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228 thoughts on “The early detection of cancer and improved survival: More complicated than most people think

  1. David Gorski says:

    Materialism DOES NOT EQUAL science.

    Yet another straw man from you. I didn’t say it does, although a good argument can be made that science can’t really study anything that is not of a material nature that can be measured.

    Leaving that aside, in my long experience debating these issues, I’ve noticed that it is rare for a scientist to disparage a scientific result or the process of science by bandying about the term “materialism” with a sneer, as you did. That sort of characterization almost always comes from people of either a religious or spiritual bent, whose beliefs do not allow them to accept the results of well-established science. Indeed, the “materialism” charge most frequently comes from creationists who do not accept evolution because of their religious beliefs. Not uncommonly, it also often comes from “alt-med” aficionados who believe in some sort of extra-material or supernatural “life energy” or other force in healing.

  2. HCN says:

    I still want to know what the natural treatment or prevention is for those born with the BRCA1 and BRCA2 gene.

  3. apteryx says:

    HCN, it sounds like you are demanding that natural products and evolutionarily appropriate lifestyles be the salvation of even the most unfortunate. Those things will not cause an established tumor to evaporate; while they can reduce the risk of developing an established tumor, they can’t reduce it to zero, most especially not if someone has a high-penetrance genetic defect. That doesn’t make them worthless for the vast majority of people who do not carry such a defect. One might as well demand to know what the allopathic treatment or prevention is for people who carry the Huntington’s gene.

  4. Fifi says:

    pec – The question is really whether you’re capable of adjust your thinking and beliefs when the objective scientific data contradicts your idiosyncratic/religious explanation of what you’ve subjectively experienced. For instance, if you experience sleep paralysis and believe the traditional/religious “explanation” which is that you have a demon sitting on your chest and you see/hallucinate what your believe system proscribes, can you let go of your belief in demons sitting on your chest when it’s objectively shown that sleep paralysis has an entirely natural explanation that doesn’t need supernatural explanations? It seems you can’t from the evidence so far.

  5. weing says:

    HCN,

    They could try primrose oil, daily exercise, and a healthy attitude. If they develop cancer, it’ll be because they missed a few exercises, didn’t have the right attitudes or didn’t use enough primrose oil.

  6. weing says:

    apteryx,
    There is none. Treatment is of symptoms and unsatisfactory. Research is being done on the mechanisms involved and eventually a treatment/prevention will be found to interfere with the ‘natural’ progression of the disease.

  7. David Gorski says:

    I am a real scientist, because I look at the evidence, whether from my own experiences, or scientific research, or the experiences of others.

    How do you weigh the types of evidence relative to each other? After all, as has been discussed here, personal experience and anecdotes are among the very weakest forms of evidence for the efficacy of a treatment. That is because human beings have so many cognitive quirks that make memory unreliable and lead us to remember occurrences and information that confirm our prior beliefs and world view and forget those that conflict with them or even remember versions of incidents with huge differences from what actually happened. Scientists learned this hard lesson over time, which is why the scientific method was, in fits and starts, developed: Because it does as well as any human method can controlling for the biases of researchers and the cognitive quirks that all humans have in observing the natural world and drawing conclusions from it. Indeed, it is these quirks that lead humans to believe that homeopathy or reiki works, despite extreme implausibility and lack of evidence.

    You appear to place far more weight on “personal experience” and the experiences of others than you do on science. That appears to be why you come to such fallacious conclusions.

  8. Harriet Hall says:

    pec,

    You only responded to 2 of my 8 numbered points. Shall I assume you have conceded that you were wrong on the other 6? I won’t answer the ones you responded to until you comment on the other 6.

  9. HCN says:

    apteryx said “HCN, it sounds like you are demanding that natural products and evolutionarily appropriate lifestyles be the salvation of even the most unfortunate. ”

    I’m not demanding anything. I want those who claim cancer and disease is a consequence of lifestyle choices to give me good answers on the ones that are shown to be genetic. I get so tired of the “you need to change your lifestyle” arguments, when the cause of the illness is genetic.

    But at least you revealed where you are coming from.

    Personally, I prefer looking at the whole picture. I’m just an engineer, I would never ever claim to be a scientist. But I’ll wager I have a better handle of what is better evidence than others.

    weing said “They could try primrose oil, daily exercise, and a healthy attitude. If they develop cancer, it’ll be because they missed a few exercises, didn’t have the right attitudes or didn’t use enough primrose oil.”

    Yeah, I thought so… of course there are also those lovely natural products that come from castor beans and apricot pits.

    ;-)

  10. Dacks says:

    “When Americans are led to believe that there is, or will soon be, a pill for these diseases they are less likely to worry about lifestyle. For example, if they knew that the “cure” rate for cancer is so much lower than it seems, they would be less complacent.”

    I think this statement illustrates the widespread inclination to find a scapegoat for death and disease. We know smoking is a high risk factor for lung cancer, so when a person develops lung cancer we say, ‘Well, he smoked for 20 years,’ or ‘Wow, he never smoked in his life.’ In other words, we need something to blame disease on. And there is a moralistic aspect in pointing to a failing that someone else has (not me, of course) that caused his or her problems.

    This is not to say that lifestyle elements are not crucial to good health, but that disease and death are somewhat mysterious (uh-oh, I’m sounding a little woo) in when and whom they strike. I can’t agree that complacency leads to cancer.

  11. apteryx says:

    HCN writes:

    “I want those who claim cancer and disease is a consequence of lifestyle choices to give me good answers on the ones that are shown to be genetic. I get so tired of the “you need to change your lifestyle” arguments, when the cause of the illness is genetic. But at least you revealed where you are coming from.”

    I did? Where is that, pray tell?

    Is this a straw man? I doubt anyone would claim that all disease is due to lifestyle, with none due to genetic defects or pathogens to which all people may be equally exposed. Given the enormous evidence that environmental factors affect the incidence of cancer, I’m sure you likewise would not try to claim that the sole cause of cancer is “bad genes,” whether one really bad gene or a thousand simply imperfect and human genes. Most of us could and would get some type and degree of cancer if we lived long enough. Rather than saying we are all genetic defectives and there’s nothing any of us can do but wait for the MDs to save us, it makes sense to try to control known environmental risk factors.

  12. pec says:

    “How do you weigh the types of evidence relative to each other?”

    Dr. Gorski,

    Pure, objective, scientific evidence wins every time. Of course, that does not mean do an experiment and be satisfied. Definitive conclusions are not easy to reach — but that is the goal.

    However most of our questions have not been answered; even more have never been asked.

    I do not believe in ANYTHING that high quality scientific evidence has shown to be false.

    When I experience something directly, such as the effect of correcting subluxations, I trust my experience, especially if it occursrepeatedly over many years. There is NO scientific evidence that contradicts my belief in subluxations. There are ideological, materialist reasons to disbelieve subluxations, but no scientific reasons.

    There are many other examples of things science has no evidence for or against, but which are nevertheless important to me and to many others. If we have directly experienced something which does not fit the materialist paradigm — so what? I don’t believe in “materialism,” whatever that word means.

    If you say things are “material” only if they can be measured, and you only believe in those “material” things, you are really saying you only believe in things ALREADY discovered and measured by scientists. You fail to see that we humans are a miniscule spec in the overall scheme of things. If we have not discovered or measured something, that does NOT mean it doesn’t exist.

    As our knowledge increases, our ignorance remains infinite.

  13. pec says:

    Harriet,

    I responded to all 8, and I numbered them. Please check my previous comments on this post.

  14. Fifi says:

    pec – “When I experience something directly, such as the effect of correcting subluxations, I trust my experience, especially if it occursrepeatedly over many years.”

    Where does all this experience with “subluxations” come from? Are you a chiropractor?

  15. David Gorski says:

    There is NO scientific evidence that contradicts my belief in subluxations. There are ideological, materialist reasons to disbelieve subluxations, but no scientific reasons.

    Actually, there are plenty of scientific reasons to believe that there is no such thing as subluxations, as Harriet wrote about a couple of months ago. Nor is such disbelief “ideological,” although your belief in subluxations certainly strikes me as such.

  16. Harriet Hall says:

    pec,

    “I responded to all 8, and I numbered them. Please check my previous comments on this post.”

    Nice try at deflection, but I won’t let you get away with it. You did not respond to the 8 numbered items in my comments of 14 May 2008 at 8:00 pm. Your answer on 15 May 2008 at 6:00 am only addressed 2 of them, and it did not even answer 3 of the specific questions I asked you in item 8. Please go back and answer those questions. And if you concede you were wrong on the other 6, just say so. If not, please explain.

  17. pec says:

    “Where does all this experience with “subluxations” come from?”

    I have practiced hatha yoga all my life. Subtle adjustments can make dramatic differences in how you feel. Nerves, skin, muscles, joints, internal organs — all can be adversely influenced by overly-tense muscles and even slightly misaligned vertebrae.

    Subluxation is not a simple concept and it would be unfair to dismiss it just because it has not been acknowledged or investigated by mainstream medicine.

    I find it hard to understand why you would not expect nerves to be influenced by the joints they pass through. And why do you think posture can have such a dramatic effect on the way we feel? If you hunch over your desk all day you are going to feel aches and tiredness. If you deny the possible existence of subluxations, I don’t see how you can explain this fact, something that almost all of us have probably experienced at least occasionally.

    Aches and pains are considered an inevitable result of age in our society, but very often they are the result of subluxations and the modern lifestyle. I have LESS of that kind of pain, not more, than I had 25 years ago.

    We spend long hours sitting in chairs, slouching in front of computers, driving in stressful traffic. We wear shoes that squeeze our toes and force our spines out of balance (well actually I never wear those shoes, but lots of women do).

    All of that can damage the precarious balance of our spines. It’s bad enough that we have to balance on two legs without a tail (maybe nature isn’t always so smart!). But it’s made so much worse by weak muscles, tense muscles, inactivity, bad posture, etc.

    I think yoga, or other similar exercises, is better than chiropractic because chiropractic adjustments are temporary. To make lasting changes we have to train the muscles, and that is a long and difficult process.

    Well I am not selling anything. I don’t even teach yoga. I just want people to be healthy, or as healthy as they can be given our less than ideal lifestyle.

    The voluntary muscles, the breathing process and the alignment of the spine are all central concepts in the “science” of yoga. It’s sad that mainstream medicine continues to ignore it.

    And yes, yoga is a science to me. I try things and notice the results. It isn’t clinical trials, but it’s still empirical and rational. I would not continue doing something that does not work and makes no difference.

    And of course I am not the only person who has benefited from yoga.

    Can you explain yoga in terms of mainstream medical concepts? I’m sure someone here will try to claim it’s all simple relaxation. Well maybe, but why is relaxation so good for our health? For one thing, it allows joints to return to their natural positions, removing pressure from nerves and allowing them to function normally.

    Words alone can’t convince anyone of something that has to be experienced directly. So that’s enough, good night.

  18. PalMD says:

    I find it hard to understand

    Yes, we noticed.

  19. pec says:

    http://en.wikipedia.org/wiki/Vertebral_subluxation

    “Chiropractic also asserts that spinal health and function are directly related to general health and well-being. Preliminary research concerning the intricate functioning of the nervous system suggests that this speculation may have some support.”

    http://www.ncbi.nlm.nih.gov/pubmed/10714536?dopt=Abstract

    “Researchers at the RMIT University-Japan, Tokyo studied reflex effects of vertebral subluxation with regards to the autonomic nervous system. They found that “recent neuroscience research supports a neurophysiologic rationale for the concept that aberrant stimulation of spinal or paraspinal structures may lead to segmentally organized reflex responses of the autonomic nervous system, which in turn may alter visceral function.”

    “Researchers at the Department of Physiology, University College London studied the effects of compression upon conduction in myelinated axons. Using pneumatic pressure of varying degrees on the sciatic nerves of frog specimens, the studied supported the idea of nerve conduction failure as a result of compression.”

  20. pec says:

    PalMD,

    There is more to this universe than what they happened to teach you in medical school. We can study all our lives and still only know a fraction of what has been learned. And what has been learned is an infinitesimal fraction of what exists.

    You are very typical of someone who is in love with the idea of being an expert and having the answers. Anyone who has not been indoctrinated into your world view must be inferior in some way.

    Some of us have more curiosity and have continued reading outside the little areas we studied in school. The result is that we are baffled and amazed by the confusing complexity we were born into. We lost our childish faith in authorities and experts, and replaced it with a passion for learning. We question every established myth and think for ourselves.

    The materialist ideology is reassuring; it says there are no real mysteries, since everything not yet explained will be explained in terms of substances we already know about. What would happen to your sense of superiority if you had to acknowledge there might be questions science has not yet begun to answer, or even to ask?

  21. Fifi says:

    pec – You seem to want to go off in a whole other direction rather than share where you gained all the experience with diagnosing and treating “subluxations” that you claim you’re basing your claims on. Or are you claiming that all the experience you’re talking about is from doing yoga yourself?

    I’ve never heard the term “subluxation” used by a yoga teacher or even a yoga therapist but perhaps your teachers have also been interested in chiropractice or you’re just transposing the beliefs you’ve taken on from chiro onto another system. (Or you’re trying to pretend you’re not a chiro while promoting chiro by pretending it’s a part of yoga.) Yogic systems – and there are a wide variety of schools of yoga – obviously are more aligned with ayurveda. Just because something is a system or a practice doesn’t make it a science. I could make the claim “art is a science” or “gymnastics is a science” or “weight training is a science” just as validly as you claim “yoga is a science”. Yoga doesn’t even need to involve practicing asanas (postures, the physical arm of yoga) – there are purely devotional schools of yoga.

    I’d certainly hope that you’d be in okay shape if you’ve been practicing yoga your whole life – though if it’s your whole life then it’s a bit strange that you present a before/after scenario as your anecdotal evidence. Since you’re proposing a before/after scenario over 25 years you’re either very young or exaggerating just a wee bit here.

    I think we can both heartily agree that exercise (including yoga) is generally far superior for getting back into or keeping in shape, and improving posture, than going to a chiropractor. Of course, like all exercise, when one has a chronic injury it’s important to be aware of what one is doing and refrain from contraindicated movements that would make it worse. There are a wide variety of asanas that need to be modified or shouldn’t be done if a person has certain injuries (a good teacher will offer the modification because it’s easy to see when it’s needed if one’s observant and knows what to look for). A well trained teacher will know this and ask any new student if they have any injuries and work within the person’s limitations. Of course, there are those teachers who think yoga is a panacea and injure their students by getting them to repeat damaging movements and posture, to “push past pain/resistance” or who adjust peoples bodies into ill advised postures (there’s a reason why all yoga studios get students to sign wavers absolving the studio and teacher of responsibility for injuries that occur during class). Not surprisingly as yoga increases in popularity more injuries are being seen, and it’s not uncommon for people to be injured by teachers “making adjustments” (which can translate to forcing someone’s body into a position that’s damaging).

    Yoga teachers with a firm understanding of anatomy, exercise safety and physical limitations are much less likely to injure students. There are great yoga teachers out there, it can be a fantastic form of exercise and more than that if one also meditates, and there are a very wide variety of schools of yoga – from purely devotional to a more contemporary secular physical practice.

    It’s so interesting that you claim authority via your personal experience of yoga but deny the validity of the personal experiences of others. I’m not sure what physical aspect of yoga that you don’t think can be studied scientifically. There are already studies going on about meditation (yoga is traditionally a preparation for meditation) and some on yoga.

  22. pec says:

    Fifi,

    What personal experiences of others have I denied? I don’t know what you’re talking about. If someone has an experience I don’t necessarily take their word for it, that would be crazy. Anyway, i think you’re just trying to argue.

    I specifically said I practice HATHA yoga, which involves breathing and physical exercise, as well as meditation. If yoga teachers don’t talk about subluxations, well that could be because most people stay inside their little boxes. I look for parallels and analogies. As soon I as read a book on chiropractic, years ago, I saw that the basic concepts were ancient, not new.

    Yes I have before and after experience with hatha yoga. I was in a car accident many years ago, and I live the modern lifestyle (desk, computer, car), except for the woman’s shoes — even if I had a dress-up job I would keep my $2 chinese slippers. So my spine needs adjustments, and I find that yoga works. Maybe a great chiropractor (and as in any profession competence varies widely) would be helpful in addition to yoga. But I am not trusting and prefer doing things myself if I can.

    Yoga (meaning hatha yoga) is great, but of course it can’t cure everything and of course it has risks. I have always been very careful, and I have never been injured by yoga.

  23. Fifi says:

    pec – Actually I’m trying to discuss yoga, “subluxations” and what experience with “subluxations” you’re offering up as evidence – you keep avoiding giving a straight answer about what evidence you’re basing you claims upon.

    What I see you doing is trying to give “subluxations” all kinds of auras of authority by associating it with practices and traditions other than chiro.

    I’ve related my experience and observations regarding the dangers of yoga teachers that believe yoga can do no harm and that are poorly trained. You’ve just glossed over and avoided discussing this. You say it would be crazy for you to accept other people’s personal experience and observations yet you expect everyone else to accept the assertions you make from your personal experience. Considering you’re not a chiropractor (or at least won’t own up to being one), you’re not a yoga teacher or a medical professional, are you speaking only about self diagnosis and treatment?

    That’s great that yoga is helping you with the natural consequences of the unhealthy “modern” lifestyle you’ve chosen. Any kind of physical activity will but if you enjoy yoga then it’s a great choice for you. Of course, one could just choose to live in a healthier way in the first place – prevention really is the best medicine. It’s also great that you’ve been careful and never been injured practicing yoga – that doesn’t mean that all students or teachers are careful, educated or caring enough to avoid preventable injuries. And, of course, it’s not “yoga” that injures people but poor teachers who don’t understand anatomy or sports safety, or poorly designed asanas, since there are so few standards for training or what is or isn’t yoga it’s really a buyer beware kind of thing. Which, if you’re as wary and “untrusting” as you say, should certainly give you pause in promoting yoga (hatha or other schools) as a panacea for injuries.

  24. pec says:

    “Of course, one could just choose to live in a healthier way in the first place ”

    This is getting to be a really weird conversation. I live in the healthiest way I can, and spend at least 2 hours every day on various kinds of exercise. What more can a human being possibly do? I have to work and I prefer to use my brain at work than load trucks or something more active.

    And if there are bad yoga teachers, well there are bad members of any profession.

    I don’t expect anyone to accept the reality of subluxations because of my personal experiences. I accept them because of MY experiences, because it’s OK to trust your experiences. And I recommended that others try it and find out for themselves.

    Subluxations can be recognized once to learn how to feel that a vertabra is not correctly aligned. Very often the whole spine is just “off.” This is not unusual — probably everyone is “off” to some degree, especially if they’re older and not active enough. We each have our own ways of being not quite right, and we can learn to recognize and correct problems.

    I am not going to write a dissertation on yoga here. Try it, learn about it, be amazed.

    I do not provide any kind of health treatments for anyone. I write software. I try to help myself and people I know by recommending various kinds of exercise. I think walking is one of the best, aside from yoga. Other kinds are good also, depending on what you like.

  25. Harriet Hall says:

    pec has deflected the discussion to other issues. She has not responded to my last message, so I will repeat it:

    pec,

    “I responded to all 8, and I numbered them. Please check my previous comments on this post.”

    Nice try at deflection, but I won’t let you get away with it. You did not respond to the 8 numbered items in my comments of 14 May 2008 at 8:00 pm. Your answer on 15 May 2008 at 6:00 am only addressed 2 of them, and it did not even answer 3 of the specific questions I asked you in item 8. Please go back and answer those questions. And if you concede you were wrong on the other 6, just say so. If not, please explain.

  26. pec says:

    Ok Harriet, I found it. No problem but it will have to be later. I wasn’t deflecting it, just got side-tracked. And then I thought you were refering to the first 8, not the second 8.

  27. Joe says:

    Pec on 14 May 2008 at 6:35 pm “A lot of these drugs weren’t even present 5 years ago. It IS logical to see a difference between substances our species has been eating for tens of thousands of years, and newly concocted concocted.”

    Logic is not at your service when your premise is incorrect. Fully modern humans left Africa ca. 50k years ago, moved to Australia ca. 40kya, and the Americas 10kya. In each case, they encountered and (abruptly) began using, natural products which they they had evolved to use. Natural products from the Americas were introduced in Europe (e.g., quinine) only a few hundred years ago.

    Pec on 15 May 2008 at 6:00 am “Many things have never been studied by science. And for heaven’s sake why should I doubt my own experiences anyway?”

    You should doubt your experience because it can, and does, fool you. Someone I know says ‘we only began making progress when we realized how easily we fool ourselves.’ You are no exception.

    Pec on 15 May 2008 at 6:00 am “On the other hand I love science and I do care about evidence.”

    Sorry; but there is scant evidence that you know what science is.

    Pec on 15 May 2008 at 6:00 am “There is NOTHING in your brand of pseudosience, however, to demonstrate the non-existence of subluxations.”

    Now we are pseudoscientists? We cannot prove non-existence, you must prove your claim of existence. That’s the rule, I don’t make the rules, I just follow them. In addition, as for “correcting subluxations” Crelin proved that, even if they existed, it was impossible http://www.chirobase.org/02Research/crelin.html

    Pec on 15 May 2008 at 9:43 am “I believe objective scientific data, and i believe my own direct experiences.”

    You clearly don’t understand the difference between “objective” and your (‘direct’) “subjective” experiences.

    Pec on 16 May 2008 at 5:04 am …

    Wikipedia is not an authoritative source for anything. Neither is JMPT, your second link; it is written by and for quacks.

  28. Joe says:

    In my last post, “In each case, they encountered and (abruptly) began using, natural products which they they had evolved to use.” Should be “In each case, they encountered and (abruptly) began using, natural products which they had NOT evolved to use.”

  29. pec says:

    (1) “Any discussion that mentions biophosphanates is clearly about SECONDARY prevention, i.e. preventing fractures in patients who already have decreased bone density.”

    Well maybe that is what PalMD was talking about, but in the context of that conversation it seemed like we were discussing the pros and cons of giving these drugs to all older women.

    This is what Jane said: “We are all beaten over the head with the message that MOST adult women are at risk and face that fate if they don’t get medicated”

    Anyway, it was a long conversation. I hope you are right and that PalMD would never give these drugs to a healthy woman, whatever her age.

    “You still have not given me a valid example of a doctor who thinks drugs are equal or better than lifestyle measures for preventing disease in the first place.”

    Yes doctors have been gradually seeing the importance of lifestyle. But I know people who have been harmed. I described the guy who was treated for RLS and is now much worse off than before. His doctor never suggested trying exercise, even though this is a person who smokes and never does any form of aerobics or stretching. Wouldn’t you expect that kind of person to come down with RLS, or some other annoying illness? There is also another guy at work who smokes and is overweight and is taking Ambien for sleep apnea. If I were his doctor I would say “I will not let you have any more Ambien until you make some kind of effort to be healthy.”

    We can all think of many examples of people whose doctors give them drugs when their lifestyle is obviously out of whack.

    (2) “There is no reason to assume that a new chemical is any worse for the body than a previously existing chemical. Some of the things that our species has been eating might be bad for us, and some new things might be good for us. The only way to find out is to test them.”

    Well I just don’t agree. We are products of evolution, we evolved within a biological context. I am not an environmentalist, but anyone can see that much of what we are eating, drinking and breathing now is not very good for us. Why are so many other species dying if unnatural chemicals aren’t harmful?

    When you create a substance in the lab you really don’t know how it affects all the complex systems of the body over a period of years or decades. Yes our bodies are great at surviving and adapting, but there are limits. And people who are on a lot of drugs probably don’t feel nearly as well as they would without the drugs. How we feel does matter. One of my friends is on statins, etc., for heart disease and he almost never feels really good. Yes it’s important to survive, but it’s better if you can survive AND feel well.

    (2a) Vitamins: I have heard over and over — and I’m sure you have also — that it’s better to get your nutrition from natural food, rather than from pills. Vitamins in food are not isolated, and this can be important. I am no expert on vitamins. Just thought this was common knowledge.

    (3) “you’re wrong that they do not restore health. Sometimes they DO restore health.”

    Ok well there may be certain drugs that restore health. I don’t think the ones that are being pushed on TV and that are the biggest sellers are likely to restore health. Most of them are meant to be taken for life, so obviously no one expects them to cure anything.

    (4) “In some cancers, survival and recovery are not exceptional, but routine.”

    I think you have to think more carefully about lead-time bias and over-diagnosis.

    (5) Type 2 diabetes in traditional cultures.

    We know that type 2 diabetes caused by obesity is becoming an epidemic in America, and even some children are getting it. This was not the case a couple of generations ago. It’s obvious that our lifestyle makes this disease much more likely than it has been in other cultures. Maybe people in non-modern cultures did get it occasionally, but it certainly has never been as common as it is here and now.

    (5a) “I’ve seen lots of pictures of people in traditional cultures who were obese.’

    Well I haven’t. Maybe the pictures you saw were taken after they opened a MacDonalds.

    “Type 2 diabetes can itself CAUSE obesity and can make it extremely difficult to control weight”

    That is the opposite of what typically happens. Yes type 2 diabetes makes it hard to lose weight, but refine carbohydrates and inactivity are known to be the most common causes of the disease. If we want to be scientific we should focus on what is typical, not the odd exceptions.

    (6) “At least half of invasive cancers can be cured today.”

    http://rex.nci.nih.gov/NCI_Pub_Interface/raterisk/rates28.html
    http://www.users.on.net/~pmoran/cancer/cancercure.htm

    Some, possibly most, of this is related to lead-time bias and over-diagnosis. This type of account has been so misleading, to the public and to MDs.

    (7) “Some psychiatric drugs do cause withdrawal symptoms; some more than others. Most do not.”

    That’s not what I have read. But you like drugs, we see it differently. It does not seem possible that soaking the brain in these unnatural chemicals can do any good in the long run. I have known people whose lives were saved by them, but those people were severely mentally ill before the drugs, and drugged (not sane) afterwards. I believe in avoiding them if at all possible. I know a woman who put her teenage son on drugs when his father (her husband) died. It’s NORMAL to be sad when a parent dies, for heaven’s sake! It was so hard to keep my mouth shut when she told me this.

    (8) “Since chiropractic has been trying to demonstrate subluxations to the scientific community for a century and has never been able to do so, can you admit at least a tiny possibility that your experience might have misled you?’

    Your “scientific” materialist community is never going to believe any non-materialist theory, no matter what.

    (8) “If you trust your personal experience more than scientific evidence,”

    I trust both. When a medical question has not been settled one way or the other — and most have not — my experience counts.

    People should trust their experience more than they trust the “experts” and authorities. We can read and think. When there is evidence that seems conclusive we believe it, until something else comes along and contradicts it. When there is no clear evidence we should trust our own experiences and intelligence, and the opinions of others we trust and respect. That does not include the drug industry or anyone profiting heavily from drug sales.

  30. pec says:

    That last post was for Harriet, and the numbers refer to her questions from 5/14 at 8 pm.

  31. David Gorski says:

    Some, possibly most, of this is related to lead-time bias and over-diagnosis. This type of account has been so misleading, to the public and to MDs.

    Neither of the links, especially not Dr. Moran’s, that you reference supports the contention that most of the improvement in cancer survival is related to lead time bias and overdiagnosis. Some almost certainly is, but not most.

    Nice job twisting what the references say, though.

  32. Harriet Hall says:

    pec,
    1. You said doctors “think drugs are equal or better than lifestyle measure for preventing disease in the first place.” The examples you gave do not support your claim. Both of your examples were of patients who were already ill.

    “We can all think of many examples of people whose doctors give them drugs when their lifestyle is obviously out of whack.”

    Yes, but that doesn’t mean they think drugs are equal or better than lifestyle measures for preventing disease in the first place, which is what you claimed.

    Incidentally, Ambien is not a treatment for sleep apnea; in fact, sleeping pills can CAUSE sleep apnea and are contraindicated for this potentially life-threatening condition. Are you sure you got the story straight?

    As for RLS, I would not “expect” someone who smokes and doesn’t exercise to come down with it. Smoking cessation and exercise might improve his symptoms, and I can’t be sure that his doctor never suggested those things. Patients have been known to say, “My doctor never told me that” when the doctor did tell them that and they refused to hear it or promptly forgot it. The responsibility works both ways, and patients often let doctors know that they have no intention of changing their lifestyle and that all they want from them is a pill or a quick fix.

    2. You don’t agree that we shouldn’t assume a new chemical is worse for the body than an old chemical without first testing it? You are free not to agree, but you can’t expect to convince others on opinion alone. Scientists test things; they don’t just assume that something is good or bad for us. The “natural vs unnatural” origin of a substance is meaningless. Some “unnatural” chemicals are harmful; some aren’t. Some natural chemicals are good for us; some are lethally toxic.

    Why are so many other species dying? I don’t know, but I suspect there are a lot of different reasons and I don’t think we can lay all the blame on unnatural chemicals.

    “And people who are on a lot of drugs probably don’t feel nearly as well as they would without the drugs” Probably not, because all effective drugs can have side effects. We are all in agreement that it is better to prevent illness than to take pills once you are sick.

    2a. First you said, “Even natural substances, such as vitamins, often can’t be used by our bodies when they have been separated from their natural context in food.” That is wrong. All vitamins can be used by our bodies when they have been separated from food.

    Now you say, “it’s better to get your nutrition from natural food, rather than from pills.” That is right. But it’s not at all what you said.

    3. First you said “Drugs don’t restore health.”
    Now you say, “Ok well there may be certain drugs that restore health.” You admit you were wrong. Good.

    “…the ones that are being pushed on TV …are meant to be taken for life, so obviously no one expects them to cure anything.” Some people might think that pills that don’t “cure” them can still maintain them in a state of health. I guess it depends on how you want to define health.

    4. I said, “In some cancers, survival and recovery are not exceptional.” You said, “I think you have to think more carefully about lead-time bias and over-diagnosis.”

    I think I have thought carefully, and I read Dr. Gorski’s article, and I am talking about cancers that were discovered when they became symptomatic, not just cancers that were diagnosed early or overdiagnosed.

    5. First you said “people from non-Western cultures do not get type 2 diabetes.” That is false. Now you say, ”It’s obvious that our lifestyle makes this disease much more likely than it has been in other cultures.” OK, I can agree with that.

    5a. There were obese people in primitive cultures long before McDonald’s, and I suspect more of them would have been obese if they could have obtained all the food they wanted. Obesity was a sign of prosperity and health for some cultures. I found a website that said the prevalence of overweight in adult females in traditional Western Samoans was 46%. I have heard of a tribe in Africa where the men have periodic eating contests and put on massive amounts of weight to make themselves attractive.

    You said, “refined carbohydrates and obesity are known to be the most common causes of the disease.” I don’t think that’s accurate. Only about 55 percent of type 2 diabetics are obese. The etiology is multifactorial, partly genetic, and poorly understood. One hypothesis is that obesity and sedentary lifestyle trigger the genetic elements that cause the disease.

    I completely agree with you that we would be healthier if we exercised, avoided obesity, and ate a healthy diet, but making rash generalizations about diabetes without checking the facts only impairs your credibility.

    6. You questioned whether “one in a billion” cancers were cured. I said half of invasive cancers are cured. You said, “Some, possibly most, of this is related to lead-time bias and over-diagnosis.”

    I don’t think most of it is. Invasive cancers are ones that have already started to spread. There are statistics that compare the survival rates for cancers at various stages. Dr. Gorski is far more knowledgeable about the numbers than I am, but I think he would agree that even after allowing for lead-time bias and over-diagnosis, the real cure rate is much closer to 50% than to one in a billion.

    7. I said, “Some psychiatric drugs do cause withdrawal symptoms; some more than others. Most do not.” You said, “That’s not what I have read. But you like drugs, we see it differently.” If you want to share with us what you have read, we can discuss the evidence. It’s not a matter of “liking” or disliking, and it’s not a matter of seeing differently. It’s a matter of whether the evidence supports your claim.

    You said, “It does not seem possible that soaking the brain in these unnatural chemicals can do any good in the long run.” And then you contradicted yourself by saying “I have known people whose lives were saved by them.”

    I agree with you that psychiatric drugs often have significant side effects and should not be over-prescribed, but you could make that point without exaggerating the dangers.

    8. You said you had experience with subluxations. I asked you if you could admit at least a tiny possibility that your experience might have misled you? You didn’t answer.

    I asked if you understood why some chiropractors have given up the subluxation myth. You didn’t answer.

    You suggested subluxation might cause RLS. I asked if you have any evidence that indicates the cause of restless legs?” You didn’t answer.

    You said “I can’t think of any other drugs right now that are worthwhile.” I provided a list of other drugs and asked “How can you not know about any of these or think they’re not worthwhile?” You didn’t answer.

    You said,“People should trust their experience more than they trust the “experts” and authorities.” I don’t think they should trust the experts and authorities, but I don’t think they should trust their own experience either. I think they should trust scientific evidence above experience. If their experience suggests something is true, they should withhold judgment until it can be tested. If you think something works for you, it’s reasonable to keep doing it, but it’s not reasonable to advance a general truth claim based on that experience.

    People’s experience throughout many centuries convinced them that bloodletting balanced the humours, relieved symptoms, cured illnesses, and saved lives. When their beliefs were tested, we discovered they were wrong. How can you possibly know your beliefs are not wrong until they have been tested?

    .

  33. pec says:

    http://www.dlife.com/dLife/do/ShowContent/type2_information/causes_and_risk_factors/causes_and_risk_factors.html

    “According to the National Institutes of Health, an estimated 80% of people with type 2 diabetes are overweight or obese”

    The other 20% are probably elderly and extremely inactive. It’s wrong to suggest that 45% of the time type 2 diabetes occurs for genetic reasons, or for reasons unrelated to lifestyle.

    “the real cure rate is much closer to 50% than to one in a billion.”

    You are probably defining “cure” as 5-year survival. I will try to find more information about this. I am very skeptical about the claim that chemotherapy cures half the time, for non-early stage cancer.

    “then you contradicted yourself by saying “I have known people whose lives were saved by them.””

    It is not a contradiction. There are mainstream treatments that keep people alive, but do not restore their health. Is it better to be insane or drugged? Well both are very bad.

    “You said you had experience with subluxations. I asked you if you could admit at least a tiny possibility that your experience might have misled you?”

    No there is absolutely no possibility of that. My experiences with this are 100% real. But I can’t convince anyone unless they try it and have similar experiences. There are uncontrolled variables that could make my experiences different from someone else’s. Sometimes we know things with absolute certainty even though we can’t prove it to someone else. That does not make our knowledge unscientific. It’s just the way life is.

    “I think they should trust scientific evidence above experience.”

    I have said this several times already but you missed it: If there is conclusive scientific evidence about something we should trust the evidence. I keep saying it, you don’t read it.

    I said:
    “When there is evidence that seems conclusive we believe it, until something else comes along and contradicts it. When there is no clear evidence we should trust our own experiences and intelligence, and the opinions of others we trust and respect.”

    “If you think something works for you, it’s reasonable to keep doing it, but it’s not reasonable to advance a general truth claim based on that experience.”

    I never did. I said I can know something because of my own experiences, but I would not make a general claim based on that. If I were the only person in the world who believes in subluxations and has experience with them, I would probably never talk about it until I found some convincing evidence. Then I would become famous for being the first to discover it. But subluxations are a well known concept that is widely accepted and believed. If as you say there is no scientific evidence, well that’s just another reason we need more CAM research.

    “How can you possibly know your beliefs are not wrong until they have been tested?”

    You can’t. And I don’t believe in any weird therapies that have not been tested. Most medical treatments throughout history have been at least partly wrong. That’s because human beings just don’t know enough to cure most diseases. MDs are human, and every often they can’t cure their patients.

    I do not believe you are curing half of patients with invasive cancer.

  34. Pec, based on your personal experience you have some great theories about the benefits of things like good posture and yoga, but in my personal experience they haven’t worked for me nor for a few of my friends and relatives.

    I was trained in classical dance as a child, a discipline which emphasizes the importance of good posture teaching how the spine should be used to support body weight. However, I discovered through personal experience over 50 years ago that sitting straight exhausts me. That probably has to do with the fact that I am natuarlly exceedingly flexible and it requires a great deal of muscle strenght for me to hold my body upright while sitting. I’ve knowingly slouched for those fifty years and feel just fine.

    I also studied yoga many years ago but I avoided any of the exercises that moved a hinge joint in a direction nature hadn’t intended it to go, another lesson learned studying classical dance.

    In the late 1970s I returned home to have a visiting friend tell me he had just dislocated his shoulder doing yoga. He said he had dislocated it several times in the past and I assume it wasn’t always when he was practicing yoga. He had seen a sign for a chiroprator nearby and told me to take him there which I did.

    Since he didn’t speak English, I had to translate. The chiro fixed his shoulder then said that he could give him treatments so that it wouldn’t pop out again. I didn’t know anything about the topic but it sounded very strange. All my dance training had taught that you can stretch and tighten muscles through exercise but not tendons or ligaments which were what I assumed kept the shoulder in place. When I questioned the chiro about that, he assured me that he could treat Fernando so that his shoulder would stay in place. It would take 14 treatments. I translated that. Fernando said he was leaving in a week. When I told that to the chiro, he said, “Then I can fix it in two treatments.”

    I translated that. Fernando and I managed to get out of the office without laughing. He didn’t return.

    My point is that I and a few others I know personally have had very different experineces than you have with things like good posture and yoga although I expect you will blame Fernando’s experience on bad teachers.

    Actually, I think it would be wonderful if there was some kind of expert, a medical anthropologist perhaps ?, who could write a blog on what is suspected about the influence of lifestyle on health and longevity. I say suspected because I don’t think it is an area where it is possible to get hard evidence since you can’t lock people up for years to do studies in which you control the food they eat and the exercise they get or all the other variables that come into play. But it would be interesting to hear what someone who had actually studied different cultures in depth had to say. Based on my experiences, and I have lived in several different cultures, I used to speak 3 languages in addition to English, I would suspect that lifestyle really isn’t as important as many healthy people obsessed with good health assume.

  35. Fifi says:

    Harriet – “You said you had experience with subluxations. I asked you if you could admit at least a tiny possibility that your experience might have misled you?”

    Pec’s response – “No there is absolutely no possibility of that. My experiences with this are 100% real. But I can’t convince anyone unless they try it and have similar experiences. There are uncontrolled variables that could make my experiences different from someone else’s. Sometimes we know things with absolute certainty even though we can’t prove it to someone else. That does not make our knowledge unscientific. It’s just the way life is.”

    No doubt you had your experiences, no one’s questioning that you had an experience (or experiences). It’s your interpretation and theories about your experiences that are being questioned (meaning the story you tell yourself to explain your experience to yourself – and us).

    Actually, yes, claiming absolute certainty in a situation where the evidence contradicts your interpretation of your experience is unscientific. Even if there wasn’t evidence that sheds doubt upon your subjective interpretation of your experience, being 100% sure of something is “real” simply because you experienced it shows a great lack of understanding of how the brain and mind work.

    Refusing to even consider contradictory evidence that may disprove your theory is a prime example of a full blown confirmation bias. All in all you’ve shown your attitude to be pretty much the definition of an unscientific perspective and attitude towards knowledge.

    Also, were you really advocating that doctors should blackmail patients into making lifestyle changes by withholding needed medicine? That doctors should be able to punish people for being unhealthy and impose lifestyles you approve of upon them? You seem to be promoting an extremely paternalistic model of medicine that totally negates patient freedom and responsibility regarding their own life and the style they live it in.

  36. David Gorski says:

    Actually, yes, claiming absolute certainty in a situation where the evidence contradicts your interpretation of your experience is unscientific.

    Actually, claiming absolute certainty about any data is unscientific. That’s why scientists always use phrases like “the evidence strongly supports the contention that” rather than “there is no doubt about the contention that.” ;-)

  37. Fifi says:

    Thanks for the clarification David, it seems I was missing the forest while focusing on the tree :-)

  38. Harriet Hall says:

    pec,

    OK, let’s see if I understand correctly. You have conceded that you were wrong about almost everything you wrote about the 8 numbered points except for two items:

    1. You are questioning the actual cure rate of invasive cancer. But apparently you have recognized that it is clearly much greater than the 1 in a billion you originally suggested as a possibility.

    2. You are questioning the relative causal contributions of genetics and other factors for type II diabetes. You questioned my numbers for the percentage of obese diabetics, but you countered with numbers for overweight AND obesity, which are not the same thing. For a breakdown of the actual numbers for obesity and/or overweight broken down by age and sex, see http://www.cdc.gov/mmwR/preview/mmwrhtml/mm5345a2.htm#tab2. These numbers don’t match the 45% figure I found elsewhere, but they are in the same ballpark. All the references I found say that the cause of type II diabetes is multifactorial and that there is a significant genetic component. It is simplistic and inaccurate to say “obesity causes diabetes.” And it is clear that at least some of the overweight diabetics are overweight “because” they are diabetic.

    As for psychiatric drugs, you say you didn’t contradict yourself. But you did clearly say you thought they didn’t do any good, and then you said they saved lives. The only way you could justify this as not being a contradiction is if you believed that saving lives is not good. Do you think it’s better to be dead than to take medication with side effects? A relative of mine was schizophrenic. He was diagnosed when he nearly succeeded in killing himself under the influence of a delusion. He spent the rest of his life, several decades, on psychiatric medications. He was “drugged” and not normal, but he was able to marry, raise a family, enjoy his grandchildren and live a life that was limited but that included much joy. I think the medications saved his life; do you think they “did no good”?

    You still haven’t answered some of the specific questions I asked:
    1. Do you understand why some chiropractors have given up the subluxation myth?
    2. Do you have any evidence that indicates the cause of restless legs?”
    3. “How can you not know about any of these [other drugs that are worthwhile] or think they’re not worthwhile?”

  39. Harriet Hall says:

    pec,

    I asked you if you could admit at least a tiny possibility that your experience might have misled you?”

    You answered, “No there is absolutely no possibility of that. My experiences with this are 100% real.”

    I never suggested your experiences weren’t real. I suggested that those real experiences might have misled you. The experiences of bloodletters and their patients were very real, but they led the experiencers to conclusions that were not correct. They were misled by the post hoc ergo propter hoc fallacy, the natural course of disease, the placebo effect and other sources of error.

    When you see a magician “disappear” a rabbit, your experience of the disappearance is very real, but if you concluded that the rabbit had really vanished into thin air you would be letting your experience mislead you into making a false conclusion.

    You said, “Sometimes we know things with absolute certainty even though we can’t prove it to someone else.” I’m sure the bloodletters “knew” with absolutely certain that bloodletting worked. The world has always been full of “true believers” who were absolutely certain about things that were wrong.

    In my review of Burton’s book “On Certainty” (http://www.sciencebasedmedicine.org/?p=103) I explained why the feeling of certainty can be deceptive. When you say you “know” something with absolute certainty, what you are really saying is that you have a strong feeling of absolute certainty. It has been demonstrated over and over that such feelings are not always consistent with the truth.

  40. pec says:

    “I and a few others I know personally have had very different experineces than you have with things like good posture and yoga”

    rjstan,

    My experience with yoga has not been simple either. I have learned some of it from various books and classes over the years, but a lot of it has been trial and error. I have found that no one can really explain correct posture — you just have to learn how to recognize it. It’s hard, takes patience and a real determination to improve your health.

    You said you aren’t able to sit “straight” — well good posture isn’t straight; the spine’s correct shape is an “S.” And it’s awfully difficult to get everything lined up to minimalize subluxations. As I said, for me it’s partly trail and error. And I once read a short book on Alexander technique that was tremendously helpful. I have tried to combine that with what I learned about yoga and chiropractic. If I had more time to devote to health I probably would have made faster progress. But the progress has been really great anyway.

    Since I learned so much from one little book on Alexander technique I imagine I could have learned a lot more from actually getting the training. And there are many different body therapies. Maybe different ones work for different people.

    The point is I just know that posture makes a difference. And I am hardly saying anything revolutionary — even our grade school teachers told us that.

  41. pec says:

    Harriet,

    I did not concede I was wrong about almost everything. I am trying not to be dogmatic and argumentative. I don’t pretend to know everything.

    When I express any uncertainty you say I conceded I was wrong. When I express certainty you and others say anyone who feels certain about something must be wrong.

    This is all silly quibbling that intentionally misses the important points.

    Communication can never be exact. In order to understand each other, people must give each other some benefit of doubt. Adversaries seldom learn anything from each other because they focus on picking apart every little thing. That’s easy to do, because the nature of language is imprecise. The nature of knowing and understanding, and living, is imprecise.

    People who agree with each other on a topic communicate well on that topic. That’s because they aren’t zooming in looking for tiny inaccuracies so they can “win” points.

    So people who agree with each other talk to each other, and their preconceptions are continually reinforced. You talk to like-minded people all day, and your sense of being right has strengthened over your life time.

    I like to question things and I don’t mind finding out I was wrong about something. I would like to see the evidence showing a 50% cure rate for invasive cancer. That goes against everything I have heard and it would be an interesting surprise.

    I would like to see evidence that type 2 diabetes is not primarily a disease of modern Western society. That would certainly be an interesting surprise.

    For most of what we are talking about here there is no clear evidence and nothing that would be easy to interpret. As I keep saying, most things just are not known. I am always making the kind of comments that good skeptics should approve of. But you don’t, because I am not a materialist. When I eventually claimed to be certain about something, that was jumped on immediately — oh look, she is not a skeptic after all, she claims to be sure about something.

  42. Harriet Hall says:

    pec,

    You said, “I am trying not to be dogmatic and argumentative.” Maybe you are “trying” but you’re not succeeding. You have repeatedly made statements that could only be interpreted as dogmatic and argumentative.

    You have clearly contradicted yourself and then denied that you did so. You have admitted you were wrong by backing down from your original statements to quite different ones. For examples, see my comments from 16 May 2008 at 11:50 pm You have given ridiculous examples like a doctor giving Ambien for sleep apnea, and you don’t comment when these examples are challenged. You have repeatedly failed to answer specific questions. You have mis-read or misinterpreted our words repeatedly.

    We are not just talking about semantics and quibbling. Precision of language is essential when you are discussing scientific evidence, or anything for that matter. You can’t say A is B, then learn that A isn’t B and then make the excuse that you what you really meant was that A is C. It’s not fair to move the goalposts in mid-game.

    You said, “When I express any uncertainty you say I conceded I was wrong. When I express certainty you and others say anyone who feels certain about something must be wrong.”

    That’s not true. I didn’t say you were wrong because you expressed uncertainty; I said you were wrong because you made false claims that you couldn’t support and it was only after you were shown that you were wrong that you backed down and expressed uncertainty. If you had expressed uncertainty from the beginning, our discussion would have been very different. And if you will read carefully, you will see that I never said people who feel certain MUST be wrong; I said that they are often wrong and that the feeling of certainty is not a reliable guide to truth.

    You didn’t respond to my arguments about the certainty of bloodletters. I hope you can recognize that their certainty was misguided, and I hope you don’t think you are of some superior species that is immune from such errors.

    The whole edifice of science is built on the recognition that humans are very prone to all kinds of errors and that the only way to approach the truth is to test human beliefs objectively against reality. If you are welded to beliefs formed by personal experiences and are unwilling to even admit a minuscule possibility that you could be wrong about, for example, subluxations, then you are essentially rejecting the whole concept of science and retreating to a world where we can’t have any meaningful dialog.

    You said, “I am always making the kind of comments that good skeptics should approve of. ” I’ll grant you that you do make such comments – but you keep interspersing your legitimately skeptical comments with dogmatic nonsense. What are we to think?

    It has become clear that you are not arguing on the level that the rest of us have come to expect from scientists and critical thinkers. And when you can’t hold up your end of the argument, you play the “poor me” card and fall back on excuses like saying that you don’t pretend to be an expert or suggesting that we’re being mean to you just because we don’t share your views.

    I’m going to make a suggestion even though I don’t think you’ll follow it. I would suggest that for a time you refrain from commenting except for comments that you can frame as legitimate questions on the subjects covered in this blog.

    Go back and look at your earliest comments on this thread, and think how differently our discussion might have evolved if you had simply asked Dr. Gorski what he thinks the true rate of cancer cures is after correction for the errors he discusses in his article.

  43. Pec, now you are treading on my biases. :-) You said that “…good posture isn’t straight; the spine’s correct shape is an ‘S.’” I am defining proper posture as “straight” the way that I remember it being defined by ballet teachers eons ago. Where did you get the idea that correct posture means that the spine is shaped like an ‘S’, something that sounds ambiguous to me since it doesn’t address the sharpness of the curves? Is that a concept from yoga or chiropratic? Do you know many professional ballerinas? Since you said that you have a PhD in statistics, I would think your would reserve judgment on which type of posture is best for health until you have seen studies with statistically significant differences comparing groups who have what I referred to as straight posture to those who have what you refer to as ‘S’ posture.

    You also said, “The point is I just know that posture makes a difference. And I am hardly saying anything revolutionary — even our grade school teachers told us that.”

    Yes, and they told us to drink 8 glasses of water a day, to eat plenty of red meat and have a good old American breakfast like bacon, eggs and sugar coated cereal.

  44. pec says:

    The spine should be straight when seen from the back or front — not curved to one side or the other. When seen from the side, the spine is shaped like an “S.” This is well-known, obvious, and you can see it on any illustration or x-ray. Sorry I have to say I am certain about this, but I have to because it is a perfectly obvious fact. If you have never seen a picture of a normal spine, that is quite amazing. Just look.

  45. pec says:

    http://encarta.msn.com/media_461516367_761555694_-1_1/human_spine.html

    Here is one. It took me half a second to find. I can’t believe I’m getting involved in this level of lunacy

  46. “Level of lunacy”? Pec you are not talking to a nice MD, scientist or Skeptic trained to me unemotional. You are insulting me, Rosemary Jacobs, a person who was seriously injured by an MD who was almost as foolish as you are but a lot nicer.

    You may not be dangerous in person because you may be wearing a fur coat when it is 90 degrees out so that people who see you realize that they can’t rely on what you tell them, but on the Internet the kind of nonsense you utter does hurt people who become victims of unsciedntific medicine and the utter nonsense you preach.

    I have seen x-rays. I have seen skeletons, but you obviously have never seen a ballerina. What’s more you have no desire to. You have no desire to see anything that contradicts the rosy little world you’ve created for yourself.

    The only question I have is whether or not you are terrified of sickness and death or just another alt trying to make a buck not caring who you hurt trying to convince the public that scientific medicine is evil and the alt kind is good or that a “good lifestyle” can protect them from everything bad when that is only true in your own deluded world.

  47. pec says:

    It’s a fact that the spine is not “straight.” Ballet does not teach you correct posture anyway — we are not meant to walk on our toes with knees pointing outwards.

    I always say here that I do not use alternative treatments and that I have not opinion on most of them. I don’t promote any kind of treatments.

    I also always say that mainstream medicine is great for certain things. And I always say that lifestyle can’t prevent all diseases — but it can prevent many of the modern chronic diseases associated with aging.

    I think the alignment of the spine is extremely important for health — and of course MDs get enraged when I say that.

    The spine is not straight and no one who has seen an x-ray or a skeleton would deny that and angry about it. Unless they were nuts.

  48. dcardani says:

    pec,

    you say:

    “I always say here that I do not use alternative treatments and that I have not opinion on most of them.”

    You keep saying that, and people here keep not believing you. Why do you think that is?

  49. pec says:

    “You keep saying that, and people here keep not believing you. Why do you think that is?”

    It’s because I am not a materialist, and I have a more “holistic” philosophy. They don’t like that. They want to feel confident that “materialism” is correct.

    I think some mainstream treatments are useful and some alternative treatments probably are also. Mainstream medicine has more money for research, and I’m glad if funding for CAM is increasing.

    So I am accused of believing in any crazy alternative therapy that’s advertised. They’re good at using logical fallacies to seem to win arguments.

    Mainstream materialists want to believe they have effective treatments for cancer, and that progress is continually being made. If you question that they feel threatened. Harriet believes that invasive cancer is cured half the time, but won’t explain why she believes it.

    This post was about how hard it is to determine cancer cure rates, but no one explained how it can be done. They say “yes we know it’s very hard, you aren’t telling us anything we didn’t know.” Ok great, I didn’t tell them something they didn’t know. But they still haven’t provided answers.

  50. David Gorski says:

    It’s because I am not a materialist, and I have a more “holistic” philosophy. They don’t like that. They want to feel confident that “materialism” is correct.

    No, it’s because you so often spout utter nonsense (such as “pre-moderns didn’t get cancer”) that you are unable back up with any evidence other than your “personal experience” or “experiences of others,” that’s why so many commenters around here take issue with you, including Harriet and myself. When shown evidence that clearly demonstrates you to be incorrect, you just keep spouting the same nonsense again.

  51. Fifi says:

    pec – How is your philosophy more “holistic” than that of others here? If you mean “holistic” in the new age sense then certainly the beliefs and philosophy you’ve expressed here seem to be. If you mean “holistic” as in “recognizing the functional relationship between the parts and the whole”, you certainly don’t seem to be expressing a more holistic philosophy.

    You’re not accused of anything, you expressed a 100% unshakable belief in “subluxations” (an idea you obviously learned from someone) based on subjective experience and interpretation while totally ignoring the evidence that was presented. This doesn’t make you “loony” but it does make you appear naive enough to believe in all kinds of wacky things that don’t exist.

    You keep calling people “mainstream materialists” – first of all CAM is extremely mainstream and much of it is corporate, despite promoting itself as grassroots and alternative. The majority of people in America are theists and have faith based life philosophies (though American theists sure do like to gobble up more than their share of material resources, so they’re theist materialists I guess, who also believe that science and technology should perform magic for them! Another side effect of magical thinking, no doubt!).

    Pec, you’re part of the majority because theists ARE the mainstream and this is why religion is so influential in the US (along with the admitted governmental bias against “reality based thinking”). CAM/new age and Christian Fundamentalists are really part of the same assault on “reality based thinking” – not surprisingly they actually often end up in bed together politically since they have the same agenda. A recent example is the Rove/McCain/RevMoon connection. It’s hardly surprising that CAM/Big Vita, Christian Fundamentalists and neo-Conservative politicians all have it out for reality-based and critical thinking – it makes the sheeple much harder to herd and fleece. So, at the end of the day, while there are certainly individuals of all kinds within CAM (and I know some lovely acupuncturists and CAM healers) the overall philosophy and commercial interests actually support the most rigid, unprogressive and repressive elements of our society.

  52. Harriet Hall says:

    pec said, “Mainstream materialists want to believe they have effective treatments for cancer, and that progress is continually being made. If you question that they feel threatened.”

    I don’t feel threatened. I just think anyone who denies that there are effective treatments for cancer is out of contact with reality. It annoys me a bit, just as I am annoyed by those who deny the germ theory or evolution.

    I don’t appreciate being labelled as a materialist. That’s a philosophy, and as such it has no bearing on a discussion of science. Science is a method to study those things that can be objectively investigated with various ways of observing and testing that make up the scientific method. Science does not presume to say whether the immaterial can or can’t exist. It doesn’t even presume to say whether what it studies really exists in a metaphysical sense.

    “Harriet believes that invasive cancer is cured half the time, but won’t explain why she believes it.”

    I wish you wouldn’t presume to tell me what I “believe.” I try not to “believe” anything but to hold provisional conclusions based on the best available evidence. I provided evidence like this:
    http://rex.nci.nih.gov/NCI_Pub_Interface/raterisk/rates28.html

    I read Dr. Gorski’s article, and I know these statistics don’t reflect the considerations he raised. They represent a starting point, and the “real” cure rates can be approached by adjusting for things like lead-time bias. And these “cure” rates are really 5-year survival rates; 5 years of survival is a rough indication that the cancer is probably cured but a minority of patients may still have recurrences after 5 years. Anyone with a shred of common sense recognizes that the actual corrected cure rates would be lower than 50% but also realizes that speculations like pec’s “one in a billion” are ludicrous.

    “This post was about how hard it is to determine cancer cure rates, but no one explained how it can be done.”

    I thought it was obvious that it can be done by correcting for sources of error like lead-time bias. The process is not simple, and each cancer is different. The best answer will still be only an approximation. It seems you are looking for precise answers, and there aren’t any, but we can be 99.999…% confident that the true overall cancer cure rate is less than 50% and MUCH MUCH more than one in a billion.

  53. Pec said, “Ballet does not teach you correct posture anyway — we are not meant to walk on our toes with knees pointing outwards.”

    Your ignorance and illogical thought processes are overwhelmingly apparent again. It is not true that ballerinas walk on their toes with their knees pointing out and if you are certain that their posture is bad, then you had better do some investigating to see if they have a statistically significant amount of disease over and above that of people like yourself, assuming there actually are others like yourself, who have whatever it is you define as good posture because if they do not it clearly demonstrates that your insane beliefs about the benefits of whatever it is you call “good posture” are inaccurate.

    All I ever hear you say is, “I am right because I know I’m right. I’ve experienced this or that and that is how I know that I am right. Everyone who doesn’t believe me or has the audacity to ask for objective evidence is evil or a fool or an evil fool.” That is crazy.

  54. pec says:

    “we can be 99.999…% confident that the true overall cancer cure rate is less than 50% and MUCH MUCH more than one in a billion.”

    Ok, “one in a billion” was an exaggeration. But we are now left wondering how much lower than 50% the real cure rate might be. You say we can’t know precisely — all right, but how do we correct for bias and approach some kind of realistic estimate?

    This is important because when you say there is a 50% cure rate, as you did say, people will generally take your word for it. If you say there is a 50% cure (or 5-year survival) rate, but we have to correct for various sources of bias, people will assume those corrections will be relatively minor.

    But is that a warranted assumption?

    We are left not knowing if the real cure rate is closer to 50%, or 30%, or 10%, or what. We don’t know, until we have some reasonable way of correcting for bias. How is that generally done?

    I think I am asking a perfectly legitimate question.

  55. Joe says:

    pec on 18 May 2008 at 2:16 pm “We are left not knowing if the real cure rate is closer to 50%, or 30%, or 10%, or what. …?”

    You should have some idea about the answer to questions you ask, so why not tell us? I know- you don’t know the answer, you don’t even have an estimate; but you think posing it, as if none of us has thought of it, validates your shaky notions.

    A 10% cure rate is 100 hundred million times better than 1 in a billion. I doubt you realize the difference. Yours was not a ‘slight’ discrepancy in numbers. It is like claiming you can pick up a stone in your driveway, and you can also lift a battleship.

    The reason I thought you were a naturopath is that you are not, merely, uninformed about health (and science); you are thoroughly misinformed. One is reminded of a character, invented by Lewis Carrol (I believe), whose words mean just what the character intends- no more, no less. Your personal notions of facts have no currency.

  56. weing says:

    pec,
    “We are left not knowing if the real cure rate is closer to 50%, or 30%, or 10%, or what. We don’t know, until we have some reasonable way of correcting for bias. How is that generally done?”

    I am repeating what I posted earlier regarding this.

    “That is the reason for staging and stratifying lesions based on size in controlled studies. This helps to eliminate lead-time and length bias. Then you can see if and how your treatments are working compared to others.”

    Are you really saying that only about 7 people in the world have been cured of cancer?

  57. pmoran says:

    Pec “We are left not knowing if the real cure rate is closer to 50%, or 30%, or 10%, or what. We don’t know, until we have some reasonable way of correcting for bias. How is that generally done? ”

    We do know roughly what the ultimate cure rate for cancer is because we have masses of long term statistics such as those at ttp://www.users.on.net/~pmoran/cancer/cancercure.htm
    . If you think there are biases that might materially affect the conclusions drawn there, it is up to you to say what they are.

  58. Harriet Hall says:

    pmoran,

    You left an “h” off the beginning of the link.

    I gave that same link to pec on14 May 2008 at 8:00 pm. Either she didn’t read it, or she didn’t believe it (for reasons that she has not shared with us), or she is incapable of understanding it. Based on the quality of her comments, I suspect the last of the three.

    I think she wants something simplistic like total cure rate minus effect of lead time bias length time bias minus cancers that were overdiagnosed, misdiagnosed, or would never have progressed. And even if you could give her that, I suspect she would remain unsatisfied.

    The link mentions that carcinoma in situ and skin cancers are excluded from the figures. Omitting carcinoma in situ effectively removes most of those cancers that might never have progressed enough to harm the patient. And since skin cancers are eminently curable, if you were to add them to the mix, the overall cancer cure rate would only rise.

    Pec,

    you say “people will assume those corrections will be relatively minor.” That will be a correct assumption, pec. Read Dr. Gorski’s article again. Look at the data.

    Remember that these data represent an average. The cure rate of cancers varies from 100% to 0% depending on type of cancer and stage.

  59. pec says:

    “The overall permanent cure rate of cancer lies in the vicinity of 50%, and is improving. ”

    That web page is just another example of the kind of misleading claims we were supposedly talking about. If 50% of patients diagnosed with cancer are alive 5 years later, that tells you nothing about how many would have survived without the treatment.

    The first graphs shows that cancer incidence has increased in America since 1972 while mortality remained fairly constant. The author makes the usual conclusion, that mortality rates would have increased with incidence rates, if not for the treatments. But that fails to consider that better diagnostic technology is finding more cases that would never have progressed.

  60. pec says:

    http://www.slate.com/id/2103428/

    “Not only do some abnormalities grow very slowly, some actually regress without treatment, as a result of complex interaction between precancerous cells and the body’s immune system. This can be true, for example, of LSILs and HSILs, low-grade and high-grade squamous intraepithelial lesions, detected by Pap smears and linked to cervical cancer. As it turns out, through processes that are not well-understood, many—and some say most—LSILs and HSILs will simply improve on their own.”

    “subtle, cellular alterations may fall into a gray area between cancer and not-cancer, particularly for early stage cases—the very realm in which screening is routinely used.”

  61. Harriet Hall says:

    pec,

    You have failed to understand the data on that web page. It DOES tell you something about how many would have survived without treatment, albeit indirectly. You do the author a disservice; he is fully aware of the kind of biases Dr. Gorski covered and all the known sources of error. We can’t do a controlled study on humans where we diagnose cancer and only treat half of the patients, but we can reach reasonable conclusions indirectly, based on the kind of data on that page and based on known survival rates for untreated cancer, for instance see table 6 at http://www.mcn.org/c/irapilgrim/toc20.html.

    Your examples of LSIL and HSIL show your ignorance. They are not cancer. They have nothing to do with the statistics about invasive cancer.

    You are obviously way out of your depth here.

  62. pmoran says:

    “>The overall permanent cure rate of cancer lies in the vicinity of 50%, and is improving. ”

    >That web page is just another example of the kind of misleading claims we were supposedly talking about. If 50% of patients diagnosed with cancer are alive 5 years later, that tells you nothing about how many would have survived without the treatment.

    >The first graphs shows that cancer incidence has increased in America since 1972 while mortality remained fairly constant. The author makes the usual conclusion, that mortality rates would have increased with incidence rates, if not for the treatments. But that fails to consider that better diagnostic technology is finding more cases that would never have progressed.”

    Pec, the claim on that page is not merely that 50% of cancer patients are alive (and cancer-free) 5 years later, but that in excess of 50% of cancer patients are now cured *permanently*. The overall five year cancer-free survival rate in the latest figures is well in excess of sixty per cent. But because deaths continue to occur from some cancers after five years the ultimate cure rate would probably now be closer to 55-60% range.

    It is true that some of the increasing overall incidence will be due to the discovery of tiny asymptomatic breast, prostate cancers via screening, and possibly a small number of other cancers that might not be progressive. But even thirty-five years ago, before such technology, overall cancer cure rates were running at 40-50 per cent. We have always been able to cure a lot of breast cancers, bowel cancers, cervical cancers etc. Also, breast cancer screening seems proven to be able to reduce absolute death rates, suggesting that at least some of the screen-discovered ones are lethal.

    So yes, I suppose somewhere in the figures there will be a few cancers that will not progress, but these are extremely rare with *symptomatic cancer*, as most of these cases still are. If we surgeons leave even a little bit of these cancers behind the patient can be in deep trouble.

  63. pec says:

    I did not see anything on that web page to help estimate how many people would die of cancer without treatment. The incidence went up in 30 years, but that could be because of earlier diagnosis. The mortality rate didn’t change much. Are you saying your treatments are effective, but have not improved much in 30 years? If the new drugs were effective we would expect the mortality rate to have decreased greatly in 30 years. The only way you could claim your treatments have been improving would be if the increasing incidence could not be accounted for by earlier diagnosis. And you didn’t mention anything about that.

    There are many articles on overdiagnosis saying that it’s very possible that most cancer never causes disease. Are you taking that into account? I don’t see any hint of that idea on that web page.

    The article I linked — and there are many like it — explains why we really don’t know the cure rate for cancer, in general. And therefore we don’t know how effective the treatments are, or if the treatments are improving.

    And I would say that if the treatments have not improved much in 30 years research must not have made much progress in understanding cancer.

  64. pec says:

    “You do the author a disservice; he is fully aware of the kind of biases Dr. Gorski covered and all the known sources of error.”

    Then how come he never mentioned overdiagnosis? Some people do not think overdiagnosis is a big problem, because they think cancer usually progresses. But as the article I linked, and others I have read, explains, that may not be true.

  65. Harriet Hall says:

    pec,

    “Are you saying your treatments are effective, but have not improved much in 30 years?” No, he’s not saying that. He’s saying that cancer treatment was effective 35 years ago before widespread screening and before lead-time bias and overdiagnosis became an issue.

    The treatment for some cancers has improved more than others; overall it has improved significantly. The charts on the website demonstrate continuing improvement over time.

    The historical comparisons show that overdiagnosis and lead-time bias can be corrected for, and the corrections are SMALL.

    I gave you a reference showing the survival rate for untreated cancers. Did you read it? If you would take the time to look at the untreated numbers and compare them to the treated numbers, you could see for yourself how effective cancer treatment is.

    When you talk about cancers that don’t progress, you are mainly talking about carcinoma in situ. The studies we showed you are for invasive cancer, cancer that has ALREADY progressed. Can’t you understand the difference? You are mixing apples and oranges. Carcinoma in situ may never develop into invasive cancer, but once a cancer is invasive, it is very rare for it to regress spontaneously.

    I repeat: it is obvious that you are out of your depth. It seems to me that you have made up your mind that modern cancer treatment does more harm than good, and you are stubbornly resistiing all evidence to the contrary.

  66. pmoran says:

    Pec, you have not grasped the significance of the fact that even today most of the cancers that we treat are already producing symptoms. There is no basis in medical experience for believing that cancer can progress to the stage of causing an enlarging lump, an ulcerating crater, pain, visceral obstruction or rectal bleeeding and then progress no further. (It can happen, but mostly as spontaneous remission — extremely rare with most kinds of cancer.)

    Prostate cancer screening is by far the major potential source of non-progessive non-symptomatic cancers, and you can actually get an impression of its impact on the figures from the graphs on my web page. Look at them again and read the fine print. You will observe that even that very large source of possibly non-lethal cancers would have negligible effect on the deliberately conservative estimate that about 50% of all invasive cancers are now cured.

  67. pec says:

    http://findarticles.com/p/articles/mi_m0815/is_n6_v22/ai_19501725

    “In a special report entitled Cancer Undefeated, the authors compared the most recent cancer mortality rates with those of 1970, just before the National Cancer Act began releasing billions of dollars for cancer research. Overall, the odds of dying of cancer are 6% higher today then they were in 1970.”

    “Breast cancer mortality, for example, has dropped 25% in younger women. However, the majority of those diagnosed with breast cancer are over age 55; and the death rate has actually increased among these women by 10% since 1970.”

    “Changes in lung cancer mortality are due to changing patterns of smoking rather than treatment advances. ”

    “There are treatment successes, but they are largely confined to the rarer types of cancers, such as Hodgkins disease and childhood cancers.”

    “The public regularly receives inflated news reports about cancer treatment progress from organizations like the American Cancer Society and the National Cancer Institute (NCI), which have a vested interest in making things appear rosier than they are. Admitting defeat in the war on cancer tends to put a damper on donations and research grants.”

  68. Harriet Hall says:

    Rather than going by secondary sources, here is the abstract of the article: BACKGROUND: Despite decades of basic and clinical research and trials of promising new therapies, cancer remains a major cause of morbidity and mortality. We assessed overall progress against cancer in the United States from 1970 through 1994 by analyzing changes in age-adjusted mortality rates. METHODS: We obtained from the National Center for Health Statistics data on all deaths from cancer and from cancer at specific sites, as well as on deaths due to cancer according to age, race, and sex, for the years 1970 through 1994. We computed age-specific mortality rates and adjusted them to the age distribution of the U.S. population in 1990. RESULTS: Age-adjusted mortality due to cancer in 1994 (200.9 per 100,000 population) was 6.0 percent higher than the rate in 1970 (189.6 per 100,000). After decades of steady increases, the age-adjusted mortality due to all malignant neoplasms plateaued, then decreased by 1.0 percent from 1991 to 1994. The decline in mortality due to cancer was greatest among black males and among persons under 55 years of age. Mortality among white males 55 or older has also declined recently. These trends reflect a combination of changes in death rates from specific types of cancer, with important declines due to reduced cigarette smoking and improved screening and a mixture of increases and decreases in the incidence of types of cancer not closely related to tobacco use. CONCLUSIONS: The war against cancer is far from over. Observed changes in mortality due to cancer primarily reflect changing incidence or early detection. The effect of new treatments for cancer on mortality has been largely disappointing. The most promising approach to the control of cancer is a national commitment to prevention, with a concomitant rebalancing of the focus and funding of research.

    This seems at odds with the statistics we’ve seen elsewhere. I noticed that there were several letters to the editor about this article, but I don’t have access to them. I suspect the letters challenged the authors’ conclusions. And it is addressing overall rates and only covers up to 1994. We know treatment has improved for some individual cancers since 1970.

    pec,

    Let me ask you this: even if you could prove that cancer treatment had not improved since 1970 (which I don’t accept), wouldn’t it still be true that modern scientific medical treatment is effective in curing close to 50% of cancers? It appears to me that you are looking for a certain kind of tree and entirely missing the forest.

  69. pec says:

    “The effect of new treatments for cancer on mortality has been largely disappointing.”

    If the conventional approach to treating cancer were promising, we would have seen a lot more improvement over the past 30 years.

    And I still disagree with you about overdiagnosis. I think it might be a much bigger factor than you realize, and might account for a large percentage of the 50% of patients who survive at least 5 years. Even invasive cancer might be defeated by the immune system in many cases. I don’t think we really know right now. How can you be sure that 100%, rather than 50%, would have died before 5 years if they had not been treated?

    At this point, I am not at all convinced that standard cancer treatments are effective in general. Maybe surgery is sometimes effective, maybe certain treatments that suppress certain hormones, etc. But standard chemotherapy does not look good, from what I have read so far.

  70. daedalus2u says:

    You can’t just look at cancer mortality, you have to look at other types of mortality too. Someone could make cancer mortality go to zero by killing everyone with herbal poisoning. Does that make lethal herbal treatments great for cancer? No it doesn’t.

    Everyone is eventually going to die of something. Moving the age of death from 35 to 55 (as seems to have been done to some extent with breast cancer), saves 20 years of life. That is progress.

    If fewer people die from heart attacks, eventually they are going to die from something else. I think that is why the idea of “cure” is too simplistic and misleading.

  71. pmoran says:

    Pec, are you shifting the debate onto cancer treatment progress, or lack of it?

    If you look around you can find plenty of mean-spirited opinion concerning the slow progress that medicine has made with this very difficult foe. At least this concedes that the overall cure rates of cancer are improving, which is all that anyone here has claimed. None of us would claim that our results are spectacular, although the fact that some previously incurable cancers can now be regularly cured is definitely not to be sneezed at.

    I am not interested in arguing whether the glass is half full or half empty. I have been disappointed with medical progress, too, there being a time in my career when it looked as though the “magic bullet” might be just around the the corner.

    And it is not that we don’t now have many powerrful weapons against cancer, ones that can virtually obliterate many types. Eliminating every last cancer cell has proved to be the problem, once cancer has spread beyond the scope of surgery or radiotherapy. There is no reason to assume that any “alternaitve” method would not share the same problem.

  72. pec says:

    I have never promoted any alternative method. I am just saying that I think you started down the less promising path decades ago and don’t want to start over. Obviously I don’t have the answers, but I do think certain ideas from alternative science make a lot more sense than the standard approach. I think that cancer, and some other diseases, are often caused by an imbalance of the system as a whole. You assume the disease is caused by cancer cells, while I think that at least sometimes the cancer cells are merely a symptom.

  73. Harriet Hall says:

    “If the conventional approach to treating cancer were promising, we would have seen a lot more improvement over the past 30 years.”

    If the conventional approach works, it works – whether we have seen a little improvement or a lot. There is certainly no more promising form of treatment. There is promise in prevention, which we all advocate, and in basic research, which continues to investigate how cancers start and progress and may eventually result in totally different kinds of treatment.

    “Even invasive cancer might be defeated by the immune system in many cases.”

    You have been told repeatedly that this almost never happens. Why are you so resistant to accepting the facts?

    “How can you be sure that 100%, rather than 50%, would have died before 5 years if they had not been treated?”

    We have statistics for untreated cancer. I gave you a link to the data. Didn’t you read it? Here’s the link again. http://www.mcn.org/c/irapilgrim/toc20.html See figure 6.

    It depends on the cancer: on this graph, for cervical cancer, essentially everyone was dead at 5 years without treatment; for leukemia about 90% were dead at 5 years. The rates for specific types of cancer and different stages will vary.

    “I am not at all convinced that standard cancer treatments are effective in general. Maybe surgery is sometimes effective, maybe certain treatments that suppress certain hormones, etc. But standard chemotherapy does not look good, from what I have read so far.”

    This really sounds ignorant. “maybe” surgery is “sometimes” effective? Oh, come on! Face reality!

    Chemotherapy doesn’t look good? I don’t know where you’re looking. For acute lymphoblastic leukemia, chemotherapy is the initial treatment of choice, and 85% of children are cured. Six months of anthracycline based chemotherapy reduced the annual death rate from breast cancer by about 38%. Numbers like those look pretty good to me.

  74. Harriet Hall says:

    “less promising path” Less promising than what?

    “I do think certain ideas from alternative science make a lot more sense” There is no such thing as alternative science.

    “I think that cancer, and some other diseases, are often caused by an imbalance of the system as a whole.” This is meaningless mumbo jumbo.

    “at least sometimes the cancer cells are merely a symptom.” A symptom of what, pray tell!

  75. David Gorski says:

    “at least sometimes the cancer cells are merely a symptom.” A symptom of what, pray tell!

    Oh, no. Pec appears to believe in something akin to German New Medicine:

    THE GERMAN NEW MEDICINE provides us with illuminating explanations about the origin, development and healing of both physical and mental disorders. In 1981, Dr. Hamer discovered that every DISEASE is caused by a shock experience that catches us completely off guard. He found that this shock not only occurs in the psyche but simultaneously in the brain and on the organ level. At the moment the unexpected trauma takes place the shock impacts a specific area in the brain causing a lesion that is clearly visible on a brain scan as a set of sharp concentric rings. With the impact the affected brain cells communicate the disturbance to the corresponding organ. Whether the organ responds with a tumor growth (cancer), with tissue degeneration, or with functional loss, is determined by the exact type of conflict shock. Based on the analysis of over 40,000 case studies Dr. Hamer is the first to provide scientific proof that cancer is not caused by a malfunctioning organism producing deadly cancer cells but is rather the result of an innate meaningful survival program that has been successfully practiced for millions of years. Since HEALING can only occur after the conflict has been resolved, the GNM-therapy focuses on identifying and resolving the original conflict. By understanding healing symptoms such as painful swelling, infections, fever, or inflammation in their psychological, biological and evolutionary context, we are able to liberate ourselves from the fear and panic that often come with the onset of an illness. Dr. Hamer’s findings offer a completely new understanding of so-called diseases. His scientific discoveries revolutionize entirely our view of medical conditions and their causes.

    There are also a number of other “alt-med” beliefs that postulate that the cause of cancer isn’t the tumor cells, but rather some sort of “imbalance” or that the tumor is the result of some emotional trauma. In reality, such ideas are at their core no different than ancient concepts of imbalances in the four humors or the miasma theory of disease. the things these all have in common, along with German New Medicine, is that they view the cancer cells as a symptom rather than the cause of the disease.

  76. pec says:

    Of course you searched for something ridiculous and pretended that’s what I meant.

    The problem is that you have no concept of how a system can be out of balance. That’s why you can’t imagine anything other than your reductionist approach.

    Type 2 diabetes is an easier example to explain. According to complementary medicine, it starts gradually as the metabolism gets increasingly out of balance. The cause is usually diet and lifestyle, and it is sometimes called “metabolic syndrome” or “syndrome x.” The eventual result can be insulin resistance. Lifestyle changes can help restore balance, but drugs and insulin only try to slow the progression of certain side effects. Insulin is actually harmful for type 2 diabetics, in the long run.

    I hope that helped you understand a little about the concept of balance. Maybe there is a better word, or a better way to explain it.

    So much of what I think is wrong in mainstream medicine results from a refusal to think in terms of complex systems.

  77. pec says:

    “There is no such thing as alternative science.”

    There are alternatives that challenge mainstream views. You know nothing about any of the alternatives, because in the past they had not been taught in medical school.

  78. David Gorski says:

    Of course you searched for something ridiculous and pretended that’s what I meant.

    What you appear to believe is very much akin to the German New Medicine. After all, you yourself said that sometimes cancer cells are a “symptom,” not the disease itself.

    That’s exactly what German New Medicine says as well, the only difference being that it says that it’s not just “sometimes” and that you haven’t told us what the “real” problem is that causes the “symptom” of cancer.

  79. weing says:

    There is an alternative to medical science and its proper name is quackery.

  80. David Gorski says:

    So much of what I think is wrong in mainstream medicine results from a refusal to think in terms of complex systems.

    Indeed. I agree with you. You do seem to refuse to think in terms of complex systems.

  81. pec says:

    “What you appear to believe is very much akin to the German New Medicine. After all, you yourself said that sometimes cancer cells are a “symptom,” not the disease itself.”

    You’re having a problem with logic. If I agree with one thing the German New Medicine says, that does not mean I agree with them on other things.

    Yes I do believe that there may be times when cells become cancerous for a reason, not just by accident. In those cases, the reason, the cause, should be considered as much as the result.

    I used type 2 diabetes as an example of how the system can gradually get out of balance, resulting in a complex disease with many symptoms. Maybe some forms of cancer could be understood in this way. If you were looking for this kind of understanding, but you are not. You are still mainly focused on finding ways to destroy cancer cells.

  82. weing says:

    pec,

    If it quacks like the German New Medicine. Is it a cow?

  83. Harriet Hall says:

    “you have no concept of how a system can be out of balance.”

    Yes we do. We understand how diabetes develops. We understand lots of other physiologic and hormonal feedback mechanisms. We understand how specific things can be out of balance and we can measure them. What we don’t understand is your vague idea of “the system out of balance as a whole” because it means absolutely nothing and can’t be measured.

    “The cause is usually diet and lifestyle”

    I tried to explain to you before that this is a simplistic idea. The causes of diabetes are multifactorial and there is a stong genetic component.

    “but drugs and insulin only try to slow the progression of certain side effects.”

    No, drugs and insulin try to (and succeed in) maintaining normal blood sugar levels. In one sense, they “restore the balance.” The purpose of treating diabetes is twofold: to slow the progression of side effects and to prevent the symptoms of high blood sugar.

    “Insulin is actually harmful for type 2 diabetics, in the long run.” Where on earth did you get that idea? Multiple studies have shown that type II diabetics have better outcomes with insulin than with no treatment.

  84. Harriet Hall says:

    pec said, “There are alternatives that challenge mainstream views. You know nothing about any of the alternatives”

    There are alternatives within science that challenge mainstream views. There are alternatives outside science that are too silly for scientists to take seriously. There is no such thing as alternative science.

    You know nothing about how much I know. I happen to know a great deal about the kind of alternatives you are talking about: I’ve been studying them for many years now. I’m not impressed.

  85. Harriet Hall says:

    pec said,
    “Yes I do believe that there may be times when cells become cancerous for a reason, not just by accident….You are still mainly focused on finding ways to destroy cancer cells.”

    Gee, I thought cells always became cancerous for a reason. I thought we had learned quite a bit about some of those reasons. I thought medical science was very interested in finding out more about why cancer develops and how to prevent it.

    Is there anything wrong with clinical research focusing on ways to destroy cancer cells and save some lives while we wait for basic science to figure out how to prevent cancer in the first place? Maybe you’d rather we put a stop to all clinical cancer research and let more people die now so we could possibly learn faster how to prevent all deaths at some remote point of the future?

  86. pec says:

    “Multiple studies have shown that type II diabetics have better outcomes with insulin than with no treatment.”

    That is not relevant to what I said. They would be better off without injecting insulin, if they are still producing their own. High insulin is responsible for much of the blood vessel damage associated with type 2 diabetes. Low insulin is not the problem in type 2, except sometimes in advanced cases. It is MUCH better to avoid insulin injections if at all possible, except when blood sugar levels are out of control. Insulin does not help to restore a healthy balance, since the problem is that the cells have become insulin-resistant. And this happens mostly because of refined carbohydrates in the diet and an inactive lifestyle.

    So many things get out of balance in this syndrome, long before insulin resistance becomes obvious. It can be reversed if caught in early stages, and it can be improved by lifestyle changes at most stages.

    Please consider the possibility that some forms of cancer are like type 2 diabetes in this respect. We know that obesity can increase the likelihood of cancer, so maybe we should consider that something about the typical unhealthy lifestyle can lead to either cancer or type 2 diabetes.

    Who knows? But it certainly seems worth thinking about.

  87. weing says:

    What a load of crap. I don’t have the time to correct all your misconceptions about diabetes and insulin but you are way off base and don’t know what you are talking about.

  88. Harriet Hall says:

    pec,

    I’m tired of telling you over and over: WE ALL AGREE that it would be better to prevent disease than to treat it once it’s established. It seems you are under the misconception that scientific medicine only wants to treat disease rather than prevent it. That is absolutely untrue. We encourage prevention in every way we can, but we also have to deal with people who either rejected prevention or developed disease in spite of preventive measures.

    Your comments about diabetes are based on a partial understanding of a complex subject and a misunderstanding of many aspects. I suggest you consult this website. Among other things, it has a whole section on prevention of diabetes where it recommends changes in diet and exercise. http://www.diabetes.org/home.jsp

    Scientists are well aware that lifestyle factors DO contribute to diseases like diabetes and cancer, and these things ARE being actively pursued by researchers around the world. If you weren’t so blinded by your prejudices, you might be able to see that.

  89. pec says:

    You missed my whole point. I am using the analogy of type 2 diabetes to suggest that cancer might also be a complex syndrome, in which cancerous cells are not the actual cause. Just as high blood sugar is a result, not a cause, of diabetes.

  90. pec says:

    weing,

    I know exactly what I’m talking about. Low insulin is not the cause of type 2 diabetes and if you don’t know that you are not an MD. Injecting insulin does nothing to correct the syndrome and may cause additional harm. Type 2 diabetes is caused by insulin resistance and if you didn’t know that I am not wasting time trying to teach you.

  91. Harriet Hall says:

    pec,

    Your idea of causation is curious. Obviously cancerous cells are not the cause of cancer. They are the cancer. The question is what caused the cells to become cancerous.

    And it’s more complex than that, because abnormal cells are being produced all the time through copying errors and mutations. The body has mechanisms that eliminate most abnormal cells. We need to find out how cancers escape our self-protective mechanisms.

    And as for low insulin, there is a RELATIVE deficiency of insulin in type II diabetes. Injecting insulin doesn’t correct the underlying problem of insulin resistance, but it compensates for the relative insulin deficiency and “balances” the system. It’s not an ideal solution, but it’s the best we’ve got.

    As for insulin causing harm, it can cause hypoglycemia if too much is used. It may cause minor and usually temporary side effects such as rash, irritation or redness at the injection site. Any “harm” it does is far outweighed by the good.

  92. weing says:

    pec,
    Why don’t you take a look at the website about diabetes that Harriet gave you. Learn a little about it before spouting anymore nonsense.

  93. pec says:

    “abnormal cells are being produced all the time through copying errors and mutations. The body has mechanisms that eliminate most abnormal cells. We need to find out how cancers escape our self-protective mechanisms.”

    Precisely my point.

  94. pec says:

    “As for insulin causing harm,”

    From what I have read, the high insulin levels of type 2 diabetes may be related to the blood vessel damage that leads to heart disease, a common result of type 2 diabetes. When the cells are insulin-resistant, insulin levels can become very high, and this is not something the body is prepared to deal with. Of course the same is also true of high sugar levels.

    i think, from what I have read (lots of things over many years, do not have links ready), that injecting insulin should only be a last resort. It does nothing to correct the syndrome, and might make it worse.

  95. PalMD says:

    pec, hyperinsulinemia is probably not a good thing, however, hyperglycemia is worse. If a patient comes to me with an A1C of 14 and fasing sugars of 350, it would be dangerous for me to say, “insulin is bad for you, so change your eating and exercise habits”. They will go into a hyperosmitic state and die while we wait.

  96. weing says:

    There is also a difference between endogenous and exogenous insulin. In my practice, I have been starting my patients earlier in the disease than I did 5-10 years ago.

  97. pmoran says:

    The common “alternative” belief that curing cancer might be simply a matter of eliminating causes is not born out by experience. Not in the slightest. In most cases of cancer the cause is long gone, as in those due to radiation of various types. Thus shiielding from the sun does not cure skin cancers. Stopping smoking does not cause lung cancer to regress in the slightest. Cancers due to occupational exposure to carcinogens can also occur long after exposure ceases. Many are determined mainly by inherited factors.

    What’s more, while some precancerous states can be reversed by the treatment of whatever is causing the cells to misbehave, it is difficult to find any instance in either clinical experience or in vast animal experimentation with carcinogens where the cells of an invasive cancer have reverted to normal as the result of removal of causative agents. Once triggered, the cancer goes on its own merry way.

    And this experience fits in with what we know about the nature of cancer, that it is due to mutations that will always be passed down from cell to daughter cell. We may learn how to switch important cancer genes on and off, and influence cancer behaviour that way, but we do not yet have any way of replacing the bad genes. We probabaly will one day, but medical progress very often has to wait upon technological advances.

    This is the reason why just about all treatments that have any effect upon cancer do so by either directly killing the cancer cell, inducing the cell to kill itself (apoptosis), or by inducing the immune system to attack the cancer cell. We cannot return them to normal.

  98. Harriet Hall says:

    I said, “abnormal cells are being produced all the time through copying errors and mutations. The body has mechanisms that eliminate most abnormal cells. We need to find out how cancers escape our self-protective mechanisms.”

    pec said, “Precisely my point.”

    WHAAAT?! No, pec, YOU DID NOT MAKE THAT POINT. You “suggested that cancer might also be a complex syndrome, in which cancerous cells are not the actual cause.”

    It is idiotic to suggest that cancerous cells might NOT be the actual cause, because no one ever thought they WERE. That would be like saying the disease was the cause of the disease.

    And you did NOT mention anything about copying errors, mutations, or the body’s mechanisms for eliminating abnormal cells. You suggested cancer “might also be a complex syndrome” (which is so vague that it is meaningless) and “might” have something to do with lifestyle (which we all know IS true for some cancers, smoking and lung cancer being a stand-out case).

    And for your information, insulin is not usually the first line of treatment for type II diabetes unless the case is a severe one like the one PalMD described. For most patients, diet, exercise, weight loss and oral medications are tried first. And when insulin is required, it doesn’t make the situation worse, it makes it better.

  99. pec says:

    I think that cancer might some times be the result of a complex syndrome, and not always the result of mutations or exposure to carcinogens. If the immune system failed to kill the cancer cells we might wonder if something is wrong with the immune system. We might think about what could go wrong with the immune system that would prevent it from destroying cancer cells.

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