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Archive for October, 2013

Full of Energy

Want to know what a craniosacral treatment is actually like? How about reiki? What about Eden energy medicine – do you even know what that is? Read on, because this past Sunday afternoon I experienced all three.

But first, the why and where. The local Healing Arts Alliance of the Big Bend (which is what they call the area of Florida I live in) held an information session for the public at our local library’s meeting room. Practitioners of about 10 different “healing arts” sat at a circle of folding tables chatting with visitors and handing out information. One even brought her diagnostic machine, which measures a person’s aura. (More on this later.) Some offered free samples of their treatments. It was a great opportunity for science-based medicine field work and I aimed to take full advantage.

The Alliance handed out a free booklet at the door listing local health care practitioners who:

. . . share a commitment to the whole person, patient-centered approach to health and wellness.

But, as the booklet explains,

[w]e do not endorse any specific method or system. Our member/practitioners are committed to a nonjudgmental collaboration and cooperative relationship . . .

This philosophy is indeed fortunate. If any of these practitioners endorsed a specific method, such as, say, the scientific method, it could lead to the judgment that what some of the others are saying is gobbledygook.

The booklet contains a helpful “Glossary of Holistic Health Terms,” which further serves to make the point that nonjudgmental collaboration is absolutely necessary to the cause. A few examples:

BioMat: This device delivers the highest vibrational resonance deep into all the tissues of the body using negative ions, amethyst, and Far-Infrared light to open the channels for intelligent cellular communication leading to DNA repair and total body wellness. Negative ions, found in abundance in nature, heighten alertness and mental energy, and decrease drowsiness. Amethyst enhances strength, stability and vigor. Far-Infrared light assists blood flow, helps release toxins and enlivens metabolism. Elevating temperature eliminates bacteria, heals and relaxes muscles, boosts immune system [sic], and promotes cardio fitness and healthy arteries.

Total body wellness is hard to beat. The one true cure, indeed! (more…)

Posted in: Cancer, Chiropractic, Energy Medicine, Health Fraud, Herbs & Supplements, Homeopathy

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Lorenzo’s Oil

Augusto Odone is an Italian economist best known for his son, Lorenzo, after which Odone named the oil that he helped develop to treat his son’s neurological disease. Lorenzo’s oil was the subject of a 1992 movie starring Nick Nolte and Susan Sarandon, and of course what most people think they know about the story they learned from the Hollywood version.

This past week Augusto Odone died at the age of 80, prompting another round of media reporting about Lorenzo’s oil.

Probably because of the Hollywood movie, this story more than any other is an iconic example of the disconnect between the simple narratives the media love to tell (and we love to tell ourselves) and the more complex reality.

The basic facts of the story are not in dispute. Lorenzo Odone, son of Augusto and his wife, had a neurological disease known as X-linked adrenoleukodystrophy (X-ALD). This is a devastating genetic disease in males, with two basic forms. Childhood onset tends to progress rapidly and typically death occurs by age 10, although lifespan can be increased if an early bone marrow transplant is given. In adult onset, symptoms may not appear until adulthood, and then tends to progress more slowly, over decades. Some boys with the X-ALD gene do not develop clinical findings. Women are carriers, with partial protection from their second X chromosome. About half of female carriers become symptomatic, with the slower adult form of the disease.

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Posted in: Neuroscience/Mental Health, Science and Medicine

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Chiropractic Abuse: An Insider’s Lament

chiropractic-abuse

There is a new book critical of chiropractic: Chiropractic Abuse: An Insider’s Lament. The author, Preston Long, DC, PhD, is a chiropractor who says he made a big mistake when he chose chiropractic as a career. He has written an intriguing book explaining his mistake and the experiences that resulted from it during 3 decades as a chiropractor and a critic of chiropractic.

Chiropractic encourages self-delusion, and those who break free of delusion have two choices: to fight or run. Preston Long chose to fight, to keep the baby and throw out the bathwater polluted with pseudoscience and quackery, to try to practice rationally and ethically, and to try to reform chiropractic from within. He soon learned that it was next to impossible for a chiropractor to make a living with a science-based, ethical practice. He eventually found his niche and put his knowledge of chiropractic to good use. He evaluates chiropractic cases for disability and fraud, has worked with the FBI, and has testified at over 200 trials. He has written two previous books, The Naked Chiropractor (2002) and The P.R.E.S.T.O.N. Protocol for Back Pain (2006). This new book tells the story of his life and exposes the delusions and misbehaviors of his chiropractic colleagues.

He reveals “20 things most chiropractors won’t tell you”: (more…)

Posted in: Chiropractic

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Chemotherapy doesn’t work? Not so fast… (A lesson from history)

If there’s one medical treatment that proponents of “alternative medicine” love to hate, it’s chemotherapy. Rants against “poisoning” are a regular staple on “alternative health” websites, usually coupled with insinuations or outright accusations that the only reason oncologists administer chemotherapy is because of the “cancer industrial complex” in which big pharma profits massively from selling chemotherapeutic agents and oncologists and hospitals profit massively from administering them. Indeed, I’ve lost track of the number of such rants I’ve deconstructed over the years. Usually, they boil down to two claims: (1) that chemotherapy doesn’t work against cancer (or, as I’ve called it before, the “2% gambit“) and (2) that the only reason it’s given is because doctors are brainwashed in medical school or because of the profit motive or, of course, because of a combination of the two. Of course, the 2% gambit is based on a fallacious cherry picking of data and confusing primary versus adjuvant chemotherapy, and chemotherapy does actually work rather well for many malignancies, but none of this stops the flow of misinformation.

Misinformation and demonization aside, it is also important to realize that the term “chemotherapy,” which was originally coined by German chemist Paul Ehrlich, was originally intended to mean the use of chemicals to treat disease. By this definition, virtually any drug is “chemotherapy,” including antibiotics. Indeed, one could argue that by this expansive definition, even the herbal remedies that some alternative medicine practitioners like to use to treat cancer would be chemotherapy for the simple reason that they contain chemicals and are being used to treat disease. Granted, the expansive definition evolved over the years, and these days the term “chemotherapy” is rarely used to describe anything other than the cytotoxic chemotherapy of cancer that in the popular mind causes so many horrific side effects. But in reality virtually any drug used to treat cancer is chemotherapy, which is why I like to point out to fans of Stanislaw Burzynski that his antineoplastons, if they actually worked against cancer, would be rightly considered chemotherapy, every bit as much as cyclophosphamide, 5-fluorouracil, and other common chemotherapeutics.
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Posted in: Basic Science, Cancer, Clinical Trials, History

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Anti-VEGF treatment of Macular Degeneration: Science-Based Success

Science-Based Medicine authors tend to focus attention on practices that misuse or ignore the tools of science. This is not a criticism. As a daily reader and occasional contributor, I recognize that shining a light on pseudoscience is a critical part SBM’s mission. It is what brings me back day after day. Sometimes, however, it is nice to highlight what real science and real evidence can do.

In my world of treating patients with retinal disease, a revolution has taken place over the past few years. The most aggressive form of macular degeneration has been transformed from a relentlessly progressive, disabling disease to one which can be tamed with medication. Now, patients diagnosed with exudative macular degeneration can expect stabilization and even improvement in vision.

It is a story worthy of a Hollywood movie. Start with a reluctant hero; add controversy, Wall Street, politics, and most important of all, a happy ending.
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Posted in: Clinical Trials, Science and Medicine

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Student Health Professionals and Attitudes about CAM

While I’m now two full decades out of pharmacy school, I am occasionally invited to return to give a lecture or facilitate a workshop. Pharmacy education has changed a lot since the 1990′s. For me, pharmacy was a Bachelor’s degree program you started right out of high school. Today, students must have a few years of university completed before they can apply (some already have one degree), and the more common degree granted is doctorate-level, the Pharm.D. The clinical training has been bulked up and the practical training is much more rigorous. I see all this as positive change, as the practice of pharmacy has changed along with the education standard. The era of the “count, pour, lick and stick” pharmacist is disappearing as these tasks are automated or delegated to others. Today’s pharmacist has the opportunity to deliver care in different ways, including new roles like vaccine provider, and medication review/drug therapy optimizer. Many find positions that allow them to leverage their drug-related expertise to other areas of the healthcare system.

With pharmacists’ knowledge of drug products it should not be a surprise that they are consulted widely for advice by patients as well as other health professionals. Public surveys on trust show pharmacists lead other health professionals on this measure. It should also not be a surprise that pharmacists can be quite influential in shaping drug use, particularly when it comes to advice about complementary and alternative medicine (CAM), especially when it is used with conventional, science-based drug treatments. After all, drug stores are becoming (to my professional embarrassment) purveyors of all forms of CAM, ranging from homeopathic “treatments” through aisles of herbal remedies, vitamins, and other supplements. One pharmacy I used to work at sold copper bracelets, magnets, salt lamps, ear candles, homeopathic “first aid” kits, and detox packages that were purported to “balance” your pH. If there was a plausibility limit to what this pharmacy would sell, I never saw it reached. I gave the best science-based advice I could, but eventually left due to my concerns about what was on the shelves. But my time in that setting showed me the opportunity to improve care: the pharmacist is well positioned to advise on the evidence for or against any particular treatment, as well as the describe the potential risks with combining CAM with evidence-based treatment approaches. (more…)

Posted in: Herbs & Supplements, Pharmaceuticals, Science and Medicine

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The CAM Worldview

Harriet has written some excellent recent posts about how to talk to CAM (complementary and alternative medicine) proponents, and answers to common CAM fallacies. I have written about this myself numerous times – we deal with the same logically-challenged claims so often that it’s useful to publish standard responses.

In fact, I often wonder about the seeming uniformity of poor arguments put forward by advocates of CAM and critics of SBM. Do their arguments represent common problems of thought, pathways of mental least resistance, or are we seeing the repetition of arguments resonating in the echochamber of a subculture? I suspect it’s all of those things, which all feed into a particular world-view.

Actually CAM proponents seem to fall into one of several common world views, or flavors, as I like to call them, ranging across the spectrum from pseudoscience to anti-science. There is substantial overlap, however, with common anti-scientific themes.

I recently had an exchange with an SBM reader who was demanding that a particular post be taken down, because “every single fact in the article is wrong.” I responded as I always do – please point out the factual errors, with proper references, and I will make sure that all appropriate corrections are made. This did not satisfy the e-mailer who insisted that the article was 100% false and libelous.

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Posted in: Science and Medicine

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How to Talk to People About CAM

Recently a correspondent asked me for advice about his parents. He said they use things like homeopathy, acupuncture, and copper bracelets. They use conventional medicine too, but it seems to be a 50/50 approach that gives each an equal weighting. He has tried to talk to them about things like homeopathy and the placebo effect, but the shutters come down hard and fast. He tries to criticize the alternative treatment itself without offending or attacking the person, but his mother still sees it as a personal attack. He worries that as they get older and in need of more medical care, his parents may not make the best decisions. He asks about how to tactfully have these conversations and perhaps change their point of view.

That’s a very tough question that gets asked a lot, and I don’t have any good answers; but I do have some thoughts and untested ideas that could serve as the starting point for a discussion, and I hope readers will pipe up in the comments and tell us what has or hasn’t worked for them. (more…)

Posted in: General

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Redefining cancer

Blogging is a rather immediate endeavor. Over the last nine years (nearly), I’ve lost track of how many times I saw something that I wanted to blog about but by the time I got around to it, it was no longer topical. Usually what happens is that my Dug the Dog tendencies take over, as I’m distracted by yet another squirrel, although sometimes there are just too many targets topics and too little time. Fortunately, however, sometimes the issue is resurrected, sometimes in a really dumb way, such that I have an excuse to correct my previous oversight. This is just such a time, and the manner in which the topic has been resurrected is every bit as dumb as the rant by the Food Babe that Mark Crislip so delightfully deconstructed last Friday. Unfortunately, for purposes of snark, I’m not Mark Crislip—but, then, who is?—but fortunately I am known elsewhere (and sometimes here) for being a bit “insolent.” So let’s dig in. We’ll start with the idiocy and then use that as a “teachable moment” about cancer biology. Funny how I manage to do that sort of thing so often.

Abuse of cancer science for political purposes

I realize that we at SBM are supposed to stay, for the most part, apolitical, but the idiocy that’s leading me to revisit a topic is unavoidably political because it involves using a profound misunderstanding of science for political ends. Specifically, I’m referring to the misuse of a legitimate scientific debate about cancer screening and diagnosis for purely political ends. First, however, for those not living in the US or my fellow citizens who might be blissfully unaware (in this case) of recent events, during the first half of October, our nation underwent what can only be described as a self-inflicted crisis that could have caused worldwide economic turmoil if it hadn’t been (sort of) resolved at the last minute. The reason for the crisis boiled down to the extreme resistance of some of our more radically conservative Representatives to the Patient Protection and Affordable Care Act, usually referred to as just the Affordable Care Act (ACA) or, colloquially, Obamacare. Normally when we write about Obamacare here on SBM, it’s to complain about how advocates of unscientific medicine and outright quackery have tried to piggyback their advocacy on the ACA in order to have health insurance plans sold through government exchanges cover modalities like naturopathy, chiropractic, and other so-called “complementary and alternative medicine” (CAM) or “integrative medicine.” In related posts, I’ve examined the evidence with respect to the relationship between health insurance and mortality and whether attacks on Medicaid as not improving the health of patients insured by it have any validity. (Let’s just say they are oversimplifications and distortions.)
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Posted in: Cancer, Politics and Regulation, Science and the Media, Surgical Procedures

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Scam Stud

We have evolved in order to survive reality, not to understand it. And it is a good thing that understanding and survival are not tightly linked as many people are apparently totally disconnected from the reality I inhabit, the one described by the natural sciences. When I started writing and podcasting about the SCAMverse I was under the impression that people who used SCAMs were simply misinformed. If people were made aware of the facts of the matter, they would see the error of their ways and put away their SCAMs as the childish thoughts they are.

Silly me. Reality, as I understand it, is often if little interest to proponents of SCAM. This was brought home by the Food Babe with an essay Should I get the Flu Shot? Spoiler alert. Her answer is “No, I’m not taking the Flu Shot. Ever.”

It is how she reaches that conclusion that is amazing. There are nouns and adjectives and adverbs and verbs and article and prepositions. They are strung together to form sentences and paragraphs, but somehow, though an almost magical alchemy, all that writing transmutes into content that is completely divorced from reality as I understand it. It is a tour de farce that reaches the definition of the Pauli Principle, where “It is not only not right, it is not even wrong.” (more…)

Posted in: Science and the Media, Vaccines

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