Clinical trials
oracknows | December 8, 2008In 2007, I wrote a series of posts about what I found to be a fascinating yet at the same time disturbing phenomenon, specifically self-experimentation by cancer patients using an as yet unapproved drug called dichloroacetate. If you'll recall, DCA is a small molecule drug that was used to treat congenital lactic acidosis in children through its inhibition of the enzyme pyruvate dehydrogenase kinase. This inhibition shifts the metabolism of glucose towards oxidative metabolism in the mitochondria and away from glycolysis, the product of which is lactic acid. In January 2007, Dr. Evangelos…
oracknows | December 4, 2008I've long had an interest in World War II history. Ever since I was around 11 or 12 years old, a major portion of my reading diet has consisted of books and articles about World War II. Back when I was young, my interest was, as you might expect, primarily the battles. The military history of World War II fascinated me, and I build many, many models of World War II fighter aircraft and warships when I was in my early teens. (No cracks about how the airplane glue obviously affected me, although it is true that back then it was real airplane glue, chock full of toluene and lots of other organic…
oracknows | December 3, 2008Ever since I started paying attention to it, acupuncture has, at least until recently, inspired ambivalence more than anything else in me. As a skeptic and science-based physician, I found it very easy to dismiss utter quackery like homeopathy or the various "energy healing" modalities, such as reiki or therapeutic touch strictly on the science alone. After all, homeopathy is based on magical thinking more than anything else, specifically the concepts of "like cures like," the concept that dilution with vigorous shaking can make a remedy stronger, and the idea that water has "memory" all are…
oracknows | December 1, 2008I tell ya, I'm on the light blogging schedule for a mere four days, thanks to the Thanksgiving holiday weekend, the happy invasion of family on Thursday and Friday, and a significant amount of grant writing I've had to deal with on Saturday and Sunday, and somehow I missed not only a study relevant to my field of interest, but the reaction of antiscientific quackery apologists to said study. First, let's look at the reaction, then the study, which reports that as many as 22% of mammographically detected breast cancer may spontaneously regress.
First off the block is Dr. Joel Fuhrman:
It's…
oracknows | November 28, 2008Believe it or not, sometimes even Orac has a life. I know, I know, between the ridiculously logorrheic blogging here and other online activities, coupled with even more ridiculous long hours working at his day job, it's hard to conceive. However, my wife and I had a whole passel of relatives over, several of whom spent the night. This puts a crimp in the blogging activity, but for once I don't care that much. Fortunately, there's a lot of good reading out there, of which I picked a few examples:
The "Gonzalez Trial" for Pancreatic Cancer: Outcome Revealed. Remember the Gonzalez trial? It was…
oracknows | November 17, 2008I almost feel sorry for acupuncturists these days. Almost.
Well, not exactly. Clearly, given the infiltration of woo into academic medicine, acupuncturists are in demand even in the most allegedly "science-based" of academic medical centers. After all, acupuncture is what I like to refer to as "gateway woo," an unscientific placebo-based therapy that has somehow come to be viewed as seemingly respectable, as though there's something to it. It's not hard to see why acupuncture has achieved this status. Indeed, there was a time when I, the arch-skeptic, the guy who has built up one of the top…
oracknows | November 5, 2008I guess Barack Obama's mad hypnotic powers worked.
One non-political thing that this election has reminded me of is that when you've been blogging as long as I have (nearly four years now--almost as long as a Presidential term!--assuming you're good and have found a niche in the blogosphere, you can become one of the "go-to" bloggers for certain subjects. Even though I've taken on the pseudonym (and, some might say, the persona) of a cranky talking computer with a bad attitude that looked like a cheap Plexiglas box of multicolored blinking lights and was featured in a 30 year old British…
oracknows | October 31, 2008I feel bad.
I realize that I've been completely neglecting my Academic Woo Aggregator. You remember my Academic Woo Aggregator, don't you? It was my attempt to compile a near-definitive list of academic medical centers that had "integrated" woo into their divisions or departments of "integrative medicine" (i.e., departments of academic-sounding quackery). Perusing it, I now realize that it's been over five months since I did a significant update to it. You just know that, given the rate of infiltration of unscientific medical practices into medical academia as seemingly respectable treatment…
oracknows | October 28, 2008The other day, I thought it was about time that I did some of that cool and fancy ResearchBlogging.org stuff, you know, to keep this blog from being nothing more than a collection of not-so-Respectfully Insolent spleen venting at generalized stupidity. I realize that those are some of the funnest posts here and that people like them, but a little variety is required. No study, however, had quite floated my boat, and I was almost to the point of being desperate enough for blog fodder that I considered perusing Age of Autism or even NaturalNews.com (maybe later in the week) in search of that…
oracknows | October 22, 2008I hate it when an article starts right out with a rather annoying usage of terminology, even when it provides information that interests me:
(AP) -- Nearly a fourth of widely used new-generation biological drugs that treat several common diseases produce serious side effects that lead to safety warnings soon after they go on the market, the first major study of its kind found.
Included in the report released Tuesday were the arthritis drugs Humira and Remicade, cancer drugs Rituxan and Erbitux, and the heart failure drug Natrecor. All wound up being flagged for safety.
That might surprise…
oracknows | October 14, 2008Why, oh, why do I keep perusing NaturalNews.com?
Why do I subject myself to wave after wave of neuron-apoptosing stupidity of a magnitude that even activation of NF-kappaB, Akt, and neuronal cell survival signaling pathways can barely keep the killing stupidity at bay? I guess it's because it provides such good blog fodder for a skeptical blog dedicated to science- and evidence-based medicine. On the other hand, it often gives me a headache to read its contents. Really, it does. I mean, looking at how Mike Adams, the Woo-meister Supreme and Chief Tin Foil Hat responsible for the lunacy there…
oracknows | October 8, 2008Here we go again.
It seems just yesterday that I was casting a skeptical eye on yet another dubious acupuncture study. OK, it wasn't just yesterday, but it was less than two weeks ago when I discussed why a study that purported to show that acupuncture worked as well as drug therapy for hot flashes due to breast cancer therapy-induced menopause. Unfortunately, these days these sorts of dubious studies seem to be popping up fast and furious like Whac-A-Mole, so much so that I can't always keep up with them. So it is again, although this time it's acupressure, not acupuncture. Unfortunately,…
oracknows | October 7, 2008For women undergoing menopause, hot flashes are a real problem. In my specialty, as I've pointed out before, women undergoing treatment for breast cancer are often forced into premature menopause by the treatments to which we subject them. It can be chemotherapy, although far more often it's the estrogen-blocking drugs that we use to treat breast cancers that have the estrogen receptor. Estrogen stimulates such tumors to grow, and blocking estrogen is a very effective treatment for them, be it with tamoxifen or the newer aromatase inhibors like Arimidex. The utterly predictable consequence,…
oracknows | October 3, 2008You can tell I'm really busy when I fall behind my reading of the scientific literature to the point where I miss an article highly relevant to topics I'm interested in, be they my laboratory research, clinical interests, or just general interests, such as translational research. As you know, I like to think of myself as a translational researcher. Translational research is research that (or so we try to do) spans both basic science and clinical science; i.e., bridges the gap between basic and clinical science. Now don't get me wrong; I don't devalue basic science, and I've said so many times…
oracknows | October 1, 2008When I first started blogging, I liked to refer to myself as a booster of evidence-based medicine (EBM). These days, I'm not nearly as likely to refer to myself this way. It's not because I've become a woo-meister of course. Even a cursory reading of this blog would show that that is most definitely not the case.
So what's changed? Basically, I've come to the realization that EBM is an imperfect tool. Don't get me wrong, EBM goes a long way towards systematizing how we approach clinical data, but there's one huge flaw in it. (I can just see a quack somewhere quote-mining that sentence: "Orac…
oracknows | September 24, 2008Here we go again.
Tuesday night and yesterday, you probably saw it, plastered all over the media, in the newspapers, on ABC, on the radio, in press releases, and around the blogosphere. Yes, it was another bit of science by press release, with news outlets practically falling all over themselves to hype the results of an acupuncture study reported earlier this week at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO). Leading the pack was ABC News:
A new medical study finds that acupuncture, an ancient form of healing that has been around for thousands…
oracknows | September 23, 2008If there is one difference that defines scientific medicine compared to "alternative medicine" it is the application of the scientific method to health claims. Science and the scientific method require transparency: transparency in methodology, transparency in results, transparency in data analysis. Because one of the most important aspects of science is the testing of new results by other investigators to see if they hold up, the diligent recording of scientific results is critical, but even more important is the publication of results. Indeed, the most important peer review is not the peer…
oracknows | September 16, 2008Ah, science!
In no other fields can we ask such amazing questions and, through rigorous experimentation, get the answers.
Answers like this:
A study commissioned by a phallically named insurance company proves beyond all doubt that the unbridled roar of an Italian supercar turns women on but the soft purr of a fuel-efficient econobox doesn't stimulate anyone's MPG-spot.
David Moxon subjected 40 men and women to the sounds of a Maserati, Lamborghini and Ferrari, then measured the amount of testosterone in their saliva. He found everyone had higher levels of the stuff -- a measure of their…
oracknows | September 10, 2008I hate postmodernism.
Well, not exactly postmodernism per se, but I hate it when pseudoscientists and purveyors of dubious "alternative" medicine treatments invoke bizarre postmodernist-sounding arguments to attack science or, in the case of medicine, science- and evidence-based medicine. Usually these attacks involve a claim that science is nothing more than one other "narrative" among many others, a "narrative" that isn't necessarily any more valid than any other. Even worse, these sorts of arguments often claim that science (or, in this case, evidence-based medicine) is nothing more than a…
oracknows | September 8, 2008If there's one thing that cancer researchers, indeed most biomedical researchers in the U.S., know today it's that the research funding climate sucks right now. Indeed, after the completion of the near-doubling of the NIH budget in 2003, during which time it was flying high, the NIH budget in essence crash landed--hard. Paylines, which had been well over the 20th percentile (meaning that over 20% of grant applications in any give deadline cycle were funded) plummeted to near single-digit ranges almost overnight. Indeed, I almost fell victim to this myself in 2004. The initial score on my R01…