Feb 27 2012
We here at SBM have been very critical of Dr. Mehmet Oz, who through his relentless self-promotion (and with more than a little help from his patron Oprah Winfrey) has somehow become known as “America’s doctor.” Back in the early days, when he was the regular medical expert on The Oprah Winfrey Show, Dr. Oz was at least tolerable. Much of what he discussed was reasonably science-based and even sensible, mainly advice to eat better and get more exercise, which is what most primary care doctors tell their patients every day. True, he did “integrate” some non-evidence-based therapies in with the evidence-based therapies, which was not good given how a typical viewer wouldn’t be able to tell where the science-based advice ended and the magical thinking began, but for the most part, even on Oprah’s show, he kept his woo somewhat in check. At least, there were boundaries beyond which he wouldn’t pass, even though Dr. Oz’s wife is a reiki master and he has been a fan of reiki (gaining fame for inviting reiki masters into his operating room during cardiac surgery) since at least the 1990s. More recently, Dr. Oz has testified in front of NCCAM patron Senator Tom Harkin’s committee to promote “complementary and alternative medicine” (CAM) or, as its advocates like to call it now, “integrative medicine.” He’s also been the Medical Director for the Integrative Medicine Program at New York-Presbyterian Hospital/Columbia University Medical Center since 2001. (How he does his TV show, holds a job as a professor of surgery at Columbia University, and holds positions as Clinical Trials of New Surgical Technology, Attending Surgeon, and Director, Clinical Perfusion Services at the same hospital, I’ll never know. He must have the most understanding partners ever.)
Be that as it may, even after Dr. Oz landed The Doctor Oz Show, for the first half of his first season he kept it fairly straight and science-based. However, two years ago the mask began to slip when Dr. Oz first aired a credulous feature about reiki under the title Dr. Oz’s Ultimate Alternative Medicine Secrets. Not long after that, Dr. Oz featured a man who is in my opinion arguably the foremost promoter of quackery on the Internet, Dr. Joe Mercola, along with the master of quantum quackery, Dr. Deepak Chopra. It was at that point that one could rightly say that Dr. Oz had “crossed the Woobicon.” Since then, it’s been one thing after another, beginning in earnest about a year ago. For instance, in January 2011, Dr. Oz featured Dr. Mercola again in a completely credulous portrait that painted him a “brave maverick doctor,” only without a hint of irony. A couple of weeks later, he featured a yogi who advocated “detoxing” and a faith healer from my old stomping grounds in Cleveland. Then, just when I thought Oz couldn’t go any lower, he featured psychic scammer John Edward.
Finally, back in April 2011, Dr. Oz’s producers apparently figured out that there was a problem with Dr. Oz’s image, except that they saw it as an opportunity to gin up a little controversy on the show. They invited our very own Dr. Steve Novella on the show as the “skeptic” who criticizes Dr. Oz. I very much admire Steve for going into the lion’s den, where, he knew in advance, he would be the underdog and the audience would be against him. Steve acquitted himself well, and after his appearance, I have to admit, I pretty much stopped paying attention to Dr. Oz for several months. He basically faded into the background of quackery, a prominent voice “integrating” quackery with medicine, pseudoscience with science, in the apparent belief that mixing fantasy with reality somehow improves medicine. Personally, I prefer Mark Crislip’s take and will steal his statement about “integrative medicine”:
If you integrate fantasy with reality, you do not instantiate reality. If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.
I just learned last week that Dr. Oz, while trying to make the cow pie taste better, is only continuing to succeed in making the apple pie taste worse. Witness an episode from last week featuring a long segment entitled Dr. Mercola’s Most Radical Alternative Cures, or, as the banner on the segment calls it, “Radical Cures Your Doctor Thinks Are Crazy.” Not surprisingly, Dr. Mercola has been bragging about his fourth appearance on Dr. Oz’s show yet again. (Video: Part 1 and Part 2).
In the first part of the segment, we’re immediately treated to what have now become standard tropes favored by Dr. Oz’s producers when introducing Dr. Mercola. Dr. Oz first opines about how much he believes that the greatest breakthroughs in medicine come from thinking “outside of the box,” which makes me want to ask him, “What about outside of reality?” Well, Oz does concede that sometimes “even I’m challenged by unorthodox thinking.” Apparently he’s not challenged enough to decide that he’s promoting quackery and stop making his show into an infomercial for Dr. Mercola’s quackery. No doubt his shows featuring Dr. Mercola bring in the ratings, and that, apparently, is enough. Oz claims he put his “medical team” on the case to investigate these treatments. One wonders who is on his medical team. Oh, wait. I know: Michael Roizen and Tanya Edwards.
In any event, next up is the obligatory video segment introducing Mercola thusly, “Your doctor may consider him the most dangerous man in America.” The “most” dangerous? Probably not. Incredibly dangerous to your health if you listen to his quackery, well, yes, I’d agree with that. Mercola then makes four teaser claims to draw the viewer in:
- You can eliminate the most common cancer with a fruit.
- Your body might be loaded with a toxic poison that your doctor hasn’t talked to you about, but, don’t worry, Dr. Mercola has a “simple solution” to eliminate these “dangerous toxins.”
- There’s an “all natural” way you can make yourself healthy.
I’ll cut to the chase in case you don’t want to watch the full video. What Mercola claims is this:
- Eggplant cream can cure skin cancer.
- Amalgam fillings release mercury that causes “brain fog,” but you can cure yourself with algae.
- “Grounding” (i.e., walking barefoot and/or sleeping on a sheet or mat that is connected to ground with wire) will significantly improve your health.
Now that you know what we’re dealing with, let’s check out the videos. Dr. Oz’s first question is a nice hanging curve that Mercola attacks the way our new Tiger slugger Prince Fielder attacks pitcher’s mistakes. Dr. Oz basically asks Mercola why he thinks that anything “outside the mainstream” is considered by medicine to be “radical.” If a straw man that size were set on fire, you could easily see it from space. Mercola then quotes Arthur Schopenhauer’s famous quote that he probably didn’t say:
All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.
This quote is just plain silly, and I’ve hated it for a very long time. Indeed, whenever I see anyone cite this quote, my skeptical antennae start a’twitching because I consider use of this quote as a strong indicator of a crank. The quote isn’t even correct. For instance, in science Albert Einstein’s Theory of Relativity wasn’t exactly “violently opposed,” and a lot of other scientific findings that challenge the existing paradigm have been embraced. When cranks invoke Schopenhauer the implication behind their parroting the above quote is that they have The Truth. They then invoke the quote to argue that the reason that they are being ridiculed or opposed is that they simply haven’t made it to the “third stage” of Schopenhauer’s view of how Truth is accepted—but that they will be! In other words, “They’ll see! I’ll show them! They thought me mad, but I’ll show them!” Unfortunately, they just can’t seem to get it through their head that, even if Schopenhauer was correct, “untruth” never makes it to stage three—nor should it!
Again, I will cite Mark Crislip because, as we all know, the world needs more Mark Crislip. He discussed Schopenhauer in the context of the antivaccine movement:
All antivaccination truth passes through three stages. First, it is based upon feelings instead of reality. Second, it is opposed by the rationally inclined. Third, the more complete the information that falsifies it, the more vehemently it is embraced as self-evident.
I consider this quote perfectly appropriate, given that Mercola is rabidly antivaccine; so I’ll call this the Crislip vaccine variant of Schopenhauer. Now I’ll add the Gorski variant for alt-medicine:
All “alternative medicine” truth passes through three stages. First, it is ridiculed by the rationally inclined because it is based upon feelings and prescientific beliefs instead of reality. Second, it is opposed by the rationally inclined. Third, the more complete the information that falsifies it, the more vehemently it is embraced as self-evident by its non-rationally inclined believers.
Mercola is nothing if not non-rationally inclined when it comes to medicine, as evidenced by his response to Dr. Oz’s asking him why he thinks these “cures” work. Basically, he says it’s because of anecdotes and evidence. Note how he mentions anecdotes first. That’s how Dr. Mercola rolls.
Eggplant: A “cure” for cancer
The first claim Mercola makes is that a skin cream made of eggplant extract can cure cancer. However, compared to what he said in the opening segment, his claim turns out to be a lot less impressive than it initially sounded. Basically, Mercola claims that this cream, known as Curaderm, can cure non-melanoma skin cancers, particularly basal cell cancers. This is a lot less impressive than saying that “eggplant can cure cancer.” For one thing, basal cell cancers are not particularly malignant. They can grow locally, sometimes reaching impressive sizes, but they are cured by complete excision and rarely metastasize. Squamous cell carcinomas of the skin are a little nastier, but not hugely. They are cured with complete excision as well and are rarely fatal if treated promptly. Indeed, for all comers, there are an estimated 700,000 cases of squamous cell carcinoma of the skin per year in the U.S. and only 2,500 deaths. It just isn’t a particularly lethal cancer. Now, if Curaderm were shown to be potentially curative for melanoma, then I’d sit up and take notice.
Let’s get one other thing straight. Certainly, it’s possible that an extract from eggplant might have therapeutic value. As I’ve said before many times, herbal or plant-based medicines are about the only kind of “alternative” medicine that has significant prior scientific plausibility based on what we know about science. That’s because plants often contain biologically active molecules; i.e., they often contain drugs. Of course, the problem with plant-based medicines is that they are, in essence, highly contaminated drugs, the predictability of whose responses is variable because the amount of active ingredient can vary widely. However, there’s a big problem when claims for a plant-based compound become grandiose. It immediately makes me suspicious, even when there might be some biological plausibility that some compound with derived from a plant might have anticancer properties, when I see claims of “cancer cures” or the extensive use of testimonial evidence, which is all that Mercola had. Mercola seems to have derived his claim from someone named Dr. Bill Elliot Cham, who basically claims that eggplants cure skin cancer. Naturally, I know it’s true because I saw it on the Internet, and I’ve even seen some credulous reporting on it:
This is how Dr. Cham’s book The Eggplant Cancer Cure is described in its foreword:
Perfection or near-perfection is rare in any area of medicine. Dr. Bill Cham has achieved it in the treatment of two common cancers, basal cell carcinoma and squamous cell carcinoma.
Even better, for those who want to know “how does it work”, this book tells us exactly how. The explanation is simple, easy to understand, and yet scientifically elegant, a molecular ballet. Here’s the explanation in one line of simple English: Dr. Cham has found substances which can penetrate and kill skin cancer cells but can’t penetrate normal skin cells, so normal skin cells are untouched and unhurt while the skin cancer cells die!
Can this “eggplant cure” actually do what Dr. Cham claims it can? In the video, he claims it’s been tested in “randomized trials” in the U.K.; so I figured that I could find the results of those randomized trials by searching PubMed. Silly me. A search of “eggplant” and “skin cancer” revealed…two references, neither of which are by Dr. Cham and neither of which present evidence that an eggplant extract can cure cancer, while a search of “solasodine glycosides” and “skin cancer” revealed only three. Meanwhile a search on Dr. Cham’s name plus “cancer” revealed six publications, one of which looked like a review article, and the most recent of which is over 20 years old. Only one of them showed any sort of clinical study suggesting that a cream formulation containing high concentrations (10%) of a standard mixture of solasodine glycosides (BEC) might be effective in treating non-melanoma skin cancers. The problem with the study, however, is that it did not appear to be randomized or to have matched its tumors for size and depth very well.
Somehow, though, Dr. Cham claims that he’s done Phase I, Phase II, Phase III, and even Phase IV (post-marketing) trials. Now, I wouldn’t necessarily expect phase IV trials to be published; postmarketing surveys often remain unpulished. However, I would expect to see the phase III trial supporting his “Curaderm” to have been published. Oddly enough, many of the studies listed on Dr. Cham’s website don’t appear to be even particularly relevant to the question of whether his cream cures skin cancer. Particularly suspicious are a couple of articles that could have come straight from Kevin Trudeau, The skin cancer cure so effective, it’s being kept secret and The skin cancer cure nobody wants you to know about.
Now we’re talking crankery!
The odd thing is that the compounds isolated by Dr. Cham appear promising. Basal cell carcinoma, for example, is a type of cancer that is rarely fatal and rarely metastasizes. However, it can grow to large sizes and become disfiguring if neglected. Currently, surgery is indeed the only treatment of basal cell carcinoma. Simple surgical excision is curative (as they say, nothing heals like surgical steel). Consequently, a topical agent that caused basal cell carcinoma to regress would be very useful to dermatologists and skin cancer surgeons. I’m less enthusiastic about using such compounds to treat squamous cell carcinoma, because these tumors can invade and metastasize. Their treatment can require lymph node dissection and radiation. Treating such tumors is often more than just a matter of simple surgical excision. At least Dr. Cham doesn’t claim that his Curaderm can treat melanoma. That would be truly irresponsible.
So how, if it works, does Curaderm supposedly work? That’s where I see more red flags going up. There’s a long and seemingly plausible explanation in his book. There’s a listing of clinical trials, but none of them appear to have been published, at least not by Dr. Cham. Then, of course, there’s the conspiracy-mongering by Dr. Cham himself:
These dermatologists put pressure on the government health regulators who then decided to put Curaderm BEC5 as a prescription only drug. Because of this no public awareness of Curaderm BEC5 was allowed and of course these dermatologists did not support Curaderm BEC5. Consequently, I attempted to reason with the Health Authorities that Curaderm BEC5 should be widely available to the public. This fell on deaf ears. The health regulators reasoning was the glycoalkaloids BEC were toxic because they were extracted from the Devil’s Apple plant.
I then examined a whole host of solanum plant species and found that the exact replica of BEC was present in the eggplant. Most importantly the amount of BEC in one tube of Curaderm BEC5 is the equivalent to approximately 5g of eggplant (approximately 1 table spoon). So how can the BEC in Curaderm BEC5 be considered toxic, especially after we had done full toxicological studies with the BEC where it was shown that it was completely safe at the concentrations found in Curaderm BEC5. With this new information in hand I again approached the Therapeutic Goods Administration (TGA) to have Curaderm BEC5 back as an OTC (over the counter) item. The TGA said they would get back to me. I have been waiting for over 8 years but they have not responded to my request. I finally gave up on them and sought and obtained registration of Curaderm BEC5 as an OTC in the Republic of Vanuatu.
He then says he would love it if the FDA would approve his drug, apparently clueless that the FDA doesn’t come looking for drugs to approve. The inventors have to submit their treatment to the FDA for approval. Indeed, Dr. Cham has flirted with, if not outright crossed, the border from being a physician-scientist into becoming a crank. After all, he claims to have done all these studies on the BEC compound in extensive clinical trials, but they do not appear to be published in the peer-reviewed medical literature. Rather, they’re only discussed in his books, which, of course, you have to buy. Oddly enough, a few years ago, another group did actually do a clinical trial using a related compound and reported some efficacy.
So what we have here is a salve that might have some efficacy but has not yet been adequately validated (or validated at all) in adequate clinical trials. One notes that Dr. Cham is also claiming efficacy for terminal “internal” cancers, but that he also hasn’t managed to publish anything. Good physicians and scientists would see this and say something like, “Hmmm. This is interesting. There might be something here.” Then they’d do the work to figure out once and for all if there is, in fact, anything there. They would not recommend it as a “cure” for a disease for which we already have a treatment that is more than 95% effective, instead opting for conspiracy mongering about why his cure isn’t yet accepted.
No wonder a quack like Dr. Mercola likes him.
Here we go again…
Next up, Dr. Mercola tells Dr. Oz that people are being “poisoned” by their amalgam fillings and that the mercury allegedly being released from such fillings is responsible for a whole host of chronic health issues and diseases, including psychological, neurological, and immunological problems. Basically, if you have a chronic health complaint and amalgam fillings, the alt-med world will frequently tell you that it must be due to the fillings. In any case, this is an alt-med myth so hoary that it probably crawled up out of the primordial ooze (apparently, along with mercury), which is why I don’t feel the need to discuss it in detail, particularly given that Harriet Hall has covered the issue before. I will, however, mention that in his article discussing his appearance with Dr. Oz, Mercola posts the infamous “smoking teeth” video that Harriet had so much fun mocking (and rightfully so, I might add; that’s one of the silliest videos I’ve ever seen).
Instead, I’ll look at Dr. Mercola’s “cure” for this nonexistent health problem. Basically, it’s an algae known as Chlorella, which, if you believe Mercola, is a lot like the Oil of Aphrodite and the Dust of the Grand Wazoo. (I know, I know, another Frank Zappa reference in a mere week. It fits, though.) In any case, back in the 1940s and 1950s, Chlorella was seen as a new and potentially promising food source that had the potential to provide large amounts of high-quality food at a low cost. For whatever reason (probably mainly the clearing of more arable land and huge increases in the efficiency of farming, this potential was never realized, but Chlorella maintains its cachet as a “superfood” and alt-med cure-all. If you Google Chlorella, you’ll find lots of sites selling Chlorella supplements, and near the top of the list is Joe Mercola’s Chlorella supplement.
But does it do what’s claimed for it?
Well, with respect to treating problems caused by mercury from amalgams, the answer is certainly no, because there’s no good evidence that mercury from amalgams cause any disease. As for Chlorella, searching PubMed leads me to a bunch of articles looking at this particular algae as a food source, as a a test for hazardous effluents management and adsorbing mercury using Chlorella immobilized on silica gels. Chlorella, apparently, can bind mercury and heavy metals. Of course, there’s a disconnect here. While it might be somewhat plausible that an algae like Chlorella could bind mercury and other metals in the GI tract, it’s not so plausible that it could do so in the blood and tissues, because that would require a chelation agent being absorbed that can chelate heavy metals and lead them to be excreted through the urine. Let’s also not forget that amalgams don’t lead to the absorption of harmful amounts of mercury anyway, so even if Chlorella did what Mercola claims it wouldn’t mean that it’s a useful therapy for “brain fog.”
One can’t help but note that Dr. Mercola has been selling Chlorella for quite some time now. In fact, the ever-reliable Quackwatch notes that in 2005 Mercola received a warning letter from the FDA telling him to cease and desist, in part, from claiming that Chlorella can fight cancer and normalize blood pressure. In 2006, he received another FDA warning letter telling him to stop claiming that one of his Chlorella supplements can “help to virtually eliminate your risk of developing cancer in the future.” Basically, what Mercola is doing here appears to be extrapolating from in vitro and animal studies that suggest that Chlorella extracts can bind heavy metals and using them to justify selling them for human use to treat—you guessed it—heavy metal poisoning as a “detoxification” method. Again, Mercola puts the cart before the horse and massively exaggerates the potential benefits.
Mercola’s final claim is basically the naturalistic fallacy on steroids. To hear him tell it, shoes are the root of all evil. You shouldn’t wear them any more than you have to because, well, they keep the soles of your feet from contacting
Gaia the earth. Here’s what he says on Dr. Oz’s website (where the video of the segment in question can be found):
Dr. Mercola claims that a process called “grounding” or “earthing” can significantly change your health. Grounding or earthing refers to contact with the Earth’s surface electrons by walking barefoot outside or sitting, working or sleeping indoors connected to conductive systems, transfering the energy from the ground into the body. Emerging research supports that this may result in reduced pain, better sleep and less inflammation. The logical explanation for the reduction in inflammation is that the Earth’s negatively charged antioxidant electrons enter the body and neutralize positively charged free radicals in the body. To get this benefit, Dr. Mercola recommends grounding or earthing sheets, made with fine thin strands of silver and which connect to an outlet; these cost about $200.
How does Dr. Mercola know this? Here’s how:
Many people realize while on vacation, how great it feels to walk barefoot on the beach. I have personally prioritized grounding myself to the earth as much as possible for over 5 years. The preliminary information confirms what I have believed for years, grounding yourself to the earth may significantly improve your health. The soles of our feet are the best contact to make with the earth, and will naturally discharge inflammation.
Because it couldn’t be all that exercise Mercola boasts about doing, could it? It has to be the contact with Mother Earth. In any case, he also features a video of himself discussing “earthing” with one of the men who started it all, Clint Ober:
I’ve heard of “grounding” before. But where? Where? Oh, I remember now. The original website to which P.Z. Myers linked doesn’t exist anymore, but there is a successor website, Earthing.com, which has a whole bunch of pseudoscientific nonsense on it. It must be Clint Ober’s new website, along with the Earthing Institute.
So what is the rationale? Here’s (allegedly) how. First, it’s because of thunderstorms:
The earth’s electrical field is maintained by thunderstorms — 1,000 to 2,000 thunderstorms are continually active across the earth. Since the earth’s surface is highly conductive, this electrical charge is evenly and rapidly dispersed across the earth. Standing barefoot on the earth (or otherwise connecting to the earth) connects the human body with the unlimited supply of free electrons resident in and on the surface of the earth. The whole circuit is referred to as the global electrical circuit. It is estimated that this current would disappear in less than an hour if all thunderstorm activity ceased. Standing barefoot on the earth also connects the human body with rhythmic cycles of the earth’s energy field. These are essential for synchronizing biological clocks, hormonal cycles and physiological rhythms.
And because free electrons from the earth neutralize free radicals in our bodies:
The earth is a vast reservoir of naturally produced electrons. This is important because these electrons stabilize (neutralize) free radicals and stop free radical damage. The earth is therefore the best antioxidant available – and it’s free. Connecting with the electrons on the surface of the earth can stop the destructive cycle that causes free radical damage. No wonder re-connecting with the earth is so important for our well-being.
Regular readers of this blog should immediately recognize the above as being nonsense. Basically, it’s the overlaying of “science-y”-sounding terminology to earth worship, where the power of the earth somehow maintains and protects us, and the cause of all illness is because of man’s “disconnectedness” from the earth. Basically, it’s magical thinking on par with homeopathy. Yet it is the rationale for why Clint Ober recommends that everyone go barefoot and sleep on the ground.
But how can you accomplish this? What if you live in Chicago (like Mercola) this time of year? You’re not about to be out and about going barefoot. What if you have a job, as most of us do? I don’t know about you, but people would frown on it if I tried to go barefoot to work, and it’s not just because I have ugly feet. Patients would be appalled, and who knows what’s on the floor of my lab? Fortunately for people like me, there are lots of places that sell conductive mattress pads. Basically, they’re pads with a cord that you hook up in various ways to “ground” the pad to the earth. I kid you not. If you want a good belly laugh, read this FAQ about grounding pads. Basically, this variety of earthing pad is a blanket made with silver threads that’s hooked up to a wire that can be used to ground the pad. Particularly amusing is this question:
Q. I don’t want to spend any money for any grounding device when I can make one myself. All I have to do it get a ground rod, some 20 gauge wire, and then wrap the wire around my ankle or foot at night.
A. You can certainly do it. People have done it many times. However, it is not particularly comfortable. You could possibly cut off circulation if you wrap the wire too tight around your extremity. Secondly, a sharp end on a wire wrapped around the ankle could tear the sheet.
What about one’s skin, I wonder?
So what does Dr. Oz have to say about this amazing new health intervention? This:
Before spending money on a device for grounding, try just stepping outside, in your yard. Avoid wood surfaces, as wood insulates you from the earth. See if doing so improves your energy levels.
Can you say “placebo effects”? Sure, I knew you could.
Dr. Oz: Still “America’s doctor” of quackery
It’s been ten months now since Steve Novella appeared on Dr. Oz’s daytime TV show. In that time, there has been no evidence that the scientific standards have improved on The Dr. Oz Show and lots of evidence that they’ve gotten even worse, if this latest appearance by Dr. Mercola is any indication. It goes beyond just this silly episode, however. In recent months, Dr. Oz has ignited a scare over arsenic in apple juice and had Dr. Mercola on his show other times, telling people not to take blood pressure medication, statins, or antidepressants and not to get flu shots. Other times, he’s pushed moxibustion, ubiqinol, and Bonito peptide supplements.
Whenever I’m asked why things are so bad and getting worse when it comes to the infiltration of quackery into medicine, particularly the phenomenon of quackademic medicine, I look at Dr. Oz. He reaches millions of viewers every day with his “bread and circuses”-style of medical infotainment, where anecdotes trump studies and snake oil hucksters like Joe Mercola are welcome. I keep hoping that some day he’ll have an epiphany and realize that he is no longer a scientist. Worse, he is no longer a responsible doctor. Instead, he’s become an enabler and cheerleader, either wittingly or unwittingly, for quackery. I fear that epiphany will never come. Promoting quackery is just too lucrative.
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