When testimonials attack

As you may have noticed if you've been paying attention to the comments over the last few days, you may have noticed that we've had a bit of an infiltration of believers in "alternative cancer cures" (or, as I will abbreviate them, ACCs). The main focus of the infiltration appears to be in this post about Daniel Hauser, the 13-year-old boy who refused chemotherapy for his Hodgkin's lymphoma and whose case was recently decided, with the judge ordering his parents to obtain repeat staging studies and then to get him to a science-based practitioner in order to get appropriate therapy. Oddly enough, one of the woos to show up is Happeh, whose wankery-filled (literally) website was the target of one of my editions of Your Friday Dose of Woo. His comments are too inane to bother with in a separate post, utterly devoid of educational value.

However, there were at least two commenters whose comments provide just the right "teachable" moment about ACC testimonials that I thought they'd be worth looking at in more detail. First, there was mertle:

I did a proven protocol for invasive breast cancer, I took the herbs and did the diet, plus exercise, prayer, purest water I could find. My tests were all clear of cancer the following year. I'm getting more tests, to see how I'm still doing. I did nothing else to cure it. I hope I've been faithful enough with herbs/diet to stay cancer-free. If not, I will go back to totally healthy eating/living, and get rid of it again. The same way.

Thousands have been healed of cancer thru proven plans of herbs/diet. It's just ridiculous to assume the American people are such idiots to believe otherwise! Are we assumed to be so stupid that capitalism must murder us, it's our fate...the chemo/radiation "ovens" that pay our doctor's med school bills and fill up the cemeteries with our bodies...that there's no other way? and no way to live well after cancer and live 20-30 years well???

God's given us what we need to find healing, if we'll stop being brainwashed and do His herbs and created foods.

Are you so angry and full of dead people's money, that you continue to spout death and dying on the masses?

If you'll only find your forgiveness in Jesus Christ, who died for our sins willingly, and then be a fountain of healing and life, it's so so much better!!! You do have a great future with Him...He is full of life and healing, for you and for all.

I replied:

Do tell. Who are these "thousands"? Where is the documentation. Rest assured, if thousands had truly been "cured" by such regimens, medical science would sit up and take notice. Not surprisingly , whenever anyone tries to investigate these claims scientifically, they can never seem to find all these "thousands" of people.

But let's get to the nitty gritty. What size was your tumor? Were your lymph nodes positive. How, exactly, was your cancer diagnosed? What kind of biopsy was done? Do you have the pathology report? What was the histology? What tests are currently showing you to be "free of cancer"? Answer those questions, and I may start to take your testimonial more seriously.

Mertle replied to me and other commenters who pressed her for more details:

My degree is a lowly B.A., I have a bro. who's an atty, and etc. My daughter is a nurse. However, if I myself were in the cancer treating medical community, this is why I (without Christ Jesus) would not acknowledge actual cures existed:

(1.) I would hate to admit I'd been wrong and thousands had perished because of it, for decades.

(2.) I and the rest would lose TONS of money in all the facets of "cancer treatments", should the cures be acknowledged publicly.I'd have to actually love people and their health, more than the money in my pocket.

And don't a great God's herbs/diet look "stupid" next to man's great machines and knowledge? Well, we were all there, once.

Here is some work for you to do: Google... "Essiac", and go to www.beating-cancer-gently.com. Also, google "Dr. Budwig", "Dr. Brandt"...for starters! You don't want to take everything in at once. The grief of realizing that the death and dying that's going on, is because of raw capitalism and ignorance, not illness, is heartbreaking.

As for the particulars on the cancer I had, without the papers at hand, I can say it was a 9 mm tumor, a "needle" biopsy was done, it was invasive, and etc. The tests done were first a bloodtest, CA 27 29, a mammogram and an ultrasound. All clear. I would love your scrutiny! Let the challenge begin! You do your homework, I'll do mine, by God's grace.

I do so love a challenge.

So let's look at mertle's story in a bit more detail. What I can reconstruct is that mertle apparently had an abnormal mammogram. At least, that's a reasonable assumption because 9 mm is less than half an inch. It's fairly uncommon to find such a small tumor by physical examination alone, unless it's very close to the surface of the breast. By a needle biopsy, it's likely that she had either an ultrasound-guided core biopsy or a stereotactic biopsy under mammographic guidance. Either way, a large core needle would be used to take pieces of the tumor and a small metallic clip left behind. The reason the metallic clip is left behind is because in the case of small lesions it can be hard to find them again. That's why it doesn't matter to me that mertle claims that her mammogram and ultrasound are all clear; that means nothing with respect to whether the tumor is still there or not. It almost certainly is, although it's possible that it was removed by multiple needle biopsies given how small it was. Occasionally, I have operated on women with small cancers who have undergone needle biopsies, only to find no tumor left behind.

One should also be aware that blood tests for breast cancer, including tumor markers like CA 27-29 are notoriously unreliable. Sometimes they can be useful in advanced disease, but in the case of women with tiny tumors like mertle's it's pretty worthless as tumor markers go. It's not very specific, and it's definitely not very reliable. Indeed, I can't figure out why so many oncologists still bother with it. Indeed, the NCCN guidelines for breast cancer state: "In addition, the Panel notes no evidence to support the use of "tumor markers" for breast cancer..." If there's one area of breast cancer therapy that isn't as science-based as it should be, it's the common use of tumor markers by so many oncologists.

What all this means is that mertle's story is not evidence at all of being "cured" by whatever natural woo it is that she is using. Not that that should come as a surprise. Either one of two things has happened. Either her tumor has been removed by the needle biopsy, and mertle is cured, or she still has her tumor. In the latter case, because it was so small, it could take years to progress. Indeed, in the natural history of untreated breast cancer, there is a small, but detectable, rate of ten year survival, and the median survival is 2.7 years. These were from large tumors from 100 years ago. For small tumors, such as mertle's 9 mm tumor, the median survival is probably much higher. Moreover, as I've described before, there is evidence that some small breast cancers detected only on mammography either spontaneously regress or never progress. It's probably not the 20% estimate claimed, but it's also probably not as rare as we used to think. In other words, taking into account the biology of untreated breast cancer, mertle's story is no evidence whatsoever that she has been "cured" by woo.

Here is more detail of her story:

The protocol ended in December, 2007. Woo-hoo! What joy. In February, 2008, I was granted a CA 27 29 bloodtest for breast cancer, which would also be elevated if other reproductive cancers were present. Well within the reference range of 0-38.6, it returned at 5.5. I was elated. A mammogram and ultrasound followed in June-July of 2008. The doctor's first report stated the tumor was "no longer evident". Later, after two letters confirming this statement, he said nothing had changed and that I was refusing surgery. This called for a second opinion. A friend of the family, a doctor by profession, volunteered his time and effort to view the films himself. His report? He could find "nothing of concern". Two nurses, one my own daughter, viewed the films. The metal clip on the grayish tumor in the before films was clearly visible in the after films. However, that murky mass around the clip, was replaced on the after films by clear, black space. No more gray! Praise the Lord!

First off, what that "friend of the family" said about the mammogram is pretty meaningless unless he is either a mammographer, a radiologist, or a surgeon or other specialist who routinely treats breast cancer. In fact, I routinely tell patients that for subtle abnormalities don't trust my reading. I'm not a mammographer. In any case, what this story most likely signifies is that the tumor was probably removed (or mostly removed) by the needle biopsy. If that's the case, I'm actually happy for mertle. What I'm not happy for her is that she's using her story, which is no evidence at all for the efficacy her Essiac woo (which, as Quackwatch points out, has no evidence supporting its efficacy in cancer whatsoever). Neither do the other forms of woo mertle is using, including colon cleanses, her herbal concoctions, and various other woo.

In other words, mertle's testimonial tells us nothing about whether she is "cured" or whether her "proven" regimen did anything whatsoever.

Now, armed with the knowledge I've imparted over the last four years, let's see if you can handle analyzing the second testimonial, that of Micki. Here's a hint how to do it.

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Maybe, instead of calling them ACCs for "alternative cancer cures," you should call them QACCs for quintessential alternative cancer cures.

God's given us what we need to find healing, if we'll stop being brainwashed and do His herbs and created foods.

If God has given us what we need to fight cancer, why do we need herbs and spices to improve on that? If, as mertle seems to be writing, God has given us the ability to get help for our illnesses, God has included conventional medicine in the help that is available. God does not appear to discriminate against seeking treatment with conventional medicine, but does seem to discriminate against QACC remedies. After all, there is no evidence that QACC remedies work. Why would God allow that if they actually worked?

Actually, I'm not using my testimony to prove Essiac works...I don't know where that came from, really. I used a plan of herbs/diet from an Amish healer. And no, my tumor was not removed by needle biopsy...it was there on the mammogram afterwards. But after the protocol, it was gone.
I know a Baptist minister who had cancer everywhere after traditional treatments. He went to another country for a holistic treatment, discontinued everything else, and has lived for 31 years, when he was given a very short time to live.
Isn't it funny how determined you are to deal healing a death blow? why aren't you interested in seeing it work?
why are you so determined to keep death moving forward?
If I were you, I'd be asking questions in a positive manner, looking for healing for people with cancer, not batting down everything that could help them.
You're loyal to an industry of death...that's the underpinning of all your arguments. Or you're a renegade intellect, "proving" your mnind is superior!
You're not loyal to healing, only to what puts food on the table of the "doctors". People be doomed.
You can "prove" whatever you want to, intellectually. However, my cancer is gone, I'm free and happy, and thousands of others (yes, healed by Essiac and other herbs/diet) are, too...without surgery, chemo or radiation.
This is still the USA...we can find healing and share that freely, if we want to.
Maybe you should live somewhere more to your mode of operation. Of course, the herbalists elsewhere may have a few words for you, lol. You sound like the Gestapo, determined to put people's bodies in the "ovens" of failure and death. Do you enjoy that or something? Why don't you try it on yourself, and then give us all a report? Just to experience what the patient experiences, you know.
Surely you care that much, right.
Jesus came to earth and suffered in all points like we do.
Yet without sin, as the Son of God.
That's why I love Him, because He cares so much.
I'm sorry you don't.
Love you all,
Mertle

Wow, the crazy is strong in this one...

But anyway, the micki thing, I'm going to go with the lack of detail and the lumpectomy being a primary cancer therapy

Oh and goodwin violation, mertle loses the thread.

Micki wrote:

The doctors ignore clinical evidence of success with alternatives, calling it anecdotal. They will have you believe that the scientific studies they have picked and choosen to back them up are the absolute truth. They, the drug companies and the American Cancer Society play the numbers to keep the cash flowing in.

If the alternatives were effective, the quacks would not have any reason to avoid participating in controlled studies of their treatments. Think of the benefit to people, if they could prove that their treatments actually do work.

How can anyone be so barbaric that they have a real cure, but hide it from people by not allowing it to be tested?

If these treatments work, only by testing the treatments in controlled studies can we prove that they are effective. An anecdote is just an example of something that might have happened, but there is no evidence. The something that might have happened, might be related to the treatment the patient might have received, but we have no way of knowing. We only have the word of the salesman/pusher/quack/witchdoctor.

These people make a lot of money pushing these ineffective treatments, so they are not to be trusted. The scientific study of treatments is the most effective way to decrease the effect of that bias.

mertle,

Isn't it funny how determined you are to deal healing a death blow? why aren't you interested in seeing it work?

why are you so determined to keep death moving forward?

Actually the scientific method is the only way that has been shown to demonstrate the effectiveness of treatments. By demanding scientific evidence of effectiveness, Orac is avoiding the treatments that are ineffective. Why are you selling the treatments that cannot be shown to work.

Why do you claim to know what others are thinking? Are you psychic, too?

If I were you, I'd be asking questions in a positive manner, looking for healing for people with cancer, not batting down everything that could help them.

The scientific method is the positive manner for finding out the truth. The treatments you propose have not evidence to support them.

In other words, you are the one pushing death for 30 pieces of silver. You need to repent.

The most damning evidence of your misguided notions are the plain fact that Orac simply asks a series of investigative questions, and her responses continue to evade the point and bring up religion and god to obtain a moral high ground (in her eyes). We all know Orac's disdain for woo, but instead of writing you off, he asks very concise and specific medically relevant questions to your situation. All you do is say "You're loyal to an industry of death.....You can "prove" whatever you want to, intellectually"

You take a combative and defensive viewpoint of the situation, rather then presenting your case wrt the points Orac made. You are clearly seeking to proselytize your beliefs and convictions, without any grounding in reality or evidence.

Honestly? If these medicines worked, the doctors would be all over them. The less complicated (generally means less effective) medical treatments, the less likely they are to get sued or cause harm to a patient. Orac would jump on board if an article in Science showed a measurable success in use of Essiac for cancer treatment.

You claim the doctors are loyal to a evil multinational conglomerate, but be honest, Do you believe that pharmacy companies and medical companies have that much hold over the millions of doctors worldwide?

You must be thriving off all this attention, but tell me, if you believe in God as fervently as you do, why are you condemning us for our beliefs? Isn't the golden rule applicable here? Would you want us to condemn you for your beliefs, call you a Nazi supporter, say you want people to die? What happened to

'But in your hearts honor Christ the Lord as holy, always being prepared to make a defense to anyone who asks you for a reason for the hope that is in you; yet do it with gentleness and respect'

You are not being very respectful.

By peter syms (not verified) on 19 May 2009 #permalink

Mertle, here's a question for you. I don't know either you or Orac. He says that pretty much small tumors are hard to track, slow-growing, and possible to remove fully in the procedure that diagnoses them, so that could explain why you are showing no cancer. You say that your diet and exercise regime healed you.

Now, how would you suggest I distinguish who is right? Or even a general claim, of 'Person A says X, Person B says Y, who is right'? I mean, to steal a phrase from pop culture, I want to believe that diet and exercise and maybe a few extra herbs on my chicken or in my tea would mean that not only would I be in good shape and at a healthy weight, but that I also wouldn't get cancer. It sounds a lot easier than chemotherapy and surgery to treat cancer, which both you and Orac admit is not a terribly fun experience. On the other hand, I also wanted to believe that things like canceled flights, traffic accidents and other displays of bad luck will never happen to me, and that's demonstratively not true.

Orac says that I can use the scientific method to determine the validity of claims. What would you suggest?

By Becca Stareyes (not verified) on 19 May 2009 #permalink

I won the game today while wearing my red socks. I wore my red socks during the next game and we won, therefore wearing red socks means I will win my games. Repeat phrase until you self limit your experience as the sample size increases.

Mertle:

Again I ask you - why do you rely on modern methods of diagnosis and reject modern methods of treatment?
Both were developed using scientific methods, both were developed by people with the same basic training and the same knowledge base, and are performed in close collaboration with each other.
If scientifically developed means of diagnosis are OK with you, then why aren't scientifically developed means of treatment?

Oh yes, why did God give you the experience of getting cancer?
Why didn't he diagnose it for you?
Why does God permit cancer to exist in the first place?

Don't bother with the last 3 questions, they're rhetorical.
I am curious to know your answer to my first question, however.

By T. Bruce McNeely (not verified) on 19 May 2009 #permalink

Once someone invokes religion or some other magic (aliens, sasquatch, whatever), there's no way to converse with them logically. Mertle may or may not have had a cancer, may or may not have had it removed by biopsy, may or may not be fully recovered, may or may not drop dead tomorrow from a late stage cancer but definitely did not receive any benefit from some herbs. In fact, Mertle's story fails on so many levels, but one of the better ones is post hoc ergo propter hoc. In other words, Mertle believes she was cured (if she was) because she ate some plants or believes in some religion, but it doesn't work that way. I eat popcorn (without butter, sadly) nearly every day for a snack food, and I'm currently cancer free, have a normal blood pressure, low LDL's, and good eyesight. Based on Mertle's logic, I'm writing a book tomorrow!

The reason we use science is to discern the answers to all of the questions I posed about Mertle's health. There are herbs that have been useful in treatment of many diseases. One of the famous examples, of course, is taxol, taken from a pacific yew plant. But you can't go chew on a few leaves or make a tea from it, because the right safety and efficacy testing needed to be completed to make certain that it would be useful. Of course the story of how they discovered the plant is much more entertaining and educational that Mertle's fake story.

As for Micki's story, I'll let you real doctors tell me what had happened. I'm sure it will be very fascinating.

"Amish Healer". Is this profession somehow related to "Lakota Healer"? I like their pumpkin rolls and bread. Their knowledge of medicine, not so much.

By Tezcatlipoca (not verified) on 19 May 2009 #permalink

I and the rest would lose TONS of money in all the facets of "cancer treatments", should the cures be acknowledged publicly.

This is simply not true. There is nothing stopping doctors from making money off of various cancer cures, if they actually work. If an herb makes cancer go away, every doctor would start growing that herb themselves, not just for the money, but because they actually do care about helping people. It's the herb pushers who just want your money even if it means death. Dead people don't give testimonials, so it works out great for them. Scientific studies do count dead people, so doctors have to care about them even if they wouldn't otherwise.

If you think God would want you to use herbs instead of science, then why did he make you go to a doctor to be diagnosed? Don't you think he could have provided you with doctors and modern medicine to save your life? I'm sure he has no problem with you using a heater to keep warm in the winter, and probably doesn't even mind you using an air conditioner to stay cool, even when the heat is not life-threatening. So why wouldn't he want you to use modern technology to save your life? If he has given you access to effective medicine, that's the way in which he is trying to save your life.

Isn't it funny how determined you are to deal healing a death blow? why aren't you interested in seeing it work?

Mertle,

If your cancer is indeed gone, than I'm very happy for you.
But please note, there is a big problem with testimonials.

Those that have died can't testify. I don't know about Orac, but I'm not particularly interested in seeing it work. I've already seen what happens when it fails.

What if 1000 people all tried your cure? If 100 of them "heal" and don't have cancer, but 900 of them die, that's potentially 100 testimonials. Does it mean the herbs worked? No, infact it means the herbs didn't work!

Please don't reply by telling me that the herbs always work. They don't. I'm not an oncologist, I'm a med student, and I've still been in the hospital long enough to see herbs fail.

Please don't couch your answer in religous terms. Please don't make further comparisions with Hitler. This is not WWII, you are not being persecuted, noone is trying to kill you, noone is trying to commit genocide against your people.

When you do these things, you make it look like these are mainstream ideas for people of faith, which it isn't.

You can "prove" whatever you want to, intellectually.

Or to quote a great contemporary philosopher, "facts are meaningless. You could use facts to prove anything that's even remotely true!"

Mertle, you've been had.
"Join the 3,000+ people who have read my book and are free of cancer today as a result."
Yeah, well, he doesn't say they had cancer to begin with!

@Michael Simpson:

Mertle may or may not have had a cancer, may or may not have had it removed by biopsy, may or may not be fully recovered, may or may not drop dead tomorrow from a late stage cancer but definitely did not receive any benefit from some herbs.

We can't say that she definitely received no benefit from the herbs (although in the absence of any good evidence that herbs would have benefited her, it seems likely that she received no benefit). There's simply not enough information in an anecdote like this to come to any conclusion one way or the other, because we can't know what would have happened if she hadn't taken the herbs.

Catgirl:
" It's the herb pushers who just want your money even if it means death. Dead people don't give testimonials, so it works out great for them. Scientific studies do count dead people, so doctors have to care about them even if they wouldn't otherwise."

One of the most brilliant comments I've seen, but I want to take it another step. Orac and other doctors have seen their patients die, because they waited too late to check out a problem, because they wasted time on quackery, or because some problems are simply not reversible -- and unlike quacks who claim "We cure EVERYTHING!" doctors know this last is true.

I am sure Orac has had to "Call it" on many patients, and from what I know of him from his writing, probably had at least internal tears on every one.

But most quacks -- the Hoxseyites might be a particularly ugly exception -- never see their failures, never experience personaly the pain of seeing someone die in front of them. (The 'distance healers' may never even see a real-live patient.)

So, mertle, what sort of a monster would Orac be if he denied hope he knew was authentic to those patients? (Giving false hope to the hopeless might be bad, but think how much worse the reverse is.) His sincerity, of course, doesn't mean he's right -- though he is -- but think about what you are accusing him of doing. You are accusing him of being a totally heartless 'serial killer for hire.' But that would mean that he has, over years now, publicly maintained a facade so contrary to his 'real self.'

Okay, so go back, spend a couple of days reading entries from the Archives at random, and tell me of the slips he made -- because no one could maintain that solid a facade without making some mistakes.

If you want to argue he's wrong, fine, try and make your case. But you are accusing him of much worse.

By Prup (aka Jim … (not verified) on 19 May 2009 #permalink

From catgirl:

There is nothing stopping doctors from making money off of various cancer cures, if they actually work.

This is the logical fallacy that drives me up the wall. The woomeisters always state that greedy (economically driven) Big Pharma and physicians conspire to keep better cures off the market. I would say that Big Pharma is economically driven. Let's say that physicians probably are somewhat economically driven (you guys just don't know what Beverly Hills plastic surgeons are like). If there were better cures out there, Big Pharma would figure out a way to patent it, test it for safety and efficacy, bring it to market, and make more money than ever.

So you can't say that Big Pharma and physicians are in a conspiracy to keep profits by blocking herbs from the market. They would actually be in conspiracy to bring them to the market.

When we Big Pharma types sit in our luxurious penthouse suites to count our money, bind physicians to our outrageous marketing plans, and establish plans to manipulate the world, we laugh hysterically at the idiocy of woomeisters, because we'd be all over their junk science. You do not know how many times an executive of a company will say "check into this idea I read on the internet", and the serfs of the R&D department go forth and study it. Then they come back with a single page report--nothing.

There must be someplace where this fallacy makes sense, but not in Big Pharma.

If there were better cures out there, Big Pharma would figure out a way to patent it, test it for safety and efficacy, bring it to market, and make more money than ever.

Would, hell. They do. Someone correct me if I'm wrong, but I was under the impression that quite a few modern chemo drugs were originally synthesized from plant sources used in herbal medicine. And that's just among cancer therapies - there are plenty of other drugs derived from "natural" medicine (aspirin, penicillin, and opioid painkillers being the most common, I would think).

If essiac, or hoxsey, or any of the others was actually effective, Merck or whoever would be planning the ad campaign and coming up with a better trade name right now.

Mertle

1/ Please confirm the new link provided by Orac: http://healingplan.synthasite.com/the-story.php
is indeed you.
2/ Today your story changes to an Amish healer. Is that Solomon Wickey?
3/ On May 16 you promised to provide more information. However, you have not provide what you promised.

I would love your scrutiny! Let the challenge begin! You do your homework, I'll do mine, by God's grace.
Posted by: Mertle | May 16, 2009 8:51 AM

Need I quote what the Bible (like you so freely reference) has to say about false promises?

By RMM Barrie (not verified) on 19 May 2009 #permalink

...And no, my tumor was not removed by needle biopsy...it was there on the mammogram afterwards. But after the protocol, it was gone.

So now you're saying that a mammogram showed it was still there, but it vanished after the mammogram was taken? By what means did you find this out? Another mammogram?

Isn't it funny how determined you are to deal healing a death blow? why aren't you interested in seeing it work?

We ARE interested in seeing it work -- that's why we're badgering you for all these crucial details you don't seem interested in providing. Why aren't YOU interested in showing us proof that it works?

By Raging Bee (not verified) on 19 May 2009 #permalink

Being related to someone a lot like Mertle, I'm guessing that for her, her experiences are God speaking to her. She may reject randomness altogether. I've heard many times "God wouldn't lie to me" when I have suggested that something could be coincidence. When someone is committed to an assumption like that, I don't know how you can ever come to agreement if you think things can be random. Really, I don't know, someone please tell me!

Yeah, Orac! You're not "loyal to healing", you big meanie.

As heartless as this may sound, aren't people like mertle just a sign of evolution in progress? A survival of the least gullible?

I still can't understand if the Pharma conspiracy is so vast and powerful, why are the woomeisters still alive? Why would the powers that supposedly control the millions of doctors and government regulators throughout the world not be able to make these people "disappear?"

As heartless as this may sound, aren't people like mertle just a sign of evolution in progress? A survival of the least gullible?

No, because that's not how evolution works. She might have already produced quite a litter and perpetuated any and all genetic basis for gullibility, not to mention raised said litter in the ways of woo.

Besides, being gullible does not necessarily correlate perfectly with intelligence.

Right, so how does evolution work for us now?

And she has reproduced-- she stated that her daughter was a nurse. Perhaps her woo didn't transmit.

Mertle:

If God is willing/able to heal anyone who has faith, then why wont god heal amputees? Are you saying that everyone with an amputation is a non-believing sinner who is undeserving of gods love and healing?

My mother lost both parents and her husband to Cancer. She is still devout, her prayer circle gathered each time to help her, She has never lost faith. But apparently god doesn't love my family as much as he loves you... or maybe Orac is a Doctor who knows what he's talking about, and God isn't taking an active roll.

@Bozzy:

Isn't it obvious, they are EVIL. The EVIL Pharma likes to taunt people with the truth. They allow a few people to tell the public the truth about everything because they are so evil they want to watch us squirm with hope before the EVIL courts step in and make us take POISON! Just ask Daniel Hauser, he can tell you the end game of the EVIL plot.

(Note, when reading this the word EVIL must be said in a sinister voice while placing the back of your pinky against the side of your mouth.)

...And no, my tumor was not removed by needle biopsy...it was there on the mammogram afterwards. But after the protocol, it was gone.

So now you're saying that a mammogram showed it was still there, but it vanished after the mammogram was taken? By what means did you find this out? Another mammogram?

I was wondering that, too. She parcels out her story in dribs and drabs, and key details start changing in the meantime.

Aside from whether or not she's telling the truth, I was interested in the idea that a tumor can be so small as to be easily removed via biopsy. Orac and other surgeons have often stated that surgery is the primary tool for dealing with most forms of cancer, and that radiation is used mainly to ensure the extirpation of any cells the surgery may have left behind. So mertle, though she won't recognize the possibility, may well (assuming she is actually cancer-free) have been cured by surgical intervention in the form of a biopsy.

As heartless as this may sound, aren't people like mertle just a sign of evolution in progress? A survival of the least gullible?

Gullibility and lack of education are probably not genetic traits.

mertle,

i desperately need your guidance for my problem--what herbs should i take, what diet should i eat, how much ultra-pure water should i drink, what prayers should i say (and to whom), to re-grow my amputated leg? any help that you could give would be so appreciated! thanking you in advance, and praise be and so forth...

ennui

Okay, the layperson here is going to tackle Micki's case:

Micki says:

As a patient and an employee of a major medical destination center, I had the opportunity to have an appointment with an oncologist for an opinion on alternatives. My sister had a friend with colon cancer who successfully treated herself with diet, supplements and juicing. This oncologist worked with her, monitoring her progress. Several years later, he himself got colon cancer and contacted her to see what she did. He couldn't give me any help, because the law says only a drug can cure a disease. It's true, the docs don't want to take their own medicine.

And by the way, I was diagnosed with a needle biopsy at this wonderful place I work for and underwent a lumpectomy. I did not let them take my lymph nodes. Cancer was later found in the lymph node, I then went to Mexico. I still follow with tests at both facilities. The lymph nodes are clear.

Hmmm. Now, Orac has already mentioned, in this post and earlier, that surgery is not only the primary tool of oncologists, but in the case of smaller cancers, it can sometimes be the only tool needed, though a wise person generally goes for the radiation or chemo treatments just to make sure. So, just like mertle, Micki's had a needle biopsy -- though unlike mertle (at least, from what mertle's told us so far) she has had a lumpectomy and at least one lymph node removed and examined.

From Orac's earlier post:

The reason breast cancer testimonials sound so convincing is that most lay people don't know a lot about the disease, particularly that surgery alone "cures" many breast cancers. Early stage cancers are cured by surgery alone more often than not, and a significant minority of patients with even large tumors and multiple positive lymph nodes can be expected to have long term survival with surgery alone.In the case of a lumpectomy, the local recurrence rate in the breast is in the 30-40% range. Radiation can reduce it to less than 10%. That means that women who forgo radiationare still more likely than not to avoid local recurrence in their breast, particularly if their tumor is small. As far as distant metastases, chemotherapy and hormonal therapy improve survival, but the effect is small in patients with early stage cancers and becomes more impressive with more advanced operable tumors. Because many breast cancer patients will do well with surgery alone, clinical trials with large numbers of patients are needed to find true treatment effects due to adjuvant therapies.

[...]

Some might ask: Why do patients fall for this? It is not a matter of intelligence. In my experience, women who pursue alternative therapy are, more often than not, intelligent and/or highly educated. Instead, they do not possess the scientific knowledge or enough critical thinking skills to separate truth from nonsense in medicine. It also seems to be a question of human nature. The diagnosis of breast cancer is devastating emotionally. Formerly self-assured women feel themselves losing control of their lives. Unfortunately, our system of medicine reinforces this feeling of loss of control, as it is all too often impersonal and even disrespectful of patients. Patients find themselves going to multiple doctor's visits, where all too often they have to wait for hours in crowded waiting rooms to see their doctors, who then, thanks to the demands of managed care, often only spend 5 or 10 minutes with them discussing a life-threatening disease. They deal with voicemail hell trying to reach their doctor when they are having problems and endure other indignities. They often conclude from this that the system does not respect their time or them and that they are considered nothing more than a number, a disease, or money. In contrast, alternative practitioners often provide the human touch that is too often missing from modern medicine. They take the time to listen to the patient and make her feel good about herself and her decision, all too often giving erroneous information about chemotherapy and radiation therapy. When a woman makes a decision to choose alternative therapy, she often sees herself as "taking control" of her treatment from uncaring doctors whose treatments, she is told, do not treat the root cause of her disease. Understandably, she may feel liberated and back in control. In addition, many testimonials have religious overtones as well, where lost, suffering women misguided by conventional doctors and without hope find a savior (their "healer") and/or enlightenment (the "alternative" therapy) that leads her out of the darkness and into the light of health. Her ignoring the reportedly dire warnings of doctors (unbelievers) is validated. Filled with quasireligious (or explicitly religious) fervor, they want to convert the doubters. Depending upon a woman's background and beliefs, this religious appeal can be as powerful as the desire for regaining control.

There you go.

If the alternatives were effective, the quacks would not have any reason to avoid participating in controlled studies of their treatments. Think of the benefit to people, if they could prove that their treatments actually do work.

How can anyone be so barbaric that they have a real cure, but hide it from people by not allowing it to be tested?

One woo-ish answer to that (though I have no clue if it would be Mertle's) would be: "The evil scientists and/or doctors will sabotage the experiments and/or lie about the results, so participating in any such studies would be playing right into their hands."

By Matthew Cline (not verified) on 19 May 2009 #permalink

I've not had anything like cancer (as far as I know yet), but the doctors think it's likely I have an IBD, and I've noticed throughout my life that I have a high tendency to want a placebo/ritual in case of illness even when I know that stuff won't have an active effect because it feels like I'm doing something, and often times drugs are not available or unnecessary (such as tea during a cold, or if I'm trying to minimize caffeine since I have an extended sleep cycle, I might use lemon and hot water or something, which is a lot cheaper than supplements that don't do anything but cost more than a lemon and tap water).

I wonder if people doing some low impact exercises, and maybe some hot water or coffee or something (by oral route of course!), with the idea in mind of trying to focus on not letting the cancer (or other disease) take over your life, some psychological exercises or something (so not to portray it as a "disease-fighting" agent or anything, as obviously that could easily get hijacked by woo-pushers or the person might decide to use that alone rather than in conjunction with appropriate treatment).

Love you all,
Mertle

No....no I really don't think you do....I mean you mouth the words well but how can someone who doesn't know me tell me that I'm sacrificing the health and well being of my patients for the almighty pharma dollar? What, do you think I have some kind of lucrative concession on pharma pens? The point is that you don't really have any idea what I do to care for my patients and you've already made a value judgement. Religious extremists are the only people I know who can say "bless you" and make it sound worse than any curse.

Mertle, not everyone who reads blogs like this is an atheist - I'm a Christian, too. I believe that God loves us, and that Jesus redeemed us.

This doesn't mean science, and science-based medicine, are bad. Yes, God gave us herbs and the natural healing properties of many plants, and so on - God also gave us the capacity to go beyond that. Many "modern" medicines are, in fact, little more than refined forms of the exact same things that give natural medicines their efficacy. Medical science expands our options for healing.

Why would one thing be a gift of God, and another thing be only a tool of Man? As the song goes - all good things around us are sent from Heaven above. If God gave us gifts, they include the capacity to help one another, and with it, the chance for a greatness we would otherwise lack.

Assuming that God would leave us the tools to heal diseases like cancers, but hide them in such a way that they don't withstand scrutiny, that they're incompatible with the science that lets us understand the glory and complexity of the world, so that anyone who thought logically and consistently would be denied such healing... well, that assumes a malice that I cannot ascribe to the loving God we were told about by Christ.

If you have faith in a loving God, you must, surely, have faith too that he would not play such a cruel trick on us all.

(Note to others: I am thoroughly sincere when I say that I am a Christian, but also believe in science. I am aware that this kind of blog has its share of militant atheists. I will make no effort to convert you to Christianity; I would appreciate it if you would make no effort to convert me to atheism, nor to insult my intelligence for adhering to my religion. Thank you for not smoking your courtesy.)

Exactly what does Mertle think we make drugs out of?

Dishcloths??

I would ask, what would have been an average price for Micki's treatment from a regular doctor...more or less than $3,500?

By Richard Eis (not verified) on 19 May 2009 #permalink

Sami, yours is a post in the finest tradition of discourse. Thank you. I am an NHL survivor, Orac reader and atheist. I am also a hypothesis tester. A pursuit of the truth produces a very different tone and tenor than does service of the ego. It should not be about subordinating anyone else's intellect or ideas. Comparing them to see which withstand scrutiny never requires demeaning them.

The pivot point, for me, in Mertle vs. Orac, is sample size. And it is a, perhaps _the_ downfall of most argument from anecdote. Mertle has a case-study of one. Even most alties will give lip service to the idea that controlling for variables is useful in determining efficacy (of anything). Because that's nearly impossible with anecdotal information, it does not meet the standard for truly testing a hypothesis.

This does not mean it is insufficient basis for making a decision. It simply means that such a decision will be based on faith rather than knowledge. Obviously, some of us are better wired for that than others.

True faith can withstand the assault of knowledge. Historically, knowledge suffers more profoundly when the political power is in the faith camp. But either bent seems hyper-inclined to bewail there persecution at the hands of the others.

Thank you for sharing your story, Mertle. I don't agree that it meets the standard of evidence but I am glad that your health is improved, hope you maintain NED and encourage you to keep engaging. The cure for most problems is people continuing to refine their ideas, a principal component of which is testing them against other ideas.

Thank you Phoenix Woman. That extract made me aware of why I prefer medicine to altmed sham. I too like to be in control of my treatment; that means I want to understand exactly what is going on, how the drugs work, how they will affect me and so on.
Doctors can explain all that to me. For instance, when my doctor told me that surgery wouldn't work for my particular form of SVT, we spent about 10 minutes discussing it, with him explaining exactly why and even drawing diagrams for me. He answered all my questions; I went away disappointed that I wouldn't be suddenly cured, but satisfied that I had done all I could.
In contrast, the 'healers' that I went to in the past couldn't tell me anything about how their 'healing' worked, beyond vague mumbo-jumbo about vibrations. They couldn't even give me an assurance that their healing would definately work - they had all kinds of caveats about 'positivity' and so on. And of course, they couldn't say that it wouldn't work. They were all nice, sincere people but I found their uncertainty and lack of knowledge (none of them had the faintest idea of what tachycardia is, for example) not at all reassuring.

Sami, yours is a post in the finest tradition of discourse. Thank you. I am an NHL survivor, Orac reader and atheist. I am also a hypothesis tester. A pursuit of the truth produces a very different tone and tenor than does service of the ego. It should not be about subordinating anyone else's intellect or ideas. Comparing them to see which withstand scrutiny never requires demeaning them.

The pivot point, for me, in Mertle vs. Orac, is sample size. And it is a, perhaps _the_ downfall of most argument from anecdote. Mertle has a case-study of one. Even most alties will give lip service to the idea that controlling for variables is useful in determining efficacy (of anything). Because that's nearly impossible with anecdotal information, it does not meet the standard for truly testing a hypothesis.

This does not mean it is insufficient basis for making a decision. It simply means that such a decision will be based on faith rather than knowledge. Obviously, some of us are better wired for that than others.

True faith can withstand the assault of knowledge. Historically, knowledge suffers more profoundly when the political power is in the faith camp. But either bent seems hyper-inclined to bewail there persecution at the hands of the others.

Thank you for sharing your story, Mertle. I don't agree that it meets the standard of evidence but I am glad that your health is improved, hope you maintain NED and encourage you to keep engaging. The cure for most problems is people continuing to refine their ideas, a principal component of which is testing them against other ideas.

Rats. Stoopid browser. Repeats blamed on chemo brain.

I've been using herbs in very carefully measured doses now for several years and I can say without a shadow of a doubt that as a result my Bolognese has never had a tumor.