr. Myers,

Those who get regular sun (South/SouthWest area) have less melanoma than people in the
North because of Vitamin D. I thought you believed in Evolution. It is shame
that you will never touch the Cholesterol/Vitamin D link. Pharmaceutical have
scared the people to stay way from sun, take Cholesterol lower drugs and
now take Vitamin D supplement directly obsfucating Evolution.
I don’t know what kind of research you advocating since humans
spend most of their life directly harming their genes then expect
miracle drugs to work like magic that is what you call science.
How do you propose to map the epigenome.
#109 Kseniya
June 13, 2008

It touches everyone. Good post, PZ.
#110 pwnagepanda
June 13, 2008

first off, fantastic article. One of the most emotional science articles I have ever read. It’s true, the govenment is spending less and less on real science, it needs to be fixed.

@#108(rd)
what the hell did you just try and fail to say coherently? my guess is that you tied to say: vitamin D is from the sun, the sun gives radiation, radiation changes DNA, because of tis evolution/modern medicine are false. What?
#111 Kerry
June 13, 2008

Jennifer (#105)

First please allow me to express my condolences at your loss. I lost my wife to lung cancer in January after a 23 month battle.

I know that the Doctor who treated Donna consulted with other Doctors at Seattle Cancer Care Alliance (btw – SCCA has Docs from University of Washington, Childrens Hospital and Fred Hutchinsons Cancer Research Center).

I am sure that the medical personnel that cared for your mother did everything in their power to cure her.

Kerry
#112 QueenoftheHarpies
June 13, 2008

I have a co-worker that was diagnosed with testicular cancer. They thought he was in the clear after removing a testicle and chemo, but when they did an ultrasound they found some more. This summer he is having surgery to scrape all of the lymph nodes in his abdomen. We got some Livestrong bracelets and sold them at school. The students raise over $1000 to help with his expenses this summer and some of them were planning a car wash this summer to raise more.
#113 Ex Partiate
June 13, 2008

My condolences on the loss of your sister-in.law. I just had a spot removed from my face and the dermatologist said if I had let it go any longer it would have changed, possibly to a melenoma.I am just glad I went and had it checked when I did.
#114 Gray Lensman
June 13, 2008

My wife’s father was the original administrator of the M.D. Anderson Hospital in Houston. He worked his whole career there and was a leader in developing programs to make it possible for doctors to do research, train others and do the medicine.
#115 aiabx
June 13, 2008

Seven months ago, someone died in a hospital bed*. Won’t someone take a stand for her?

*my mom.
#116 Pat
June 13, 2008

Best post ever, PZ. Thanks for fighting the good fight.
#117 j
June 13, 2008

Thanks, Prof. Myers. You are a good person.
#118 Peter Ashby
June 13, 2008

I’ll add to Kitty’s measure, I’m 42. When I was 8 a friend died in the night from a bad asthma attack. At university a college mate died from leukemia. End.

Progress.
#119 jh
June 14, 2008

On my first visit to my Medical Oncologist, the Doctor thanked me. Before I was a cancer patient, I had been a platelet donor. Tim said that I had probably helped some of his patients, perhaps even some that were in the infusion room at the time. Platelets are an important part of many cancer regimes: Leukemia patients need lots, the therapies that are saving their lives wreak havoc on the rest of their systems. Leukemia and other cancer patients may need to have their bone marrow killed off, and restarted with someone else’s bone marrow – until they’ve developed enough of the new marrow, they’ll need platelets every couple of days – because platelets only live for a few days.

Platelet donation is a bit of a bother, I’d spend almost an hour and a half watching movies with needles in both arms as my blood circulated through the machine. For me, the hardest part was having to ask a nurse to wipe my nose! I had to give it up after a couple of years of donating every couple of weeks – my veins were getting tough. I had been planning on trying to get back into donation, but now I no longer qualify.

Platelet donors are mostly recruited from blood donors, but prior donation isn’t a requirement. What is required are good veins (preferably in both arms, double needle is faster and easier), the right blood types (platelet matching is different from whole blood matching), the time commitment, and access to a platelet donation center (Red Cross or Hospital based).

Not sure you’re up to platelet donation? Give whole blood. Lots of cancers require major surgery to remove the primary tumor. Major surgery requires blood. Single needle, about 45 minutes of your time. Juice and cookies afterwards. Probably a T-shirt or other small gift.
Can’t deal with needles, don’t qualify as a donor? Volunteer at a blood drive.

Somewhere along the way, give a DNA sample for the Bone Marrow registry. The odds that you’ll get called for a possible donation are slim (and you can refuse), but if you do become an actual donor, the odds that you will save the life of an identifiable single human being are quite high.

Call 800-GIVE-LIFE for a Red Cross blood drive in your neighborhood or for more info on donating blood or platelets. Or check with your local hospital, they’ll be happy to hear from you.

* I have bladder cancer. We caught it before it invaded the bladder muscle, so I get to keep my bladder. While I’m not cured, the odds that I’ll die from this cancer are very small. The surgery is minor day surgery – they burn the tumors out from the inside of the bladder a few times a year. Treatment is a minor nuisance – they fill my bladder with biological? or chemical agents once a week for several weeks. Since the treatment agents are only inside the bladder, the side effects are minimal.

? I need to thank the researchers who figured out the crazy idea that filling my bladder with attenuated Tuberculosis bacteria would trigger my immune system to attack the cancerous and precancerous cells. Having to bleach my urine on treatment days, and abstain from sexual contact for six weeks after treatment is a small price to pay.
#120 Susan
June 14, 2008

There was a related article in Slate last week on reasons for some of the lagging specialties (for instance, cures for various psychiatric illnesses):

Old Drugs, New Tricks
Why big health advances rarely involve new medicines.

http://www.slate.com/id/2193294/
#121 Tony P
June 14, 2008

I was shocked seeing those graphs. It’s amazing the progress we’ve made but there’s still much more to be made because 10% are still dying.

I’m not that much of an optimist to think we can catch all of them, but I do think we can get as low as a 3 or 4 percent death rate from cancer.

But you’re right, we need to re-invest in the U.S. else we face the real danger of becoming a third world nation.
#122 FhnuZoag
June 14, 2008

I’d love to have those Kaplan-Meier graphs on a T-shirt, under the caption ‘Evidence-based medicine. It works.’
#123 Clark Goble
June 15, 2008

It appears that total funding was increasing through 2005 and then decreased in both 2006 and 2007.

Umm. Wasn’t that when Democrats took control of the congress? Weren’t they supposed to reverse the Republican “war” on science? Why have they made it worse?
#124 Debbie
June 15, 2008

The day that Karen called me and told me that the UW doctors told her that there was nothing else they can do for her, my heart sank to the most vast hole in this earth. We had a special bond, our birthdays are the same but in different years. Sis was a very caring thoughtful person and even tried to help several family members with their personal problems and tried to not say anything bad about a person. And that Karen has five sisters and 1 brother. We all contribute to the relay for life and so does our parents some more than others. As for the research, I work in the medical find myself and I see others with different types of cancer, and they too are looking for a cure too. thank you
#125 mgarelick
June 15, 2008

PZ — something you said early in your post, about the pediatric oncologist, resonated with me. My wife is 107 days out from a bone marrow transplant, so I have a lot of experience with cancer-focused health workers (nurses, doctors, physician-assistants). I’m sure they get a lot of inspiration from how well so many patients are doing these days, but there’s still a good percentage who don’t do well, so I’ve been amazed at their optimism and good spirits. It’s a huge help to the patients and caregivers.

There’s a sign in the hallway at Stanford that says something like “Angels at work; be prepared for miracles.” It always irritated me, because I know that all the great work is being done by mere mortals, and that’s fine; in fact, it’s better than angels, because it’s real.
#126 NBHope
June 25, 2008

Thanks for this post. It is absolutely crucial to continue to fund research, both public and private, for the fight against these evil diseases.
A couple of quibbles.
Only a small percentage ( 3%) of ACS (Relay for Life) monies go toward funding pediatric cancers. Don’t be mislead by the frequent use of children for tugging at the heart strings.
ALL is an excellent example of your point, viz. the progress we’ve enjoyed over the past several decades due to basic research on pediatric cancers. But it is the exception, not the rule. For some, there has been little or no progress. This is not the fault of the science (or scientists). My point is this: highlighting this chart may be counter-productive, suggesting that our work here is finished. It is not. There are many other forms of cancer for which progress is elusive. This chart is good for lots of (appropriate) self-congratulations but may not be quite so effective for raising new, desperately needed funds.
Thirdly, my daughter has had neuroblastoma for six years. She’s an outlyer on any curve. Once, when visiting an oncologist who (rightly) figured she must certainly be in the last stages of disease, he looked at a very healthy (albeit tumor ridden), bright, smiling young girl on his exam table and said: “It’s the biology.” He then perused her charts to try to figure out, from the biopsy data, why she was relatively healthy rather than dead. The answer wasn’t in those charts, but he persisted: “It’s the biology.” Now, I happen to think that all his (scientific) bluff and bluster was correct; there is something about the biology of her tumor that accounts for her good fortune. Still, I had to ask: “why does her disease have this particular biological make-up.” Was I wrong to think that it had something to do with the gazzilion people praying for my daughter’s good health? When the treatment plan works, we might say: “It’s the medicine,” neglecting to give credit to the doctor who, in her wisdom, formulated and prescribed these drugs per our pleas for healing. It would be a tragic mistake to credit the drugs and fail to recognize the good will of the doctor who administered those agents. Similarly, why suppose that “It’s the biology” is somehow incompatible with the responsive care of the Great Physician. There is plenty of opportunity for contribution. No reason not to give credit where credit may be due. Prayer and practice: it is not a zero-sum game.
#127 Dennis N
June 25, 2008

I’m happy your daughter is healthy now, thats excellent!

However, there is a way to find out where credit is due. That is through double-blind scientific studies. All that have been conducted show that praying has no effect.
#128 NBHope
June 25, 2008

Thanks, Dennis N

Would a double-blind scientific study reveal whether or not your mother had decided to drop a few dollars into the mail for you in response to a financial need? Maybe, but failure to conform to experimental parameters would tell us nothing about the responsive heart of a free and caring person. God is neither tool nor mechanism.
#129 Nick Gotts
June 25, 2008

Was I wrong to think that it had something to do with the gazzilion people praying for my daughter’s good health?

Simple answer: yes.

I hope your daughter continues to do well, and indeed recovers completely.
#130 Dennis N
June 25, 2008

No, but are you saying god made your mother give you money? Your mother being a nice person (and it seems she is) is a simpler, more rational explanation.

I’m confused, why would something fail to conform to experimental parameters? Normally, that’s because something is unreliable, or tainted, or doesn’t exist.

I wouldn’t claim god is a mechanism or tool, but how does he interact with this world in any measurable way, if not through a mechanism?
#131 nBHope
June 25, 2008

Thanks for your good wishes, Nick.

I guess I meant that as a rhetorical question. I understand the position so well represented by this thread, I just don’t understand what reason we might have for thinking that a mechanistic approach is somehow incompatible with a personal contribution. (Why, exactly, was I wrong? Saying so doesn’t make it so.)
#132 Dennis N
June 25, 2008

Well, prayer helps in the sense that someone knows people out there are thinking about them and caring about them. That is always a good thing. Also, your mother’s and others’ personal contributions help, too. However, there is no evidence anything supernatural (god) is involved.
#133 NBHope
June 25, 2008

Sorry Dennis (#130), I screwed up the analogy. Suppose the money was given anonymously. Was it from Mom? Gee, I don’t know; how can I find out. Should I try to replicate the conditions and see if she responds in kind? (I’m not sure how to set it up as a double blind experiment.) She wouldn’t have to be unreliable not to respond to my attempts at manipulation. She would simply have to have reasons of her own that I may or may not understand. I didn’t mean to suggest, in the example, that the money came from God. It came from Mom and failure to replicate could not prove otherwise.

Suppose it’s more than just biology. So by what mechanism might God have used to determine the specific biology of the tumors? I have no idea. Suppose I find the monies in an envelope in my mailbox, no return address, no stamp, etc. How (exactly) did it get there? No matter. I’m going with mom as the simplest explanation (I’ve heard that she does these sorts of things), even though I can’t say exactly how she got it there.

Hope this helps.
#134 Dennis N
June 25, 2008

I see now. But in that case you have prior experience with which to base that decision. You have met your mother, you know she loves you, you know she would send money, you know she knows your address. Additionally, you know how to recognize money and you know the mail system works.

None of this can be said for the biological side of the analogy. You have never met god, you don’t know his feelings or if he exists, you don’t know how he would react in this situation. Also, there is no way to tell if god intervened or if it is just how biology and medicine work, you don’t know through what mechanism (his postal service) he would work, and on and on.

There’s just no reason to assume god in all that unknown, when the natural laws already have it covered.
#135 Nick Gotts
June 25, 2008

Why, exactly, was I wrong?

Because magic doesn’t work.
#136 Nick Gotts
June 25, 2008

Incidentally, NBHope, if God could fiddle with the biology of your daughter’s tumour, why not just get rid of it altogether? Or stop her acquiring it?
#137 NBHope
June 25, 2008

Dennis (#132),
I’m not offering any of this as (positive) evidence for God’s involvement. If there were no evidence, then the belief would be unwarranted and probably counterproductive. Suppose I had evidence of the supernatural, it could be shortsighted to suppose that such a being weren’t somehow involved in this outcome. So, I ask again, why not pray for favorable histology?

BTW: I actually take no comfort from another’s thoughts, unless I thought they might lead to helpful interaction. There is no power, or hope, in good wishes alone.
#138 Dennis N
June 25, 2008

Are you saying it’s possible there’s a god so why not pray? Kind of like a version of Pascal’s wager?
#139 Nick Gotts
June 25, 2008

NBHope – Your #137, first paragraph, just doesn’t make sense. What are you trying to say?
#140 NBHope
June 25, 2008

Dennis (#134).

I’m falling behind. Your response #134 is spot on. I do (in the analogy) know all this about dear old mom. Do I know it of God? I believe it based on prior evidence. I can’t say that I know God according to your standards of knowledge. I gather that I do know God, but it may be a mere belief according to your criteria. I also gather than my wife has a mind, is conscious if you will, but I know I couldn’t “prove” it.

Maybe it’s all, only biology. Maybe it would have happened this way whether there were a God or not. Of course, I can’t say. But there are no (few?) atheists in either foxholes or pediatric cancer wards. My belief in prayer is not based on a desperate wish, but I would be remiss were I to just assume, without “proof,” that healing could not come by means of both prayer and lots of amazing science (and scientists). (My daughter will begin her 8th Phase I clinical trial in a couple of weeks. Just maybe this is the one; where there is life there is hope.)
#141 MAJeff, OM
June 25, 2008

But there are no (few?) atheists in either foxholes or pediatric cancer wards.

Oh, fuck off.
#142 Nick Gotts
June 25, 2008

But there are no (few?) atheists in either foxholes or pediatric cancer wards.

Evidence?
#143 NBHope
June 25, 2008

Dennis (#138)

Exactly, but more like William James’s “Will to Believe,” or as he preferred, “The (epistemic) Right to Believe.” I’d cite James rather than BP only because he makes it clear that evidence for that belief might be forthcoming only after sincerely acting upon it. So, I’ll revise: at some point we may pray out of desperation. We have little choice but to take that leap. Why not (that same nagging question)? What comes of it? My daughter lives to fight another day, and enter yet another clinical trial — the fruit of the scientific research we’re working so hard to fund. Answer to prayer? I think so. These things don’t come labeled. But the fact that she’s alive is only part of the evidence that God hears and responds — in God’s own way — to these prayers. For a full account of the evidence that vindicates this desperate act, you’d have to hear the rest of her story. God is good in so many ways.
#144 Nick Gotts
June 25, 2008

God is good in so many ways.

Really? Rabies was a tremendously benevolent idea of his, wasn’t it? Oh and smallpox – what a boon! Parkinson’s disease – God played another blinder there, eh? I knew a kind and pious old woman whom he struck with this. For some time before she died she had, effectively, the choice between paralysis and insanity – the only treatments drive people mad if the dose is too high, and over time, the margin between effective and psychosis-inducing disappears. I know she talked to her pastor about this repeatedly – why was God doing this to her? She was quite ready if he wanted to call her home, but why was he torturing her first? Gah!
#145 NBHope
June 25, 2008

Nick (#144)

You’re preaching to the choir. Google Neuroblastoma. It sucks in every way you can imagine and then some. We’re talking kids.
No one said that we’d somehow see good in everything that happens, only that there has been so much good that has happened. Was it really good, or am I just brainwashed by the church or something? You’d have to ask my daughter. She keeps insisting that, in spite of her suffering — which about kills us, there’s good. I don’t presume to speak for anyone else.
#146 Bill Dauphin
June 25, 2008

(@140)My daughter will begin her 8th Phase I clinical trial in a couple of weeks. Just maybe this is the one; where there is life there is hope….

(@143)… the fact that she’s alive is only part of the evidence that God hears and responds … to … prayers.

NBHope, I quite literally know how you must feel: My own daughter was diagnosed with brain cancer at 10. I have no idea what your daughter’s diagnosis or prognosis is, but maybe it will help to know that my daughter is now 17, out of treatment for almost 6 years, cancer-free, and will be attending Yale in the Fall.

But I don’t attribute her recovery, nor your daughter’s current survival, to prayer; I attribute both to scientific, evidence-based medicine. If your faith gives you comfort, I’d be the last to try to talk you out of it: I know full well how important comfort is, from whatever source, in your situation. But don’t be surprised that the rest of us don’t accept medical success as evidence for the power of prayer.

Unfortunately, some of the most powerful advocates for prayer are the same people who would gut the science curricula of our schools… and if they succeed, where will the doctors who might someday save our daughters’ daughters’ lives come from?
#147 NBHope
June 25, 2008

Bill. Delighted to hear that your daughter is flourishing. Thanks also for your charity and good wishes.

Just so we’re clear. I’d be on thin ice were I to base my faith on this one case of medical “success” — such as it is (and naive were I to expect this story to change many minds). I don’t offer any of this as evidence of answered prayer or the existence of God. That said, I do believe God hears and answers prayer which is why I take much of what has happened as God’s response to those gazillion people who continue to pray for my daughter. I’d like to think that if you were privy to the whole story you would think: “Ya, I can see why he might regard all that as evidencing the providential care of a benevolent being, in spite of the god-awful suffering.”

The original point was that absence of proof is proof of absence (Dennis #127). We’ll continue to disagree as to whether God is involved in this situation (or that of your daughter). Maybe, maybe not. Can’t definitively prove it either way. All biology and chemistry? Maybe, but its pure “bluff and bluster” to suppose we can prove it. Only biology and chemistry? We’ll never know. Ever. Divine intervention? Maybe, and I won’t pretend to prove that either. Both? Now there’s a novel thought. It’s my take on it, actually, which means we better get busy funding more and more basic science research. It’s how God (I believe) often works. It also means we better resist those obscurantists who would dare denigrate science or stand in the way of science education.

Two parting shots:

A personal thanks to all you scientists who have dedicated your lives to saving others. We are all massively indebted to you.

Secondly: Kudos to PZ; support cancer research (for adults too!).
#148 Dennis N
June 25, 2008

I think you’re getting at the point of, why not pray? That would be simple in a world with only one hypothetical god. But the world we live in has 1,000s of hypothetical gods. Most of them are mutually exclusive. How do you pick which god? By picking any one, you are angering the 1,000s more. Or maybe god helps those who think rationally, do things on their own, and don’t look to him? There’s no way of knowing any of this. There’s no reason to believe prayer brings positive or negative consequences.
#149 NBHope
June 25, 2008

This one (#148), I think, is simple. No scientist can explore every hypothesis (much less every possible hypothesis), so they choose one for various reasons and go with it. So long as it continues to pan out, they rightly regard it as doing good science. It would be especially lame to be paralyzed by the possibility that they might be wrong. There is no way of knowing any of this (before hand). How to choose? Sometimes you’ve just got to go with what seems most promising, often the one you’re most familiar with. That’s my story.
#150 Dennis N
June 25, 2008

But does it continue to pan out? People pray every day for things to the same god and it doesn’t pan out. To be honest about it, you must mark that as a failure; it is a cop out to say something along the lines of god has other plans. If he has plans, why should prayer change them? He’s going to do what he wants anyway.

Also, there are atheists in foxholes. One of the main reasons you don’t hear about it more is that the American military has been overrun by Christian fundamentalists, making it very difficult for them to come out. I have heard that a few are afraid of being killed by friendly fire from their fellow soldiers. To say there are no atheists in foxholes is very insulting. I’m going to take it you didn’t know this, so we’ll (I’ll) forgive you.
#151 Bill Dauphin
June 25, 2008

The original point was that absence of proof is proof of absence

I understand that that’s a logical fallacy, and I would never make that argument. However, absence of proof is still absence of proof, and the existence of God, never mind the assertion that He anwers individuals’ prayers, is a claim that requires proof, because it’s both counterintuitive and extraordinary. Throw in a couple slices from Occam’s Razor, along with the fact that all the phenomena attributed to God — including young girls who survive cancer or triumph over other severe trials — can be explained without reference to God, and… well, I agree that absence of proof isn’t proof of absence, but it’s powerfully suggestive of absence: Absent proof, absence must be the default (albeit admittedly unproven) assumption.

But I don’t want to be in the position of knocking out your emotional support braces. If belief in the power of prayer is key to your personal strategy for emotional survival, maybe a blog whose masthead proudly proclaims its godlessness isn’t the right place to be hanging out?

In any case, I wish you, your family, and especially your daughter nothing but the best.
#152 NBHope
June 25, 2008

I apologize. I mean no disrespect to atheists. It is a turn of phrase. I hope I didn’t offend any choir members earlier either. Thanks for the grace. I actually meant to make a point that I thought you might agree to, viz. people tend to turn to God out of desperate personal circumstances rather than good evidence. I’m conceding this.

You’re starting to make me look a bit pathetic (I know, I’m preaching to the choir here). Does it pan out? Look, she still has a fatal disease, so I guess it depends on what you mean by panning out. Failure? No. Here’s the original point: this is not a scientific experiment. It is a relationship with an often surprising, very independent agent. You might say that my marriage didn’t “pan out” either, but it is far from a failure. I’m happily married to an often surprising, very independent agent, not a machine. She’s pretty strong headed, as it happens, but I still put in my requests with hopes of occasionally moving her will.

Look, I think it’s a question you have to answer for yourself. I can’t answer it for you; nothing I could say (about her experience) will convince you. You’ve got to go into the laboratory of life and see if it doesn’t pan out. This is not peer reviewed data, but it’s data nonetheless. It’s more like what “Christian fundamentalists” call personal testimony. I’m just throwing it out there in hopes that it might move the will.
#153 NBHope
June 25, 2008

Bill (#151), again, thanks. But wait, don’t you end up insisting that absence of proof in this case is proof of absence? Yes, granting that there is no proof of anything and “strongly suggesting” is supposed to carry a lot of freight.

Question (since I can’t seem to extricate myself from this thread): who gets to set the defaults here. Are there public default settings determined by universal standards of rationality? Sociological? Cultural? I’m skeptical, which is why I don’t presume to put forth anything smacking of a “proof” based on premises we can all agree to. By the way, to return to an earlier allusion, my default is that my wife does have a mind — that there is something it is like to be her (until shown otherwise). I’m a bit reckless that way; it’s my default. So also with God.

Finally, I appreciate your sensitivity. I don’t mean to use these present circumstances as a club to tamp down civil response. I threw this stuff out there because I read this blog regularly; I’m very secure in my beliefs, for what I’m trying to suggest are good reasons. It’s not as if this is the first time I’ve thought about such questions. Life is funny that way.
#154 Dennis N
June 25, 2008

The problem with this personal experiment is that all of the data points will come from those who survive. They have reason to rejoice. Those that don’t pan out are not around to “count their blessings” as they say.
#155 NBHope
June 25, 2008

Dennis (#154),
You realize, of course, that none of us survive. It’s the human condition, as they say. So what are you gonna do? There are no guarantees that you’re getting it right (if you are admitting that some actual data points do point toward God); you don’t have the luxury to gather any other evidence. Were we to take my daughter off all treatments, then she might remain stable. But it’s not an experiment we have the luxury to perform — the stakes are just too great — so we go with the data points that suggest that it is these drugs that are keeping her going. What are you going to do? You’ve got to choose (Wm. James again).
#156 Nick Gotts
June 26, 2008

NBHope,
You might be interested in this study:

Benson H, Dusek JA, Sherwood JB, et al. (2006). Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients: a multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer. American Heart Journal. Apr;151(4):934-42

In brief, being certain that others were praying for them, rather than uncertain, resulted in an increase in medical complications. So having “gazillions” of people praying for your daughter – which I assume she knows about – may not be such a one-way bet as you think. Of course, in individual cases, or for some conditions, or even in most cases, it may be beneficial – but what little evidence there is, suggests otherwise.
#157 Kseniya
June 26, 2008

The notion – nay, the unqualified claim – that “prayer works” is a slap in the face to anyone who has lost loved ones prematurely, to diseases such as cancer, despite any and all extreme good-faith attempts to fortify medical treatments with petitions to the Almighty.
#158 Tsu Dho Nimh
June 26, 2008

Thanks … I started as a med tech during the red line years. It’s nice to see the changes.

PS: It was a Catholic Hospital. Yes, they prayed, but we did a lot of research too.
#159 Kseniya
June 26, 2008

Nice handle, Tsu.
#160 David Marjanovi?, OM
June 26, 2008

This one (#148), I think, is simple. No scientist can explore every hypothesis (much less every possible hypothesis), so they choose one for various reasons and go with it.

No. No. No. No. No!

You keep talking about proof. But proof is impossible in science (science isn’t math). All that’s possible in science is disproof: if a hypothesis says something can’t happen, but it happens, the hypothesis is wrong. As long as you can answer the question “if I were wrong, how would I know?“, you are doing science; as soon as you can’t answer it, you aren’t doing science.

So, scientists come up with a hypothesis (no matter how), and then they try to DESTROY it. Not to prove it — that isn’t possible anyway. If they fail to disprove it, they publish it, so that their colleagues all over the world, can join the firing squad, perhaps with new & improved weapons that nobody thought of before or that nobody else was able to afford. Science is quite the splatter movie.

And then, if they all fail, they use Ockham’s ~~War Axe~~ Razor: whenever two or more hypotheses explain the same data equally well, the one that requires the fewest additional assumptions must be preferred. “Preferred” means “provisionally accepted as most likely for the time being”.

And then they go back to dreaming up one more hypothesis. Or a dozen. And then the pwnage starts anew.

Science is not a quest for truth. It’s a quest for falsehood: if something is wrong, we want to find out that it is wrong.
#161 Bill Dauphin
June 26, 2008

Bill (#151), again, thanks.

De nada.

But wait, don’t you end up insisting that absence of proof in this case is proof of absence?

No, I’m saying the assertion that prayer works (or that God exists, for that matter) is an extraordinary claim that demands extraordinary evidence; in the absence of such evidence, it’s reasonable to evaluate those assertions as not true. Plenty of things are not proven, and we believe them or not based on the preponderance of evidence and based on our own experience of the world. I, personally, have seen no persuasive evidence of the healing power of prayer, nor does my experience suggest that it might be reasonable to believe in same… so I feel it’s reasonable for me to not believe, even though I cannot claim that the hypothesis has been logically disproven.

[Dennis@154]: The problem with this personal experiment is that all of the data points will come from those who survive.
[NBHope@155]: You realize, of course, that none of us survive. It’s the human condition, as they say.

Aww, but you know what he meant. Imagine four families, each with a child diagnosed with a deadly disease. Two are Christian families who pray, and one of those children survives; two are atheist families who do not pray, and one of those children survives. Objectively in this case, there’s no difference between praying and not praying (yes, I know it’s not a statistically significant dataset, but that’s tangential to my point, which is…) but the only story the world will ever hear is about the family who prayed, and their child survived. It won’t occur to the atheists to make any claims about prayer, and the Christian family whose child died is unlikely to stand up in church and shake their fists at God… so the net testimony will be skewed in favor of “prayer works,” despite the absence of any actual evidence.

It would be interesting (in an abstract, academic sort of way) to study health outcomes in atheist families to determine if not praying has any measurable effect… but I don’t actually have any reason to hypothesize that it would.
#162 NBHope
June 27, 2008

I wanted to respond since you’ve gone to a good bit of trouble to engage these questions.

First, further apology for the “atheist in foxholes” comment. I thought on that and completely understand its insensitivity in this context.

Nick (#156): I am interested in this study and won’t pretend to rebut it (based on the title). Does it trouble me? If you take this study, or many others like it, to disprove the hypothesis — to have falsified the claim that “prayer works,” then there it is. But, I don’t, in part because of other studies that suggest otherwise, but mostly because I just don’t think that God is the business of convincing us of his existence through miraculous healings. Jesus’s own brothers made this suggestion but Jesus rejected the strategy. So, even failure to catch God in this net does not ultimately trouble me.

David (#160): I mention proof only in the context of this catch-phrase. You are right, and I believe I’ve gone to some lengths to make the point myself, there is no proof in these matters (science or faith). That said, I don’t accept the Popperian line of strict falsification. I don’t imagine many of your colleagues here will agree with the claim that they are not interested in “confirming” evidence, but only “disconfirming” evidence (I use scare quotes to indicate, again, the lack of anything that smacks of either proof or disproof.) Two problems that occur to me: if we only look for falsification, then we must ignore even new and unexpected findings that lend support for an hypothesis, say the discovery of a new fossil (e.g. ventastega). Secondly, which hypothesis to disprove: Prayer works, or prayer doesn’t work. So, agreed: no proof. Maybe only pointers or nudges in favor, but not negligible for all that.

It’s beginning to sound like “prayer works” is unfalsifiable. I only claim that our failure to exerimentally show its efficacy is not a falsifier although there may be many other falsifiers to the claim that God exists, is active, cares about us, etc. E.g., failure to fulfill his promise to give life would be one of those. I just don’t think we have to wait until the eschaton to find out if this is true. She may be dieing (we all are) but she couldn’t be more alive.

Bill (#161): Historically, and in my rather ordinary experience, the claim that God exists is not extraordinary, even if it is a claim about an extraordinary being. It is rather the apparent default. That my wife is conscious is rather ordinary, although I take consciousness to be an extraordinary property of anything. Note: I’m speaking to my experience, not necessarily yours (or anyone else’s). So, yes, it may be reasonable for you to hold your position; it may also be reasonable for me to maintain my belief as well. Blanket statements about burden of proof miss this nuance entirely and I’m not sure it’s all purely a matter of reason. (But this doesn’t distinguish this claim from lots of fundamental claims put forth under the auspices of science).

Kseniya speaking no doubt for many others (#157): Prayer has not appeared to spare the life of my daughter. I’ll let you know how things go as I and many others will continue to pray for her. As it stands, she’s on a pretty certain path. So please take no offense; I make no claim to special powers or privileged position. Further, I make no claim that God only intervenes on behalf of those who hold certain beliefs. It strikes me that we each of us enjoy life at his behest. You probably missed the post, or possibly the nuance of my post that indicated that there may be other (amazing, surprising, remarkable, extraordinary) answers to prayer than the one I might have hoped for. Do I want to lose her? Of course not. Am I glad for how things have panned out? Eternally. But this is just the long version of why I would insist that we cannot set precise experimental parameters and subject this notion that prayer “works” to the test.

Point taken: I have no proof that my daughter — still riddled with disease, far from cured, on a path toward death — is even alive today (she “should” have died long ago) because of prayer. It is my belief. The doc who might claim that it is because of natural biological processes and agents has no proof either. It is his belief. As I said above, I happen to agree with him as well. These are not incompatible. Have I violated a parsimony principle? Only if I didn’t have independent reason, i.e., independent from this particular episode, for thinking that God exists and prayer “works.”

PZ’s original point: “fund research because prayer does not work” is right in the first instance and wrong in the second. We can appeal for funding without the under-funded proposition that prayer is ineffective. That’s all.
#163 David
June 28, 2008

Thank you for sharing this excellent and highly provocative post! My sincere condolensces to you regarding the loss of your sister to Melanoma Cancer. I am an ALL Leukemia survior whose case contributed to the research on ALL Leukemia protocols in the 1980s and my family has contributed a great deal to the noble cause you espouse. I am profoundly grateful for modern medicine, God, and natural remedies, as I believe all three worked together to heal me of my cancer. Of course at first I had to rid myself of the false idea that people are healed either scientifically via doctors or by God, and that spiritual healing is somehow superior. The reality of course is that God usually works through human hands and uses science and doctors to effect our healing–St. Judes hospital being a great example of this.

In the article you posted, I think you make the opposite error I made, in that you think only science heals people. Forgive my lengthy post, but here is why I think your view is as misguided as the one I initially had. In my case as a deeply religious Catholic/naturalistic medicine believer and stubborn 17 year old, I initially pulled out of the protocol for treating my Lymphoblastic Lymphoma, and it evolved into full blown ALL. But to be honest, I also quit my protocol because I was so disgusted with my medical care or science’s response to my illness up to that point. First, I had to visit more than 3 doctors, and an oral surgeon and experience 6 months of agony before I was correctly diagnosed with cancer (Now that I’m older and wiser I undersand how hard these diagnoses are but prior to my illness I had almost complete faith in my doctors and science’s ability to heal me). Then when I finally started my protocol, I was afflicted with some kind of terrible chemical menangitis after each methotrexate shot in my spine, which would leave me on my back unable to move without uncontrollably vomiting for several days after each shot. At the time I would have rather been dead. After several weeks of exploring the issue, my doctor and his colleagues had no clue as to the cause. And their only answer was to do a fairly dangerous operation on my brain to install a shunt to administer the methotrexate. Worse they could not guarantee me this shunt would alleviate the problem since they didn’t know what was causing it in the first place. Now I know my doctors did the best they could with what they had at that time and I should have been more patient and understanding but hey I was only 17 and dying. And I’m sure that even as a scientist, at some point you and your family may have been frustrated with the doctors failure to cure your sister.

In any event, at that point my brother in law introduced me to a book on faith-healing and said I should just go that route. As a believer I found some of the Biblical arguments convincing and frankly by then I was desperate to sieze any out that would spare me those days lying on my back unable to move. Since I was already in remission I decided to go for it and trust God for my healing. But for safe measure I also added some naturalistic elements to my alternative spiritual treatment (macrobiotic diet, vitamins, special exercise program etc.) In effect I was trusting, no demanding that God heal me supernaturally, with a little naturopathy thrown in as insurance.

Naturally the cancer came back, except this time as full blown Leukemia. And I was foolishly refusing treatment because of my bro in law’s faith healing book. My bro did finally telephone the religious author, and to his credit, the faith healer verbally told me it was o.k. to accept treatment from the doctors. Of course by now I was in so much pain from all the blasts in my blood and bone I figured it would be easier to just die and go to heaven.

Then a couple friends dropped me notes saying they knew how religious I was and if God would allow someone really religious like me to die they didn’t want anything to do with him. Up til now I pretty much felt betrayed by everybody from the doctors who misdiagnosed me and couldn’t heal my pain and faith healers, to my friends who weren’t calling anymore, but God himself had always been there comforting and loving me, so I decided I would accept treatment and be healed to prove that at least God had been faithful to me. During my prayers that week I also believe God told me I would be healed, but through the doctors.

The same time this was happening, a new doctor became involved in my case and reviewed my history and religious reasons for refusing treatment. Because he was open-minded and tolerant of such belief, he engaged me in dialogue and took the time to figure out why I was so disillusioned with my previous medical treatment. He then recc. I undergo a Bone Marrow Transplant procedure, and said if I survived it, it would cure my cancer. (IF they survived the procedure, BMT patients had higher long-term survival rate and were considerd cured after 5 years in remission whereas successful treatment of my Lymphoma at that time was a coin toss with less favorable long term survival rates).

Again the science that would ultimately heal me got in the way again. The other doctors said I wasn’t going to make it because of my stubborn refusal to take earlier treatment, that they couldn’t put me back into remission again, that a large compound fracture on my leg would severely complicate any treatment, ect. All of which were probably scientifically true, but a death sentence for me.

But I chose to believe instead. With less than 10-20% chance of surviving because of the large open wound on my leg(according to one doctor) I began the BMT procedure and one coincidence (miracle in my book) after another seemed to confirm the wisdom of going with the science, God and naturopathy. BTW, I almost had my transplant done at the U. of MN hospital in 1985, roughly the same period when you were doing your work there?? I got a major answer to prayer when another transplant patient–a doctor–called (who died a couple months later from complications) and shared a drug cocktail with my doctors that completely alleviated the chemical menangitis I was getting from the methotrexate shots. I was successfully put into remission at the U. of MN and then went on have my transplant done in WI.

Out of a batch of 3 patients that were started that month, I was the only one who survived (the survival rates were much worse back then) and to this day my mother thinks one of the contributing factors was that I was not downing all the milk shakes the other patients were given at the time (some of the transplants died from pneumonia)and after much argument she finally got the doctors to add additional vitamin C and other vitamines? to the intravenous food line they were using to feed me when I lost my gastrointestinal tract. I don’t kow if they still give the transplant patients all the dairy and meat but I think they now put more vitamins into the TBN fluid.

I’m sure that prayer also contributed to my healing as my mother had me on every prayer list in the midwest. And to be honest there were several days during the transplant when it became as much of an emotional/psychological contest to confront and defeat the graft vs host disease, depression and fear as a physical contest to defeat the cancer. So prayer, meditation and Bible verses definitely helped sustain me in the darkest hours, just like religion has been recognized to help psychologically promote and sustain other peoples in crisis—something which I think even scientists, or at least historians acknowledge (Look how long religion sustained the hopeless Southern cause in the C.W.). I might add, that as a survivor of ALL, after expereincing the loss of 3-4 other patients around me(including the two boys) during my long hospital stay, I somtimes suffer from survivor’s guilt and get a bit depressed on the anniversary of my transplant. My faith has really helped me cope with that too. I don’t know why prayer doesn’t always work and my heart will always be stricken for those families (religious or not) who lost their loved ones.

So yes, science is awesome and largely responsible for much of what we call progress and civilization today (including my healing). But as some of the greatest Christian and Islamic scholars have noted while science feeds and strengthens the body, religion plays an equally important role in sustaining our human spirits during the darkest moments of our existence. And if there is such a thing as God and Heaven, it leaves a door open for supernatural insights or providential events which just might save us in those hard times (Even as a highly successful scientist and philosopher of science, I doubt you have all the answers). In any event, I hope you and all your readers can someday see the value and importance of both science and faith to living a truly happy life in this world and hopefully the next. As a struggling but faithful Catholic, I will keep you, your sister (Sorry Catholics are wierd that way, we never stop praying for the departed), and all the enlightened readers of this page in my prayers. And I will also keep supporting cancer and scientific funding! Apologies in advance if I have in any way offended anyone who has lost a loved one to this awful disease.

Best,

David
#164 Nick Gotts
June 28, 2008

other studies that suggest otherwise – NBHope.
Can you give examples? Incidentally, we need to distinguish between the effect of prayer itself (which I would say is zero in either direction, since magic doesn’t work); and the effect of believing you are (or may be, or are not) being prayed for, which could be either positive, neutral or negative, quite possibly depending on your own beliefs.
#165 Nick Gotts
June 28, 2008

So, scientists come up with a hypothesis (no matter how), and then they try to DESTROY it. Not to prove it — that isn’t possible anyway. – David Marjanovi?, OM

I think this is an error: it assumes all science consists of universal generalisations (“All self-replicating entities use nucleic acids in their genetic material”), of which it is certainly true. But suppose a scientist hypotheses that there is likely to be some form of life of which this is not true – and specifies where and how one should look. I would say that hypothesis is scientific, and can be proved. Some would say it has been, if prions really are, as they currently appear to be, self-replicating entities consisting entirely of protein.

Other scientific hypotheses are historical: “mammals existed before the end of the Triassic” (I can’t recall whether they did or not, but one fossil would prove it).

You may say that any of these “proved” hypotheses could later turn out to be false – but the same is true in mathematics: there have been several “proofs” accepted by the relevant expert community and later found to be flawed.
#166 Nick Gotts
June 28, 2008

If you take this study, or many others like it, to disprove the hypothesis — to have falsified the claim that “prayer works,” then there it is. But, I don’t, in part because of other studies that suggest otherwise, but mostly because I just don’t think that God is the business of convincing us of his existence through miraculous healings.

Either evidence is relevant, or it isn’t; you’re trying to have it both ways here. If you’re prepared to go on evidence, then all studies in either direction are relevant, if well-conducted. If you say in advance “whatever the evidence, I’m going to go on believing”, which is what your second clause I’ve quoted amounts to, well, discussing the matter with you is a waste of time.
#167 Nick Gotts
June 28, 2008

I see NBHope made essentially my point against David’s strict falsificationism before I did! I stopped reading the thread to answer David.
#168 Nick Gotts
June 28, 2008

That my wife is conscious is rather ordinary, although I take consciousness to be an extraordinary property of anything.

No, it’s an inevitable concomitant of sufficiently complex goal-directed information processing. Read Dennett’s “Consciousness Explained”, if you haven’t. you’ve used the example of your wife’s consciousness before, and spoken as if there could, in the normal course of events, be justifiable doubt about whether a currently acting and socially-interacting human being is conscious. That’s not so. Again, read Dennett.
#169 Nick Gotts
June 28, 2008

I’m not sure it’s all purely a matter of reason. (But this doesn’t distinguish this claim from lots of fundamental claims put forth under the auspices of science). – NBHope

Such as?
#170 Nick Gotts
June 28, 2008

David@163. What I get from your account of your illness and treatment is that medical science cured you in spite of your stubborn stupidity. I see zero evidence that God or “natural healing” had any effect whatever.
#171 NBHope
June 28, 2008

Nick (#164):
Point taken: magic does not work. Prayer is not incantation. If this is what you reject, then we agree completely.

Prayer is a conversation, an opportunity to express needs and desires and to open oneself to God’s active will. Who can say how God might respond. It is rarely the sort of thing from which one might infer God’s existence, although I guess I wouldn’t rule out the possibility of a truly, undeniably miraculous response. But in Jesus’s own experience, as Scripture admits, there were many who didn’t believe in spite of the miracles. So why would God continue to pander to our requirements for “scientific rationality,” especially when it holds little promise of positive response. God will not coerce the will, nor (apparently) make every (futile) effort to prove God’s self. This is why I’m very willing to concede that your position is perfectly rational, given your prior posture.

I offer this as an explanation for my position as well as for why I’d guess this conversation is probably going nowhere. (If I told you we prayed for a cure and my daughter was inexplicably healed, I would receive scorn (see above) and disbelief from this list. If it happened to your daughter then your response might be different, but I certainly wouldn’t wish upon anyone such desperate straits.)

To the point: we pray with specific requests, and then watch as often very surprising, unexpected events transpire — the sort that would give anyone pause — taking us in a direction we couldn’t have anticipated and yet which produces an outcome that is undeniably good. As it turns out, our prayers didn’t work (we pray for healing; she has not been healed). You are trying to disabuse me here of a belief I don’t hold.

I don’t have citations for positive studies, but recall the names David Larson, Harold Koenig and William Harris. I put very little stock in these studies and only mention them to stress that studies to the contrary settle nothing.

I wish you all the best.
#172 NBHope
June 28, 2008

Nick (#166): Scientific studies do not constitute the only form of evidence. My point is that I do reject both.
(#168): I’ve read Dennett — so I am credentialed. It says nothing about whether or not there is something it is like to be my wife or anyone else. He assumes consciousness (in others) and then offers an account of it. There is no proof of other minds because there is no direct access to another’s mind (old philosophical conundrum). It is, of course, a reasonable conjecture, especially based on her having a brain (which I never actually seen). But, so I believe, is belief in God — a reasonable conjecture based on evidence other than scientific studies.
#173 Nick Gotts
June 28, 2008

If I told you we prayed for a cure and my daughter was inexplicably healed, I would receive scorn (see above) and disbelief from this list.

Actually as I understand it, spontaneous remission (“inexplicable” healing) is by no means unknown, with or without prayer. Almost certainly due to the immune system “recognising” the cancer as something to attack – there’s much that remains to be understood about both the immune system and cancer. In a very recent case, a case of late-stage melanoma was cured by taking immune system cells (I don’t recall what type) from the patient, multiplying them in an external medium, and reinjecting them in numbers much greater than the immune system can itself produce. Anyhow, all the best to you and your daughter.
#174 Corn
July 2, 2008

Thx for that post. I’m a cancer researcher myself (in Germany, that is) and we sometimes need a little encouragement in the face of still overwhelming cancer and the sometimes painfully slow progress things make, due to a lack of funding, public ignorance, and dumbass politicians wasting money for soldiers stumbling about in afghanistan instead of boosting science and research.
#175 Corn
July 2, 2008

Thx for that post. I’m a cancer researcher myself (in Germany, that is) and we sometimes need a little encouragement in the face of still overwhelming cancer and the sometimes painfully slow progress things make, due to a lack of funding, public ignorance, and dumbass politicians wasting money for soldiers stumbling about in afghanistan instead of boosting science and research.
#176 Nick Gotts
July 2, 2008

I’ve read Dennett — so I am credentialed. It says nothing about whether or not there is something it is like to be my wife or anyone else. NBHope

You read it, but you clearly didn’t understand it: he is arguing that any entity that interacts with the outside world in the complex, integrated way a normal human being does must, in order to do so, have “something it is like” to be that entity. Having “something it is like” to be you is interacting with the world in that way. This is the point of his discussion of the utter implausibility of there being “zimboes” – entities that behave (including talk) just like people, but have nothing going on inside them.
#177 CPHM
July 3, 2008

Re #172, #176

Actually I believe NBHope is right, from a purely philosophical viewpoint. Even accepting the Cartesian principal (I think, therefore I am) you have no information about the existence of other people – and some philosophers even reject the evidence of existence of self. The null hypothesis is nothingness, if you like.

Mind you, it’s pretty hard to function in daily life if you believe the rest of the world, and maybe even your own consciousness, is a figment of your imagination. In real life we tend to assume the realness of other people, just like scientists assume the axiom of choice for practical purposes (except for some mathematicians with too much time on their hands).

Ever read Sophie’s World? Well worth the time.