Articles

Archive for March 23rd, 2009

Alternative medicine use and breast cancer

Of all the posts I and my cobloggers have written for SBM over the last 15 months, most provoke relatively few comments. However, a few stand out for having provoked hundreds of comments. The very first post that provoked hundreds of comments was Harriet’s excellent discussion of the International Network of Cholesterol Skeptics. In fact, Harriet seems to be quite good at writing posts that provoke a lot of comment, as another of her posts, specifically the one in which she discussed circumcision, also garnered hundreds of comments. However, to my great surprise, the one post that stands out as having received the most comments thus far in the history of SBM is one that I wrote. Specifically, it was a post I called Death by “alternative” medicine: Who’s to blame?, which has collected an astonishing 611 comments thus far. The topic of the post was a case report that I had heard while visiting the tumor board of an affiliate of my former cancer center describing a young woman who had rejected conventional therapy for an eminently treatable breast cancer and then returned two or three years later with a large, nasty tumor that was much more difficult to treat and possibly metastatic to the bone, which would make it no longer even potentially curable. My discussion centered on what the obligation of a physician is to such patients who utterly refuse the science- and evidence-based medicine that we know to be able to cure them of a potentially fatal disease, and I was not only surprised but somewhat taken aback by the vehemence of the discussion.

Since that post, I’ve always been meaning to take a look at what, exactly, the effect of choosing “alternative” medicine over “conventional” medicine is on the odds of survival for breast cancer patients. Even though intuitively one would hypothesize that refusing scientific medicine and relying on placebo medicine instead would have a detrimental effect on survival, it turns out that this question is not as easy to answer as you might think. For example, if you do a search on PubMed using terms like “alternative medicine,” “breast cancer,” and “survival,” the vast majority of the hits will be studies of complementary and alternative medicine (CAM) and breast cancer with little reference to what possible effect these therapies might have on survival. I can envision several reasons for this, the first being that–thankfully–relatively few women actually use alternative medicine exclusively to treat their breast cancer. Also, those that do probably drop off the radar screen of their science-based practitioners, and it is difficult, if not impossible, to capture data regarding their outcomes, given that they all too often stick with their alternative healers until the end. True, they may pop up again in their surgeon’s or primary care doctor’s office with huge, fungating tumors, only to be told that they have to undergo chemotherapy to shrink the tumor before any surgery is possible, after which they will often disappear again. Another important reason is that the natural history of breast cancer is extremely variable, from nasty, aggressive tumors that kill within months to indolent, slow-growing tumors that, even when metastatic, women can survive with for several years. (It is, of course, these women who usually show up in “alternative medicine” testimonials, because they can survive a long time with little or no treatment before their tumors progress.)
(more…)

Posted in: Cancer, Herbs & Supplements, Science and Medicine, Surgical Procedures

Leave a Comment (70) →

Welcome another new blogger for SBM

I’d like to take this opportunity to announce the arrival of another new blogger for SBM. Please wecome Dr. John Snyder.

John Snyder, M.D., is Chief of the Section of General Pediatrics and Medical Director of Pediatric Ambulatory Care at Saint Vincent’s Hospital in New York City. He is also Assistant Professor of Pediatrics at New York Medical College. Since 1994 Dr. Snyder has been active in pediatric resident and medical student education with a particular interest in evidence based pediatrics. His main area of interest is medical myth and the ways in which parents utilize information in making medical decisions for their children. One area of focus has been vaccine myth, and he lectures frequently on this subject in both academic and community settings. Dr. Snyder graduated form Mount Sinai School of Medicine and completed his residency training in pediatrics at The Mount Sinai Hospital in New York City. He is board certified in Pediatrics, and is a Fellow of The American Academy of Pediatrics. He is the founding partner of Pediatric Associates of Saint Vincents, a mutli-specialty pediatric faculty practice in New York City.

I first encountered Dr. Snyder on the HealthFraud mailing list, where, along with our very own Harriet Hall, he’s done yeoman’s work in the discussions there. Given how much the antivaccine movement has figured into the topics discussed here, I’ve also been looking for a skeptical pediatrician for quite a while now, which is why I’m very glad we’ve landed Dr. Snyder, who will be posting approximately once or twice a month. His first contribution to SBM will be posted later this week.

Please welcome him and be sure to comment on his first post, which will likely appear by Wednesday afternoon.

Posted in: Announcements

Leave a Comment (10) →