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No, carrying your cell phone in your bra will not cause breast cancer, no matter what Dr. Oz says

I don’t think very highly of Dr. Oz.

Yes, yes, I realize that saying that is akin to saying that water is wet, the sun rises in the east, and that it gets damned cold here in the upper Midwest in December, but there you go. This year, I’ve been mostly avoiding the now un-esteemed Dr. Mehmet Oz, a.k.a. “America’s doctor,” even though his show could, if I paid much attention to it anymore, provide me with copious blogging material, because I’ve come to the conclusion that he is beyond redemption. He’s gone over to the Dark Side and is profiting handsomely from it. There’s little I can do about it except for, from time to time, writing about some of Dr. Oz’s more egregious offenses against medical science and reason, putting our tens of thousands of readers per day against his millions of viewers per day. It’s an asymmetric battle that we don’t have much of a shot at winning. However, at least from time to time I can correct misinformation that Oz promotes, particularly when it impacts my speciality. Consider it doing something pre-emptively to help myself. When one of my patients ask about something that’s been on Oz’s show, I can simply point her to specific blog posts, as I did the last time around when Oz arguably flouted the human subjects protection regulations of his own university and of the Department of Health and Human Services by running in essence a poorly-designed clinical trial to show that green coffee bean extract can promote weight loss. Of course, it showed nothing of the sort.

This time around, Dr. Oz caught my attention about a week and a half ago. I had planned on blogging about it last week, but the case of the Amish girl with cancer whose parents stopped her chemotherapy after less than two full courses, thus endangering her life, intervened. (It also didn’t help that I hadn’t recorded the show and the segment hadn’t shown up on Dr. Oz’s website by Sunday night last week.) I figured that I probably wouldn’t get back to Oz, but—wouldn’t you know it?—a week later I’m still annoyed at this story. So better late than never.

The story aired on December 6 and was entitled Why You Should Keep Your Cell Phone Out of Your Bra. The entire segment, lasting ten minutes or so, is one blatant piece of fear mongering. Even by the usual low standards of a typical Dr. Oz segment, this one was bad. How bad? I’ll give you a taste. Let me start just by asking what you might expect in a segment claiming a link between an environmental exposure of some sort and a specific cancer? You’d expect some actual scientific evidence, wouldn’t you? Some epidemiology, perhaps, showing that women who hold their cell phones in their bras have a higher risk of breast cancer, perhaps with some relative risks that were at least statistically significant. You might expect some scientific evidence suggesting why the proposed mechanism is plausible. You might even expect that there would be convincing (or at least suggestive) evidence that women who put their cell phones in their bras, when they develop breast cancer, develop it more frequently on the side where they stick their cell phone. These would be reasonable things to expect that, even though they wouldn’t be convincing proof, would at least raise concerns.

There was none of that at all. Zero. Nada. Zip. In fact, I was shocked at how evidence-free this whole segment was. Usually Oz at least tries to slather a patina of scientific evidence on his pseudoscience. OK, maybe not usually, but he does at least sometimes try when he’s not doing a story on alternative medicine, “complementary and alternative medicine,” or “integrative medicine,” anyway. Not here. It’s as if Dr. Oz’s producers weren’t even trying for this one.

So what evidence do we get? It starts out with Dr. Oz saying how he understands how easy and convenient it is for women to stick their cell phones into their bras because it leaves their hands free. A prerecorded segment shows several women listing all the things they keep in their bras these days and why, things that include money, keys, and credit cards, among other things—and, of course, cell phones. One woman even keeps her son’s pacifier in her bra, which sounds kind of disgusting to me. I suppose if she’s still breast feeding, what’s a little more spit? In any case, we get the message. Bras hold more than breasts these days.

Dr. Oz then points to an image on a screen in the studio, repeating how he understands how convenient bras are to carry things, but then goes on to warn that he never wants you to do this again. A breast surgeon like myself can recognize the image immediately as a breast ultrasound, with a mass in it. The mass is darker than the surrounding tissue (hypoechoic, as we call it) and irregular. It looks suspicious, and it is suspicious, because Oz tells us that it’s breast cancer, which is never convenient. (No kidding, doc. No one knows that better than a breast surgeon like myself, except for breast cancer patients, of course!)

Here’s where Dr. Oz introduces a young woman named Tiffany Frantz, who believes that carrying her cell phone in her bra caused her cancer because it was on the same side and in the same area where her phone came into contact with her skin. Tiffany tells the audience that she kept her cell phone there for four years and that her cancer was right where the phone used to sit, helpfully demonstrating at Dr. Oz’s request how she would carry it in her bra. I noted immediately that she happened to carry it in such a way that it covered (mostly) her upper outer quadrant, which is the most common location for breast cancers to appear because anatomically there is more breast tissue there. Right away, I was sure that this was almost certainly a coincidence.

It’s also an idea planted in her head by her mother, Traci Frantz, who apparently didn’t like the way that her daughter used to carry her cell phone in her bra, particularly the way it stuck out. Once her daughter got breast cancer at age 21, her mother latched on to the cell phone as the cause, after, of course, doing her “research” on the Internet. She emphasized that Tiffany was young and healthy, that there was no family history of breast cancer, and that she didn’t have any genetic mutations known to predispose women to cancer, sometimes at a very young age. She also mentioned that she had been contacted by a “half a dozen” women who were convinced that their cell phones caused their breast cancer. It all sounds very convincing if you don’t know much about breast cancer.

Naturally, those nasty doctors didn’t believe her and produced, as Dr. Oz put it, “pushback,” as though their skepticism was unreasonable. When Dr. Oz asked Mrs. Frantz about this, her response was very telling. She didn’t say that she was trying to figure out whether cell phones cause breast cancer. Instead, she said:

My objective now is to collect the data necessary in order to validate a possible link between cell phones and breast cancer.

In other words, she’s looking for evidence to confirm what she already believes to be true. I know this from other news stories about Tiffany in which her mother has weighed in, such as this one, in which Mrs. Frantz is quoted as saying, “I absolutely believe that storing her cell phone in her bra gave her cancer. No doubt.” If you absolutely “believe” something, there’s no room to change your mind, at least not easily. Don’t get me wrong. I can completely understand the shock Mrs. Frantz felt when her daughter felt a lump in her breast and it turned out to be cancer. Breast cancer is rare in women under 30. But how rare? Stay tuned.

In the meantime, I can’t help but note that Tiffany Frantz and her mother have been appearing all over the media over the last couple of years, for example, here:

And here:

Note how the doctor interviewed in this segment says that breast cancer at this young age is “unheard of.” Let me tell you that it is not. Uncommon, even rare? Yes. “Unheard of”? No. Not really. Let’s just put it this way: I’ve seen a case in a woman even younger than 21. So let’s look at the medical expert brought in for the second half of the segment. It’s a breast surgeon named Dr. John West, who is based in Los Angeles. A quick bit of Googling on his name revealed rather quickly that Dr. West also strongly believes that carrying cell phones in the bra can cause breast cancer. His explanation as to why, both on Dr. Oz’s show and elsewhere, is less than convincing. He starts out with the story of a 39-year-old patient of his who developed breast cancer. Now, I’ve seen plenty of 39 year olds (and younger) with breast cancer; so this patient’s age doesn’t raise any suspicions of an environmental cause. To his credit Dr. West acknowledged this. However, unfortunately he also related how this woman was totally convinced that her cancer had been caused by carrying her cell phone in her bra. Dr. West also said that she had multiple tumors that corresponded “basically” to where the cell phone used to rest. He even presented the case to a conference of breast surgeons (hmmm, I wonder if it was an American Society of Breast Surgeons Meeting that I attended—probably not, as I would have remembered) and that he “got laughed off the stage.”

An appropriate reaction, I would say. I’m relieved that my fellow breast surgeons understand at least that much.

The rest of Dr. West’s evidence consists of three more patients with breast cancer, one of whom was Tiffany. Interestingly, he mentions one of these patients as having come to his attention six months ago, although from articles from 2012 it’s clear that he’s believed in this link for a while. This was another 21-year-old with breast cancer. Dr. Oz intones gravely how he “wasn’t convinced” (of course not!) until he saw these images. A breast MRI is shown with a typical ductal pattern of enhancement, where the “bright spot” follows a ductal distribution. Dr. Oz acts as though this were some sort of major surprise, but it’s not. Breast cancer most commonly arises from the milk ducts, so it’s not surprising to see this sort of pattern. In this particular case, however, because the pattern involved ducts on the lateral side of the breast, which is where this woman held her cell phone, obviously it must have been the cell phone. The funny thing is that the “phone” drawing that is superimposed on the MRI image only matches up with one-half to two-thirds of the distribution of abnormal enhancement. In other words, even the “correlation” is not that convincing. This is even more true when you consider that only a small part of the phone, the antenna and radio, is actually responsible for generating the radio waves, not the whole phone. So it’s almost completely irrelevant whether the phone matches where the tumors were. What matters is whether the antenna and radio match where the tumors were. The same goes for all these cases.

Be that as it may, how common is breast cancer in young women? It turns out that the median age at diagnosis for breast cancer in this country is 61. Dr. West brags that he’s been practicing for 40 years and has personally treated 10,000 women. That’s about 250 women a year, which is not an unbelievable number for a busy breast surgeon. What I find rather hard to believe is Dr. West’s claim that he’s only seen three women with breast cancer who were under 30. Let’s just put it this way. I’ve only been practicing less than 15 years, and, because I run a lab, I haven’t even been practicing full time. I’ve treated far fewer women with breast cancer than Dr. West says that he has, but I’ve already seen at least five patients under 30 with breast cancer. My youngest patient ever was 19 years old when she was diagnosed. I know of a patient treated at my institution before I arrived who was 14 at the time of diagnosis. I do realize that I’ve spent all my career at two different NCI-designated comprehensive cancer centers. These are the best of the best, and there are only 41 such centers in the country, which means that we probably see more young patients than the average private practice breast surgeon. Even so, it strains credulity that Dr. West has seen so few young patients in his 40 years of practice.

I’ll try to show you what I mean. Dr. West goes on to state that only 3 out of the 10,000 patients he’s treated over the course of his career were under 30 at the time of diagnosis. If you go to the SEER Registry, which tracks cancer cases in the US, you’ll see that 1.8% of new cases of breast cancer occur in women under 34. That means, by random chance alone, if his patient population were a representative sample of the breast cancer population at large, Dr. West would expect to see somewhat less than 180 patients under 30. Because of the difference between age 30 and 34, let’s take a conservative estimate, which would be that he should probably have seen at least 100 patients under the age of 30. (In fact, I operated on a 33-year-old with breast cancer in the last month.) That’s a little more than two per year. Yes, that’s rare, but not that rare. Either Dr. West’s memory is faulty, or his patient population does not correspond to the normal age distribution of breast cancer cases. I’m assuming the latter, in which case no wonder he’s so amazed at having seen 21 year old with breast cancer and is so susceptible to leaping to the conclusion that it must be due to an environmental exposure! Moreover, if a large percentage of young women keep their cell phones in their bras at least part of the time, you can assume that by random chance alone most women under the age of 34 who develop breast cancer will have carried their phone in their bra. Half of those women by random chance alone will have a breast cancer on the same side as they usually carry their cell phone, and a significant number of those women, again by random chance alone, will have a tumor near where they carry their phone.

That’s why careful epidemiological studies are so important. Word to Dr. Oz and Dr. West: The plural of “anecdote” is not “data.” In fact, your anecdotes aren’t even all that suggestive; that is, if you look at them without the lens of a pre-existing belief that there is a cause-and-effect relationship.

I would also be remiss if I didn’t cover the issue that was mentioned multiple times, namely that Tiffany didn’t have a “gene” predisposing to breast cancer. I hate to be blunt (well, actually, no I don’t), but that means very little. The vast majority of breast cancer cases, including breast cancer in young women, are not linked to genetic predisposition. Indeed, only 5-10% of cases are inherited, and less than 20% are associated with a genetic predisposition. That means that over 80% of cases are sporadic, which basically means “we don’t know what caused them.” They are not linked to a strong family history or mutations in a gene known to predispose to breast cancer. It means almost nothing that these women didn’t have a family history or other evidence of a genetic predisposition. As for women under 40, it is hardly impressive to have found four women under 40 with breast cancer who might have been keeping their cell phones in their bras. To put it into more perspective, there are approximately 232,000 new cases of breast cancer a year. If 1.8% of those cases are in women aged 34 and under, that means that there are approximately 4,200 new cases of breast cancer in women under 35 every year.

Finally, besides pointing out the utter lack of evidence linking cell phone radio waves and breast cancer, we at SBM have written many times about both the scientific implausibility of the concept that radio waves cause cancer and the lack of any sort of compelling clinical evidence supporting a link. There just isn’t any biological plausibility. Radio wave energy at the power level used by most cell phones is not ionizing. It’s not even close, being several orders of magnitude too weak to break chemical bonds. Our understanding of cancer is that, in general, ionizing radiation is what is required to cause or contribute to cancer. That does not mean that there might not be a potential mechanism, as yet undiscovered, by which non-ionizing radiation might cause cancer, but simple physics and chemistry make the hypothesis that cell phone radiation causes or contributes to cancer not particularly plausible on the basis of currently-understood biology. On a basic science basis, at present there doesn’t appear to be strong evidence (or much of any evidence at all) supporting plausible mechanism by which cell phone radiofrequency radiation might cause cancer or an actual effect in which they do.

Add to this that the stories presented as evidence that cell phones cause cancer (i.e., the anecdotes) aren’t even that convincing, including Tiffany Frantz’s story, based on the lack of a plausible biological mechanism and a time frame between four and six years during which Tiffany Frantz said she was carrying her cell phone in her bra. (I note that she said four years in the Dr. Oz segment but her mother said six years in another segment.) I can understand why her being diagnosed with breast cancer was such a shock, given her young age, but it’s not unheard of. Certainly if I’ve taken care of a 19 year old with breast cancer, it’s not so unbelievable that a couple of 21 year olds could have breast cancer. I feel bad for the Frantzs, as no one should have to face a diagnosis like breast cancer at such a young age. It’s even worse, given that apparently Tiffany Frantz has bone metastases now, a horrible thing at such a young age. However, just because I feel bad for these patients does not mean I must accept their belief that cell phone radiation caused the breast cancer.

On the other hand, I can blame Dr. Oz for fear mongering not supported by science, and I do. I can also blame Dr. John West, and another surgeon, Dr. Lisa Bailey, for a depressing lack of critical thinking skills that led them to promote this concept. Truly, they embody the human trait of craving settling on a causative explanation. It’s very understandable why a patient like Tiffany and her mother might leap to confuse correlation with causation (except that it’s not even clear that there’s a correlation here). It’s the same need for causality that leads parents to become antivaccinationists. However, physicians and surgeons should know better. Unfortunately, they often do not. Indeed, Dr. Bailey and Dr. West have even been featured on that font of all things quackery, NaturalNews.com:

A new study raises concerns of a possible association between cell phone radiation exposure and breast cancer in young women.

The research team, led by Dr. Lisa Bailey, a former president of the American Cancer Society’s California Division and one of California’s top breast surgeons, studied four young women – aged from 21 to 39 years old – with multifocal invasive breast cancer.

The researchers observed that all the patients developed tumors in areas of their breasts next to where they carried their cell phones, often for up to 10 hours per day, for several years. None of the patients had a family history of breast cancer. They all tested negative for BRCA1 and BRCA2 – breast cancer genes linked to about one-half of breast cancer cases – and they had no other known breast cancer risks.

Imaging of the young girls’ breasts revealed a clustering of multiple tumor foci in the part of the breast directly under where their cell phones touched their body.

Here’s the study, and a less convincing collection of four anecdotes is hard to imagine. Case 1, for instance, is particularly unconvincing, given that the cancer takes up the whole side of the breast, with an area of pleomorphic calcifications measuring 12 cm, the description being too vague to make any correlations. (Maybe this woman’s cell phone was a Samsung S4 or something even bigger.) Particularly hilarious is the claim that having invasive cancer intermixed with extensive ductal carcinoma in situ (malignant-appearing cells that haven’t invaded through the basement membrane) is unusual. It’s not. All in all, it’s a pretty sad attempt to link a biologically-implausible carcinogen to breast cancer. There’s nothing unusual about the locations or the histology of the cancers; yet Drs. West and Bailey try to claim that these cases are incredibly worrisome based on nothing but confusing correlation with causation. Is it possible that cell phone radiation can increase the risk of breast cancer? Sure, but it’s incredibly unlikely. There’s no currently known biological mechanism by which it could happen, although I won’t bore you with more than a brief one of usual swipes at people with a simplistic, “Cancer Biology 101″-level understanding of cancer declaring piously that it is absolutely physically impossible because radio waves can’t break chemical bonds and thus can’t cause mutations. Carcinogenesis is more complex than that. Even so, at least the people claiming cell phones cause brain cancer try to present epidemiological evidence to support their case. It’s almost uniformly negative and unconvincing evidence, but at least it rises above the level of anecdotes. Drs. West and Bailey (and, of course, Dr. Oz) have nothing.

As I said, I’ve given up on Dr. Oz’s ever seeing the light again. Money and fame have corrupted a man who was once a promising academic cardiovascular surgeon, combined, of course, with a propensity for woo. All I can do anymore is to try to counter his misinformation when I can, which is not that often. After all, I could easily devote a whole blog to trying to refute the medical misinformation that Dr. Oz dishes up every day on his show. Instead, I choose to comment only when his misinformation impacts my area of expertise or for whatever reason catches my interest. It’s all I can do anymore.

Posted in: Cancer, Science and the Media

Leave a Comment (331) ↓

331 thoughts on “No, carrying your cell phone in your bra will not cause breast cancer, no matter what Dr. Oz says

  1. Jay says:

    No, carrying your cell phone in your bra will not cause breast cancer…

    Well, that’s a relief.

    -Jay

  2. Kathy says:

    I’m waiting for the day he tells men not to carry their cellphones in their pocket because … errrrm …. well, you know.

    1. John Milligan says:

      Actually, several years ago he did a show on precisely that.

      1. Kathy says:

        LOL! Are you serious? How did he keep a straight face I wonder. Mind you, how he keeps a straight face while he spouts what he must know is trash, show after show, is a matter for even greater wonder.

        1. windriven says:

          Every time he starts to break into a grin and say, “nah, I made that up” he remembers how much harder surgery is than reading from a TelePrompTer.

    2. KKline says:

      That’s what I was thinking!!!

  3. Chris Hickie says:

    Once I read that Dr. Oz skips flu shots for his kids/wife and “spreads out” vaccines (http://scienceblogs.com/insolence/2010/01/13/regarding-dr-mehmet-oz-whoops-maybe-i-sp/), the verdict against Oz being worth listening to was a resounding “no”.

    To paraphrase from “The Wizard of Oz”–”Ignore that man behind the microphone”.

  4. Dolph says:

    What the f*** is wrong with US women? Carrying stuff in their bras??? I can’t believe it, but it’s probably a secondary effect of obesity…

    1. Nashira says:

      Or it could be because very few pairs of women’s pants and almost no skirts have useful pockets, and a bra cup is a convenient place to stash my phone when I’m headed to break or whatever. Grabbing my purse isn’t always sensible.

      1. AnObservingParty says:

        Preach it. Bras are quite convenient when other manners or storage are not.

      2. mousethatroared says:

        RoyalRobbins is good about putting pockets in their skirts. They specialize in travel wear. Not sure if they are your style or appropriate for your job, though. Might be worth checking out.

        1. Harriet Hall says:

          On of the things I liked about being a flight surgeon was that the flight suit had zipper pockets everywhere: on the sleeves, lower legs, hips, and chest. I soon discovered one drawback: I’d forget what I’d put in which pocket.

          1. mousethatroared says:

            LOL – I have a plethora of pockets in my tool tote. Seems it always takes me 6 or 7 tries before I find anything. They should make the pockets transparent.

        2. Nashira says:

          Technically, my office is ‘business casual’ but I tend to overdress, because er… I’m also a giantess (well, 5’10″ with a 36″ inseam…) and the one store that sells my length is dressy. :D I will have to remember Royal Robbins next time my wardrobe needs a new skirt; their ‘enroute’ skirt would work perfectly. Thank you!

          1. brewandferment says:

            I have you beat by 2 inches in height…but I have found JC Penney–but only online–sells pants with 36″ inseams, sometimes even unfinished at 37″, and generally pretty reasonable prices. Their “ultra tall” (uggh, hate the name) line usually is properly proportioned, not just long on the leg lengths. But if you see something you like, jump on it because they tend to run out of stock quicker than they should.

      3. i hear you on the lack of pockets thing! … and even when we DO have pockets they don’t work. Things don’t fit or fall out of them. Often!
        I had an embarrassing moment when a spare tampon dropped out of my pants pocket & rolled across the free weights room floor at the gym. where it sat for ~10 min before I noticed. And I was the only female there at the time. nice. *gah!*
        Then and there was then I decided to DO something. so that’s how it all started. Now have a patent on PortaPocket & been helping people help themsleves for the last 6.5 yrs.
        A friend sent me the link to that Dr Oz show and while I agree with you here on the lack of hard science to back it up re: link between cell phones in bras and cancer, I still think it’s a bad idea for multiple reasons. One of which is people call me after their phone breaks from the sweat in the bra. And then they decide to find an alt/ better way. Wish people would call me BEFORE the problem and not after…!

    2. irenegoodnight says:

      Hey Dolph, I often carry my phone in my bra for the reasons Nashira states, and I’m not obese. Your presumptions are offensive and ignorant. What do you care WTF I put in my bra, anyway?

    3. Itscords says:

      Why would it have anything to do with obesity??? I carry stuff in my bra, including a phone, when I run.

  5. mousethatroared says:

    I don’t know. I’m my world being told not to keep my phone in bra is rather like being told not to keep my rock collection in my shoes.

    I don’t need a respected cardiac surgeon using anecdotal threats of cancer to discourage me.

    …and on a hot day (not that I can imagine a hot day with several inches on snow on the doorstep ). Doesn’t the phone get all sweaty? Can’t be good for the phone.

    Maybe it’s one of those fairy tale type fears. People believe it because it provides a deterrent to doing something that’s frowned upon. If someone could come upon with an anecdote that shows sagging pants cause cancer, I’m sure it would be all over the media.

    1. Calli Arcale says:

      Cell phones are pretty robust; I would think that for most people, sweat would be gross but not harmful to the phone*. As long as you’re not sweating actual buckets of sweat and the case isn’t compromised, it will probably be okay. Just gross.

      * Well, not harmful to the inside of the phone. The ports might need periodic cleaning. But phones and computers have survived far worse. It helps that the manufacturers basically assume you’re gonna abuse the thing.

      1. irenegoodnight says:

        Why is it “gross”? What’s wrong with sweat? I put my phone in my bra when I run. Being older, what I call “running” isn’t all that demanding, but I DO sweat. I remove the phone when it gets bad because I ruined an iPhone by having it in the bathroom when I have a hot bath–corroded the ports.

        I don’t get this idea that anything to do with bodily fluids is gross. I’m certainly interested in hygiene, but maybe because I never worked indoors much, I’m just accustomed more to “gross”. :-)

        1. Calli Arcale says:

          Sweat in and of itself isn’t gross. Sweat that has been left on something and built up over month, congealing in the grooves and crannies of a device . . . THAT is gross. ;-)

        2. mousethatroared says:

          For me a bit of activity or exercise outside wouldn’t be gross. But I don’t take my cell jogging or walking (usually). One of the times I do need to carry my cell is when I’m working an art fair. By the end of a 13 hour day in 90+ temps, plus sunscreen and street dust, I certainly feel gross (although hopefully, I still look fresh as a well slightly wilted daisy) :)

          Not to mention that I use a Square, which means handing your phone to the customer to sign.

        3. Candace says:

          The only problem I see with that is that you might have to buy a new phone. Which is what happened to me when sweat came into contact with my phone.

      2. Andrey Pavlov says:

        It depends. I’ve actually destroyed cell phones by having them in my jersey pockets while cycling. I always put them in a ziplock baggie before going for a ride now. On a summer day, cycling for 4-6 hours will generate enough sweat to fry the internal electronics.

        1. Calli Arcale says:

          Most cell phones can tolerate very high humidity environments, and cell phones dropped into lakes can usually be dried out and work again. So I’m not sure the internal circuits are getting “fried”, so to speak, when you’re jogging. It is possible that excess heat caused damage, but I don’t think putting it in a baggie would help with that problem. Interesting! Now I’m curious as to the mechanism of your device failures. ;-)

          1. Andrey Pavlov says:

            @calli:

            If you drop it in fresh water, yes it has a decent chance of survival. Drop it in salt water and that is a different story. Your sweat is quite salty. The mechanism is that the phone is on, high electrolyte content water gets into the phone, hits the PCB, and shorts the circuits. I’ve dropped phones in the sink, toilets, and other fresh water sources and been able to dry them out, no problem. I’ve dropped a phone in the ocean, soaked it through with my sweat on a ride, and had an underwater camera housing fail in salt water and all lead to a non-resurectable phone. I actually took the camera apart and put it in silica gel to try and save it, but the corrosion from the ocean water still showed up just a day later. In retrospect, had I rinsed it thoroughly in de-ionized water before putting it in the silica gel that may have saved it. I don’t know and don’t want to test it, but I will should the unfortunate opportunity arise again.

            1. Calli Arcale says:

              Yeah, dunking it in saltwater or juice will be bad for it (my dad lost a phone by dropping it into his heavily sweetened coffee once), but I’m just questioning whether you could actually get significant penetration of sweat into the innards of the phone. Maybe if it has keys and not a touchscreen?

          2. mousethatroared says:

            Really? I lost a cellphone to a water or diluted juice spill in my diaper bag years ago…maybe I just didn’t dry it out enough, maybe the technology has improved… I’ve always just been very careful about getting them near much moisure since.

            1. windriven says:

              The sugar in the juice was likely the culprit, not in hastening corrosion like salt, but because of the conductivity of the sugar. You significantly altered the circuitry essentially “shorting everything out.” I did something similar when I spilled a glass of very nice Rioja on the keyboard of my Toshiba Sattelite. RIP

  6. mousethatroared says:

    This is off-topic (duck). But it’s easier to reach several SBM writers this way.

    If anyone is looking for a topic. I’d appreciate an article (some perspective) on the latest announcement that whole fat organic milk is better for your health than skim standard milk.

    1. stanmrak says:

      Do you like your milk with a good dose of pharmaceuticals?

      Typical non-organic milk contains up to 20 pharmacologically active substances including antibacterials (chloramphenicol, florfenicol, pyrimethamine, thiamphenicol), nonsteroideal anti-inflammatories (diclofenac, flunixin, ibuprofen, ketoprofen, naproxen, mefenamic acid, niflumic acid, phenylbutazone), antiseptic (triclosan), antiepileptic (carbamazepine), lipid regulator (clofibric acid), β-blockers (metoprolol, propranolol), and hormones (17α-ethinylestradiol, estrone, 17β-estradiol) in milk samples.

      http://www.ncbi.nlm.nih.gov/pubmed/21469656

      Of course, this ‘study’ didn’t mention that!

      You’re not still concerned about saturated fat, are you? The saturated fat/heart disease hypothesis has been proven to be fraudulent. You could look it up elsewhere.

      1. windriven says:

        “Typical non-organic milk contains up to 20 pharmacologically active substances …”

        So what, stan? The devil is in the dosage. Can you direct us to some studies that demonstrate actual harm? There are pharmacologically active substances in drinking water and in many other items that we routinely ingest. Yet people live longer and healthier (barring consumption to the point of obesity) lives than they did when essentially everything was ‘organic’.

      2. CHotel says:

        Yeah, no.

        The study you linked to is an Analytical Chem paper where they developed a method of simultaneous detection for up to 20 compounds that they themselves put into various types of milk. It does not say “Milk has these thins in it” anywhere, nor does it mention organic milk at all. All it does is say “If these agents were in milk, we’d be able to test for all of them at once”

        You also created the “Typical non-organic milk contains up to” part of your comment before copying the drug list in their abstract, trying to make it seem like what you said is what they said.

        1. windriven says:

          Nicely done, CHotel. I rarely check Stan’s links anymore because they are often to sources of questionable character. But this was a pinnochio of astonishing bald-facery even for stan. I wonder if stan,stan, the marketing man worked on any ACA issues?

          (Don’t flame me for the ACA reference. I didn’t cite either side of that mess, neither one of which could speak the truth if the fate of civilization depended on it)

          1. Charles Grashow says:

            http://www.nytimes.com/2013/12/10/health/organic-milk-high-in-helpful-fatty-acids-study-finds.html?hpw&rref=health&_r=0

            Whole milk from organic dairies contains far more of some of the fatty acids that contribute to a healthy heart than conventional milk, scientists are reporting.

            Drinking whole organic milk “will certainly lessen the risk factor for cardiovascular disease,” said the study’s lead author, Charles M. Benbrook, a research professor at Washington State University’s Center for Sustaining Agriculture and Natural Resources.

            “All milk is healthy and good for people,” he continued, “but organic milk is better, because it has a more favorable balance of these fatty acids” — omega-3, typically found in fish and flaxseed, versus omega-6, which is abundant in many fried foods like potato chips.

            The research was largely funded by Organic Valley, a farm cooperative that sells organic dairy products. But experts not connected with the study said the findings were credible — though they noted that the role of milk in a healthy diet and the influence of fatty acids in preventing or causing cardiovascular disease are far from settled.

            “I think this is a very good piece of work,” said Dr. Joseph Hibbeln, a nutritional neuroscientist at the National Institutes of Health.

            The researchers looked at 384 samples of organic and conventional whole milk taken over 18 months around the country. Although the total amount of fat was almost the same, the organic milk contained 62 percent more omega-3 fatty acids and 25 percent fewer omega-6s.

            The ratio of omega-6 to omega-3 in the organic milk was 2.28, much lower than the 5.77 ratio in conventional milk. (The figures do not apply to nonfat milk, which strips away the fatty acids.)

            http://www.plosone.org/article/info:doi/10.1371/journal.pone.0082429
            OPEN ACCESS PEER-REVIEWED
            RESEARCH ARTICLE
            Organic Production Enhances Milk Nutritional Quality by Shifting Fatty Acid Composition: A United States–Wide, 18-Month Study

            1. WilliamLawrenceUtridge says:

              Of course, the amount of omega fatty acids found in organic milk was, at its highest, 0.03g/100g, and the daily requirement for these types of fats is on the order of 1g/day. And the lowest level of omega fatty acids found in nonorganic milk was about 0.01 (and the highest in nonorganic milk was about 0.26). And since you have to consume the full-fat version, you’re taking in a fair amount of calories to get even 10% of your RDI, much of it in the form of saturated milk fats. Oh you pesky facts and context!

              Not to mention – conflict of interest from Big Pharma? Evil! Throw out the study! Burn them to the ground!

              Conflict of interest from an organic products association? Just fine! The data is trustworthy! You can trust organic farmers, they grow crops because they love them, not because of profit motive!

            2. goodnightirene says:

              Ha-ha! I vacation regularly near the town where Organic Valley has its headquarters. They are so wooish, it would shock even the most hardcore SBM follower. Many of their practices are also not very animal friendly, but who cares how the animal was treated as long as the egg or milk is “organic”!

              This study must be making the rounds on the inter webs because I ordered a latte the other day in a small town and was informed by the very hippie-groovy barista that I could only have whole mile because he was a “proponent of the health benefits of whole milk”.

              Sadly my daughter grabbed me and pulled me toward the door before I could tell him off properly. She outweighs me by 150 lbs, so I didn’t have much choice.

        2. WilliamLawrenceUtridge says:

          Reading the full text FTW!

      3. WilliamLawrenceUtridge says:

        Hey Stan, how many of those chemicals would survive the first pass effect of the liver to reach tissues in biologically-active levels? No wonder you are terrified of nearly everything that you come in contact with, you appear to think the human body is incredibly fragile. What’s it like to live in constant fear of contamination?

        You’re not still concerned about saturated fat, are you? The saturated fat/heart disease hypothesis has been proven to be fraudulent. You could look it up elsewhere.

        In other words…trust you? But you’re an idiot, why would anyone believe a damned thing you have to say?

    2. I haven’t read the study or abstract yet, but i did hear about it on NPR. My takeaway (assuming the study was of decent quality, which I can’t be sure of without reading it or its abstract) was that the difference in nutritional content was due to the organic milk cows being grass fed vs corn/grain.

      Organic milk (supposedly) has more Omega 3 due to the cows being fed grass rather than grain as most diary cows are. The study found that organic milk had 62% more omega 3 fatty acids than regular milk, and 25% less omega-6 fatty acids.

      The study did not address whether there was any demonstrated clinical benefit to this difference.

      Also, the difference was not attributed to any other difference in organic production beyond the feed given to the cows, so even with demonstrated health benefits, it would hardly be a ringing endorsement of organic production practices in general. One could keep all other conventional dairy production practices and only change the feed given to the cows and produce the same nutritional difference without the milk being produced organically.

      1. Additionally, since we’re talking about fatty acids here, I think that the difference was only significant for whole milk. I’m still trying to find time to read the study.

        However, if you’re an adult, you probably don’t drink much whole milk

      2. mousethatroared says:

        Karl Withakay – Yes, that’s the milk report I was thinking of, basically grass feed (organic) vs traditional feed.

        I buy a local diary milk, which is only grass/hay feed in the summer, grain in the winter. Just wondering if it actually makes a noticeable nutritional difference, over all.

        I don’t want to interrupt David Gorski’s thread though. Just wanted to make a request for a future article on the study.

  7. windriven says:

    “The researchers observed that all the patients developed tumors in areas of their breasts next to where they carried their cell phones, often for up to 10 hours per day, for several years. None of the patients had a family history of breast cancer. They all tested negative for BRCA1 and BRCA2 – breast cancer genes linked to about one-half of breast cancer cases – and they had no other known breast cancer risks.”

    Hmmm … Using Ozian logic that would suggest that BRCA genes are protective against breast cancer arising from cellphone radiation. Probably next week’s topic.

  8. windriven says:

    Also, I would argue that Oz has gone to the green side rather than the dark side.

  9. Angora Rabbit says:

    “They all tested negative for BRCA1 and BRCA2 – breast cancer genes linked to about one-half of breast cancer cases – and they had no other known breast cancer risks.”

    I recall reading in the recent kerfluffle when the gene patent law was overturned, that Myriad Genetics (home of the BRCA test) had many more suspect alleles in their arsenal than were being used in clinical testing. Part of the problem was that the patents were locking up those other alleles and preventing their clinical use.

    Absence of evidence is not evidence of absence. While BRCA1/2 are the best understood, it would be naive to assume that current clinical tests capture all possible genetic modifiers. To wit, note the recent announcement that a Cyp allele (forgotten which one) differentially metabolizes estrogen into forms with greater or lesser tumor promotion activities.

    Methinks a reviewer was asleep on that paper’s sentence.

    1. Kenny H. says:

      I read your comment and immediately thought of this article I found on /r/TIL: http://www.washington.edu/news/2013/12/12/scientists-discover-double-meaning-in-genetic-code/

  10. Chris Hickie says:

    Oz the indiscriminate should have covered something more relevant–such as men shooting themselves in the groin with their handguns (just google it–there’s no end of these cases). Of course, finding a guy who has done this and willing to go on the show might be difficult.

    1. windriven says:

      One of.my favorite Darwin Awards stories told of a couple of guys returning from a hunting trip when the headlights went out. The driver found a blown fuse but didn’t have another. He did though realize that the fuse* was about the size of a .22 calibre bullet and he promptly stuck one in. Voila, the lights came on and off they drove. Sadly, whatever caused the fuse to blow remained unrepaired and some time down the road the cartridge went off, penetrating the femoral artery of one of the hunters.

      *Back in the day automobile fuses were tubular devices with the fusible link visible through a glass tube with metal contacts on either end.

    2. windriven says:

      “men shooting themselves in the groin with their handguns”

      I wonder if that explains the, ahem, explosion in testosterone replacement therapy?

    3. Nashira says:

      Oh lord. I work in a work comp office that covers some prisons. We’ve both had people shoot themselves and we’ve had to pick up treatment costs, since it happened at work, and had one poor idiot manage to kill himself cleaning his gun at home. He didn’t safe it before he cleaned it, which I’m not even sure how you manage to do… when I was taught to clean a handgun, the first four things you did was safe it, and then you did it again a fifth time just to be sure. :P

      1. windriven says:

        Amen. Safe the weapon. Eject the clip or open the cylinder and remove any cartridges. If an auto loader, rack the slide and eject the cartridge in the chamber. Visually confirm that all ammunition has been removed. Double check that the safety is engaged.

        Now you can start to clean your weapon. Moreover, treat every weapon as loaded even when you ‘know’ that it isn’t.

      2. Geekoid says:

        He probably wan’t cleaning his gun. If you say suicide, then no death benefits.
        It makes no sense. How can you eve begin to clean a handgun with a round in the chamber?

        1. Nashira says:

          Well — believe it or not, my company actually willingly pays death benefits. If he’d been at work, his family would have gotten them. It was clearly an accident, too, and not a suicide; I believe his life insurance did pay out.

  11. Joanna says:

    I’ll stop carrying my cellphone in my bra when they start putting decent pockets in women’s clothing. I’m not worried about getting breast cancer from it, but I do worry that I’ll forget to mute the phone while I’m in a work meeting.

    1. Chris says:

      Yes!

      Actually, I look for pockets in pants. And I have enlarged the front pocket in several pairs, plus added pockets to them.

      I stopped carrying a purse since a pickpocket took all of my cash when I was sixteen years old. It was then that I started to install pockets in my slacks and skirts, plus putting inside pockets in the tailored jackets I wore at work.

      Years ago I watched a video sewing program by Sandra Betzina on sewing pants, and she included how to modify the pockets so that they would be useful! Then I have a book by Kenneth D. King on making tailored jackets that include putting in the pocket in the inside lining, but unlike those in menswear are lower than breast level.

      Obviously, this is an issue that bothers those who can make their own clothes. Now I just wish the manufacturers of women’s clothing would catch on (especially those that put fake pockets!

      1. irenegoodnight says:

        Buy men’s trousers. They’re much better made and you won’t have to make new pockets. It helps that I am not pear-shaped–men’s clothes actually fit me better through the hips.

        1. mousethatroared says:

          As a representative of the pear shaped, men’s trousers really don’t fit. In fact the majority of women’s trouser’s don’t fit. Luckily I wear jeans much of the time, which have pockets. In the summer, hiking type skirts often have pockets. But, I know many folks don’t have the luxury of my casual dress and I’m pretty sure I would horrify Tim Gunn.

          When I don’t have pockets, I carry a wrist strap wallet, which my cell fits in.

        2. Chris says:

          I have done that, and they don’t fit well.

          Some of us are just not built like men. Which is what made using a sliderule a bit silly in the early 1970s. Back then I still had a ten inch delta between my waist and hips. The guys in my classes had holsters for their twelve inch long sliderules. If I had done that, it would have stuck out and injured others in the hallways between classes. I carried my cheap sliderules in with my books, but the slides kept falling out.

          (funny how Firefox does not know that “sliderule” was a real thing)

          1. Chris says:

            “(funny how Firefox does not know that “sliderule” was a real thing)”

            Sigh, because it has been so long since I have used one that I forgot it is two words: slide rule.

            1. windriven says:

              When the first portable calculators came out, I would scoff at early adopters because I could generally compute an answer with my slip stick faster than they could punch the numbers into the calculator. I came across my old Pickett not long ago (complete with holster and matching pocket protector*) and outside of simple multiplication and division I couldn’t remember how to use it :-(

              *OK, I made up the part about the matching pocket protector.

          2. goodnightirene says:

            I’m NOT built like a man, thank you :-) I have plenty of what makes a girl look like one–I just don’t have big hips or thighs, so men’s pants work well.

            1. oldebabe says:

              Same here, so I can agree wholeheartedly.

      2. windriven says:

        Chris and Irene-

        I wear man’s trousers essentially every day. But I have found it necessary to carry a quite rugged and manly iPad bag with cellphone pocket which some small-minded people mistake for a “murse”. My iPhone is too big a load for pants pockets.

        1. Chris says:

          This is why I mostly go for small dumb phones instead of a smartphone.

          I actually have a small laptop bag from a few years ago that my tablet fits nicely in the zip pocket on the side. The part where the laptop is supposed to go works well for a book or two. It does not look like a purse. I think we got it for our first tiny Windows 98 laptop over ten years ago.

          But I never ever put my wallet, keys and phone in a bag.

      3. Angora Rabbit says:

        OMG. A post that covers both skeptical thinking and Kenneth King. I think I’ve just gone to heaven. :) Yes, you are exactly right, Chris, about making your own clothes to get what you need and fits correctly.

        Palmer and Pletsch make an excellent fitted blazer pattern from McCalls. Worth taking a look at if you’re seeking a pattern. It sews beautifully and lots of options for pockets. Yes, it is a huge problem, trying to avoid a purse.

        Sorry for the OT post – I totally couldn’t resist!

        1. Chris says:

          I own that pattern. :-)

        2. Chris says:

          By the way, I am now watching Project Runway All Stars on Hulu. I do record it on the DVR, but only in SD. Daughter also watches, but as a college student she catches up during breaks… so sometime next week.

          That same child is why I had to give away a skirt with a much narrow waistband this week. I could wear it after child #2, but not #3. Every thing seems to have moved. My age 30s body is so much different from my age 50s body. Le sigh.

          By the way in my sewing queue are two sets of culottes with the large pocket variation from Sandra Betzina (the pocket placket goes all across the front to provide some stability and hide muffins). But they all require a belt. The waistband had elastic, but could not stay up because I no longer have the hourglass figure I had thirty years and forty pounds ago. So I am adding belt loops and going to be making belts.

          This past weekend I went to sample sale of a fairly pricey clothing company that I can wear, but the pants are too long and the pockets too short. So I will be modifying the half price to fifteen dollar slacks. They do have pockets, but they are too small. Happily I do not have to modify the winter coat I got for $45.

          I still do not do purses.

        3. Nashira says:

          Oooh, thank you for the pattern recommendation! I am difficult to fit (giantess, broad shoulders, big boobs) and so off-the-rack blazers are just… not an option. I’ve been trying to find a good blazer to start making muslins of. It’d be my first major garment project, but to be honest, I learn better if I start something complex. :P

          And Kenneth King… oh my. I want his books, all of them, so bad.

      4. anyone on this thread that wants to save themselves the trouble of putting pockets in each and every garment…there is a way to make your life easier. Separate the pocket from the garment and wear it by itself. Way more versatile that way and you can move it around your body based on different outfits and activities. Equally useful at the gym and at black tie affairs. best thing to wear under your outfit since SPANX. and works for guys too.
        demo: http://bit.ly/dt71V
        more info at http://www.portapocket.com
        best wishes

      5. Geekoid says:

        Ladies, here is your answer:
        http://goo.gl/QQrQEE

        :)

        1. Chris says:

          Yuck.

          You should hear the fanny pack discussions that were on the SGU podcast.

  12. Trindel Maine says:

    Not in anyway disagreeing with your post but thought I’d point to a serious research paper that at least posits a plausible mechanism by which cell phone radiation might cause cellular damage (Dr Kirschvink was my son’s graduate advisor in geology.) http://web.gps.caltech.edu/~jkirschvink/pdfs/JoeMicrowave.pdf

    1. David Gorski says:

      “Cellular damage” ≠ carcinogenesis. I’m also not sure we have the same definition of the word “plausible.”

  13. stanmrak says:

    There will never be any studies that ‘prove’ cellphones are harmful — the cellular industry will see to that, even if it was possible to conduct such a study. It would have to take 20 or 30 years in length probably. And no, there are no legitimate studies that prove they’re safe, either.
    The industry has also carefully crafted the language in the disclosure document that comes with your cellphone that guarantees that they cannot be sued if in fact it is discovered that cellphones do cause harm.
    Cellphone signals, no matter how weak, DO disrupt cellular communication in your body — that can’t be good.

    1. David Gorski says:

      Cellphone signals, no matter how weak, DO disrupt cellular communication in your body — that can’t be good.

      Citation needed.

    2. WilliamLawrenceUtridge says:

      Since the cell phone industry, apparently any industry according to Stan, is all-powerful, it’s amazing they’ve managed to do things like set safety standards. Or enact driving bans. Or, to expand the industries a bit, take Vioxx and thalidomide off the market, to force car companies to recall certain models, to link organic produce to deadly E. coli breakouts. Ban certain herbicides and pesticides. Enact emission standards. Recall the whole-cell pertussis vaccine and replace it with the acellular version.

      In fact, they’ve manged to regulate just about every industry out there except supplements and vitamins (thanks DSHEA!)

      Amazing, those all-powerful corporations.

  14. stanmrak says:

    If you’re going to pose as an expert, do some homework first.

    http://www.ewg.org/cellphoneradiation/executivesummary
    http://www.ewg.org/cell-phone-radiation-affects-brain-function

    Go ahead… pooh pooh the studies. The disclosure that comes with your cell phone includes a safety warning for you to hold the phone AT LEAST 2 INCHES away from your body at all times, including when you’re talking on it. Why is that?

    1. David Gorski says:

      You act as though we haven’t seen these studies before.

      In fact, we’ve blogged on some of the very same studies cited in these links. Suffice to say, they are not impressive, and the preponderance of evidence with respect to cell phones and cancer is overwhelmingly negative. Add that to the utter biological implausibility, and the answer is clear: It’s incredibly unlikely that cell phone radiation causes harm.

      One could throw it right back at you: If you’re going to cite studies, know what they actually say and what their weaknesses are.

      1. stanmrak says:

        Since the harm from radiation takes decades to surface, no study shorter than that will prove anything.

        1. Sawyer says:

          And those long term studies are performed less frequently is because of a massive conspiracy to cover up and because scientists are all evil close minded jerks, right?

          Wrong. The reason we don’t see too many of these studies published is because the methods they employ are very weak and vulnerable to bias. And because longer studies would be less frequent by definition. And because there’s zero underlying biological plausibility. And because there is an opportunity cost associated with not researching other suspected carcinogens. And because the literature we do have on this topic shows no effects. And because no one is forced to stick a cell phone in their bra anyway.

          That’s five reasons that took me a whopping 1 minute to come up with. How have you not thought of these issues after years of obsessing and trolling on this topic?

        2. WilliamLawrenceUtridge says:

          Hey stan, what about the radiation that comes from your computer? Do you use wi-fi? It might give you cancer! Be afraid! For that matter, your monitor emits radiation, the hard drive uses a magnetic field, and the battery, oh sweet Jebus the battery, think of the battery!

          A better option might be to avoid any sort of electronic device altogether. Especially computers.

    2. Sawyer says:

      @stan

      I’ve used chemicals from JT Baker and noticed that their health rating system is often one higher than the standard NFPA rankings. How could this be? Obviously JT Baker knows something that the evil government and sadistic fire engineers had been covering up for years! There couldn’t possibly be any other reason why they might put more conservative safety estimates on their product, could there? Nope. Obviously a conspiracy is going on. If I ever get bone cancer it must be from that one time I spilled methyl ethyl ketone on my hand.

      And thanks for constantly employing the “begging the question” fallacy. It makes these parallels much easier to draw, and to reveal the ridiculousness of your premises.

  15. Jay Schufman says:

    Dr Oz (if he actually is a docotor) is a fool!

    What I do believe is that the neurotic tendency of Americans to keep their cell phones glued to the left side of their heads is causing them to active their left-frontal lobes, reducing them to god-fearing sheep!

    1. Calli Arcale says:

      Unlike some TV doctors (Dr Phil comes to mind), Dr Oz really and truly is a doctor. He’s a cardiothoracic surgeon. Practicing, too; he didn’t retire to take up television, and is still doing surgery. Regardless of what one may think of his opinions, I know I’d find it very strange to be worked on by a celebrity.

      1. agitato says:

        I would too. Afterwards, I’d probably feel like calling a tabloid and asking them to print my “DR OZ DID MY SURGERY!” story. Or do you sign a waiver saying you won’t do this?

  16. gah. head->desk.
    So yeah here http://en.wikipedia.org/wiki/File:EM_Spectrum_Properties_edit.svg
    is the EM Spectrum. Cell phones use microwaves which bounce off your skin, clothes, etc.
    The stuff that causes cellular damage is all that stuff on the other side of visible light which you get by just going outside when that big yellow thing is in the sky. Cell phones cant cause cancer any more than the rest of the ‘radiation’ that we are a awash in all bloody day. Heck I probably get more real dosage from my basement walls where my home office is than I get from my cell phone.

  17. Pmoran says:

    And yet,  –  might you not advise your daughter to avoid this practice until there WAS clear scientific evidence of its safety?   

    How sure can we be from physical principles or other kinds of evidence that intimate cell-phone exposure of this degree is completely benign, especially when a phone is pressed up against a cancer-prone organ like female  breast tissue for very long periods?      

    Everything David says is true, if you are to look upon this as an issue where near-absolute standards of proof are demanded before there was any precautionary medical advice.   But in medicine we are normally much more sensitive to risk than that.  We warn about possible drug side effects, for example, on minimal anecdotal evidence.    We worried about stroke from neck manipulation at a time when there was little more evidence than a few suggestive cases.    

    The mammogram shown in the case study could certainly be the result of coincidence but it is somewhat disturbing .   Multifocal  cancers to that degree are not very common and here are  (supposedly) four very young patients with much the same clinical picture.

    1. David Gorski says:

      How sure can we be from physical principles or other kinds of evidence that intimate cell-phone exposure of this degree is completely benign, especially when a phone is pressed up against a cancer-prone organ like female breast tissue for very long periods?

      How sure can we be from physical principles alone or other kinds of evidence, that homeopathy doesn’t work?

      In any case, there were really only two very young patients. One of the others was 39, which is not remarkable with respect to breast cancer. The other was 33, which is young, but not beyond the pale. As I pointed out in my post, I have a 33-year-old breast cancer patient right now. Two 21 year olds are unusual, but there are likely at least a couple of hundred new breast cancer patients in that age range in the US every year. Given how common it is for young women that age to stash their cell phones in their bras, it would surprise me if at least half of them didn’t do it at least some of the time. Finally, I’m a bit puzzled. Multifocal cancers to that degree are not uncommon. I see a fair number of them. It could be because I’m in an NCI-designated comprehensive cancer center, but even so they’re not that uncommon, at least 15% detected by newer imaging modalities. (We could get into the discussion of stage migration, but let’s not right now.) It’s particularly common with cancers associated with lots of DCIS. So, no, the multifocality of the tumor shown does not sway me.

      As for risk-benefit, well, each person has to decide what level of risk she is comfortable with, but that needs to be done based on sound information, not fear mongering of the type that Dr. Oz demonstrated.

    2. Vicki says:

      Will you advise your children (any genders) to avoid watching television, eating eggplant, and traveling by automobile, especially on rainy days, until there is clear scientific evidence of the safety of those activities? Why is this suddenly a case where you want to prove a negative, in the face of a culture that seems to make an active effort to stop women from being able to carry things? Tiny or nonexistent pockets in almost all our garments, and when women find a way around that, suddenly there’s scare-mongering about the solution.

      Is Dr. Oz working for the handbag industry, or for a secret cabal of purse-snatchers?

      1. Chris says:

        “for a secret cabal of purse-snatchers?”

        This made me laugh out loud!

        After reading this article and the comments, could we use Dr. Oz and his following to get manufacturers of women’s clothing to get serious about pockets?

        1. been trying to get people to “get” why I do what I do for 6.5 years. and spoken with clothing companies to license this common sense and super practical solution. Yet more often than not I have been ignored. Why? I’m convinced clothing companies will NEVER put pockets of functional value in their clothing as it always seems to be fashion over function for them. So it seems my solution would make total sense (and it does). But yet… here I am…still working on changing the world and putting a little dent in the universe like Steve Jobs…

    3. WilliamLawrenceUtridge says:

      If I had a daughter, I would tell her that wearing a cellphone in her bra is kinda crass. I would worry about her texting and driving. I would worry about sexting. I would worry about long-distance charges and expensive cellphone bills.

      I would not worry about her getting cancer from it.

      As for comparisons of chiropractic and strokes to cellphones and cancer: chiropractic manipulation of the cervical vertebrae has no proven benefits. Cellphones have myriad benefits, even if very, very few are related to physical health. Further, there are far, far fewer women getting chiropractic adjustments than there are women with cellphones. It’s far, far easier to find rare cancers in young populations when your total possible population numbers in the tens of millions.

      1. Andrey Pavlov says:

        I would worry about long-distance charges and expensive cellphone bills.

        Dude, no need to be alarmist here. We already have unlimited everything plans for well under $100 a month and more and more free long distance calling. By the time your ankle biter has a cell phone all that stuff will be included and you could call the Curiosity rover for your included monthly price.

      2. goodnightirene says:

        Why is it “crass”? I do it all the time. What is all this prudery about bras? A bra is just a garment and makes as good a holder of things as any other type of garment.

        1. windriven says:

          “A bra is just a garment and makes as good a holder of things as any other type of garment.”

          I don’t know, Irene. I was gonna stuff my iPhone in my Speedos but I was afraid of some kind of Anthony Weiner scandal erupting :-)

          1. MadisonMD says:

            Awesome, win

        2. WilliamLawrenceUtridge says:

          I’ll admit, this is totally personal opinion – not about prudery though. And in an unpleasant bit of personal trivia, it’s apparently a bit of unwarranted classism on my part since it’s a behaviour I associate with the people I see on Cops.

          Interesting, I’m not sure where it’s coming from and it’s obvious that it’s wrong. My apologies Irene, and thanks for calling me on it.

  18. Frederick says:

    What in part of non-ionizing people don’t understand, tired of that paranoia about electromagnetic wave some groups continue to spread out, go learn so physic. the more powerful EMW people face everyday is freaking light. it is millions time more powerful than cell phones. they are scared of cell phone but go down to TAN under UV light.. yeah.. talk about ignorance .

  19. Brad Smith says:

    ““Unheard of.” No. Let’s just put it this way: I’ve seen a case in a woman even younger than 21″

    A girl I went to school with died of breast cancer at the age of eighteen. Very shocking and sad. We had an “unlucky” year group at school, lost one to a skiing accident, one to leukemia, one to some sort of brain disease, another ended up in a coma and another has recently been diagnosed with MS.

  20. Joe says:

    Somewhat off-topic, but it’s about cancer. I guess since this is CAM you guys are against it, but to a non-medical type like myself it makes sense (8 pages):

    http://cancerstrategiesjournal.com/McKeeMDReprint.pdf

    He talks about the tumor microenvironment, double-blind RCT, stress, thermal ablation and the in vivo vaccine effect, irreversible electroporation, site specific immunotherapy, use of tetrathiomolybdate for an angiogenesis blockade, the work of Dr Robert Nagourney and Larry Weisenthal to test tumor specimens from the patient against combinations of chemo, tumor dormancy, and other issues.

    1. Andrey Pavlov says:

      I haven’t even read the link but I fail to see how research using the words you are bandying about are in any conceivable way “alternative.” A few of them sound like a little wishing thinking, some are already in use, some sound like a good idea that just hasn’t come to the fore yet.

      Now, in skimming through the link I see where he goes off the rails. He talks about stress relief and the techniques for doing so. Perfectly reasonable science based stuff. But then he talks about how stress relief actually helps cure you of cancer and even makes the claim that it is more effective than adjuvant chemotherapy. Now that is BS.

      He talks about right brain vs left brain thinking as “masculine” and “feminine” respectively, an idea that is well disproven.

      He goes on about this ridiculous idea that oncologic based diet plans are often used to try and “starve” the tumor just a mere sentence or two after saying that they are also only concerned with the calories and that “ice cream, hamburgers, and so on” are part of the diet. Well, which is it? He uses this to bolster the claim that CAM treatments are nourishing and nurturing.

      He makes the claim that in conventional oncology the oncologists are highly skeptical of immunologic therapy for tumors. Couldn’t be further from the truth. I have learned for well over a decade now about the role of the immune system in cancer. In fact, I’ve had patients where the dilemma is that we want to give them an immunosuppressant for one reason but they have cancer so we can’t. We even have a disease entity known as post transplant lymphoproliferative disorder which is a feared complication of immune suppression leading to malignancy. The issue is that we don’t have the knowledge or technology to exploit the immune system the other way – to treat cancer. But even in my undergrad days I remember my professor telling us that was the “holy grail” of cancer treatment. Researchers are working on it. It isn’t that we are skeptical of immunological therapy; it is that we know it hasn’t arrived yet and we are skeptical of so-called CAM that claims to have salubrious immunomodulatory effects.

      He bashes RCT because, according to him, the point is to try and control for variable but that is “an illusion” because we can’t control for all variables. No duh.

      Just skimming through the intro and there is already a lot of misattribution, outright errors, and anything actually science based is then imbued with magical properties and woo.

      So it isn’t that he is IM/CAM that makes us against it but because he is simply scientifically wrong on most (but not all) of what he says.

      1. Joe says:

        Thanks for the detailed response.

        On the diet issue, he was comparing his approach to that of conventional oncology which he said was only concerned with calories and protein, and would include ice cream, hamburgers, etc.

        1. MadisonMD says:

          “Conventional oncology” recommends hamburgers and ice cream? Please. Hamburgers and icecream are your 8-year old nephew requests for lunch. Here is professional “conventional” oncology advice on nutrition.

        2. Andrey Pavlov says:

          You are welcome.

          As for the diet issue, as MadisonMD pointed out that is basically a false premise. That said, we do sometimes encourage people to eat things like hamburgers and ice cream because in more extreme cases people simply cannot eat more frequent healthy meals and indeed pure calories do actually become more important. Give someone their favorite food (or at least one that is calorie dense) and that is better than them having no food at all. But overall, as Madison pointed out and the link demonstrates, that is not the default nutritional advice we give cancer patients.

          The author’s entire piece is riddled with half truths and false premises bandied about as a foil to try and make his ideas seem better.

  21. dandover says:

    Okay, so maybe the idea that the phone’s RF radiation is causing cancer isn’t plausible. But have you considered that virtually all of those phones have ANGRY BIRDS on them?! No?! Didn’t think so. See, there IS a plausible link! Clearly Angry Birds is (are?) carcinogenic — how could anyone doubt that? I think an apology is in order.

    I patiently await your retraction.

    Oh, wait. Dr. Oz is a douchebag. Never mind, carry on.

  22. garuno says:

    @stanmrak “The industry has also carefully crafted the language in the disclosure document that comes with your cellphone that guarantees that they cannot be sued if in fact it is discovered that cellphones do cause harm.”

    That wouldn’t work. There are no guarantees at all that they won’t be sued, and it is not legal to shrug off responsibility in disclosure or any other documents, no matter how cunningly worded.

    1. stanmrak says:

      Suing is one thing. Winning a lawsuit? Good luck!

  23. madisonMD says:

    Someone should tell Dr. Oz that bras and underwear emit black body radiation. High energy photons in your underwear! (At least high energy compared with cell phones). Maybe Oz should wear liquid-helium cooled underwear to deal with the problem. There may be shrinkage.

    1. Calli Arcale says:

      You owe me a new keyboard. Mountain Dew all over when I got to the last line. :-D

  24. PMoran says:

    David, you have said outright that there is NO risk, when what you really mean is that in your opinion there is no good reason to suspect any risk. They are not nearly the same thing.

    You have an arguable scientific position, yet —.

    “Multifocal cancers to that degree are not uncommon. I see a fair number of them. It could be because I’m in an NCI-designated comprehensive cancer center, but even so they’re not that uncommon, at least 15% detected by newer imaging modalities.”

    Two or three foci of breast cancer may occur with about that frequency, but here we are talking about four upwards, also as demonstrated on standard mammography or pathology findings.

    ” — there are likely at least a couple of hundred new breast cancer patients in that age range in the US every year”

    Yet here we have four cases with a number of OTHER features in common that so far as we know occurred in a small part of California. ( I am not sure about that; the whole paper is online for anyone who wish to consult it. The authors are very aware of the limitations to their data. )

    ” As for risk-benefit, well, each person has to decide what level of risk she is comfortable with — ”

    If true, this is a very serious, if possibly rare risk to young women that is avoidable by a fairly trivial change in behaviour (sorry, pocketless ladies!) and wherein there is no question of any redeeming medical benefits.

    AND, we, as medical scientists heavily reliant upon public trust in so many very important ways, cannot afford to be wrong on this.

    I have no strong brief (scientifically) either way. There apparently is evidence that cell-phone signals can cause tissue heating, and while, so far as I know, this has not yet been shown to cause cancer in any similar setting, phones in bras does go against the advice of cell-phone manufacturers not to keep them in contact with skin. Why do they advise that, I wonder ? — probably just being cautious, I suppose.

    So we are talking about a small element of scientific uncertainty and what might be prudent action pending further information on a not previously investigated matter (that I know of).

    So, again, what should we tell our daughters? I would say something starting with “it may be wise, for now, —”.

    1. Harriet Hall says:

      @PMoran,

      Did he say there is NO risk? No, he said “there doesn’t appear to be strong evidence (or much of any evidence at all) supporting plausible mechanism by which cell phone radiofrequency radiation might cause cancer or an actual effect in which they do.”

      “four cases with a number of OTHER features in common that so far as we know occurred in a small part of California.” Clusters are seen in random data. You know very well that these 4 cases could be attributed to coincidence and that a proper statistical study would be needed to show a correlation.

      Why do the manufacturers advise not to keep them in contact with skin? Perhaps so people who develop cancer for whatever reason won’t blame the cell phone and won’t have any excuse to file a lawsuit.

      I tell my daughters that while we haven’t absolutely proved that cell phones can’t possibly cause cancer, we have enough information to judge that if there is a risk, it is a very tiny one indeed and that the unlikely possibility must be balanced against other considerations like convenience.

      1. My epiphany for archetype human behavior was years ago. I had a heroin user, 2 ppd smoker, 12 beers a day with aortic valve endocarditis who came to clinic in follow up while on therapy and complained of new shortness of breath; an ominous finding when combined with his change in murmur.

        My first step was to order a chest x-ray which he refused because of the fear of radiation risk.

        When I pointed out the risks of his choice in the context of his other bad habits he gave me a shrug and said “You do what you can”.

        1. Calli Arcale says:

          Wow. That is *epic* fail for understanding relative risk, isn’t it? The x-ray would’ve mitigated the risks he was taking with his lifestyle choices.

        2. WilliamLawrenceUtridge says:

          Given the totality of his health, he seems to be doing the very opposite of what he can.

        3. mousethatroared says:

          I wonder if he might have just been afraid of what the x-ray would show and was making up excuses to avoid the bad news.

        4. goodnightirene says:

          I know at least two alcoholics who only drink reverse osmosis water, eat almost only organic food and take handfuls of supplements/herbs, practice almost every woo you can name; but continue to drink cheap, not organic, not made with reverse osmosis water, beer night after night until they fall into a stupor.

    2. Andrey Pavlov says:

      As Dr. Hall said, Dr. Gorski did NOT say there was outright NO risk.

      He said that the risk was extremely small based on available evidence. Which is exactly true. No matter how you slice it, even if it were proven that cell phones in bras could cause cancer, the incidence must be incredibly small because all sorts of studies have failed to show a correlation between cell usage and cancer. If they were underpowered then the effect size remaining is, by definition, minuscule.

      What would I tell my daughters? Well if they worry about meteorites hitting them in the head or lightening striking them I’d suggest they not walk outside.

  25. nukenorth says:

    Cell phones and other radio frequency devices radiate electromagnetic energy with frequencies that couple to vibrational and bending modes of molecules. This is the mechanism that heats food in a microwave oven. At high intensity this energy can heat biological material to oxidation temperatures — burnt popcorn in the microwave for example. No atoms were ionized in this process.
    To ionize an atom the radiation must interact with the atomic electrons directly, scattering the electron out of the atom. The photons corresponding to radio frequencies & microwaves have too little energy to evict an electron from its atom no matter how intense the radiation is (many low energy photons).
    What is interesting is that the cell phone is very close to biological material — the material is in the “near field” of the antenna. In this situation the coupling is more “capacitive or inductive”.
    In any case, it’s down to localized heating. If the tissues are not well-cooled by blood flow one might imagine temperature sensitive chemistry would have an opportunity to do something or other. However the actual power levels are low, so it seems unlikely there would be any cooking-like phenomena at work.
    The DNA of every cell in the body is attacked may times each day by free radicals that result primarily from oxygen. The cell repair maintenance systems do a great job — otherwise we wouldn’t get to be old enough to worry about cancer.

    1. Sawyer says:

      What I would really like to see (and likely never will, as it’s a huge waste of resources) would be a comparison between holding a phone to your head for 10 minutes versus wearing a baseball cap during the summer. Develop a theoretical model for heat transfer and take some IR measurements to see which one generates a greater local temperature increase. This would force the anti-cell phone people to admit that they are also anti-hat. Or that constant support for the Red Sox is more important than people dead from brain cancer.

      One can imagine the hilarious follow-up studies for all the various methods of increasing your skull temperature by 0.1 degrees C.

    2. windriven says:

      ” In this situation the coupling is more “capacitive or inductive”.”

      I understand the capacitive coupling in this scenario but I’m struggling with the inductive. What am I missing?

      1. TiredFather says:

        windriven, it depends on the source antenna. You can couple energy between two loops due to mutual inductance. (PS nukenorth is absolutely right to point out that we are talking here about nonionising radiation.)

        1. windriven says:

          I’m a physicist. I understand the electronics. I understand the inductive component on the transmission side but not on the biological side.

    3. Calli Arcale says:

      I’m willing to bet that direct heat energy from the phone’s electronics and battery are more significant than anything from the radio waves.

      1. Sawyer says:

        Ack, you beat me to it! I meant to include that point in my proposed experiment. My phone tends to get hotter the more things that are running on it, so we’ll have to test that variable. ANGRY BIRDS CAUSES CANCER!

  26. PMoran says:

    Harriet, and Andrey, I refer you to Dr Gorski’s headline — – .

    “No, carrying your cell phone in your bra WILL NOT cause breast cancer, no matter what Dr. Oz says” (my emphasis)

    There is nothing equivocal or “it’s very rare” (Andrey) about this take-home message, now presumably figuring near the top of any search on the matter.

    I have agreed that the evidence might be due to various coincidences — we regularly encounter unusual clusters of cancer.

    On the other hand it is also exactly the kind of preliminary evidence that we might expect if there WAS a causal association here, not noticed previously because we never thought to ask breast cancer patients about their cell-phone habits.

    1. David Gorski says:

      On the other hand it is also exactly the kind of preliminary evidence that we might expect if there WAS a causal association here, not noticed previously because we never thought to ask breast cancer patients about their cell-phone habits.

      No, not really. Even as individual anecdotes, these are not convincing cases, for the reasons I’ve explained ad nauseam.

      I also stand by everything I’ve written. On pure physics alone, a link between cell phone radiation and cancer is incredibly unlikely. Not homeopathy-level unlikely, I’ll concede, but getting almost to that level of unlikeliness. Indeed, I’m considered a bit of a heretic among physicists because I concede a very, very tiny possibility that there might be a hitherto unknown mechanism by which low energy radio waves might induce carcinogenesis, but it’s so incredibly unlikely that there’d have to be some seriously convincing evidence to counteract the highly established physics and biology that say that it can’t.

      1. PMoran says:

        “No, not really. Even as individual anecdotes, these are not convincing cases, for the reasons I’ve explained ad nauseam.”

        No one has said they are convincing, except for that entertainer! Nor that they be looked at as individual cases — just the opposite.

        Nor do your “reasons” establish that such a cluster of cases is conclusively due to chance or remove any onus upon us to be very, very sure of that. Your pointing to other cases wherein cell-phone use may be unknown leaves us no further ahead, especially if this is, as you say, likely to be common practice among young women.

        If you are indeed now seeing an apparently comparable number of young women with all these characteristics then perhaps you should ask them about their cell-phone use, because in my day, before cell-phones were as prevalent, such cases were quite rare. Such enquiries may also be inconclusive, but simple studies should clarify matters

        I accept that there is no clear, established mechanism and that that weighs against the association without eliminating it entirely.

        All I am suggesting is more cautious language, and advice that takes into account the seriousness of the condition being risked, the ease of avoidance, and the option of precautionary suggestions without having to commit ourselves regarding the science, pending the additional evidence which is certain to follow.

        1. David Gorski says:

          Ah, I understand now. That bit about “cautious language” and seriousness and all that.

          You’re concern trolling again.:-)

        2. Andrey Pavlov says:

          @pmoran:

          You do actually know the science and epidemiology behind cancer clusters right? And how many clusters that superficially seem much, much, much, much much more convincing than this have turned out to be negative, right?

          Cancer.gov:

          A large number of cases of one type of cancer, rather than several different types.

          A rare type of cancer, rather than common types.

          An increased number of cases of a certain type of cancer in an age group that is not usually affected by that type of cancer.

          So how, exactly, is 4 cases which fit well into the background level of cancer qualify here? Yes, still could be, yes there is a chance that it could represent a small increase in incidence but we’ve established why even that is very unlikely. Perhaps you could prove that 1 or 2 people worldwide get cancer as a result of cell phones. Would that mean you would now advise women to to stop keeping phones in their bras, because they have a higher chance of getting hit by lightening than they do of getting cancer as a result of the phone?

          More and more lately you seem to be in a state of decision paralysis and teetering on the edge (quite frankly you take a swim in it from time to time) of the nirvana fallacy.

          You are asking for more certainty than is possible in order to say something that isn’t a waffling bit of piffle that will, without a doubt, inflate the risk in the person’s mind well beyond reality. In other words, confidently saying “no” is vastly closer to reality than your waffling prose.

          1. PMoran says:

            Now the name-calling from David. And other forms of ad hominem from Andrey.

            That is rubbish — unworthy debate for a site that should be demonstrating how science and medicine work together, often wisely, sometimes not so much.

            Such characterisations of me are ridiculous, when I differ, often only marginally, from a small fraction of the opinions expressed on this site.

            So –. I see that as confirmation bias. I also see the dodging of salient points. Straw men, too (“demanding certainty” — I have not). Self-reassuring ad hominem. Tribal acquiescence rather than independent thought.

            I think I could be good at this.

            1. David Gorski says:

              Now the name-calling from David.

              Not at all. Saying that you were tone/concern trolling was a description of your behavior, not of you as a person. Describing behavior is usually not an ad hominem attack.

              That is rubbish — unworthy debate for a site that should be demonstrating how science and medicine work together, often wisely, sometimes not so much.

              Another example of that behavior, thus confirming to me that my original assessment was accurate.

              Such characterisations of me are ridiculous, when I differ, often only marginally, from a small fraction of the opinions expressed on this site.

              Not at all. In fact, you’ve hit on nearly the very essence of concern/tone trolling. You agree with nearly all of the substance. You said so yourself. You admit that your only real complaint about this post is that you don’t like its tone and, in your view, excessive level of certainty in criticizing Dr. Oz’s fear mongering. Again, that’s the very essence of tone trolling: No substantive disagreement, just complaints about “tone.” This is a pattern with you that’s been going on for at least four years now.

              So –. I see that as confirmation bias. I also see the dodging of salient points. Straw men, too (“demanding certainty” — I have not). Self-reassuring ad hominem. Tribal acquiescence rather than independent thought.

              I think I could be good at this.

              What makes you think you weren’t already?

              Over the last four years or so, we have tried to “address salient points” (in your opinion) that you bring up time and time and time again. We’ve been incredibly patient. I’ve been incredibly patient in deference to your awesomeness back on misc.health.alternative 12 years ago and how you were one of my inspirations to start my hobby as a skeptical blogger. However, patience only lasts so long. Decade-old hero worship only gets you so much deference. Over those four years, those “salient points” of yours that we’ve tried to address more times than I can remember almost inevitably always boil down to complaining about the tone or aggressiveness of posts here on SBM. Over and over and over and over again, ad nauseam.

              If anything, I’ve moderated my tone over the last couple of years, but I have no plans on changing it any further unless it happens to evolve organically. So I guess you’ll be complaining about it as long as I write these posts and you read them.

            2. Andrey Pavlov says:

              @pmoran:

              I’m sorry, where was my ad hom? I commented on you and how you write and the ideas you convey. I didn’t try to say that they were wrong because you write poorly or you are an evil person or something. So I fail to see how an ad hom exists.

              I called into question your understanding of cancer clusters and the reality of how many times they are demonstrated to be true vs not and how difficult it is to do so, even in much more clear cut cases than the likes of these. That is not ad hom – that is a rhetorical question since, quite frankly, you write as if you have no idea of these things. I know you almost certainly do, but you wouldn’t know it from what you are writing these days.

              And yes, finding 2 rather uncommon and 2 somewhat uncommon cases of breast cancer in a society where 91% of the adult population owns a cell phone and then thinking there is any sort of reason to waver in our certainty that the cell phone is only circumstantially related to the cancer is simply ludicrous. I mean really, perhaps I could find 10 breast cancer patients under the age of 20 who all wore blue shirts a lot or who all had long hair that constantly draped over their breasts and come up with a word of caution for Dr. Oz’s show. It’s no less ludicrous a thought.

              And, as Dr. Gorski pointed out, the entirety of your posts around here boil down to “Yes, I agree with you in every way, except that I just don’t think you should say it quite that forcefully. Your tone is just too aggressive and off putting.” Guess what? That’s a tone troll Peter. And it adds nothing at all useful to the conversation.

              1. David Gorski says:

                That’s what bugs me the most about tone trolling. It basically says, “Even though I agree with you, I’m discounting what you write because it doesn’t live up to my standard of civility and/or doesn’t express sufficient nuance or uncertainty.” Worse, it’s a colossally arrogant response to anyone’s article in that it demands that others write the way that Peter thinks they should write. As you point out, it contributes nothing of substance to the conversation.

            3. WilliamLawrenceUtridge says:

              The worst feuds are between brothers. The worst wars are civil wars.

    2. MadisonMD says:

      pmoran:
      Consider both the following statements:

      “No, carrying your cell phone in your bra WILL NOT cause breast cancer, no matter what Dr. Oz says”

      “Santa Claus doesn’t exist”

      They are equally true even though it is not possible to “prove ” either beyond all certainty.

      You are suggesting that everything needs to be adjudicated by clinical evidence, when in fact some hypotheses can and must be ruled out on fundamental principles.

      1. David Gorski says:

        Which is exactly the essence of science-based, as opposed to evidence-based, medicine! :-)

      2. PMoran says:

        MadisonMD. I take your point about proving the negative, but the public does expect, and has every right to expect something near that of us in certain contexts. For example vaccines given to healthy children in low risk environments have to be very safe. Over-the-counter medicines should be very safe.

        This is not necessarily one of those instances, anyway. Women could easily side-step the issue at some personal inconvenience. The immediate question is what advice it is wise to offer, pending further data.

        1. MadisonMD says:

          Your point about how easy to sidestepping the issue is well taken. However, it would be hard to carry a cell phone around without it being somewhere near your body unless you carry it on a pole attached to your belt. Moreover, if you sidestep every potentially harmful non-issue, your focus will be diverted from things you can actually do to improve your health.

          the public does expect, and has every right to expect something near that of us in certain contexts.

          This was actually my second point. We can be almost certain by what we know now and so obtaining clinical evidence is more likely to cloud than clarify the issue.

        2. WilliamLawrenceUtridge says:

          Given the difficulty of even detecting any association between cell phones and cancer, with a safety margin at worse, several dozen orders of magnitude below that of even OTC medication, I’m surprised you’re spending time on cell phones rather than painkillers. Painkillers have known, obvious risks and you’d save far more lives and suffering spending your time concerned about them versus cell phones.

    3. Sawyer says:

      “not noticed previously because we never thought to ask breast cancer patients about their cell-phone habits”

      We’re right back to the old XKCD jelly bean conundrum. The crazy number of hypotheses that can be generated by asking patients questions about frequency of use and location guarantee you’ll be able to generate some sort of spurious evidence. The basic question – can a cell phone cause cancer – is split into dozens of questions. Any breast cancer? Left breast? Right breast? Testicular cancer? Left side? Right side? Skin cancer? Skin cancer with already high sunlight levels? Skin cancer with lower sunlight levels? Brain cancer? Left side? Right side? Encephalopathy? Alzheimers? Morgellons?

      How is this a reasonable approach to cancer research, or any type of medical research? To find a real signal in any of this noise you’d have to use insanely high statistical standards, which will end up washing out any real correlations that may be hiding in the data. I actually have this nutty idea that people that use cell phones for 2 hours a day may have slightly higher risk for many diseases due to stress, but I don’t think obsessing over patient anecdotes would improve our ability to test this hypothesis.

      1. PMoran says:

        No, Sawyer, there is already a very precise hypothesis to test, if so decided, one generated by level-headed clinicians who have been struck by a few breast cancer patients that display common characteristics.

        Many advances in medical knowledge have derived from such observations. They can generate a lot of noise, as you say, but we cannot afford to be too dismissive of any that point to very serious dangers for young women.

        I suspect that even now there will be no leap into major studies. Other oncologists will include this question in the data collections that go on all the time and major studies would only occur if others were making similar observations.

        1. MadisonMD says:

          As an oncologist who does do research, I’d rather invest my times in more fruitful inquiry. There is more important data to collect with the limited resources available.

        2. WilliamLawrenceUtridge says:

          Many advances in medical knowledge have derived from such observations.

          But most of those observations have turned out to be spurious.

          Right now you and Dr. Oz are saying “because there might be a risk here, we must treat it as if it were a risk”. That’s nonsense, particularly for something with as low a probability as this, particularly given the numerous fearmongering studies of this question consistently coming up negative. I mean Jebus, are you worried about being 300 degrees above absolute zero? That’s an awful lot of infrared radiation you’re bathed in, and it’s four orders of magnitude more potent than cellphone radiation! Plus, I’ve never seen someone cooled to absolute zero with an active tumor – hey, that’s anecdotal evidence!

          1. PMoran says:

            WLU: “But most of those observations have turned out to be spurious.”

            I have allowed something like that. Yet anecdotal evidence varies immensely in quality. It cannot be totally dismissed simply because it is anecdotal.

            WLU: “Right now you and Dr. Oz are saying “because there might be a risk here, we must treat it as if it were a risk”.”

            So? Medicine gives precautionary advice about risk on minimal evidence all the time. The wording can be adjusted so as to convey an impression of the scientific likelihoods, leaving action up to the user.

            What I am advising is in accord with scientific norms. The trenchant dogmatism of the heading to this piece is not.

            Like some others, you are trying to argue a case from general principles and ridiculous examples. I don’t find that compelling because this matter, as sometimes applies within medicine, involves a number of highly individual, even somewhat extreme circumstances, all of which bear upon how we should most wisely (or unwisely) react to the matter. I have drawn attention to those in the above and will not repeat them here..

            1. Andrey Pavlov says:

              @pmoran:

              How many sigma of certainty do you require before it is ok to say that this is fear mongering and cell phones do not cause cancer? Because, you realize, that everything in science – literally everything we know – has exactly the same caveats and limitations you are invoking. What’s your threshold Peter? Can you say for certain that every single homeopathic nostrum won’t work on any of the 7 billion human beings on the planet? (and of course by “work” I mean intrinsically and better than placebo) Should we caveat our speech with homeopathy and try to say how it really probably almost certainly doesn’t work, but hey maybe just by some small chance it does, so, dear patient, take that as you will and decide if you want to use the stuff? Is that not patently ridiculous?

              What is your threshold for finally saying bullshit is bullshit?

              (and it seems you are starting to wander over to the world of methodolatry – are basic principles meaningless? Does the fact that the energy is so low and non-ionizing simply mean nothing?)

              1. David Gorski says:

                How many sigma of certainty do you require before it is ok to say that this is fear mongering and cell phones do not cause cancer? Because, you realize, that everything in science – literally everything we know – has exactly the same caveats and limitations you are invoking. What’s your threshold Peter? Can you say for certain that every single homeopathic nostrum won’t work on any of the 7 billion human beings on the planet? (and of course by “work” I mean intrinsically and better than placebo) Should we caveat our speech with homeopathy and try to say how it really probably almost certainly doesn’t work, but hey maybe just by some small chance it does, so, dear patient, take that as you will and decide if you want to use the stuff? Is that not patently ridiculous?

                What is your threshold for finally saying bullshit is bullshit?

                What Peter seems to object to is that we call anything—anything at all—bullshit, even when it is clearly bullshit, like homeopathy. He seems to want us to qualify everything, even though for homeopathy to work several of our best-established theories and laws of physics and chemistry would have to be not just wrong, but spectacularly wrong.

                But maybe I’m wrong; so I, too, will ask Peter: How certain do you have to be before you are willing to call something bullshit? You certainly didn’t have a problem calling the Gerson therapy, laetrile, and other obvious cancer quackery bullshit (and rightly so!); yet, based on the principles of physics alone, the chances that cell phone radiation can cause cancer are easily much less plausible than the possibility that supplements and coffee enemas might have an antitumor effect. So why is, for example, Gerson therapy bullshit and you’re not afraid to call it such, while you clutch your pearls when I refer to Dr. Oz’s fear mongering over cell phones and cancer as bullshit, although I didn’t use that particular word? Please explain. What is the difference?

                Remember, compared to physicists and others who have written about this topic, I tend to be less dogmatic about the possibility that cell phone radiation can have biologically relevant effects. Remember this one?

                http://www.sciencebasedmedicine.org/reassessing-whether-low-energy-electromagnetic-fields/

                I was roundly castigated as being so open-minded that my brains fell out after I wrote that one.

              2. MadisonMD says:

                (and of course by “work” I mean intrinsically and better than placebo)

                If I remember correctly, Dr. Moran has asserted another definition of works and so you are applying a special meaning to “works.”

                Pmoran: feel free to correct me if I misunderstand your position.

            2. Harriet Hall says:

              “The trenchant dogmatism of the heading”

              Funny, I read it as “oversimplification to make a point that scientifically unsophisticated people could take home” and I thought the oversimplification was well compensated for by the fuller, nuanced explanation in the article itself. David’s tone didn’t bother me, but Peter’s did: it sounded like nit-picking and tone trolling.

            3. WilliamLawrenceUtridge says:

              Pete, your “precautionary advice” would, applied to other circumstances, lead you to advising against drinking water for fear of hyponatremia. That precautionary advice about breast cancer is much better applied to the unarguable, and orders-of-magnitude-higher risks of things like obesity, fatty foods and alcohol. Medical precautionary advice, in the absence of clinical trails and other such studies, would not advise concern about cell phones and cancer since the biological plausibility is so low. Your advice is not in keeping with scientific norms since it does not reflect the prior probability of the claim. Your concern trolling has extended itself into medical advice.

  27. TiredFather says:

    For all those conspiracy theorists out there let me reassure you that mobile telephone companies contribute a minute fraction of the research funds. I’ve been in the area of computational electromagnetics for about 17 years and have been to numerous conferences. This area really has been researched nearly to the point of exhaustion, including some long term health studies (I could go on but there is an excellent summary aleady in another posting that has already been cited). The truth is that much of the work has been government funded, and if there was a bias then it would be to establish a link which would in turn result in more funding and more work for us! It seems like we have ‘moved on’ since it became clear that if there are any effects at nonthermal exposure levels then they are absolutely miniscule. I’m rather glad of this outcome because there are plenty more interesting things to research.

  28. Garuno says:

    @stanmrak “Suing is one thing. Winning a lawsuit? Good luck!”

    This is the “Oh, but I meant something completely different from what I said” defence.

    It means you disown the original claim. Thanks.

  29. Sara says:

    I’m more concerned about the millions of women who don’t wear a bra that fits properly. If you can carry your keys and phone in your bra, chances are the cups are way too big…

  30. PMoran says:

    I have said nearly all I wish to say, despite now having it trivialised by quite unnecessary, demeaning name-calling and (albeit unrecognised) ad hominem.

    While it suits some not to recognise it, what I have said is underpinned by serious scientific questions, to do with how we weight various kinds of evidence; also how medicine deals with immediate practical issues when so often faced with incomplete or conflicting evidence, and extraordinary variations upon the themes of cost/risk/benefit/likelihood.

    1. David Gorski says:

      None of which you have addressed in a substantive fashion. All you’ve done is to clutch your pearls and express horror at the title of this post as being oh so shockingly assertive, just as you seem to do with many of my posts. You seem to have a particular dislike for my style. In any case, Andrey and I have been trying to get you to make a substantive commentary, but, really, that’s all you seem willing or able to do here: Complain about tone. Seriously. Let’s hear some substantive specifics about communicating about the science and medicine that do not involve doing nothing more than complaining about the tone of this post.

      As for the annoyed “tone” of my comments, I assure you, it’s from sheer frustration at trying to understand exactly what your point is, or even if you have one other than that I’m not as nice or wishy-washy as you think I should be discussing this issue.

    2. Andrey Pavlov says:

      @pmoran:

      I certainly apologize if there was truly ad hominem in my writing. I suppose “tone-troll” could be considered name calling, except that Dr. Gorski and I have both outlined extensively, over and over, in many different ways why that is simply the most accurate and succinct description of your posts here. Is it a pejorative? Well, somewhat, yes. But once again it is directed at your content, not you, and our contention is that you are indeed in the negative here so it stands to reason that the descriptor used is pejorative to some degree. Take note though that we have never once used it as simply a means to dismiss your argumentation. We have explained, quite extensively actually, what it means to be a tone troll and why your writing fits that description. It is not an off hand comment intended to silence or marginalize you.

      Yes, what you have said is indeed underpinned by serious scientific considerations. That is not at all our contention. The contention is what you then do in a subjective sense with that serious scientific underpinning. And you hedge in a manner that we here find unreasonable and, frankly, contrary to the raison d’etre of this blog; namely to discuss the hierarchy of evidence and argue for the modifications we advocate. Which includes a stronger use of lower tiers of evidence, including bench science and first principles, to inform higher orders of evidence. It also includes a keen understanding of the extremely small and limited role anecdote plays. It is a hypothesis generator, and a bad one at that, at best. Your argument that somehow these anecdotes are much more serious is nothing but a reflection of your personal bias and an argument from incredulity. I have watched OB residents literally panic at a code while I calmly grab what is necessary and begin placing central and arterial catheters. Why? Because I spent 3 years working in a Level 1 trauma facility and 3 months in the ICU this year. You see these cases and it seems that they are somehow “more significant” anecdotes to you. Dr. Gorski, I reckon, has much more experience in these matters and is less excited. And that is the point – the anecdote is in the eye of the beholder and saying one anecdote is better than another is like saying two cheerios is better than one.

      That alone is not enough, but with all the rest of the evidence, including basic science and first principles, it seems pretty damned reasonable to have some confidence and call a TV segment that harps on how scary this is fear mongering. I mean really, would you tell your patients that if they take aspirin they could develop a lethal bronchoconstriction? Because they can. Or that if they walk outside they may get struck by lightening and they should consider the risks and benefits and see what makes sense to them? Of course not. That is just stupid. And, coming from a physician, your patient may think your aspirin admonition to be silly but at the same time find it concerning enough that they may never take an aspirin again, even if it would really benefit them.

      And that is exactly what you are advocating here. Taking something just as likely and demanding that we take the time to discuss the insanely minute chance that it may be a real phenomenon and then leaving it up to the patient to decide how minuscule that really is and what it means to them. Quite frankly, Peter, that is somewhat cruel to our patients. We should be able to provide them comfort, both physical and mental. And taking the time to give credence to such incredibly unlikely outcomes accomplishes nothing but waste your breath at best and invoke anxiety in your patient at worse. When tucking your child into bed, if they ask “Daddy, will I die tonight?” Would you say “No! Don’t be silly!” or would you say, “Well, it is indeed extremely unlikely, but it is not inconceivable that a murderer could break in tonight and before I am aware of it kill you and abscond. Now sleep tight!” And that scenario has a much higher likelihood of happening than a cell phone causing breast cancer!!

      I can already predict your response – we are physicians and have a higher standard and a delicate social contract. The scenario is fundamentally different. No, not really. We are also still human and so are our patients. Why would I subject my patient to anxiety and mental consternation but not my child with even less evidence and reason to do so? And you do, supposedly, agree from a scientific basis as to the evidence and science that tells us how unlikely this is. Yet you still want to say our stance is much too staunch and aggressive on the issue. Well I’m sorry Peter, but thanks to Dr. Oz fishing for such ludicrous segments for his show, there are undoubtedly now thousands if not hundreds of thousands of women out there who are now going to live with at least some glimmer of concern that they may be at a higher risk for cancer and, even worse, think they may be at fault if, by chance, they actually get breast cancer. And for no goddamned good scientific reason, just the barest grasping of straws with the protestations of “but, but, it could maybe happen and we should say so.” Yeah, about a million things could happen. We also have a social contract to help our patients understand the magnitude of risk they are actually exposed to and actually offer them comfort when that risk is so infinitesimally small.

      Now, in between all this caring about my patients and other people’s feelings, I’m going to go sneak in some good ol’ being a big ol’ aggressive meanie.

      1. David Gorski says:

        Take note though that we have never once used it as simply a means to dismiss your argumentation. We have explained, quite extensively actually, what it means to be a tone troll and why your writing fits that description. It is not an off hand comment intended to silence or marginalize you.

        What’s also so incredibly frustrating is that, when we engage Peter and try to get him to give a reasonably specific description of how he would do things differently, invariably we don’t get it. We just get more complaining about “tone.” Peter might actually have something to say that I should listen to, but I would never know, because he never actually says anything other than that I’m a big dogmatic meanie who is too sarcastic, too dismissive, and too certain for him. OK, Peter, I get it. I get it. You’ve repeated that ad nauseam.

        Now tell me how, specifically, you would communicate this message. And, as I requested before, explain to me why you are so horrified that I refer to links between cell phone radio waves and cancer as bullshit, while you have no problem correctly referring to various forms of cancer quackery as bullshit (although you don’t use that word), even though on a purely scientific basis there is more reason to think that supplements and coffee enemas might have an anticancer effect (they are, after all, introducing chemical substances into the body that might have antitumor activity) than there is to think that radio waves have carcinogenic effect, given the lack of a mechanism.

        1. Andrey Pavlov says:

          Now tell me how, specifically, you would communicate this message.

          Now, to be fair, he has – at times – given some indication here. Basically he is saying we should hedge our bets so hard and so far that anything must be framed from a very Milquetoast position wherein we always offer the risk, no matter how tiny, and then try and explain how tiny that risk is and give the patient the benefit as well so that they may make the valuation judgement.

          This is I believe, in a technical sense, an attempt at utmost patient autonomy. I’ve recently been in an argument with a different physician about this and he essentially feels similarly – that everything must be left up to the patient and anything less than 100% full and utter respect of autonomy is paternalism. The problem is, as has been written about here numerous times mostly by Drs. Novella and Hall, is that there is no such thing as 100% pure autonomy. The patient cannot, by definition, make such an informed and nuanced decision because in order to do say they would have to have our level of education and training. And even we can’t be fully autonomous outside our field of expertise.

          The pitfall that Peter doesn’t seem to see or recognize which we are implicitly and explicitly saying here is that merely by virtue of the inequality of the doctor-patient relationship (which can never, ever, ever be truly equal no matter how much we strive for it) we can never possibly convey to a patient the true minusculity of the risk involved here. Any mention of risk from us will invariably inflate the risk in the mind of the patient. We can speak academically of such matters and appreciate the reality of the risk, but people are people. We do not, in our every day lives and experience, consider such small risks. There are simply too many of them for it to be reasonable. And even as physicians we live and experience this. After an incredibly rare complication that leads to the death of a patient, how many of us would not be hypervigilant and take extraordinary measures to prevent it in the future, even though we know the risk is so tiny and it was merely bad “luck” and enough time that led to that specific complication in the first place?

          So yes, I believe in a way Peter has told us what he thinks we should do. But it is very simplistic, honestly somewhat trite, lacking in nuance, and – most importantly – simply a point we disagree on. And that’s the end of that. Except for Peter who is trying to convince us that there is more profundity to his charges despite being able to come up with anything more than what amounts to tone trollery.

          At least, that is my take on it. Perhaps I am mistaken.

          1. David Gorski says:

            I don’t believe that you are.

            However, to get at Peter’s apparent message requires delving through post after post in which he hints at what he means, says sort of what he seems to mean, and suggests what he might mean, all without his actually clearly stating what, exactly, it is that he means. That’s why your interpretation of what he means, while defensible, took a lot of wading through Peter’s verbiage to come to.

            Even after you do that, all you’re left with is an approach even more flawed than any approach we might use coupled with attacks on anyone who advocates a more muscular approach as having the wrong “tone.” It’s very unhelpful and comes across as nagging.

            1. Andrey Pavlov says:

              Agreed. It certainly has taken significant wading through his verbiage to get to some semblance of what I think he is trying to say… all without the edification of him actually saying what it is he is actually trying to say. And as you know, Peter and I have shared the word or two over the past few years. The tricky part is that he simply refuses to be pinned down on something; which is part and parcel with what I have divined as his message – never get pinned down and just lay out everything and let someone else (the patient) decide. It completely unburdens him from taking responsibility for putting his money down on something. I had this discussion with Dr. Hall when she and I had dinner together at TAM this year and we were both in agreement – he is simply constantly slippery in his language and will only go so far before changing gears. At the time we concluded it was that his own thinking was muddled, but perhaps that is merely what he is attempting to advocate even though he can’t (or won’t) verbalize it. Or some combination of the two. Mind reading was the class I did poorly in during medical school.

              The crux, methinks, is that I feel we, as physicians, should take some ownership and responsibility for the decisions we make with our patients. It is a partnered decision and yes, we can be wrong and culpable for it. Peter seems to be thinking that wrong decisions can tarnish our profession and lead to distrust from our patients which we can nary afford. I agree with him, to an extent, but for me the solution is not passing the buck to our patients but being utmostly transparent with our own decision making process, what we expect, and what we (as in me and the patient) will do if we turn out to be wrong. The data overwhelmingly supports the idea that physicians being up front with patients and apologizing for mistakes leads to fewer law suits, better outcomes, and good patient satisfaction. Patients are people just like we are. For the most part they don’t expect us to be perfect, but they do expect us to make it abundantly clear we are working together with them for the best outcomes and health.

              No matter what angle I try and attack it from, it simply doesn’t support what I think he is trying to say. It’s not that it isn’t a possible strategy nor that it is completely outside the realm of what the hard empirical science says on any given narrow topic. It is just that as a whole there is plenty of evidence that it is simply an inferior approach for myriad reasons.

          2. windriven says:

            I’m with Gorski on this Andrey. Peter has been invited to do a guest post to lay out his argument in detail. He has been asked in this thread and some others to lay out his argument with specificity. But he hasn’t.

            Peter’s position has some real appeal to me. I think. But I’m never quite certain that what I agree with is what he actually means.

            1. Andrey Pavlov says:

              @windriven:

              I don’t know that Dr. Gorski was in disagreement with me. But, as you say, the point is that Peter will just never outright tell us in clear and unambiguous language what it is he means. Which is why I am trying to piece it together and you think you might agree with something of what he says. I doubt any of us would give it this much time and consideration if it were some random troll, but he is smart, scientific, clinically trained, and does make valid points. At a minimum I feel it is useful for me to keep guessing at it and poking and testing and prodding so as to see if I can figure out something useful for myself. In essence to use Peter as a foil even though his intent is (I think) not that. I have yet to be significantly swayed.

              1. windriven says:

                “I don’t know that Dr. Gorski was in disagreement with me”

                I took it as you having been in disagreement with him :-)

                “I feel it is useful for me to keep guessing at it and poking and testing and prodding so as to see if I can figure out something useful”

                Agreed! I just wish Peter would help you (us?) along.

                I am coming to believe that Peter takes an ad hoc approach to to the BS-line rather than having a well defined a philosophically consistent BS-line against which he measures the subject at hand. If so, we’ll always be guessing.

    3. Andrey Pavlov says:

      To add to my aspirin analogy, it is even worse. Would you go on TV and say, “As a physician and academic scientist, I’m here to tell you that aspirin could cause lethal bronchoconstriction.” How many people do you think will happen to die for a completely unrelated reason shortly after taking an aspirin? How much anxiety do you think that would cause to people? How many people who need aspirin for their CV disease would stop taking it? How many would die as a result? Isn’t even one of any too many? But the same kind of fear mongering with cell phones is OK (granted I think it much less likely for people to die from this one, but harm is harm)

  31. PMoran says:

    “I am coming to believe that Peter takes an ad hoc approach to to the BS-line rather than having a well defined a philosophically consistent BS-line against which he measures the subject at hand. If so, we’ll always be guessing.”

    If you are referring to the “bullshit line”, my response would be that “bullshit” is not a useful scientific or philosophical term. It is an emotional response to a disputed proposition. It has its place, I guess, but not in serious scientific analysis.

    I do have overarching principles –.

    That all scientific knowledge is tentative, although it would be ridiculous to seriously dispute some propositions.

    That the degree of rightness of wrongness of a proposition depends upon the precise claim and the strength of the evidence, but that any MEDICAL action that that may be taken on this basis will be influenced by other likelihoods, context, cost, and the potential consequences of making a wrong judgment.

    An important principle is that as physicians the welfare of the public and our patients is our dominant concern and that science is to serve that, not the other way around. For many of the purposes of medicine we cannot defer action while awaiting the levels of certainty that underpin “knowledge” for “purer” scientific disciplines, such as physics and chemistry, although we do aspire to that.

    Taken together, these principles mean that if a tiny, or faintly conceivable, but very serious risk, can be prevented at the cost of missing of an occasional phone call (i.e. turn the phone off if keeping it in your bra) , or perhaps minimised by switching unneeded cell-phone services such as GPS off, then might not the trivial precautions required be appropriate temporary measures for the level of risk, or likelihood of risk, while awaiting more information?

    It is a matter of subjective opinion either way, but which is more responsible? Which one can look like a reflex, unthinking or poorly understood dogmatism, potentially arousing even further anxiety in some? This is at least a suitable matter for debate, rather than another reason to analyse my supposedly muddled behaviour and impenetrable mouthings so that everything can still be made to look right with our individual worlds!

    We go on and on about a relationship with our patients based upon openness and mutual trust yet here it assumed that that kind of communication with the general public is impossible and fraught with unspecified dangers. This is due to our confirmation biases, our constant exposure to the worst of human medical intellectual activity..

    While in general we seek the highest standards of evidence in medicine, and we can privately reserve judgment in as strong terms as we like, we do have other responsibilities. Sure, defend the integrity of science and its processes, but keep some sense of proportion and an awareness of our undoubted personal and collective fallibility.

    .

    1. windriven says:

      “If you are referring to the “bullshit line”, my response would be that “bullshit” is not a useful scientific or philosophical term.”

      We’ll agree to disagree on this. One might choose a more elegant term but ‘bullshit’ captures the essence, if you will, in one simple word. Scientific certainty about very nearly anything, as you suggest, falls somewhere on a continuum ranging from false (the moon is composed entirely of cheddar cheese) to almost certainly true (consistent MAP greater than, say, 130mmHg is a good predictor of elevated risk for CVD). My bullshit line is that place on the continuum where absence of scientific plausibility and lack of profound empirical affirmative evidence coexist. Homeopathy falls on the BS side of that line. Coffee enemas as cancer treatment fall on the BS side of that line. Subluxation theory falls on the BS side of that line.

      Thank you Peter, this is the money paragraph:
      “Taken together, these principles mean that if a tiny, or faintly conceivable, but very serious risk, can be prevented at the cost of missing of an occasional phone call (i.e. turn the phone off if keeping it in your bra) , or perhaps minimised by switching unneeded cell-phone services such as GPS off, then might not the trivial precautions required be appropriate temporary measures for the level of risk, or likelihood of risk, while awaiting more information?”

      I think, and do correct me if I’m wrong, that your BS line on the continuum is extremely close to the ‘as false as geocentric theory’ end. This might suggest physicians counseling new parents to never allow their child to eat a peanut because the child might conceivably have an allergy and that could lead to anaphylactic shock and even death. People can live without active cellphones in their bras and they can just as easily live without peanut butter sandwiches.

      “It is a matter of subjective opinion either way, but which is more responsible?”

      I don’t see it that way. A physician need not tell her patient that cell phones do or do not cause breast cancer. Either statement would be incorrect. But there is nothing to prevent a physician from telling his patient that there is neither evidence nor even scientific plausibility that cellphones in bras cause breast cancer.

      Medicine is a less certain science than physics. But sinning so far to the side of caution that one avoids anything with the most remote possibility of being a risk or embracing anything that has even the most remote possibility of being beneficial is neither scientific nor, in my non-physician opinion, a service to patients. These are opposite sides of the same counterfeit coin.

      1. Andrey Pavlov says:

        @windriven:

        Well said. I particularly liked the peanut butter sandwiches and counterfeit coin. Absolutely spot on.

      2. MadisonMD says:

        Pmoran: These decisions do not exist in a vacuum. If you are not putting your cell phone in your bra you are doing one or more of the following:

        (1) Putting it in your trousers pocket, accepting the infinitesimal risk of incurring cancer of the testes, vulva, or lymphoma originating in inguinal nodes, although no such mechanism is suspected given current state of knowledge of biology and physics.

        (2) Putting it somewhere else on your body, incurring the infinitesimal risk of incurring skin cancer (although again no reason to suspect this).

        (3) Not carrying it at all, in which case you could find yourself accepting the infinitesimally likelihood that a very large boulder should roll onto your leg and you are unable to reach help, and so no emergency call is possible without said cell phone.

        (4) Turning the phone off, thereby dispensing with at least half of the utility of carrying one in the first place, and yet still actually holding it to the side of your head when using it. Again you are of course accepting the infinitesimal and unlikely effect on cancer of the brain although such an effect is implausible and no such association has been seen even. Perhaps however we could concede that this is a touch less implausible than other cell phone cancer risks, though since, well, this is when the phone is actually emitting radiation.

        Thus, these decisions do not live in a vacuum but as a series of alternatives of choices with unlikely but not provably zero risk.

        Keep in mind that whereas this post is about cell phones and breast cancer, there are, of course, an infinite number of ways we can incur serious risks with infinitesimal likelihoods. How many of these unlikely risksmust we give ask the public to heed? Shall we only give Ozian warnings that prey on popular misconceptions? (e.g. all radiation causes cancer.) Or should we simply advise avoiding all avoidable risks (peanuts, driving to the movies, putting a laptop well on our laps?).

        Now lets ignore the sheer impossibility of warning the public against every implausible risk. If we do try to ask the public to heed them all, might it dilute the more important messages– to get vaccinated, stop smoking, wear seatbelts, don’t overeat, don’t drink too much? Moreover would the warnings against cell phone use perpetuate the misconceptions of the scientifically illiterate? (After all, two posters in this thread already posed the question of why manufacturers recommend you keep phones away from your skin–as if this were proof of the dangers.)

        Your argument about the possible serious consequences of wrong judgement seems compelling at first blush. However, when I consider the ramifications, I can only conclude that it is both impractical and advisable.

        1. MadisonMD says:

          typo: impractical and inadvisable.

        2. Andrey Pavlov says:

          @MadisonMD:

          Exactly what I wished I’d said and extremely well done.

      3. WilliamLawrenceUtridge says:

        “Taken together, these principles mean that if a tiny, or faintly conceivable, but very serious risk, can be prevented at the cost of missing of an occasional phone call (i.e. turn the phone off if keeping it in your bra) , or perhaps minimised by switching unneeded cell-phone services such as GPS off, then might not the trivial precautions required be appropriate temporary measures for the level of risk, or likelihood of risk, while awaiting more information?”

        Well, what if the woman with the cell phone is in end-stage kidney failure, and turns off her phone just before a kidney becomes available for transplant? Boom. Pete Moran’s advice to turn off your cellphone while holding it a bra just killed a woman. I mean, that seems like the very definition of a tiny, or faintly conceivable, but very serious risk.

    2. Andrey Pavlov says:

      @pmoran:

      Well, windriven really hit it home but there are still a few points he neglected that got me.

      Firstly, I – and I would wager Dr. Gorski – agree wholeheartedly with your first three paragraphs of overarching principles. 100% concordance.

      The rest of it though, is where we differ. And where I think you make a series of errors.

      Firstly, you admit your assessment is just as subjective. Yet your standard argument against us is that we step outside the boundaries of rigorous science. Well, any subjective assessment does and you are doing it just as much as we are.

      Which is more responsible? How about not volunteering information about each any every infinitesimally possible harm out there? That is, by the way, the definition of scaremongering. And if our patient asks us, yes, we tell them that while it is a hypothetical possibility so is just about everything else one can imagine and in this case it is so unlikely and so unsupported by the evidence, that they needn’t worry about it. And most certainly they needn’t blame their cancer on it and by extension themselves. We do not merely present the data and let them decide what it means to them. We assuage their fears. Nobody here has been suggesting hiding the data from them. But presenting as Dr. Oz has is fear mongering and is unnecessarily harmful to patients.

      You may not like Dr. Gorski’s particular verbiage and adjective use, but that is – yep, you guessed it – tone and style. And someone who criticizes that is… a tone troll.

      We go on and on about a relationship with our patients based upon openness and mutual trust yet here it assumed that that kind of communication with the general public is impossible and fraught with unspecified dangers.

      Hey Peter. Try this one day. Walk into a patient’s room and just very nonchalantly say, “Hi Mrs. Jones! There is a small, very small, chance you may have cancer.” Now, pause for a moment and then say, “The risk is actually exceedingly small. In fact, there really isn’t much particularly compelling evidence but there have been a handful of stories that seemed unusual and could be similar to you. Anyways, it really is basically nothing to worry about, I’m sure you’ll be just fine.” What do you think Mrs. Jones will do? Assess your level of risk and realize how small it is and feel fine? Or may she needlessly worry herself until you finally come to the final diagnosis?

      Or what if Mrs. Jones asked you if [x] could cause cancer? Perhaps we should warn our patients that PVC can cause cancer. You can manage your life without having to touch PVC. Maybe. But hey, the risk is there (and actually has a higher prior probability than cell phones and cancer). So perhaps we should warn her about that while we are at it.

      So no, as much as you’d wish it, our speech carries with it certain weight. Regardless of how much we wish it didn’t and strived to minimize it. People hear “cancer” and then not a single word after that. People with cancer and in despair often look to blame themselves. We must consider our words and our cautions carefully because yes, they do carry with them unforeseen dangers. And my patient’s psychological well being is important to me as well.

    3. WilliamLawrenceUtridge says:

      That’s great Peter. We’re all very impressed with your philosophical approach. One question:

      Given what is known about cancer, cell phones, chemical bonds, electromagnetic energy at the level used by a cell phone, skin penetration of EM radiation within that band, the demographic characteristics of cell phone use and breast cancer, DNA repair mechanisms, and all the other background knowledge and clinical trials involved in testing for associations between cell phones and cancer, if you had a daughter, would you tell her to avoid putting her cell phone in her bra strap?

  32. PMoran says:

    Windriven, I found someone who expresses the situation better than I have. This is from a publication called “Late lessons from early warnings: the precautionary principle 1896–2000″ of the European Environmental Agency. It has a collection of cases where early warnings were dismissed by science and industry.

    Quote –

    “The bias in science towards avoiding false
    positives (very much in evidence in the above — PJM) inevitably involves generating false negatives, which, if they are human and or
    environmental disasters, as in most of these
    case studies, is not sound public policy.”

    My question for you, and anyone else interested : “If there were an ‘early warning’ about cancer from certain uses of cell-phones, what would it look like?”

    Re your example — there is a third and more sensible option – test your child out with a peanut product while being prepared should there be a reaction. That would avoid the “test” otherwise catching everyone out unawares and unprepared, as is usual.

    1. windriven says:

      Peter, I do understand your position now. Andrey and Madison have already touched on the response that I would forward: when does the abundance of caution cross the line into fearmongering?

      Madison asked, ” If we do try to ask the public to heed [cautions on extremely remote possibilities], might it dilute the more important messages– to get vaccinated, stop smoking, wear seatbelts, don’t overeat, don’t drink too much? I think this is an important argument. When the boy cries wolf too often, his cries cease to register – even when the threat is quite real.

      Excessive caution carries its own risk too. Historically, breast cancer was treated with increasingly aggressive surgical approaches until eventually breast cancer surgery was horrifically mutilating. Surgeons wanted to track down and remove every possible cancer cell for fear the disease would recur.

      In quite recent times we have tested broadly and aggressively (if not with great certainty) for breast cancer and prostate cancer. False positives and inconclusive results led to untold numbers of biopsies and other invasive procedures but did little to move the dials of longevity or quality of life.

      Our disagreement is one of degree rather than kind. It is important that physicians communicate important risks to their patients: diet, exercise, smoking, and so forth. But there is a point of diminishing marginal utility where the list gets longer and the risks get smaller and people simply stop listening. It seems to me a choice between hammering in a few big consequential nails versus playing a never ending game of whack-a-mole.

      1. David Gorski says:

        I think that Peter’s answer, while somewhat clarifying, still leaves my key question unanswered. It is a question that both Andrey and I asked: How certain do you have to be before it’s justifiable leave out all the waffling and caveats? Or, to put it another way, what degree of uncertainty is necessary to make the inclusion of waffling and caveats necessary? His answer seems to suggest that no level of certainty is enough, and that’s where I have a problem. One notes that I actually did include some mild caveats in my post, to the level that I thought appropriate given the topic and the level we have about the scientific certainty of the topic. Peter nearly completely ignored them, focusing obsessively on the title of the post above nearly all else to castigate me as somehow being dogmatic and too certain. Indeed, in that I freely admit that I think that Peter done me wrong, so to speak. He also is relentless in his complaints about “tone,” which never fails to irritate, particularly when he can’t seem to offer anything of substance. That’s why I now applaud him for at least trying, even if his attempt falls flat.

        In any case, the key issue is the reason I brought up the example of homeopathy, and perhaps Peter can answer a rephrased question based on that key issue: Why is is OK to say that homeopathy doesn’t work, without qualifying such a statement? (I note that Peter, if he’s read any of my posts on homeopathy, should know that even for homeopathy I frequently qualify it by saying that there is an infinitesimal chance that homeopathy might work, but for it to work several major tenets well established in physics would have to be not just wrong, but spectacularly wrong.) The physical principles governing low energy radio waves produced by cell phones are nearly as well grounded in physics and chemistry as the principles that say homeopathy can’t work. The only area where there is less certainty (and, quite frankly, not that much less) is in the mechanisms of carcinogenesis that might be impacted by cell phone radio waves. Yet, to Peter it is an abomination to be too certain in writing about the lack of risk of cancer due to cell phone radiation. In other words, there is a very marked inconsistency there, and I want to explore that inconsistency because it is at the heart of the problem: How certain is certain enough?

        Windriven is correct to bring up the example of vaccines, seatbelts, and other such risk reducing strategies that carry a tiny risk. I would say that vaccines have such a low risk that it doesn’t make much sense to say anything other than that they have an incredibly low risk of causing significant harm. Seatbelts have a higher risk of causing injury, but the risk-benefit ratio of wearing them (i.e., one’s chance of dying or suffering serious injury in a car crash if you’re wearing seatbelts versus the chance if you’re not) is very much in favor of seatbelts. So, tell us, Peter: Why is homeopathy obviously quackery, and we don’t have to qualify saying so by conceding a tiny chance that it might work, but cell phone radiation, even though almost as likely on purely physical principles to be harmful as homeopathy is likely to help, must always be treated as though the risk is credible? Remember, again, I’m the one who routinely gets into minor scuffles with skeptics on this issue because I concede a tiny possibility that there might be a physical mechanism by which cell phones could have biologically significant effects that might even lead to cancer. You praised me for the post. Most others ripped me a new one.

        1. windriven says:

          “Why is homeopathy obviously quackery, and we don’t have to qualify saying so by conceding a tiny chance that it might work, but cell phone radiation, even though almost as likely on purely physical principles to be harmful as homeopathy is likely to help, must always be treated as though the risk is credible?”

          I believe that it is the positive/negative risk balance that shapes Peter’s approach. Homeopathy has zero ‘risk’ of doing anything good and nearly zero risk of doing harm – other than dissuading someone from seeking competent medical advice. Cellphone radiation has nearly zero risk of causing cancer but in his calculus the potential damage if it does cause cancer is so catastrophic that he sins to the side of caution. If this accurately conveys his position, I would argue that it is misguided for the reason that there are so many infinitesimally tiny risks that taking action to minimize or eliminate them all would be a full-time job, would create ‘risk fatigue’, and would do little or nothing to improve the human condition.

          “complaints about “tone,””

          An uncompromising tone taken with those who are disingenuous or who seek financial or ideological profit at the expense of the vulnerable seems reasonable to me.

        2. Harriet Hall says:

          Peter espouses the precautionary principle. At first glance this seems eminently reasonable: if there is any chance of a risk, why not avoid it just in case? There is a problem with this reasoning. Sometimes when we avoid one thing, we substitute something else that has not been tested. There are many examples where the substitution did more harm than the original. For instance, thimerosal was removed from US vaccines on the precautionary principle, although there was no evidence that it caused harm. For a time, hospitals delayed newborn vaccination because there was no thimerosal-free product on the market: at least one baby died as a result. Before you recommend avoiding something, it is incumbent on you to make sure the alternate course is not equally or more harmful. Here are some examples of the “law of unintended consequences:” http://www.aei-ideas.org/2013/11/ten-examples-of-the-law-of-unintended-consquences/

          1. Pmoran says:

            Harriet: “Peter espouses the precautionary principle. At first glance this seems eminently reasonable: if there is any chance of a risk, why not avoid it just in case? There is a problem with this reasoning. Sometimes when we avoid one thing, we substitute something else that has not been tested”

            Yes, someone might miss out on an important phone call until they can next switch their phone on!

            You are right, of course, but everything in medicine is about context (one of MY principles), so that a principle that is highly relevant to one setting, will scarcely figure in another.

            You and I have had other discussions where I have referred to science’s typically intense error-aversion. A degree of that is necessary if Science is to fulfil its role as a seeker of and guardian of what is true.

            But it can lead to serious mistakes, because once having adopted an extreme sceptical stance, few find it easy to switch to “I might be mistaken”. The tendency is to keep on finding reasons for doubt even as the evidence strengthens bit by bit and is calling for some backing off.

            It may be in part a protection against this undesirable phenomenon that authentic scientific language has come to be smothered in qualifications and caution: “The available evidence suggests –” etc.

            1. WilliamLawrenceUtridge says:

              But it can lead to serious mistakes, because once having adopted an extreme sceptical stance, few find it easy to switch to “I might be mistaken”.

              I find this hilarious that you say this Peter, since I think this sort of contrarian tendency is what starts you down your road to tone-trolling.

              Peter, would you counsel any of your patients regarding where to stow their cellphones?

    2. Andrey Pavlov says:

      “If there were an ‘early warning’ about cancer from certain uses of cell-phones, what would it look like?”

      Well, considering how incredibly wide spread cell phone usage is and has been for a decade or so, I’d expect to see an increase in overall cancer incidence.

      A better question is: “If there were something that weren’t an early warning sign what would it look like?” If we had nothing else to back us up, sure I could maybe consider some sort of admonition that it may be better to keep the cell phone out of the bra. But we have those first principles to inform it even more.

      And, as Madison pointed out, we’d expect much more OTHER cancers as well, regardless of where we kept the phone. Why is it that the breast is such a special part of the anatomy? Are you now going to postulate that there is some tiny signal in the noise JUST for breast cancer? That somehow the radiation from cell phones specifically targets ductal cells? Or is it perhaps because in this case it is directly next to the skin whereas in others it is separated by a bit of fabric and a centimeter or two of distance? Because if that is the case, how would you expect the radiation to penetrate down to the ducts? Water is an excellent shield against radiation, so why would it be unable to penetrate a few mm of fabric and a centimeter or two of air (both very poor shields) but be able to penetrate through the cm or two of water laden tissue of the breast to induce ductal carcinoma?

      How far down the rabbit hole of prior probability do we need to go before you will admit that it is simply ludicrously overcautious to be concerned about cell phones in bras causing cancer?

      And that is all still neverminding Madison’s other point that the cell phone doesn’t actually even emit 99% of the radiation it does emit unless it is on. Are women now having the bulk of their phone calls while the phone is still in the bra? Why aren’t we seeing more GU cancers from people keeping the phone in their pockets while talking on bluetooth or wired headsets? Somehow the cautionary “early warning sign” is these slightly interesting but actually unremarkable coincidences, so small they are well hidden in the background noise?

      And your justification is that it is trivially easy to simply take the phone out of the bra? Your argument is “hey there! take this thing out of your bra because we think it may actually increase your risk of cancer and put it somewhere else very near your body” And you do realize that, on the whole, if you had to get cancer from your phone breast cancer would probably be the best one to choose? It has the best combination of likelihood of early detection and treatability. Skin cancer, sarcomas, reproductive cancers are all much less likely to get diagnosed early and/or have less success in treatment.

      Seriously, how far down the line of prior probability must we go before it becomes ridiculous for you? It would be simple and cheap enough to advise everyone to wear a safety helmet at all times because of the non-zero chance a meteorite, bullet, or otherwise randomly falling projectile could hit you in the head as well.

    3. David Gorski says:

      Windriven, I found someone who expresses the situation better than I have. This is from a publication called “Late lessons from early warnings: the precautionary principle 1896–2000″ of the European Environmental Agency. It has a collection of cases where early warnings were dismissed by science and industry.

      Quote –

      “The bias in science towards avoiding false
      positives (very much in evidence in the above — PJM) inevitably involves generating false negatives, which, if they are human and or
      environmental disasters, as in most of these
      case studies, is not sound public policy.”

      This is a bit of a “science was wrong before” trope. It all depends on how well-established the physical science is. I like to go back to the example of homeopathy. I suppose there is a chance that multiple laws of physics and chemistry that rest on a very solid foundation of research and theory are not just wrong, but spectacularly wrong (which is what would have to happen for homeopathy to work), but it’s highly unlikely. In the case of cell phones in cancer, the physical laws of radio waves and their interaction with matter are as well established as the laws that make homeopathy physically impossible barring some new massively disrupting scientific discovery. This is very different than, for example, tobacco companies denying that smoking has adverse health effects, because there quite literally is no plausible physical mechanism for cell phone radio waves to cause cancer. In contrast, even back in the 1950s and 1960s, believing that there were carcinogens in tobacco smoke didn’t violate any physical laws and was quite plausible. Postulating that there were chemicals in the smoke that could contribute to heart disease and lung disease was not outside the realm of understood science.

      My question for you, and anyone else interested : “If there were an ‘early warning’ about cancer from certain uses of cell-phones, what would it look like?”

      It would not look like this. Really, it wouldn’t. The correlation between where the cell phone was carried and the tumors isn’t even that convincing, if you know that cell phone radiation doesn’t come from the whole phone, but just from the radio and antennae, which occupy a fairly small area in the phone and that the energy of this radiation rapidly falls with distance. Then there’s the issue of timing. Tiffani, for instance, claims she was wearing her phone in her bra for 4 years. Biologically, that’s really not enough time for breast cancer cancer development due to carcinogens, which usually takes considerably longer. If there really were a link between cell phone radiation and breast cancer, we’d expect the signal to show up more like a decade, or even more, later. Even for ionizing radiation used in treating, for example, mediastinal Hodgkin’s lymphoma in the chest in teenaged girls, it usually takes two decades or more before the elevated breast cancer risk from the exposure to ionizing radiation rears its ugly head, and we’re talking significant doses here, way more than a few X-rays or mammograms.

      So that’s the point. Not only is there no currently known plausible mechanism, but this “warning signal” is very unconvincing to anyone who knows breast cancer biology and clinical behavior.

      1. Pmoran says:

        “This is a bit of a “science was wrong before” trope.”

        Why does name-calling figure so much in your debating style, David? As a someone so constantly and heavily critical of the logical fallacies and underhand ploys of others I do wish you would clean up your own act.

        You go on to explain why, in your opinion, this case might be different to all these others, because of what you and many others (and I to a limited extent) believe is super-strong biological implausibility to the question under discussion.

        That is OK, and you make some reasonable points, not previously aired. (The aerial would move around a bit so that one of your arguments is weak. And do phones get hot from battery and circuitry activity? – I have to admit I haven’t yet noticed that).

        Some might like, just to be more sure, some direct evidence that breast tissue in intimate contact with a cell phone for long periods in an already warm environment is not causing some tissue heating, offering a little more certainty that that could not trigger cancer in susceptible young women. bowse around suggests that not all scientists are convinced that the final word has been said on this and related matters.

        But back to the “trope” remark. What does it contribute to the discussion?

        Large sections of the public are already sparing in their trust of medical science. Having a dismissive and demeaning name for the very basis of that mistrust is not going to inspire confidence that we have learnt anything from our past mistakes or have given any thought to what led to them.

        1. David Gorski says:

          Why does name-calling figure so much in your debating style, David? As a someone so constantly and heavily critical of the logical fallacies and underhand ploys of others I do wish you would clean up your own act.

          Why do you so regularly and reliably label criticism of your arguments as “name calling”? It’s not. Seriously, I assure you, it’s not. It’s a criticism of your argument, nothing more. I’m not calling you stupid or anything else; I’m simply saying that I don’t find your argument convincing. That’s it. Maybe it was a little blunt, but that’s all. Yet you seem unable to distinguish criticism of your arguments from insults.

          But back to the “trope” remark. What does it contribute to the discussion?

          An accurate and succinct description of the bad argument you used, that’s what. Your basic argument appears to be that, because some environmental risks have been dismissed before and that dismissal later turned out to be wrong, then the cell phone-radiation link must be taken seriously. As others have pointed out, that’s a bad argument, and it does fall in line with the “science was wrong before” trope, gambit, or whatever you want to call it. Windriven described very well why it’s a bad argument, namely because there are so many other things that could cause an infinitesimally small risk of cancer—a greater infinitesimally small risk even, than the purported risk due to cell phones—that it’s impossible to differentiate between them all and impossible to act on them all.

          Large sections of the public are already sparing in their trust of medical science. Having a dismissive and demeaning name for the very basis of that mistrust is not going to inspire confidence that we have learnt anything from our past mistakes or have given any thought to what led to them.

          Yada, yada, yada.

          You know, I’m getting the feeling that you’re intentionally bringing up “tone” again because you’ve figured out that it gets under my skin. Of course, now that I’ve figured that out, the rhetorical weapon is neutralized. :-)

        2. Andrey Pavlov says:

          @Pmoran:

          I just can’t wrap my head around why you absolutely refuse to cede the point. This has been so thoroughly examined and beaten in that it is simply mind boggling that you are still even remotely holding on to your position. As Dr. Gorski pointed out, even with doses of actually ionizing radiation order of magnitude larger than you can ever hope to get of the NON-ionizing radiation from cellphones it takes a decade or longer to develop breast cancer. In SOME people. So how is a 19 year old girl getting breast cancer from her phone Peter? Did they supercharge the damned thing and strap it to her mother’s belly and then keep it taped to her chest from the time she was an infant? Or are you trying to postulate some magical mechanism wherein in SOME people they have magically susceptible ductal cells specifically to cellphone radiation?

          And no, there was no name calling. Seriously. Copy and paste the part of Dr. Gorski’s reply that has any sort of name calling. Even the tiniest hint of it. He refered to your QUOTE as the “science has been wrong before gambit.” That is not calling you – or even IT – a “name.” It is a descriptor of what the quote is saying.

          It is not just super strongly biologically implausible but also has nothing – NOTHING – but a couple of random anecdotes that are much more easily – and likely – explained as mere coincidence. How LITTLE evidence do you need before you’ll just admit something is not there? At what level will your scientific agnosticism finally cede to the reality of practicality and ludicrousness? Is there ANYTHING you will admit simply does not and cannot exist? Or is literally EVERY single imaginable possibility out there something you consider worthy of entertaining in any serious manner?

          Because I am sure I could dig up some very young women with breast cancer who are convinced some sort of invisible spirit being gave it to them. Is THAT finally enough lack of prior probability for you to consider the idea ludicrous? Because you can’t say for SURE that isn’t that case.

  33. Deb says:

    There are not enough hours in the day to complete all of Dr. Oz’s life saving recommendations. Many thanks for the true and scientific information!

  34. Pmoran says:

    Anddrey: “If there were an ‘early warning’ about cancer from certain uses of cell-phones, what would it look like?”

    Well, considering how incredibly wide-spread cell phone usage is and has been for a decade or so, I’d expect to see an increase in overall cancer incidence

    ————————————————-
    Why so? Surely it would be likely to show up first where there was very prolonged and close exposure of a cancer-prone tissue, as here. Those being likely prerequisites for the carcinogenesis, then there may be no detectable impact on other sites for cancer, or one that may take many more decades to show up in the statistics.

    1. David Gorski says:

      I explained earlier why this is not what an “early warning sign” would look like. On this point, Andrey is correct. You are not.

  35. Pmoran says:

    Windriven: “Cellphone radiation has nearly zero risk of causing cancer but in his calculus the potential damage if it does cause cancer is so catastrophic that he sins to the side of caution. If this accurately conveys his position, I would argue that it is misguided for the reason that there are so many infinitesimally tiny risks that taking action to minimize or eliminate them all would be a full-time job, would create ‘risk fatigue’, and would do little or nothing to improve the human condition”

    Agreed, in general, but what we do is influenced by the WHOLE context, remember? THIS risk is in the news. It has been dumped on the plate of medical science, whether it likes it or not, and it must respond. Relevant to how it responds is another aspect of context, that this risk can be so easily avoided, pending further evidence either way.

    So having established that we must present a position on this, is it really wise to respond as disgruntled scientists annoyed at the inconvenience? Or do we respond as doctors who would also be alarmed if young women were being devastated by breast cancer unnecessarily, but who thankfully observe simple ways in which any risk can be avoided.

    We have bridges to build, or rebuild, I might remind everyone.

    I am not sure what you think I am proposing, but what I would tell my daughters is “the risk is by no means established, but for now it might be wise to switch off your phone if carrying it your bra.”

    How it responds should take into account another aspect of context, i.e. that the risk does not have to exist — it can be simply avoided.

    , while
    and I think it must respond with nous , without attempts at self-aggrandisement , and some thought to the constitution of the target audience.

    .

    So is the above going to be your answer, when the image that most of the public has in their minds is going to be very young women being devastated by breast cancer? I don’t think so.

    The other missing aspect to your context is that THIS risk can be simply avoided, pending further reassurance (or otherwise)..

    the answer . It is also a risk, that unlike many others, can be easily avoided pending further reassurance.

    A response is needed, and we must ask what should that be? and can be so simply avoided. It has been dumped upon the plate of science whether we like it or not.

    The question is how do we respond wisely to it? We can regard it as a purely scientific question and get all agitated about too much weight being given to anecdotal evidence and too little to plausibility issues. The public will be thinking of young women being devastated by breast cancer and

    That is a vital feature of this setting, and “everything in medicine is about context”, remember?

    You are still trying to make specific principles and absurdist examples apply to a mtterto rule

    1. Harriet Hall says:

      “Without attempts at self-aggrandizement” ??
      I haven’t seen any such attempts.

      “It is also a risk, that unlike many others, can be easily avoided”
      No, it hasn’t been established that it is a risk; that’s the point.
      Aren’t you committing the very sin you accuse us of: making a dogmatic statement without explaining the nuances or considering how the message will be received by the audience? You might at least have qualified it by saying it is a possible risk

  36. Pmoran says:

    Sorry about the added material. Cur out after “we have bridges to build”.

  37. Andrey Pavlov says:

    @pmoran:

    but who thankfully observe simple ways in which any risk can be avoided.

    How, Peter? Turning off the cellphone when in the bra? What about when it is elsewhere on your person? You still haven’t addressed why cellphones cause breast but no other cancer. What is your evidence that this is the case? If you have none, then you must assume an equal amount of risk no matter where the phone is on your person. So your solution is to keep your cellphone off at all times while you carry it. Is that really reasonable? Really? You DO realize the utility of the cellphone right? And how RECEIVING calls is a big part of that utility? It is wonderful that you seem to be a person who is perfectly content not having a cellphone or at least don’t care if you can receive calls on it. That is simply NOT an option for most people these days. And, even if it were, you are now substituting an infinitesimal risk for a much greater one. What if that woman was to be accosted or assaulted? Do you not think there is some TINY benefit to having your phone on and ready to make a phone call in the VASTLY more likely scenario that a woman gets into some sort of potentially dangerous altercation?

    No matter how you slice it Peter, the risk here is so ludicrously small that ANY substitution is simply a WORSE risk:benefit.

    Oh, but this is in the NEWS. Well, my oh my. Are we not allowed to say that ANYTHING is so ludicrously unlikely that we can just write it off and move on? Is ANYTHING that ANY wackjob like Oz who can get and random tripe into the “news” warrant our serious consideration and changing our behavior over? What if Oz comes out next week and says that the dye in blue jeans may cause auto immine disease? And then the following week that flip flops can lead to acral lentigenous melanoma? Shall we now seriously consider these claims and start admonishing people to switch to khakis and closed toed shoes?

    That’s the point here – where is the line? Where can we FINALLY say that something is so incredibly far fetched that we frankly have better things to waste our time worrying about? Your tack paralyzes us. It leaves us with no option except to constantly wait to give serious consideration to every random, ridiculous, bullshit claim that any crackpot with an audience can come up with. And on top of that admonish people to change their behavior because YOU, yes YOU PERSONALLY, find that the switch in behavior is trivial.

    We don’t have bridges to build or rebuild. We have bridges to defend. And letting those who would like to destroy or occupy our bridges with quackery and nonsense come on over so we can give them serious consideration is precisely counterproductive.

    “the risk is by no means established, but for now it might be wise to switch off your phone if carrying it your bra.”

    What other things could you substite there? What other non-established risks with insanely low prior probability and absolutely no legitimate signal to think it even exists should we modify our behavior over? Because hey, with all the EM radiation all over the place, I feel like I should line my entire house with aluminum foil and sleep in a farady cage. You know, just to be on the safe side, even though the risk has by no means been established.

  38. MadisonMD says:

    THIS risk is in the news. It has been dumped on the plate of medical science, whether it likes it or not, and it must respond. Relevant to how it responds is another aspect of context, that this risk can be so easily avoided, pending further evidence either way.

    Ah, so that’s it. We need only convey the Ozian risks that prey on popular misconception. No need to actually educate folks about what radiation is and what it does. No need to evaluate and warn about less popular risks — even if somewhat more likely. Instead, we should take every misbegotten fear-mongering notion and say, ‘you may be right.’ Then we are obligated to amplify the Oz megaphone — to warn a credulous but scientifically illiterate against each and every fantastically unlikely risk that has already entered the psyche of a fearful public. (You need not concern yourself here with what schizophrenic whisperings might feed into this awesome circular feed-forward amplifier). We will get the message OUT.

    Next, science needs to engage the misconception. To “build bridges,” scientists must stop coming up with plausible hypotheses guided by their own educated notions, and just start watching Oz– the great hypothesis generator. They must investigate phantasmagoria endlessly until each, in turn, is demonstrably false– six sigma minimum and clinical evidence ONLY (no prior plausibility based on accumulated knowledge, please–the public does not trust preconceived notions of established scientific cognoscenti). Once we have accomplished this, then we will have built a bridge and earned the public trust.

    As a shining example of the success of the above approach, science did engage in the vaccine-autism scare. Fortunately, the science clearly demonstrated there is no currency in the vaccine-autism hypothesis and laid the issue to rest forever, to the eternal opprobrium of a grateful public.

  39. MadisonMD says:

    Now, then. Going back to my original point. Until anyone *proves* me wrong, I plan to amplify the message that reindeer with bright shiny noses might be able to fly. After all it is such a nice notion and I do want to build bridges with the public this time of year–especially the young’ns.

    Happy Holidays pmoran and all.

    1. mousethatroared says:

      If I ever see a real reindeer with a actual glowing red nose, I WILL assume it might be able to fly. Although not to the point that I would jump on his back and ride off a roof-top.

      Just sayin’…

    2. Andrey Pavlov says:

      Here, here! And Happy Holidays to you as well MadisonMD!

      1. windriven says:

        Merry Atheistmas and a generic, non-denominational, racially sensitive, gender neutral happy holidays to those who are not otherwise offended by these wishes.

  40. Dave says:

    Good Lord! 182 comments on whether cell phones are a cancer risk. The safest thing you can do with cell phones is to put the damn things ANYHERE but in your hands when you are driving! Dr Oz should be commenting on that!

    1. David Gorski says:

      It’s largely because there is someone who thinks that I’m being too blunt and dismissive about Dr. Oz’s fear mongering without evidence. Even though he says he mostly agrees with me, he apparently thinks that we should take seriously every bit of sensationalistic fear mongering that Oz comes up with, no matter how little science or clinical evidence there is to support it.

      1. Andrey Pavlov says:

        he apparently thinks that we should take seriously every bit of sensationalistic fear mongering that Oz comes up with, no matter how little science or clinical evidence there is to support it.

        Exactly the point of my last post to Peter. Just because something gets sensationalized we MUST take it seriously? Then we can all hang around being navel gazers and wondering how many angels it takes to fly from your cellphone to your ductal cells to succesfully inhibit p53.

    2. mousethatroared says:

      Well, to be fair a good amount of the comments were on the lack of pockets in women’s clothing. Which annoying regardless of dr. Oz’s drama.

      Enjoying your comments, by the way. Thanks for taking the time to add your perspective.

  41. Dave says:

    I do understand where the numerous posts are coming from. It seems like worrying about a miniscule or non-existent cancer risk is far outweighted by the other obvious risk cell phones have. A little like straining at gnats but swallowing camels. I had a similar feeling on the cholesterol guidelines post. Lots of people, most of whom I am sure had never seen a person in cardiogenic shock, were hung up on the side effects of largely reversable myalgias and ignoring the admittedly less frequent but irreversible and potentially lethal problems of heart attacks and strokes.

    By the way, thanks for this website. I’m not sure how many minds you change but there is value in the education. It gets people thinking. I hope I’m contributing.

  42. PMoran says:

    “How, Peter? Turning off the cellphone when in the bra? What about when it is elsewhere on your person? You still haven’t addressed why cellphones cause breast but no other cancer.”

    Andrey, you also wonder why I have not yet bowed to the pressure of superior argument/evidence, and weight of numbers.

    One of the things that leaves me uneasy is that the level of conviction I am being asked to embrace is based upon some less than convincing argument. Why is that so, if your own conviction is based upon a serious personal examination of the matter, rather than habitual allegiances and habits of mind?

    Some examples: firstly the matter quoted above was raised by MadinsonMD and others, and, IIRC endorsed by Dr Gorski.

    This is the tenth time I have had to point out that the phone in bra example involves unusually intimate and prolonged exposure of cancer-prone tissue. THIS is why cancers occurring in this setting could be an early warning of a previously unsuspected, and possibly very use-dependent problem with this recently introduced device. Possibly or perhaps probably not, but not definitely so.

    I was also factoring in the large Danish study, the one offering evidence that cell phones probably don’t cause cancers of the head and neck or brain, at least with the levels of exposure reached thus far.

    But in that study the exposure was different and the exposed tissues markedly less cancer-prone. There is thus no reason at all why the risk would have to be the same wherever or however you used your phone.

    The plausibility argument has some little weaknesses, too. It is mainly based upon the assumption that any processes involved would have to behave much the same as would ionising radiation. But we think that ionisation is NOT involved, so how much weight do we give this kind of argument?

    I admit to probably being as hesitant as any here to propose a totally new mechanism of carcinogenesis based upon tissue temperature or some unknown property of microwaves . I can think of only one possibly relevant clinical example and that is the increased rate of testicular cancer in young men if their testes don’t descend into the lower temperature of the scrotum. That’s not much to go on and there may be other reasons for that cancer.

    Yet such a novel process would not necessarily need to be a stand-alone carcinogen like ionising radiation. It may merely trigger or advance the onset of cancer in susceptible individuals. Somewhat against that theory is that none of these patients had family histories of breast cancer or BRAC genes. But then, why would young people be getting cancer at all in sufficient numbers to create what looks like an unusual collection of cases, at least to some experienced observers? The lack of substantive statistical data works both ways.

    Another popular argument refers to homeopathy, implying that my perceived lack of sufficiently extreme scepticism on the cell-phone issue should lead me to some kind of epiphany on that.

    Well, policies and attitudes towards homeopathy hang upon a totally different set of considerations, some of which can also give rise to debate. But a very little thought should have revealed considerable differences in the scientific aspects of the case.

    Homeopathy is based upon a whole collection (at least four) of extremely improbable and unsupported propositions ALL of which have to be true if it is to work as claimed or as commonly used. There is also a substantial body of evidence directly contradicting those propositions AND its claims of clinical efficacy.

    Both matters involve speculations arising from clinical observations that may have other explanations. That is about all that they have in common. We can be more certain of the “other explanations” in the case of homeopathy (spontaneous changes in symptoms and/or non-specific influences including placebo) because that is what innumerable clinical trials suggest. We don’t have quite same assurance with these cases of breast cancer.

    I think I have a point, but all I can do is to keep laying out my lines of thought and hoping that people are at least getting to exercise some intellectual muscles in debates that would not otherwise occur in a cosy collection of like minds like this.

    Whether you accept them or not is up to you, but if you are going to try and overcome my misgivings think your arguments through well before putting them in print. David has put as strong a scientific case as anyone can. That heavily affects the odds without being conclusive enough to dominate in EVERY question, especially those to do with wise, somewhat pragmatic public policy.

    1. Andrey Pavlov says:

      @pmoran:

      Sure, except that your assumptions in this case are simply wrong. Particularly a key assumption and a misleading word choice.

      This is the tenth time I have had to point out that the phone in bra example involves unusually intimate and prolonged exposure of cancer-prone tissue. THIS is why cancers occurring in this setting could be an early warning of a previously unsuspected, and possibly very use-dependent problem with this recently introduced device. Possibly or perhaps probably not, but not definitely so.

      Firstly, why is the bra “intimate”? What does that imply? From a scientific sense it should just mean “near the body.” Yet if that is the case then keeping it anywhere on your person should be “intimate”. Unless the 2mm of pocket fabric separating it from your skin somehow makes the bra “intimate” and the pants pocket “not intimate” in some scientifically relevant sense.

      Next, you argue that placing it in the bra is not only “unusually intimate” (as if being a mere centimeter or two away from the genitals is not intimate) but that it is also “unusually prolonged” exposure in a “cancer prone area.” Really? You honestly think that more people keep cellphones in their bra for longer period of time in a bra than in their pants pocket? And that the GU system is, for some reason, not a “cancer prone area” whereas the breast is an “unusually cancer prone area?”

      That hardly sounds scientific to me. Sounds a lot like you are injecting a lot of personal bias into what strikes YOU as “unusually intimate and cancer prone” and ignoring the fact that pockets are, undoubtedly, a vastly more common place to keep a phone and leads to vastly more exposure. In other words, it makes no sense why the bra would be “unusually prolonged” exposure.

      I was also factoring in the large Danish study, the one offering evidence that cell phones probably don’t cause cancers of the head and neck or brain, at least with the levels of exposure reached thus far

      So you factor in how there is no signal for cancer from extensive cell phone use/exposure to justify how exposure to the breast indicates a reason to believe that cancer can arise? That seems perfectly illogical to me. I get that you are trying to use at as some justification that the breast is “unusually cancer prone” but there is a leap of logic here that you need to justify (and I don’t think you can).

      I admit to probably being as hesitant as any here to propose a totally new mechanism of carcinogenesis based upon tissue temperature or some unknown property of microwaves

      And yet, you seem perfectly content to do so in order to give “serious consideration” to the idea that there is a signal of increased breast cancer from keeping the phone in the bra. On the one hand you chastise us for not sticking rigorously to the science yet you admit you must “hesitantly” propose some here to for yet unknown mechanism by which the non-ionizing radiation and/or thermal energy from cellphones to cause cancer.

      Which also, once again, belies your false assumptions based on not knowing how cellphones actually work or behave. Firstly, they emit only minute and sporadic amounts of radiation when not actively on a call. Secondly, they do not generate thermal energy unless actively being used either. So your “unusually intimate and prolonged” exposure is limited to the case touching the skin. The radiation dosage (regardless of what is) is thus minuscule as is the thermal impact, regardless of how long the phone is actually kept in the bra. By this line of reasoning having extra padding in the bra should also be a plausible mechanism for oncogenesis because that increases the amount of thermal energy retained next to the intimate area.

      Yet such a novel process would not necessarily need to be a stand-alone carcinogen like ionising radiation. It may merely trigger or advance the onset of cancer in susceptible individuals. Somewhat against that theory is that none of these patients had family histories of breast cancer or BRAC genes.

      Keep digging Peter. The plausibility increases with the number of just-so stories you can contrive to possibly explain a possible, though improbable, mechanism yet to be discovered and counter to any of the currently identified mechanisms.

      But then, why would young people be getting cancer at all in sufficient numbers to create what looks like an unusual collection of cases, at least to some experienced observers?

      And, once again, this is where we all here, myself included just have one word to say. BULLSHIT. As Dr. Gorski has pointed out – as someone vastly more expert in the relevant field than either you or I – there is NOTHING about this that “looks like an unusual collection of cases,” no matter how much you try and claim it is. Seriously Peter, instead of trying to relegate your thinking on the matter to “some experienced observers” (which is who, exactly? Dr. Oz?) try and consider what Dr. Gorski has explained clearly – there is nothing so unusual about women of that age with no history and no genetic predisposition getting breast cancer and, as I pointed out, 91% of the population has a cellphone!. So what strange association are you seeing here Peter?

      The lack of substantive statistical data works both ways.

      No, it doesn’t. You realize what you are saying right? Literally the antithesis of this site and, quite frankly, science in general. You are saying that the lack of data allows you to reasonably make up whatever story you like.

      Homeopathy is based upon a whole collection (at least four) of extremely improbable and unsupported propositions ALL of which have to be true if it is to work as claimed or as commonly used.

      How is that different? Your claim rests on a number of highly improbable assumptions ALL of which have to be true as well.

      1. Non-ionizing radiation of extremely low power can cause cancer
      2. The radiation can penetrate at least a centimeter of tissue
      3. This effect can happen more rapidly than actual ionizing radiation effects
      4. This effect somehow has a predilection for ductal cells

      But somehow this is all plausible enough for us to give serious consideration.

      We don’t have quite same assurance with these cases of breast cancer.

      I’ll agree here, but this harkens to the RCT about parachute use in jumping from planes. Oft misused, but here it applies nicely.

      I think I have a point

      Clearly. The difference between you and I is that when a whole bunch of otherwise qualified scientifically and medically knowledgeable people, including one with significant expertise particularly relevant to the topic, tell me otherwise (especially when I admit it tenuous at best to begin with) I re-evaluate my stance. I question myself and wonder why I am wrong, not assert everyone else is wrong. All while ironically accused everyone else of being dogmatic.

      Whether you accept them or not is up to you, but if you are going to try and overcome my misgivings think your arguments through well before putting them in print

      Ah, there’s the old Peter. Getting angry because the uppity med student dares to upsmart on the seasoned attending. Well, I’m officially a physician now. So you’ll have to get mad that the lowly intern dares question the seasoned attending.

      especially those to do with wise, somewhat pragmatic public policy.

      Pragmatic? Seriously Peter, do you even own a cellphone?

      1. David Gorski says:

        Ah, there’s the old Peter. Getting angry because the uppity med student dares to upsmart on the seasoned attending. Well, I’m officially a physician now. So you’ll have to get mad that the lowly intern dares question the seasoned attending.

        It is rather a pattern with Peter, I’m afraid. He’s very dismissive of you in an obvious way characteristic of slapping down an “uppity” underling who questions his pronouncements. If this were the first time, that would be one thing, but he’s made a very obvious habit of it. If I were you, I’d be irritated too.

        1. Andrey Pavlov says:

          Yes, I’ve given him the benefit of the doubt many times, but he really did give away the goose some time back when he really lost it and absolutely became the stereotypical old guard surgeon throwing a temper tantrum. Dr. Hall even had to come in and chastise him about it.

          It is mildly annoying, but I honestly don’t begrudge him it. If anything it just makes me more confident in my arguments and (on occasion, like above) gives me the greenlight to sling a little back at him.

  43. PMoran says:

    “But back to the “trope” remark. What does it contribute to the discussion?

    David: An accurate and succinct description of the bad argument you used, that’s what.”

    Pull the other leg!

    You had better explain that further, because it is not in the least clear what that term says about ANY argument. The argument that undue fear of false positives can lead to damaging false negatives (the one you were responding to) also did not come from me but from the European Environment Agency.

    What this “name-calling” actually looks to be saying in context is “I (meaning you) don’t need to take this on board so much” without giving any reason as to why you shouldn’t, and overlooking the fact that your opinions are in general expressed in much more dogmatic terms than most writers on any medical subject. That is why this keeps coming up. It may be that you have a very specific audience in mind but unwary readers are at risk of assuming that this is how science goes about its business and should be taken to the broader public.

    “Trope”, “gambit”, “tone troll”, “concern troll” — it is difficult to regard the name-calling as being anything other than a debating ploy intended to demean or diminish opposing person or opinion, with hints at illogic, bad faith or unworthy agenda, but without having to be specific as to why the term is warranted.

    The worthlessness of the practice is indicated by the fact that hardly anyone else seems to have the need to do it. They point out why arguments are bad, when they are bad, with salient rebuttal.

    Give Andrey another pat on the head for defending you against the accusation of name-calling. He probably was not here when you introduced SBM to the use of the term “altie”.

    1. David Gorski says:

      Of course, one rather glaring thing that Peter fails to mention is that 95% (at least) of the reason why this issue “keeps coming up” about my “tone” is because he himself keeps bringing it up and perseverating over it. Pretty convenient, eh? The issue is rarely brought up on SBM by anyone else. Indeed, I’m very hard-pressed to remember the last time someone else brought the issue up first other than Peter. (I suppose this perception could be a case of confirmation bias on my part, but I really don’t think so, at least not this time.) It’s almost always Peter complaining about how he doesn’t like my tone. It’s a self-fulfilling statement: Complain about my tone incessantly and then, when called on it, try to justify complaints about my tone because the issue “keeps coming up.” Genius!

      Well of course the issue of my tone “keeps coming up,” Peter! You yourself keep bringing it up! Hardly anyone else does. In fact, in this particular post, your latching onto the issue like the proverbial bulldog and refusing to let it go is a big part of the reason why we’re up to nearly 200 comments on this thread as I type this! I realize you do this because you really, deeply believe that I’m a world-class jerk who, despite my brilliance at writing, is seriously harming science and medicine communication because I’m so nasty, but it really is disingenuous of you to justify your complaints about me because the issue of my tone “keeps coming up” when you are the primary reason it “keeps coming up.” I also understand that you probably don’t realize that that’s what you are, in fact, doing, but you are.

      As for “altie,” I’m flattered you remember. Yes, indeed, I did “pioneer” the use of that word, if you want to call it that—back in 2005. I haven’t regularly used that word at least since 2008 or so. In fact, I can’t even remember the last time I actually did use that word in a blog post. Come to think of it, I don’t know if I’ve even ever used that term on SBM. I just searched the blog for it, and I couldn’t find it. It is a term that I appropriated and used on my not-so-super-secret other blog for a while for humorous effect, basically as an excuse to do a Jeff Foxworthy-inspired riff, and then let fade away. Ironically, I did so largely because of issues of tone.

      Oh, and finally, that condescending swipe you took at Andrey was really uncalled for. Not very good “tone” at all. You complain to me about being “dismissive” to CAM practitioners or fear mongering by people like Dr. Oz, but then you dismiss a young person as a child—and not for the first time. What could be more “dismissive” than infantilizing Andrey and, in effect, dismissing him the way one would dismiss a child (“pat on the head” and send him on his way)? He is an adult, a competent medical student, and a valued commenter.

      1. Andrey Pavlov says:

        Oh yeah, and whilst you accuse us of slinging name calling…

        Give Andrey another pat on the head for defending you against the accusation of name-calling.

        Feel free to continue being a condescending asshat. Because unwary observers will learn that is how science is done.

      2. Andrey Pavlov says:

        Thank you Dr. Gorski. I actually wrote my “asshat” comment before reading this. It did also catch my eye. I do have a thick skin and it really doesn’t actually get to me (plus I think it reflects poorly on him rather than me), but it is always nice hearing a positive comment. So thanks!

    2. Andrey Pavlov says:

      They have well defined meanings, Peter. They are shorthand for the fallacious argumentation used. We needn’t write out the same long explanation every. single. time. Perhaps saying “Gish Gallop” would be calling someone a name in your book. But it is much more accurate and succinct than explaining that it was popularized by Duane Gish as a way of flooding the respondent with more fallacious arguments than can be reasonably addressed giving the false impression of “winning” the debate. Isn’t “Gish Gallop” just more succinct and easy? We needn’t explain in detail every single time there is a fallacious argument, particularly when it fits well into an already established and defined specific type of fallacious argument.

  44. MadisonMD says:

    Well, pmoran, I do admire the way you stick to your guns. Care to respond to the other criticisms raised:

    (1) Focusing only on “Ozian” risks will result in ignoring a larger set of more significant and more likely risks.

    (2) Warning the public about Ozian risks will feed ignorance and misunderstanding which will make it harder for the public to understand and rationally assess other risks.

    (3) If science were to engage these risks, this would result in abandoning more fruitful lines of inquiry which have a higher probability of improving the human condition.

    (4) You cannot “build bridges” this way. If science were to engage after the inciting public fears by warning above #2, this would leave a cohort of people who will never abandon the idea, even as scientists push the needle from 3 sigma, 5 sigma, and onward. (BTW, did you ever state how much confidence is required and whether prior plausibility should be admitted to the calculation?) An example of this outcome is the vaccine-autism hypothesis.

    I want to point out your argument here is disingenuous:

    But in that study the exposure was different and the exposed tissues markedly less cancer-prone. There is thus no reason at all why the risk would have to be the same wherever or however you used your phone.

    (a) As pointed out already, the phone is actually emitting radiation when the head/neck/brain is exposed.
    (b) You maximize your “false positives” and maximally inflame public misconception by a focus on the most cancer prone tissues. This is disingenuous when you do so by positing an as-yet-unknown mechanism. (Even more so when this yet-unknown mechanism doesn’t makes sense given (a))

    I think I have a point, but all I can do is to keep laying out my lines of thought and hoping that people are at least getting to exercise some intellectual muscles in debates that would not otherwise occur in a cosy collection of like minds like this.

    Well, maybe this is your way of conceding the point after all.

    1. David Gorski says:

      I want to point out your argument here is disingenuous:

      But in that study the exposure was different and the exposed tissues markedly less cancer-prone. There is thus no reason at all why the risk would have to be the same wherever or however you used your phone.

      I don’t know if “disingenuous” is the right word. “Straw man” would be the appropriate term. No one here actually claimed that the risk would have to be the same wherever or however you used your phone, only that if cell phone radio waves could be carcinogenic we would expect to see the effect in more tissues besides breast. That’s a very different argument.

      1. Andrey Pavlov says:

        @ Dr. Gorski:

        In re-reading my comments I concede that may have not been perfectly clear in my own posts. But yes, that is precisely what at least I was trying to say. With all the exposure to other areas we would expect some increase in cancer associated with that. I further argue that we would expect even MORE increase in cancers of the pelvic area since phones are kept in pants pockets VASTLY more than in bras (especially considering that by definition twice as much of the population has the option of doing so). This doesn’t necessarily have to be an identical increase, but the fact that we are only seeing it in breast cancer (well, not even actually seeing it, but for the sake of argument) is yet another big strike against the hypothesis.

    2. PMoran says:

      Yes MadinsonMD, I haven’t said much to you directly, but you will have found argument relevant to come of your assertions and anxieties in recent posts.

      “1. Focusing only on “Ozian” risks will result in ignoring a larger set of more significant and more likely risks.”

      There is no question of “focusing ONLY on Ozian risks” –. and we would be confronted with this question whether Oz intervened or not.

      “(2) Warning the public about Ozian risks will feed ignorance and misunderstanding which will make it harder for the public to understand and rationally assess other risks.”

      The public will be warned by the media, not us. Our job is to create as truthful a context for the matter as we can. If we cannot be ABSOLUTELY sure that young women are not getting breast cancer unnecessarily we should not say that we are.

      The public can understand words like “unlikely”. They can understand caution also precautionary action, when the stakes may be very high for some individuals. Not being privy to all the relevant science, they are quite often less sure about how we can be so certain on some matters, so that excessive or aggressive dogmatism may have the opposite effect to that intended.

      “(3) If science were to engage these risks, this would result in abandoning more fruitful lines of inquiry which have a higher probability of improving the human condition.”

      Why? I don’t expect any major “engagement” on this, unless other oncologists found themselves confronted with similar cases. Then some more active study might be justified.

      A massive amount of data is routinely collected by cancer centres regarding their breast cancer patients and it would require minimal effort to also gather data about cell-phone use.

      “(4) You cannot “build bridges” this way. If science were to engage after the inciting public fears by warning above #2, this would leave a cohort of people who will never abandon the idea, even as scientists push the needle from 3 sigma, 5 sigma, and onward. (BTW, did you ever state how much confidence is required and whether prior plausibility should be admitted to the calculation?) An example of this outcome is the vaccine-autism hypothesis.”

      Once again you characterise my position as “warning” the public when I see it as responding to fears already aroused (every few by Oz, BTW) , and in a largely reassuring way, but with a hint of simple, precautionary advice just in case.

      This does not have to be a big deal. The only way it could become a big deal is if we get our advice wrong. THEN we will have a problem the next time a similar suggestion of risk surfaces.

      So I don’t share your anxieties. The public is constantly confronted with dubious risks, also very real risks like driving a motor car around, and has its own ways of dealing with them.

      1. Harriet Hall says:

        @ Peter “Our job is to create as truthful a context for the matter as we can. If we cannot be ABSOLUTELY sure that young women are not getting breast cancer unnecessarily we should not say that we are.”

        I think David has done exactly what you recommend.

        I didn’t find David’s title objectionable because I saw as a rhetorical device, an attention-getting oversimplification to make a point. His message could only be misinterpreted if a reader read no further than the title. He goes on to create as truthful a context as possible and to say “Is it possible that cell phone radiation can increase the risk of breast cancer? Sure,… ”

        “The only way it could become a big deal is if we get our advice wrong. ”
        David gives no advice. He only provides information.
        As a general principle, nervous Nellies who over-use the precautionary principle and advise substituting a potential risk with an unknown, untested one, are just as much at risk of getting their advice wrong.

      2. MadisonMD says:

        My “anxiety” as you call it is that focus on numerous false and nonsensical risks diverts attention from real risks, resulting in poor health outcomes of a misinformed public. It is a big deal.

        Now to your points:

        1. When confronted with the problem of risk fatigue, you said above:

        THIS risk is in the news. It has been dumped on the plate of medical science, whether it likes it or not, and it must respond.

        Now you say:

        There is no question of “focusing ONLY on Ozian risks” –. and we would be confronted with this question whether Oz intervened or not.

        So which is it? Do we focus on the risks dumped on medical science due to popular misconceptions, or do we focus on the totality of all risks, sorting by what is most likely? I don’t think this is a false dichotomy since a perusal of this “medical hypotheses,” Oz (or this website, quackwatch, snopes) can enumerate thousands of the dumped risks and it would be a full time job to go through them all.

        2. You say that we cannot say something does not cause cancer when we are not ABSOLUTELY sure. Above you admitted we cannot prove the negative. Ergo, your argument is that one should never say that something does not cause cancer. That is ridiculous. (If you change your mind on this, you will still need to answer what degree of certainty is required and whether non-clinical evidence is admitted–you’ve avoided answering this question several times).

        3. You say that a ‘massive amount of data is collected by cancer centers.’ I work at a cancer center, do you? I know exactly what is required to do a study: securing funding, writing a protocol, scientific review, IRB approval, enrolling patients, collecting data with accuracy, auditing data, selecting primary and secondary endpoints, selecting controls, publishing, cautiously interpreting data to reach conclusion. You are underestimating the time, effort, and resources involved. You are overestimating the value of a p0.05, it still wouldn’t prove anything. Perfect definition of useless research.

        4. You say that we should offer precautionary advice on the risk that Oz brought up but that offering such precautionary advice is not ‘warning the public.’ Yet you yourself above said:

        [Keeping cell phones in a bra goes] against the advice of cell-phone manufacturers not to keep them in contact with skin. Why do they advise that, I wonder ? — probably just being cautious, I suppose.

        So giving this advice won’t be understood as a warning? A similar precaution appears to have been misunderstood as a warning by you.

        Now, perhaps, disingenuous would be an accurate description of your argument.

      3. Sawyer says:

        “it would require minimal effort to also gather data about cell-phone use.”

        This is the linchpin of your entire argument, and it’s why no one here has any interest in this type of research (well, besides the biological plausibility issue). Do you understand the massive limitations of patient surveys, particularly when involving controversial research? Some women may be embarrassed to admit how often they store phones in their bras, or forgetful if you don’t offer it as a possibility. Others will over-report how often they do it because it sticks out in their minds. And that’s just the tip of the iceberg. Getting patients to accurately report their cell phone use is much, much harder than it sounds. I’d refer you to the crappy research that’s been done on brain cancer and cell phones if you want to see how these quickly these problems crop up.

        It bothers me that you’re not already familiar with this stuff.

        1. MadisonMD says:

          Peter says cancer centers collect “a massive amount of data” already. Apparently this means to him that we have already collected data on whether women have placed their cellphone in the right or left bra cup, exactly how many hours per day over what period of time and whether it was on or off. Apparently this data– and much much more– would be recorded as some sort of government-mandated cancer registry and so would not be part of a study nor require funding or IRB approval. These very same registries that struggle with limited staff to maintain huge databases including stage, pathology, treatment, basic demographics, recurrence, and survival.

          He clearly hasn’t got a good sense of reality on this point… especially when, with all this data from hundreds of cancer centers, his argument is that you still cannot ever say that cellphones don’t cause cancer, because, well, you are not ABSOLUTELY sure.

          1. Sawyer says:

            Well hold on now Madison, maybe we already have most of the data:

            NSA cell phone records + smart phones with GPS + TSA full body scans + Obamacare medical records + nanobot GPS trackers implanted into every woman’s breast = complete data on cell use, proximity to breasts, and incidence of breast cancer

            It all makes sense now! Every controversial national security issue from the last 5 years is really just part of a massive cancer study. And this whole time I’ve been worried…

            I eagerly await DARPA funding boob nanobots in 2014.

            1. MadisonMD says:

              Ha. Yes, that definitely explains it. And Snowden didn’t want us to figure this out b/c he is a cell phone shill.

            2. David Gorski says:

              I eagerly await DARPA funding boob nanobots in 2014.

              Only if I can get in on some of that grant action. :-)

              1. WilliamLawrenceUtridge says:

                DARPA – throwing money at the improbable since…

                I read a book on their failed and probably spurious attempt to produce a hafnium bomb based on a dental x-ray and a styrofoam cup.

  45. MadisonMD says:

    Yes, perhaps disingenuous is not quite right. Straw man it is. But additionally the idea will inevitably touch the public psyche where it is most tender and where it is prone to falsely conclude cause-effect from inevitable anecdotal associations between very common things (breast cancer, carrying cell phones).

    I suppose it is ‘disingenuous’ only if actually calculated to accomplish this– and I doubt pmoran wishes to raise false fears. Instead he seems to think that science and medical advice should primarily serve to optimize public relations ; whereas I and most seem to think it should primarily serve to optimize public health and benefits.

  46. PMoran says:

    It’s a thrill when the reason for conflicting viewpoints finally becomes clear.

    I had been taking it as read that others also understood that it will be much harder to cause cancer in skin, fat, and muscle and probably bone than in the breast. It puzzled me that medical colleagues should keep making arguments that did not seem to recognise that. This was a key element in my weighing up of the likelihood/unlikelihood that these few cases could, at an only moderate degree of stretch, be an early signal of something.

    You simply have to look at cancer statistics to observe an enormous inherent difference between the propensity of different organs towards cancer (actually of different cell types.)

    David Gorski, in what he says is a large experience of breast cancer, will thus not be likely to have ever seen a skin cancer, liposarcoma, or leiomyosarcoma in or around the radiated area after treatment of breast cancer. But he may well have seen an occasional lung cancer or, oddly enough, an angiosarcoma, rarely seen elsewhere.

    The young thyroid is an organ that is peculiarly prone to cancer following external radiation, and typically the only cancer observed in the clinical setting..

    So, when also taking into account the intimacy and consistency of exposure, cell-phones might NOT be expected cause many cancers in “the pelvic area” if kept in a pocket. It would certainly not be likely to affect the testis, mentioned by someone, or any internal organ, on the physical principles likely to apply..

    1. David Gorski says:

      David Gorski, in what he says is a large experience of breast cancer, will thus not be likely to have ever seen a skin cancer, liposarcoma, or leiomyosarcoma in or around the radiated area after treatment of breast cancer. But he may well have seen an occasional lung cancer or, oddly enough, an angiosarcoma, rarely seen elsewhere.

      Uh, wrong. I’m a surgical oncologist, and while it’s true that I’ve specialized in breast cancer for well over a decade now I used to be a general surgeon and surgical oncologist, and I had to cover general surgical oncology on call for eight and a half years. Heck, I even did trauma surgery for a while, thankfully brief, as I’m not really suited to the specialty.

      You know, I get the feeling that Peter is applying the same sort of condescending dismissal to me as a young whippersnapper who “only” takes care of breast cancer that he applied to Andrey as “only” a medical student. Here’s a hint, sir. You don’t have to have seen everything to be familiar with the literature, the scientific principles of cancer, and epidemiology. (In fact, doing my CME for keeping track of surgery recertification before the end of the year has forced me to defamiliarize myself with cancers outside my usual area of clinical practice.) Sure, none of us can be as awesome any more as you old school surgeons who did everything, but that’s because times have changed. In academics, you have to specialize.

      Be that as it may, you’re setting the same straw man aflame again. No one ever said that there aren’t significant inherent differences in sensitivity to the carcinogenic effects of radiation. The point was that the timing of these ridiculous cases presented as “evidence” or sentinel events by Dr. Oz don’t match up with the biology of radiation-induced secondary cancers. The timing’s all wrong on at least a couple of them, and the locations of the tumors don’t even really match up convincingly with the area of alleged exposure.

    2. MadisonMD says:

      Cancer-prone tissues get cancer by definition of “cancer prone.” This makes anecdotal evidence nearly worthless, unless you want to play on popular biases and misconceptions.

      It’s a thrill when the reason for conflicting viewpoints finally becomes clear. I had been taking it as read that others also understood that it will be much harder to cause cancer in skin, fat, and muscle and probably bone than in the breast.

      So you simply assume that the physicians here are ignorant of cancer statistics, even after I specifically referred to such statistics in my last post. I really see how this makes anything clear except that you’d rather have your tone tiff and Andrey and David than address substantive criticisms.

      Anyway, you don’t appear to have a real response to the substance. Carry on and good luck.

      1. PMoran says:

        Actually, David, I thought that you had more to do with clinical breast cancer than you actually seem to have had, and that was the basis of my remark regarding what you will likely to have experienced through the differing susceptibility of different tissues to carcinogens. So let’s neither of us over-read what the other intends.

        .

    3. Andrey Pavlov says:

      No, Peter, I would not expect the same rise in cancer of the pelvis as in cancer of the breast. I understand that cells that have a higher rate of division (e.g. ductal cells vs muscle cells) would have a higher likelihood of oncogenesis. What you are ignoring is that the level of “exposure” to the pelvic area is orders of magnitude higher than the level of exposure to the breast. First off the population possibly affected DOUBLES and secondly cellphones are kept in pockets much, much, much more than bras. So I would expect SOME increase in pelvic cancers attributable to cellphones. There should be nothing magical by which ductal cells can be susceptible to cellphone radiation but not pelvic structures, particularly testes. Yes, the signal should be lower, but also the exposure is vastly higher. Yet we don’t see such things.

      And all of that is nevermind the fact that this data simply cannot, by any reasonable person, be construed as a signal of cancer at all, let alone one that could be attributed to cellphone use.

      1. PMoran says:

        “There should be nothing magical by which ductal cells can be susceptible to cellphone radiation but not pelvic structures, particularly testes. Yes, the signal should be lower, but also the exposure is vastly higher. Yet we don’t see such things. ”

        That is a half-valid point, though confused by different uses of the word “exposure”.

        I am pretty confident that the inverse relationship of any radiation effect to the square of distance should easily cope with the greater number of persons who might be at risk of testicular or internal pelvic cancer from carrying cell-phone around their pelvic region.

        Compare the predicted signal strength, at say, 1 cm to a typical 15-20 cm distance between a trouser pocket and a testis. There is no contest. We are into massive numbers.

        If any effect was actually from tissue warming then there is no question of affecting such organs no matter how cancer prone they were..

        It is accepted that the evidence is not strong and that there are plausibility questions, but the factors that I have mentioned along with other contextual matters still make me reluctant to support absolute statements on the matter.

        1. David Gorski says:

          Funny, but no one that I’ve been able to find has made “absolute statements” on the matter. Not even myself, other than the title of the post, which is what you seem to be perseverating about. I’m serious. Go back and read my post. Find an absolute statement. You won’t be able to.

        2. Andrey Pavlov says:

          Compare the predicted signal strength, at say, 1 cm to a typical 15-20 cm distance between a trouser pocket and a testis.

          Perhaps you wear very different pants to any that I have ever seen but my pants pockets are no more than about 3-4 cm from my testes. That is through air and clothing material followed by much less than 1cm of tissue to get to the seminiferous tubules. Contrast this with >1cm of tissue to get to the ductal cells of the breast (honestly at LEAST 2cm of adipose tissue as the phone will be placed closer to the axilla and not the areolar region where the ducts are much deeper. Depending on the actual breast size and body habitus this could be well over 3-4cm). Tissue, particularly adipose, but especially water containing cells will attenuate any EM radiation by orders of magnitude more than air and cotton.

          In other words, to within a first approximation, the exposure to ductal cells and to pelvic structures should be roughly similar. At a minimum it should be enough to have some sort of signal. Or at least you should be similarly willing to admonish against keeping a cell phone in your pocket. Perhaps you could invent a device to strap to your hip and keep the phone 10cm away from you at all times. You know, just to be on the safe side since we can’t absolutely prove that it doesn’t cause cancer.

          If any effect was actually from tissue warming then there is no question of affecting such organs no matter how cancer prone they were.

          Correct, that is a separate point. However, once again we have no mechanism delineated, no probable reason as to why it would, and even more importantly is the fact that the phone does not warm up unless it is actively being used. So besides very low prior probability, the mechanism simply doesn’t exist. Cellphones don’t actually work the way you seem to think they work. Keeping any random object in your bra will generate just as much thermal energy by trapping body heat. In which case we should warn against wearing sweaters and padded bras.

          No matter how you slice it, everything about this is so incredibly improbable that while we can’t say that ABSOLUTELY no chance of oncogenesis exists. But we also can’t say that leprechauns and unicorns don’t exist either. But I’m not about to live my life as if they do.

          but the factors that I have mentioned along with other contextual matters still make me reluctant to support absolute statements on the matter.

          The only absolute statement here is that it is ridiculous to fear monger about something so incredibly unlikely. You DO realize that was the entire message of this post, right? Never, ever once that it is absolutely certain that cellphones can’t cause cancer. Merely that the likelihood is so incredibly low that it is scare mongering to warn against keeping cellphones in bras based on the incredibly (stupendously incredibly) thin evidence.

          1. pmoran says:

            Andrey, you wish to instruct a surgeon in breast anatomy? Try your version on David, too.

            Among other matters, only the extremely obese will approach subcutaneous fat 2 cm thick over the breasts, and you should have learnt in med school (or elsewhere?) that the breast extends into the axilla as far as the mid-axillary line. (Reference: Playboy, any issue.) :-)

            So you wear jeans, not trousers? That might increase the testicular exposure but even at an improbable and/or rare 3 cm it will be nine times less than that at 1cm, won’t it?

            Easily overwhelming any small effect from that in our thought experiment, the distance between phone and breast tissue will be little more than the thickness of the skin when a phone is pressed against the breast in a thin woman. Even in the obese, local pressure would deform everything substantially so that 1cm might be easily achieved.

            I largely accept your fear-mongering point, but if that was indeed the whole intent of Dr Gorski’s piece the heading could have read “Unjustified fear-mongering from Dr Oz.” couldn’t it?

            If Dr Gorski is making less absolute statements elsewhere, doesn’t that beg the question as to why I am being attacked for supporting a less than absolute stance? I point out that your own initial reaction simply asserted that any such outcomes would be rare.

            1. Harriet Hall says:

              I have twice tried to explain why I don’t find the title objectionable, and no one has commented on my reasoning. Dr. Gorski IS “making less absolute statements” – not “elsewhere,” but in the body of the article itself. He is doing exactly what Peter asks him to do – everywhere but in the title of the article itself. Seems like a lot of animosity to direct to the title alone. I maintain that it is perfectly acceptable to overstate and oversimplify in a title as a rhetorical device to get a reader’s attention. It makes a point, and then he qualifies and explains his thinking fully. Now Peter will tell me why it is categorically WRONG to use such a title, and why it will alienate people and interfere with our educational goals. If there is clear evidence that people read only titles, or that such titles prevent understanding of the articles themselves, I might be persuaded; a reader survey asking for how they understand the issue before and after reading the article might shed some light; otherwise, I will ignore unsupported opinions. In our goal of educating audiences, we are in competition with non-science-based writers who use all kinds of rhetorical tools, advertising techniques, and psychological ploys. I submit that a “catchy,” simplistic title with a clear message is perfectly OK.

              1. MadisonMD says:

                Agreed, Dr. Hall.

                In fact, perhaps David perhaps bent too far backward in not making definite statements. If we have to hedge on every association without plausible mechanism or evidence, then, apparently, we cannot ever use the statement:

                [x] does not cause cancer

                I counsel patients on cancer risks on a regular basis. If I hedged on every statement, no coherent message would get across. I think most of my patients would rather have me make ‘absolutist statements’ than hedge when I have >99% confidence.

              2. David Gorski says:

                Dr. Gorski IS “making less absolute statements” – not “elsewhere,” but in the body of the article itself. He is doing exactly what Peter asks him to do – everywhere but in the title of the article itself. Seems like a lot of animosity to direct to the title alone.

                I get the feeling that with Peter it’s more than about just the title. It’s about me. I wish I didn’t get that feeling, and I keep trying to deny it, but four years or so of unrelenting criticism by him have made it impossible for me to deny it to myself anymore. The animosity in Peter’s comments appears to derive from his oft-demonstrated intense dislike of me and how I discuss science, medicine, and quackery, to the point that, when it’s me, I really do think he reacts far out of proportion to the imagined offense. Certainly he doesn’t attack the posts of any other SBM blogger nearly as frequently or intensely as he does my posts, nor does he demonstrate the persistence, perseveration even, in criticizing other SBM bloggers’ posts. In fact, from my perspective, he appears only fairly infrequently to criticize posts by other SBM bloggers at all.

                As you (and I) have pointed out (and, quite frankly, Peter has at least partially conceded), in the body of the post I actually did what he thinks appropriate, and qualified my statements regarding the lack of risk of breast cancer due to cell phone radiation. In fact, I wonder if I qualified it too much in the same way that I was accused of giving too much credence to those in vitro studies of radio waves that I blogged about a couple of years ago that led to accusations that I had allowed myself to become so open-minded that my brains fell out.

                In the end, the title really does seem to be the only thing about this post Peter seems to have a significant beef with, other than “how many angels can dance on the head of a pin?”-style nuances about how I discussed the issue in the body of the post. Quite frankly, I’ve had enough. If he disagrees with my arguments and/or dislikes how I comport myself in my blog posts, that’s just tough. I’m not changing. My only mistake was in letting him get under my skin to the degree that I did to the point that let him lead me around in circles revisiting the same arguments again and again. Mea culpa maxima.

  47. PMoran says:

    David: ““Straw man” would be the appropriate term. No one here actually claimed that the risk would have to be the same wherever or however you used your phone, only that if cell phone radio waves could be carcinogenic we would expect to see the effect in more tissues besides breast. That’s a very different argument”

    Actually it was asserted by several that we should be expecting cancers elsewhere if there were a few showing up in the breast which is as close to “the risk would have to be the same” (if I actually said that) as you could get. .

    But note how calling my statement a “straw man” has completely missed crucial matters. The true reason for those differences of opinion have been outlined in my last post.

    I don’t know how I forgot “straw man” as a hopelessly overused, often inappropriate and redundant bit of “name-calling”. To the extent that it is often not fully justified, it is a sure way of annoying those subjected to it and of poisoning what might otherwise be valuable interactions.

    If something is being misrepresented it is sufficient to simply describe how that is. Typically a half-truth is involved, which might be acknowledged if you wish to stay on good terms . Here, there is, at minimum, a 98% truth.

    I have the suspicion that I am being baited by David in these third party discussions, though, and I will try to remind myself not to take them too seriously.

    1. David Gorski says:

      I don’t know how I forgot “straw man” as a hopelessly overused, often inappropriate and redundant bit of “name-calling”.

      Why is it that you keep trying to portray criticisms of your arguments or behavior as “name calling”? They’re not. Really. However, I can see how reacting to them as though they are “name calling” would be a comforting attitude to assume. It allows one to tell oneself that one is not doing anything wrong; it’s just a bunch of meanies engaging in “name calling.” It’s an easy way to dismiss criticism.

      I have the suspicion that I am being baited by David in these third party discussions, though, and I will try to remind myself not to take them too seriously.

      Funny, I got the same suspicion the other day about your frequent recourse to complaining about my “tone,” hence my facetious comment earlier in the thread about how, now that I’m pretty sure all these comments about “tone” from you are primarily for the purpose of getting under my skin, that particular rhetorical weapon is neutralized. In other words, yes, I am not really taking your pearl clutching seriously any more. :-)

  48. PMoran says:

    “Why is it that you keep trying to portray criticisms of your arguments or behavior as “name calling”? They’re not. Really.”

    I stand totally by what I have said. The “name-calling”, of course, does not only refer to terms applied to persons. When applied to argument it has the same dubious usefulness and proneness to misuse, as in that recent “straw man” example from you, indeed in many of the many occasions on which you resort to it.

    It is meaningless on its own. It requires an additional explanation as to what why the argument is based upon a misrepresentation. If that is sound there was no real need for the “straw man” appellation. If it is weak the use of the term looks like underhand debating tactics, whether intended or not.

    In the one that prompted my remarks, you provided an explanation, but one that was utterly specious given that it was based upon different wording for essentially the same thing.

    1. David Gorski says:

      I stand totally by what I have said.

      So do I, completely, and seeing that you are doing exactly the same thing you accuse me of doing (i.e., providing an utterly specious explanation based upon different wording for essentially the same thing) I really don’t see much point in continuing this “debate” any further. It is clear that you are perseverating, as you always answer basically the same thing to every attempt I make to explain why you are on the wrong track, and I’ve almost certainly carried this on longer than I should have, given the inability for anyone to get through with you. Mea culpa. It is also clear that you too easily conflate criticism of argument with criticism with person.

      1. WilliamLawrenceUtridge says:

        I wonder if Pete has read Mistakes were made (but not by me). If not, he should – because he gives every indication of being unwilling to accept any challenge to his self-perception, and equally unwilling to ever admit having been wrong.

  49. PMoran says:

    “So do I, completely, and seeing that you are doing exactly the same thing you accuse me of doing (i.e., providing an utterly specious explanation based upon different wording for essentially the same thing)”

    My example is laid out above. Where exactly have I ever accused someone of a “straw man”, let alone followed it up with a specious explanation? I just don’t do that, and your accusation makes no sense outside of that context.

    But let’s leave it, for now, if you wish. Have a good Christmas.

  50. goodnightirene says:

    @PMoran

    I find your over-concern-to-the-point-of-condescension about my breast tissue offensive. Not a thing you have said would stop me putting my phone in my bra and I hate to admit it, but that’s because of your “tone”. Even if your arguments had merit, I’d put my phone in my bra just to mentally flip you off. We women are perfectly capable of protecting ourselves without your minutae-of-nothing concern for our breasts.

    I cannot imagine why the good doctors here (and some others) keep trying to make a point–it speaks very well of their enormous patience.

    1. pmoran says:

      GNI, if you only read one or two to of my posts or some of the reactions to them and the aggression behind some of it, it could well look like I was making a case for a serious risk from cell phones. That was NEVER so.

      I was pointing out several small ways in which it is difficult for us to be ABSOLUTELY sure the other way, even before we factor in the healthy sense of potential fallibility which underlies all sound science and most scientific discourse.

      If my points are sound, they shift the balance of probabilities slightly away from the degrees of certainty that nearly everyone else here seems to think should form the basis of our public utterances on the matter.

      There are other considerations that make excessive dogmatism a more far more risky matter than more moderate but likely just as telling statements such as “we think that is very unlikely on the present evidence” and simply explaining why.

      I am certain that no other medical body will be likely to put the case in quite that way, and it is not interests of this group to be thought be representative of extremist views (even if we think they are not extreme) ,

      OF COURSE you will make your own mind up on the matter. You will drive a car, despite the potentially serious risks of that.

      1. WilliamLawrenceUtridge says:

        Pete, if that was truly your point, you could have made it in a single post. It’s claims like this that make us suspect your real point bears no resemblance to your stated point.

  51. MadisonMD says:

    Do you also find it difficult to be sure that unicorns can’t fly?

    1. David Gorski says:

      Come now. Of course they can’t. But they do exist. :-)

      1. MadisonMD says:

        That (and the title of this post) in the absence of absolute proof, apparently make you a chippy little autodidact.

  52. pmoran says:

    WLU, this was the full text of my first post. What other agenda are you suggesting that that I was pursuing?

    “And yet,  –  might you not advise your daughter to avoid this practice until there WAS clear scientific evidence of its safety?
       
    How sure can we be from physical principles or other kinds of evidence that intimate cell-phone exposure of this degree is completely benign, especially when a phone is pressed up against a cancer-prone organ like female  breast tissue for very long periods?      

    Everything David says is true, if you are to look upon this as an issue where near-absolute standards of proof are demanded before there was any precautionary medical advice.   But in medicine we are normally much more sensitive to risk than that.  We warn about possible drug side effects, for example, on minimal anecdotal evidence.    We worried about stroke from neck manipulation at a time when there was little more evidence than a few suggestive cases.    

    The mammogram shown in the case study could certainly be the result of coincidence but it is somewhat disturbing .   Multifocal  cancers to that degree are not very common and here are  (supposedly) four very young patients with much the same clinical picture.”

    1. David Gorski says:

      Multifocal cancers to that degree are not very common and here are (supposedly) four very young patients with much the same clinical picture.”

      No, Peter. As I have said before, you are simply mistaken about this. Multifocal and multicentric breast cancers are common, or at the very least not uncommon. (To put it simply, multifocal means multiple foci near enough to each other that they can be encompassed in one surgical specimen; multicentric means their too far apart and require mastectomy.) It’s controversial what the exact incidence of multifocal disease is, with wide-ranging estimates, but none of them are particularly uncommon. Indeed, estimates range from roughly 9% to more than 65%. The estimate has risen since the widespread use of MRI because MRI is so sensitive. It has been argued that to some extent this multifocality demonstrated by MRI is overdiagnosis and that small additional foci identified are in most cases taken care of by radiation. The MRIs shown on Dr. Oz’s show and in the paper I looked at were not in any way unusual. I’ve seen more MRIs like that than I can remember.

      1. pmoran says:

        AS a sign of good faith I will leave you with the last word.

        I do suggest you find out what population these four cases were gleaned from. That affects their force.

        Also show the published films to other breast surgeons and radiologists and see if they interpret them quite the way you do.

        I am sure they will agree that they might be due to chance. as do I. But the likelihood of that subjective judgement, isn’t it?

    2. Harriet Hall says:

      Peter, you’ve made your point. Why do you keep making it over and over? Surely you don’t imagine that anyone here will change their mind just because you say it 10 times instead of 9.

      1. David Gorski says:

        That appears to be exactly what Peter seems to think. Either that, or he just can’t believe that anyone would disagree with him and so keeps making the same point over and over again. Of course, what he doesn’t seem to be willing to acknowledge is that there’s more than a little in him of the characteristics he decries: Argumentativeness, refusal to admit error, and dogmatism.

    3. WilliamLawrenceUtridge says:

      I would advise my daughter that absolute proof is an impossibility, high certainty is expensive, these four absurd anecdotes are not evidence of anything when you consider the number of cell phones on the planet numbers in the billions, and Dr. Oz is so lacking credibility that one should almost do the opposite of anything he says.

      Multifocal cancers to that degree are not very common and here are (supposedly) four very young patients with much the same clinical picture.

      Ahahaha, really? Peter, you’re a cancer specialist. Perhaps you could help me find an indication of the actual incidence of multifocal breast cancer in the general US population, ideally broken down by age. My contribution will be to find cell phone ownership rates in the same populations, and demographic numbers for each slice of the population. We’ll multiply the numbers together, and find out that we can expect dozens, if not hundreds of young women with cell phones and multifocal breast cancer in the United States, indicating these people are indeed rare – but do exist. And that worrying about cell phones and cancer is, for lack of a better term, stupid.

  53. Becky Weaver says:

    Of course it’s “GREAT” for YOU to have more women carry their cellphones in their bras. HOW MANY MORE BREASTS CAN YOU CUT OFF IF THEY LISTEN TO YOU?

    ALL YOU FEMALE FOLLOWERS, LISTEN TO THIS GUY, because it simply cannot be true that our own immune systems, (IF GIVEN THE RIGHT RAW MATERIALS & DE-TOXED, OR DESTROYED BY THE CHEMO, CAN HEAL US!)

    …. AND THEN SCHEDULE YOUR MASTECTOMIES WITH Dr. WooHoo AS SOON AS YOU CAN!

    And if you don’t get “CANCER” from the electro-magnetic radiation from your cellphone, or from the toxins in your food / drinks, then surely over time, after enough mammograms, you’ll get it. (add 5% risk per year for 10 yrs = 50% added risk from the brilliant designers of medical equipment – all men, by the way!)

    So, go ahead, listen to this “educated” man.

    1. Dave says:

      I think your sexism is showing through. There are lots of women physicians. In my hospitalist group we have 5 women and three men. Our surgical dept is 30% female.

      Believe me, men are not interested in women getting uneeded mastectomies. Quite the opposite.

      The following is information on radiation doses and risks of mammography, from the resource UptoDate:
      “The purpose of screening mammography is to decrease mortality by identifying early stage breast cancer. There is no evidence that routine screening mammography in women, initiated at age 40, is associated with increased risk from radiation [22].

      There is concern, however, that women with BRCA1 or BRCA2 mutations are at increased risk for radiation-induced oncogenesis, because of impaired DNA repair mechanisms. For these women, in whom initiation of screening at an early age is usually recommended, the risk of radiation-induced cancer needs to be balanced against the risk of gene-related early onset cancer; the appropriate age to initiate mammogram screening is uncertain [23]. (See “Management of hereditary breast and ovarian cancer syndrome and patients with BRCA mutations”.)

      For all women, it is important to keep the radiation dose as low as possible without compromising image quality. The development of more efficient emulsions and screens in film screen mammography has decreased the dose per exposure [24-26]. Despite technologic improvements, a film screen system does not use all the x-ray photons that pass through the breast. Digital mammography is associated with a lower radiation dose than film screen mammography for the same image quality [27-29].

      The radiation dose absorbed by the breast depends upon the breast tissue thickness, with the dose absorbed increasing with the thickness of the breast [29]. Most mammography equipment delivers a mean glandular dose of 0.1 to 0.2 rads (1 to 2 mGy) per exposure. The American College of Radiology recommends that the mean glandular dose exposure for a breast that is 4.2 cm thick should not exceed 0.3 rads (3 mGy) per image.

      The effective radiation dose is often expressed in sievert or millisievert (mSv) units. Sievert units account for relative sensitivities of different tissues and organs exposed to radiation. The effective dose received from a routine screening mammogram is 0.7 mSv, equivalent to the dose received from natural background radiation over three months. (See “Radiation-related risks of imaging studies”.) “

      1. David Gorski says:

        Believe me, men are not interested in women getting uneeded mastectomies. Quite the opposite.

        Quite true. In fact, these days, I not infrequently find myself trying to talk women who are excellent candidates for breast conserving surgery out of getting a mastectomy (or even getting both breasts removed), when a lumpectomy/partial mastectomy would do quite nicely. It would be very easy just to say yes, not to mention financially advantageous given that the reimbursement for mastectomy is so much higher than for lumpectomy, but it wouldn’t be the right thing to me medically.

        1. Dave says:

          It’s so crazy! Her comments are so hateful against a surgeon who spends his life trying to cure women of this dreadful disease. Unbelievable!

    2. Chris says:

      Ms. Weaver: “So, go ahead, listen to this “educated” man.”

      So what is your education? What kind of credentials do you have to explain to us mere women how to prevent breast cancer?

      I’ll have you know my immune system is just fine. It works so well it tried to suffocate me just the other evening with an allergic reaction. I must have also accidentally touched some nickel, because now I have a rash on my hand.

  54. Ashlee says:

    I was really eager to read this because I saw the exact story and didn’t think it sounded correct. That being said, 2 minutes into reading I realized this was only a Dr. Oz bashing article. This is not what I expected nor did I appreciate it. I care nothing for Dr oz but this was incredibly unprofessional. Thank you for your views but I will be looking for another source.

    1. Chris says:

      Oh, I’m sorry. Were your feelings hurt because Dr. Oz, a cardiology surgeon, was criticized for making statements without any data and outside his field of expertise? If you think that this is bashing, then I suggest you stay away from all scientific writing where anyone who proposes something without data is roundly given criticism.

    2. Chris says:

      Or were you more offended when women in the comments complain about the lack of pockets in women’s clothing?

    3. WilliamLawrenceUtridge says:

      So, you don’t care about Oz, but you don’t like the article because it’s mean to Oz? You need to pick a premise and stick with it. What do you think about the reasons why Oz is being criticized? What do you think about scaremongering about cell phones on the basis of a series of cherry-picked anecdotes? What do you think about Oz’s entire audience being exposed to a tremendous amount of fear on the basis of those anecdotes?

      What do you think about the rather lengthy discussion of why the claims made by Oz being spurious and unjustified?

      Oh, I guess you don’t think anything because despite your tremendous interest in the topic, you stopped when Dr. Gorski said something mean about Oz.

  55. JW says:

    If you are so afraid of cell phone radiation then you might as well stop living when there are far more *gasp* dangerous things like crossing the road or driving a car.

    How about me saying methane in the air is causing mental retardation. My conjecture is no less plausible than cell phone radiation cancer and infinitely more other links between A and B.

  56. commonsense says:

    Why, if after there IS SHOWN even the slightest possibility of a correlation between where it was worn, to where the tumor started in the 22 y/o patient, why on earth would you want to so jokingly discount it as crap, or take the risk? have you ever lost anyone to breast cancer? I would rather my girls, and women I know take a little caution, than do something that could potentially cause harm , or ignore, simply bc the scientific ‘proof” has yet to be determined. if you apply that mindset, then how do you argue all the scientifically proven beneficial treatments are now in the courts for having failed or worse, killed people. use some common sense with something so easy, if it can prevent, then do it. if it can’t, then what does it hurt to simply carry the cell somewhere else. geeze

    1. Harriet Hall says:

      A correlation has not been shown, only anecdotes. To show a correlation, you would have to compare the incidence of cancer in those who used cell phones and those who didn’t. It doesn’t hurt to simply carry the cell phone somewhere else, but it hurts to engage in fear-mongering where there is no reasonable evidence. If we tried to avoid all the things that someone thinks might be correlated to a health hazard, we would have to live in an isolation cell.

    2. Sawyer says:

      We’re once again faced with a situation where doctors and patients need to understand the importance of Bayesian analysis in determining risk (or just understanding the general concept of the convergence of evidence in science).

      Any minor correlation that is discovered has to be weighed against our knowledge of physics, and the steadily decreasing odds that non-ionizing radiation can cause serious harm to living tissue. The “slightest” possibility shrinks by several orders of magnitude when this physical limitation is imposed. This risk is now lower than hundreds of things that we do on a regular basis without even thinking about. Brushing your hair with a comb vs. a brush probably has a higher cancer risk than cell phones, but are we going to demand scientists study this? Are we going to sue comb manufacturers for failing to notify consumers?

    3. David Gorski says:

      Why, if after there IS SHOWN even the slightest possibility of a correlation between where it was worn, to where the tumor started in the 22 y/o patient, why on earth would you want to so jokingly discount it as crap, or take the risk?

      No correlation has been shown. None. Zero. Zip. Nada. All we have are at most four anecdotes, none of which is particularly rigorous or convincing. Couple the fact that no correlation has been shown with the utter lack of a plausible biological mechanism by which cell phone radiation could cause cancer, and I do dismiss Oz’s latest nonsense as pointless fear mongering.

      have you ever lost anyone to breast cancer?

      Yes. I also treat breast cancer on a daily basis and do research into improving breast cancer treatment.

    4. windriven says:

      @commonsense

      No one is forcing you or anyone else to keep your cellphone in your bra.

      That said, this is a site dedicated to science. The argument is simply that no causal link has been established. You may choose to carry your cellphone in your purse, your pocket or your bra. Just don’t ask the current science to validate your choice.

  57. Elle says:

    I was diagnosed with inflammatory breast cancer last year. I kept my cell phone in my bra for at least 10 years. Do you have a degree in radio frequency radiation? I didn’t think so.

    1. David Gorski says:

      I’m terribly sorry to hear that you have breast cancer. However, I would point out that physicists who have “degrees in radio frequency radiation” are even more insistent than I am that cell phone radiation can’t cause cancer based on basic physics alone (i.e., that it’s physically impossible). I know this because I have on occasion gotten into somewhat heated discussions with a couple of them (one on this very blog) because they base that claim on what I refer to a “Cancer 101″-level understanding of cancer that is simplistic and ignores other mechanisms of carcinogenesis other than just mutation. Be that as it may, the physics here is so basic that you don’t need a “degree in radio frequency radiation” to be able to understand why it’s so incredibly unlikely that cell phone radiation can cause cancer. (Nor do you, actually.) The radio waves used by cell phones just don’t have enough energy.

    2. WilliamLawrenceUtridge says:

      What else did you do for that 10 years? Did you eat apples? How do you know it wasn’t the apples that caused your breast cancer. Did you sneeze? How do you know sneezing didn’t cause your breast cancer. Did you watch TV? How do you know the Sporanos didn’t cause your breast cancer.

      One must separate “sympathy for the sufferer” with “credibility of their assertions”. Merely because you have breast cancer does not mean your beliefs about what caused it are suddenly more relevant, important or true than what science and scientists believe about the topic. Merely because cell phones use the scary word “radiation” doesn’t mean they are cancer-causing.

      I am sorry you have breast cancer, and that my comment probably comes across as abrupt and mean. But far more people are helped by cold, discomforting truths than are helped by comforting false beliefs.

  58. KSo says:

    I’m 25 years old and had a lumpectomy on my left breast to remove a tumor that was growing in the same spot I placed my cell phone while I ran. That’s roughly 3 hours a week for almost 7 years. My family has no history of cancer or really any health problems at all, so how would you explain my recent health problems if there’s no link?

    1. windriven says:

      I’m sorry to learn of your tumor. Best wishes for a complete recovery.

      “how would you explain my recent health problems if there’s no link?”

      I wouldn’t. Cancer happens. My sainted aunt Pat died at an early age of anaplastic thyroid cancer. She also sang atrociously … and disturbingly regularly. There is little incidence of cancer in my family and no history of thyroid cancer. So did the atrocious singing cause her thyroid cancer?

      We are a species wired to build causal inferences. Unfortunately many women at some point present with breast cancer. Some of them will have carried their cell phones in their bras and some of the tumors will be located near where the phone was kept. When those happenstances converge the woman is likely to draw the inference that the tumor was caused by the cellphone.

      1. David Gorski says:

        Exactly. Most breast cancer, even in young women, is not related to a familial predisposition or identifiable genetic mutation. True, such associations are more common in breast cancer diagnosed in young women. Even accounting for that, the vast majority of breast cancers in young women are still what we call “sporadic,” meaning “we don’t know what caused it.”

        As hard as it is for KSo to accept, by far the most likely explanation is simple coincidence, given the lack of a physical mechanism by which cell phone radio waves could possibly cause cancer and the lack of even convincing case studies suggesting that it can. Given how common it is these days for women to carry their cell phones in their bras it was inevitable that there would eventually be a sizable number women who (1) develop breast cancer on the side where they usually carry their phone and (2) the cancer roughly corresponds to where the phone used to sit.

        There are now roughly 233,000 new cases of breast cancer diagnosed per year. What percentage of those women carry their cell phones in their bras? Even if it’s only 20% or even less, we’re talking tens of thousands of women. Cut that in half to find the number of women who have breast cancer diagnosed in the same breast as where they usually tuck their cell phone in their bras, and it’s still tens of thousands.

        1. Andrey Pavlov says:

          Heck, even if it is only 1% and you cut it in half that is still over 1,000 cases per year. And if only 1% of that was “young” women that is still 10 cases per year. And Oz is working with less cases than even that to try and claim some sort of link. Even with the most ridiculously conservative numbers (1% really is absurdly low) you’d still expect roughly the same quality of “evidence” as we see just by absolutely random chance. But then again, people are inherently bad at grasping the idea of the law of large numbers.

      2. Andrey Pavlov says:

        I believe it was Carl Sagan who said that human beings are “significance junkies.” We are constantly looking for patterns and the moment there is one, we immediately assume it must mean something. This is why one of the single most profitable inventions in the history of Las Vegas was the number board above roulette tables.

        I am sorry to hear about cancer in a 25 year old, but the simple answer to your question is “simple bad luck.” It has to happen to some small percentage of the population for reasons currently unknown. When it happens to you it is, quite reasonably, of extreme significance. It becomes difficult to accept that it was just random luck; in this case bad luck. It is the same phenomenon as if you were about to step off the curb to cross the street and a church bell suddenly rang and startled you, preventing you from stepping directly into a car that otherwise would have hit you. That is an example of random good luck, but many would look at it as a “sign” – perhaps from god – in the same way that one may look at a cell phone near the general location of a breast cancer as a cause.

  59. LIbbie says:

    I think the medical experts agree there is not enough evidence ON EITHER SIDE, though anecdotal observations are giving cancer experts concern. There is no study DISPROVING a link between cell phone storage and breast cancer and the title of this article is very deceptive. As far as I know you are a blogger who does not have a medical degree, nor are you a scientific researcher. You are not qualified to weigh in on this, and it is distressing that people who don’t know any better are citing this blog post as if it is scientific fact. More research needs to be done, but for your to post an article saying there is NO link when no one knows that is irresponsible and reckless. Shame on you!

    1. David Gorski says:

      I think the medical experts agree there is not enough evidence ON EITHER SIDE

      Incorrect. There is lots of evidence that there is no known physical mechanism by which radio waves could cause cancer. They just don’t have enough energy. Also, there are plenty of epidemiological studies showing no link between cell phone radiation and cancer. The sole exceptions are studies from a single group with an ax to grind whose results have not been replicated. See:

      http://www.sciencebasedmedicine.org/cell-phones-and-cancer-or-how-this-blogger-has-probably-utterly-destroyed-any-opportunity-he-might-have-to-work-for-the-university-of-pittsburgh-cancer-center/

      http://www.sciencebasedmedicine.org/cell-phones-and-brain-tumors/

      http://www.sciencebasedmedicine.org/cell-phones-and-cancer-again-or-oh-no-my-cell-phones-going-to-give-me-cancer-revisited/

      http://www.sciencebasedmedicine.org/new-data-on-cell-phones-and-cancer/

      http://www.sciencebasedmedicine.org/a-disconnect-between-cell-phone-fears-and-science/

      http://www.sciencebasedmedicine.org/critique-of-risk-of-brain-tumors-from-wireless-phone-use/

      http://www.sciencebasedmedicine.org/are-cell-phones-a-possible-carcinogen-an-update-on-the-iarc-report/

      http://scienceblogs.com/insolence/2011/06/01/the-bride-of-the-son-of-the-revenge-of-c/

      As far as I know you are a blogger who does not have a medical degree, nor are you a scientific researcher.

      Also incorrect:

      http://www.med.wayne.edu/surgery/faculty/DGorski.html

      You are not qualified to weigh in on this, and it is distressing that people who don’t know any better are citing this blog post as if it is scientific fact.

      I’m easily more qualified to weigh in on this than are Dr. Oz and the breast surgeon he had on his show, as I’m an actual breast cancer researcher and surgeon while neither of them are both. The breast surgeon featured appears to be a private practice breast surgeon who doesn’t do much, if anything, in the way of research.

      More research needs to be done, but for your to post an article saying there is NO link when no one knows that is irresponsible and reckless.

      Nope. It is very responsible and doing nothing more than stating what science knows thus far. However, I am glad that people are posting my article around the Internet to combat the ignorant fear mongering over cell phone radiation that is so common. It is good to be able to help the cause of science, even if in this small way.

    2. WilliamLawrenceUtridge says:

      Note that it is incumbent on the person making the claim to provide the evidence. If there is good evidence to suggest breast cancer and cellphones, we haven’t seen it. Four anecdotes are not good evidence, and Dr. Oz does a public disservice by promoting the idea as if it were credible. It’s fearmongering to drive ratings. What is distressing is making women worry about a harmless practice, particularly when breast cancer is also a rather terrifying diagnosis in the first place.

      Also, Dr. Gorski is a breast cancer surgeon and researcher, making him a rather qualified subspecialist to comment on the issue. What you know is clearly quite limited.

      Spending research dollars on this idea is pretty much akin to spending research dollars on investigations of homeopathy, for similar reasons.

  60. libbie says:

    Well, I just read that you claim to have medical credentials. You should have learned in medical school to not make sweeping pronouncements without studies to back you up, I see you claim to be a medical researcher as well. Found articles like this one:

    http://www.ageofautism.com/2010/06/david-gorskis-financial-pharma-ties-what-he-didnt-tell-you.htmland

    My views about you are still that it is reckless for you to take a position on this without there being adequate studies to back up your position. Perhaps you can seek a grant from Verizon Wireless to back up your views that young women should put themselves at risk when it’s quite a simple matter for them to just keep their phones in their purse.

    1. Chris says:

      Perhaps instead of the very boring and tired Pharma Shill Gambit, you could have produced actual evidence to support your claims. Do tell us what data shows that cell phones cause breast cancer. We eagerly await being educated by your superior information.

    2. David Gorski says:

      Found articles like this one:

      http://www.ageofautism.com/2010/06/david-gorskis-financial-pharma-ties-what-he-didnt-tell-you.html

      Amusing. That post is a pack of distortions and lies by someone who really, really hates me, as I’ve described before:

      http://www.sciencebasedmedicine.org/in-which-i-am-once-again-in-the-crosshairs-of-age-of-autisms-pharma-shill-machine-gun/

      http://www.sciencebasedmedicine.org/the-price-of-skepticism/

      Seriously. Age of Autism is a crank/quack site that promotes the scientifically discredited notion that vaccines cause autism, and Jake Crosby, the author of that post, is a true believer in that pseudoscience. Its proclamations and science and/or the truth are only ever related by coincidence only or by AoA trying to torture science or facts to serve its agenda. Jake’s general MO is what I like to call the “Kevin Bacon technique,” in which he tries to find the six degrees of separation or less between his target and someone who is connected to pharma, no matter how peripherally.:

      http://scienceblogs.com/insolence/2012/01/13/a-one-trick-pony-does-his-one-trick/

      My views about you are still that it is reckless for you to take a position on this without there being adequate studies to back up your position.

      That’s nice. That and a couple of bucks might get you a cup of coffee. Got any evidence to contradict my assertions, which are backed up by science?

    3. Sawyer says:

      If the cell phone companies are as evil as you think, they aren’t going to bother with such an obvious scheme as funding Science Based Medicine. A far more productive and devious strategy would be to extend the conspiracy two levels deep – give grants directly to cell phone fearmongers. These people statements that are so ludicrous that it makes the guy working at the Verizon mall kiosk look like Stephen Hawking by comparison. Your absurdity would distract attention away from any real conspiracies or bad science regarding cell phones. What an insidious way to hide the truth!

      It all makes sense now. WHERE’S YOUR PAYCHECK FROM BIG CELL AND BIG PHARMA LIBBIE!?!?!?

      :)

      1. mousethatroared says:

        Sawyer “If the cell phone companies are as evil as you think,”

        Oh they are. Have you seen what they charge for data? :)

        Even if it was true that putting a cell phone in your bra increased your chance of breast cancer, I doubt it would put a dent in the cell manufacturers service providers profits….they’d just come up with some sort of shielding device and charge more (probably double a reasonable mark-up)

        Ex: We know that texting and talking on cellphones* while driving increases the rate of automobile accidents, deaths and injuries, but a huge number of people still do it.

        *Except with long distance truck drivers, apparently, where talking on hands free phones seems to lower accident rates.

    4. WilliamLawrenceUtridge says:

      Libbie, why is Dr. Gorski “reckless” to say that there isn’t a risk based on prior probability and extensive research that fails to find a link between cell phones and any type of cancer, but Dr. Oz isn’t spreading unnecessary concern to say that there is a risk based on four anecdotes? Are you stupid, or merely a hypocrite?

    5. MadisonMD says:

      Re: Libbie’s rant

      Goodness. The shouts for “clinical evidence to prove the negative” are always deafening. But nary a whimper about mechanism.

      1. David Gorski says:

        It’s very similar to antivaccinationists. They’re always demanding proof of a negative or proof of absolute safety and efficacy.

  61. Tiffany says:

    I am the one and only Tiffany Frantz who this joke of a doctor is talking about and right at the beginning he calls me amish… none of the things this doctor says is true because I am not amish to begin with… so get your facts straight before you start stating unbelievable lies!!

    1. David Gorski says:

      Tiffany,

      If that is indeed really you, first of all you have nothing but good wishes from me, even though, based on what we know about the science of radio waves and breast cancer, you are almost certainly mistaken about your cell phone having caused your breast cancer. I hope you continue to do well, despite my discussing why I think you and your mother are mistaken to attribute your breast cancer to your old habit of carrying your cell phone in your bra.

      Second, please read what I wrote again when you’re less angry. I suspect it will not seem so nasty to you then, although I could be wrong. Whatever the case, I did not “call you Amish.” In my introduction, I merely made an offhand reference to another case that I had written about before yours that had distracted me from Dr. Oz’s segment on cell phones and breast cancer and how I found that at the time of deciding what to write for this post Dr. Oz’s segment still rankled me enough to write about it. The Amish girl to whom I referred is Sarah Hershberger, not you, as the link in the sentence demonstrates. I thought that it should be obvious that I wasn’t referring to you given that I mentioned that I had written about this girl’s case because her parents had taken her off of her chemotherapy in favor of alternative medicine.

      Finally, if there are any specific errors of fact about your history in this post, feel free to correct them in the comments. I based my account of your story on your interview with Dr. Oz and on publicly available news accounts in which you and/or your mother were interviewed, some of which I linked to in my post. If I got anything wrong on the facts or the timeline of your story it’s because that’s the way it was reported in one or more of those sources. I did my best to go through the sources and synthesize them into a coherent description of your case, but it is possible that I missed something or got some specific fact wrong, which brings me to my final point. There is a difference between being mistaken and lying. Even if I am mistaken about something, I was not lying because I reported what I thought to be, to the best of my knowledge and skills to determine, factual information. As for the claimed link between cell phones and breast cancer, I am quite confident that I am not in error about that, based on our current scientific understanding of cancer and the physics of radio waves.

    2. weing says:

      “I am the one and only Tiffany Frantz who this joke of a doctor is talking about”
      I know he’s a joke. I hope you learned your lesson and never go for interviews with him again.

    3. WilliamLawrenceUtridge says:

      Tiffany, what do you think of Oz using your story to spread unreasonable fear about cell phones causing cancer?

  62. Harriet Hall says:

    Tiffany,

    You misread. The reference to the Amish girl was not about you, but about a girl whose parents had stopped her chemotherapy. Dr. Gorski wrote about that case at:
    http://www.sciencebasedmedicine.org/an-update-on-the-case-of-sarah-hershberger-parental-rights-trump-a-the-right-of-a-child-with-cancer-to-live/

  63. Candace says:

    Ok on the cellphone but what about grabbing your breasts and playing with them. I have a tendency to grab them then push on them with my palms or even go up and down. My mom keeps saying that I could cancer by doing so. Is that even possible?

    1. Andrey Pavlov says:

      A bit of an odd question perhaps, but the short answer is not really. Excessive traction, irritation, or otherwise causing inflammation can hypothetically lead to increased likelihood of cancer, but even that is rather small. It is unlikely that you are pressing so hard as to cause inflammation, in which case there is almost zero chance you are increasing your risk of breast cancer by that behaviour.

      1. WilliamLawrenceUtridge says:

        My guess is that Candace is a 14-year-old boy masquerading as a human with breasts.

        Or a 40-year-old man.

        1. Andrey Pavlov says:

          That was my gut reaction as well. But until proven otherwise, it seems best for me to provide a reasonable science based answer.

  64. pixielee3 says:

    Ummm……playing devil’s advocate here (someone has to), and correct me if I’m wrong……..but aren’t all scientifical hypothesis based on “an idea or preconceived notion of what ‘might’ be happening’? So if Dr OZ and other ‘Dr’ think this is happening, then it is not so far-fetched to assume that the “hyposthesis” needs “validation” from studes. In order for that to happen, you need many “young girls” to enroll in a trial to “show the validity of the claim”. Woulldn’t that be unethical or against the creed of “do no harm”, to let the girls “develop possible cell phone cancer” in order to enroll them in a study? If he is prewarning them there COULD be a link to “cell phone bra holding and breast cancer in young woman”, WHERE is the harm? He is upholding the creed of do no harm! He would prefer to warn them, than to see them develop “possible cell phone related breast cancer”. (Thereby creating a smaller “pool” of potential study enrollees.) Now let’s just imagine he is TOTALLY off base in his ‘theory’, then what ‘harm’ did he actually cause the patient? The patient would quit a disgusting practice anyway and be ‘inconvenienced’? So either way, he isn’t really harming anyone! Remember, they said Christopher Columbus was ‘crazy’ when he stated the world wasn’t flat! I prefer to interpret crazy, quack and other such mudslinging words as “thinking outside the box’, “inovative”, “new ideas”, and the person who vigorously and vehemently shuts the idea down as “close-minded”, “deceptive”, and “suspicious”. Now on to the claim that “he thought that cell phone and breast cancer was linked and there was no changing his mind, it was made up already”…..Isn’t that EXACTLY what you, the opposer of the article, is doing? You seem pretty close-minded and set in your conclusions (that it is NOT possible) also. So maybe you both are on the opposite ends of the spectrum, and the truth lies somewhere in the middle! At least he is true to form! If he is the holistic person you tout him to be, it would, in essence, be his duty to the holistic world to warn them of something unnatural invading their body and doing it harm. What is your deal? Right, I forgot. You have a vested interest in “surgery, chemo and radiation” (a combination proven NOT to work I might add – Yes I said proven, and yes still being pushed heavily by Drs) …of course it makes you angry that Dr. Oz is cutting into your income…..oops, I meant ‘practice’. No bias there I suppose. I need to put a disclaimer on here……I do not watch Dr. Oz, nor do I particularly care for the man, I have seen him in the past and he bored me, so I switched the channel, but felt the need to have people think for themselves when reading on the internet, then draw their own conclusions, intellectually, without “fear and doom” from EITHER “end-of-spectrum theologists”. :)

    1. WilliamLawrenceUtridge says:

      Hi Pixie,

      The thing is, there are essentially an infinite number of scenarios that can be hypothesized for nearly any situation. Breast cancer could be caused by cellphones, or perhaps by the croaking of frogs, or the songs of angels, or implantation. Or to be more realistic, by apple juice, or potato chips, or gasoline fumes. To chase every single one down would require essentially infinite resources, which we don’t have. Thus, scientists rely on existing knowledge to build towards future hypotheses. Given what we know about cancer (undifferentiated cellular division caused by specific gene mutations, ultimately coming down to chemical bond strength) and what we know about the EM band that cellphones operate on (extremely low-power EM transmissions that lack the power to break bonds between base pairs – once described as “akin to leaf dropping on someone’s head, and cracking their skull open), this simply doesn’t appear to be a promising route to take. Merely the fact that Oz (a cardiothoracic surgeon, not an oncologist or cancer researcher) used his access to the public to promote this fearmongering, doesn’t mean that genuine experts give it any credibility.

      While there haven’t been studies of breast cancer and cellphones specifically, there have been studies of other types of cancer (notably brain cancers), and they have also come up showing no link. That’s another strike against some sort of hitherto-unappreciated oncogenic mechanism.

      So there’s a possibility that cell phones might cause breast cancer. It’s just highly, highly unlikely. For Oz to spread fear about it is irresponsible, much like it was irresponsible of Geraldo to spread fear about satanic cults in daycares eating babies in the 1980s.

      “Do no harm” cuts both ways – if there were a reason to link cellphones and cancer, then warnings would be warranted. But with no such reason, the harm that is being done is the spreading of unwarranted fear. Admittedly, this might lead to the inconvenience of not carrying your cellphone around with you, but still – that inconvenience is unwarranted. Just because somebody says something on TV doesn’t make it true.

      Columbus knew the earth was round, by the way. All upper-class Europeans did. His error was in his estimation of the diameter of the earth, not its shape.

      Also, your claim of “if you both disagree, the truth is probably in the middle” is a logical fallacy, specifically argument to moderation. The truth is where the truth lies, it is no where the difference is split. There is a correct answer here, and genuine experts on the subject believe that the answer is “cell phones don’t cause cancer”. Oz is not such an expert.

      Final note – Oz himself stands to gain financially by pushing up his ratings – which he can do by spreading unwarranted fears. Like this one. Perhaps your skepticism could cut both ways – drama sells, and Oz is attempting to create drama. Totally unnecessary drama.

      1. MadisonMD says:

        Thanks WLU– Outstanding and lucid.

    2. weing says:

      “You have a vested interest in “surgery, chemo and radiation” (a combination proven NOT to work I might add – Yes I said proven, and yes still being pushed heavily by Drs)”
      Could you elaborate on this? Also, it would help to know what you have as proven to work.
      Regarding the COI, what if this practice of carrying cell-phones prevents heart attacks? It’s just as plausible as it causing cancer. Could Dr. Oz be trying to maintain his income from heart surgery by having you avoid this practice?

    3. Chris says:

      “Remember, they said Christopher Columbus was ‘crazy’ when he stated the world wasn’t flat! ”

      Wrong, very very wrong. It had been known for almost two thousand years that the earth was round. And Eratosthenes, a Greek scholar, had even estimated its circumference around 200 BC.

      They thought Columbus was nuts because he insisted the size of this planet at much less than that estimate. They did not know there was a whole other continent, and without it all of those on the ships would have died.

      Next time, before you try to use an argument from history, actually try reading about it first.

      1. Dave says:

        Erotosthenes calculated the circumference of the earth to within a few hundred miles by observing that at noon on the longest day of the year a vertical stick (or actually a well shaft) at a town on the equator cast no shadow, whereas one a known distance north did cast a shadow. Using his brain and simple geometry of the angles of the shadow, he was able to deduce the earth’s circumference. Critical thinking at it’s best. People back then also noticed that the masts of ships at sea were visible before their hulls were due to the earth’s curvature.

        1. Chris says:

          I remember reading about that in about third grade. It was when we had actual science instruction.

          But that was a long time ago in Ft. Ord, CA back in the days when the USA was trying to boost science education after Sputnik. Pixielee3 seems to have tragically missed out on that kind of education as school funding was cut.

          1. Sawyer says:

            Hey now, the Cosmos reboot is one month away. That’s where I first learned the Eratosthenes story. There’s always hope!

            1. Chris says:

              I missed the first Cosmos because I was in college, and was quite busy. Yeah, some of us actually studied in college.

            2. Chris says:

              Oops, looked at the year. Um, actually I was working full time and attending grad school part time. So even less time when I was an undergraduate!

              1. Andrey Pavlov says:

                You should watch it! My engineer better half and I are re-watching the old series in prep for the new one. Sagan was just awesome!a

              2. Chris says:

                One of the early dates I had with my husband was a talk on campus by Carl Sagan in the late 1970s. It was just before the first Viking Lander landed on Mars.

  65. BD says:

    This is about something else Dr. Oz said once. He said pregnant women get morning sickness because the body is trying to protect them from spoiled food. So when a pregnant woman eats something with a strong taste or odor, she gets nauseous. Well, I had extreme nausea (hyperemesis gravidarum) with all three of my pregnancies, to the point where I couldn’t keep anything down 24/7 for about five months or so (forget the 3-month myth), and even on a completely empty stomach I was ravaged with dry heaving and retching, bringing up only stomach bile. I was put on a home IV due to dehydration. Well, through research and discussions with my doctors, I learned it was caused by hormones produced by the pregnancy. My body was reacting badly to the hormones, It had nothing to do with food. I enjoy Dr. Oz’s show, he is entertaining, and maybe he knows the truth about “morning” sickness now, because I heard his erroneous statement about it years ago. But still, many poor women suffering like I did probably still believe what he said.

    1. Andrey Pavlov says:

      I’m sorry to hear about your HG. I’ve seen a few patients with it and their misery is palpable. Dr. Oz’s idea on it is completely ridiculous though. It is what we call a “just-so” story and I am personally a little hypersensitive to these kind in particular since it hinges on evolutionary biology and I hold a degree in evo bio. It is very easy to concoct a story that has a seemingly plausible rationale but has only the flimsiest evidence to support it and that is precisely what he did. It is like seeing constellations – you have 5 or 6 points and all of a sudden you “see” Orion the hunter with a club and a boar.

      But that is precisely the problem with Oz. He is very entertaining and tells good stories. And he does actually mix in some legitimate tidbits, real science and medicine, and some morsels of good advice. But it is all mixed in to just about any random garbage you can imagine. I advise anyone who will listen not to waste their time watching Dr. Oz – it will leave you less informed (since in general people don’t have the relevant expertise to sort out the legit bits from the horse hockey) and prone to believing stuff that may be harmful (or at least waste your money).

  66. Christine says:

    What is sadder is articles like yours long rather boring but certainly just as uninformed as those you are attacking.
    I don’t think for a minute there has been any study on what cell phones do or cause to our health so by saying they do not cause cancer is as misleading as someone saying they do.
    Gosh the internet brings out all sorts of people pretending to be so many things.
    Keep using your little blog to try to discredit Dr Oz and anyone else you fear.

    1. WilliamLawrenceUtridge says:

      Hi Christine,

      Did you read the entire article? Did you get to this paragraph, which included numerous links to discussions of why cell phones are extremely likely to cause cancer? Did you note the bold part?

      Finally, besides pointing out the utter lack of evidence linking cell phone radio waves and breast cancer, we at SBM have written many times about both the scientific implausibility of the concept that radio waves cause cancer and the lack of any sort of compelling clinical evidence supporting a link. There just isn’t any biological plausibility. Radio wave energy at the power level used by most cell phones is not ionizing. It’s not even close, being several orders of magnitude too weak to break chemical bonds. Our understanding of cancer is that, in general, ionizing radiation is what is required to cause or contribute to cancer. That does not mean that there might not be a potential mechanism, as yet undiscovered, by which non-ionizing radiation might cause cancer, but simple physics and chemistry make the hypothesis that cell phone radiation causes or contributes to cancer not particularly plausible on the basis of currently-understood biology. On a basic science basis, at present there doesn’t appear to be strong evidence (or much of any evidence at all) supporting plausible mechanism by which cell phone radiofrequency radiation might cause cancer or an actual effect in which they do.

      Dr. Gorski does not say cell phones do not cause breast cancer. He says it is extraordinarily unlikely on the basis of prior probability (and if you check the links – several studies examining this question came up null) and that the cases cherry-picked by Oz are far more parsimoniously explained as simply young patients who do show up as part of the general background rate of cancer.

      The internet does bring out all sorts of people. In this case, a genuine expert in breast cancer has laid out the reasons why Oz (who is a cardiovascular surgeon, not a breast cancer specialist) is most likely fearmongering, not informing the public. For many topics, Oz does not deserve the credibility that his program has afforded him and it is a genuine shame that the public has such a knee-jerk willingness to swallow everything he says. Nobody is perfect, and in this case – Oz is very, very obviously not perfect. He is wrong, he is overselling the issue, and he is creating fear where none needs to be created.

      I’m sorry you didn’t understand the blog post, perhaps if you re-read it and check out some of the links you will develop a better grasp of the issues.

  67. Avery Davis says:

    “No, carrying your cell phone in your bra will not cause breast cancer…”

    *My emphasis

    That does not logically follow from the fact that some quack, without scientific evidence, makes the claim that cell phones carried in the bra will cause cancer.

    1. David Gorski says:

      One notes that all Ms. Davis can come up with is a quibble with the—shall we say?—stridency of the title of my post. One also notes that she apparently has no substantive criticism of the scientific and medical analysis to present. It is, however, gratifying to realize that one of the foremost promoters of the almost certainly nonexistent cell phone-cancer link is being harsher on Dr. Oz than even I am. Even I’ve never called Dr. Oz a quack. Now, she has. Excellent. :-)

  68. I found this page after a friend posted a warning about this topic-me, being me, I Googled first-and found this article/blog. Fantastic! For a long time I have told people that Dr Oz is not worth investing your time-misinformation/part information-just enough to scare people but not to actually inform them! Women have been carrying money etc in their bras for far longer than phones-why is money not the cause of their cancer? Seriously- I agree with you Dr Oz was, once, someone to respect and to heed advice- but thanks to Oprah-he is caricature of himself. So very very sad.

  69. libraryfiend says:

    Making that statement, “no, carrying your cell phone in your bra will not cause cancer” is just as bad without scientific evidence. Doctors didn’t think cigarettes caused cancer either. Put aside your dislike for Dr. Oz and just say that we need more research. Or– simply give me an article about why you don’t like Dr. Oz, because this is what this is.

    1. Sean Duggan says:

      I agree with you that one needs backing. That said, this has been addressed several times here in the comments, pointing out that this article does indeed show that said cancer is terribly unlikely, even once we set aside our knowledge that the person claiming it is a known deceiver.

    2. Andrey Pavlov says:

      I agree with Sean Duggan here.

      If you read the article carefully you will note that, except for the title, it does not say 100.00% for sure that cells phones don’t cause cancer. It says that it is extremely unlikely that they do. And it state exactly why based on much scientific evidence. It explains why the anecdotes by Oz don’t actually mean anything and are not evidence.

      This is vastly different than cigarette smoking where there really was a paucity of evidence followed by “tobacco science” to perpetuate the bottom line. There is ample evidence to say that for all practical purposes cell phones don’t cause cancer.

    3. Sawyer says:

      “Doctors didn’t think cigarettes caused cancer either”

      I’m sorry if you’re new here libraryfiend, but this is one of those canards that gets used over and over again, and I have yet to see it used correctly. The most sensible conclusions are in fact the exact opposite of what you’re proposing. We didn’t think cigarettes caused cancer before understanding A) the mechanisms of carcinogenicity and B) the massive epidemiological data that shows us the indisputable link between smoking and lung cancer. As soon as we started to understand those connections, many of the confounding variables could be eliminated as major causes of lung cancer. We already understand what low dose RF and microwave radiation does to human tissue. We understood this decades before the cigarettes/cancer research. We already had ample data to show that there’s very little correlation between cell phone use and cancer, and any connection that does exist is almost certainly from the hundreds of other environmental risks of living in a modern, urban society. All those other risks deserve far more research than they currently get.

      Diverting precious funding and laboratory space to study cell phone radiation reminds me of tobacco companies dumping money into studying dozens of phony (or phone-y :) ) sources of cancer. Useless doubt-mongering and a step backwards in our understanding of cancer.

    4. WilliamLawrenceUtridge says:

      This has been addressed repeatedly, both in the main body of the post and in the comments section (see here), plus there are several other whole posts on the lack of evidence and lack of theory supporting the cell phone-cancer link (here, here and here and here and here for example). The wavelengths that cell phones transmit at are much better at heating water molecules (slightly, XKCD’s most recent comic in its amazing what if series has some relevant information on just how powerful cell phone signals are) than they are at breaking bonds.

      Oz is a celebrity-whoring, fear-mongering douchebag who should no longer be treated with respect. His shilling of supplements alone makes him a net loss to the world’s health.

  70. Rebecca says:

    I was diagnosed with breast cancer a year ago. I just turned 41 years old. My breast surgeon, my oncologist and the radiation doctor all were surprised I had cancer due to my age! My breast surgeon was sure it was a mistake. I didn’t carry my phone in my bra, nor am I suggesting a connection, but I just wanted to correct the misperception that it is common for a young women to have breast cancer. It is not common UNLESS you have the BRCA gene.

    1. David Gorski says:

      Best wishes to you in your battle.

      However, I do feel obligated to point out that no one ever said breast cancer was common below the age of 40, but, as I discussed in this post, it’s definitely not rare, either. I’ve personally taken care of plenty of women in their late 30s and early 40s with breast cancer who did not have a known BRCA mutation. Commonly the story is that the woman gets her first mammogram, which is abnormal, which leads to a workup that diagnoses breast cancer. Indeed, the increased incidence with age of breast cancer starts to go up at age 40, which was part of the reason why age 40 was chosen to begin mammographic screening.

      This graph can give you an idea:

      http://seer.cancer.gov/statfacts/html/breast.html

      Roughly 10% of all breast cancer cases are diagnosed between the ages of 35-44. So, to be honest, I’m really not sure why your surgeon, oncologist, and radiation oncologist would be so surprised unless they don’t take care of large numbers of breast cancer patients. Anyone who takes care of a lot of breast cancer patients will see a fair number of women between the ages of 40-50 with breast cancer. I do.

    2. Andrey Pavlov says:

      Dr. Gorski is certainly the definitive word on these topics around these parts, considering he is a cancer surgeon and PhD cancer researcher, and actually does surgery for breast cancer as his daily job.

      However, during my general surgery rotation in medical school I did 1 week – just one week – of breast and endocrine surgery and in that week alone I personally scrubbed in on 3 cases (which I can remember) of women under 45 to excise their breast cancer. Taken alone that could just be a random cluster, no doubt. But it certainly supports Dr. Gorski’s point and the actual data. It is certainly not at all rare, albeit uncommon. I have also personally seen a woman who came in for her second breast cancer surgery – the first one having been when she was in her late 40′s and this one in her late 60′s. She also had no BRCA mutations, yet had clearly developed a second de novo case of breast cancer.

      I echo Dr. Gorski’s sentiments in your continued battle. Hopefully it was a small and non-aggressive tumor. Our methods these days yield excellent results in such cases.

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