naturopathic oncology

Clinical trials

institutional review board

NatureWorksBest

http://www.phmiracleliving.com/pdf/alkadiet.pdf

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Social Sciences

published in 2016 in the International Journal of Cancer Research and Molecular Mechanisms.

The publisher in this case, "sciforschenonline.org", is as "International" as the Taj Mahal, hence the Germanic-styled title. Specifically, it's three tech grifters in Hyderabad.
http://domainbigdata.com/nj/MRHvL-AoVuUOdjZBnzWvLQ

It is conceivable that someone might publish through them without being an out-and-out fraud, just not very likely.

In the paper the author only mention
[...]at one clinic. [...] etc. I might have missed it, but i can't find a mention of which clinic it was. Out of curiosity I quick searched on Bell's list for the journal SciForschen. Ofc it was there.

Can someone explain me the reason for choosing these two groups for comparison; [...]two categories: all patients: 151/317=48% and those who ate
sweetened foods: 9/29=31% [...] instead of comparing with a non-sweetened food eating group?

Two bit quack can't stand one bit of criticism.

The criticism may affect Huber's income stream. So sad.

Cancer is the second leading cause of death, and the vast majority of people use allopathic doctors to treat it. That in itself is persuasive evidence that allopathic doctors have very little understanding of cancer. And they have absolutely no interest in trying to figure out why the cancer developed in the first place. Maybe that's why cancer so often reoccurs, especially when coupled with the severe damage chemo does to the body.

It seems naturopathic doctors don't understand cancer too well either--they all have different theories, and nothing seems to work for everyone or for all cancers. Still, it's no surprise that more people are opting out of allopathic treatment. The cancer industry can manufacture all the psyence it wants to make it seem as if great strides are being made--but again, cancer is the second leading cause of death, and the allopathic "success rate" speaks for itself. You'd think a little humility would be in order--but when hundreds of billions of dollars are at stake, humility tends to fly out the window.

And they have absolutely no interest in trying to figure out why the cancer developed in the first place.

Really? Because there is evidence that a great deal of work has gone into this.
https://www.cancer.org/cancer/cancer-causes.html

Sure, Johnny. I wonder how many cancer doctors even bother to check vitamin D levels, or glyphosate levels in the body.

Thank you herr doktor bimler! I was wondering all through this (and while reading about it at ND blog), “who would publish this crap to begin with?”.

Wow, Ginny, you are obviously totally clueless about cancer.
You write "nothing seems to work for everyone or for all cancers."
Of course not-in part because cancer is *not* a single disease. Even cancers originating from the same primary site-e.g., breast cancer-are not a single disease, because, using the example of breast cancer, there are multiple different forms of breast cancer that respond differently to treatment. For example, some patients have hormone-receptor positive breast cancer and are likely to respond to hormonal therapy (e.g., tamoxifen or, in postmenopausal women, aromatase inhibitors), while other patients hormone-receptor-negative but HER2 positive and may respond to trastuzumab, whereas others have triple-negative breast cancer and will not respond to either hormonal therapy or trastuzumab.

My point is that cancer is not one disease, but many-you seem to be unaware of that.

All patients selected and purchased all of their own food, all of which originated from and was almost entirely consumed outside of the clinic.

So Dr. Huber knows what foods these patients consumed how exactly? Self reporting? We know how unreliable that is. Clairvoyance? Possibly better but for the small detail that it doesn't exist.

So I see enough in the "methodology" section to reject the paper, and I'm not even an expert in the subject. I'm sure other readers could find much more.

HDB already explained how this paper got published: the corresponding author found a bottom-feeding journal. Yet more evidence that publication in something titled "International Journal of X" should raise a red flag.

"the allopathic “success rate” speaks for itself."

Indeed. Prior to the development of chemotherapy, acute leukemia was a death sentence. Today the survival rate for acute lymphoblastic leukemia is at least 80% in children. The same is true for Hodgkin's lymphoma.

Many with chronic myeloid leukemia now live long, fairly normal lives which is now a manageable illness in many cases thanks to drugs (imatinib, nilotinib, etc) that target the specific genetic abnormality that is drving force behind CML.

Some patients with metastatic melanoma (Jimmy Carter is a great example) are now living for years without disease after treatment with drugs like nivolumab or pembrolizumab, whereas previously such patients almost always died within a year or two of diagnosis.

Of course, there are still great areas of unmet need, and sadly little progress has been made in the treatment of some cancers (e.g., pancreatic cancer, glioblastoma), but that's certainly no reason to pretend that science based medicine cannot treat cancer.

Florian@2: If you do the arithmetic you find that of patients that supposedly did not eat sweetened foods, the remission rate was 142/288 which is about 49%. Not so different from the total group.

There is something else that doesn't change: the difference in remission rates does not even meet the 95% confidence threshold. For the sweetened foods group, that range is 6 to 15 out of 29. The higher end of that is above the rate reported for the full group, or that I derived for the "unsweetened" foods group.

Ginny, do you know what else speaks for itself? The fact that cancer patients who refuse real treatment and use quackery instead have a far lower survival rate than those who receive real treatment. A recent study confirmed what should have already been obvious to everyone-choosing alternative medicine is often a fatal mistake for cancer patients.

The study found that breast cancer patients who choose quackery instead of are five times more likely to die than those who receive real medical treatment, that those with colon cancer are four times more likely to die if they choose quackery over real medicine, and that those with lung cancer who refuse real treatment and instead choose quackery are twice as likely to die.Of course, this should be common sense-untreated cancer progresses, that's what it does, but I still cited the study below:

Johnson, Skyler B., et al. "Use of Alternative Medicine for Cancer and Its Impact on Survival." JNCI: Journal of the National Cancer Institute 110.1 (2018).

Wow, anonymous commenter called Jonas Suck, you really are deceptive in how you characterized what I said. Huffing and puffing with hubris about how well you and the cancer industry understands cancer. Maybe you'd sound more credible if it weren't the second leading cause of death.

Ginny, you obviously know little if anything about cancer. You are embarrassing yourself, to be honest. And I take it that you are totally ignoring the findings of the study I cited above.

I wonder how many cancer doctors even bother to check vitamin D levels, or glyphosate levels in the body.

I'll take non sequiturs for $1000.

It's interesting that Ginny's (unspoken) point can be so very right, but for all the wrong reasons.

Jonas and Johnny: Please do not feed the troll.

Of course, the treatment of leukemias, especially childhood ones, show what a complete liar and idiot NWO reporter truly is.

"I wonder how many cancer doctors even bother to check vitamin D levels, or glyphosate levels in the body."

Uh, even if glyphosate was proven to be a carcinogen (which is not the case), what good would it do for oncologists to check glyphosate levels in the body? Is there a Natural Cure for glyphosatanomas that the medical establishment/New World Order doesn't want us to know about? Coffee enemas? Special Rife frequencies? Don't hold back, reveal the Secret!

@ #5 NWO

. . . the vast majority of people use allopathic doctors to treat it [cancer]. . . .

You say that as though it were a bad thing.

How do you jump from the first two sentences by NWO Reporter to the third, exactly?

Anyway, good for Ms. Hermes for calling out this person and her dangerous work. I hope she doesn't have too much hassle in dealing with the legal aspects.

Hmph. It looks as though the ICANN UDRP doesn't apply to this case of cybersquatting. From a USian perspective, this is a fine line, as "britthermessucks," for example, would be perfectly fine, but I have no idea what goes in the German legal system.

Cancer is the second leading cause of death, and the vast majority of people use allopathic doctors to treat it. That in itself is persuasive evidence that allopathic doctors have very little understanding of cancer.

Sorry, but that statement makes no sense. It does not follow from the fact that cancer is the second leading cause of death that doctors have poor understanding of it: it could simply mean that doctors have a fair understanding of it but that it's really hard to defeat.

Of course, the treatment of leukemias, especially childhood ones, show what a complete liar and idiot NWO reporter truly is.

Gindo styles herself as a satirist, but this seems to be simple confusion over the meaning of the word. I'd go with "self-parodist," but that might be another barbarous neologism.

Wow, anonymous commenter

Now, that's hilarious. Remember when you were bitchin and whining about "doxing" by vipers, Ginny? Put down the jimsonweed, already.

@viggen:
It could also mean that the main reason that cancer is now one of the leading causes of death is because we've reduced or eliminated a lot of the other causes, but everybody will still eventually die of something.

Cancer is the second leading cause of death, and the vast majority of people use allopathic doctors to treat it. That in itself is persuasive evidence that allopathic doctors have very little understanding of cancer.

Ginny, are you actually recommending homeopathy as a front-line cancer treatment, or do you just not understand the meaning of the word "allopath"?

Ginny, when or if you ever have cancer; we'll just make a voodoo doll and stick a pin in the spot with cancer and cure you.

That is at best what homeopathy and naturopathy can do to cure cancer.

The author of this article is the uneducated quack.

"Nature Works Best"

Nope, sorry, we all can see it doesn't. Huber lost me at the URL.

Even If feel we assume Mother Nature had the ability to know and was focused on effectiveness and had a set of values to determine what is best, I'm not sure what's behind the assumption that her idea of "best" is "what keeps humans alive and well."

Seems an awfully humancentric view. Why wouldn't she see less humans or weaker humans as "best" for nature, for example?

How can bicarbonate be used intravenously when blood has a very narrow pH range?

Oh, baby child, you're new here, aren't you?

I do not mean that as an insult, we were all new here at one time. But our host has written many time about how silly bicarbonate is as a cure for, well, anything other than an upset stomach, really.

Up top is a search box. Type 'bicarbonate' therein, and be prepared to read a while. I would post links, but 3 or more links go into moderation, and our host has to spend time approving the post, and there are many more than 3 posts he has written on the subject.

But the one time that discussion of blood pH really stood out for me was a comment made by the MIA poster Krebiozen. He provided a very detailed discussion of what happens when blood pH goes outside of it's normal range. It struck home because it was after my mom died. The call I received (because my sister wasn't available) letting me know that she had been admitted to the hospital, also let me know that her blood pH 'isn't compatible with life'.

I knew what that meant, but I didn't really understand it until Krebiozen's post.

....drs who should really know better collaborating with naturopaths and then taking self-righteous umbrage when it is pointed out that they are betraying their duty to patients by collaborating with quacks, mainly because they don’t realize that naturopathy is so rooted in pseudoscience that you can’t have naturopathy without homeopathy, which is an integral part of it.

That looks like the self serving attitudes of MSM, reminiscent of Wilk. Whatever their flaws, some of the NDs seem to answer serious deficits in conventional practices and MSM's iatrogenic injuries. Again, my direct experience with naturopathic oncologists is limited to two NDs (one a 1.5-2 hr discussion at a public health fair over a decade ago), several discussions with a busy ND consultant; and one "over-the-shoulder" series of an at-risk cancer friend getting cytokine labs sent out and (phyto)chemical extracts, in. AFAIK, homeopathic treatment (e.g. 20C etc) has never come up at all. MSM simply sucks at therapeutic nutrition and literally doesn't seem to know much about even the ABC...s, much less newer stuff.

Intravenous vitamin C? It almost certainly doesn’t work.

You guys don't seem to know much about the subject; I haven't even detected much pulse yet, Kerbiozen being the best. Mostly ust bad mouthing, misdirection and perhaps ignorance/incompetence from my point of view, particularly on the Mayo results. And there is successful clinical experience with surgery, even 60-70 years ago. Surgery wise, sepsis, shock, post-surgical recovery, pain relief, immune function, wound healing speed, strength and fusion quality were greatly improved.

For cancer kill, with the common fatal markers, vitamin C was an additive ("synergistic") adjunct, in my obviously limited experience. I hired a post doc from the leading public ivy with relevant outside lab experience, and had live tissue work done. 5FU alone didn't work, some vitamin-5FU binaries were starting to work, better than the std MSM treatment binaries. A vitamin combo with 5FU beat even the experimental (brutal) MSM combos hands down. The subsequent bloodwork showed several results highly consistent with this.
-----
If MSM providers were as good as they think/say they are, most NDs might not exist. Perhaps AMA killed off too many legitimate alternative MDs. As for ugly war stories, I think I've seen worse from MSM MDs... at least, no one called them "alternative".

From a patient perspective, separating the wheat from the chaff for both MD and ND can be a serious issue in a voluntary society and fair criticism is important. We the public could probably use more information upfront, with more "truth in advertising" from both. Historically, MDs have had monopolistic tendencies where now, MSM sometimes veers toward police state solutions. Summarily suppressing the NDs is the latter.

I wouldn't jump on Carolyn too quickly, Johnny.

The answer is, no, it can't work for that exact reason. If you somehow did overcome those mechanisms and push the blood pH high enough for an effect, lots of other bad things would happen throughout your body.

prn @34

Not a link in the whole thing.

"We the public could probably use more information upfront, with more “truth in advertising” from both."
It's required in medicine, but not in "alternative medicine." AFAICT, One has the FDA, self-regulation and policing, standards of care, correction with new evidence - the other has NONE of those things.

" Historically, MDs have had monopolistic tendencies where now, MSM sometimes veers toward police state solutions. Summarily suppressing the NDs is the latter."
CITATION NEEDED. One works, the other don't. Easy as that.

Historically, MDs have had monopolistic tendencies

With the crapload of crappy, quacky, fraudulent NDs like Huber here where I live in Arizona, it sure doesn't seem that way.

I wouldn’t jump on Carolyn too quickly, Johnny.

That was not my intent. I made an effort to make it clear that nothing I said was meant to suggest Carolyn was wrong to ask. If my comment came across as suggesting she was wrong to ask, I say directly to her -

I apologize. Please do not think that asking questions here is wrong, and don't let that interpretation of my behavior drive you from posting, as it was not my goal.

My intended message was that Carolyn was correct that blood pH in living persons is in a narrow range, and that if it is outside that range, you don't live long, and IV bicarbonate is a really stupid idea.

My intended message was that Carolyn was correct that blood pH in living persons is in a narrow range, and that if it is outside that range, you don’t live long, and IV bicarbonate is a really stupid idea.

The dearly missed Krebiozen explained this repeatedly.

Thanks, Johnny and Narad.

Do we know anything about the quantity and/or rate of administration of bicarb in Huber's "treatment?" If the rate is low enough, even a large quantity should present little challenge to pH maintenance.

If the tumor itself is susceptible to pH increase, then it would seem to me far more useful to administer a base directly into the tumor or intra-arterially upstream of the tumor, though I have no idea if the latter would be feasible.

An aside on this: I haven't checked to see if it has been resolved, but there was an extreme shortage of sodium bicarbonate for injection across North America a few months ago. The shortage was so bad that many hospitals were considering preparation of solutions in-house.

Hm what does IV vitamin C do to blood pH?

"If we put this ascorbic acid in you, it will kill the cancer! If we put this bicarbonate in you it will make you less acidic and thus kill the cancer! Honest, we know what we're doing!"

Emma Crew :If I recall correctly, most naturopaths think ascorbic acid IS a base. (I've heard it claimed elsewhere that lemons are alkaline. I can't tell if the people claiming that are lying or just that dumb.)

Highly buffered ascorbic acid, ph 5.5 - 7, or else sodium ascorbate are the injectable forms of vitamin C with regard to pH.

The buffered stuff, aka Ascorbic acid for injection or Ascorbic acid, injection USP are the pharma terms used since at least USP XIV (1950), no doubt causing endless confusion amongst the unwashed hoi polloi.

Pgp: I suspect the notion that lemons are alkaline comes from misunderstanding of the difference between citric acid and citrate (rather than the ascorbic acid content).

Lemons contain a considerable amount of citric acid. It is a triprotic acid, meaning each molecule can yield 3 H+. I +don't know what believers in lemon juice magic think happens to those pesky protons, but they don't just fall off and disappear. Regardless of what happens subsequently to citrate, the protons are going to find something basic to react with. I suspect that citric acid remains intact in the stomach, then "consumes" bicarbonate in the intestine (I'm not sure of this - doesn't seem to be a lot of info out there.) So, given the following, the process is rather moot.

If citric acid is reacted with a base (e.g. bicarbonate or hydroxide) the result is citrate (e.g. sodium hydroxide & citric acid react to yield sodium citrate and water). Potassium and sodium citrate solutions are basic as-is (pH around 8). Citrate is metabolized to bicarbonate, which means it really is useful for treating things like acidosis, though not as promptly as IV bicarbonate. Problem is, if you used up bicarbonate to neutralize citric acid in the first place, you don't come out ahead in terms of available bicarb.

The WHO oral rehydration salts formula currently in use includes sodium citrate for just this purpose. Earlier formulas used sodium bicarbonate, but it isn't very stable at higher temperatures and tends to react with the glucose in the formula during storage in tropical climates. Sodium citrate is better behaved. (Little packets of chemicals using the WHO formula save hundreds of thousands of little kids' lives every year.)

Ascorbate from vitamin C isn't metabolized like this. Excess is mostly excreted intact in urine.

Doug: That's really interesting. I highly doubt naturopaths know any of that though.

PRN: You know, you're really failing hard at trying to sell 'natural medicine.' Snarling at us 'unwashed hoi polloi' only reinforces the desire to stay the heck away from naturopaths- and their patients.

I'd just like to know in what bizarro-world sense is this a "controlled" study? Patients who violate protocol do not constitute controls.

In the immortal words of Bugs Bunny, "What a maroon!"

PRN: You know, you’re really failing hard at trying to sell ‘natural medicine.’
I'm not trying to "sell" natural medicine. There many things that you have no concept or are so totally misinformed.

Maybe, just maybe, I can change that. And that doesn't mean that I think I know everything "natural" or "naturopathic" either.

Snarling at us ‘unwashed hoi polloi’ only reinforces the desire to stay the heck away from naturopaths- and their patients.
That's fine. My biggest concern is when people interfere.

The idea that 'lemons are alkaline' comes from the quackery of Robert O. Young, who has been the topic of much insolence, respectful and otherwise.

See page 3 for a "sample shopping list helps one to know what kinds of foods typically stock the fridge and cupboard of an Alkalarian", that includes lemons.

Thanks to doug for that explanation about citric acid metabolism.

It's an article of faith among the woo crowd that citrus fruits are an alkaline food, supposedly resulting in net basic impact - but as you indicate, those H+ ions produced in metabolism to citrate don't just vanish without effect.

Johnny: Oh, wow. I expected hilarity and I was not disappointed.

Problem is, if you used up bicarbonate to neutralize citric acid in the first place, you don’t come out ahead in terms of available bicarb.

Not according to one "Marsaan."

Thanks for the link, Narad. I hadn't seen that discussion previously.

Trying to digest that whole discussion is rather more than I want to do at the moment. He and I agree on my sentence which you quoted, but it's far from obvious. His first comment is correct, but to come to that conclusion it is necessary to extract the important point he was trying to make from what the excess of obfuscatory words he actually wrote. (the point being that lemon juice contains both citric acid and citrate salts, and a net positive amount of bicarbonate is produced from the latter but not the former)

PRN: I'm better informed than you on a TON of things, and unlike you, my brain hasn't ossified.

I don't really understand why you're here, except to try and sell your treatments or just to snarl at people. Maybe you should get a hobby- or three.

I wish Google would stop allowing cons like "Dr"Robert Morse (naturopath,diploma mill funded, anti-vacciner,loyal Teump supporter) who pushes the ALLOPATHS DON'T UNDERSTAND THE LYMPH SYSTEM! line and that humans should only eat fruit and fruit and more fruit!!! (While he deals with smokers cough) in his videos. He's all Irisdology is true and tinctures of bull butt and all that.

Or "Dr" Robert Cassar who is "making over the earth terrain vessel", and founder of the Earther Academy, his allopathic home retreat in Hawaii whete people pay thousands to go stay with him and "fast" LOL while taking turns sitting in his sauna and getting they lymph nodes pinched LOL sorry...but yeah, I find it funny...how in the he'll canthey get away with this crap!?...oh, and Cassar periodicially blames people for all their parasites and tapeworms "You did it to yourselves! I just call them demons now. It's like that. It's like you have demons in you and YOU let them in there! Well, I can't get them out for you. You have to do it! Because they're feeding off of YOUR will power because YOU eat that food! That's why I let people come here and make these Earth products. Now, let's get some vodka poured on your skin, into the infared sauna, and get at those lym h nodes!" He also likes to lift his shirt sms point at his abs which may be the result of either synthol or liposuction. Prior to his career in chiropractonaturpathy, he rode his bike up and down the beach with maccaw parrots on his shoulders.

Pgp: I don’t really understand why you’re here, except...
Oh, I do learn things here. Although it's like picking through chicken entrails sometimes. 'Specially since K went MIA.

I’m better informed than you on a TON of things
Must be a ton of degenerate matter. Impress me.

Colleen Huber states in an online article "Why I Became A Naturopathic Physician" that her eyes were opened to the nefariousness of Allopathic Medicine in the 1970s, when Sloan-Kettering quashed investigation into laetrile and it was made illegal.

As counterpoint, there's a recently published case report about a man who took daily apricot kernel extract in an attempt to guard against prostate cancer recurrence, and managed to poison himself with cyanide:

http://www.iflscience.com/health-and-medicine/man-takes-apricotbased-al…

I found an ND who preaches against taking apricot kernels, and claims that his fellow NDs avoid it too. This ND instead claims success with such things as mistletoe, IV vitamin C and artesunate.

http://yaletownnaturopathic.com/integrative-oncology/

Imagine my surprise to find that ND Huber presented her self-advertisement to OMICS scamferences.
https://www.omicsonline.org/abstract/glycemic-restriction-in-cancer-pat…
http://cancer.global-summit.com/europe/abstract/2015/defeating-cancer-r…

OMICS. It's as if she wants people pointing and laughing at her.

BASTYR UNIVERSITY’S RECENT SUCCESS AGAINST DEFAMATION
A career anti-naturopath living in Germany defamed Bastyr University on a blog and webpages, among other venues. Bastyr sent her a Cease and Desist letter, through a European attorney. The defamer then posted that entire letter on her website. Within a few days, the defamatory pages against Bastyr had broken links. The group generally found this to be a pleasing outcome.

IOW Britt Hermes accused Huber of cybersquatting, setting up websites in her name (BH's) that dishonestly presented her as supporting Huber's grifts.
Huber lost the websites, so the links in BH's accusatory blogpost were broken.
Huber is presenting this to her claque as a victory so that they can forget the whole episode.

This is not the behaviour of someone who believes that she has a strong case of defamation and intends to pay lawyers to pursue it.

Somebody else has posted about this before, but an article had more news. Belle Gibson has been heavily fined by the Courts in Australia.
http://www.news24.com/World/News/australian-who-faked-cancer-fined-for-…

Canberra - An Australian cookbook author who falsely said she beat cancer through healthy eating was fined by a court on Thursday for misleading consumers by lying about her charitable donations...
Federal Court Justice Debra Mortimer on Thursday ordered Gibson to pay a total of AU$410 000 ($320 000) for five contraventions of the law relating to false claims that the proceeds would go to various charities...
The judge said the 25-year-old had been "cavalier about the truth", unconcerned about representations she had made and "prepared to tell outright lies".

That's going to leave a mark.

How cute. Naturopathic oncologists are pretending that theirs is a real medical specialty.

oracknows — Tue, 27 Dec 2016 02:00:28 +0000

How cute. Naturopathic oncologists are pretending that theirs is a real medical specialty.

With the Christmas holiday over, I thought it would be a good time to revisit a topic that I've discussed before from time to time over the last several years. Part of the reason is that I saw something that irritated me before the holidays. Another part of the reason is that Christmas was so busy that some of you might recognize parts of this post. Fear not, more original Insolence will be forthcoming, likely tomorrow.

In any event, given that I’m not a fan of naturopathy, it probably comes as no surprise to our readers that I’m even less of a fan of the emerging “specialty” of naturopathic oncology. As I and other bloggers here have described time and time again, naturopathy is a cornucopia of quackery that encompasses modalities as diverse as acupuncture and traditional Chinese medicine (TCM), applied kinesiology, chelation therapy, UV blood irradiation, organ repositioning, and, yes, The One Quackery To Rule Them All, homeopathy. Indeed, as I’ve pointed out many times, you can't have naturopathy without homeopathy because homeopathy is an integral part of naturopath training, so much so that it is part of the NPLEX, the examination naturopaths take for licensing purposes. (And, as I say every time I mention the NPLEX, I would really, really love to see some questions from the exam.) While it’s true that naturopaths also emphasize diet, exercise, and lifestyle interventions, whatever legitimacy they have as a specialty is completely undermined by the massive amounts of quackery they “integrate” with such advice, which often goes far beyond what the evidence supports anyway. We’ve frequently asked whether there is a naturopathic standard of care and come to the conclusion time and time again that there is not. Basically, naturopaths don't know their limitations, and naturopathic oncology is quackery, plain and simple.

So, just because naturopaths have decided to produce a “specialty” that they’ve dubbed “naturopathic oncology” does not in any way legitimize naturopathy, although clearly by taking on the trappings of conventional medicine and its specialties naturopaths hope that they seem more like a real medical specialty. Unfortunately, in the ultimate failure to heed the warning that it’s good to be open-minded but not so open-minded that your brains fall out, the Society of Integrative Oncology not only admits naturopaths as members but includes them as authors in their attempts to legitimize the integration of pseudoscience into medicine with the publication of dubious clinical guidelines for breast cancer and other cancers.

To give you an idea what I mean about how clueless physicians practicing “integrative oncology” are regarding naturopathy, I like to repeat an anecdote from time to time. Back when I published my review article, "Integrative oncology: Really the best of both worlds?" in Nature Reviews Medicine two years ago, the SIO immediately criticized me for spending so much of it discussing homeopathy. Of course, the amusing thing was that homeopathy was a far smaller part of the first draft, but reviewers made me add more. Even more amusing (or disappointing—or both) was that it was clear that the SIO had no clue how integral homeopathy is to naturopathy, forcing me to point out that naturopathy schools include many hours of homeopathy in their curricula and that naturopaths are tested on homeopathy in the NPLEX. I also couldn’t resist twisting the knife a little bit by pointing out that one of the authors of the SIO clinical guidelines for breast cancer was a naturopath who had an open clinical trial of homeopathy listed on ClinicalTrials.gov.

The bottom line is that naturopathic oncologists, as they like to call themselves, can form their own society (Oncology Association of Naturopathic Physicians, or OncANP) and append “FABNO” after their name as much as they’d like. None of this makes them actually oncologists or any less quacks than regular naturopaths. That doesn’t stop them from trying, though. Jann Bellamy sent me an example of them doing just that again in the form of an article published this year in Integrative Cancer Therapies by naturopaths from a variety of clinics.

Applying the Delphi method to nonsense: Prelude

The article I’m referring to is by Hill et al and entitled "Naturopathic Oncology Modified Delphi Panel." I had heard of the Delphi method before. As described in the introduction of the paper, it’s a structured communication method developed by the RAND Corporation in the 1950s, which describes it thusly:

RAND developed the Delphi method in the 1950s, originally to forecast the impact of technology on warfare. The method entails a group of experts who anonymously reply to questionnaires and subsequently receive feedback in the form of a statistical representation of the "group response," after which the process repeats itself. The goal is to reduce the range of responses and arrive at something closer to expert consensus. The Delphi Method has been widely adopted and is still in use today.

Now, it might sound weird that a group communication process to achieve a convergence of opinion from experts in a specific field regarding a specific question that was designed during the Cold War to forecast the impact of technology in warfare, but the system has evolved since then and has been applied to many other areas. If you search PubMed for “Delphi method” or “Delphi consensus,” you’ll find thousands of articles on topics ranging from developing consensus on the diagnosis and treatment of personality disorders, identifying language impairments in children, founding multidisciplinary units for treating psoriatic arthritis, and even the treatment of chronic constipation. (To be honest, I couldn’t help but think of chronic constipation as I read Hill et al attempt to do a Delphi panel on key issues in naturopathic oncology.)

So what is the Delphi method? Basically, it is a process that is based on the idea that forecasts or decisions from structured groups of individuals will be more reliable than those from unstructured groups. A panel of experts is chosen and then serially queried. The experts answer questionnaires, after which a facilitator provides an anonymous summary of the experts’ answers, forecasts, and recommendations from the previous round, as well as reasons provided for the answers given, after which the experts are queried again and can change their answers in light of each round of answers shared among the panel. Thus, the Delphi method is supposed to result in a convergence of opinion from the experts towards the “correct” forecast or answer. The process is in general stopped after pre-defined stopping criteria are reached, such as number of rounds of questioning, achievement of consensus, or stability of answers). The method can be illustrated thusly:

Obviously, this is the simplest outline of the Delphi method. There are now many variations. There are also several key characteristics that should be briefly mentioned:

Anonymity: Usually the participants remain anonymous in order to prevent prestige and authority or force of personality from skewing the results too much. Anonymity is generally maintained even after the final report is published. I note that this general feature of Delphi panels was not followed in this study, as the members of the panel were named in the methods section and listed as co-authors of this paper. In fact, there was no anonymity at all among the panelists, as far as I could tell.
Structured information flow: Initial contributions are collected in the form of answers to questionnaires and panel members’ comments about these questions and why they answered the way they did. This prevents the negative effects of interpersonal interaction by minimizing problems of group dynamics.
Regular feedback: Participants comment on their own answers, on other participants’ answers, and on the emerging consensus.
Facilitator: The facilitator sends out the questionnaires, collects and analyzes the responses, and prepares the summary for each iteration of questioning.

As you can imagine, though, there are a lot of complexities here, and everything depends on the definition of the problem and how the questions related to the problem are phrased. Let’s take a look at how this Delphi panel went.

Applying the Delphi method to nonsense: And so it begins

There were eight experts participating in the panel. They were chosen by a rather involved process, beginning with the requirement that any panel member must:

Hold a degree of Doctorate of Naturopathic Medicine from a 4-year accredited medical school
Attend the third annual OncANP conference during the date and time of the modified Delphi panel
Have a minimum of 7 years of experience with a majority (>50%) of patients seeking cancer treatment or support
Sign a consent form providing permission to use the participant’s name, biography, and any recorded dialogue in the final publication

So you can see right there that all the advantages with respect to anonymity of responses was thrown right out the window. The eight panel members met at the third annual OncANP conference in person. It should also be noted that their discussion was recorded, although it was structured this way:

This, of course, demonstrates that this “modified Delphi panel” also doesn’t do anything that the Delphi method was intended to do to minimize group dynamics, influence due to personality, and the like. This is basically no different from a typical roundtable or panel discussion that you can see at any professional meeting, only a bit more structured, with time limits for each panelist to make a statement and conclusion and for the open discussion.

Be that as it may, how were the panelists selected? Here is the methodology:

A summary of the Delphi study and protocol was distributed on the OncANP online forum. The members of the OncANP were encouraged to select and nominate 8 physicians to represent the field of naturopathic oncology and sit on the Delphi panel to discuss and debate questions regarding ethics, philosophy, and research development. The members were encouraged to self-nominate if they desired to be considered for selection to the panel of experts. The OncANP members were asked to share the e-mail, study summary, and nomination request with any colleague in the field of naturopathic oncology. This request was made in an attempt to allow naturopathic oncologists who are not members of OncANP to nominate themselves or their desired representatives. A total of 389 members subscribed to the forum at the time the study summary was posted, and 39 physicians received nominations from their colleagues in the field of naturopathic oncology.

In addition to nominating other physicians in the field, the OncANP members were encouraged to self-nominate, indicating that they were interested in participating in the study, able to attend the panel at the designated time and location, and met all the criteria and qualifications required to participate.

This large group was then winnowed down thusly. Nominees had to provide more information, including:

Personal statement of philosophy to naturopathic oncology
Years of clinical experience
Type of clinical work (hospital/private practice, licensed/unlicensed state or province)
Research and publications
Additional related information

And then:

This additional required information and total number of nominations was organized into a rubric format used to compare the physicians. The rubric assisted in selecting panel members with a combination of the following: (1) the most years of clinical and/or research experience, (2) varied philosophical approaches to naturopathic oncology, (3) relevant additional oncology experience pertinent to the topic of ethics, philosophy, and/or research development, and (4) a higher number of colleague nominations. A total of 15 physicians provided self-nominations and the required additional information for consideration for panel selection. Two physicians were removed from consideration because they had less than 7 years of clinical experience. The research team unanimously selected the physicians who satisfied the rubric categories for panel qualification to the greatest degree.

This resulted in the following panel:

Tim Birdsall, ND, FABNO
Daniel Rubin, ND, FABNO
Gurdev Parmar, ND, FABNO
Neil McKinney, NDa
Davis Lamson, ND, MSa
Lise Alschuler, ND, FABNO
Dugald Seely ND, MS, FABNO
Shauna Birdsall, ND, FABNO

We’ve met Dugald Seely before. He runs the Ottawa Integrative Cancer Centre and somehow has managed to score two rather rich grants from an anonymous benefactor to run clinical studies of naturopathy in cancer patients, one for $4 million and then another for $3 million. He was also the naturopath co-author of the SIO guidelines that I meant when I mentioned how naturopathy and homeopathy can’t be separated.

We’ve also met Tim Birdsall before. He was the Vice President of Integrative Medicine at the Cancer Treatment Centers of America from 2002 to 2012 and has been voted physician of the year by the American Association of Naturopathic Physicians. In 2013 he was promoted by CTCA and now serves as Senior Vice President of Information Services, Chief Medical Information Officer & Naturopathic Physician Western Regional Medical Center. (He’s also quite adept at spinning negative studies of supplements to look not quite so negative.) Shauna Birdsall also works for CTCA and is the Medical Director of Naturopathic Medicine and Integrative Oncology at Western Regional Medical Center. Now, I’m clearly no expert in the Delphi method, but it appears to me that it would not be a good thing for avoiding the “bandwagon effect” or minimizing bias to have two members of the panel working at the same medical center, much less for them to be related to each other. It just goes to show that, whenever naturopaths try to undertake science or other structured, evidence-based undertakings, they just can’t seem to follow the protocol expected.

But what about the questions? Here’s the method used to formulate the six questions:

A request for question suggestions for the panel discussion was distributed on the OncANP online forum. OncANP members were encouraged to share the question submission request with any colleague in the field of naturopathic oncology. OncANP members were encouraged to develop questions that (1) discuss the main topics of the panel, which are ethics, philosophy, and research development of naturopathic oncology; (2) integrate these main topics with a subset of topics relevant to the field of naturopathic oncology, including, but not limited to, clinical approach, research, and future goals of the field; (3) are open-ended, possibly multifaceted, controversial, and able to initiate thorough debate among the physicians on the panel. A total of 45 questions were submitted for consideration for question selection. Questions were categorized to assist in selecting topics of interest as identified by the physicians in the field of naturopathic oncology. The research team indicated their preferred questions and topics, and the principal investigator for the study selected and formatted the top 6 questions that were used in the discussion.

So basically, they polled the OncAMP membership. That’s probably an OK method, but note how the research team “indicated their preferred questions and topics.” No chance of bias there, is there?

Applying the Delphi method to nonsense: The naturopathic panel speaks

Here are the questions that this convoluted process ultimately yielded for the panel to answer:

What are 3 topics in naturopathic oncology that generate consensus among practicing physicians? What are 3 issues in naturopathic oncology that generate the most controversy?
How do you approach research evidence that contradicts other research when making a clinical decision? How do you approach research evidence (or lack of evidence) that contradicts your clinical experience and/or personal philosophy to the practice of naturopathic oncology?
What ethical responsibility does a naturopathic oncologist have when a patient’s wishes are contrary to evidence or contrary to the physician’s philosophy? Please provide a real or hypothetical example of how this situation should be managed.
What research evidence will make the most difference to the clinical practice of naturopathic oncology? What type of research is needed to benefit the field of naturopathic oncology? Explain how and why.
What criteria should determine the priorities for the development of “best practice” guidelines with respect to naturopathic oncology?
What symptoms or diagnoses should naturopathic doctors who have no additional oncology training be able to treat? For example, is it ethical for primary care NDs to treat side-effects of chemotherapy and/or directly treat the cancer?

These questions are, as far as panel questions go, reasonable enough, even somewhat uninteresting. What interested me more were the answers. For instance, for the first part of question #1, answers number one and two were, by far, supporting “quality of life” and “focusing on the whole person.” Of course, as I’ve said many times before, the whole issue of “focusing on the whole person” is a common trope used in “integrative medicine.” It’s a false dichotomy, where it’s implied (or even outright claimed) that you have to embrace the “unconventional” modalities (translation: the quackery) in order to be able to take care of the whole patient. I know several science-based family practice doctors and internists who would beg to differ on that.

There was also quite a bit of mention that naturopathic oncology should be “integrative” in that it should work within the standard of care and not be an alternative to the standard of care. For example, panelist 6 said:

I think most in naturopathic oncology would agree that naturopathic oncology is typically integrative and not alternative to the standard of care.

And panelist 4 added:

I agree that one of the consensus is that naturopathic oncology is inherently integrative and that our role is to play within the system to help support people going through that, and not as a source of alternative care.

Clearly, the naturopathic definition of “standard of care” is very different from a physician’s science-based definition of standard of care. By this standard then, other than diet and exercise, naturopathic oncologists have nothing to offer patients, and there’s no reason a dietician and a science-based supportive and palliative care physician couldn’t do that. After all, everything else naturopaths offer ranges from the unproven (such as most supplements) to pure quackery like homeopathy, energy medicine, “detoxification,” UV blood irradiation, applied kinesiology, and the like. If naturopathic oncologists—heck, if naturopaths—practiced according to this standard, they’d have to get rid of the vast majority of what they’ve been taught in naturopathy school. The “specialty” would have no purpose. (OK, from my perspective, it already has no purpose.)

A couple of the answers to question 2 stood out to me. For instance, panelist 7 said:

That actually is one of my pet peeves, is naturopathic doctors not reading the primary source of the research, the full article, themselves, and relying on somebody’s analysis that immediately dismisses the evidence because they don’t like it, and finds all the faults of the study. I think that it needs to be weighed much more carefully.

One wonders if he’s referring to the many studies that show that modalities favored by naturopaths have no effect detectable other than placebo effects or to crappy studies that purport to show a benefit that “evil” skeptics like those of us here at SBM deconstruct and show not to have sufficient evidence to support the conclusions made. Inquiring minds want to know.

Then panelist 4 says:

I think while within the context of limited evidence, and it’s being framed, I think we really have to rely also on the art of the practice of naturopathic medicine, and be guided by clinical experience, because there is a limit to what we can derive from the information

In other words, rely on anecdotal evidence and “clinical experience,” both of which can be profoundly misleading, as I’ve explained many times before.

That ties in to question 4, which is about research evidence and naturopathy, specifically what research evidence will make the most difference to the clinical practice of naturopathic oncology and what type of research is needed to benefit the field of naturopathic oncology. I found these to be very odd questions. I can’t picture any other medical specialty even asking these questions, at least not this way. In oncology, for instance, we might ask what the most pressing unanswered questions are in the diagnosis and treatment of various cancers, but I can’t picture anyone asking what would make the most difference, and especially asking what sort of research is needed to benefit the field of oncology. We’d ask what research is needed to benefit our patients with cancer, not the field. Not surprisingly, strange questions provoked strange answers. For instance, panelist 6 said:

In my opinion, the research that’s needed most, that will make the most difference in the practice and I think general acceptance of naturopathic oncology, is a systems approach. Naturopathic medicine teaches us to treat the whole person, to address their main health determinants such as diet, lifestyle, exercise, stress management, with a multitude of modalities that we have that are at our disposal. I think a study of one vitamin, or amino acid, or herb at a time, although critical and essential, it does not represent the practice of naturopathic oncologists and I think we need to be doing systems approach studies.

This is what I like to refer to as woo babble, which is like technobabble from Star Trek, but with woo. It also represents the predictable whine about “reductionistic” techniques of research that science-based physicians supposedly do. Unfortunately, naturopaths and other quacks have latched on to “systems biology” in the way that Deepak Chopra latched onto “quantum,” as an all-purpose term to make what they do sound scientific and plausible to people who have little science background.

Here’s the one, though, that best encapsulated why naturopaths shouldn’t be considered physicians under any circumstances and will never be science-based. Behold the answer from panelist #3:

I propose 4 projects that we can do now that will take us far. One is the publication of case studies by individual naturopathic oncologists should be highly fostered. These can document for the rest of us what may have helped or did not, and that’s the best kind of data at present to help us reach consistency consensus in treatment

No, no, no, no. Case studies and case reports are among the lowest forms of clinical evidence. They are useful to generate hypotheses to test by more rigorous methodology up to and including randomized, double-blind controlled clinical trials, but to develop treatment consensus guidelines? Absolutely not, with the possible exception of very uncommon or rare diseases for which it is just not possible to do rigorous clinical trials because there are too few patients. Panelist 3, whoever it was, just distilled the essence of what is different between naturopathy and science-based medicine into a brief paragraph.

Naturopathic oncology: They still don’t get it

Leaving aside the way that this “modified Delphi panel” used by the naturopaths doing this study was so modified from what a Delphi panel normally is that it’s unclear why they bothered to use the name and didn’t just refer to their discussion as a structured panel or roundtable discussion, the results of this discussion were quite informative, just not in the way naturopaths hoped. There was one thing lacking that would have likely been a key question in such a panel discussion in any other medical specialty, and that would be the most pressing areas where evidence is lacking. For instance, in a breast cancer panel, one would expect someone to bring up the lack of targeted therapies for triple negative breast cancer, as that’s a perennial problem that we haven’t solved yet. In a naturopathic panel, I was shocked to see no specific clinical problems mentioned or specific kinds of evidence lacking. And, no, the handwaving about “systems biology” doesn’t count, because it’s too vague to be meaningful. Systems biology with respect to what condition, what clinical problem, what disease? The naturopaths don’t say, or, if they did, the study coordinators chose not to cite those quotes. Instead they cited more than one panelist advocating for anecdotal evidence and not even mentioning clinical trials.

That is one key reason why naturopathic oncology, like all of naturopathy, is a fake medical specialty and will remain so until it embraces science and evidence. Of course, that will never happen, because if naturopaths ever embraced science and evidence, their specialty would disappear.

oracknows Mon, 12/26/2016 - 21:00

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That whole process sounds like children playing doctors and nurses. They can wear little white coats and hang plastic stethoscopes around their necks to look like grown-ups but they have no idea how the grown-up world actually works.

# 1 BadlyShavedMonkey

+ 1

However we should not discount the Cargo Cult explanation either.

So they are so incompetent, they cannot even use the correct terminology for what they are attempting to do. If they screw up something as simple as an analytical technique, why in the name of all that is true and proper would anyone trust them with their lives? Magical non-thinking is going to be the downfall of western civilization.

The last 15-20 years of Web 2.0 has equalised access to information but not equalised comprehension. We are paying the price for this in politics, science and medicine.

Delphi method?
Sounds more like the dillweed method in a GIGO setup.

#4 Indeed. People too often show disdain for experts with years of study and work in a field as being "elitist." Instead, too many people want to believe they are capable of googling anything and being the master of that domain in a day. It's an ego thing.

Yes, people are now assuming that because they have access to all of this information, that they also have the ability to comprehend it as well.....when one can easily "Google" the answer to any question, why should they try to comprehend the information they are receiving?

At the end of the day, we've done ourselves a huge disservice by not requiring knowledge of the "context." History is nothing without context, for instance.

The history of medicine is also easily misunderstood, without context....for example - antivaxers love to talk about how "measles" was no big deal, just look at episodes of the Flintstones or the Brady Bunch!

The two points they fail to recognize, over and over again, is that no TV executive in their right mind would show the true effects of disease on TV (especially not in a comedy)....and they also fail to grasp that parents did not see these diseases as "benign," instead, they saw them as inevitable.

The inevitability of these diseases was such that parents had to hope and pray (and do whatever little they could) in the hope that their kids would not be one of the unfortunate ones who died, or went blind or deaf, or suffered any one of the other severe complications of these diseases.

The very inability of anti-vaxers to understand the context of history - how things were viewed 100 years ago vs. today, along with all of the other host of quacks out there, is a symptom of this disease of contextual ignorance.

Reading this leads me to think again that there's such a broad spectrum of 'not-sbm' practice it's useful to observe the differences, and not tar all of it with the same brush (though tarred it still may be). In this case, naturopaths calling themselves 'oncologists' strikes me as far more troubling than the sort of 'Integrative Oncology' now practiced at a number of well-respected clinics, which offer acupuncture, or rieki or other woos as pain management therapies but only that, and only under the guidance of real oncologist MDs. I know Orac detests this 'quackademia' but I looked at a website description for one IM-Oncology program recently, and while it had a variety of CAM 'modalitie' on offer, I actually found something comforting in the way they were described. The vibe (if you will) wasn't curative, and certainly wasn't at all 'instead-of' conventional standard of care, but rather stuff-to-do in addition to that to the end of coping with the often devastating physical and psychological effects of chemo, radiation, surgery etc. etc. I found myself asking whether, in good conscience, I could feel good about denying patients what was being described, and I concluded that in all honesty my answer had to be 'No.'

At the same time, I felt this reaction was specific to the description I had read, and thought I might have reacted quite differently, and far more negatively, to a different framing of the CAM stuff.

While it seems that some of the " integrative and not alternative" language from the naturopaths is gesturing in this direction, I don't at all trust naturos to do this well. For one thing, that would include sincerity, humility, and understanding their own limitations (or, rather, flaws), and I don't see much of that in naturos. For another, the whole 'natural remedies' schtick of herbals/supplements/homeopathy has no use I can see in terms of the sort of 'supportive care' effects of those other 'modalties', which basically derive from patients spending time with sympathetic people who have skills in getting their minds off the awfulness of their situation.

As such, I have the suspicion OncANP is just a sleazy attempt to ride the coattails of approaches that have far more limited and legitimate (humanistically, anyway) ends into a wider acceptance and increased authority for naturopathy in general. And I do think that is very, very bad.

It may be that I spend too much time reading 'ScholarlyOA', but the OncANP logo looks far too much like that those of mockademic-publishing scams.
The scammers seem to have settled on blue-and-green or blue-and-beige colour schemes as a hallmark of mendacity.

https://web.archive.org/web/20161217174603/http://ayancreatives.com/por…
https://scholarlyoa.com/2016/12/20/another-dangerous-medical-publisher-…
ht_tps://scholarlyoa.com/2016/12/08/amateurish-new-open-access-publisher-launches-with-64-journals/
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@ Lawrence

I really appreciate seeing someone stand up for historical context on RI. Bravo! You also make an excellent point in noting that sitcoms rarely if ever show the true nature of anything.

I'm not really into the genealogy thing, but in a moment of curiosity I looked up the census data on my paternal grandmother's family. She had never mentioned having any siblings, and I'd kind of imagined her as an only child. But it turns out she had (iirc) 3 brothers and sisters who didn't make it to adulthood...

@Orac, I fully understand our general disdain for "Google expertise," but it does come in handy occasionally. You wrote, "as I say every time I mention the NPLEX, I would really, really love to see some questions from the exam."

Searching "NPLEX sample questions" was fairly helpful. The first two hits were from BoardVitals, with sample questions for both Part I (https://www.boardvitals.com/blog/nplex-1-sample-questions/) and Part II (https://www.boardvitals.com/nplex-part-2-naturopathic-exam).

The Wikipedia article on the NPLEX (also a first-page hit) include a statement that some sample questions were entered into the Colorado legislative record (in 2014) with a link to the relevant PDF file (http://www.leg.state.co.us/CLICS/CLICS2015A/commsumm.nsf/58e6d054c29cbe…). This one may be the most interesting, as it also shows the "correct" (shudder) answers.

There's also a commentated set of questions on MedWisely (http://www.medwisely.com/nplex-sample-question-croup-infanticide/). Holy crap. Apparently "standard of care" must be meaningless word salad to these effing nutcases.

Michael beat me to it :) I looked up the same sources for the same reason.

I also looked at the question structure using Bloom's Taxonomy, which is what nurse educators apply when writing NCLEX-RN style questions for nursing exams.

Most of the questions in the review sample are at the Knowledge and Comprehension level, which means rote memorization. A few are at the Application level (use of good clinical judgement in handling a common patient care situation). None were of the Analysis and Synthesis level, which involves coming to the correct conclusion from breaking down information or putting it together to come to a correct plan of care.

Equally interesting, a website I found that offers a practice test bank for the NPLEX noted that the most difficult section of the exam was section 1, which includes the anatomy and physiology sections of the examination. Small wonder; these are the concepts that are actually science based, and include some very difficult concepts. An article on the Arizona Naturopathy Boards exam showed the state wanted them to address the fact that their pass rate was 100% after "adjusting" scores of applicants, the reasons for which were opaque. One student had 90 questions "adjusted."

The review sample on a patient with acute coronary syndrome was as equally frightening as the questions on the kid with croup that Orac dissected not too long ago.

I would really love to see an item analysis of the actual test. I simply can't see how it measures any kind of competency for anything.

To add to what Lawrence said @7...
We see things as they are now, and forget that even 50 years ago, things were very different. My parents were born in the 40s before mass vaccination. They knew about childhood diseases. I was born in 1976. I may have misremembered, but I don't recall anyone I knew at school getting Measles, Mumps or Rubella.
We see things as they are now, and incorrectly assume that that is how they always were.

@ Panacea
"I would really love to see an item analysis of the actual test. I simply can’t see how it measures any kind of competency for anything."
Simple: if you prescribe Rhamnus purshiana and Podophylum peltatum instead of Ricinis Communis, it's eliminatory.

For BadlyShavedMonkey & Zach:

There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that 'my ignorance is just as good as your knowledge'.

- Isaac Asimov

@ Julian Frost
Here it's not a question of knowledge, but of understanding : they "know" that Rhamnus purshiana is better than Ricinus communis for some disease.

My parents were born in the 40s before mass vaccination. They knew about childhood diseases. I was born in 1976. I may have misremembered, but I don’t recall anyone I knew at school getting Measles, Mumps or Rubella.

In one episode of the Quackcast, Mark Crislip (the world needs more Mark Crislip), an infectious disease doctor, reports that he's never seen a case of Mumps.

My mom, an ordinary stay at home housewife, treated 3 cases that I know of - my cousin (who moved in with us for a week or so for just this reason), my sister, and myself.

I had excellent, evidence based naturopathic treatment for stage 3 uterine cancer in concert with surgery and chemotherapy and am cancer free

Fortunately, I live in Seattle, where we have excellent integrative naturopathic oncology and extensive research bringvdone. My MD oncologist wisely recognized the value of my naturopathic treatment and encouraged me to seek help from my naturopathic doctors on several occasions, even modifying my chemo regimen based on the naturopathic doctor's recommendations.

I've seen dozens devastated by conventional cancer treatment, and many die. I've seen great success with naturopathic treatment when conventional treatment failed.

Cancer patients deserve the opportunity to evaluate and combine treatment options that will give them the best chance of success. We are not widgets and therefore few perfect answers for cancer yet.

Learner, Washington State law only allows someone to visit a naturopath for cancer only if they are working with a real oncologist. We need to know that little fact when evaluating unsupported anecdotes.

One ND of note:
http://www.seattletimes.com/seattle-news/bothell-cancer-naturopath-acce…

Sigh. About five years ago the local paper had an interview with a local heiress who had recently been diagnosed with cancer. She spoke with great enthusiasm about Natural Medicine and how - with the blessing of her oncologist - she had great hopes for getting through this even stronger than ever.

My disgust with that article moved me to construct a little slogan, which goes something like "So-called Natural Medicine is an elaborate set of rituals for managing anxiety while hoping to get lucky and experience spontaneous remission."

Nothing that I have seen or read since then has convinced me to modify that opinion.

My disgust with that article moved me to construct a little slogan

That's pretty honking big for a slogan.

While you're busy spewing insult and your biased view, I find your perspective small minded and likely a big pharma-paid fear monger. Let's be fair and point out the fact that conventional oncology has a very limited scope, applying merely poisonous big pharma profit strategies and doing their patients a disservice by slagging anything naturopathic or homeopathic. I know far more cancer patients with successful outcomes who are still alive thanks to their naturopathic practitioners, approaching their cancer integrative and not. Those patients who didn't have the privilege, courage or knowledge to pursue other means of getting their bodies healthy haven't fared as well, if at all.

In one episode of the Quackcast, Mark Crislip (the world needs more Mark Crislip), an infectious disease doctor, reports that he’s never seen a case of Mumps.

I was sitting in on a conference call during a mumps outbreak in our county (2015) listening to an APRN thank the county health department's CD department for sending out clinical information about the disease. She's head of a local prompt care and she'd never seen the mumps. Nor had any of her medical staff.

Made me feel old.

@shay #24: I've been a nurse for 30 years. I've never seen measles or mumps . . . thank God! I've seen a few cases of pertussis, and each scared me to death. I've seen chickenpox in an adult (who got septic); it scared me to death.

I hope to God I never see the so called childhood diseases come back. That's an experience I can do without.

@ Learner #18: how do you know the naturopathy had any effect on your disease since you also chose science based medicine, including surgery?

@ Melody #23: Don't forget that SBM includes surgery for many types of cancers (solid tumor cancers). Yes, cancer treatments are quite toxic. But they work.

Homeopathy, as Orac has discussed multiple times, is simply water. Water does not have memory. There is nothing of the original molecule of the supposed medication in it. There is just no possible way it can work, and this has been demonstrated on multiple occasions.

I pray I never get cancer. But if I do, I'll take the real medicine over fake medicine any day of the week and twice on Sunday. Because I've never seen a case where fake medicine had any positive effect on a patient outcome, not in my 30 years as a nurse. And sadly, I've seen plenty of fake medicine in the hands of patients that has done nothing for them but empty their wallets.

Melody: "...likely a big pharma-paid fear monger."

How boring, it is the old stale worthless Pharma Shill Gambit.

Perhaps you should try with something new and exciting: providing actual evidence for your claims. You can start with the PubMed indexed case reports of naturopathy curing cancer without any surgery, radiation nor medications. There are many stories of those who did not do so well with homeopathy here:
http://whatstheharm.net/homeopathy.html

I view all cancer care providers MD, ND, RN, etc, as fractional contributors, at best. So I buy a la carte for general and specialized services, as needed, from the those willing and able.

Case histories actually become more useful for comparison with superior data for stratification and comparison, as limited patient numbers accumulate and begin to cognitively cluster common problems and better non-standard resolutions. In the limit, improved data would allow better direct design and personalization of treatment.

My greatest concern is transparency - what services or therapies are offered, how they are priced and what the basis of treatment is in terms of literature and local local clinical results. I don't expect magic bullets, I settle positive measurechanges, often modest sometimes dramatic, with the power in the accumulation of improvements.

@melody - yet Cancer survival rates continue to improve. Certain cancers can be cured quite regularly and we now have vaccines which prevent Cancer.....

Which of those were the responsibility of naturopaths?

My greatest concern is transparency – what services or therapies are offered, how they are priced and what the basis of treatment is in terms of literature and local clinical results. I don’t expect magic bullets, I settle for positive measured or observed changes, often modest sometimes dramatic, with the power in the accumulation of improvements.

Some results are so different that any benefit is notable to the patient. Even if ignored by std medicine, again.

"Some results are so different that any benefit is notable to the patient. Even if ignored by std medicine, again."

You what? Think you need to calm down on the big words and settle for clarity.

Case histories are a very weak form of evidence. You can compare them with superior data all you want, but by themselves they only serve to drive interest and create the research question. The superior data from stronger forms of research is how to prove safety and efficacy.

I don't care how transparent the pricing of quackery is. Without firm evidence of safety and efficacy, you're still getting your pocket picked. Your whole argument is a sham.

With alt med / integrative medicine, sometimes one can achieve effects or conditions simply not possible with conventional medicine for these situations. Situations where doctors might say less than 1 in 100 or 1K or 100k patients (actually their reaction tends to I've never seen (20-30 yrs), or some form of sudden denial of original problem).

Pancea@31
Most CAM components are previously recognized as safe.
Your rather fixed ideas about proof of efficacy are about communication and administration, rather than the

Case histories are a very weak form of evidence. for "proof" (or general acceptance) ...because of inadequate stratification, diagnosis and description.

I don't need proof on a treatment, I need (multiple) methods to yield adequate minimum results, what is for me a one-off problem.

As predictive diagnostics improve, individual cases become more analyzable, comparable. There are many kinds of analysis and misc data a good experimentalist can use to improve the odds of success, sometimes dramatically, especially with multiple processes.

You can compare them with superior data all you want, but by themselves they only serve to drive interest and create the research question. The superior data from stronger forms of research is how to prove safety and efficacy.

I don’t care how transparent the pricing of quackery is. Without firm evidence of ....efficacy, you’re still getting your pocket picked.
You seem to conflate proof of efficacy in unstratified heterogeneous groups as a requirement for to achieve any efficacy in very specific circumstances. Mission critical, one time solutions for a specific, time critical case often aren't worked that way.

Also I daresay my pocket leaks about 100x less than the more conventionally tx'd patients billed at $25k - $80k per month, where they died-out in ~3 years, OS<1% and this was not a case of zero or one wimpy, bottom 10% marker that shows up as the last survivor.

Panacea@31
Most CAM components are previously recognized as safe.
Your rather fixed ideas about proof of efficacy are about communication and administration across groups, rather than the methodical achievement of a success for one type in the broader group.

Case histories are a very weak form of evidence for “proof” (or general acceptance) …because of inadequate stratification, diagnosis and description in std medicine.

I don’t require proof on one treatment, I need (multiple) methods to yield adequate minimum results, what is for me a one-off problem with multiple roots.

As predictive diagnostics improve, individual cases become more analyzable, comparable and stratified. There are many kinds of analysis and misc data a good experimentalist can use to improve the odds of success. Sometimes dramatically, especially with multiple processes.

I don’t care how transparent the pricing of quackery is. Without firm evidence of ….efficacy, you’re still getting your pocket picked.
You seem to conflate proof of efficacy in unstratified heterogeneous groups as an absolute requirement to achieve any efficacy in very specific circumstances.

Mission critical, one time solutions for a specific, time critical case often aren’t worked that way.

Also I daresay my pocket leaks about 100x less than the more conventionally tx’d patients billed at $25k – $80k per month, where they died-out in ~3 years, OS<1% and this was not a case of zero or one wimpy, bottom 10% marker that shows up as the last survivor.

I was interested to see that when signing up for the practice NPLEX exam, that for a fee, one can get a "pass guaranteed".
https://www.boardvitals.com/nplex-part-1-naturopathic-exam?utm_source=s…

@Learner#18

I had excellent, evidence based naturopathic treatment for stage 3 uterine cancer in concert with surgery and chemotherapy and am cancer free.

This claim is the equivalent of someone saying:
"I had an excellent, evidence based prayer results during my recent moonshot (in concert with NASA technology). Isn't prayer a wonderfully effective mechanism for flights to outer space?"

Melody: "Those patients who didn’t have the privilege, courage or knowledge to pursue other means of getting their bodies healthy haven’t fared as well, if at all."

Some of them haven't fared at all? How odd.

Must be due to their lack of "courage". See, this gratuitous insulting of cancer patients is a major roadblock to my accepting alt med as a gentler and more holistic form of therapy. :(

Now it's off to start celebrating the end of 2016. You are all treated to a round of expensive cocktails, courtesy of my giant roll of $hill Buck$.

@prn

Wow. Great example of argumentum ad nauseum.

When you cut through the bullshit what you're really saying is, "if one person gets a benefit from quackery that should be good enough."

And that just isn't true.

When the time comes, you will be diagnosed with something awful that causes you to realize you actually are only made of live tissue that needs to be looked after. At which point your doctor will sit you down and give you the list of options they have at their disposal to treat you. You will take all the drugs they tell you too, then you will take the drugs they recommend to fix the side effects caused by their drugs. You will get sicker and weaker from their drugs, then eventually you will die within the time frame they gave you. You became another sad victim of a terrible disease, the doctors pat themselves on the back saying we did everything we could. And the pharmaceutical company gets paid for all the drugs the doctors used to treat/kill you. Personally i think attitudes like yours exist because people don't want to admit their lifestyles and personal habits are the cause of their illnesses. You shouldn't rubbish things until you have looked at them with an open mind. It is true that pharmaceutical companies are only interested in their bottom line, its in their best interests to rubbish therapies they can't make money off.

prn: "I don’t require proof on one treatment, I need (multiple) methods to yield adequate minimum results, what is for me a one-off problem with multiple roots."

If I am sick and I get to pick between
1. prn's opinions
2. peer reviewed evidence

I think I will go with #2.

Tonster: "And the pharmaceutical company gets paid for all the drugs the doctors used to treat/kill you. "

Pharmaceutical companies own the supplement companies so they get paid when they do science and when they do not bother. The science bit is the important part regardless.

The man with the biggest cheque book owns the science results.

Yet mortality rates for almost every disease on the planet, including Cancers, have dropped dramatically over the past 100 years....care to explain?

And the pharmaceutical company gets paid for all the drugs the doctors used to treat/kill you.

I don't know much about medicine, but I do know a little about business, and I can tell you that killing your customers is a time proven strategy that leads to glory and riches.

/sarcasm

@ Johnny
Still cancerquacks are able to get away with it, but they always come with the same excuses. It's the patients fault, the regular treatment is to blame, the patient didn't come in time, or whatever, but it's never, never the quack-treatment that has failed the patient.

Tonster @ #38:

My wife recently died of multiple myeloma. She had three separate genetic events during the course of the disease:
1. Alteration of the MYC oncogene, followed by
2. Alteration of the RAS oncogene.
At some point during this process there was also a mutation involving deletion of the P53 gene.

Given your expertise in this subject I am certain that you can easily identify WHICH lifestyle decisions of hers led to each of these discrete events and how long it took for such lifestyle decisions to impact her plasma chromosomes. Please do be specific - it will help set my mind at ease as I work my way through the grieving process.

"You will get sicker and weaker from their drugs, then eventually you will die within the time frame they gave you"

Well, you don't want docs to lose Medicare reimbursement because their patients lived longer than the time they were given.

Tonster: "The man with the biggest cheque book owns the science results."

Explain how rich people can game results with a double-blinded placebo controlled trial.

@ titmouse
"Explain how rich people can game results with a double-blinded placebo controlled trial."
1) Perform 20 double-blinded placebo controlled trials, with different medical teams and various indications.
2) Get a p < 0.05 in one of the indications by chance.
3) Subdivide your cohort in order to have a subset with a p<0.01
Pay experts to explain why later studies are not successful.

Im not a doctor im speaking from my own personal experience, which is 10 yrs ago i found i had cancer, I did all the treatments the doctors told me to do, the chemo nearly killed me it took my body 2 years to recover enough for me to go back to work. The whole time a voice in my head was telling me this doesn't make sense, cancer is is my own body cells behaving badly, so if i could fix what is causing them to mutate then my bodys immune system may be able to attack the cancer and prevent it from returning. I tryed to speak to the doctors about this and they were completely uninterested. They told me to go home enjoy my life and hopefully it wouldn't return. Well of course it returned, because a side effect of chemotherapy is cancer. But this time is worse because it has become metastatic. This time the doctors have said the treatment available will make the tumors go away for a while but they will return and eventually kill me. I went home confused and terrified, but this time was able to do alot more research about other options available. I realized if i fix my body by changing my environment, eating habits and mental attitude i have a chance of surviving this disease. So that's what I have done and so far the tumors are shrinking and I feel the best i ever have, i have not taken any of their medication this time. I am now happily working with the so called quacks, everything in my life and the lives of my family has improved, we are all alot more self aware and healthier. Whether it works long term or not im not sure, but I do know if im going to die, at least iv learned a huge amount about myself and my last years will be filled with health and balance not sickness in the form of doctors medicine. I have learned that doctors don't promote health they just medicate on top of medicating and the drug companies make $$$ out of it. And yes regardless of what you think the person with the biggest cheque book does own the results. The attitudes of you people is slowly becoming antiquated thank god!

To be fair, there's no shortage of real world examples of 'killing customers as a strategy that leads to riches' – tobacco companies, gun manufacturers, Ford Pintos, Love Canal, TRIS... heck, you could make an Orac length comment form the list.

It's also true that the pharmas do a lot of bad sh** that falls short of customer-homicide, and that "the biggest cheque book owns the science results."

None of which actually supports Tonster's theses that conventional medicine kills most of it patients, or more to the point, that alternative treatments are somehow superior.
You know, just because airplanes may not be maintained properly, and have to land and take off at too-short runways full of potholes, guided by non-union undertrained air traffic controllers who come to work hungover or tweeked – that not only don't mean magic carpets fly, it also don't mean getting dragged over a field of rocks on a magic carpet is without peril, either. Maybe even greater chances of peril than getting on the plane, which is hard to justify since the magic carpet isn't really going to get you get you anywhere...

Let's see...
Killing customers as a strategy that leads to riches:
Exhibit A: The Hippocrates Health Institute
______

Tonster is singing a familiar CT song: Natural remedies work and if people only knew the truth they'd embrace these effective and relatively cheap methods, which would put pharma profits into the sh**hole, and therefore the pharmas employ shills to "rubbish" their 'competition'. The problem is, the pharmas aren't exactly SPECTRE, they're too big and too public to conceal all the facts about how they actually make money, and how they actually spend money in efforts to boost or protect the bottom lines that are their primary priorities – including their funding of people who actually are 'pharma shills'. So you can find out a lot about who these people are, and what they do that gets the pharma overlords to keep sending them checks.

And if you actually check, you know, facts you discover those actual well-funded pharma shills don't rubbish CAM at all. There are two primary categories of pharma shilling. The first is directed at promoting high profit meds to physicians and institutions in competition with similar products from other pharma manufacturers. Alt med never enters the equation in the day to day efforts of the sales reps who do this shilling. The second is directed at influencing government policy toward directions the pharmas find favorable. In this – even if it may seem counter-intuitive to some – the pharmas are all in free market ideology and de-regulation. Which basically makes them political allies of Big Cam. And sure enough many if not most of the pharma shills in politics also shill for the supplement industry.

Working back through the CT narrative, we'd find that the pharmas are making money from all signicant market sectors of health care - including OTC remedies of dubious benefit, supplements (if not directly making and marketing them, but in providing raw materials and facilities), etc. etc. 'Naturopathic oncologists' may be a potential economic threat to sbm oncologists, but to the pharmas, they're just another target market.

And the reason the pharmas have a few toes in the less outre varieties of CAM is that CAM is not cheap, and there is, in fact, a lot of profit to be had there. If the profit motive sometimes leads to bad behavior on the part of Big Pharmas, that happens far less often there than it does in Big CAM. And, and their worst, the pharmas can't touch the evil of Big CAM outfits like Truehope.

It's misleading to frame the bottom-line thinking of the pharmas as only an interest in the bottom line. Which is to say that a lot of things go into the bottom line, there are very different strategies for maximizing profit that in contest both within large firms and between them, and so bottom-line interests become translated into all sorts of other interests. And for the pharmas, a lot of those interests are highly pro-social. The pharmas are evil sometimes. They're also good more of the time. And more often than both the clearly evil and clearly good put together, they're some mixture of both. In this, they're not that different from other massive multinational corporations. The bad stuff they do represents a fairly small percentage of their activities, and considering all the failings endemic to our species, a not particularly surprising percent at that. It's just that they are so massive and do so much that the bad stuff numbers still look 'big' to our everyday-life scales of evaluation.

Finally, the notion that 'Big Pharma' is sitting on cures to preserve long-term profit from treatment fits neither the facts of where the profit comes from, or the nature of corporate behavior. First and foremost, pharmaceutical companies not only compete tooth and nail with one another in the marketplace for pharma products, but with other capitalist firms in stock markets where shares are traded daily. Those relatively rare occasions where the profit motive leads to sketchy activities by a pharmaceutical company, that's generally a response to competitve pressures from other pharmaceutical companies. And the reasons these firms will go forward with tactics that are potentially risky to them is that when corporate executives and managers aren't focused on the bottom of the next fiscal quarter, they're most likely looking at stock prices in an even shorter time window. The strongest imperative is always to get the money in the till now. If a pharma could market a cure for any common disease, they would be on that like white on rice full-bore as windfall profits would surely abound. All the major players would get big promotions and bonuses such that they could retire into the lap of obscene luxury well before any long-term consequences of lost income from mere-treatments-not-sold would show up in the company's ledger. Not there actually would be profit-lowering losses. The pharmas are smart enough to know that every product has an economic life-cycle, and they have plenty of new products and new types of products in the R&D pipeline to fill the profit holes left by sometimes unpredictable obsolescence. Never mind that people who get cured of one disease and have their lives extended as a result will still develop other medical problems and have other health maintenance needs. Finding a cure for some nasty thing would not only bring short term riches, but expand the market of older medical-product consumers capable of buying all that new stuff the pharmas will be putting out to help them fend off hair-loss, wrinkles, wimpy weinies and all the ravages of Father Time...

My condolences.

1. Alteration of the MYC oncogene, followed by
2. Alteration of the RAS oncogene.

The herbicide atrazine -- do you live near a corn field or where one leaks into your water supply?

Tonster @#49

I asked a question at #45.

Your response had nothing of substance aside from your little personal narrative, one which demonstrates that 'conventional' oncology kept you alive for years and you haven't the cerebral horsepower to figure that out.

I am struck, however, by the revelation that cancer is merely a product of cells "behaving badly." What a magnificent breakthrough for science!! I await the next chapter in this scintillating scientific thriller!

Will it be The Cancer Whisperer, who returns misbehaving cells to normal behavior by instilling the 'pack rules' that govern normal cells?

Will it be Skinnerites, who use operant conditioning to modify the cells' behavior so they no longer misbehave?

Or will it the disciples of Dr Phil, who use a highly rated television show and promises of a two-week stay at an inpatient facility to bring the recalcitrant cells back to the straight and narrow?

Wait - maybe an old-fashioned fire-and-brimstone preacher could best let them see the error of their ways, to bring them back to the straight and narrow!

But what if the cells are Calvinist, and are predestined to 'misbehave' and nothing we can do will change them!!!

I can't wait to see which of these approaches is best to convince those recidivist cells to return to the straight and narrow. Only time will tell!!!

You can throw in all the big words and terminology you want, just because you can use a thesaurus doesn't make you intelligent. At the end of the day cancer is your own bodys cells behaving in a way that is non conducive to your health. something has caused this to happen, the holistic approach trys to figure out why and gives your body the tools to try to reverse the damage. I don't give a damn about your opinion, i only stumbled on this blog and was quite shocked at the closed minded attitudes of the people contributing. I now realize that people like me don't even bother with people like you, thats why all the posts are so narrow minded and predictable.

Forgot to close the sarcasm tag :(

"You can throw in all the big words and terminology you want, just because you can use a thesaurus doesn’t make you intelligent."

Yes, I'm also tired of doctors throwing around those big words and pretending they know more than I do. The arrogance is appalling.

Tonster @ #53:
I don't give a damn about your opinion.

Don't be modest: Your disdain for facts FAR outweighs your lack of respect for my opinion.

PS: You forgot to tell me how cuddling with a hyperdiploid plasma cell and talking about its childhood could repair chromosome damage. Please enlighten me!

Tonster: "ou can throw in all the big words and terminology you want, just because you can use a thesaurus doesn’t make you intelligent."

I suspect that Opus is taking the terminology directly from the medical reports from his late wife's doctors. I have several reports from doctors with lots of interesting terminology from the neurologist who my saw saw trying to figure why the child had seizures and could not take (by the "tonic clonic" apparently means "grand mal seizure", and "static encephalopathy" means something is wrong with the brain, we don't know what but it is not changing), and with the several cardiologists he saw for his obstructive hypertrophic cardiomyopathy, which was helped by a septal myectomy (I'll let you look them up).

"I don’t give a damn about your opinion,.."

And why should we care about yours? Perhaps you should try providing us some actual verifiable documentation to support your assertions.

"...and was quite shocked at the closed minded attitudes of the people contributing."

Oh, the irony! You could have changed our minds if you had actually answered Opus's questions with actual verifiable evidence of what "lifestyle" that would have prevented those genetic events. Perhaps you can tell me what "lifestyle" would have prevented my son's neonatal seizures, genetic abnormal heart anatomy and his autism.

By the way, make sure your reply includes the PubMed indexed studies by reputable qualified researchers... not just your life story.

Nothing i can say would change your attitude. I don't have scientific evidence i have my own experience and common sense. Iv been in the farming industry my whole life so i know the chemicals that are pumped onto the fruits vegetables and animals that we eat. Then there's the chemicals in all the washing powders, cleaners, foods drinks. Everywhere we turn we are surrounded by chemicals our bodys are unable to process, eventually they have an effect. lifestyle changes need to be avoid anything processed as much as possible, grow and eat your own vegetables dont eat processed foods, use organic cleaners all these things can help. For some people its too late their body's are too broken to fix. I'm not a scientist i can't help you with your sons problems im sorry.

Tonster: "Nothing i can say would change your attitude."

I told what could change my opinion: actual factual verifiable evidence that has been studied and shown to work.

What would change my attitude is if you would actual read what we are saying and stop grandstanding. Right now I get the feeling you are telling me that my son is the way he is because what I ate before I got pregnant? Even though I have been growing food in my garden organically several years before he was born. That is your explanation for a possible de novo mutation is that it is all my fault. Seriously?

Why should we believe you?

By the way, my family were fruit growers in the US west for over a century, and I grew up eating good food, very little processed stuff, though I did help with fall canning. Food growers are not fools, and have been using science and technology to reduce harmful chemicals and get better crops (WSU Cougers may have lost their football game, but the agricultural research is awesome!)...

.... so why do you folks make such sweeping generalizations?

Wow i originaly posted because i came across the original post and was surprised at the narrow mindedness of what was written. How did it somehow turn into me having a go at your life choices ???? I know nothing about your childs unfortunate illness and i have no interest in it either. I have experience with both conventional and alternative medicine of my illness, I was simply pointing out that the alternative holistic approach isn't rubbish. of course there is a lack of scientific evidence around this because sadly pharmaceutical companies control the information.

Tonster: " I know nothing ..."

Exactly.

"I was simply pointing out that the alternative holistic approach isn’t rubbish."

With classic worthless "argument by blatant assertion." Unfortunately that does not work around here. We need evidence, not stories and not insults about having a close mind. Real evidence that it has been proven to work. And again, if you bring up evidence then you will be taken seriously.

And not silly evidence free statements like: "... of course there is a lack of scientific evidence around this because sadly pharmaceutical companies control the information."

Um, yeah. That is the reason. I am sure all the Aggie schools in this country from Alaska to Florida make sure the pharmaceutical companies control their research.

"Iv been in the farming industry my whole life so i know the chemicals that are pumped onto the fruits vegetables and animals that we eat."

Farmers do not appreciate the claim that they are poisoning the world (and themselves):

https://petersonfarmblog.wordpress.com/2016/12/30/17-myths-about-agricu…

Well they should stop doing it then. Yes of course there are some that are environmentally conscious and more so these days, its slowly changing thank god! It still happens tho alot. Look we will not agree, iv had an attitude like some of these people but gladly i have seen the light. You guys like to wank on about scientific this and that, the fact is when i read the posts in this blog the impression i got was a bunch of people believing the rubbish you are fed. May i point out to you that Holistic medicine is based on the whole body being healed, when the patient is totally focused and making all the changes needed, thats when the medicine works properly. its alot harder to measure than giving a patient a pill and collating the results.

Tonster @ #63: "May i point out to you that Holistic medicine is based on the whole body being healed, when the patient is totally focused and making all the changes needed, thats when the medicine works properly. its alot harder to measure than giving a patient a pill and collating the results."

Actually, it's not all that hard to measure at all.

You had cancer ten years ago. If you had been treated holistically you would be dead now. You are a walking, talking example of the success of conventional oncological treatments.

The fact that you live to spout nonsense about whole body treatment, your very existence, highlights the emptiness of your arguments.

It's a classic case of spitting in the face of the people who saved your life. Your willingness to do so says all I need to know about your honesty, your courage and your integrity.

~~~~~~~~~~~~~~~~~~~

Hey, this argument by assertion is neat stuff! No need to worry about facts, research or anything! In under five minutes I was able to analyze your situation, assess your character and intelligence and adjudge you to be a worthless, ungrateful dumbass.

NOTE
Any parallels between the above comment and your approach to the issues and commenters on this post is purely coincidental.

DB: "Farmers do not appreciate the claim that they are poisoning the world (and themselves):"

Thank you. They are not robots, they are very intelligent people working in a very competitive business, and they do try to do their best with available information. That is why the aggie universities extensions exist.

Opus, my very sincere sympathies to the loss of your wife. I cannot imagine what that is like. Thank you for having better wit than I could conjure up.

Tonster: "May i point out to you that Holistic medicine is based on the whole body being healed, when the patient is totally focused and making all the changes needed, thats when the medicine works properly."

Citation needed. Essentially prove it, but with some actual data... otherwise it more worthless "argument by blatant assertion.

Which is really boring, and useless.

@ titmouse
“Explain how rich people can game results with a double-blinded placebo controlled trial.”
1) Perform 20 double-blinded placebo controlled trials, with different medical teams and various indications.
2) Get a p < 0.05 in one of the indications by chance.
3) Subdivide your cohort in order to have a subset with a p<0.01
Pay experts to explain why later studies are not successful.
So we insist that clinical trials be registered to guard against the file-drawer effect. How do the rich people game things then?

I think for every problem there is a way to tighten up the way research is done to minimize fraud.

I notice that new treatments that look promising in preclinical studies usually fail clinical trials. This means that funders do not get what they want most of the time. So the fraud cannot be too big a problem for phase 3 trials.

Chris @ 65

Thank you for the kind words. It's only been six weeks, so the magnitude of my loss is still becoming apparent. However, I have often drawn comfort from this:

https://www.youtube.com/watch?v=ZfvS2LYbZLQ

Well I didn't mean to do that!

May i point out to you that Holistic medicine is based on the whole body being healed, when the patient is totally focused and making all the changes needed, thats when the medicine works properly.

You may, but that doesn't make the statement anything more than low-rent, blobovian occultism.

Opus: "Thank you for the kind words."

You are very welcome. I lost my mother when I was eleven years old because of an aircraft accident. I know what it is to suddenly lose a bit of your being. I cannot imagine the pain of that being extended. Though this may be because I have dealt with my oldest child's multiple hospital experiences (which once included open heart surgery). Which is just an added bit of torture (though my kid is still with us).

By the way I really truly appreciate the people who work at the various hospitals that my kid has been from the emergency departments to the wards. I actually have a way too long list of the amenities of our local hospitals where he has been taken to by ambulance or just for cardiac rehab.

I just wish that was not part of my life. Which is why one thing that makes me very angry at anti-vaccers is that they think it is "better" to treat vaccine-preventable diseases than vaccinate. I pretty much know none of these parents have ever had a child hooked up to a respirator. Yep, my kid has... along with an IV and a few other fun machines that go "beep!" and "boop!"

@ Titmouse
Clinical trials are registered: treatment A has failed to show significant effect in 19 indications. p is <0.05 in one indication. How can you use the failures of treatment A in other indications to show that p <0.05 occurred by chance, when the company will say that this is proof of specificity?
Other example: 5 vaccines against HIV show total lack of efficiency. Another one, which does not differ fundamentally from the previous ones at the conceptual level, shows a borderline significance, which can be stretched to 0.05 by carefully selecting the data and the period of follow-up. The main conclusion should be that the putative protective effect is so low that the vaccine cannot be used. However, the results were published in a high impact journal as a proof of concept, with headlines in the media, and this has led to increase the funding of HIV vaccine research.
Seven years later, there is still no HIV vaccine, but many people have got money from governments.
For those who want to make money, there is always a way, even with failures.
https://en.wikipedia.org/wiki/The_Producers_(1968_film)

@Opus: my sincere condolences. I've been a very lucky person and have lost very few loved ones (grandparents, some HS friends). I can only say that I hope your memories of your time with your beloved wife give you comfort as time passes.

Panacea@37
prn... argumentum ad nauseum.
When you cut through the bullshit what you’re really saying is, “if one person gets a benefit from quackery that should be good enough.”

I say when intelligent people cut through the bullshit of both conventional medicine and CAM, that they can get a better set of combined answers, more likely to multiply their remaining lifespan.

Titmouse@39
If I am sick and I get to pick between 1. prn’s opinions 2. peer reviewed evidence. I think I will go with #2.
Tittmouse, you're recasting my comment.
I do utilize peer reviewed papers, however, I am somewhat independent on their interpretation and utilization.

I'm sharing part of my experiences. Apparently I trust my opinion and methods, more than you trust your own opinion. So I understand and accept your choices without condemnation, for yourself. Good luck.

my replys and comments in the real #75," are awaiting moderation"

Opus: My condolences. Be kind to yourself.

And when the "Holistic medicine" doesn't work, it's gotta be the patient's fault for not being "totally focused".

Blaming patients for not being cured is such a predictably obnoxious trait of woo-promoters.

As always, I prefer medicine that works regardless of whether I'm mentally "focused" on the treatment, and whether I believe in it or not.

Quackery is known for its "heads I win, tails you lose" philosophy.

I might have to bone up on the subject matter a bit, but the company that e-mails me come-ons for primary care medicine jobs has come up with a real doozy.

Job Title: Family Medicine/Alternative Medicine Physician - Oregon Metro Job Summary: Greater Portland, Oregon Family Medicine 4.5-Day Work Week - 1 Year to Partner No Sales Tax - Tort Reform State Practice: Enjoy an outpatient only practice with a 4.5-day work week Base salary with partnership track of 1 year Work alongside 3 OB/GYNs, Family Nurse Practitioner and a Naturopathic physician Average patient load is about 16 to 18 per day-30 to 45-minute patient visits Have the ability to incorporate acupuncture or Osteopathic Manipulation Therapy into your practice-optional! Work with a team that combines conventional and alternative medicine to treat chronic diseases In-house lab, EKG and medical spa-ability to perform procedures once ramped up Be a part of a practice that believes in patient centered health care Hip, Urban and Affordable | No Sales Tax | Tort Reform Bedroom community to Portland"

Wow - hip, urban, affordable and less likely to be able to sue you into oblivion when the homeopathy backfires! Count me in!*

*on second thought, if you're seeing that many patients for up to 45 minutes each, you could wind up working 13 1/2 hour days and needing naturopathic stress relief. :(

@73

You're describing pharmaceutical research in motion. If one HIV vaccine candidate out of five shows significance of effect, that does call for more research, doesn't it? Hence, the increased funding to HIV vaccine research?

Let's also not forget that it's never one clinical trial that gets a drug or vaccine approved. If there's a Type I error in one trial, usually that will be confirmed or disconfirmed with another trial.

@ Opus:

I'm very sorry to hear of your loss.

Six weeks is an awful time in the roller coaster of an emotional schedule you're currently riding..

HOWEVER it may be better than three weeks. I hope it is.

I wish you can find something intriguing/ important/ meaningful/ not totally horrible with which to occupy yourself over the next few weeks.

Perhaps DJT and company with oblige with some hilarity and, at the very least, NOT a new war or a nuclear attack.

I will make note of Melania's / Ivanka's outfits.
I need something to look forward to
( although, personally, I doubt I would ever wear anything like what they usually choose)

"May i point out to you that Holistic medicine is based on the whole body being healed, when the patient is totally focused and making all the changes needed, thats when the medicine works properly. its alot harder to measure than giving a patient a pill and collating the results."

And may I point out that "holistic" was a huuuuuge buzz word in UK-ian nurse training back in the '80s: it was pretty meaningless then and remains so now...

And may I also point out that pretty much ALL "conventional" medicine is rather more than pill pushing?

@ Ben
For a drug, I think that one clinical trial may lead to approval. The example of the vaccine was to show that you don't need efficiency to make money. What you need is to convince governments to support basic research with a goal that politicians can understand. Then, if something emerge, make money until the drug is shown to be useless. Many anti-cancer drugs were successful in clinical trials without any effect in clinical practice.

Opus #45 I am sorry to hear about your wife.

Opus #52 I need to tell you I’m still laughing. (paraphrasing) What if they’re Calvinist ?

In the morning (I am PST) I'm going to play Rush's Free Will in honor of your wife's battle with recalcitrant cells. If you would prefer a different song, let me know and I will dedicate that to her instead.

The quackery that is "naturopathic oncology"

oracknows — Wed, 01 Jun 2016 04:00:51 +0000

The quackery that is "naturopathic oncology"

With a bill to license naturopaths (HB 4531) wending its way through the Michigan legislature supported by supplement manufacturers, its current status being in consideration by the full House of Representatives, periodically I feel the need to provide ammunition to the bill’s opponents, because we need to protect the patients in the state of Michigan from the naturopathic quackery that would be unleashed if this bill were to be passed into law.

If there is one area that naturopaths have been invading with a vengeance and even gaining enough seeming legitimacy to propose what they risibly refer to as “evidence-based guidelines,” it’s oncology. Many are the times I’ve written about how much naturopaths, who use the abbreviation “ND” (which from my perspective means “not a doctors”) and have formed their own specialty of “naturopathic oncology,” signified by FABNO (which I like to refer to as, “FAB? NO!”) subject patients to. Not surprisingly, one organization that’s really embraced naturopathic oncology is the Cancer Treatment Centers of America, a for-profit hospital chain that’s made its name advertising the “integration” of quackery with real medicine, known as “integrative medicine.” Depressingly, the Society for Integrative Oncology (SIO), an organization supporting the integration of “complementary and alternative medicine” (CAM) modalities (i.e., quackery) with real oncology, seems to accept naturopathy as a valid specialty, as two naturopaths were among the authors of the aforementioned SIO guidelines for the integrative treatment of breast cancer. As I found out, their naivete is profound, as evidenced by the SIO’s surprised and indignant reaction to my dwelling on homeopathy in my critique of integrative oncology. The SIO responded by accusing me of dwelling on the modalities with the “weakest evidence bases” (like homeopathy), apparently unaware that naturopathic training includes a lot of homeopathy and the naturopathic licensing examination (the NPLEX) has a whole section on homeopathy, and that one of the naturopaths who wrote the SIO guidelines for breast cancer was running a clinical trial of homeopathy at the time. Heck, an ex-naturopath has even revealed a scary practice question for the exam. That’s not even counting what naturopathic oncologists say when they think no one’s listening and the quackery to which they subject their patients.

Naturopathic oncologists even brag about it. They’re proud of it, so much so that they’re more than happy to publish what they do, as they did in this article for Integrative Cancer Therapies entitled Breast Cancer Integrative Oncology Care and Its Costs. But wait. I bet you’re thinking, “But, Orac, integrative oncology and naturopathic oncology are not the same things.” Right you are! Two of the authors of this paper are FABNOs, and they declare in the abstract, “Naturopathic oncology in conjunction with conventional treatment is commonly referred to as integrative oncology (IO),” and state specifically that the purpose of this study is to “To describe the types of IO therapies prescribed to breast cancer patients by ND FABNO physicians.” So, yes, this paper is about naturopathic oncology more than “integrative” oncology. Sure, there’s a fair amount of overlap, but not all integrative oncology is naturopathic oncology, although all naturopathic oncology is integrative oncology; that is, if you accept the nomenclature, which I do not.

Nor do I accept this premise of the study:

Because of their training and their licensed scope of practice, ND, FABNO are among those able to offer comprehensive whole-person integrative cancer care. For this reason, IO clinics directed by ND, FABNOs are a source of high-quality data for describing these therapies and their costs and measuring clinical outcomes. IO clinics are a rich source of data for cost-effectiveness research. Such care consists of a whole-person-oriented approach, including a variety of evidence-based complementary and integrative medicine practices that include a diversity of nutrient and botanical natural products, diet and exercise plans, acupuncture, hyperthermia, and mind-body medicine. Many of these therapies are based on clinical evi- dence. Although cost and cost-benefit analyses of CAM and integrated health care have been conducted5, and CAM use among breast cancer patients described, neither IO care nor its costs as it is practiced in community settings has been well described. Description of IO medical services is a required step toward evaluating its impact on disease-free and overall survival in breast cancer as well as measuring its cost-effectiveness.

Of course, to measure cost-effectivness, there has to be effectiveness to be begin with. With the vast majority of naturopathic treatments, the evidence of efficacy is sketchy at best, usually nonexistent, or at worst contradictory to any claims of efficacy. In any case, there were 324 patients with breast cancer treated at one of six naturopathic oncology clinics in the Seattle area, who agreed to be enrolled in a five year observational outcomes study. Of course, given that there’s no control group and any outcomes observed would have to be compared to historical controls, this trial design virtually guarantees that naturopathy won’t be embarrassed by poor outcomes, mainly because it’s likely that women attracted would be a select group. Indeed, I note that only 3.7% of the participants had stage IV disease when they sought out naturopathic treatment, and only 9.9% were stage III. Thus, the vast majority of the subjects had early stage disease. In fairness, though, I do note that only 6.2% of the patients had stage 0 disease (ductal carcinoma in situ, or DCIS, which is premalignant and noninvasive), a lower percentage than at most cancer centers.

Table 5 is the money table. It shows the types of treatments received by the subjects in the cohort who had at least two office visits. These included, predictably, a whole boatload of supplements, such as Coriolus, also known as Yun Zhi, Turkey tail, or Trametes versicolor, which an astonishing 62.7% of the patients received. I was unfamiliar with this particular herbal medicine. Basically, it’s a mushroom used in traditional Chinese medicine as a tonic. There are studies that suggest antitumor activity for some cancers, but the results in breast cancer have been unimpressive. The rest of the supplements included the usual suspects, such as melatonin, vitamin D3, digestive pancreatic enzymes, green tea, seaweed poultice, black cohosh, and many others. About 12.3% of patients received various injectables:

Of the 287 women described in Tables 4 to 6, 76 (26%) were prescribed some type of injectable therapy. Injectable IO therapies included subcutaneous injections of mistletoe (Viscum album) and a diversity of parenteral therapies that included vitamin B complex intramuscularly (12%), IV high-dose ascorbate (12%), IV artemisinin (7%), and IV nutrition and hydration (4%). Injectable therapies were used almost exclusively in stage 4 breast cancer patients (data not shown).

Other than hydration, the vast majority of these treatments range from quackery to unproven. Worse, they’re used for the patients who can’t be cured and would be expected to be most desperate. I’ve discussed high dose vitamin C/ascorbate on many occasions. It almost certainly doesn’t work for any cancer, and even if it does it requires incredibly high doses for incredibly underwhelming effects. As for nutrition, which is supposed to be the strong point of naturopaths, who castigate MDs every chance they get for supposedly not knowing much about nutrition and not emphasizing it enough in their treatments, this is what the naturopaths provided:

Whereas some patients (20%) were referred for nutritional counseling by a certified nutritionist, most received dietary advice from the IO physician within the visit. Dietary recommendations included increased green tea as a drink (24%), increased vegetables (17%), broth fast (16%), increased protein (13%), increased water (15%), reduced simple sugars (8%), increased fish (7%), and decreased mammalian fat (5%).

None of these are likely to be harmful, other than a broth fast, which is not a great idea for a cancer patient undergoing chemotherapy. Be that as it may, there were other recommendations that are less helpful, such as juice fasts, eliminating dairy, eliminating wheat, and the like. Of course, one can’t help but note that the 20% referred to nutritionists were almost certainly referred to woo nutritionists, as real nutritional counselors practicing evidence-based nutrition counseling are called dieticians.

In any case, the remainder of the modalities examined were of the “mind-body”variety, including massage, meditation, unspecified “mind-body” therapy, and qi gong, which aren’t likely to be harmful, but 6.8% were also referred for the quackery known as craniosacral therapy.

Now let’s look at the cost:

The direct costs of care include medical visits (naturopathic oncology consultation and mind-body medicine visits), procedures (acupuncture), and pharmacy. Pharmacy includes nutritional and botanical medicines administered orally, intravenously, subcutaneously, intramuscularly, or topically. Yearly cost for office visits ranged from $512/year to $1084/year. Stage 3 women had the most visits and the highest visit costs compared with women at other stages of breast cancer at diagnosis.

That doesn’t sound so bad. However, this does:

We asked the ND, FABNOs to describe an ideal core protocol for IO care for each stage and type of breast cancer. We then calculated the cost of IO pharmacy for 1 year of care for a stage 4 cancer patient. Table 8 presents an IO core therapy program for 1 year of treatment for a stage 4 breast cancer patient. Total cost of the medicines used in this treatment plan for 1 year is approximately $27137. Parenteral therapies were the most costly of IO treatments, and few stage 4 breast cancer patients completed such an idealized treatment. Total costs (visits and IO pharmacy and procedures) of 1 year of IO treatment for a women with progress- ing stage 4 breast cancer is approximately $31662/year. ND, FABNO visits cost approximately $4525/year (see Table 3). Office visits are reimbursed by medical insurance providers, including Medicaid but not Medicare.

Naturopaths will say that chemotherapy costs more, and that much is true. The difference, however, is that chemotherapy is an effective adjuvant therapy for early stage breast cancer and for stage III, while it can, when judiciously used, be a good palliative treatment for stage IV breast cancer. Nothing in the list of intravenous treatments for breast cancer listed in Table 8 is proven, either as an adjuvant therapy or palliative therapy. Certainly nothing in Table 8 is curative.

So how does one justify spending $30,000 a year on intravenous therapies that do nothing? The funny thing about this article is that it doesn’t even try. It is simply an observational study, which reported what treatments were received by this cohort of 324 breast cancer patients and how much it cost. The naturopathic oncologists and other authors of the paper seem to have simply assumed that these treatments are worthwhile and effective. They do not question them. From my perspective, doing studies like this is totally putting the cart before the horse. Efficacy should be established first, and then utilization and cost are worth studying. In the world of naturopathic oncology, it doesn’t matter if the treatments being studied work or not. In fact, this study gives a falsely reassuring picture of just how quacky naturopathic oncology and naturopathy in general are. Remember, this studied only clinics affiliated with an academic medical center, which are the ones that are trying to be the most "respectable" and whose practitioners are under the delusion that they are evidence-based. As I've shown many times, if you go beyond these clinics, you'll rapidly find incredible quackery offered, such as IV ozone therapy, homeopathy, applied kinesiology (a favorite!) for food "allergy" or "sensitivity" testing, and more quackery than I can describe in even a 2,000 word post.

I’d just like to leave with a question and an answer. The question is: Who funded this study? The answer: The National Center for Complementary and Integrative Health. Yes, the NCCIH continues to waste taxpayer money on pointless studies like this.

oracknows Wed, 06/01/2016 - 00:00

Categories

Medicine

Yearly cost for office visits ranged from $512/year to $1084/year.

The lower end of that range would be 3-4 office visits, for patients who are undergoing active "treatment" for a chronic condition. Let's just say that my BS detector is giving me a signal here. What are they not including in the cost of an office visit? And do they really see the patients that infrequently?

IV artemisinin. Great. There is no better way to ecourage the evolution of resistant organisms than to misuse antimicrobials. I hope this is not used by quacks in areas where malaria is endemic,

Still incredibly ill-informed about IV vitamin C.
Figure 52-104 infusions per year at $200 each. I paid less for retail service to the MD's office for 62 gram infusions in a large US city. That's $10,400 - $20,800/yr high side.

Even terminal, horizontal patients are put on their feet, able to go out and enjoy the day.

But one big deal is with respect to histamine, HIF-1a, KRAS mutant patients. This fundamentally alters cancer patients production of VEGF-A without the toxicity of Avastin or similar.

It must be embarrassing when drs so openly fall behind, that civilians can do better at home than at the hospital.

My challenge for quacks who want to be taken seriously is always the same. Show me one example of a treatment that was used by your community of practitioners, which was tested, found to be wrong, and discarded.

No field of human endeavour is immune from error. I don't think anybody would seriously dispute that. So either you have examples of things that have been abandoned as incorrect, or you have no functional mechanism for distinguishing valid and invalid therapies.

Any system of treatment that has no objective mechanism for self-correction, will necessarily result in a positive-feedback loop. And positive feedback loops always drive to the extreme. If you have no robust mechanism for testing, evaluating and discarding treatments then it is not only likely but pretty much inevitable that you will end up using dangerous and ineffective treatments.

@prn: IV vitamin C does not actually have any objectively demonstrable effect, so it doesn't really matter if the scammer is "only" bleeding the patient of ten thousand dollars (which is ten thousand dollars more than the annual cost of healthcare in my country, by the way) or a hundred thousand.

@ Guy Chapman

So either you have examples of things that have been abandoned as incorrect, or you have no functional mechanism for distinguishing valid and invalid therapies.

I remember an article by homeopaths testing different speeds of succussion to activate some nostrum. Their results showed that the speed set by Hahnemann more than one century ago was the best.
It's possible that someone got it right the first time, or that the technology available at his time was sufficient to test different modalities and focus on the better one - although there is no trace of these tests, AFAIK.
Still, these results were very convenient.

I remember an article by homeopaths testing different speeds of succussion to activate some nostrum. Their results showed that the speed set by Hahnemann more than one century ago was the best.

I haven't read the article in question, but this sounds like the kind of study where one needs to be especially careful about investigator bias. If the patient knows he's getting an "experimental" rather than "traditional" homeopathic remedy, that could have an effect--and the only way a patient would know is if somebody running the trial told him which group he was in.

I've been hearing about the Turkey Tail mushroom ( and Shiitake and Miitake ) for cancer for a long time- in fact, even though I can't access it now, I have a 1990s tome about natural health that discusses that .
IIRC prn knows about these therapies.

That's MAITAKE

Can we pause for a sec and talk about that question Britt Hermes posted? That kid is not just in respiratory distress; that's pending arrest. 60 and gasping is bad, bad, bad. 60 respirations is an easy one to remember because that is tachy at any age; at 8 that's more than twice the normal range.

And he's working hard. 60 is not sustainable when it's effortless. With the cough and gasping this kid is quitting sooner than later.

Note that there's no mention of mental status which would be the first thing I would need to know for deciding treatment. Normally you don't want to agitate croup patients but I'd they're altered you need to get aggressive.

And lastly, remember this is a phone call. A PHONE CALL! Doesn't the Ezekiel story make more sense? Tannis did exactly what she was trained to. How is it that they have any success when they kill children in their test scenarios?

Sorry for the digression Orac. Pediatric emergencies were my thing so that really grinds my gears.

@Guy Chapman #4:

So either you have examples of things that have been abandoned as incorrect, or you have no functional mechanism for distinguishing valid and invalid therapies.

Or, option C: they do not care which of their "therapies" are valid or invalid, as long as they attract marks.

Guy@5
@prn: IV vitamin C does not actually have any objectively demonstrable effect,
You're just parroting and shouting an extraordinarily uninformed, dogmatic opinion.
At 1 gram per kg, infusion time is the primary delay, otherwise for redox effects, including toxins, the benefits can visibly start in minutes. Toxins, ROS, and excess histamine are being chemically neutralized rapidly as well as other processes occurring.

We've had to implement several of Klenner's uses, including a smaller, slower motion version of the caterpillar incident, and our results are consistent with his.

(which is ten thousand dollars more than the annual cost of healthcare in my country, by the way) or a hundred thousand.
If IV vitamin C were streamlined for administration, the IV costs might be under £25 by UK medical accounting. Of course, US prices are way inflated, largely controlled by supplies, restrictions, and lack of volume and competition.

Denice Walter@8
I’ve been hearing about the Turkey Tail mushroom ( and Shiitake and Miitake ) for cancer for a long time
The asians have scores of turkey tail papers for PSK and PSP. My data show some improvement in 5FU-LV chemo activity, and was key to stopping/slowing/reversing WBC erosion on chemo. At something like triple dose, both PSK and PSP, I was able to spike WBC from 5 to over 9. A lot of chemo patients get in trouble when their WBC goes below ~1.5 after a few times or months.

One Japanese paper had data suggesting that PSK had a targetable OS association with initial CEA level.

@prn #12 Deja-moo: the uncanny feeling that you've heard this bull before.

Yes, quackery shills always describe the reality-based view as uninformed and dogmatic. They also come up with equally unhinged guesses as to how much the NHS could save by spending money on quacks rather than evidence-based treatment. Guess what? None of that counts. What counts is systematic reviews of large scale clinical trials, plausible mechanisms of operation, and (importantly) the advocates of a treatment not being obviously charlatans.

You’re just parroting and shouting an extraordinarily uninformed, dogmatic opinion.

I suggest you type the words "vitamin c" into the little box that appears at the upper right underneath the words "Search This Blog". That will allow you to read what Orac has posted on the subject in the past. You will find that in 2014 he commented on a paper that purported to show such an effect, and he was unimpressed by the evidence. He noted that very high concentrations of vitamin C (unrealistically high, in his opinion) were required to see any effect at all, and even then the effect was not terribly large. There were also issues with study design, something that happens with depressing regularity. The journal in which this study was published is a sister publication of one of the so-called "glamour mags": journals which have a reputation of pursuing impact factor at the expense of rigor. That by itself doesn't mean that this paper was wrong, but it's good reason to be skeptical, especially when the evidence presented is less than slam-dunk.

Of the 287 women described in Tables 4 to 6, 76 (26%) were prescribed some type of injectable therapy. Injectable IO therapies included subcutaneous injections of mistletoe (Viscum album)
Table five fails to mention mistletoe. What's up with that, Standish, Dowd, Sweet, Dale, Weaver, Osborne, Anderson?
Mistletoe injections are not approved for use in the US outside of clinical trials, yet NDs in Utah, California, Colorado, New York, Utah, Arizona, Vermont, and probably other states, advertise it as one of the possible therapies the ND may prescribe. If they are not reselling it, they teach patients how to obtain it illegally from Canada or Germany (its use is legal in both those countries).
I suppose either too few people have complained, or the FDA and the FTC have bigger fish to fry, but why do none of the naturopathic schools, 'professional' organizations, or naturopathic licensing boards sanction these NDs?

mho @16: Mistletoe! Right, because what I really want when I'm fighting an pernicious growth is injection with a plant that is a ... pernicious growth! Mistletoe is a parasite, and if it weren't so pretty in winter (giving it religious connections) then no one would let it grow.

@Eric Lund
yep, b.s. about the $. One of the FABNOs directs clients to obtain $1200 worth of blood tests before their first visit. Legitimate tests, but they are largely irrelevant. Said FABNO also has them repeat many of the tests on a monthly basis, even for clients who are in remission.

"Mistletoe is a parasite, and if it weren’t so pretty in winter (giving it religious connections) then no one would let it grow."

An example of survival of the cutest?

For the record, Trametes versicolor (syn. Coriolus versicolor) and crude extracts thereof are far from the same thing as the purified Japanese drug, PSK (Polysaccharide Kureha) derived from the fungus. Crude extracts are legally available as dietary supplements, but PSK is not. Yet, among others, naturopaths commonly conflate the two. What's next? Crude extracts of Taxus brevifolia or T. baccata conflated with Taxol?

There is no reliable evidence to show that either a crude extract of the fungus, PSK, or PSP, another polysaccharide derived from the fungus, are effective against breast cancer. To suggest otherwise is unconscionable.

Eric Lund@15
Guy: @prn: IV vitamin C does not actually have any objectively demonstrable effect...
prn:You’re just parroting and shouting an extraordinarily uninformed, dogmatic opinion.

Eric, my comment in this exchange refers to treating acute viruses and toxins with IV C, not cancer which is far more lengthy and complex. MSM has sidelined a full tx where NNT-->1 for too long. Probably the simplest solution is to vote with our feet, our dollars and faint praise.

....and he was unimpressed by the evidence. He noted that very high concentrations of vitamin C (unrealistically high, in his opinion) were required to see any effect at all, and even then the effect was not terribly large....
MSM once again missing the boat. While C itself is a mild tumorcide, it's properties against histamine, HIF-1a, VEGFA are being more recognized as antimetastatic.

Increased tumorcidal performance is achieved with multiple adjunct modulations and even light chemo like oral 5FU drugs. We're increasingly unimpressed with MSM.

@ Guy #5: I disagree that it doesn't matter if the scammer is only getting $10K vs $100K since the treatment doesn't work.

It matters. It matters a lot. What I think this study Orac has discussed does is expose naturopathy for the financial fraud that it is. Orac is right when he says you study efficacy before you study cost. The study authors skipped that part, so what they have shown is cost without proof of benefit, a benefit they didn't show because other studies of these "treatments" have shown little to no benefit.

So if you're giving a patient treatments you know don't work, that's fraud.

The good news is, now that we know how much the fraud costs, since there is no demonstrable benefit, CMS will not classify these treatments as best practices under the ACA, and quacks will have a hard time getting Medicare to reimburse for them, which will give insurance companies leverage not to reimburse either.

mho @18
One of the FABNOs directs clients to obtain $1200 worth of blood tests before their first visit. Legitimate tests, but they are largely irrelevant. Said FABNO also has them repeat many of the tests on a monthly basis, even for clients who are in remission.
Do you have a link or a name that discusses the test details?

For a high risk, borderline stage III likely to recur the first 2 yrs, $1200 per month is an investment if it alters the odds or detects a recur sooner. An unresectable recur in CRC likely means $50-60,0000 per month in billed costs, plus social costs (e.g. jobs and young kids) and death.

If the test series streamlines with a learning curve, areas of application are defined, or costs are reduced with volume or competition, then I call that progress.

Lighthorse@20
For the record, Trametes versicolor (syn. Coriolus versicolor) and crude extracts thereof are far from the same thing as the purified Japanese drug, PSK (Polysaccharide Kureha) derived from the fungus. Crude extracts are legally available as dietary supplements, but PSK is not. Yet, among others, naturopaths commonly conflate the two.
PSK in Japan can have a common source for a supplement sold in the US. Sometimes fiber products are imported from multiple sources, graded, and sold as different lines of supplements

prn: if the tests don't have anything to do with a recurrence of cancer, then it is NOT money well spent.

Pancea@26 I'd like to see the specific tests myself. I have found NCCN and ASCO guidelines insufficient for my purposes, so I am curious there. Also I have a friend that gets a different set of tests from an ND that I'd like to see the differences there too.

@prn #25: That doesn't mean anyone is taking PSK in the clinical doses used in Japan in supplements sold in the US.

Here's an example of the kind of conflation of PSK and Trametes versicolor that I mentioned in my earlier post. It's one of the worst studies on breast cancer that I have ever seen. Guess who was behind it? None other than Leanna Standish, ND, PhD, LAc at that illustrious bastion of bull, Bastyr University. Moreover, to call T. versicolor a "mushroom" is just plain wrong for the simple reason that it lacks a fleshy cap.

Follow the hype and you will find the product used in the study is made in the U.S. and promoted by the manufacturer in direct regard to breast cancer. WARNING: the video may cause certain viewers to become upset.

ADDENDUM to #29: Contrary to the simplistic description of <A HREF="Standish et al, PSK or "Krestin" is not a mere "hot water" extract of the inedible wood-rotting fungus T. versicolor.

Well, that failed. The reference to Standish's claim of PSK being a mere "hot water" extract of the fungus is:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369477/

Sort of O/T but here's a good example of what happens in the university department of medicine when you let in the trojan horse of "integrative" medicine: Spoon-bending workshops.

http://www.cbc.ca/news/trending/university-alberta-spoon-bending-1.3612…

Yes, I'd like to know more, and please do post the list of what the ND you know orders. I have no medical training, so I'm not 100% sure of myself here and I'm quite curious about them. I asked about a few of these tests and googled others, but I didn't want to waste much of my physician's time on naturopathic baloney. I'm somewhat familiar with a number of the tests, although neither my primary or my onc. orders them routinely--for example we check thyroid about once a year. A friend asked her nurse practitioner, who laughed, and then got mad and took a copy to share with her colleagues.
Ferritin and copper are the first two that come to mind. Yes, ferritin might have something to do with fatigue, but if RBC is in normal range, why would a ferritin test be called for, particularly if the ND had not seen the client or taken a history yet? And why do serrum copper and ceruloplasmin? Give patients something else to worry about, that the naturopath can claim to fix, again--typical. I'm not a doctor--but testing for copper? What's she going to do, recommend--chelation? Yes, there're some mouse studies about copper and cancer, but this is so typically ND--experiment on patients.
Homocysteine?--again, without having a history? He4 plus a CA-125? CA-125 is a better marker, and without even knowing if the CA-125 is a good predictor for that patient, why order it in advance?--its a $300+ test. Why get it monthly? HgA1c--I asked my oncologist, and he said the tests he does make the hgA1c unnecessary. And again, monthly? C-reactive protein isn't even done routinely for heart patients, is it? Is an “anti-inflammatory diet” (that nds love) meaningful for cancer patients, or anyone else? Isn't the gene mutation that a G6pd reveals very uncommon?, but then, you need that if you're going to sell IV vitamin C, don't you?

TPO antibodies, antithroglobulin, TSH, T3 and T4? As far as I know, another naturopath gambit is sub-clinical thyroid disease. All those tests are on top of the tests an actual oncologist would d, and (cbc, magnesium, phosphorus, white blood cell, RBC, various sed rate tests that I don't have in front of me) And there are a few others that I may have copied incorrectly and don't recognize. -d-dimer, Pal-1. vegf. (is vegf a rountine test now? Lets see what I forgot...insulin, Ig1, fibrinogen.
The $1200 was using the price list from one of those online discount labs, so I don't know if the prices are accurate, I'd guess normally they cost more.

D dimer? We use that to test for coagulation disorders, specifically to rule in or out pulmonary embolism, DVT or DIC.

If a patient is in remission, there is no clinical indication to test for that unless they are symptomatic.

It’s one of the worst studies on breast cancer that I have ever seen.

It's from Hindawi. I'm sure you can find something even worse.

From Lighthouse's link:

one-way ANOVAs with Turkey post hoc multiple comparison

FFS.

It’s one of the worst studies on breast cancer that I have ever seen.

I grant you, collecting three heterogeneous cases and calling them a "cohort" is hard to beat.

Thanks panacea. Any info for me on the other tests?
See what I mean?-legit. sounding tests--not so quacky as live-blood analysis--but inappropriate and therefore unnecessary. This Nd, and all of them I suppose, launches into a full-on gish gallop about these, and her clients are dazzled and think she has such a wealth of information that they can't get anywhere else. Never mind that they haven't a clue what it means...

Well, and I should clarify that we wouldn't do a d dimer for a cancer patient in remission unless they had s/s of DVT, PE or DIC, not if there was a question the cancer was coming back. Sorry if that wasn't clear.

I'm a nurse educator, not a physician, and I don't work in oncology (my first job was on a med surg/oncology floor but that was 30 years ago) so I'm not familiar with every one of the tests you mentioned. I wrote about the D dimer because that one stunned me so much.

TSH, T3 and T4 is a thyroid panel. TSH is Thyroid stimulating hormone, T3 (triiodythyrone), and T4 (thyroxine). The thyroid is a gland in your neck that produces hormones that play an important role in metabolism, oxygen consumption of cells, and calcium regulation (through production of calcitonin). That's way over simplified btw. Usually if the TSH is high, the thyroid is hypothyroid, and the correction for that is adding iodine to the diet (which is why we add it to salt because it doesn't take much). Hyperthyroidism is a cause of Graves Disease.

The only reason to do a thyroid panel is to check thyroid function. But if someone was treated for thyroid cancer, part of the treatment is to remove the thyroid, to my knowledge they take out the whole thing and it doesn't grow back. Patients have to be on life long Synthroid and calcium supplements. So doing that test at all, much less monthly, is completely unnecessary and expensive.

There are some people who have a normal thyroid panel but still have a thyroid disease, but they are rare and there is a more sensitive test for that but I can't remember what it is. It's not tracked monthly, and it should be diagnosed by an endocrinologist not a naturopathic quack.

HgA1C measures blood glucose consumption over the 120 day life cycle of a RBC. Totally unnecessary to do monthly.

C reactive protein is an inflammation marker. It's more sensitive than the erythromycin sedimentation rate (sed rate). In people with cardiovascular disease, it indicates risk and possible indication for statins. There's been some study of risk relative to colon cancer, but that's fairly new and I don't know much about it. But it wouldn't need to be done monthly.

Yeah, you can test to see how much insulin is in the blood, but we control it by measuring the blood glucose. Knowing what the insulin level is is only useful in some limited diagnostic instances, like when trying to decide to switch a Type II diabetic from an oral med to insulin. But since that decision can be made with less expensive tests based on clinical judgement of the physician (and we have tons of literature on how to do this, so doctors have a good grasp of what they're doing) there is no need to do this test for most patients and again, it tells us nothing on a monthly basis.

Fibrinogen only tells us something about how the coagulation system is working. A doctor would only order it for someone who is having bleeding issues that are difficult to control. I don't see what it has to do with cancer, nor that it would be useful on a monthly basis.

Ig1, I guess that means testing the immunoglobulins (IgA, IgG, IgE and IgM) antibodies. It's a measure of our immune systems, or part of it (our acquired immunity, ironically this is the part of our immune system vaccines stimulate). Again, unless the patient is having a problem with recurrent infection I don't see a need to test for it, certainly not monthly.

Most of the others I'm unfamiliar with. I'm sure some of the physicians here can correct any errors I've made or elaborate further if needed.

Oh yes. All those tests. You have to understand that naturopathis are constantly seeking ways to justify their experimentation on people. If they can make some correlation to a marker, all the better. Let's see. Thyroid function, because without it, how would the body make T cells? But C-reactive protein and cancer? Last time I checked up on the subject, which was about 5 years ago, I came away unimpressed. CRP levels were often elevated in people with excessive body fat around the waist, whether they healthy or not. CRP is a non-specific marker associated with inflammation, but not an inflammatory substance itself. But hey! The more tests you do, the more likely you are to come up with some correlation or other to justify your beliefs, experiments on people, and your bill!

Well, except that T cells form in the bone marrow (like all blood components) and populate the thymus (not the thyroid) to differentiate into the various types of T cells.

But I can see how a quack could confuse the two. ;)

The extra blood tests typically reflect the environment of cancer (e.g. inflammation sources increasing cytokine levels) and nonspecific markers that become more useful in advanced cancer.

I've seen a lot of friends and acquaintances blindsided by misdiagnosis (early or missed stage 4's dx'd as 2 o3) and missed recurs, and die sooner. Belated dx means they missed their last windows of curative tx.

Assiduous tracking of extra bloodwork means fewer surprises and a better handle on what's going on. The naturopaths are also attempting to modify the molecular environment of any residual cancer cells, keep them quiescent if possible and improve immune performance (leucocytes full of ascorbae, lower inflammation, etc) .

D-dimer can be used for prediction of CRC mortality or and nonspecific detection of recurs, or even tx. Some papers:

Preoperative plasma D-dimer predicts 1-year survival in colorectal cancer patients with absence of VTE

Elevated D-dimers are also a marker of underlying malignancy and increased mortality in the absence of venous thromboembolism.

Systematic review- D-dimer to predict recurrent disease after stopping anticoagulant therapy for unprovoked VTE.

Oy. Where to begin.

First of all, NONE of the articles you have cited have anything to do with detecting a remission of cancer, which is what the original discussion was about.

The first two articles are about research that is suggestive that a positive D Dimer is correlated with a poor prognosis in colon cancer in patients who do not have a VTE, but it doesn't tell you anything of use beyond that. There is no reason to "assiduously" track this blood work, certainly not on a monthly basis. Just what is a practitioner supposed to do with these results? Your first article only indicates a lower 1 year survival rate than the negative D dimer group. It doesn't change the course of treatment though, and there's nothing to indicate a recurrance of cancer, only a correlation of outcomes.

What needs to be done with this research is to determine WHY an elevated D dimer results in worse outcomes for those who have a negative D dimer; what is it about the coagulation cascade that is at play here, why, and through what mechanism. THEN we can start thinking about how to use this result clinically.

Your third article is completely irrelevant as it has nothing to do with cancer.

This is just taking research and using as an excuse to over treat for billing purposes.

prn, are you just googling papers and posting them without checking content or were you hoping we wouldn't check? Seriously, that is some of the laziest cherry-picking I've ever seen.

As Panacea said, the third paper is on the recurrence of venous thromboembolism not cancer. This is why I generally choose not to engage people like you and Keith Bell. It takes so little effort to google a handful of papers that superficially support you and much more effort to show otherwise.

That said I couldn't resist here because it was such a nice demonstration of your intellectually dishonest methods. And this is the best way to counter the Gish.

I turn off the killfile for a bit only to find that prn has adopted the majestic plural? Lesson learned.

Narad
I turn off the killfile for a bit only to find that prn has adopted the majestic plural?
Not sure where the the royal "we" is here, Narad. If I say "we" , that's my family or some part.

capnkrunch
Yeah, there were a bunch of new papers. Read two more (I worked on this area 5 yrs ago). I meant to grab a few correlated studies then ran out of time, and had to hurry off too quick.

Sloth. I'm assuming "the Gish"" is Duane Gish?

Panacea@
There is no reason to “assiduously” track [D-dimer] certainly not on a monthly basis
I don't. CEA works well, so DD is low priority, annually, right now. If I were an advanced CRC patient with low CEA values at dx, I would consider DD instead.

Assiduous tracking of extra bloodwork means fewer surprises and a better handle on what’s going on.

I 'm tracking several cheap markers including CEA "at base frequency" (10-65 days depending on circumstances). CA199 costs me money though. Some bloodwork I get ca every 4-5 mo. I can't arrange d-dime for the LEF price of $60, so it's annually.

...using as an excuse to over treat for billing purposes.
You realize that I'm on the buy side and not the sell side?
And no, I didn't get from an ND.

Yep, You guys are really on your toes. Mine, too.

Speaking of cancer quackery, this is what black salve can do.
NSFW Warning.
http://thatviralfeed.com/u842p409/woman-left-with-massive-hole-in-her-n…

Sh*t naturopaths say, part 3: Nobody expects the Spanish Naturopathic Inquisition!

oracknows — Thu, 25 Feb 2016 07:35:16 +0000

Sh*t naturopaths say, part 3: Nobody expects the Spanish Naturopathic Inquisition!

When last I visited this topic, I was highly tempted to start out out by making a simple observation, namely by quoting John Wooden's famous adage, "The true test of a man's character is what he does when no one is watching." Since I didn't use it for the two posts I did on this particular topic, Sh*t naturopaths say and Sh*t naturopaths say, part 2, I just did it for this post. It's the perfect quote for this topic.

What I'm referring to is a private discussion forum for naturopaths known as Naturopathic Chat, or NatChat for short, and how a leak from the group had revealed the sort of pure quackery that naturopaths talk about when they are among themselves and think that no one else is listening. Basically, NatChat revealed just how quacky naturopaths are, based on the advice they gave each other about patients and their general discussions of what passes for "naturopathic medicine." I found examples of naturopaths recommending intravenous peroxide, homeopathic drainage therapy, black salve (for a huge protruding breast cancer), and (elsewhere) even ozone to treat a postsurgical J-pouch abscess that clearly required the attention of a colorectal surgeon. After naturopaths on NatChat became widely aware that someone on the list had revealed discussions on the list, apparently the moderators, instead of moving to another platform, stayed on Yahoo! Groups.

None of what I've described in this brief recap of my first post about NatChat should be surprising to regular readers of this blog (and my not-so-super-secret other blog), who would also know that I am not particularly fond of naturopaths, even the nice ones, who might be perfectly fine as people. Of course, it is naturopathy we don't like, mainly because it is, as I like to describe it, a cornucopia of quackery based on prescientific vitalism mixed with a Chinese restaurant menu "one from column A, two from column B" approach to picking quackery and pseudoscience to apply to patients. Indeed, whenever the topic of naturopathy comes up, in addition to suggesting that they search this blog for the word "naturopathy," I like to refer readers to Scott Gavura's excellent recurring series "Naturopathy vs. Science," which has included editions such as the Facts Edition, Prenatal Vitamins, Vaccination Edition, Allergy Edition, Diabetes Edition, Autism Edition, Fake Diseases, and, of course, the Infertility Edition. I've also described just what happens when a naturopath tries to treat a real disease like whooping cough. The results are, to put it very mildly, not pretty.

Of course, as I've pointed out, any "discipline" that counts homeopathy as an integral part of it, as naturopathy does to the point of requiring many hours of homeopathy instruction in naturopathy school and including it as part of its licensing examination, cannot ever be considered to be science-based. Not surprisingly, we oppose any licensing or expansion of the scope of practice of naturopaths, because, as skeptics have explained time and time again, naturopathy is pseudoscience and quackery.

Interestingly, what led the Reddit user and naturopathy critic NaturoWhat (who inspired my earlier posts regarding NatChat) to give me the heads up as to what's going on in NatChat again is an incident on the discussion board involving a naturopath who featured in the previous edition of my coverage of NatChat, Eric Yarnell. He's a naturopath who tried to point out to his fellow naturopaths how black salve is a really nasty treatment because of the way it fries normal tissue just as badly as it fries abnormal tissue. He also appears to be one of those rarest of beasts, a seemingly pro-vaccine naturopath. I say "seemingly," because whenever I encounter a naturopath billing herself as pro-vaccine (e.g., Erika Krumbeck), a closer examination of his or her views almost always reveals he or she believes in at least some antivaccine misinformation. Surprisingly, Yarnell is the naturopath who comes closest to actually being pro-vaccine that I've seen.

That being said, it must be noted that questioning naturopathic dogma about vaccines, in which the risks are inflated and the benefits downplayed, is what got Yarnell in hot water over at NatChat. Basically, he didn't expect the Spanish Inquisition to descend upon him, but it did, with about as much competence as the characters in the famous series of Monty Python sketches.

Basically, his story taught me two things. First, there do exist occasional naturopaths who are not as antivaccine as the vast majority of naturopaths and might even be called pro-vaccine. Second, all you have to do as a naturopath to be attacked or even shunned by some of your peers is to cite approvingly anything on this blog or other "quackbusting" blogs or to be written about in less than a derogatory fashion by "quackbusters." That alone is enough for you to fall under dire suspicion by your fellow quacks to the point of being temporarily banned from a discussion forum like NatChat.

Naturopathic apostasy, or: How dare a naturopath say vaccines are safe?

NaturoWhat was kind enough to provide me with a link to a Pastebin containing more recent posts on NatChat. The most relevant conversations occur in these files, spanning discussions going back a couple of weeks:

The fun (such as it was) began on February 17^th, when a naturopath named Laura Flanagan noted that Yarnell had been "booted off NatChat" (errors in original):

I am very disappointed in the decision to kick Dr Yarnell off of NatChat. He is a dedicated ND who has given more to our profession than just about anyone I can think of. I appreciate his wisdom and always read his posts ( except for this week because because I am really tired of the vaccine bickering) with extra care. He has great knowledge that he shares generously. He is not a traitor to our profession and I think the accusation was a mean spirited, uncalled-for attack.

I hope that his banning will be recinded soon.

So I'll give Flanagan credit in that, although she notes that most of the naturopaths on NatChat disagree with pro-vaccine viewpoints such as those espoused by Yarnell, she at least thought it was unfair that Yarnell had been booted from the group. I'll also give several other naturopaths credit that they, too, were very upset about Yarnell being removed from the group, some, like Joshua Goldenberg and Ron Mariotti, so much so that they told the moderator of NatChat, Mona Morstein, point blank that if Yarnell's removal from the group stood they'd be leaving the group too. On the other hand, certain naturopaths defended Morstein for her actions. The whole kerfuffle lasted a few days and provided an impetus for naturopaths to show exactly why they are not science-based.

We learn a little later from a naturopath named Shiva Barton that, allegedly anyways, it wasn't Yarnell's pro-vaccine views that got him booted but this:

According to Eric he was not removed for his pro-vaccine views. He was temporarily removed because Mona thought he might be the Britt mole because evidently he cited some research from her group. De-listing him is misguided - McCarthyism at its finest. Now, I can see banning Eric because he is really pale (we should be tanning him, not banning him) or because has a bad sense of humor, but the guilt by association thing is a little scary. I know that Mona deeply cares about NatChat and it bugs her no end that there is a mole. However, it is not a logical conclusion that citing that research equates with moledom. So, Mona, please let the dude back in so I can continue to skip over all this back and forth vaccine stuff and steal Eric's clinical pearls when he responds to other posts with his continued very useful information.

Barton is correct. It is not a logical conclusion, but given how antivaccine most naturopaths are it is not in the least bit surprising that, in a situation where there is a suspected mole, suspicion would fall first on the member of the group espousing viewpoints that do not jibe with the prevailing views of the group.

Now here's where things get interesting. Morstein, obviously stung by the criticism, tries to explain why she banned Yarnell:

I always wish to have NatChat be transparent. It is true I have temporarily removed Dr. Yarnell, but not due to his innate views on vaccines, food allergy testing or whatever. NatChat welcomes all views on topics. However, without going into details, behind the scenes (and yes, also due to his using Gorski as a reference) some concerns have risen about Dr. Yarnell. This is a test removal. If the flow of information to Britt is not stopped by Dr. Yarnell's removal, I will offer a very sincere, heartfelt public apology to him and Natchat. However, I feel it is my responsibility to try to do whatever I can with whatever clues come my way to staunch the flow of information to Britt Hermes.

I do not wish for this to cause people to be upset or resentful. We need to keep our profession together since many outside people are against us. Please trust me that I do not do anything willy-nilly and needed to accumulate information before taking this step.

So let's see. Yarnell used me as a reference, and suddenly he's suspected of being the NatChat mole! I never realized I (or my not-so-secret other blog) wielded so much power or struck so much fear into the heart of naturopaths, or that citing me approvingly must mean that you would betray your fellow naturopaths by leaking their secrets! Seriously, I highly doubt that Yarnell particularly approves of me, even if he was willing to cite me in a discussion about vaccines. In fact, I know that, in spite of the fact that he appears to be much closer to the science on vaccines than his fellow naturopaths, even Yarnell doesn't much like science-based medicine and "quackbusters":

I am sorry, but I don't keep a map on my wall of all the opponents of naturopathic medicine. I don't look up the history of every source I cite. No one does this. And if I am to be banned and accused of being a traitor or a mole because of citing a source you or anyone doesn't like, then this list definitely needs to be shut down.

And:

No, I don't like, support, or agree with the quackbusters on issues of our profession. They are biased and uneducated about this. I don't know what Orac or some other specific people have said against our profession, but I know their ilk. But I do know that the specific post Orac made regarding immunization that I cited has useful information in it and it supported how I came to my position about immunization. I both stand by the citation and my right to use it without buying in to the anti-naturopathic pap from the same source.

So what happened? Basically, here's where he committed the offense that got him banned. In response to questions about William Thompson, the CDC scientist who became the "CDC whistleblower," Yarnell cited two posts, "The William Thompson Documents. There's no whistle to blow" on Left Brain, Right Brain, and this post by me about William Thompson having apparently gone all antivaccine. In response, the reaction was—shall we say?—not positive, not positive at all. Apparently, it went beyond just complaints on NatChat to private e-mails to Morstein accusing him of being the mole.

Paranoia, much?

Quote naturopath Michael Uzick: SBM is criminal!

If there's one thing I've learned from this latest dump from NaturoWhat, it's that naturopaths, really, really hate us here at SBM. Frequent were the references to us as "quackbusters" (they say that as though it were a bad thing) and complaints about us being biased. Of course, I am biased—biased towards science, which is exactly why I have such a big problem with naturopathy as a profession. To some, it goes beyond this. At least one naturopath, Michael Uzick, appears to think we are criminals:

I also agree with all of the great things mentioned about Dr. Yarnell. However, citing a "Science based medicine" criminals, who are actively trying to destroy our profession is shocking to me. This same group are [sic] using posts from this forum to damage individual naturopaths and our profession. To essentially post as evidence to support vaccination something Britt Hermes or her boss has written definitely begs the question of whether Eric is the mole?

Anyone want to bet whether it was Uzick who complained to Morstein about Yarnell and accused him of being the "mole"? There's no way of ever knowing unless one of them reveals what happened, but my money's on Uzick. That's not a particularly difficult guess to make, though, given that at one point Uzick explicitly asks, "Eric Yarnell, are you the mole?"

Whether I'm right or wrong about this guess, at this point I didn't know whether Uzick was referring to me as Britt Hermes' boss (because she has provided me with guest posts for my not-so-super-secret other blog) or Yarnell (Britt informs me that he was her former teacher). Certainly, I am not Britt's boss in any sense of the word. I do, however, admire her courage in having realized how full of pseudoscience naturopathy is and, above all, for having the courage to make a very difficult mid-course career change after having spent so much money and effort to become a naturopath. I admire her speaking out on her blog, Naturopathic Diaries. It should also be noted that Uzick isn't exactly a reputable character by comparison. A Google search on his name quickly revealed this RationalWiki entry on him, which tells me that he is another "naturopathic oncologist" who is also an HIV/AIDS denialist and imported and administered an illegal cancer drug called ukrain to his patients. This led to him being disciplined by the Arizona naturopathic board with a letter of reprimand, which is pretty damned bad; given how pathetically inadequate the regulation of naturopathy is in states that license naturopaths, any sort of formal reprimand of a naturopath is very damning indeed. Yet Uzick remains a respected member of the naturopathic community.

And here's another little tidbit, pointed out by a naturopath named Lisa Chavez:

I have to say, respectfully so, that Dr Uzick it is really ironic that you of all people would name Dr Yarnell, (one who I know to be as genuine a nerd and naturopathic patriot as you can possibly find which I say that with fond respect) as a potential mole when you run the clinic that Britt Hermes worked at in Arizona, no?

Dr Uzick, it would really be insightful to hear your take on Miss Herpes [sic and sick] tales, I don't recall ever hearing your side of the story- like have you filed suit for defamation, etc??

"Miss Herpes"? How childish. (And, no, I don't think that was a typo.) It's also interesting to learn that Uzick was Britt Hermes' boss.

I will give Yarnell proper credit, though. He is quoted twice as having said, "I continue to say to those who don't support the CDC schedule to present evidence of something better." Truly, he apparently is a rare beast, indeed. Whenever he's quoted saying this it causes a backlash of antivaccine pseudoscience, such as this bit from a naturopathic oncologist named Colleen Huber who lists herself as the President of the Naturopathic Cancer Society:

Abundant evidence exists that the CDC schedule, and that most vaccines used in the United States, are both dangerous and ineffective.

Over 400 studies in fact, that have been published in the medical literature, including in journals such as: Pediatrics, Lancet, BMJ, JAMA, Infection, Neurodegeneration, showing the risks and failures of vaccines. Many of these studies are referenced in Neil Z. Miller, Critical Vaccine Studies. This book would be a good place for you to start.

If you are interested in learning about the history of vaccines, the most comprehensive and objective book that I have read is Suzanne Humphries, MD, Dissolving Illusions.

It is impossible for you to read either of these and be willing to give even one more vaccine, having learned of the damage already done, the evidence that the vaccinated suffer so much more than the unvaccinated, both from infectious diseases and vaccine side effects. First Do No Harm requires that naturopathic physicians not administer vaccines, at least not in their present form. If a much safer, more effective vaccine is developed in the future, I will keep an open mind, but will not administer it until proven safe and effective in credible, uncorrupted double-blind studies. Those studies have not happened with current vaccines.

First I see Michael Uzick and what I view to be his highly unscientific "medicine," which includes high dose intravenous vitamin C, mistletoe extract, homeopathy, detoxification, and hydrotherapy (among others) as therapies for cancer. Now I see Colleen Huber citing Suzanne Humphries and Neil Z. Miller as authorities on vaccination? And naturopaths wonder why I consider "naturopathic oncology" to be 99% quackery! Suzanne Humphries? Seriously? We've met Humphries before. She is antivaccine to the core, refers to vaccines as "disease matter," and routinely uses among the most ridiculous antivaccine arguments there are out there. And Neil Z. Miller? He's at least as bad! He fancies himself an epidemiologist and vaccine researcher. Perhaps the most hilariously bad example of his "work" (if you can call it that) was his truly risibly incompetent attempt to negatively correlate vaccination schedules of various countries with their infant mortality rates. I deconstructed his pathetic attempt at science when it was first published. Basically, he used typical antivaccine tricks to artificially inflate the number of vaccines American children receive and appears to have cherry picked the countries used. It doesn't get much worse than Miller's work. He also wrote a book with Mayer Eisenstein, who was pretty damned antivaccine himself, purporting to provide a "balanced" view of vaccine but citing Andrew Wakefield and the like. Harriet Hall tore it apart with facts and science.

This is the sort of "evidence" Huber considers so compelling, Suzanne Humphries, Neil Z. Miller, and a bunch of crappy studies that antivaccinationists occasionally manage to get published in real peer-reviewed journals, rather like how antivaccinationists managed to get a dubious article claiming to link Gardasil with behavioral issues published in Vaccine, of all journals; that is, at least until editor-in-chief Gregory Poland found out about it and got it removed for further review. It happens. (Fortunately, Poland retracted that study.) The overwhelming bulk of the science of vaccines indicates that they are safe and effective and do not cause all the harm that antivaccine naturopaths (but I repeat myself) like Huber seem to think they do.

Later in the thread, Uzick compares advocates of science-based medicine to a number of bad things. Specifically, he likens citing our writings to citing Nazi eugenics, the terrorist group ISIS, and tobacco company denialist science, a trifecta of poisoning the well:

Simply, these people have one intention, to destroy naturopathic medicine. I'm a naturopath and thus I'm offended by them and anyone who would use as credible the blogs of the most biased, unscientific and vicious opponents of naturopathic medicine.

There have been a lot of erroneous assumptions put forth today. Perhaps the most important is my assumption that you were aware of who the science based medicine/quackbusters are and Britt's connection with them. In addition, her long list of activities fighting against our legislative efforts, regularly slandering our profession in articles and blogs, attacking individual doctors and engaging in the exact same tactics the quackbusters have always used.

Of course you are free to cite who ever you like. But if you cite in a professional medical forum, tobacco industry "research", Nazi eugenicists blogs, ISIS medical hypothesis or the quackbusters that slander you and our profession and who are bent on its destruction, you might expect a provocative response in return.

Gee, Uzick says that as though he thinks that were a bad thing! And of course, we're just like ISIS. Note our support for beheading apostates. Don't forget the Nazi eugenicists and how we advocate forced sterilization and the euthanasia of the severely handicapped. Oh, wait. We've never supported or advocated anything like that! Actually, judging from how some naturopaths started suspecting Yarnell of being a mole just for citing science-based sources, one can't help but wonder if there is a bit of projection here.

I will make no bones about our stance that naturopathy is quackery and therefore not a legitimate medical specialty, however. There is simply no other way to put it, given that one of its "core competencies," if you will, is homeopathy. As long as that is true, naturopathy can never claim to be science-based, never claim to be anything more than quackery. Uzick and his naturopath colleagues, however, seem to have an apocalyptic view of their opponents' efforts against them, as you will see.

Criticism on the Internet ≠ Terrorism

So, based on the existence of a mole on their discussion forum, the denizens of NatChat recently devolved into borderline paranoia and mutual accusations over who might be the mole. Although it got heated and then Michael Uzick seemed to back down and apologize, it was clear that there was a lot of suspicion and hostility. Of course, this is not surprising, given that Uzick seems to view our activities at SBM, Britt's activities on her blog, and the activities of other supporters of science-based medicine who oppose increasing the scope of naturopathic practice as terrorism, as he tries to explain why Morstein might have banned him:

Mona and our profession are being terrorized. She was thinking of the greater good and has been through a lot. You may not have understood that Britt is working for them and who they are, but Mona does know and cares about this profession.

I'm sincerely sorry for the degree of upset you appear to have over my question to you. It's not about you Eric. It's about our enemies. We are on the same side and there has been confusion, assumptions and hurt feelings that are obscuring the truth.

Uzick is not alone. Elsewhere, Colleen Huber notes that they might not have a mole, that maybe it's a hacker getting their information through leaky e-mail servers. She mentions "core naturopathic principles, and our comprehensive medical education, and our board exams that no MD has EVER passed (without also going through ND education), even though our clinical questions on NPLEX are indistinguishable from those on USMLE," which gave me a hearty chuckle because no MD would really want to pass the NPLEX. Also, I dare Huber to show me the USMLE questions on homeopathy that the NPLEX has, given that homeopathy is a key component of naturopathic education and featured prominently on the NPLEX. I highly doubt that there are questions like the NPLEX homeopathy questions on the USMLE. But, in reality, what Huber really, really hates are quackbusters in general and Britt Hermes in particular:

Letting the disgraced Hermes silence us, in any way, is letting the terrorist win. She does have control over the Wikipedia page, but intelligent laypeople can see past the desire to label any evidence that is inconvenient as "pseudoscience." Wikipedia can tell you how many kangaroos in Australia [sic], or how long the Mississippi River is, but it is notoriously untrustworthy and inadmissible as reference in universities and even now in some high schools. Intelligent laypeople I think are mostly on our side whenever they go to any effort to see what we are all about. We know that the average naturopathic patient has a higher level of education than the average American; they can see through nonsense.

Letting an ex-naturopath turned advocate of science-based medicine silence Huber is akin to "letting the terrorist win"? Seriously? I admire Britt, her ability to admit a massive error and make a painful choice to correct it, and her advocacy of science-based medicine since then as much as anyone else here, but come on! No one, not Britt Hermes, not Steve Novella, not Kimball Atwood (until recently the real nemesis of naturopathy), nor any of us at SBM or on other "quackbuster" sites has the power that Huber seems to think we do. Would that we did! But we don't. After all, if we did, naturopathy would not be licensed in any state, much less seventeen! There would not be a provision in the Affordable Care Act that requires that any health care professional licensed in any state, naturopaths included, be reimbursed by health insurance programs offered in the exchanges. Naturopaths wouldn't be expanding their scope of practice so that they can be considered primary care doctors, even though their training and pseudoscientific practice (e.g., as they have in Hawaii) render them grossly unqualified for such a role.

Terrorism. I do not think it means what naturopaths think it means. Certainly, it doesn't mean writing snarky critical posts on blogs and in magazines, trying to make sure that Wikipedia stays science-based, or using our Constitutional rights to oppose their efforts to expand their scope of practice to ply their quackery as primary care providers. (Mark Crislip's description on Friday of their latest efforts in Oregon to be able to allow naturopaths to provide release to return to playing sports for school athletes who have suffered a concussion is truly scary.) Seriously, I'd really like to hear from Mr. Uzick and Ms. Huber specific examples of this "terrorism" that they've experienced. Nasty blog posts do not qualify. These claims of "terrorism" are even more risible in light of the overwhelming superiority in finances and numbers naturopaths have over those of us who advocate science-based medicine. They have so many advantages, in terms of influence, that it's demoralizing at times. What keeps us going is that we have the one advantage that matters: Science is on our side.

Aftermath, or: What have we learned?

I'm grateful to NaturoWhat for having sent me this link. It was most illuminating and provided information that built on what I already knew about naturopathy. The first thing I know that was reinforced about naturopathy is that naturopaths, other than a tiny minority, tend to be very much antivaccine. Naturopaths are so antivaccine that they will cite antivaccine pseudoscientists like Suzanne Humphries, Neil Miller, and Andrew wakefield as convincing evidence of the evils and dangers of vaccines. Moreover, merely voicing pro-vaccine viewpoints will immediately land a naturopath in hot water with the majority of his colleagues and even lead some of his colleagues to suspect him of betraying them to the evil naturopathic apostate Britt Hermes and her SBM paymasters.

Speaking of Britt Hermes and us, the second thing I learned is that naturopaths really hate us. They really do. They hate us so much that it's warped their perspective beyond anything having to do with reality, leading them deep into the heart of conspiracy land. Of course, it is not surprising that naturopaths would be prone to conspiracy theories. They are, after all, naturopaths and therefore already divorced from science, their futile efforts to declare themselves pro-science notwithstanding. Indeed, in their conspiratorial thinking, they ascribe to us far more power than we actually have, which, sadly, is not very much. Would that our power and influence to make medicine science-based were as much as naturopaths apparently seem to think it is! In the end, though, Britt, as influential as she has become, is still an ex-naturopath with a blog, and we are supporters of science-based medicine with a blog. We have an organization that you should all support, the Society for Science-Based Medicine, but it is not (yet, I hope) nearly as wealthy or influential as the main naturopath "professional group," the American Association of Naturopathic Physicians.

Still, they really really hate Britt, especially Gary Piscopo:

I monitor both the medicine and medical student subreddits. Hating on chiropractors, homeopaths, naturopaths, Dr. Oz, etc. is a religion. Britt Marie Hermes is in the pantheon of deities. The current "re-examination" that Reddit is going through, sadly, is not going to touch this in the slightest because there is nothing hateful, sexist, racist, or bigoted about these opinions. In fact, for many, it is simple common sense.

I wonder if Britt knows she is a deity on Reddit.

In any case, it turns out that, chastened by the criticism of her fellow naturopaths, Mona Morstein did ultimately reinstate Eric Yarnell on NatChat. That there was enough backlash to Morstein's ban to force her to bring him back is a good thing. Maybe there is hope for some of the naturopaths on NatChat after all, but as long as naturopathy as a profession is a cesspit of quackery and pseudoscience, I doubt it.

From what I can tell, the crisis appears to have passed, at least for the moment. Eric Yarnell is calling for distributing power away from just Mona Morstein and threatening to form his own discussion forum if it doesn't happen. I expect that some changes will likely be made, or NatChat will splinter into more than one group, and life will go on for naturopaths. They'll be able to get back to doing what they do best, like using quackery like chelation for heart disease, denying the seriousness of the Disneyland measles outbreak, claiming that naturopathic medicine could have saved the 500 children a year who used to die of the measles before the vaccine existed, asking for advice on purchasing an ozone generator, or spreading misinformation about vaccination.

It's the sort of quackery naturopaths do best.

oracknows Thu, 02/25/2016 - 02:35

Tags

Skepticism/Critical Thinking

quackery

vaccines

http://www.healthnutnews.com/a-holistic-doctors-open-letter-to-the-fbi-…

Categories

Brain and Behavior

How cute. The way they are complaining about how their "profession" is under attack make it sound like they actually believe it is a valid one. Like pets displaying quasi-human behavior "Awww... she thinks she's people!"

"Awww... he thinks he has a legitimite career!"

Also, I hope this is quite an eye-opener for Yarnell that pushes him to leave quackery alltogether. I doubt it will happen, but one can hope.

Yiiii!
These people are as rife with internecine intrigue as the anti-vax contingent are!

Maybe if you're not concerned with data and perceivable reality, you start conjuring up soap opera about supposed enemies lists, moles and convoluted plotting ( see esp AoA on Insel, today).

At any rate, I notice that both of the alt media woo-meisters
( prn , NN) I follow recommend NDs instead of MDs but interestingly, both also admit that emergency medicine ( w/ MDs) is excellent.

What I don't get in that emergency medicine is not an isolated limb which can be amputated from the body of SBM intact - after all, it is part of what is studied and researched.

BUT at least it shows that they have a minute level of self-awareness that they can't do what EM does- attach severed parts, re-start stopped hearts and revive those who have lost most of their blood in shootings.

Try vitamin C drips and chelation, right.

I note Bofa's Law of Professions: If your defense of a profession (community) consists of "Not everyone involved is bad" then that profession (or community) has a serious problem.

Yarnell may be a beacon of vaccine light in a sea of anti-vaxxers, but he's just the exception that proves Bofa's rule.

Although I will say, I really enjoy reading this stuff. The dirty laundry of these folks when they don't think anyone is listening is a hoot.

I really hope Yarnell is not the mole and they keep getting leaks even as he is banned. That would lead to the best meltdown.

@MMM: IIRC, the leaks did continue, which was one reason they reinstated Yarnell. There were more comments on the post on Britt's blog about it. And the fact that they can't figure out *who* it is, is driving them mad.

@ Marry Me, Mindy:

There's is a whole lot of dirty laundry on the internet concerning woo-meisters, anti-vaxxers etc, Pablo..

I am currently finding some highly interesting material. Hopefully, I'll have more soon.

IIRC, the leaks did continue, which was one reason they reinstated Yarnell. There were more comments on the post on Britt’s blog about it. And the fact that they can’t figure out *who* it is, is driving them mad.

Awesome

It's possible there could be more than one, even. I could imagine that happening.

The odd thing is that they would think it's the most vocal ... um..adversary (for lack of a better term). Wouldn't you figure the mole is going to be playing it as far on the downlow as imaginable?

@denice

There’s is a whole lot of dirty laundry on the internet concerning woo-meisters, anti-vaxxers etc,

And of course they need to keep it quiet. Over at SkepticalOB, we hear the exact same crap from midwife groups. What they say when they get together and think no one is listening is pretty frickin scary.

I am fairly certain it was unintentional, but a nice touch listing wakefield with a lowercase "W".

Calling criticism a terrorist act is just the sort of thing folks do when their case cannot be made with rational arguments.

"Calling criticism a terrorist act is just the sort of thing folks do when their case cannot be made with rational arguments."

You're a Bully.

@ Dangerous Bacon:

Heh.
( Although I think that they'd be more apt to say 'sociopath' these days).

Thanks DB, I am honored:)

Britt Marie Hermes is in the pantheon of deities.

Britt Hermes turned me into a newt!

I don't really blame Colleen Huber for suggesting that the Quackbuster Army are terrorists.

She's probably still overwrought that the F.B.I. ignored her appeal to investigate the Holistic Doctor Murder Conspiracy.

"claiming that naturopathic medicine could have saved the 500 children a year who used to die of the measles before the vaccine existed,"

Well, why didn't it, then? Looking at a few pro-naturopathy sites, they claim a lineage ranging from anywhere between ca. 380 BCE to 1892. Even using the least pretentious date, that's still seven decades in which they utterly failed to put a dent in measles before the vaccine was developed.

MMM@6 --

And of course they need to keep it quiet. Over at SkepticalOB, we hear the exact same crap from midwife groups.

You mean lay midwives, I suppose? Certified Nurse Midwives often practice in hospital settings and tend not to be particularly wooish in my experience.

I sure wish they'd called themselves something else, because of all this confusion.

"Britt Hermes turned me into a newt!"

That's okay. On the internetz nobody knows you're a newt.

Eric Yarnell is calling for distributing power away from just Mona Morstein and threatening to form his own discussion forum if it doesn’t happen.

It seems he wants his own Judean People's Front.

These people are supposed to be medical "professionals." There is a new rant by Michael "Ukrain" Uzick leaked to Pastebin (http://pastebin.com/25vP2uNi):

We are having a strange little drama in our profession which I think is really about one or two individual naturopaths and their own issues with themselves and each other that has become attached with this horrific betrayal of a naturopath resigning from the profession, joining the quackbusters and trying to severely damage us. These quackbuster/"science based" Nazi's originated from a vicious criminal conspiracy of a medical profession - the Chiropractors - in this US in the 1970's.

This is no imagined vaccine conspiracy, in case you don't know, the AMA was found guilty of conspiring to damage the Chiropractic profession by our US Federal courts in the 70's. These court battles led to the national licensure of the Chiropractors.

So what were the quackbusters and the AMA doing that led to charges of conspiracy in the Federal courts? Well, you can read about some of it in this NY Times article from the 70's discussing one of the rulings. Or for those of you who are aware of Britt Hermes and her husband's work, just read the list of activities they are up to. It's the same. Everything from writing "scathing" letters to legislators about our licensing, to reporting naturopathic doctors to governors, attorney generals, the FDA and you name it - I'm sure Obama has several letters - to creating fake Facebook pages and slandering naturopaths on their review pages. Ask yourself, how much money would it take to get you to do something like that?

...

Today, the quackbusters/science based scum appear on their own blogs, "internet magazines" they tweet, they take claim for unsuccessful legislative efforts. Today, no one cares about them. They appear no where. I've been told with confidence by those involved in our licensing efforts that Britt has no impact. Did I say hated and not believed? They can trick some people momentarily and terrorize a bunch of naturopaths. But beyond that, we thousands are making meaningful differences in peoples lives on a daily basis. We truly care about people, true science based medicine and everyone can tell we are genuine in our efforts. Their agenda is paid for and there's no lie or dark deed that's too low for them. They have no meaningful impact, because they have nothing meaningful to offer.

Compare coming to the aid of a terminal cancer patient and their desperate family, with Britt doing everything in her power to prevent that man from receiving his only hope. She was the doctor of these of his 3 beautiful children aged 7 through 11 and she did everything in her power to stop their father from receiving treatment and closing the clinic where he and so many patients with cancer come for received help. A treatment his oncologist said was a miracle. How do those two doctors compare? That's the difference between Britt and myself. As well as, the difference between Britt and every human being with a soul.

TL;DR: Michael Uzick argues it is okay to treat cancer patients using a drug imported from Austria from quack who faces criminal charges for fraud. Oh yea, the drug is not FDA-approved.

" I sure wish they’d called themselves something else, because of all this confusion.
ah but that's the point...

Correct me if I'm wrong, but I see no reason to connect Britt Hermes with Naturowhat, other than various blogs (including hers) referring to both of them. I've been assuming Britt gets her information from Naturowhat's Pastebin and Reddit posts, same as the rest of us?

Correct. As far as I know Britt has nothing to do with NaturoWhat. That doesn't stop the naturopathic quacks on NatChat from trying, though.

If a much safer, more effective vaccine is developed in the future, I will keep an open mind, but will not administer it until proven safe and effective in credible, uncorrupted double-blind studies.

Must be convenient to be able to dismiss anything you disagree with because "CONSPIRACY! Also, why are vaccines the only thing they want studies on? IV vitamin C is perfectly acceptable based on anecdote and "why the hell not?" Good fantasy worlds are at least internally consistent.

Naturopaths can prescribe insulin?. Terrifying.

I always wish to have NatChat be transparent. It is true I have temporarily removed Dr. Yarnell, but not due to his innate views on vaccines, food allergy testing or whatever. NatChat welcomes all views on topics. However, without going into details, behind the scenes (and yes, also due to his using Gorski as a reference) some concerns have risen about Dr. Yarnell. This is a test removal. If the flow of information to Britt is not stopped by Dr. Yarnell’s removal, I will offer a very sincere, heartfelt public apology to him and Natchat. However, I feel it is my responsibility to try to do whatever I can with whatever clues come my way to staunch (sic) the flow of information to Britt Hermes.

Our chief weapon is surprise, fear and surprise! Two chief weapons, fear, surprise, and ruthless efficiency!

If a much safer, more effective children's car seat is developed in the future, I will keep an open mind, but will not administer it until proven safe and effective in credible, uncorrupted double-blind studies.

Delphine @23 -- Brilliant.

The NDs are doin' CTs. They don't have a 'mole' (an enemy agent undercover), they have a leak. And it's not necessarily a member of the NatChat group: it could be a spouse/partner/family member who knows the ND's Yahoo password. If it was one of the NDs in the group, that person would almost certainly be "playing it on the downlow". Yarnell seems like a sincere guy trying to coax a bit of reform from his peeps. If so, there's no way he risks his credibility by going behind their backs.

True 'moles' lay low while burrowing-in, but in general the goal of infiltrators is to wreak havoc, not just pass on intel. A commenter noted on SBM, "the mole is always the most enthusiastic believer, the least forgiving of dissent." This isn't just cover, during the Vietnam war, for example, the Red Squad spooks were always trying to push the movement towards crazy talk and violence to discredit it. If NatChat did have a mole, he'd sound a lot like Michael Uzick.
______

More bad metaphor from NDs. If "hating on [alties] is a religion," Britt Hermes isn't a deity, she's a high preistess, or maybe an oracle. Sheesh,. You'd think with all the Eastern Mysticism in woo, these folks would know that there are religions without deities (Buddism, Taoism, Shintoism...). religions. Besides, Britt can't be a deity unless she's hiding a Noodly Appendage under her armpit of something.

capnkrunch @23-- it's probably a one-off kinda thing--for the patient, that is.

@palindrome

You mean lay midwives, I suppose? Certified Nurse Midwives often practice in hospital settings and tend not to be particularly wooish in my experience.

Yep. Actually, I'd say the line is more "homebirth midwives." That includes some CNMs, but is predominantly the CPMs (who have to do homebirths because they don't have the credentials to work in a hospital). Most CNMs are hospital based and, as you say, are not particularly wooish. The CNMs that are out doing homebirths are the whacks, but they are only a small fraction (under 10% of homebirths are with CNMs).

I sure wish they’d called themselves something else, because of all this confusion.

As mho says, that's the point.

Actually, this is where I put a little criticism on the CNMs, and especially the ACNM. They have not done a good enough job making clear the distinction between them and the wannabees. Which is really surprising, because you would think that a professional organization that holds itself to high standards would want to take a hard stand against unqualified pretenders who try to coopt the brand. Cleo McDowell was always on the watch for folks from McDonald's coming after him. However, the ACNM has actually been chummy with CPMs and always talks about ways of welcoming them. It's basically the same as if the AMA were reaching out to include naturopaths. God no. The ACNM needs to make it clear that CPMs are NOT qualified midwives, and that is why we have the CNM.

"It is difficult to get a man to understand something, when his salary depends on his not understanding it." - Upton Sinclair

Posted by: ScienceMonkey, Homeopath, Naturopath, Nutritionist, Herbalist (This one is new this week!), Board Certified by multiple boards, Reiki master – both near field and long distance, Doctor of Metaphysics, Doctor of Divinity,
Ordained Minister, Astrologer, Pet Psychic, People Psychic
Plant Psychic, and Life Coach. (This is all true while also being all a joke.)

Oh, I also have degrees from the real schools I went too.

There's a hilarious story on that cruise with Brian Wakefield on Jezebel:

http://jezebel.com/sail-far-away-at-sea-with-americas-largest-floating-…

Thanks for the link, Jane. The Jezebel article is excellent: well reported, well written, and thoughtful. One excerpt for lulz, though:

Laura Eisenhower did note during her presentation, however, that no one should vote for Hillary Clinton: “She’s definitely not human.”

Literally. It's not clear, though, whether HRC is a shape-shifting Reptillian alien, or one of the "'dark energy' beings called Dracos."

Well, you know what they say about broken clocks... ;-)

definitely begs the question of whether Eric is the mole?

must... fight... urge ... to pedantry...

@ sadmar:

No no no! It could never be.
Reptilians and Dracos dress better.

rs@15: "That’s okay. On the internetz nobody knows you’re a newt."

Ah, but do they know if you're Bonnie Offit?

"I expect that some changes will likely be made, or NatChat will splinter into more than one group, and life will go on for naturopaths."

Schism! Schism! Schism! Schism!

MIke Ma

Calling criticism a terrorist act is just the sort of thing folks do when their case cannot be made with rational arguments.

Terrorist is the new Communist

Speaking of cultural conflict, a recent article on the subject of "chemonoia" may be timely:

http://het.sagepub.com/content/34/12/1272.long

BBC covers it here:

http://www.bbc.com/future/story/20160225-chemonoia-the-fear-blinding-ou…

MMM @28 -- Being, uh, associated with a CNM and seeing their literature, I see your point exactly.

I'm not a scholar of all this, or anything, but my impression is that the OB community alienated a lot of women back in the 60s and 70s with totally arbitrary, non-science-based practices (shaving, stirrups, etc) which were perceived as mainly asserting the doctor's control over the patient. The home-birth movement arose as a reaction to this, and the CNM profession grew up as a way of ensuring that at least some midwives were competent. And then it turns out that in a good hospital situation, with good communication, CNMs can handle the majority of uncomplicated births with little or no consultation and excellent safety, and they cost a lot less than MDs, This makes them a really attractive alternative for hospitals -- with the added benefit that they bring in patients who might otherwise opt for homebirths.

But in order to appeal to the wooish client, they need to retain that bit of branding -- hence the name. Or so I speculate.

Herr Doktor @32 -- You need to see this if you have not:

http://begthequestion.info/cards/

@Militant Agnostic
Terrorist has not exactly replaced Communist but rather joined it along with fascist and socialist thereby adding to the curses they can spew without understanding or meaning.

I'm not with the naturopath guys, but I don't know how you can say that the US medical system has never advocated for forced sterilization of the handicapped. I know an older man with fetal alcohol syndrome and he was sterilized when they realized he had it. He was not given a choice in the matter. I have also read although I can not remember where that it used to be in the law books in Wisconsin to sterilize those with mental issues such as schizophrenia back in the '50s.

@Sarah #41

I’m not with the naturopath guys, but I don’t know how you can say that the US medical system has never advocated for forced sterilization of the handicapped.

Simple : Orac never said that. The naturopaths were talking about blogs like this one or Science based medicine.org, not the old practices of the US medical system. These bloggers never defended forced sterilization.

I have also read although I can not remember where that it used to be in the law books in Wisconsin to sterilize those with mental issues such as schizophrenia back in the ’50s.

See Buck v. Bell.

Can anyone give a sentence where it's ambiguous which meaning of "beg the question" is intended?

Can anyone give a sentence where it’s ambiguous which meaning of “beg the question” is intended?

The simplest would be "that's begging the question." The meaning may not be obvious even with the context of the previous statements.

Cancer Treatment Centers of America, naturopathy, and "naturopathic oncology"

oracknows — Mon, 26 Jul 2010 07:00:00 +0000

Cancer Treatment Centers of America, naturopathy, and "naturopathic oncology"

Note: Parts of this post have appeared elsewhere, but not in this form.

If there's one aspect of so-called "alternative medicine" and "complementary and alternative medicine" (CAM) is that its practitioners tout as being a huge advantage over what they often refer to sneeringly as "conventional" or "scientific" medicine is that -- or so its practitioners claim -- alt-med treats the "whole patient," that it's "wholistic" in a way that the evil reductionist "Western" science-based medicine can't be. Supposedly, we reductionistic, unimaginative physicians only focus on disease and ignore the "whole patient." Of course, to me this claim is belied by the hectoring to which my own primary care physician has subjected me about my horrible diet and lack of exercise on pretty much every visit I've had with her, but then maybe she's an anomaly, along with PalMD and pretty much every other primary care doctor I've ever dealt with. Anecdotal experience, I know, but since alt-med mavens appear to value anecdotal evidence above pretty much all else I thought it appropriate to mention here. Also belying the claim of alt-med practitioners that they "individualize" treatments to their patients in a way that science-based medicine does not is the maddening tendency of various alt-med modalities to settle on just One True Cause of All Disease, be it liver flukes as the One True Cause of Cancer, heavy metal toxicity as the One True Cause of cancer, autism, and various other diseases, or "allergies," acid, or obstruction of the flow of qi as the One True Cause of All Disease.

Given the claim of "wholism" that is such an advertising gimmick among many of the varieties of woo, I'm always interested when I see evidence that alt-med is imitating its envied and disliked reductionistic competition. True, this is nothing new, given how alt-med has tried to seek legitimacy by taking on the mantle of science-based medicine wherever it can. Examples include the National Center for Complementary and Alternative Medicine (NCCAM), various organizations that try to confer legitimacy to pseudoscience by providing "certification" in various flavors of woo, and moves to push state medical boards to go further than that and confer legally protected status to practitioners by actually licensing them. This latter tactic has been very successful in that many states now license acupuncturists, while some states even license naturopaths and "homeopathic physicians," the latter of which I find quite amusing because the term perfectly encapsulates what must remain of such a physician's medical training after being diluted to 30C with woo. The only difference is that, unlike what is claimed with homeopathy, diluting MD medical knowledge with woo does not make it stronger. In terms of naturopathy, though, one of the most alarming aspects of the infiltration of naturopaths into the health care system is that some states in the U.S. and provinces in Canada are seriously considering allowing them to prescribe real pharmaceutical medications, even though they lack the training and knowledge to use such drugs safely.

Imagine my combination of bemusement and alarm, then, when I learned of a new specialty of pseudoscience, namely the field of naturopathic oncology.

Be afraid. Be very afraid. (I know I was when I first encountered this specialty.)

Naturopathy versus science-based medicine

Before I discuss naturopathic oncology, it's probably useful for me to do a quick recap of what naturopathy tends to believe about disease and use for therapies. If you want an idea of the sorts of woo that are considered "mainstream" by naturopaths, a perfect place to go is to the AANP blog, which discusses the upcomming AANP Convention in Portland, OR from August 11-15. According to the AANP blog this year's woo-fest will be "one of the best gatherings to date." Given that the speakers are listed in alphabetical order, I couldn't help but notice immediately as I perused the list of speakers a talk by a naturopath named Mikhael Adams, BSc, ND, who will be giving a talk entitled Viruses & Pandemics in the 21 st Century: Truth or Dare and the Case for Nature Cure. His talk is described thusly:

This presentation will explore the researched and documented facts relating to viruses and pandemics in the modern age and the vaccinations offered to prevent them, as well the immense toxic burden the average human presents with and its effects on the immune system. Historically, Nature Cure has provided us with a template for repairing and maintaining the "self-healing" and "auto-regulating" mechanisms of our body. This presentation will focus on updated, detailed, effective, and successful "Nature Cure" for today's chronic conditions.

Connoisseurs of CAM language will recognized immediately a number of code words and phrases in this paragraph, chief among them being the "immense toxic burden" and how it allegedly destroys our immune systems. It's highly unlikely, of course, that Adams will present anything resembling actual scientific evidence to support his claims of an "immense toxic burden," but previous experience tells me that it's extremely likely that he will be laying down a swath of anti-vaccine propaganda, given his reference to "facts" relating to viruses, pandemics, and vaccinations, particularly given how deeply imbedded anti-vaccine beliefs are in naturopathy (only 20% of whom even recommend vaccination), coupled with the belief that uncharacterized (and often unnamed) "toxins" are responsible for most disease.

You'll also notice that Adams is also a homeopath, and homeopathy is The One Quackery To Rule Them All. If you really want to get a feel for what kind of practitioner Mr. Adams is, though, you should check out the webpage of his group naturopathy practice, The Renascent Integral Health Center in Milton, Ontario, which describes its approach to patient care thusly:

The emphasis of treatment is placed on removing the blockages that keep the individual from being a self-healing, auto-regulating organism. Therapies are implemented that support the individual's body, as it specifically responds to external stress, toxic challenges and energetic impressions held by the body, that have manifested into the current state of disease. Whether entering treatment at the centre, or having a Medical Intuitive Scan done by distance, the goal becomes to target disease by identifying and addressing the body's underlying imbalances that have created its symptoms. To resolve the symptoms, Mikhael and Alison's approaches go beyond the given diagnosis, to reinitiate the body's ability to recognize the challenges it faces, and support its ability to resolve its state of disease.

It gets better. I didn't really know for sure what Auricular Medicine or a "Medical Intuitive" scan is. Fortunately, Adams is happy to tell us, given that he has a "medical intuitive" on his staff, namely his wife Alison Feather Adams, who will "scan" you, either in person or over the phone, and tell you everything that's wrong with you. Meanwhile, as best as I can figure it out, Auricular Medicine is reflexology, only with the "mappings" of various body parts and organs to the ears, rather than to the feet and hands. Here's Adams' description:

Auricular Medicine is an energetic reflex technique in which the pulse and filters are used to detect points on the ear. The points that show up on the ear can indicate the location of specific imbalances within the body. Through the use of filters we are able to identify specific dysfunctions within the body.

Auricular Medicine is a specialized field of Energetic Medicine...The Doctors in this clinic use Auricular Medicine as their key diagnostic tool and work with their clients to stimulate self-healing (vis medicatrix naturae) through assessment of the disease state, prevention of disease, evaluation of a client's state of health, and treatment and care of client's using means and substances that are in harmony with the client's own self healing processes.

Auricular Medicine in conjunction with conventional medical tests can find and treat the cause of disease. Many conditions, acute and chronic, can be treated by Auricular Medicine.

I'm sure many diseases and conditions "can" be treated by Auricular Medicine. Whether they should be treated by Auricular Medicine or can be treated successfully with Auricular Medicine is another question entirely. I wonder if Adams uses Col. Niemtzow's auricular acupuncture as well.

Perhaps my favorite talk at the AANP, at least judging by its title, will be the talk by Sharum Sharif, ND entitled Visual Homeopathy - Identifying a Person's Constitutional Homeopathic Remedy in Minutes, which promises:

Patient and Hollywood videos will be used to demonstrate how to quickly identify a patient's constitutional remedy by looking for simple behavioral cues and asking 2-5 questions. The presentation will be focused on the most common remedies accounting for the majority of the population of a general naturopathic clinic.

Who knew it was that easy? As a couple of questions, and pick out some water to treat your patient.

Overall, there appear to be at least seven homeopaths speaking. There's also Matthew Baral, ND, who is a certified Defeat Autism Now! practitioner, and if there's a richer source of autism and anti-vaccine quackery besides the roster of DAN! practitioners, I am unaware of it. There's so much more than even this lengthy post can encompass. Woo that's considered "mainstream" by the AANP is the environment from which the misbegotten specialty of "naturopathic oncology" sprang.

Naturopathic oncology

It's not surprising that I first discovered the "discipline" of naturopathic oncology at the Seattle Cancer Treatment and Wellness Center, which is affiliated with the Cancer Treatment Centers of America. As a science-based physician and surgeon I really detest CTCA because it is expert at combining state-of-the-art science-based medicine with pseudoscience like naturopathy, chiropractic, and acupuncture, as well as scientifically tested modalities known not to be particularly helpful in the clinical management of cancer, such as chemotherapy resistance testing (which could be the topic of an entire post). Suffice it to say that the last of these was prominently featured in Suzanne Somers' cancer book last year. In any case, CTCA covers a continuum from the boringly "conventional" (surgery, chemotherapy, and radiation) to the questionable (chemotherapy resistance testing) to pure pseudoscience (naturopathy, acupuncture, homeopathy) mixing them together to the point where it is difficult, if not impossible, for the average patient to know which is science-based and which is not.

So what is naturopathic oncology? Apparently it's an "emerging field" within naturopathy concerned with applying naturopathy to cancer. I don't know about you, but to be an "emerging field" within naturopathy is akin to being an emerging new paranormal phenomenon in the field of parapsychology. But, then, I'm just one of those nasty, reductionistic, skeptical, scientific physicians, so what do I know? On the other hand, Kimball Atwood characterized naturopathy as a "pseudoscientific cult"; so maybe even Orac is not that nasty, at least not in comparison. Be that as it may, let's take a look at a couple of definitions, written by naturopaths themselves. First, there's the Oncology Association of Naturopathic Physicians (OncANP) (yes, there is an Oncology Association of Naturopathic Physicians). This is how OncANP defines "naturopathic oncology":

Naturopathic oncology is the application of the art and science of naturopathic medicine to the field of cancer care and treatment. Naturopathic oncologists work both in hospital oncology settings and in private practices bringing their wisdom, perspective and experience to aid oncology treatment teams that seek the best positive outcomes for their patients.

It all sounds relatively benign; that is, unless you know what naturopathy is. OncANP tries to justify the "need" for naturopathic oncology thusly:

Aware that modern medicine has made little advance in its War on Cancer, many people with cancer choose to also include complementary and alternative medicine in their fight against cancer. They reach out and employ a wide range of therapies including meditation, prayer, acupuncture, herbal, botanical, nutritional, homeopathic, dietary and other holistic practices seeking benefit.

Naturopathic doctors and physicians are trained in accredited naturopathic medical schools in modern scientific nature cure. They are trained in both modern science and natural medicine. They emerge from their training well versed in the use of botanical medicine, homeopathy, diet, fasting, nutritional supplementation, orthomolecular medicine, psycho-immunology and other complementary and alternative medical techniques; they serve as capable guides for patients interested in exploring alternative medicine.

Those naturopathic doctors who choose to specialize in naturopathic oncology understand both the standard treatments employed by medical oncologists and how best to work with them in a collaborative model of cancer co-treatment. They are well aware of the multitude of 'alternative therapies' promoted to cure cancer and can help patients understand which might be useful and why.

Note the common CAM claim that we have made "little advance" in the War on Cancer used as a justification for offering pseudoscience. Most of the "therapies" offered are fairly benign, such as meditation and prayer, although I can't figure out why meditation and prayer are represented as "therapies" rather than manifestations of religion. Of course, much of what else falls under rubric of "naturopathic medicine" and "naturopathic oncology" is pure pseudoscience, in particular, orthomolecular medicine, a construct popularized by the late Nobel Prize winner gone woo Linus Pauling, is pure quackery, advocating as it does megadoses of various vitamins and supplements. Given how late in his life Pauling had come to believe that megadoses of vitamin C would cure cancer (they don't, alas), it's not surprising that Pauling was attracted to this particular form of quackery.

Then there's acupuncture, the Jack of All Trades in CAM. It's one of those modalities that, it seems, can do anything. Treat pain? Acupuncture. Improve the success rate of in vitro fertilization? Acupuncture. Reduce menopausal symptoms in women with breast cancer requiring anti-estrogen therapy. Acupuncture. Got migraines? Acupuncture. Asthma, allergies, bronchitis, sinusitis, sore throat, laryngitis, colds and flu? Acupuncture. Irritable bowel, colitis, constipation, diarrhea, gastritis, heartburn, food allergies, ulcers? Acupuncture. Cystitis, menstrual cramps, irregular or heavy periods, infertility, menopausal symptoms? Acupuncture.

Death? Maybe acupuncture can allow one to rise from the dead more effectively than Jesus. I think you get the idea.

Naturopathic oncologists even have their own board certification, just like real oncologists. They even put the letters after their name, FABNO, which stands for "Fellow of the American Board of Naturopathic Oncology." (Personally, I think it stands for "FAB? NO!") Of course, given the panoply of dubious therapies, some of them contradictory to each other, that naturopaths use, I really wonder what the certifying test is like. When, for instance, do you choose megadoses of vitamin C over acupuncture or vice-versa? When do you choose live cell therapy over this supplement or that supplement? And what is the scientific evidence that any of it does cancer patients any good whatsoever? Especially homeopathy. (More on that in the next section.)

The mind boggles that this "specialty" has its own board certification. How long before naturopathic oncologists push for special privileges in the states that license naturopaths? It's not even beyond my imagination to visualize them applying for, and getting, the prescribing power to administer chemotherapy along with their herbs, supplements, and other woo. Why would naturopathic oncologists even want this? Easy. For the same reason that naturopaths in general seem to be seeking prescribing power: Real drugs work, and if one mixes real drugs with naturopathy then patients will tend to attribute the success not to the evil pharmaceutical drug but rather to the naturopathic nostrum.

The Cancer Treatment Centers of America, naturopathic oncology, and other woo

I've often complained about the infiltration of what sometimes refer to as "quackademic medicine" into medical academia. Quackademic medicine, as you recall, is the term we use to describe how so many medical schools have taken to studying fairy dust treatments like reiki and acupuncture as though they are science-based, often justifying this study with the rationale that they are "ancient" treatments and that lots of people use them. Promoters of pseudoscience have even managed to carve out a whole center at that bastion of science-based medicine, the crown jewel of the biomedical research effort of the United States the National Institutes of Health. That center is the National Center for Complementary and Alternative Medicine (NCCAM).

While we've spent a lot of time on RI lamenting and doing my tiny part to combat the infiltration of pseudoscience into medical academia, we've spent comparatively little time on what is arguably an equally serious threat to science-based medicine. That is the infiltration of "integrative medicine" into private medical institutions that use integrative medicine as a marketing tool in order to distinguish themselves from the rest of the pack. Arguably, no hospital chain has been more successful at this than The Cancer Treatment Centers of America. Over more than 20 years, CTCA has built up a network of hospitals in suburban Chicago, Philadelphia, Tulsa, and suburban Phoenix, as well as a network of physician practice groups in Seattle and elsewhere. CTCA was founded in 1988 after its founder's mother lost her battle with cancer, its mission being to "change the face of cancer." Unfortunately, at least in its hospitals it is succeeding, and not in a good way. This is how CTCA describes its founder, Richard J. Stephenson's, mission to find treatment for his mother:

After his mother's diagnosis, Mr. Stephenson embarked on a mission to find the most advanced and effective cancer treatments available. He hoped his efforts would enable his mother to recover and remain an integral, irreplaceable part of his life and the lives of his children.

The Stephensons were sorely disappointed by what they found. What were regarded as world-renowned cancer treatment facilities were singularly focused on the clinical and technical aspects of cancer treatment, ignoring the individual needs of the patient and the multi-faceted nature of the disease. Tragically Mrs. Stephenson did not live to watch her grandchildren grow and mature.

To keep his mother's memory and spirit alive, Richard vowed to change the face of cancer care. He selected a group of outstanding oncologists and challenged them to find a way to deliver whole-person cancer treatment in a compassionate, nurturing environment.

Death from cancer is tragic; it's often painful and slow, and the sense of helplessness and loss that accompany watching the decline of a loved one to cancer is sometimes more than a person can bear. Mr. Stephenson might have done more good if he had dedicated his grief to founding truly science-based cancer hospitals that had ingrained in their culture caring and the "human touch." Unfortunately, he appears to have confused compassion and the human touch with "integrating" pseudoscience into science-based medicine. Instead of producing an institution that could really transform cancer care by preventing the tendency of large institutions to become impersonal, he's created a Frankenstein monster cobbled together using a lot of perfectly sound science-based treatments, including surgery, chemotherapy, and radiation with pure pseudoscience like naturopathy and traditional Chinese medicine bolted on like the head of the Frankenstein monster.

Let me show you what I mean. I happen to have a few quick-and-dirty rules of thumb that allow me to rapidly identify a practice that is full of woo. These are just my opinion, but I find them fairly useful. One of these rules of thumb states that, if a CAM practitioner offers "detox foot baths" as one of his services, he's a quack until proven otherwise (and he's unlikely to be proven otherwise if he's actually sufficiently cynical or enough of a true believer to charge for quackery like "detox foot baths"). I haven't seen a naturopathic oncologist, either at CTCA or elsewhere, offer detox foot baths (yet), but I have seen them offer homeopathy, and I've seen them advertise it at CTCA. In my opinion, homeopathy is rank quackery; there's just no other way to put it. In fact, these are the treatments that the naturopaths at CTCA offer:

Nutritional supplements, including vitamins, minerals and amino acids
Botanical medicine (the use of herbs)
Homeopathic medicine
Hydrotherapy

I'm always irritated when I see nutrition co-opted this way. If you go to the nutrition page of CTCA, you'll find a lot of verbiage that sounds perfectly reasonable and science-based (albeit with exaggerated claims that science-based physicians don't pay any attention to nutrition). It's also claimed that malnutrition is one of the main causes of cancer death, accounting for perhaps one third of them, which is one of those claims that is superficially true but also ignores the fact that many cancers cause cachexia (wasting syndrome) by mechanisms that are poorly understood. Cachexia can't be reversed just by providing nutritional support, nor can it be so easily prevented. Worse, CTCA uses the term "superfoods," which is a marketing term designed to make claims about various foods far beyond what science will support. Certainly, it's not a medical or scientific term, and it's particularly annoying when CTCA claims that "superfoods" actually "fortify the immune system," as that's the same trivially meaningless claim made by woo peddlers of all stripes. In any case, the claim that CTCA is any better than any other cancer center at nutrition falls apart when I see things like this on its website:

According to the National Cancer Institute, 20% to 40% of cancer patients die from causes related to malnutrition, not from the cancer itself. CTCA chef Kenny Wagnor suggests loading your diet with anti-oxidants, which are found in bright colored foods such as berries. Chef Wagnor prepares a blackberry strudel packed with tasty berries and pecans -- a great combination of cancer fighting foods!

At the risk of annoying certain readers, I will point out the logical fallacy here: non sequitur. It does not follow from the observation that 20-40% of cancer deaths are related to malnutrition that eating lots of antioxidants will help you beat cancer. In fact, it's controversial whether antioxidants help or hinder chemotherapy; it probably does one or the other depending on the tumor type and the chemotherapy. My pet peeve about how CAM practitioners abuse nutrition as being somehow "alternative" and not considered important by scientific medicine, note how CTCA naturopaths actually offer homeopathy to cancer patients. Yes, cancer patients are being given magic water in order to relieve the side effects of their cancer therapy.

The coopting of science-based modalities like nutrition at CTCA doesn't end there. It's everywhere. For instance, look at the CTCA webpage on Oncology Rehabilitation. In addition to standard physical and occupational therapy treatments, CTCA also offers:

Swedish Massage
Reflexology
Lymphedema Massage
Myofascial Release

I certainly don't have any problem with Swedish massage. It's not a "therapy" per se, but there's little doubt that it makes patients feel better. Lymphedema massage, if done according to science-based principles and not according to some "alternative" medicine techniques, is a valid technique to try to reduce the lymphedema that can occur as a complication of lymph node dissections performed for breast cancer and melanoma. However, reflexology is pseudoscience, as is myofascial release. Once again, CTCA is "integrating" woo with science. This is not surprising, given that its entire website is permeated with what Dr. Atwood would call the Weasel Words of Woo. Here is an example from the Bone Cancer Treatment page:

Your body is designed to inherently establish, maintain, and restore health. The healing process is ordered and intelligent; nature heals through the response of the life force. The role of the naturopathic practitioner is to facilitate and augment this process, to identify and remove obstacles to your health and recovery, to help your body maintain its healthy equilibrium, and to support the creation of a healthy internal and external environment for you.

Note the vitalism inherent in this brief passage, in which nature heals through the "life force." This is not science. It has no place in science-based medicine.

"Naturopathic oncology" versus science-based medicine

Given the vitalism and woo that permeate naturopathy in general, a small taste of which I just described above at the "official" yearly gathering of American naturopaths, it's not surprising that "specialized" naturopathic oncologists, like naturopaths in general, are not too receptive to scientific testing of their "art." Sure, they say they are, but when it comes right down to it, in contrast to science-based physicians, naturopaths can't accept negative clinical trials. For example, take a look at what naturopath Timothy Birdsall, FABNO, who is Vice President of Integrative Medicine for CTCA, says about research finding that his favored therapies don't work. In the American Association of Naturopathic Physicians' blog, he wrote an essay earlier this month entitled The Problem With Research in response to clinical trial results showing that selenium doesn't help patients with lung cancer. Here are some choice quotes:

To top it off, the reason I was out of the office last week was that I was attending the National Advisory Council for Complementary and Alternative Medicine, the advisory body to NIH's NCCAM. On that council, we have talked about just this issue -- why do therapies which seem to make biological and physiological sense, which have some epidemiologic data to support their use, and which naturopathic physicians (and other alternatively-minded practitioners) have been using for decades (or much longer), seem to fail in double blind, randomized clinical trials?

We science-based physicians ask ourselves the very same question time and time again. Many are the seemingly plausible therapies that, when tested in humans, failed to show benefit in cancer. Here's the difference: when we see therapies, no matter how plausible, that fail in randomized clinical trials, we abandon them. True, it may take more time than we'd like. The process may be messier than we like, as some physicians who are wedded to these therapies are reluctant to give them up when science doesn't support them. We then move on to try to figure out where our understanding of the biology went wrong. But abandon them we do. We don't blame science and the randomized clinical trial (RCT), as Birdsall does. First, he trots out the favored canard of CAM practitioners everywhere and argues that RCTs "answer simple, straightforward questions" and (presumably) his woo isn't simple. Of course, the question of whether selenium can, as he believes, be useful in treating lung cancer is actually a pretty simple, straightforward question not unlike the question of whether a certain chemotherapy can prolong survival or increase the cure rate of a cancer. Instead of realizing that, Birdsall attacks science:

And so I began to ponder the question, "What's wrong with research?" A part of me becomes enraged at the reductionistic, allopathic, biomedical model, which breaks things down into components so small that all synergism, all interdependence is stripped away, and then declares those components to be ineffective. Another part argues that the wrong component was selected, or was a synthetic form (although in the lung cancer study, they used selenium yeast). But ultimately, I find myself becoming offended because I believe that these therapies work... Whoa! Believe? OK, but where is the role for evidence? I used to believe that stress caused gastric ulcers. And then along came Helicobacter pylori, and I had to change my belief to match the evidence.

Note the standard attack on "reductionism" and "allopathy" and the "biochemical model." Then note the irony as Birdsall, while declaring that naturopathic oncologists must become science-based and train the next generation of naturopaths to be "great scientists" (I spit up my iced tea when I read that line), he proposes in essence destroying science in order to save it for naturopathy -- or, more precisely, to use it to legitimize naturopathy:

Third, we should collaborate with other professions and institutions to craft the research models necessary to adequately perform "whole systems" naturopathic research. There are examples of this type of approach already existing in the health systems research literature which can be adapted to our needs. In the end, we must create and validate the tools to dethrone the randomized controlled trial as the gold standard, and construct new ways to validate clinical approaches to health issues. Much as the homeopaths of 2+ centuries ago created the proving as a way to better understand and utilize their remedies, we must refuse to be limited by the way conventional medicine views health and disease.

I would argue that invoking the magical techniques of people who believe that diluting a remedy makes it stronger and that water remembers all the good bits that have been in it but forgets all the urine and poo (as Tim Minchin so hilariously put it) is not the way to argue for science. Of course, the short version of this is: If RCTs don't show that naturopathy works, we need to dethrone RCTs and make up our own research methods. Yes, I know RCTs have problems and limitations, but those problems and limitations don't include not being able to answer the question of whether selenium and antioxidants can improve survival in lung cancer patients.

Sadly, it's not just academia that is under siege by unscientific medical philosphies and treatment systems. True, academia sets the stage and promotes the spread of pseudoscience-based medicine because it is medical academia that does the research and trains the next generation of physicians. However, most medical care in this country is still provided by private physicians and private hospitals, and some private hospitals like CTCA have discovered that "integrating" pseudoscience-based medicine with science-based medicine can be a recipe for success. As "alternative" medicine infiltrates academia more and more, I fear that the stigma for offering these therapies will decrease more and more, leading to more hospitals and clinics like CTCA.

oracknows Mon, 07/26/2010 - 03:00

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