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612 thoughts on “Death by “alternative” medicine: Who’s to blame?

  1. HCN says:

    pec said “I am a skeptical scientist.”

    No you are not. You have shown known evidence that you can think critically, scientifically, and your obtuseness is particularly telling.

  2. HCN says:

    Fifi, she claimed to be a computer scientist:
    http://www.sciencebasedmedicine.org/?p=87#comment-2869

    Which probably means nothing. Her actions and obtuseness speak louder than any her claims of what she things she is.

  3. Fifi says:

    HCN – Thanks. How strange that she thinks that a degree in computer science translates to medicine! I have quite a few friends who are programmers, developers and on the cutting edge of various theoretical and practical aspects of computer science, some who are even university professors, but none of them think this makes them qualified to give medical advice or gives them special insight into medicine!

  4. Harriet Hall says:

    pec said,

    “Dr. Hall seems to be saying that mainstream science agrees with me, that the cancer cells may at least sometimes be a symptom rather than a cause. But I get the impression that Dr. Gorski finds this idea to be associated with ridiculous quackery.”

    You’re misinterpreting and distorting what we said. I said that science is trying to understand what conditions allow cancer to develop, and Dr. Gorski simply asked you if you had any evidence that cancer was a “symptom” of some specific disease. We both recognize that cancer is a disease in its own right once it has developed. A tendency to develop cancer might also be a disease in its own right, and science is looking seriously at that possibility.

    No one thinks cancer cells themselves are a “cause” because something had to happen to “cause” those cells to develop in the first place. And the cells themselves are necessary but not sufficient for invasive disease to occur. And “symptom” is not the right word. Cancer is an objective finding, not a subjective symptom.

    I will ask AGAIN: What do you think the doctors should have told the patient with the 1 cm cancer?

    PLEASE ANSWER THIS QUESTION

  5. David Gorski says:

    I am a skeptical scientist.

    You most definitely are not.

    I am criticizing the belief that the life-threatening diseases we refer to as cancer can be cured, or successfully treated, by eradicating the cancer cells. I am not going to pretend I know what causes all cancer.

    “Criticisms” of science tend to be taken more seriously if the person making the criticisms can produce an alternative hypothesis that is testable and could account for current observations at least as well as the current hypothesis or reigning paradigm. Your criticism strikes me as being critical for the sake of being critical because you don’t like “conventional” medicine and don’t “believe” in it. This is especially true since your criticisms are so poorly argued and based on either no data at all or misinterpretations of existing data.

    Dr. Hall seems to be saying that mainstream science agrees with me, that the cancer cells may at least sometimes be a symptom rather than a cause.

    But I get the impression that Dr. Gorski finds this idea to be associated with ridiculous quackery.

    Define “symptom” and “cause” for purposes of your argument

    In any case, the idea that cancer cells are merely a manifestation of something else or some other “disease” frequently is associated with ridiculous quackery. That’s why, if you’re going to convince me that you’re not a believer in one of the several varieties of ridiculous quackery that make the claim that cancer is not a disease but rather a “symptom” of some other problem (as, for example, the German New Medicine or Robert O. Young’s acid-base quackery do), you’re going to have to give me an idea of what you think the cause that manifests itself as cancer cells may in fact actually be and why.

    It’s not at all an unreasonable request, yet when it is made you bob, dodge, and weave like Muhammad Ali–anything to avoid directly answering it.

  6. Fifi says:

    Dr Gorksi – Isn’t that slightly insulting to Ali? The man really did float like a butterfly and sting like a bee, pec on the other hand shows neither the elegance or strength – or conviction in her beliefs – that Ali did!!! Even after he’d taken all those hits to the head!

  7. David Gorski says:

    Good point. My apologies to Ali.

  8. pmoran says:

    Pec needs to understand that “alternative” sources confuse matters by not distinguishing the causes of cancer, which can certainly affect the whole body, from the cancer itself, which is always confined to a specific tiisue or organ.

    Thus radiation can cause cancer in many tissues but the ca

  9. pmoran says:

    Apologies, I was about to say that radiation canc caradiation canc

  10. pmoran says:

    Sorry again. I am not sure what key I press that submits comments prematurely.

    Anyway, that is the point — confusing predisposing factors with what is now a well defined disease — cause with effect.

    Leukemia can affect the whole body, but it is clearly an irreversible change in one clone of one specific type of bone marrow cell. Exposure to ionising radiation can cause thyroid cancer, but it would be ridiculous to regard the cancerous cells as simply “radiation sickness”. We actually understand a great deal about the causes of cancer and most of them are either not correctable or past history by the time the cancer develops.

    Illustrating the problem, there is no consistent example in clinical experience or in experimental cancer in animals where cancer cells have reverted permanently to normal as the result of any change in the body’s environment or any treatment. In order to eliminate cancer the aberrant cancer cell has to be either destroyed or induced to kill itself.

    We will almost certainly learn to switch off cancer genes reducing the growth rate of cancers and even possibily inducing a state of dormancy, but even then the cancer cell will almost certainly eventually find ways around such treatments through its ability to mutate further.

  11. pec says:

    “if you’re going to convince me that you’re not a believer in one of the several varieties of ridiculous quackery that make the claim that cancer is not a disease but rather a “symptom” of some other problem … you’re going to have to give me an idea of what you think the cause that manifests itself as cancer cells may in fact actually be and why.”

    We know that a healthy body is able to destroy or contain most cancer cells. When the body’s natural defenses fail, it might be because the attack was overwhelming (for example, when the lungs are exposed to carcinogens for decades because of cigarette smoking), but it also might be that the body and its immune system have been weakened by some other cause.

    Considering the latter possibility has been more of a priority in alternative medicine than in mainstream medicine.

    For example, you often use chemotherapy following surgery for early cancer, even though it is more likely to be harmful than beneficial for over 90% of these patients. The patients who insist on receiving chemotherapy probably think the short term side effects will be worth it, since their chances of long-term health will be improved.

    If patients were better informed, and were told that in most cases the chemotherapy is likely to cause permanent heart damage and to weaken the immune system (when a weakened immune system may have actually caused their disease by failing to contain cancer cells), then it is not very likely they would continue to insist on receiving it.

  12. pec says:

    “there is no consistent example in clinical experience or in experimental cancer in animals where cancer cells have reverted permanently to normal as the result of any change in the body’s environment or any treatment. In order to eliminate cancer the aberrant cancer cell has to be either destroyed or induced to kill itself.”

    The body has a natural ability to fight cancer. This may become very unlikely once a critical level of disease has been reached. Furthermore, the mainstream treatments may sometimes contribute by weakening the immune system even more.

    It is not known how often cancer patients might recover without artificial destruction of cancer cells, since depriving patients of standard treatments is considered unethical.

    Maybe there are alternative treatments that help the body fight cancer naturally. I have no opinion on this. There has probably not been enough formal research done, since the huge funding grants go to study synthetic chemicals, not natural alternatives.

  13. pec says:

    This story is about an isolated case, so it does not count as scientific evidence. But this post was also about an isolated case, so you should allow me to do the same.

    I had a relative who was diagnosed with deadly skin cancer and advised to have surgery immediately. He ignored the advice because he didn’t want to be disfigured, and went on for decades with no troubling symptoms. One day he had a bad nose bleed and the cancer was somehow ejected. After that he lived to be over 90 without ever being sick from cancer.

    Just one example, but we have really no way to know how often this may happen, since most cancer patients aren’t as vain as my relative was!

    This happened long ago, when I still had a lot of faith in experts. I thought my relative was crazy to ignore their advice, and I was extremely surprised when his body somehow cured itself.

  14. Harriet Hall says:

    pec,

    Dr. Gorski’s example was a documented medical case; yours is only hearsay, and very unbelievable hearsay at that. How do you know he had deadly skin cancer? Do you have the biopsy report? Where was the cancer? How could a nose bleed “somehow eject” it?

    I will ask AGAIN: What do you think the doctors should have told the patient with the 1 cm cancer?

    PLEASE ANSWER THIS QUESTION

    I’m getting tired of asking.

  15. Harriet Hall says:

    pec said,

    “in most cases the chemotherapy is likely to cause permanent heart damage”

    That’s an outright lie.

  16. weing says:

    First of all, there is no alternative medicine. The correct term is quackery. The studies done by quacks are marketing studies to get people to buy their products, whatever they may be, prayer, beads, crystals, herbs, energy therapy, whatever. They hijack terms from real medicine and pretend they have treatment methods, that real medicine is researching, but hasn’t yet come to fruition. People with cancer are desperate. As the saying goes, a drowning person will grab a sharp razor to try to save himself.

  17. pec says:

    “Dr. Gorski’s example was a documented medical case; yours is only hearsay, and very unbelievable hearsay at that.”

    It wasn’t hearsay. It was a close relative, and my whole family knew about it. The relative was diagnosed by MDs who were friends of the family, so we knew it was a real diagnosis. It was talked about a lot for a while, since we were all so astounded that someone would ignore expert advice about something that serious.

    I saw the relative many times after that and I know he never got sick from cancer. Decades later we heard about the nose bleed. I did not witness it. But I do know for a fact that he lived to well over 90 without ever getting sick from cancer.

  18. Harriet Hall says:

    pec,

    Still hearsay. Where is the biopsy report?

  19. pec says:

    “I’m getting tired of asking.”

    I answered you repeatedly. I said the patient should be told the truth, not that the treatment has a 93% cure rate. And she should be told that chemotherapy is only useful for a small minority of patients in her situation, and that it is very likely to cause long-term damage. I also said that, as far as I know, surgery would not be likely to cause harm and might help her body defeat the cancer. But I really don’t know, am just conceding that some aspects of mainstream treatment might be helpful.

  20. pec says:

    PEC: “in most cases the chemotherapy is likely to cause permanent heart damage”

    HALL: “That’s an outright lie.”

    http://www2.mdanderson.org/depts/oncolog/articles/07/11-nov/11-07-2.html

    “Chemotherapy and even newer biological and targeted cancer therapies can weaken a patient’s heart. A study by M. D. Anderson cardiologists, published in the June 29, 2004, issue of the journal Circulation, reviewed the effects of 29 anticancer agents and concluded that every class of cancer drugs can potentially damage the heart.”

  21. weing says:

    Why should the patient be told lies? What are you talking about? Are applying data on estrogen receptor negative post-menopausal patients to a woman in her 30s?

  22. pec says:

    “Still hearsay. Where is the biopsy report?”

    Don’t be ridiculous. This story wasn’t all made up. It was such an obvious case of malignant melanoma that one of the MDs spotted it at a social event. And why on earth would I have the biopsy report?

  23. David Gorski says:

    Melanoma is a tumor that is known to undergo spontaneous regression. However, such spontaneous regressions are rare. If your story is accurate (and, given your track record on this blog, I take nothing on just your say-so given how prone you are to misinterpret information and studies; I’d want to see a biopsy report too), then your uncle was one incredibly lucky fellow.

  24. weing says:

    Biopsies are only needed under two circumstances, when you think you know the diagnosis and when you don’t know the diagnosis. Cancer diagnoses without biopsies are just hearsay.

  25. Harriet Hall says:

    pec said,

    “This story wasn’t all made up. It was such an obvious case of malignant melanoma that one of the MDs spotted it at a social event. And why on earth would I have the biopsy report?”

    If you want us to believe you, you have to present evidence such as a biopsy report or a medical record. I don’t think you made up the story. I just think the interpretation of events was wrong. Spotted at a social event? Come on! There are other things that can look like a malignant melanoma. You can’t possibly tell without a biopsy.

    My guess: he had a benign skin lesion. Someone thought it looked like a melanoma but the diagnosis was never confirmed by biopsy. The benign skin lesion resolved spontaneously, as they often do.

  26. David Gorski says:

    That is the most likely possibility without hard evidence from a biopsy.

  27. Harriet Hall says:

    pec,

    Learn to read!

    “every class of cancer drugs can potentially damage the heart” does not equate to “in most cases the chemotherapy is likely to cause permanent heart damage”

  28. David Gorski says:

    Indeed.

    Moreover, it’s all about the risk-benefit ratio and dose. For example, doxorubicin is pretty safe if the overall dose is kept below a certain level. Exceed that level, and that’s when the risk of heart damage goes way up. It’s also why oncologists try very hard to limit the dose.

    However, for some adjuvant breast cancer regimens it has been shown that if a patient doesn’t get at least 80% of the recommended target dose, they might as well not get any chemotherapy at all. That’s because if they get less than 80% of the recommended dose, their survival rate falls, approaching that of patients who received no adjuvant chemotherapy at all. Getting the dose right matters, and it is a balancing act between making sure the effective dose is received and avoiding complications.

  29. Michelle B says:

    Pec writes: The body has a natural ability to fight cancer. This may become very unlikely once a critical level of disease has been reached. Furthermore, the mainstream treatments may sometimes contribute by weakening the immune system even more.
    ____

    Efficacious treatments which encourage the body to fight the cancer without any side effects are being pursued by science-based medicine–science-based medicine would embrace any such treatment with great joq.

    Your otherwise intelligent grasp of the diseased body needing to have its own resources assisted to recovering equilibrium and health is tainted by your pitting your false dichotomy of alternative medicine against your so-called concept of mainstream medicine–toxic treatments (without juggling the derived benefits), profit/status guo oriented, and resistant to any research that would somehow threaten its perceived and undeserved monopoly.

    Many of us are on your side; we just don’t understand why you are so blind to that fact.

  30. Calli Arcale says:

    It was diagnosed at a *social event*?

    And you equate that with a case so well documented it was being discussed at a tumor board?

    *sigh*

    Okay, I admit, I know a lot of folks with degrees in computer science who aren’t very scientific. So pec would fit right in. Thing is, most of us are really trained as engineers, not scientists, so depending on where you got your degree, it can be a bit of a misnomer. Still it’s embarrassing to learn that pec is in my field.

  31. Harriet Hall says:

    pec said,

    “I answered you repeatedly. I said the patient should be told the truth, not that the treatment has a 93% cure rate.”

    That’s not what the patient was told. She was told the truth: that the 5 yr survival rate with treatment was 93%.

    ” And she should be told that chemotherapy is only useful for a small minority of patients in her situation”

    That’s essentially what doctors DO tell patients: that chemo after surgery provides a small increment in survival.

    “and that it is very likely to cause long-term damage.”

    No, it isn’t “very likely” – there is a small risk, and the risk/benefit ratio is clearly explained to patients so they can make an informed decision.

    “as far as I know, surgery would not be likely to cause harm and might help her body defeat the cancer. ”

    You don’t know if surgery improves survival?
    We know. If you don’t know, it’s only because you refuse to know.

    “am just conceding that some aspects of mainstream treatment might be helpful”

    How generous of you to make that concession! “Some” aspects “might” be helpful. HA! The fact that you said that in the way you said it makes it very obvious that you are blinded by an irrational, ideological prejudice against mainstream medicine. And yet you have nothing better to offer.

  32. pec says:

    Michelle B.,

    I am talking about general differences between the mainstream and alternative approaches. If mainstream medicine is willing to get ideas from CAM I think that’s great. I am not saying they are, or will always be, mortal enemies. I think alternative medicine should become more scientific and skeptical, and I think mainstream medicine should pay more attention to ideas from CAM, some of which make sense.

    And that is exactly what seems to be happening, with more research funding going to CAM than previously. But this blog is devoted to blocking CAM from getting any acceptance.

    One of Dr. Gorski’s comments was:

    “As for chemotherapy, even though in a case like this woman it only provides a 2-3% absolute survival benefit, most women will opt for it even when quoted that figure and when the side effects of chemotherapy are explained in gory detail.”

    Even though he knows how damaging chemo can be, and that it is very unlikely to help a patient like this one, he would still administer it to her if she “opts” for it. Now you know most patients would never opt for something with so little chance of benefit and so considerable a potential for harm. If they do opt for it, it’s because they did not get all the information, or did not fully comprehend it. They may have been misled in subtle ways into thinking chemo would improve their health in the long run, while causing only temporary side effects.

    That whole attitude is so typical of mainstream cancer medicine. Unnatural drugs are valued for their specific effect, without enough concern for what they do the body in general.

    Dr. Hall seemed to be completely unaware of how cancer drugs can damage the heart. There is just too much blind faith in the standard approach, and all I am trying to do is point that out and help make people a little more aware.

  33. pec says:

    The initial diagnosis was at a social event, because it was such an obvious case. Of course that was followed up by a formal diagnosis. I just don’t happen to have a copy of a 40-year-old biopsy report which I never would have needed a copy of in the first place.

  34. pec says:

    “That’s not what the patient was told. She was told the truth: that the 5 yr survival rate with treatment was 93%.”

    Come on Harriet. You know perfectly well that implies that 5 year survival with no treatment would be 0%.

    And you know perfectly well that statistics like 93% are proudly displayed and that everyone draws the expected inference.

  35. Harriet Hall says:

    “But this blog is devoted to blocking CAM from getting any acceptance. ”

    Absolutely untrue! This blog is devoted to grounding medicine in good science. We treat claims from CAM exactly the way we treat claims from conventional medicine.

    “Dr. Hall seemed to be completely unaware of how cancer drugs can damage the heart.”

    Absolutely untrue. I’ve made it clear that I’m aware of the adverse effects of chemotherapy and that they need to be considered as a risk/benefit ratio.

    “most patients would never opt for something with so little chance of benefit and so considerable a potential for harm”

    Absolutely untrue. Most patients DO opt for chemotherapy after being given the most accurate available information about the risk/benefit ratio.

  36. Harriet Hall says:

    pec said,

    “The initial diagnosis was at a social event, because it was such an obvious case”

    We’ve told you that what looks like a malignant melanoma may not be, so it was NOT obvious.

    “Of course that was followed up by a formal diagnosis.”

    How do you know?
    I’ve heard so many stories like this that fall apart when you attempt to document them. I don’t believe this story, and if you think we’re going to believe it just on your say-so with no confirmation, you underestimate us.

  37. HCN says:

    pec said “But this blog is devoted to blocking CAM from getting any acceptance.”

    No, that is the purpose of this other blog:
    http://crapbasedmedicine.wordpress.com/

  38. Harriet Hall says:

    pec said,

    “Come on Harriet. You know perfectly well that implies that 5 year survival with no treatment would be 0%. And you know perfectly well that statistics like 93% are proudly displayed and that everyone draws the expected inference.”

    It implies no such thing, and if anyone draws that inference, she is not thinking clearly. You may be right that most people don’t stop to ask what their chances would be without surgery. Most people assume that they will be better off with treatment, and that is a valid assumption.

  39. David Gorski says:

    And that is exactly what seems to be happening, with more research funding going to CAM than previously. But this blog is devoted to blocking CAM from getting any acceptance.

    That’s a lie.

    This blog is dedicated to applying the best science and evidence to medicine, be it “alternative” or “conventional.” Have you not seen the many other posts here criticizing some aspect or other of “conventional” medicine?

    Even though he knows how damaging chemo can be, and that it is very unlikely to help a patient like this one, he would still administer it to her if she “opts” for it. Now you know most patients would never opt for something with so little chance of benefit and so considerable a potential for harm.

    My goodness, you are unbelievably obtuse.

    Most adjuvant chemotherapy regimens for breast cancer these days are in fact pretty low risk affairs. True, there are often some unpleasant side effects (loss of hair, nausea, the occasional neutropenic fever), but it’s this horrific, risky treatment that pec likes to portray it as because she clearly hates the concept of chemotherapy for some reason. Indeed, I’ve spoken to a number of my patients after they’ve finished chemotherapy, and they were surprised at how relatively benign the treatment was. pec seems to have in his mind the “altie” stereotype of emaciated chemotherapy patients at death’s door because the patients have end stage cancer. This is not what we’re talking about when we’re talking about adjuvant chemotherapy for breast cancer.

    Also, remember that for tumors that are not as early stage as this patient (i.e., stage II and operable stage III patients) the absolute survival benefit from chemotherapy climbs markedly; there is no question that the risk-benefit ratio is in favor of chemotherapy in such cases.

    But, bringing it back to the case presented at the tumor board, very clearly she needed at the very minimum a surgical excision of her tumor, along with a sentinel lymph node biopsy and preferably with adjuvant radiation therapy. Chemotherapy would have been icing on the cake, and you can’t worry about icing if you don’t already have the cake. The bottom line is that she chose to eschew all science-based effective therapy and paid a horrific price.

    I actually have one more story like this one that’s very instructive (actually, I have more than one more story like this one), except that it not a breast cancer patient and it was a man whom I took care of during my surgical residency. It happened over 12 years ago, and I still remember it. Perhaps I’ll post it in a couple of weeks. Two such stories two weeks in a row would probably not be a good idea.

  40. qetzal says:

    pec wrote:

    I also said that, as far as I know, surgery would not be likely to cause harm and might help her body defeat the cancer.

    Interesting that pec would concede this.

    It’s been stipulated that the available data to compare surgery vs. no treatment is quite old. It’s enough to be certain that surgery IS better than no treatment (at least in cases such as in the original post), but not enough to say quantitatively how much better.

    So, despite all her protestations, she seems to reluctantly admit surgery is a good idea in such cases.

    However, she remains convinced, apparently, that radiation and chemo are BAD! That’s rather ironic, isn’t? IIRC, the data showing that surgery + radiation &/or chemo is better than surgery alone is MUCH more robust and recent. Randomized, prospective, double-blind, placebo controlled trials, stage-matched patients, etc.

    If surgery is not likely to cause harm, and “might help,” and if surgery + radiation &/or chemo is proven better than surgery alone, what can we conclude about radiation & chemo in this setting? pec? Anyone?

    David Gorski wrote:

    My goodness, you are unbelievably obtuse.

    pec reminds me of nothing so much as someone with focal brain damage. For example, damage to a certain area of the brain can render a patient unable to consciously perceive objects in one half of their visual field. Put an apple on a table in front of them but to one side, and ask them what color the object is, and they can correctly tell you it’s red. Put it on the other side and ask them what color the object is, and they’ll say “What object?”

    Similarly, pec seems literally unable to assimilate information that contradicts certain of her established beliefs. It’s not that she consciously rejects the information. It’s as if her brain refuses to process certain statements.

    It’s kind of fascinating, in a morbid sort of way.

  41. pec says:

    Personal insults are so much easier than logical arguments qetzal. Even Gorski admitted that chemotherapy would be extremely unlikely to help this kind of patient. And I linked to an article showing that cancer chemotherapy is very likely to cause heart damage.

    And aside from all of that — no one here has been able to answer my original objection, that survival rates for untreated early cancer are not known.

    This post used one example to demonstrate that mainstream treatments are good and alternative treatments are bad. That is entirely emotional and unscientific.

    My scientific and logical objections are answered with personal insults. Ok if that’s the best you can do, keep insulting. It doesn’t bother me at all, since I know it’s only because of your extremely limited reasoning abilities.

  42. Calli Arcale says:

    Personal insults are so much easier than logical arguments qetzal. Even Gorski admitted that chemotherapy would be extremely unlikely to help this kind of patient.

    You know better than to say something silly like that, pec. The whole point of the story was that surgery and chemo would helped the lady enormously if she’d done it when it was first suggested. By the time the case was presented to the tumor board, it was far too late for *anything* to help. Morphine was probably the only thing left that would even ease her suffering, and that’s tragic.

    But you know that already, which makes your comment rather mystifying unless your real intention is to confuse the issue. Not very skeptical or scientific of you, I’m afraid.

  43. David Gorski says:

    Even Gorski admitted that chemotherapy would be extremely unlikely to help this kind of patient.

    I said nothing of the sort. I merely pointed out that the benefits of chemotherapy are quite modest in a patient like this. They are much more significant in patients with stage II or operable stage III breast cancer. However, this patient never got the chance to decide on whether the risk-benefit profile of adjuvant chemotherapy would be appropriate for her because she rejected surgery and radiation therapy, the initial mainstays of treatment for a tumor like this, and let it grow to the point where it was very likely to kill her–and certain to kill her if she didn’t.

    So, I echo Harriet’s question, the question that you so assiduously avoid answering: If this patient had asked you for advice when she first presented with a 1 cm invasive breast cancer, what course of action would you have recommended?

  44. BrianTani says:

    pec said,

    Even Gorski admitted that chemotherapy would be extremely unlikely to help this kind of patient. And I linked to an article showing that cancer chemotherapy is very likely to cause heart damage.

    Maybe it’s just me, but I didn’t see Dr. Gorski’s assessment of chemotherapy for that patient as extremey unlikely to help, what I read was that chemotherapy was the icing on the cake offering modest benefits.

    And also, I didn’t see that chemotherapy is very likely to cause heart damage, I saw what appeared to be a balancing act between a good enough dosage, and too much that it could cause heart damage. Still, there was a 20% margin to help adjustment, and I believe Dr. Gorski said the dosages were given with that in mind.

    Did you not understand that? I find that actually provides evidence for the “obtuse” accusations, even though I don’t like ad hominem. Or worse, it could be that you’re purposefully distorting people’s sayings in order to make your case, which is disingenuous.

    Had you used another reference to draw the same conclusion, it could be you’d be relying on different lines of evidence. But since you’re purporting that Dr. Gorski himself said that, it leaves little margin to what could possibly be your motives if my interpretation of Dr. Gorski’s opinion was correct.

  45. pec says:

    gorski: ” As for chemotherapy, even though in a case like this woman it only provides a 2-3% absolute survival benefit,”

    pec: “Even Gorski admitted that chemotherapy would be extremely unlikely to help this kind of patient.”

    gorski: “I said nothing of the sort. I merely pointed out that the benefits of chemotherapy are quite modest in a patient like this.”

    Well if you define “modest” as 2-3%. Definitely worth the permanent heart damage.

  46. pec says:

    ” If this patient had asked you for advice when she first presented with a 1 cm invasive breast cancer, what course of action would you have recommended?”

    I answered it several times, but there are so many comments here things are getting hard to find.

    Just as well, because I should take back my answers anyway. I would not know the best course of action, and fortunately that is not my job. I do not pretend to know how cancer should be treated. I do not think that we have reliable information and statistics about the success of current standard treatments. I do not think cancer is understood well at all and I do not think understanding is progressing very much.

    It is perfectly reasonable to have criticisms and objections without claiming to have the answers. My point has been that you don’t have the answers either.

    The case described was intended to make us feel that mainstream medicine has cancer figured out and anyone who refuses the standard treatments is a fool. In reality you do not have cancer figured out, and the standard treatments can sometimes be damaging and unhelpful.

  47. BrianTani says:

    You forgot this, pec:

    Dr. Gorski said,

    Moreover, it’s all about the risk-benefit ratio and dose. For example, doxorubicin is pretty safe if the overall dose is kept below a certain level. Exceed that level, and that’s when the risk of heart damage goes way up. It’s also why oncologists try very hard to limit the dose.

  48. qetzal says:

    I could hardly have asked pec for a better illustration of my point than the last few comments.

    I don’t think she’s trying to confuse the issue. I think she is incapable of dealing with data that contradicts her beliefs. Thus her brain obscures it from her conscious consideration by covering it with a mental blindspot.

    How many times did Dr. Hall ask her question before pec even acknowledged it? And when pec finally responded, note how her response completely misses the point.

    The question challenges pec’s beliefs on cancer treatments. Thus, she pushes it out of her conscious consideration. When Dr. Hall’s persistence forces pec to acknowledge it, her blindspot still protects her from dealing with it rationally.

  49. RickK101 says:

    Pec said: “The case described was intended to make us feel that mainstream medicine has cancer figured out and anyone who refuses the standard treatments is a fool. In reality you do not have cancer figured out, and the standard treatments can sometimes be damaging and unhelpful.”

    In reality, this case showed that a variety of CAM treatments were completely useless. In reality, this patient would have had pretty good chance of a longer, healthier life by following the recommended treatment.

    Pec, you keep applying YOUR interpretations and YOUR generalizations to this case to further muddy the actual facts. YOU assumed the doctors were telling the patient that she had 0% survival without treatment, NOTHING in the case suggests that. NOBODY has said medical science has beaten cancer EXCEPT YOU. YOU created a false strawman argument and then spent hundreds of paragraphs to point out how YOUR interpretation is misleading. Your entire approach has lacked any logical basis.

    Nothing you’ve said challenges the basic facts that the patient’s doctors gave – that 93 out of 100 people in her situation live to 5 years if they undergo the recommended treatments. Nothing you’ve said changes the fact that this patient chose CAM and is probably dead now.

    But who knows. Maybe you were succesful in your mission. Maybe a cancer patient or two will read this very clear case, then read your comments. Maybe your comments will be enough to confuse some real people with real malignancies.

    Maybe your argumentative smokescreen will shorten a life.

  50. V says:

    pec tries to answer Harriet,

    “Just as well, because I should take back my answers anyway. I would not know the best course of action, and fortunately that is not my job. I do not pretend to know how cancer should be treated…

    It is perfectly reasonable to have criticisms and objections without claiming to have the answers. My point has been that you don’t have the answers either.”

    I agree–it is reasonable to have criticisms and objections without having the answer. But your criticisms have already been considered–and indeed, were first brought up–by those who support the use of surgery and chemotherapy. You are abusing these criticisms and pretending that they invalidate conclusions about the effectiveness of treatment. They don’t. Researchers and doctors are well aware that their treatments have risks, and that their methods of analysis are fallible. No one is pretending that we have the answer to everything.

    In addition, your answer to Harriet is simply an argument from ignorance. I think it does demonstrate a strong desire, on your part, to remain ignorant so that you will not have to compromise your beliefs. This is not what a scientist or a skeptic does: they actively seek out the truth to combat ignorance. Label yourself what you want, but do not misuse these labels–you have not, so far, demonstrated that you really are devoted to skepticism or science. You are neither of these things.

    Also, I’m pretty sure Harriet addressed the heart damage issue. It can potentially happen–this does not mean that it happens ‘most’ of the time in ‘most’ cases.

  51. pec says:

    “The question challenges pec’s beliefs on cancer treatments.”

    I don’t have and fixed beliefs about cancer treatments. I have read claims from the ACA and other mainstream sources that completely contradict other sources of information. The dissenters and doubters are not all fringe wackos — there are many MDs and scientists who feel that meaningful progress against cancer has not been made.

    I am someone who cares about science and about accuracy, and that is why I criticize unthinking claims that are easily misinterpreted by the public.

    Yes I question the general mainstream approach to treating and understanding cancer (and various other things, such as mental illness, for example). As I learn more about the current drug industry and the adverse effects of some of the most popular drugs, I feel that things have been getting out of control.

  52. RickK101 says:

    pec: “Yes I question the general mainstream approach to treating and understanding cancer (and various other things, such as mental illness, for example)”

    The “approach” you refer to is called the scientific method. It was developed over hundreds of years. It involves coming up with a theory, devising ways of objectively testing the theory, rejecting what doesn’t work and building on what does. It focuses on what can be measured and understood and demonstrated and proven. And the community that relies on this method is very highly critical of each other’s findings. Treatments must go through intensive critical review, which is why such a small number of potential drugs/treatments actually ever make it to productive use.

    For example, when I toured one of Pfizer’s research sites, they said only a fraction of the interesting compounds make it to clinical trials. And Phase 2 clinical trials alone weed out 75% of the potential products. There is a massive, many-year process to ensure products (1) do something useful and (2) are safe if used correctly.

    That’s the “mainstream approach”. Now, what is your alternative approach? What’s the “non-mainstream approach” that ensures treatments actually work? What process weeds out CAM treatments that are proven not to work? Can you name a CAM treatment that has been dropped when proven ineffective?

  53. Fifi says:

    pec, why don’t you share the non-mainstream sources you’ve been reading that contradict the evidence that’s been presented here?

    So far you’ve promoted a belief in subluxations as a cause of disease, which shows you do indeed ascribe to non-mainstream beliefs as promoted by non-EB chiropractors. You’ve shown zero skepticism about any “alternative to medical” treatments and have gone out of your way to misrepresent medical treatments, research and beliefs.

    From the most cynical perspective, you’re trying to steer people away from treatments that have proven to be effective by pretending that it’s not know if they are, and trying to steer them towards your profession (website builder for supplement manufacturers perhaps?). From this perspective you’re so greedy you’re willing to kill people for profit.

    From the most compassionate perspective, you’ve got some psychological and emotional issues that you’re playing out here and can’t be held totally responsible for your actions or what you say.

  54. David Gorski says:

    I am someone who cares about science and about accuracy, and that is why I criticize unthinking claims that are easily misinterpreted by the public.

    I think my irony meter just exploded.

  55. David Gorski says:

    pec, why don’t you share the non-mainstream sources you’ve been reading that contradict the evidence that’s been presented here?

    Yes, I, too, would be interested in the non-mainstream sources that pec uses to support her beliefs.

  56. Fifi says:

    Dr Gorski – Perhaps pec is in need of an irony supplement? I hear that consuming concepts spun of greed and ignorance unbalances the essential humours thereby creating an energy blockage that requires both supplementation and “cleansing” of all the fecal matter than clings so stubborning to the colon walls poisoning one’s thoughts and feelings.

  57. pec says:

    “Yes, I, too, would be interested in the non-mainstream sources that pec uses to support her beliefs.”

    I don’t think I said anything about non-mainstream sources. A dissenting opinion does not have to come from a non-mainstream source.

  58. Harriet Hall says:

    Pec,

    You have repeatedly promoted non-material concepts. Mainstream sources are often critical of specific medical practices. They are skeptical, but you are more than a skeptic; you are a denier and an antagonist.

    It seems apparent to us that you do not fully accept the scientific approach, or that you think other ways of knowing are equally acceptable. We are clearly not on the same wavelength as you, and we would like to understand where you’re coming from.

  59. David Gorski says:

    I don’t think I said anything about non-mainstream sources. A dissenting opinion does not have to come from a non-mainstream source.

    The mainstream sources you’ve used thus far to support your beliefs do not, in fact, support them. Whenever I’ve looked one of them up, I’ve found it obvious that you have misinterpreted the source through the prism of your bias against “conventional” medicine. Consequently, I have to wonder whether you’re getting a lot of your information from non-mainstream sources. If you are, why not reveal them, so that we can look at them and see if they support your viewpoint?

  60. pec says:

    “It seems apparent to us that you do not fully accept the scientific approach, or that you think other ways of knowing are equally acceptable.”

    Harriet,

    I have previously explained to you that I do not equate materialism with science. Materialism is a philosophical perspective and science is a method. I believe in the scientific method, but I am not a follower of the materialist ideology.

    No one can define “material” anyway. I have explained that matter is not made out of matter — so matter itself is not material. The whole idea of materialism makes no sense. Yet you deny that science can study anything not currently defined as material. Can scientists study gravity, for example? What sort of matter is gravity made of?

    Yes I have said I think there are substances, energies and fields still unknown to science. What reason do you have for assuming science has already discovered and described everything that could possibly exist in this infinite universe?

  61. RickK101 says:

    Pec said: “What reason do you have for assuming science has already discovered and described everything that could possibly exist in this infinite universe?”

    Again, nobody said that. You’re setting up a false strawman to knock it down again. We are quite capable of using our own words – you don’t have to put them in our mouths.

    You said you question the “mainstream approach” to medicine. The mainstream approach is founded on the scientific method. You now say you believe in the scientific method.

    It’s your contradiction – so which is it? You either agree that the scientific method of modern science leads to actual solutions (effective treatments) or you don’t.

    If you still question the “mainstream approach”, what part do you question?

    We would very much like to know on what basis you accept some data and reject other. Most of the people in this forum use the principles of the scientific method to accept or reject certain medical conclusions. We’d like to understand what criteria you use. If you have a better approach to treating cancer, then PLEASE TELL US! Even if you have just have a suggestion to improve existing methods, please tell us.

    Repeating “science misleads people” isn’t actually offering any useful suggestions.

    And by the way, the “why do you assume science has discovered everything…” is a really old and tired argument tactic. It’s just like the creationists who say “not all transitional forms have been found, therefore the Theory of Evolution doesn’t work.” That’s like saying “my kid didn’t learn everything she needed to know in her first year of school, therefore education is useless.” Just because a process isn’t complete doesn’t mean it’s a bad process.

    Please try to refrain from such argument tactics and attempt to answer the questions. They are sincerely meant from people who are in fact open minded to other, better ways of solving health problems.

  62. pec says:

    “you think other ways of knowing are equally acceptable”

    The only acceptable way of knowing in formal science is the scientific method. I have never said or suggested otherwise.

    In other areas of life, of course, we use other ways of knowing. We can’t conduct formal research every time we make an ordinary decision. Many of the things we care about and must deal with every day have never been studied by science.

    So yes, there are acceptable ways of knowing other than the scientific method, and no these other ways are not acceptable for scientific publication.

    But scientists should not close their minds to everything not already studied formally by science. We get new ideas by considering what might be true, not by looking at what is already established.

    Science is an approach that involves guessing, wondering, trial and error, as well as formal methods of analysis. It is a serious mistake to believe scientists can think only about what has already been discovered. You are wrong when you tell people their experiences are illusions and hallucinations, if those experiences have not already been verified by science.

  63. qetzal says:

    pec,

    Materialism does not mean that science can only study things made of matter! Obviously, that would be nonsensical. Perhaps that should have given you a clue that your concept of materialism was faulty?

    (Also, you would do well to learn the different between Philosophical Materialism and Methodological Materialism.)

  64. qetzal says:

    pec wrote:

    Yes I have said I think there are substances, energies and fields still unknown to science. What reason do you have for assuming science has already discovered and described everything that could possibly exist in this infinite universe?

    No scientist I have ever met assumes that. Every single one thinks there are many many things still unknown to science. (Otherwise, why be a scientist?)

    The critical question is this: do you think there are any substances, energies, and fields unknown to scientists that ARE known to anyone else? If so, can you please name one such substance/energy/field, and who knows of it?

  65. Calli Arcale says:

    No one can define “material” anyway. I have explained that matter is not made out of matter — so matter itself is not material. The whole idea of materialism makes no sense. Yet you deny that science can study anything not currently defined as material. Can scientists study gravity, for example? What sort of matter is gravity made of?

    You do realize, don’t you, that in this context “materialism” is like “allopathy” in that it is nothing more a term used to denigrate the mainstream? The scientists you consider materialistic only use the word “materialism” in the context Madonna was singing about (wanting stuff). I have yet to meet a scientist (or physician) who describes himself or herself as a “materialist” in any sense other than being a aficionado of Mercedes Benz and Ralph Lauren.

    Of course mainstream scientists can and *do* study gravity. Newton’s Laws, including his law of gravitation, remain some of the great triumphs of physics. Things don’t have to be made of matter to be studied.

    And of course matter is material. That’s what the word literally means. If you don’t consider matter to be material, then your use of the word “material” is so far away from common usage as to make discussion on the subject rather pointless. Either that or you misunderstand some rather critical basics of physics. If that is the case, don’t worry. You’re in good company. Right up there with Alexander Abian and Archimedes Plutonium.

  66. Harriet Hall says:

    pec said,

    “I have previously explained to you that I do not equate materialism with science.”

    I don’t have the patience to go back through all your comments, but I distinctly remember you saying science was materialist.

    “Materialism is a philosophical perspective and science is a method.”

    If I remember correctly, I was the one who told you that when you seemed to have confused the two.

    “matter is not made out of matter”

    I think you are confused. Matter and energy are interconvertible.
    Gravity is a property of matter and is measurable and we have developed a theory that predicts things well enough to get us to the Moon.

    “I think there are substances, energies and fields still unknown to science”

    Why do you think that?

    “It is a serious mistake to believe scientists can think only about what has already been discovered.”

    It would be a serious mistake if anyone believed that. We certainly don’t. Do you know of anyone who does?

    “You are wrong when you tell people their experiences are illusions and hallucinations, if those experiences have not already been verified by science.”

    We would be wrong if we said that, but we don’t. I don’t believe I’ve ever suggested anything of the kind. I have said that you have not ruled out the possibility that your experiences were illusory or hallucinatory, and that illusions could explain them without any need to posit the immaterial.

  67. Harriet Hall says:

    pec said,

    “In other areas of life, of course, we use other ways of knowing. We can’t conduct formal research every time we make an ordinary decision. Many of the things we care about and must deal with every day have never been studied by science.”

    Of course! When we don’t have adequate data and we have to make a practical decision, we can make an informed guess. That’s very different from making a truth claiim without adequate evidence.

    Example: if you tried untested treatment X and you felt better, it would be entirely reasonable to try X again. It would not be acceptable to claim that you know X is effective.

  68. Harriet Hall says:

    pec said,

    “scientists should not close their minds to everything not already studied formally by science”

    When you think about it, that statement is truly idiotic. If the first scientist had closed his mind, science would have been over before it started. All scientific advances have been made precisely by scientists having open minds about things that have not yet been studied.

    Scientists must have open minds, but if their minds are so open their brains fall out, they can’t accomplish anything.

  69. pec says:

    “Materialism does not mean that science can only study things made of matter! Obviously, that would be nonsensical. Perhaps that should have given you a clue that your concept of materialism was faulty?”

    qetzal,

    I was talking to Harriet and she says science must be restricted to studying the material. I know it’s nonsensical.

  70. pec says:

    “as a profession we have sat on the sidelines while antiscientific ideology has infiltrated medicine at every level. Every physician who is not outraged and actively working against the rise of CAM is to blame.”

    Steve Novella’s comment. In case anyone doubts that this blog tends to be more about politics than science.

  71. RickK101 says:

    Pec: “But scientists should not close their minds to everything not already studied formally by science.”

    And there it is… It was only a matter of time before “scientists” were labelled “close-minded”.

    Scientists and believers in the scientific method are the most open-minded thinkers there are. Show us evidence, some actual valid proof, and we’ll believe ANYTHING. Now, if you ask us to believe something that potentially invalidates a bunch of other things we thought were true, then the burden of proof is higher. Your proof must be tangible, significant, re-creatable. But if you meet that burden of proof, we’ll change our minds.

    But as I said before, I can’t think of a CAM treatment that has been tested, rejected and dropped. Most of the CAM supporters I’ve met would not change their minds regardless of the evidence was presented.

    People have been unable to prove spiritual healing / UFOs / auras / young-earth creationism / chi / psychics / etc meet the scientific burden of proof. And believers in these things tend to ignore all evidence that indicates they don’t work. THOSE people, who continue to believe in spite of a wealth of evidence to the contrary, are the most closed-minded people on our pretty blue planet.

  72. pec says:

    “I don’t have the patience to go back through all your comments, but I distinctly remember you saying science was materialist.”

    NEVER NEVER NEVER NEVER. That was not me!!! I always say, and have said repeatedly here, that science IS NOT inherently materialist. NOT AT ALL.

    I am astounded that I could be misunderstood to that degree.

  73. pec says:

    Actually, you got exactly the opposite of my intended message.

  74. Harriet Hall says:

    pec said,

    “I was talking to Harriet and she says science must be restricted to studying the material. I know it’s nonsensical.”

    Pec, PLEASE stop misquoting me!!!

    I never said any such thing! In fact, I asked you for suggestions about how science might study the immaterial.

    Science can study any immaterial thing through its effect on the material. If it doesn’t have any detectable effect, its existence becomes a moot point.

  75. pec says:

    pec: “I think there are substances, energies and fields still unknown to science”

    hall: “Why do you think that?”

    pec: “It is a serious mistake to believe scientists can think only about what has already been discovered.”

    hall: “It would be a serious mistake if anyone believed that. We certainly don’t. Do you know of anyone who does?”

    Harriet, your comments strongly suggest that you think the forms of matter and energy already described by physics are all that will ever be discovered, or hypothesized. Then you say you DON’T believe everything has already been discovered.

    You have been contradicting yourself.

  76. pec says:

    “Science can study any immaterial thing through its effect on the material. If it doesn’t have any detectable effect, its existence becomes a moot point.”

    NO NO NO NO. How can you say that? Things only have detectable effects if our senses or the instruments we already have developed are able to detect them.

    How can you think that no other senses or instruments could conceivably exist?

  77. Harriet Hall says:

    pec said, “as a profession we have sat on the sidelines while antiscientific ideology has infiltrated medicine at every level. Every physician who is not outraged and actively working against the rise of CAM is to blame.” Steve Novella’s comment. In case anyone doubts that this blog tends to be more about politics than science.”

    The only politics involved is about the struggle to keep science honest. It’s about science; it’s not about politics.

  78. pec says:

    “Of course mainstream scientists can and *do* study gravity.”

    That was my point. They study gravity, even though there is nothing “material” about gravity.

  79. RickK101 says:

    Pec: “there is nothing “material” about gravity.”

    Pec – are you proud of your ignorance? Do you wear a t-shirt that says “Don’t even TRY to teach me!”

    Harriet did not mean material as in solid matter. Materialsm as Harriet meant is a philosophical definition similar to Naturalism. In other words, science only works in the natural or material world. In other words, if it is SUPERNATURAL then it cannot be proven or disproven by science.

    Fortunately, our bodies and the electrical impulses in our brains work in the natural world, so science works for medicine. No supernatural is needed.

    “In case anyone doubts that this blog tends to be more about politics than science.”

    You consider promotion of science to be political because you fundamentally dislike science and/or scientists. Yet you live and bask in the very comfort that science has provided you. The only reason you’re sitting at your computer criticizing scientists and not out gathering firewood or repairing your hut is because of the steady advancement of the science you seem to despise.

  80. pec says:

    “The only politics involved is about the struggle to keep science honest. It’s about science; it’s not about politics.”

    No, he’s against CAM in general, as a whole. He doesn’t want any alternative approaches to be studied. That is NOT an open-minded scientific attitude.

  81. pec says:

    “The only reason you’re sitting at your computer criticizing scientists …”

    I have NOT been criticizing scientists. I AM a scientist, and I am sitting at a computer that I know how to program. I am criticizing the narrow-mindedness of SOME scientists. If you think criticizing some scientists means criticizing science in general then you need a logic course.

  82. Harriet Hall says:

    pec said,

    “NO NO NO NO. How can you say that? Things only have detectable effects if our senses or the instruments we already have developed are able to detect them. How can you think that no other senses or instruments could conceivably exist?”

    Obtusely refusing to understand me again!

    Other senses or instruments could conceivably exist, and immaterial things could conceivably be detected by their effects on material things. We ought to be able to detect such things by finding measurable phenomena that are unexplained by our current theories. We know there is conservation of matter and energy, and we have never found any data that don’t fit. If we can’t currently detect any anomalies, what are we to do?

    Our provisional conclusion is that there is currently no evidence that unmeasurable, undetectable immaterial things exist. The burden of proof is on you. You believe they exist, but you have offered no way to test that belief. You have offered no proposals for research that might lead to detection, and you have given us no reason to think one immaterial idea superior to another.

    “An idea that is not ruthlessly questioned and put to the test does not deserve to be taken seriously.” – Lewis Jones

  83. Harriet Hall says:

    pec said,

    “he’s against CAM in general, as a whole. He doesn’t want any alternative approaches to be studied.”

    There is no such thing as CAM. There is only one medicine, and decisions of what to study should be based on one standard, no matter where the idea originates. He’s not “against CAM” but “for” scientific medicine. Can’t you see the difference?

  84. Harriet Hall says:

    pec said,

    “You have been contradicting yourself.”

    No I have not. You have been deliberately misunderstanding me in every way you possibly can.

  85. Harriet Hall says:

    pec said,

    ” NEVER NEVER NEVER NEVER. That was not me!!! I always say, and have said repeatedly here, that science IS NOT inherently materialist. NOT AT ALL.”

    You said several things that sure sounded to me like you thought science was materialist. OK, then what exactly was it you said that made me respond to you explaining that science was not materialist?

  86. qetzal says:

    I agree. pec has been deliberately misunderstanding.

    If understanding threatens to invalidate her beliefs, she will deliberately misunderstand without even being consciously aware of it!

  87. David Gorski says:

    I have NOT been criticizing scientists. I AM a scientist,…

    You sure haven’t been sounding like a scientist.

  88. weing says:

    Is it possible that pec is a chatbot and we are just wasting time with it. How could anyone be so obtuse?

  89. RickK101 says:

    That we are wasting our time is beyond question.

    That Pec is a scientist however, is very much open to question and requires a large burden of proof.

  90. Calli Arcale says:

    pec quotes me and sez:
    “Of course mainstream scientists can and *do* study gravity.”

    That was my point. They study gravity, even though there is nothing “material” about gravity.

    I think Newton would have a few things to say about that. ;-) Gravity is a property of matter. Seriously. Gravitational force between two bodies (ignoring any other bodies in the universe for the sake of simplicity) is directly proportional to the product of their masses (gravity relates to the quantity of matter) and inversely proportional to the square of the distance between them (the inverse square rule). Without matter, there is no gravity.

    It has long been a mystery why matter produces gravity. Einstein moved us a bit forward by proposing that gravity isn’t really a force but is the effect of spacetime being warped by matter. This still leaves some questions unanswered, but it has proven bizarrely accurate — spacetime really does seem to be warped around massive objects, as demonstrated by gravitational lensing and by frame-dragging. The latter effect explains why Newton’s formulas don’t quite work for predicting the motion of Mercury — it’s so close to the Sun that frame-dragging becomes significant.

    So, if it can be observed, it’s worth investing science in it. Gravity moves matter around, so you can observe it even though it is force and not a thing. It’s like the wind; you can’t see it, but you can see it’s effect, and so you can be certain that it is really there. But sometimes science proposes things which ultimately cannot be observed in any way. If they exist, they must have no influence whatsoever on the observable cosmos. Therefore, it is a waste of time to consider them, at least until somebody figures out a way of observing them. A good example of this is the ether. Ever since it was proven that light travels in a wave, it was assumed that light must be traveling in some sort of medium, just like any wave. It can travel through a vacuum, so the medium must not be normal matter, at least not the kind we’re used to dealing with. The ether was proposed as a sort of placeholder for whatever it was that light waves propagated within. Yearning for an absolute frame of reference, scientists realized that the ether itself must be one. The Earth must be passing through the ether as it moves around the Sun. This would produce an “ether wind”, and light would seem to travel much faster at one time of the year (when Earth is traveling with the ether) than six months later.

    The Michelson-Morley experiment was conceived not to disprove the ether but to measure the speed of the ether wind and thus establish the universal frame of reference. The experiment was sufficiently sensitive that it would detect the ether wind due to the Earth’s rotation — so, two measurements 12 hours apart should show a difference. But the scientists were shocked. They found something completely unexpected — no difference whatsoever. The speed of light was constant. There was no ether. Science did not readily accept this; it was so extraordinary and so implausible (light *had* to have a medium!) that it took a lot of experiments of increasing accuracy before consensus was reached. It ended up being very important to Einstein’s theory of relativity — the strange fact that the speed of light in a vacuum is constant no matter what speed you are going. That was how Einstein deduced time dilation, an effect later experimentally proven by spacecraft. Today’s GPS constellation proves it all the time.

    So the ether was found to be totally undetectable. Like God Himself, really. Whether it exists or not is thus irrelevant from a scientific perspective, because science cannot do anything with the idea if there is no way to test it. Science thus discarded the ether concept. Today, we talk of photons, not ether.

  91. weing says:

    I’m serious. Is it possible that pec is an artificial intelligence program, ie a chatbot, that is interacting with this blog?

  92. HCN says:

    Well she claims to be a “computer scientist”, not realizing that title is just another way to say “Code Monkey”:
    http://www.youtube.com/watch?v=v4Wy7gRGgeA (World of Warcraft guy version)

  93. HCN says:

    Well, she claims to be a computer scientist, not realizing that is just a fancy title for “code monkey”… :
    http://youtube.com/watch?v=v4Wy7gRGgeA (okay, the World of Warcraft guy version)

  94. HCN says:

    Okay, third time… obviously this system has sophisticated software that won’t let me post the following…

    pec claims to be a computer scientist, not realizing that is just a fancy title for “code monkey”.

    youtube.com/watch?v=v4Wy7gRGgeA (okay, the WoW guy version!)

  95. pec says:

    Novella: “Every physician who is not outraged and actively working against the rise of CAM is to blame.”

    Hall: “There is no such thing as CAM. There is only one medicine, and decisions of what to study should be based on one standard, no matter where the idea originates. He’s not “against CAM” but “for” scientific medicine. Can’t you see the difference?”

    He doesn’t want CAM treatments to be studied scientifically. And he rejects them because they have not be studied enough. It’s a catch-22 motivated by his ideological preference. Novella is a typical member of the “skeptics” movement. They consider alternative science and medicine their enemy and they see this as a political war.

    I think Novella is sincere and he perceives CAM as a grave danger. He believes he is being scientific, but it’s really mostly emotion and ideology.

    There is nothing wrong with researching CAM theories and treatments. It makes Novella and others here hysterical that CAM is gaining acceptance in medical schools. They must be afraid some of it will be scientifically verified.

    I am for scientific open-mindedness, and for trying to separate politics and science. Of course, human nature will not change and every human endeavor will have its political and financial motivations.

    But we can try to moderate the effects of ideology. Materialism is an ideology; science is not inherently materialist. (Defining words like “matter” and “materialist” would take this discussion off on a long tangent and would have to consider the history of philosophy and science.)

  96. David Gorski says:

    He doesn’t want CAM treatments to be studied scientifically. And he rejects them because they have not be studied enough. It’s a catch-22 motivated by his ideological preference. Novella is a typical member of the “skeptics” movement. They consider alternative science and medicine their enemy and they see this as a political war.

    That’s the typical smear that proponents of alt-med aim at skeptics, and it’s not true at all.

    There is more to human subjects research than just the science. There is ethics. The experience during World War II with what the Nazis and Japanese did with human experimentation in their prison camps, as well as what our own government did with the Tuskegee syphilis experiment, taught us that quite starkly. That’s why the Helsinki Agreement and the Belmont Report were written: To codify the ethics of human subjects research. Human subjects research has at least three paramount principles:

    1. Beneficence, usually manifest as a favorable risk-benefit ratio, at least as far as preliminary evidence allows.
    2. Autonomy, or freedom from coercion
    3. Informed consent.

    What flows from #1 and #3 is that, before a therapy can be ethically tested in humans, there must be both scientific plausibility under current science and compelling preclinical and clinical evidence. That is why the usual order of in vivo investigations after in vitro and cell culture investigations of a proposed treatment has become as follows: (1) animal studies; (2) phase 1 human trials; (3) phase 2 trials; (4) phase 3 trials. The implicit understanding is that each step is contingent upon the previous one having provided evidence of at least safety and, in the case of phase 2 studies, efficacy. As Kimball Atwood put it in his article on the chelation trial, that sequence is “compelling for both ethical and scientific reasons, and is stipulated in part or in its entirety by pertinent treatises, including the Helsinki Declaration, the US Code of Federal Regulations, and the NCCAM’s own policies.”

    So, no, neither Steve nor any of us are opposed in principle to testing CAM treatments in clinical trials. However, we insist on ethical clinical trials. For trials to be ethical, however, there must be sufficient pre-clinical evidence that can be accurately related to patients in order to allow us to give them reasonable estimate of potential benefit versus risk. Without that estimate, truly informed consent is impossible.

    Finally, there is a matter of prioritization. The NIH budget is tight. Research funding from other sources is even tighter. Good investigators (better investigators than I) are being forced to shut down their labs because they can’t secure funding. In such an environment, prioritization of what to study becomes important. We want to study what is most likely to result in highly effective treatments, what has the most compelling supporting evidence. The vast majority of CAM modalities have so little good evidence supporting them that to study them in humans first before other more scientifically plausible and supported modalities doesn’t make a lot of sense.

    As for your claim that we “fear” that some CAM modality or other might be scientifically validated, I can’t speak for the others on SBM, but I suspect they feel the same way: I’m not the least bit afraid. If a CAM modality is validated by science, it would no longer be “alternative” medicine. It would just be medicine. Personally, I’d love it if some CAM modality or other could magically cure cancer, as some of its advocates claim. I could always apply my research skills to some other problem and/or go back to being a general surgeon.

  97. weing says:

    “I think Novella is sincere and he perceives CAM as a grave danger. He believes he is being scientific, but it’s really mostly emotion and ideology.”

    What is your basis for that conclusion?

    “There is nothing wrong with researching CAM theories and treatments. It makes Novella and others here hysterical that CAM is gaining acceptance in medical schools. They must be afraid some of it will be scientifically verified.”

    Have you considered other possibilities? I would love accupuncture and prayer to work. Sure would make life easier. But they don’t work when scientifically tested. The fear is we will have wasted precious and limited resources on crap.

    If we find that a medication like Torcetrapib doesn’t prevent heart attacks, we don’t use it. I doesn’t matter that Pfizer spent a billion dollars researching it. Why should different standards apply to sCAM? Do you think Pfizer should demand the government spend taxpayer money to do further tests on Torcetrapib to show that it is effective? Why not?

  98. pec says:

    I am not talking about magical cures for cancer. But you are not aware, and have no interest in becoming aware, of the work of scientists like Gary Schwartz, for example, who are doing research on energy healing, and other things you reflexively dismiss as unscientific. Schwartz, and other scientists who have crossed the line from mainstream to alternative, are ignored by the mainstream for emotional/political reasons.

  99. weing says:

    They are ignored for lack of evidence.

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