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Misguided Naturopath Claims To Have Cured Cervical Dysplasia

Pap test discoverer

George Papanicolaou, who originated the cervical dysplasia test that bears his name (the Pap smear)

Naturopath Kate Whimster has written a case study of a patient with cervical dysplasia who was allegedly treated successfully with naturopathic treatment. She says:

In many cases conventional treatment can be invasive, ineffective, or can put patients at risk for future complications. Fortunately, there are wonderful naturopathic treatment options available both instead of or in conjunction with conventional medical treatments. This case study is a great example of naturopathic treatment for cervical dysplasia as part of my HPV Healing program.

The Patient

The patient was a 32-year-old woman who first had an abnormal Pap smear at the age of 26. Here is Whimster’s report of the course of events:

  • February 2012: Pap HSIL, Colposcopy CIN I, Biopsy HSIL
  • April 2012: LEEP procedure
  • July 2012: Pap HSIL, Colposcopy CIN I, Biopsy HSIL
  • August 2012: Start of naturopathic treatment
  • Nov 2012: Pap LSIL, Colposcopy normal
  • May 2013: Pap LSIL, Colposcopy CIN I, Biopsy LSIL
  • July 2013: Pap ASCUS, Colposcopy normal, Biopsy normal
  • October 2013: Pap normal, Colposcopy “cannot rule out CIN I,” Biopsy normal
  • May 2014: Pap, Colposcopy and Biopsy all normal.

She was also successfully treated for a bacterial vaginal infection.

What do all those words mean? A primer on cervical dysplasia

Definition: Cervical dysplasia refers to abnormal changes in the cells on the surface of the uterine cervix, changes that can sometimes progress to cervical cancer.

Risk factors: Most cases are caused by infection with HPV (human papilloma virus). Risk factors include having sex before age 18, having a baby before age 16, multiple sex partners, illnesses or medicines that suppress the immune system, and smoking.

Pap smears: Specimens of surface cells are scraped from the cervix during a pelvic exam and are examined under a microscope. Findings are reported as:

  • AGUS: Atypical glandular cells of undetermined significance. Rare, less than 1% of Pap results; can indicate conditions other than cervical dysplasia.
  • ASCUS: Atypical squamous cells of undetermined significance. Most common abnormal result; very mild changes that could be due to infection, inflammation, or precancerous changes. Not considered cervical dysplasia unless confirmed by further testing.
  • LSIL: Low grade squamous intraepithelial lesion. Mild dysplasia, likely caused by HPV. In most cases, clears up on its own within two years.
  • HSIL: High grade squamous intraepithelial lesion. Could lead to cancer.
  • Possibly cancerous but must be confirmed by biopsy.

Biopsy: A piece of tissue is cut out and examined by a pathologist.

  • Colposcopy: An office procedure. A microscope and stains are used to find suspicious areas to biopsy.
  • Cone biopsy: A hospital procedure. Removes a cone-shaped chunk of tissue from around the entire circumference of the cervical opening.
  • LEEP excision: Loop electrosurgical excision procedure. An outpatient biopsy where a tissue sample is excised with a low-voltage electrical wire.

CIN: Dysplasia seen on biopsy specimens is classified as cervical intraepithelial neoplasia.

  • CIN I: mild dysplasia.
  • CIN II: moderate to marked dysplasia.
  • CIN III: severe dysplasia to carcinoma in situ (early cancer).

Keep in mind that Pap smear and biopsy findings depend on the interpretation of a pathologist looking at slides under a microscope. These are not clear-cut yes-or-no diagnoses; there is a subjective element, and the classifications gradually shade into one another on a spectrum, so pathologists may not always agree with each other.

Treatment: LSIL and CIN I may go away without treatment. Doctors may decide to simply follow the patient with periodic Pap smears. Moderate-to-severe dysplasia or persistent mild dysplasia can be treated by various methods. Cone biopsy or LEEP excision may entirely remove the abnormal tissue. Lasers, cryotherapy, and hysterectomy are other options.

Naturopathic treatment

This naturopath used a combination of 5 treatment modalities:

  1. Nutritional treatment consisting of both diet and supplement recommendations focused on female hormone balance and supporting the immune system in resolving viral infection. Specific nutrients included beta carotene, vitamin C, vitamin E, folic acid, zinc, and green tea extract at therapeutic doses for 3 months and then more moderate doses for 12 months.
  2. Botanical treatment consisting of a custom compounded herbal tincture focused on immune support and specific anti-viral activity for 3 months.
  3. Vaginal suppositories focused on resolving viral infection and healing cervical tissue for 12 weeks.
  4. Biotherapeutic drainage to improve female hormone balance and support healthy elimination and immune function.
  5. Homeopathic treatment to address patient’s overall state and promote healing.

On her website, she describes her HPV Healing program. She reviews past and current lab results to determine the best treatment for the individual, and if necessary she will perform a “naturopathic gynecological exam” including a Pap test. She answers the question “How does it work?” but does not ask the question “Does it work?”

Are these naturopathic treatments supported by evidence?

While it is a truism that maintaining a good state of health helps the body fight disease, these naturopathic treatments have not been tested, and there is no evidence that any of them improve the outcome in cervical dysplasia. There is good evidence that highly dilute homeopathic medicine is nothing but water: it not only doesn’t work but it can’t possibly work given our current knowledge of physics, chemistry, and biology.

Who is this naturopath?

“Dr. Kate” is a graduate of the Canadian College of Naturopathic Medicine. She developed an interest in naturopathy while she was studying economics. She “got fed up with feeling bloated, cranky, and tired” and she allegedly cured herself with D’Adamo’s unscientific Blood Type Diet. She practices in Toronto and has a website that promotes homeopathy and other questionable treatments. She offers whole body detox. She advises against birth control pills because she thinks they “obscure your true state of health,” and she recommends less reliable methods of contraception (the rhythm method and condoms).

She is treating cervical dysplasia without even mentioning the HPV vaccine, the most effective thing that can be done to prevent cervical cancer. Nowhere on her website does she address vaccines except to say that we should consider their “implications” for immune health. She says “kids need to get sick” to educate their immune systems. I suspect she is anti-vaccine or at least not pro-vaccine. Studies have shown that the patients of naturopaths are less likely to be immunized.

Jann Bellamy has written about what other naturopaths have recommended for cervical dysplasia, and their advice doesn’t align with what Dr. Kate recommends. None of their recommendations are evidence-based and nowhere do they even mention HPV vaccines. That’s probably one of the things that makes practicing naturopathy attractive: instead of following evidence-based consensus guidelines, you have the freedom to improvise and make things up as you go along.

What really happened here?

This patient’s cervical dysplasia resolved over time, as expected. The American College of Obstetricians and Gynecologists have pointed out that CIN I is most often due to a transient HPV infection that will usually clear in a year and does not require treatment in average-risk women.

This patient was appropriately treated and followed by her gynecologist. There is no reason to think the addition of naturopathic treatment affected the outcome. Whimster’s case study is a good example of the post hoc ergo propter hoc fallacy: she assumes that because the patient got better with naturopathic treatment, she got better because of naturopathic treatment. Assumptions like this from case studies are often false; they must be tested in controlled scientific studies before they can be accepted as true.

This naturopath has a different concept of “evidence” than we do on SBM. It is obvious from her website that she endorses a number of ideas that are not based on credible scientific evidence. It is easy to see how experiences like this case study and like her experience with the Blood Type Diet serve to bolster her confidence in what she is doing. Confirmation bias is at work here; she doesn’t seek out any information that might disconfirm her beliefs.

Conclusion

There is every reason to think this patient improved in spite of her naturopathic treatment, not because of it. There is no reason to think naturopathic treatment is a useful addition to the mainstream treatment of cervical dysplasia or could substitute for conventional treatment. Most of Whimster’s treatments probably do no harm, and in this case the naturopathic treatments were used along with conventional treatment, but her website suggests that she is using naturopathic treatments instead of conventional treatments in some cases. Some of her advice could be dangerous.

Posted in: Cancer, Naturopathy

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66 thoughts on “Misguided Naturopath Claims To Have Cured Cervical Dysplasia

  1. Michael Finfer, MD says:

    CIN (cervical intraepithelial neoplasia and dysplasia is outdated terminology that should no longer be in use. Instead, we use low grade or high grade squamous intraepithelial lesion (SIL) which has been found to be more reproducible and corresponds more to the biology of HPV infections. It was recently recommended that this terminology be used for all lower anogenital tract squamous lesions. It should also be pointed that HSIL can also regress, but the risk of progression to invasive cancer is high enough that most HSILs are treated.

    Of course, the naturopath’s treatment had nothing to do with the outcome here. Sigh.

    1. EBMOD says:

      Coming from the vision side of things, what we refer to as a ‘CIN’ is Conjunctival Intraepithelial Neoplasia, a tumor that is typically right on top of the white part of the eye. SIL would be much easier for those like myself who are easily confused. :)

  2. goodnightirene says:

    Why would anyone bother with such a lengthy and cumbersome regimen as the naturopathic treatment? And if you believe, then why do the standard treatment as well? What’s behind this “cover both bases” thinking? Is it simple ignorance or something more complex, having to do with cult mentality thinking?

    1. KayMarie says:

      It may have to do with perception of control. I can submit to the doctor’s procedures but most of what happens there is not in my control.

      I can change my diet, take supplements, do the exercise, etc.

      I also think some people see this kind of thing as a wake up call and feel the need to do something healthy and lifestyle overhauls kind of are a naturopath’s stock in trade. Sure you can do the same kind of overhaul totally in the science-based world, but some people like the one stop shopping and the whole very hard to do more ritualistic types of approaches (cut out whole food groups, only eat what comes out of a Vitamix, etc take 752 supplements a day at specific times in specific combinations)

      I think some of the science-based overhauls while much easier to do don’t seem to add that “I beat this, I am in control of my biology” sense for most people. I think some of us want that battle and struggle and sometimes the more intense the “program of healing” the more it appeals. Eat more veggies and take a walk once in awhile probably does as much, if not more, good. It just doesn’t help create that “in group” or “I won the war” internal sense that seems to appeal to a lot of people.

      1. goodnightirene says:

        Thanks for those insights. You see what you describe with weight loss efforts a lot–ritual and complexity as opposed to eating less.

      2. simba says:

        There is a perception that if you do more it’s more effective. Like exercise- people often don’t want to condition themselves slowly because they are impatient to get started, it doesn’t seem as ‘effective’ and things, so they go straight from ‘couch potato’ to ‘marathon on a hot day’.

        I’ve had to nurse friends who had crippled themselves doing things like that.

        With the diet I suspect it’s also about providing reinforcement.

        It takes a while when trying to lose weight to see any real result. I suspect that the reason for doing the difficult diets is simply that achieving any difficult thing will give you a sense of accomplishment, and that kicks in on the first day. You don’t have to wait ’til the end of the week to hop on the scales to feel like you’ve made a difference- and a lot of the diets promote rapid water loss which will help that ‘I’ve done something!’ sensation.

    2. Kathy says:

      Also, pleasing someone you regard as having superior knowledge/authority is also a factor I think. Dare I be un-pc and say it is especially common in women? If one could see the schedules of visits I’ll bet the patient had more visits to the naturopath than the MD, and longer ones, and that they were replete with compliments, reassurance and expressions of support.

  3. Angora Rabbit says:

    “Nutritional treatment consisting of both diet and supplement recommendations focused on female hormone balance and supporting the immune system in resolving viral infection. Specific nutrients included beta carotene, vitamin C, vitamin E, folic acid, zinc, and green tea extract at therapeutic doses for 3 months and then more moderate doses for 12 months.”

    What utter rot. We don’t recommend beta-carotene any longer for pre-cancerous conditions because of bC’s well documented effect to increase cancer risk, due to the liver’s attempts to remove (heh, detoxify) the excessive beta-carotene. This process increases increases conversion of procarcinogens to carcinogens, as documented in CARET and other trials in the 90s. (No, $tan, it wasn’t due to the “wrong form” which of course you have still failed to explain.) All our nutrition grad students know this, as do our undergrad dietetics students.

    Similarly, increased folic acid is associated with increased neoplasia risk and should not have been provided to this patient. Folic acid increases nucleotide synthesis and thus the raw materials for cell division. For preneoplasias, folic and nucleotides can be limiting and keep them in check. Feeding those cells folate adds gasoline to the fire. This is a basic principle we teach our nutrition grad students.

    Excessive Vit E is associated with increased all-cause mortality now in at least three independent studies including of cancer. The excess zinc is probably harmless in the short term but can cause copper and iron deficiency. The vit C is just peed out by the patient.

    Obviously this “naturopath” doctor doesn’t understand nutrition as well as she pretends she does.

    1. MadisonMD says:

      My reply is here.

    2. WilliamLawrenceUtridge says:

      Angora Rabbit, does this concern over beta carotene extend to foods as well as pills? I eat a lot of carrots and beets, to the point that my palms and soles of my feet are orange (very noticeable next to my wife’s hands). Should I be concerned? It’s probably at least three carrots per day, every work day, plus either one small or part of a large, raw beet. And other veggies and fruits.

      Or is it the bolus of concentrated bC in a pill that is the problem?

  4. Jann Bellamy says:

    This post is an excellent example of the disturbing implications of Section 2706 of the Affordable Care Act. http://www.sciencebasedmedicine.org/harkins-folly-or-how-forcing-insurers-to-cover-cam-undermines-the-aca/ Given Sen. Tom Harkin’s insistence that no state-licensed provider can be excluded from insurance coverage for the full range of services permitted by his or her license, insurers may be forced to include naturopaths in their provider panels. This will lead to insurance claims for the sort of ineffective and possibly dangerous treatments described in the post. Insurers will either have to pay these claims or build up a library of evidence supporting their exclusion. (As insurers have done with chiropractic “subluxations.”) Given the fact that, in naturopathy, “instead of following evidence-based consensus guidelines, you have the freedom to improvise and make things up as you go along” this could turn out to be quite expensive.

    1. Shell Bush says:

      Someone needs to put a stop to Harken and that other asswipe who keep trying to push the agenda their natural medicine buddies are paying them to promote.

      1. Windriven says:

        Harkin, praise Darwin, is retiring. I’m not sure which other idiot you’re referring to, there are several. But as with most things rooted in fantasy, stopping belly-button gazers and wishful thinkers is a game of whack-a-mole.

      2. Dan McPeek says:

        Orrin Hatch: Quack, I mean Senator from Utah!?

        1. Windriven says:

          And that butt cheek has promised to retire in 2018. Good riddance.

          1. Calli Arcale says:

            I’m not terribly optimistic that will help. Yes, he’ll be gone, but the lobbyists who have supported him thus far are aware of that fact and are surely already grooming potential replacements.

            1. Windriven says:

              No doubt, Calli. But you have to take the little wins when you can get them. Hatch was a fully stenotic quack supporter; nothing was going to change his approach. Hopefully there will be a better chance of reaching someone with a broader appreciation of reality.

      3. WilliamLawrenceUtridge says:

        One doesn’t need to restrict this to merely the natural medicine crowd. Nearly any well-financed lobbying effort will probably inevitably result in improved conditions for the lobbying group, and worse outcomes for the general public.

    2. EBMOD says:

      As an optometrist, I have been quite at odds with the AOA over the Harkin Amendment. In a vacuum, it is a great piece of legislation for OD’s because we can’t be discriminated against now and are included in the ACA. Of course, the downside is that we kind of sold our soul in teaming up with alt med CAMsters to get it.

      Unfortunately, I think that that there are many OD’s who are users/believers in CAM, which is sad considering that my school even had a class called evidence based optometry that educated us on how to properly assess medical studies for bias and logical fallacy…

      1. Thor says:

        I’ve seen it first hand, EBMOD. Wherever CAM can manifest, it certainly will— there is no off limits. This fellow was a client of mine for about fifteen years (before I became disabled). I had an office once in a facility that practiced this “light therapy” using machines that Dr. Downing created and patented. I gave it a six-month trial on my own eyes for a particular medical problem, but got no results. It was touted as pretty much a panacea. It seems to be quite “out there” in terms of the woo-factor. Anyway, the link is sent for your own amusement.

        http://www.eyeandbraincare.com

        1. EBMOD says:

          Yeah, it definitely makes me facepalm seeing such things. It enrages me to no end that the people who embrace this woo are often in the top tier of earnings since they are usually practicing in a cash pay monopoly since rational and self-respecting OD’s refuse to step in the woo…

          1. goodnightirene says:

            I have always respected OD’s, having been acquainted with one in my youth, as they prided themselves on rigorous training and considered themselves (as my friend put it) “doctors from the neck up”, yet he firmly held to strict ethics of when to defer to MD’s. I’m sorry to hear they have joined in the pseudoscientific glut that infects so many who should know better–but then again, why do people fervently believe that Jesus loves them?

            1. EBMOD says:

              I should clarify that it isn’t a majority of OD’s that are steeping in the woo, I would guess that the percentage is similar, though a bit higher than for MD’s. The AOA’s endorsement of the Harkin Amendment I think that essentially zip to do with approving of CAM, I think it is simply that it ensured inclusion and reimbursement for OD’s.

              There is a bit of friction between some ophthalmology/MD’s and OD’s, and I think that that ‘red headed stepchild’ treatment that many OD’s gets from OMD’s serves to push us a bit away from the mainstream and leave some more open to woo since many MD’s view us as ‘alternative’.

              Though, don’t get me wrong, there are many great OMD’s that work with us to manage patients without any stigma or condescension…

  5. Yodel lady says:

    I find it very chilling when “alt” practitioners — and their followers — show complete ignorance of the history of disease. Cervical cancer is a real killer. In some developing countries it is still the leading cause of cancer deaths in women. In the U.S. and the UK Pap smears have allowed us to stop most cervical cancers before they ever become cancerous, and the HPV vaccine will be even more successful. This is a case where conventional medicine has been so wildly successful quacks can play “let’s pretend” and not get caught.

    1. WilliamLawrenceUtridge says:

      I find it completely unsurprising. The entire profession, the entire field is based on a glorious absence of major killers, the luxury of one’s children being almost certain to survive to their adulthood, and the fact that with adequate support the body is quite able to get better on its own.

  6. Mary Russell says:

    http://www.plannedparenthood.org/health-info/birth-control/fertility-awareness
    Just a small correction to Dr. Hall’s excellent summary above: it doesn’t appear to me that this naturopath advocates the rhythm method but a version of fertility awareness. The differences are summarized above. It is not CAM birth control but is based on the physiology of the female reproductive system to determine the fertile window of each cycle. Effectiveness data is easy to find and in fact puts it in the same ballpark as oral contraceptives.

    1. goodnightirene says:

      How does this differ from the Rhythm Method and how is it equal to the pill–in convenience if nothing else?

      1. Windriven says:

        “How does this differ from the Rhythm Method”

        Ummm, syncopation?

        I went to the link and read the spiel. Looks just like rhythm method to me.

        1. Mary Russell says:

          With both the rhythm method and fertility awareness methods the user is determining when it is possible to conceive and when it is not in each menstrual cycle. But the mechanism used to do so is different between rhythm and FAM. Rhythm uses calculations based on past cycle length to predict the fertile window in future cycles. FAM users are taught to look for the signs of fertility during each cycle to determine the beginning and end of the fertile window for that particular cycle. It is quite effective and

          1. Mary Russell says:

            …easy to use.

            1. Mary Russell says:

              Sorry for multiple postings… Here’s a large effectiveness study of Creighton method, one of the largest fertility awareness models taught in the U.S. http://www.ncbi.nlm.nih.gov/pubmed/9653695 on the U.S.

          2. Windriven says:

            I do not claim particular expertise but recall that looking for temperature spikes and calculating offset from menses were part and parcel of the rhythm method as taught in the early 70s.

            1. Kiiri says:

              The problem with this is still the same problem with the rhythm method, you are looking for subjective changes in your body (temperature, cervical mucous, etc.) every month. This is not only inaccurate and open to interpretation woman to woman it isn’t all that effective. I looked into a lot of this when I was first trying to conceive my son, working out my fertile window every month. I have no idea why anyone would eschew a proven method of contraception (pill, implant, IUD) for hoping she guesses right when she is fertile and doesn’t have sex. This kind of information should never be promoted as an alternative to real effective birth control.

              1. mouse says:

                Heck even dystopian zombies youth* have effective birth control, no reason regular people can’t.

              2. Windriven says:

                ” I have no idea why anyone would eschew a proven method of contraception (pill, implant, IUD) for hoping she guesses right when she is fertile and doesn’t have sex.”

                The pope’s gonna whack you with a rolled up newspaper!

              3. Calli Arcale says:

                A few years back, I read about a study in African women attempting this form of the rhythm method, which was being promoted because quite frankly they didn’t have a lot of alternative besides abstinence as both barrier and pharmaceutical options were both expensive and nearly impossible to find for sale in any case. So it was a good population to look at, because realistically their only alternative was the “hope” method. They found that women using the method did quite well, much better than they were expecting, and had a much lower than average birth rate.

                They also looked at women using the method for the opposite purpose, the same one you were using it for: to attempt to conceive a child. They found it was surprisingly disappointing for that purpose, and speculated that this was because it indicated too large a window. That would be okay for avoidance, but less helpful if you were trying to find the right day to conceive.

  7. Chris Hickie says:

    Isn’t the phrase “misguided naturopath redundant?

  8. MadisonMD says:

    Similarly, increased folic acid is associated with increased neoplasia risk and should not have been provided to this patient. Folic acid increases nucleotide synthesis and thus the raw materials for cell division. For preneoplasias, folic and nucleotides can be limiting and keep them in check. Feeding those cells folate adds gasoline to the fire.

    Thank you for this information, AR. Although folate is required for cell proliferation and antifolates are useful cancer therapies, is there any evidence that folate is actually rate limiting for tumor growth under ordinary circumstances? Some reasonable evidence seems to suggest folate supplementation can reduce the risk of colorectal cancer, suggesting that things might be a bit more complex. See the ACS information on folate here.

    Not that this detracts from your main point– that folate supplementation is not known to be useful for preinvasive cervical disease. Here is what the ACS site says:

    … two randomized, controlled trials found that folic acid supplements had no effect on women who already had pre-cancerous conditions of the cervix.

    1. Angora Rabbit says:

      Yeah, it did pop up. When the folate supplementation occurred, there was a prediction that preneoplasia and neoplasia rates would increase, and a few studies post-supplement captured that. I’d have dig out those references. But it was like breast cancer screening, in that once the first few years of supplementation was over, the rates fell back to normal. In other words (this is for readers other than MadisonMD), it only acted upon pre-existing conditions and wasn’t, in of itself, a promoter.

    2. Angora Rabbit says:

      Thanks for the link. It looks like it related to pre- and early supplement periods. Might be related to DNA silencing in folks where methyl groups were limiting? Of course, this is just hand-waving. And as you say, it looks like the benefit disappeared as intakes rose. And, of course, (on the third hand) folks who take supplements are more likely to be better informed about risks, have better access to health care, and are more likely to have practices other than supplements that reduce overall risk. In epidemiology studies, it’s hard to distinguish between association and cause-and-effect, as you know.

  9. Michael Busch says:

    “Risk factors: Most cases are caused by infection with HPV (human papilloma virus). Risk factors include having sex before age 18, having a baby before age 16, multiple sex partners, illnesses or medicines that suppress the immune system, and smoking.”

    I’m a bit confused: why didn’t you include “did not receive HPV vaccine” in the list of risk factors?

  10. mho says:

    Somewhat OT, through google, I’ve just discovered that some naturopathic doctors think they can treat traumatic brain injury with nutrients.

    1. Harriet Hall says:

      “some naturopathic doctors think they can treat traumatic brain injury with nutrients”
      They’re right. Of course they can treat it. They can treat it with homeopathy, too. The question is “Does the treatment work?”

  11. fxh says:

    I had a bit of a chuckle at risk factors -” having sex before 18 years old ” – so that means all ” normal ” people!

  12. steven says:

    Wow. This is quite the hatchet job. At the end of the day, the patient in this case study had a positive experience and the Naturopath is actually sharing her treatment process as a case study (as any good evidence-based scientist should commend). And for her troubles, she gets this libelous attack that makes unfounded and uninformed claims about her medical opinions. It seems especially odd that the author would mock this Naturopath’s belief that “kids need to get sick in order to educate their immune systems.” It seems to me that this statement is foundational to our understanding of the way vaccines actual work and is wholly uncontroversial. If you’re looking to win over the hearts and minds of logic-driven, and evidence-based readers, I would suggest that you engage in a constructive discourse on the contents of this case study instead of making ad hominem attacks against the author.

    1. Windriven says:

      Where was the ad hominem, Sparky? Did Hall say the naturopath had stringy hair?, buck teeth? Body odor? Scabs on her knuckles from dragging them going up stairs?

      I don’t recall but if Dr. Hall said the naturopath was deluded, had a barely childish understanding of science, or shouldn’t be allowed to lay hands on a dead squirrel much less a living human child, that would be a statement of fact, not an ad hominem.

      The authors here in general and Dr. Hall quite especially are very careful not to call bat sh1t crazy by its name. You should be thankful.

      The issue at hand isn’t a small difference of opinion about arcane scientific minutiae. The issue at hand is an inappropriately educated fool playing doctor with living human beings.

  13. Sawyer says:

    It seems especially odd that the author would mock this Naturopath’s belief that “kids need to get sick in order to educate their immune systems.

    Steven, did you even bother reading the sentence that succeeded this one? The reason why Harriet was suspicious of this sentiment is because many Naturopaths make a fictional distinction between natural infections and vaccines. Heck, this idea is literally embedded in their own name. Did you not understand why using the concept of vaccines for support of naturopathy is completely disingenuous and hypocritical?

    I’m always amazed at how often terms like “hatchet job”, “ad hominem”, or “slander” are now used by the quacks to describe the process of simply presenting the facts.

  14. steven says:

    Statements like, “I suspect she is anti-vaccine or at least not pro-vaccine.” show that the author is not really interested in presenting evidence to make a case herself. She should at least hold herself up to the same standards she expects from others. And sharing and publishing case studies is an important part of the process towards developing evidence on the efficacy of treatment protocols. So it seems very strange to hammer this Naturopath for daring to begin this process.

    I think its fair to accuse the author of an ad hominem attack when she makes baseless assumptions about another person’s opinions “I suspect she is anti-vaccine” or at least of using red herrings by going onto her web page and attacking (and misrepresenting) her views on a variety of topics instead of focusing on the case study itself. Anyone interested in evidence-based medicine, should applaud the efforts of naturopaths to attempt to present a case study for public and peer review. There are naturopaths who are highly committed to evidence-based processes (this Naturopath appears to be one). They should be encouraged to continue down this path. The Canadian College of Naturopathic medicine (where this Naturopath was educated) has published some very thorough and methodologically rigorously studies of late.

    But the attacks here, and especially in the comment thread, seem to be based on some caricature of Naturopathic medicine. When the author attacks someone for not being “pro-vaccine” it tips me off to the fact that this is not actually a site for rational or skeptical analysis. There is no place for cool skeptical distance in the analysis and discourse happening here, it’s all hot and emotional, and based on very rigid and unquestioning faith in conventional approaches and a knee-jerk prejudice against any alternative to these approaches.

    By basing her criticism of this course of treatment on the Naturopath’s credentials, undergraduate focus, views on contraception, and suspected views on vaccines, the author shows me that she is not interested in practicing reason-based analysis or in the scientific method. A case study is essentially a very simple argument for (or against) the efficacy of a certain treatment, by attacking the person making the argument instead of the argument itself, the author is guilty of an ad hominem attack.

    1. Chris says:

      “Statements like, “I suspect she is anti-vaccine or at least not pro-vaccine.” show that the author is not really interested in presenting evidence to make a case herself.”

      Why did you not include the next statement after that quote: “Studies have shown that the patients of naturopaths are less likely to be immunized.”

      It includes a link where that particular evidence is laid out in excruciating detail. Why do you insist she repeat it, when it was all there if you had bothered to click on the blue letters. But just in case you don’t want to be bothered to scroll up the page and look for those blue letters, here it the actual link:
      http://www.sciencebasedmedicine.org/naturopathy-vs-science-vaccination-edition/

      It includes several PubMed indexed studies on the Not Doctors’ attitudes towards vaccination.

      “There are naturopaths who are highly committed to evidence-based processes (this Naturopath appears to be one). They should be encouraged to continue down this path.”

      Come back to us when naturopathic schools remove fantasy based treatments like homeopathy, acupuncture and reiki from their curriculums, and all of their graduates pass the USMLE. Then they, like the osteopaths, will be considered real medical practitioners.

      1. steven says:

        That is called a “guilt by association” ad hominem attack. Also, it should be pointed out that the title of this article is patently false. Whether the Naturopath is “misguided” is a matter of opinion, but she definitely didn’t claim to have cured cervical dysplasia.

        1. Chris says:

          Actually, that was pretty clearly laid out with the naturopath not understanding the nature of the tests, and how the condition naturally proceeds:

          Treatment: LSIL and CIN I may go away without treatment. Doctors may decide to simply follow the patient with periodic Pap smears. Moderate-to-severe dysplasia or persistent mild dysplasia can be treated by various methods. Cone biopsy or LEEP excision may entirely remove the abnormal tissue. Lasers, cryotherapy, and hysterectomy are other options.

          You must have missed that the woman was appropriately treated by a real doctor:

          This patient was appropriately treated and followed by her gynecologist. There is no reason to think the addition of naturopathic treatment affected the outcome. Whimster’s case study is a good example of the post hoc ergo propter hoc fallacy: she assumes that because the patient got better with naturopathic treatment, she got better because of naturopathic treatment. Assumptions like this from case studies are often false; they must be tested in controlled scientific studies before they can be accepted as true

          Try reading the article with a bit more comprehension.

          And the data still show a naturopath is less likely to recommend vaccines. If you have evidence contrary to the several laid out in the link I provided, then please provide those PubMed indexed papers.

          And it is not an ad hominem to note that the naturopath used nonsense when one of the five treatments included homeopathy. Again, if you have any evidence that homeopathy is effective for any non-self-limiting disease like cancer, please present those PubMed indexed studies by qualified reputable researchers (not anecdotal case reports).

        2. WilliamLawrenceUtridge says:

          Ad hominem is when you attack someone’s character at the expense of their argument. In this case, the argument is that naturopaths bring something scientific to the treatment of cervical dysplasia. Pointing out that naturopaths as a profession oppose, are unfamiliar with, or have no competence in well-founded scientific areas of medicine (such as vaccination, a key, effective and safe public health intervention responsible for reducing incredible amounts of morbidity and mortality in the modern world) isn’t ad hominem, it’s appropriate context. Further, Dr. Hall discussed why opposition to vaccination in general is relevant for cervical dysplasia specifically since HPV is the primary driver of cervical cancer.

          Discussion of vaccination is both relevant to the general competency of naturopaths and the specific topic of cervical dysplasia.

          And that’s not even touching on the complete lack of support for the guiding principles of naturopathy, the central dogma of vitalism that was disproven centuries ago.

          Naturopaths are quacks. At best they provide mainstream advice that is redundant to a nutritionist. At neutral they co-opt conventional recommendations and waste time, money and resources of patients and society. At worst they actively oppose, in an Orwellian and deceptive manner, the most effective interventions of modern medicine and kill their customers.

    2. Sawyer says:

      Steven,

      You seem to have a keen interest in the presentation of naturopathy, yet somehow you’ve managed to miss a *very* common sentiment expressed by naturopaths. How is this possible? The “getting a disease is the only way to become immune” trope has been covered on this site many times. If you don’t like reading about it here you can choose one of the dozen other blogs that covers science-based medicine, or go right to the source and read one of the hundreds of naturopathy websites that promote this idea. This information is not difficult to find.

      It is not unfair, unrealistic, nor an ad-hominem attack for Dr. Hall to assume that Kate Whimster’s take on the immune system is similar to pretty much every other naturopath’s understanding (or misunderstanding) of the immune system. If Whimster is indeed a promoter of widespread vaccination, she is welcome to make that viewpoint better known. I suspect she won’t do this, knowing that it would severely taint her reputation among other practitioners of naturopathy.

      We’ve also seen ample evidence of naturopaths, homeopaths, chiropractors, acupuncturists, and other medical gurus using a fluke success story to promote a tangential aspects of their practice in the press. It is not an “attack” to question whether naturopaths may be employing the same technique with this story, considering that’s exactly what you’re starting to do in the above comments.

    3. WilliamLawrenceUtridge says:

      Naturopaths have a long history of opposing vaccination, have higher incidence of unvaccinated patients, and their patients have higher rates of vaccine-preventable diseases. Naturopaths will often bey coy about “educating” patients, when what they mean is presenting a blatantly one-sided discussion of the (often spurious and disproven) vaccines with no discussion of the importance of herd immunity. Further, this case study is an example of how naturopaths are pseudoscientific, adopting the trappings of science, the appearance of science, without any of the actual merit. In this case, completely failing to note how usual care can be totally curative and that conditions like the ones diagnosed will commonly regress spontaneously. It’s rather like reporting a miraculous ability to walk on water, but leaving out the part where you’re on a dock.

      There are naturopaths who are highly committed to evidence-based processes (this Naturopath appears to be one).

      Then why did this naturopath leave out any and all discussion about spontaneous regression and the natural course of pre-clinical endometrial changes?

      The Canadian College of Naturopathic medicine (where this Naturopath was educated) has published some very thorough and methodologically rigorously studies of late.

      Where? And about what?

      By basing her criticism of this course of treatment on the Naturopath’s credentials, undergraduate focus, views on contraception, and suspected views on vaccines, the author shows me that she is not interested in practicing reason-based analysis or in the scientific method. A case study is essentially a very simple argument for (or against) the efficacy of a certain treatment, by attacking the person making the argument instead of the argument itself, the author is guilty of an ad hominem attack.

      That’s kind of amusing given your complete failure to grasp or reference why Dr. Hall found the case study unconvincing.

  15. steven says:

    I think my larger point was that the author was trying to suggest that the Naturopath’s assumed position on vaccination somehow invalidated her case study. I don’t think that being anti-vaccine (or more specifically, not being pro-vaccine) should preclude someone from engaging in a rational discourse. I think you could make the case that they used faulty reasoning in one instance and are likely to do so again. But it seems unhelpful to throw that assumption into the mix, when you don’t even know for certain what her position is.

    1. AdamG says:

      Vaccinations at a young age supercede or alter the natural immune response to many common illnesses that we used to get during childhood. The subject of vaccines is large and is beyond the scope of this blog. However, I think is it clear that vaccines do not replicate the experience of actually having the same illness. Research in this area is constantly evolving, so there is still much debate about the long-term effects of vaccines.

      It seems that Dr. Hall is not too far off the mark when it comes to Whimster and vaccines. By the way Steven, do you have any substantive criticisms of Dr. Hall’s points regarding causation? That’s really what invalidates the ‘case study’ here. You seem to be avoiding Dr. Hall’s main point altogether.

      1. Chris says:

        That quote shows that either the school she went to for her ND degree did not teach immunology, or that she fell asleep during those classes.

        Perhaps Steven can clarify. Right along where he explains how her use of homeopathy was valid by explaining its efficacy in cancers.

        1. steven says:

          I think you’re right to question the use of homeopathy in this treatment (or any other). I won’t defend it. I also think the author should have focused on this type of analysis of the case study instead of introducing the “who is this naturopath?” section, which seems intended to frame her in a negative light by cherry-picking biographical details and by attributing beliefs (probably anti-vax) and reasoning (post hoc ergo propter hoc) to the ND for which she presents no evidence. Unless the author has some special access to the mind of the ND, then I don’t believe she has a right to speculate on motives, reasoning, and personal beliefs without presenting relevant evidence.

          Offering statistics that suggest that the patients of Naturopaths are less likely to be vaccinated than others, is hardly evidence of this particular Naturopath’s beliefs. I can offer you evidence that Christians are more likely to believe in the existence of angels than non-Christians, but that doesn’t mean I can accuse all Christians of this belief, and I certainly shouldn’t use these statistics as an argument for ignoring any rational argument presented by any Christian.

          And while I applaud the author’s concise description of post hoc ergo propter hoc fallacy, I think she is speculating when she says the ND is guilty of this line of reasoning. The ND noted the use of conventional medicine (that’s how you know about it) and also noted that the infection had persisted for several years. She never claims to have cured cervical dysplasia as the title of this article suggests, but she does lay out the course of treatment and the results (as all good case studies do). The author rightly points out that case studies often make post hoc ergo propter hoc assumptions, but the ND in this case seems to have been careful not to go down that road.

          Try to stay classy sciencebasedmedicine.org.

          A little introspection amidst the demon hunting might be a good idea too.

          1. Chris says:

            “Offering statistics that suggest that the patients of Naturopaths are less likely to be vaccinated than others, is hardly evidence of this particular Naturopath’s beliefs”

            That quote from her own website is sufficient. Did you miss that?

          2. Harriet Hall says:

            “She never claims to have cured cervical dysplasia as the title of this article suggests”

            To quote her own words from her case report, she was “describing a case of cervical dysplasia that was successfully treated with naturopathic medicine.” She is clearly claiming success for something that she almost certainly should not get credit for.

            I think the “who is this naturopath” section is fully justified as an attempt to understand how someone could be so misguided as to offer treatments like homeopathy and to assume her naturopathic treatments were successful. I may not have “special access to the mind” of this particular naturopath, but I have developed considerable insight into the unscientific, uncritical thinking that underlies the whole field of naturopathy by reading what they write about themselves.

          3. WilliamLawrenceUtridge says:

            I also think the author should have focused on this type of analysis of the case study instead of introducing the “who is this naturopath?” section, which seems intended to frame her in a negative light by cherry-picking biographical details and by attributing beliefs (probably anti-vax) and reasoning (post hoc ergo propter hoc) to the ND for which she presents no evidence.

            Then submit a guest post or start your own blog FFS.

            Offering statistics that suggest that the patients of Naturopaths are less likely to be vaccinated than others, is hardly evidence of this particular Naturopath’s beliefs.

            Noting that this particular naturopath didn’t discuss or reference the HPV vaccine at all is pretty damning in and of itself. And again, feel free to submit a guest post or start your own blog FFS.

            And while I applaud the author’s concise description of post hoc ergo propter hoc fallacy, I think she is speculating when she says the ND is guilty of this line of reasoning.

            What do you think about Dr. Hall’s overall comment on how cervical dysplasia often gets better on its own and how this patient was undergoing usual care FFS? Way to miss the forest because you were hitting your head against one tree.

            She never claims to have cured cervical dysplasia as the title of this article suggests, but she does lay out the course of treatment and the results (as all good case studies do).

            Oh bullshit. Her treatments are irrational, there is no acknowledgement of the very common regression of cervical dysplasia, and homeopathy FFS. If the ND was “careful” about anything she was “careful” about avoiding all the readily available evidence that her care did nothing. The article is primal evidence for how pseudoscientific the profession is, adopting the trappings of research and academic publications without any of the substance and oversight that makes academic publications so superior to the just-so stories of CAM and naturopathy.

            Try to stay classy sciencebasedmedicine.org.

            Don’t be an asshole.

    2. Andrey Pavlov says:

      Well Steven, it actually does in a more direct way than you may think.

      It is not just that this person is anti-vax. It is also why she is anti-vax. It is not merely because she lacks specific knowledge. If that were merely the case, your argument would be much more accurate. But it is also that she came to that position as a logical course of thought stemming from fundamental assumptions about how the human body and science work that are patently false.

      So when this same person is writing case reports on outcomes of interventions for pathological conditions, I think it is indeed fair to say that her perspective will almost necessarily make the work useless. She is seeing this condition, using this treatment, and validating it to her patients by actively believing in nonsense. How can one think it likely that her writing on it will be correct and useful except in the most trivial and/or accidental of ways?

      Anybody with a silly beliefs or set of beliefs can do good science. Unless that science happens to directly contradict their beliefs. In this case, doing good medical science would necessarily contradict the beliefs that NDs have based their own practice on. Of course, there are always exceptions. But that is what they are – the unusual exceptions.

      1. steven says:

        I’d be curious to hear you describe these “fundamental assumptions about how the human body and science work.” I’d appreciate some insight into your understanding of Naturopathic principles.

        1. Andrey Pavlov says:

          @Steven:

          Just read up on naturopathy right here at SBM. It has a full gamut of information for you.

          But here is a very simple TL;DR: naturopaths must be educated in, trained in, and tested on homeopathy in order to graduate and obtain their licensure. If anyone with even an inkling of any actual science or even the tiniest understanding of how human physiology actually works doesn’t demand their money back and leave a school teaching homeopathy and a profession requiring knowledge of it for licensure then they clearly have profoundly wrong foundational principles of how to approach disease and treatment of it.

        2. WilliamLawrenceUtridge says:

          Naturopathy is fundamentally based on vitalism, using a bunch of mutually-contradictory interventions to “boost the vital force” of the body, which the body doesn’t have. While naturopaths will co-opt conventional advice about diet, exercise, stress and sleep to pretend they are “scientific” and “cutting edge”, the reality is they are merely parasitic on the appearance of science with none of the rigor. They will often recommend herbs or supplements based on historical uses (themselves based on the doctrine of signatures which looks to the shape of a plant or its parts rather than the chemicals to determine medical utility) or petri dish studies which any real scientist knows are premature. They will often recommend high-dose vitamins and other supplements, often expensive, which they conveniently sell, instead of recommending patients get adequate nutrition from their diets.

          And that's not even getting into their opposition to mainstream medicine overall as a form of knee-jerk reaction and self-definition.

          Any other questions?

  16. Lacri says:

    I was treated for cervical cancer, stage 1B, a few years ago. I was part of an online community, and another young woman received a similar diagnosis at around the same time. We both underwent a radical trachelectomy. My margins were clear, and I went on to carry a full term pregnancy. Although my subsequent medical history has not been entirely uncomplicated, and I’ve had to go on to have a hysterectomy and laser treatment for recurring HSIL, I am still here and, as far as I know, cancer-free 6 years later. The other young woman was not as fortunate. Her margins were not clear, and she was advised to undergo radiation therapy. She declined this in favour of a naturopathic regime, promising the online community (far too many of whom were supportive of her chosen route) that she would document her “journey”. Several months later most of her posts were deleted, and in due course we were informed that she had died. Naturally, her “journey” remains undocumented, and one can only speculate as to exactly what happened. Nobody receiving conventional treatment for stage 1 cervical cancer should die, though.

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