“Liquid biopsies” for cancer screening: Life-saving tests, or overdiagnosis and overtreatment taken to a new level?
I’ve written many times about how the relationship between the early detection of cancer and decreased mortality from cancer is not nearly as straightforward as the average person—even the average doctor—thinks, the first time being in the very first year of this blog’s existence. Since then, the complexities and overpromising of various screening modalities designed to detect disease at an early, asymptomatic...
Donald Trump and the dangerous vaccine politics of the 2016 Presidential race
At the second Republican debate of the 2016 election cycle, Donald Trump parroted antivaccine pseudoscience, and Ben Carson walked back his previously strong support for vaccine mandates. Earlier in the campaign, Rand Paul blamed vaccines for "neurologic injury," and Chris Christie briefly pandered by questioning vaccine mandates. What's going on here? Is the Republican Party becoming the antivaccine party?
The Federal Trade Commission takes on homeopathy—maybe
Well, I’m back. OK, returning from London isn’t nearly as epic as Sam Gamgee’s final words in The Lord of the Rings returning to his wife and daughter after having accompanied Frodo, Gandalf, Bilbo, and key elves of Middle-Earth to the Grey Havens, there to say goodbye to them as they boarded a ship to the undying lands. I just love the...
“Precision medicine”: Hope, hype, or both?
I am fortunate to have become a physician in a time of great scientific progress. Back when I was in college and medical school, the thought that we would one day be able to sequence the human genome (and now sequence hundreds of cancer genomes), to measure the expression of every gene in the genome simultaneously on a single “gene chip,” and...
Vaccine Whistleblower: An antivaccine “exposé” full of sound and fury, signifying nothing
Antivaccine lawyer Kevin Barry has published a book containing what are allegedly the transcripts of telephone conversations between "CDC whistleblower" William Thompson and biochemical engineer turned incompetent antivaccine epidemiologist Brian Hooker. Suffice to say, the transcripts do not show evidence of a massive coverup at the CDC of evidence that vaccines cause autism.
How should we treat DCIS?
I’ve written more times than I can remember about the phenomenon of overdiagnosis and the phenomenon that is linked at the hip with it, overtreatment. Overdiagnosis is a problem that arises when large populations of asymptomatic, apparently healthy people are screened for a disease or a condition, the idea being that catching the disease at an earlier stage in its progression will...
“Aborted fetal tissue” and vaccines: Combining pseudoscience and religion to demonize vaccines
As hard as it is to believe after seven and a half years of existence and nearly 2,400 posts on SBM, every so often, something reminds me that we here at SBM haven’t discussed a topic that should be discussed. So it was a couple of weeks ago, when I saw a familiar name in a news story that wasn’t about vaccines....
The Woo Boat, or: How far Andrew Wakefield has fallen
File this one under the category: You can’t make stuff like this up. (At least, I can’t.) Let’s say you’re a diehard all-conspiracy conspiracy theorist and alternative medicine believer (a not uncommon combination). You love Alex Jones and Mike Adams and agree with their rants that there is a New World Order trying to suppress your rights. You strongly believe that vaccines...
The 21st Century Cures Act: The (Somewhat) Good, The (Mostly) Bad, and The (Very) Ugly
The approval of new drugs and medical devices is a process fraught with scientific, political, and ethical landmines. Inherent in any such process is an unavoidable conflict between rigorous science and safety on the one side, which tend to slow the process down by requiring large randomized clinical trials that can take years, versus forces that demand faster approval. For example, patients...
Medical marijuana as the new herbalism, part 4: Cannabis for autism
Medical marijuana. It’s promoted as a seeming panacea that can cure whatever ails you. While there are potentially useful medicinal compounds in marijuana, in general the medical marijuana movement vastly oversells the promise. Nowhere is this more true than for cancer and autism, where there is no compelling evidence that cannabis cures cancer. Worse, parents are subjecting autistic children to cannabis with...