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Alternative medicine use and breast cancer (2012 update)

[Editor's note: It's a holiday here in the U.S.; consequently, here is a "rerun" from my other super not-so-secret other blog. It's not a complete rerun. I've tweaked it a bit. If you don't read my other blog, it's new to you. If you do, it's partially new to you. See you all next week with brand spankin' new material. It also (Ih hope) complement's Scott's excellent post from Thursday discussing the same issue and the same paper, but from a different perspective.]

As a cancer surgeon specializing in breast cancer, I have a particularly intense dislike reserved for cancer quacks, which I have a hard time containing at times when I see instances of such quackery applied to women with breast cancer. I make no apologies. These women are, after all, the type of patients I spend all my clinical time taking care of and to whose disease my research has been directed for the last 13 years or so. That’s why I keep revisiting the topic time and time again. Unfortunately, over the years, when it comes to this topic there’s been a depressing amount of blogging material. Indeed, Scott Gavura took a bite out of this particularly rotten apple just a few days ago. Even though he handled the discussion quite well, I thought it would be worthwhile for a breast cancer clinician to take a look. Our perspectives are, after all, different, and this is an issue that, from my perpective, almost can’t be discussed too often.

One question that comes up again and again is, “What’s the harm?” Basically, this question boils down to asking what, specifically, is the downside of choosing quackery over science-based medicine. In the case of breast cancer, the answer is: plenty. The price of foregoing effective therapy can be death; that almost goes without saying. In fact, it can be a horrific and painful death. It is, after all, cancer that we’re talking about. Aside from that, however, the question frequently comes up just how much a woman decreases her odds of survival by avoiding conventional therapy and choosing quackery. It’s actually a pretty hard question to answer. The reason is simple. It’s a very difficult topic to study because we as physicians have ethics. We can’t do a randomized trial assigning women to treatment or no treatment, treatment or quacke treatment, and then see which group lives longer and by how much. If a person can’t see how unethical that would be without my having to explain it, that person is probably beyond explanations. (As an aside, I can’t help but point out that a randomized trial of not vaccinating versus vaccinating is unethical for exactly the same reason; physicians can’t knowingly assign subjects to a group where he knows they will suffer harm. There has to be clinical equipoise.) There’s no doubt that foregoing effective treatment causes great harm.

So when it comes to figuring out just how much harm a woman risks by choosing quackery, all we’re left with, and rightfully so from an ethical standpoint, are lower quality studies, usually retrospective, and, fortunately, not very many of them. The reason is that they’re very hard to do, again because they’re retrospective and generally it’s hard to locate a sufficient number of women who turn down all surgery. The last time I discussed such a study was three years ago. It was a small study of only thirty three patients, but it found significantly decreased survival among the patients examined who eschewed conventional therapy in favor of “alternative” medicine. For example, five out of six patients who refused surgery progressed to stage IV metastatic disease, with a median time to being diagnosed with metastases of 14 months. Another study examining 5,339 women who refused surgery alone, but not necessarily other treatments, found that patients who refused surgery had a significantly decreased survival and a two-fold higher chance of dying of their disease.

Just this month, another such study was published in the World Journal of Surgical Oncology. It’s a study out of Alberta, specifically the University of Alberta and the Cross Cancer Institute and is entitled simply Outcome analysis of breast cancer patients who
declined evidence-based treatment
. Its design was relatively simple; it was a retrospective chart review of breast cancer patients who refused recommended treatments from 1980 to 2006. Patients who had “refused standard therapy” were defined thusly:

Any patient who has completely refused the recommended standard primary treatment plan following biopsy confirmation of breast cancer is considered as refusal of standard treatment. Primary treatment could be surgery, neoadjuvant radiotherapy or chemotherapy. Patients who refused adjuvant treatments following surgery were not included in this analysis.

That makes this study one of the uncommon studies that really tries to look at what happens when women refuse all standard therapy for breast cancer. Regular readers will remember that I’ve written about the “breast cancer alternative cure testimonial” for a long time; indeed, one of my very first posts for this blog was on just that topic. What’s important to remember about these testimonials is that, in almost all cases, the woman will have undergone some sort of potentially curative surgery, usually a lumpectomy or an excisional biopsy large enough to qualify as a lumpectomy, and then have refused further therapy; i.e., adjuvant chemotherapy, antiestrogen therapy (such as Tamoxifen), and/or radiation therapy. Adjuvant therapy is just that; it’s an adjuvant to the main treatment, which is surgery. As I’ve pointed out so many times, surgery is the main curative therapy for breast cancer for stage I and II breast cancer; the adjuvant chemotherapy and radiation therapy are just “icing on the cake,” so to speak. Radiation therapy decreases the chance that the cancer will recur in the local area in the breast where it was cut out, while chemotherapy and hormonal therapy decrease the chance that it will recur elsewhere in the body and kill the patient. (That’s a simplistic description, because there is good evidence that radiation therapy also contributes to a survival benefit, but it is, roughly speaking, a good way to articulate the benefits of adjuvant chemotherapy and radiation therapy.) In stage III breast cancer, surgery, radiation, and chemotherapy are usually all required to effect a cure, but surgery can in some cases still cure such a woman; the odds are considerably lower. It’s also important to remember that, before there was chemotherapy and radiation, surgery was the only modality that could cure breast cancer. William Halsted himself (the surgeon who developed the radical mastectomy) cured some women 120 years ago with nothing more than radical surgery.

What you will find in most breast cancer testimonials for alt-med “cures” is a woman refusing chemotherapy, hormonal therapy, and/or radiation therapy and then crediting her survival to whatever quackery she decided to try instead, when in reality it was the surgery that cured her. (Peter Moran also noted this and explained it well.) All she accomplishes by refusing additional therapy is to increase the odds that her tumor will return, but, given that in early stage cancer surgery alone has a pretty high cure rate, the woman’s odds were pretty good before receiving any chemotherapy. So right away, that makes this study important. At 185 patients, it’s one of the larger series looking at the outcomes of patients who refuse all conventional therapy. The authors used a matched analysis to pick a control group by picking matched patients who underwent conventional therapy who matched the following characteristics of the patients refusing therapy: age (± 3 years), calendar year and clinical stage at diagnosis. This control group consisted of five controls for every patient refusing therapy.

The authors then excluded patients over 75 because that has been the cutoff for clinical studies and active treatment protocols with chemotherapy in the past. This is actually one of the weaknesses of the study. Although it wasn’t all that long ago that we didn’t consider chemotherapy for women over 70, such is no longer the case. These days 75 years old no longer represents a cutoff above which chemotherapy won’t be administered. Even 80 years old is not a hard cutoff. I’ve seen our tumor board recommend chemotherapy on occasion for patients on occasion who were well into their 80s. If a patient is reasonably healthy and has a good performance status, oncologists are now increasingly willing to administer chemotherapy to much older people. However, this is a relatively recent development, and surgery has never traditionally been withheld from these elderly patients unless they are in really poor health with a life expectancy that is less than a couple of years. It’s also had not to note that the pendulum appears to be swinging back the other way, just not for older women but for all women. In other words, with the development of tests like the OncoType DX, we are getting better at figuring out who will and won’t benefit from chemotherapy at all ages. Still, given that the time period encompassed by this study is large, it was probably reasonable to make this exclusion, because in the earlier parts of the study it was probably rare for a woman over 75 to receive chemotherapy.

Be that as it may, that exclusion criteria left 87 patients under 75 who initially refused all therapy. The majority of patients who refused therapy were married (51%), older than 50 (61%), and urban residents (66%). As far as diagnostic criteria went, 57 patients had biopsy confirmation of their tumor only, while 30 ultimately underwent delayed surgery. 50 patients decided to undergo alternative medicine treatment, while the reasons the other 37 refused therapy were unclear or not described. The characteristics of the patients arelisted below:

It should be noted that the average delay of surgery in the patients who ultimately underwent surgery was between 20 and 30 weeks, while the delay among women who presented with stage I disease (or stage 0 disease, otherwise known as ductal carcinoma in situ) ranged from 41 to 101 weeks, with a median delay of 62 weeks. All the stage II and III patients returned to the cancer center with Stage IV disease, while the stage I patients returned with stage II, III, or IV disease. To put it more bluntly, nearly every patient who initially refused treatment progressed to a higher stage. In only four patients did the cancer fail to progress, and in none of them did the tumor shrink and downstage. It’s even uglier when we look at survival. The following graph compares disease-specific survival between patients who refused therapy and those who did not:

The difference in survival between those who underwent standard therapy shortly after thye were diagnosed with breast cancer and those who refused. The results are summarized thusly:

The 5-year overall survival was 43.2% (95% CI: 32.0 to 54.4%) for those who refused standard treatments and 81.9% (95% CI: 76.9 to 86.9%) for those who received them. The corresponding values for the disease-specific survival were 46.2% (95% CI: 34.9 to 57.6%) vs. 84.7% (95% CI: 80.0 to 89.4%).

Differences this huge are seldom seen in survival curves. Going back a ways to an older discussion of mine, in which as part of the discussion I discussed a classic paper by Bloom and Richardson that looked at the natural history of untreated breast cancer from the late 1800s to the early 1900s. The graph looks like this:

A proponent of so-called “complementary and alternative medicine” (CAM) might look at this curve and ask why the five-year survival for untreated breast cancer was around 18% while in the current study it was 43%? Aha! they might say, CAM does something! Well, not really. First, remember that 30 of the patients in the current series did ultimately undergo surgical therapy, just delayed by many weeks to several months. More importantly, remember that 100 years ago there was no mammography or ultrasound. Each and every cancer diagnosed was diagnosed when the woman had symptoms, the vast majority of a time a lump in the breast. Nearly all women were stage II or III when diagnosed. In fact, we have no idea of how many of those women already had metastatic disease at the time they were diagnosed. After all, there were no CT scanners, bone scans, or, in the early part of the time period covered by the Bloom and Richardson study, even chest X-rays. In marked contrast, far more patients from 1980 to 2006 were diagnosed by mammography, which led to a larger number of stage I cancers and especially noninvasive cancers (i.e., DCIS), which take longer to kill because they are earlier in their progression.

In brief, we’re comparing two different time periods, and we have no idea what the distribution of tumor characteristics were in the Bloom & Richardson paper compared to the characteristics of the patients in the current series. In other words, it’s just not possible to compare the two series, and, even in the absence of treatment (which includes the use of CAM, in my book), you can’t compare the series. Either way, by today’s standards, a five year median survival of 43% for all comers in breast cancer is pathetic. It probably is close to the expected five year survival in essentially untreated cases of early stage breast cancer over the last 20 years. Fortunately, we have no way of knowing for sure, as doing so would involve observing untreated women and measuring their median survival.

But wait! Let’s look at one more graph. This is a comparison of five year, disease-specific survival between women who chose to undergo CAM therapies instead of effective therapy and women whose reason for refusing therapy is unknown:

The authors write:

Since 58% of patients received different kinds of CAM, a comparison of the outcome was performed between groups who received CAM and those whose treatment details were not known. Figure 2 compares the survival patterns of women who refused treatment who either received CAM or for whom the reason for refusal was unknown. The 5-year overall survival was 57.4% (95% CI: 42.7 to 72.1%) for women who received CAM and 26.3% (95% CI: 11.3 to 41.3%) for those whose treatment details were unknown. The global survival for the CAM group was better than for women whose reason for refusal was unknown (p ≤ 0.05), and disease-specific survival for the CAM was better for women whose reason for refusal was unknown, but this was not statistically significant (31.5%; 95% CI: 15.1 to 48.0%).

I could see CAM supporters grasping at this graph to argue that CAM has an effect on survival. That would be grasping indeed. First, the difference in breast cancer-specific survival is not statistically significant, although the difference in overall survival is. Second, we have no idea what the distribution of stages and other relevant tumor characteristics is. Are they well matched? Probably not, but we have no idea. We also need to remember that the “unknown” group is just that, unknown. We don’t know why these patients refused therapy, and we don’t know whether or not some of them underwent some form or other of CAM treatment. In other words, more than likely the two groups were not matched for some characteristic or other. Did some of the patients who refused all therapy do so because they were at a more advanced stage and, instead of trying alternative therapy, had decided to give up? We don’t know. Were the patients who refused all therapy older? Were they sicker and therefore more afraid of undergoing therapy? We don’t know.

No matter how anyone tries to spin it, this study adds to the slowly growing body of evidence that, taken as a whole, conclusively demonstrates that (1) “conventional” science-based care works for breast cancer and (2) eschewing “conventional” science-based care has the potential to have disastrous consequences. I always tell patients after they’re first diagnosed that if there’s one “good” thing about breast cancer it’s that it’s not an emergency. There is time to think about therapeutic options and decide upon a treatment plan. The tumor has, after all, been there many months to many years, and, from a strictly biological standpoint, a delay of a month or two in treatment almost never makes much of a difference in outcomes. However, longer delays are dangerous, with the danger increasing along with the length of the delay. Choosing CAM or, let’s call it what most of it is, quackery, serves no purpose but to delay effective treatment, increase the likelihood that the cancer will progress to become incurable, and decrease the likelihood of cure. That progression can be horrible, too. Just go back and look at the case of Michaela Jakubczyk-Eckert. Do not click on the link, however, if you have a weak stomach.

At best, choosing CAM over effective therapy can preclude less invasive therapy and necessitate more radical treatments after the tumor has progressed, forcing a mastectomy when lumpectomy would have done if the tumor had been treated in a reasonable amount of time. At the worst, it can allow sufficient time for the tumor to metastasize and progress to stage IV. Choosing CAM over effective medicine not only increases the chance of dying from breast cancer, but it increases the chance of dying horribly from cancer. Suffering from carcinoma en cuirasse is a horrible, horrible way to die, and certainly refusing surgery increases the risk of carcinoma en cuirasse just as much as refusing chemotherapy increases the risk of dying of metastatic disease. This study is just another piece of evidence that reminds us of this.

Posted in: Cancer, Clinical Trials, Health Fraud

Leave a Comment (19) ↓

19 thoughts on “Alternative medicine use and breast cancer (2012 update)

  1. Jose A Hernandez says:

    I am concerned about the harm caused by CAM, but I am also very concerned about the harm associated with overdiagnosis (overdiagnosis, defined as occurring when “a condition is diagnosed that would otherwise not go on to cause symptoms or death”). This latter problem has been amply documented in breast cancer including recent publications (Kalager M, et.al., Overdiagnosis of Invasive Breast Cancer Due to Mammography Screening: Results From the Norwegian Screening Program. Annals of Internal Medicine 2012;156:491-499).

    Given these apprehensions, I found the following statement “nearly every patient who initially refused treatment progressed to a higher stage” disturbing. If this is true then there should be no overdiagnosis in breast cancer patients

  2. Geena says:

    Hi … I thought this post was really interesting and decided to comment when you mentioned the ethics behind running a RCT on complementary therapies (agree, it would NOT be ethical at all to test a group with medical intervention and a group without). I’m an energy healer based out of the UK and the approach we have in this country differs quite a bit from what you’ll see in the US:

    - Energy Healing is meant to be added to medical intervention, it isn’t a substitute. I always tell my clients and my readers that to forgo medical treatment for alternative, natural or complementary medicine would be irresponsible and it would give them less of a chance of survival. Energy Healing works on the emotional, mental and spiritual layers and I “believe” this has an effect on the physical, but that effect will not be swift enough to replace medical intervention. Why put yourself at risk when there has been so much research behind existing medical treatments.

    - With respect to any potential RCT’s on Energy Healing … I think the only way to prove or disprove it would be to have two separate groups, both would undergo the medical treatment prescribed by their doctors. One group would have qualified energy healers working with the patients to release blocks and shift energy, the other “control” group would have people going through the motions without channeling healing of any sort (or giving placebo pills, if its an alternative medicine/supplement they are testing.

    I believe in energy healing because of what I see and feel when I’m working with individual clients, and I’d love to see it tested in a robust way. The challenge might be who could fund something like that … In any case I only position myself as a complementary therapist and I choose not work with clients who reject medical care.

    I’m curious about your thoughts on the mind-body link in general and if you notice any patterns in your patients?

    Thanks,

    Geena

    ps …. I am really glad to have found your blog! At the moment I’m transitioning from a day job in science based health care to energy healing and I am very interested in where the two can meet. Hope to hear from you.

  3. Syberdragonwolf says:

    I don’t know if the people on SBM have considered it, but I think it would be good if you did reviews of books on Amazon.
    Lots of people buy books from Amazon like books by Robert Young.

    I think giving accurate reviews on there will help influence people away from these quack therapies.

  4. pmoran says:

    Jose A Hernandez: Given these apprehensions, I found the following statement “nearly every patient who initially refused treatment progressed to a higher stage” disturbing. If this is true then there should be no overdiagnosis in breast cancer patients.

    Not really. While the authors don’t say so, the large number of stage ll and stage lll lesions in that study suggests that these are symptomatic cancers, not mammographically detected ones.

    The overdiagnosis problem relates to the tiny, often 2 -3 mm lesions that can be picked up by quality mammography. It is assumed that some of these may never progress or get to produce symptoms within the patient’s lifetime. (What is needed is a way of treating these less aggressively when it is safe to do so.)

    Symptomatic cancer, which is rarely less than 1 cm in size and very often 2cm or more, is a very different subset of cancer. If a woman (or her doctor or partner) finds a <b<new lump, or if it is tender, inflamed or distorting the breast, that strongly suggests already progressive cancer.

    The high percentage of more advanced cancers in those who opted against conventional care suggests that these patients may have been aware of a breast abnormality for some time and quite likely already been trying out “alternative” care.

  5. pmoran says:

    Geena, are you saying that energy healers in the UK confine themselves to a complementary role alongside mainstream care? That would be a good thing, but do you have any documentary evidence that this is generally so?

    You will not find a very sympathetic hearing here, I am afraid, if you are claiming that what you do improves cancer survival, as opposed to offering the comforts of human interaction to some.

    Read the recent post by Dr Coyne on the results of psychotherapy and support groups for cancer patients. There has already been considerable study of mind-body interventions with very unconvincing results.

    What’s more, few experienced oncologists would expect either energy or mind-body influences to be helpful with this disease. Most kinds of cancer are just too predictable, regardless of the frame of mind, spiritual allegiances and determination of the patient. Also, where cancer is variable in behaviour, that has in many cases already been linked to differences in the the biological make-up of the cancer, permitting some individualization of treatments..

    We would need very dramatic preliminary evidence before diverting resources to looking elsewhere.

  6. Jose A Hernandez says:

    When Dr David Gorski asserts that all breast cancers progress to a higher stage (“nearly every patient who initially refused treatment progressed to a higher stage”) and also states that ” … surgery is the main curative therapy for breast cancer for stage I and II breast cancer,” he seems to be including “the tiny, often 2 -3 mm lesions that can be picked up by quality mammography” in the equation.
    Dr Moran’s point is valid – most the patients are probably Stage II and III. I am just extremely concerned about the popular misconception that all cancers progress to higher stage: a misconception driving overidiagnosis.

  7. Geena says:

    Hi P Moran, Thanks for the response …

    First off, no I don’t claim that what I do improves a client’s chance of survival (should have chosen my words more carefully). When I say “it works” I mean I can feel the energy flowing and so can my clients. I don’t have enough clinical experience with cancer patients or evidence to claim that healing will prolong their life or improve survival chances (but I’m open to the possibility) … I’ve had positive feedback from clients who came to see me with headaches, anxiety, stress, cramps, sore throats, PMS, energy levels, attitude, etc …

    Self-assessments are subjective, and these symptoms aren’t linked to survival (as far as I’m aware) so I would not claim that energy healing prolongs a client’s life.

    Back to your question about the UK being different from the US, accredited healers are regulated by a body called the British Alliance of Healing Associations, which is linked to another organization that accredits healers to work with the NHS (the national health system) and to work in hospitals. To become a member, qualify for insurance and be listed on the BAHA list of healers we have to agree to:

    - Refer to healing as complementary, not a replacement for medical intervention.
    - We’re not allowed to advertise our services as a cure, or to mention specific diseases (i.e. no mention of cancer, diabetes, etc in the advertisements) and we can’t promise or allude to a positive outcome.
    - Its also best practice to refer to our clients (and not patients) as a patient is treated by a doctor.
    - Healers that break the “Code of Conduct” are put on probation or banned

    I don’t know the Code of Conduct by heart but this is probably different from what is common in the States?

    It is possible to break the code and practice but the healer loses their accreditation, and depending on how aggressive their advertising is they might also break the law. My impression is that the regulations in the States are a lot more relaxed in general and it is easier to get away with misleading claims in that country. You can see this in something as obvious as anti-wrinkle creams, the same formula can be marketed in the States with claims that are generally thought to be “untrue” in Europe.

    Thanks for pointing out that article on support groups, I will have a look =)

  8. Scott says:

    - Refer to healing as complementary, not a replacement for medical intervention.
    - We’re not allowed to advertise our services as a cure, or to mention specific diseases (i.e. no mention of cancer, diabetes, etc in the advertisements) and we can’t promise or allude to a positive outcome.

    IOW you’re not permitted to commit outright fraud?

    I also hate to break it to you, but energy healing HAS been repeatedly and robustly tested. And found to be nothing more than an elaborate placebo. You’re not doing anything for anybody other than providing some sympathetic human contact. Which is great, but it would be so much more appropriate to not try and dress it up with false claims about healing energies.

  9. pmoran says:

    Jose: When Dr David Gorski asserts that all breast cancers progress to a higher stage (“nearly every patient who initially refused treatment progressed to a higher stage”) and also states that ” … surgery is the main curative therapy for breast cancer for stage I and II breast cancer,” he seems to be including “the tiny, often 2 -3 mm lesions that can be picked up by quality mammography” in the equation.

    (I assume Dr Gosrski is still on hols). I assure you he would not say the same about mammographically detected cancers (he has written on that subject here), although, the “nearly” could possibly be stretched that far depending on what rate of overdiagnosis is considered most accurate.

    The statement you are objecting to above refers to the outcome of a particular study and is a matter of fact for that group.

    However, these results are supported by a lot of other general experience with breast cancer. They confirm what we would expect, that “nearly” all patients who refuse treatment, or who try to treat a symptomatic breast cancer with (most) “alternative” methods, will experience cancer progression. We know from other observations that an occasional one will stay much the same for long periods and a rare one will regress spontaneously.

    On the evidence we now have this might not be quite the case with as many mammographically detected cancer.

  10. cloudskimmer says:

    Dr. Gorski,
    While it is unethical to place people in groups for no treatment, I note that this study was done in Canada, where health care is mostly available to all. Would it be possible to do a similar study in the United States where ability to pay gets people treatment, and lack of insurance puts people into a pool where they either don’t get medical care or else go bankrupt? I suppose that’s unethical, but common practice in this country.

    Geena, I’m delighted that you found your way to this site. I was especially intrigued by your comment that you can “feel the energy flowing.” Are you familiar with the Rosa study where therapeutic touch was tested and found wanting? What are your comments on that study? See http://www.quackwatch.com/01QuackeryRelatedTopics/tt.html
    And here’s a link to the abstract of the paper: http://www.ncbi.nlm.nih.gov/pubmed/9533499

    Another intriguing statement was, “I’d love to see it tested in a robust way. The challenge might be who could fund something like that…” Have you heard of the James Randi Educational Foundation and their million dollar challenge? If you can feel human energy fields, you should be a cinch to win the prize. You have to agree to a fair test procedure with clear standards for failure or success, and you have to subject your claims to verifiable standards. I’m really glad you found your way to this website, too. I hope it means that you are willing to subject your beliefs to scientific scrutiny, and really find out what is true and what is not. I hope you will read about the history of claims like those you are making, such as the story of Franz Mesmer–perhaps the first to make claims about human energy fields. And I hope you will also find your way to another good site, The Skeptics Dictionary. I’m really interested in how your search turns out and I wish you well on your journey.

  11. cloudskimmer says:

    Geena: And here is a link to the Rosa article:

    http://jama.jamanetwork.com/article.aspx?articleid=187390

  12. jmb58 says:

    Geena, if you honestly study the research on energy healing, as well as the basics of the placebo effect and confirmation bias, I have no doubt you will come to the conclusion that there is nothing to energy healing.

    I compliment you on your willingness to investigate the issue using resources like this blog.

    Jose, the study states that 6-10 patients are overdiagnosed for every 2500 screened. Numerous studies show that breast cancer screening saves lives. I’ll take that trade-off.

    In my practice I am aggressive about doing excisional biopsies/lumpectomies. They just aren’t very morbid. Of course there is the cost to the medical system, and the psycological stress to the patient. But missing the chance to cure a patient is something I hope never happens in my career.

    If it was my wife I would take an unnecessary lumpectomy over a missed chance to cure every time.

  13. Chris says:

    jmb58:

    If it was my wife I would take an unnecessary lumpectomy over a missed chance to cure every time.

    Then there are those who look more closely at the data. A friend recently went in for a lumpectomy, but that appointment was cancelled when her biopsy tests came in. The next week she had a double mastectomy. Fortunately the subsequent reports from her hubby was that they got everything, and only minimal treatment will be needed.

    The real kicker is that she is a PhD microbiologist who works for Big Pharma. More than a few times in the past few years has her employment been in jeopardy due to acquisitions, and failed drug trials. Despite assumptions, working for “Big Pharma” is no guarantee of riches (our friends only recently replaced a thirty year old car). I know of at least a couple other people whose companies were bought out, and they were let go because they refused to leave their families and move across the country.

  14. jmb58 says:

    “Then there are those who look more closely at the data”

    Uh, what? I spend a lot of time looking at breast cancer research data, especially the surgical literature.

    ‘A friend recently went in for a lumpectomy, but that appointment was cancelled when her biopsy tests came in. The next week she had a double mastectomy’

    I’m not sure what the above anecdote is meant to illustrate. There are a lot of factors that go into selecting a treatment regimen. Without knowing the details of your friends case I can’t comment on why a double mastectomy was performed.

    My point was if my wife had a lump or an abnormal mammogram finding I would be more worried about missing a cancer than overdiagnosis.

  15. Chris says:

    Oh, I am sorry. I was rushed. I meant the oncologists who looked closely at my friend’s biopsy. Their preliminary findings indicated that she just needed a lumpectomy, but further data showed that was not sufficient. They almost missed a cancer, but caught it in time.

    I was trying to support your point.

  16. jmb58 says:

    Sounds good Chris.

    Hope your friend continues to do well.

  17. Chris says:

    Thanks. We do too.

  18. Geena says:

    @ Cloudskimmer: Thanks for the links, I will have a look!

    The Therapeutic Touch they mention on the Rosa article is what I call Energy Healing, so thanks for sharing that. I’m not surprised that test failed, as its not representative of how I would experience a healing session. What I get are sensations of hot, cold or energy surges at specific points in the energy field but not throughout. So I might not always feel something over the hands. Anyhow, I don’t expect you to take my word for it. =)

    I’d be happy to have my beliefs tested at some point in the future when I have a better idea of what they are and how to go about it. In the meantime I’ll have a dig through the Rosa references to see what else is out there. Appreciate you sharing the links as I really am curious about what’s true and what’s not.

    Also, I found this quote on the latest SBM article to be interesting :

    “Similarly, I really wonder if a rational/critical thinking module is missing or rudimentary for some people. How else can someone read about homeopathy or reiki and not laugh? Or maybe it is me. I lack the necessary neurologic module that can see the truth.” – Posted by Mark Crislip on Guiding Lights.

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