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Cancer Centers and Advertising Practices

Video advertisement for the Cancer Treatment Centers of America, hosted on their website. Note at the bottom the statement “No case is typical. You should not expect to experience these results” (click to embiggen).

You have probably seen the TV commercials or other ads for Cancer Treatment Centers of America. They make it sound like “the place to go” if you have cancer. They claim to be “different,” to combine the best cancer technologies with natural therapies in a humane, patient-centered approach that helps you fight the disease and maintain your quality of life. They offer a kinder, gentler, more effective oncology. Those ads are misleading.

Dr. Gorski has written about the practices of Cancer Treatment Centers of America here and here. He has shown how they “integrate” real medicine with nonsense like homeopathy and how they misrepresent components of science-based medicine like exercise and diet, re-branding them as “alternative.”

A recent study by Vater et al. published in the Annals of Internal Medicine asked “What are cancer centers advertising to the public?” They found that the ads appealed to emotion, failed to provide important information, falsely portrayed testimonials as typical, and should be viewed as critically as any other advertising. (more…)

Posted in: Cancer, Medical Ethics, Science and the Media

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Healthy Habits Global: Spreading False Information about an MLM Coffee with Herbal Additives

Another kind of coffee pyramid scheme. Largest pyramid of coffee cups from the India Book of Records.

Another kind of coffee pyramid scheme. Largest pyramid of coffee cups from the India Book of Records.

When my husband was helping a friend with a project at the house of someone he didn’t know, the lady of the house gave him an earful about the health benefits of the coffee sold by Healthy Habits Global (HHG), a multilevel marketing (MLM) enterprise for which she is a distributor. She sent him home with samples and a brochure with a long list of health claims. She told him she could provide lots of testimonials, and there was a wealth of evidence for her products on PubMed.

Before believing any health claims, especially from an unknown source, it is only prudent to examine the evidence. I consulted the company website, PubMed, and other sources; and I learned that the company’s advertising was full of false information and the whole rationale of the products was questionable. I am not persuaded that HHG coffee has any health benefits. It appears to be just another in a long line of gimmicks used by MLM businesses to sell untested, usually ineffective “health” products to gullible consumers who have little knowledge of science. (more…)

Posted in: Herbs & Supplements

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Psychology and Psychotherapy: How Much Is Evidence-Based?

psychology gone wrong
Despite all those Polish jokes, Poland has its share of good scientists and critical thinkers. A superb new book illustrates that fact in spades:

Psychology Gone Wrong: The Dark Side of Science and Therapy, by Tomasz Witkowski and Maciej Zatonski, Witkowski is a psychologist, science writer, and founder of the Polish Skeptics Club; Zatonski is a surgeon and researcher known for debunking unscientific therapies and claims in clinical medicine. Together, they turn a spotlight on research and treatment in the field of psychology. They uncover distressing flaws, show that many commonly accepted psychological principles are based on myths, argue that psychotherapy is a business and a kind of prostitution rather than an effective evidence-based medical treatment, and question whether psychotherapy should even exist, since in most cases it offers no advantage over talking to a friend about one’s problems, and in some cases can cause harm. (more…)

Posted in: Book & movie reviews, Neuroscience/Mental Health, Science and Medicine

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Ken Burns Presents Cancer

Note: I wrote two posts today to alert readers to two upcoming television events in time for them to plan their viewing. See the second post for an announcement about a film on scientology, along with an article about Scientology’s War on Medicine that I wrote for Skeptic magazine.

Ken Burns

Filmmaker Ken Burns

Ken Burns has made a lot of outstanding films. His The Civil War has been listed as second only to Nanook of the North as the most influential documentary of all time. I was delighted to learn that he had applied his exceptional skills to a topic that is very important to us on the Science-Based medicine blog, cancer. His film is based on the Pulitzer Prize-winning book by Siddhartha Mukherjee, The Emperor of all Maladies: A Biography of Cancer.

I reviewed Mukherjee’s book in 2010. He is an oncologist and cancer researcher and also a superb writer. I characterized his book as:

a unique combination of insightful history, cutting edge science reporting, and vivid stories about the individuals involved: the scientists, the activists, the doctors, and the patients. It is also the story of science itself: how the scientific method works and how it developed, how we learned to randomize, do controlled trials, get informed consent, use statistics appropriately, and how science can go wrong.

I continue to think it is the best book ever written on cancer.

The film interviews Mukherjee and many of the researchers and patients whose stories appear in the book. If you haven’t read the book, it will give you an idea what it’s about. If you have read the book, you will enjoy it even more as you meet the people you have read about. It covers the history of cancer as well as the most recent scientific developments and is very optimistic about the future.

The movie is scheduled to premiere March 30 – April 1 at 9 PM EST on PBS, in 3 parts with a total duration of 6 hours. You can watch the trailer online. The producers sent me a press preview 1-hour highlight reel and I was very impressed. I can’t wait to watch the whole thing. I hope you will be able to watch it too.

Posted in: Announcements, Book & movie reviews, Cancer

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Scientology’s War on Medicine

Note: The film Going Clear: Scientology and the Prison of Belief will be available on HBO starting March 29th. I haven’t seen it yet, but apparently it profiles former members who reveal details that have elicited a very angry response from the Church of Scientology. I thought I would use the occasion to reprint a SkepDoc column that originally appeared in Skeptic magazine (Volume 18: Number 3) titled “Scientology’s War on Medicine.”

Scientology has openly declared war on psychiatry and is ambivalent if not openly hostile towards the rest of medicine. Its “mind over matter” philosophy promises that attaining the “Clear” state will eliminate illness.

Recently there has been a spate of exposés of Scientology, ably reviewed by Jim Lippard on eSkeptic. They offer some shocking revelations. Defectors from Scientology have described kidnappings, deliberate lying, unnecessary deaths, human trafficking, thought control (“brainwashing”), coercion, violations of labor standards, violations of human and civil rights, and other crimes. Scientology has been protected from prosecution by its designation as a religion and its vast wealth and influence; but if even a fraction of these accusations are true, Scientology has much to answer for.

Initially people are attracted to Scientology because it provides answers. Your problems are due to past experiences holding you back. Scientology can help you deal with those problems and the upper levels will reveal the secret of life itself.

Mark VIII E-Meter, from the Wikimedia Commons

Mark VIII E-Meter, from the Wikimedia Commons by Colliric

Members are audited with an E-Meter (similar to a lie detector) and one-on-one attention. The auditing process is similar to psychotherapy in that it encourages people to think about their problems and work to overcome them. In Scientology, ideas are not immaterial: they have weight and solidity. The E-Meter locates and discharges mental masses that are blocking the free flow of energy. Memories are blamed and traced back in time even into past lives. Patients keep repeating the details of the experience until they are drained of any emotional charge. Once the painful experiences and associations are drained off, there are astonishing results: asthma, headaches, arthritis, menstrual cramps, astigmatism, and ulcers simply disappear. The reactive mind is replaced by the rational mind. In one case a boy’s IQ supposedly rose from 83 to 212. (more…)

Posted in: Announcements, Book & movie reviews, Religion

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Shred360: The Weight Loss Product with the Stupidest Hype Ever

There was a half-page ad in my local paper, thinly disguised as a “Special Report” by a Health and Fitness Editor, for a new fat-melting pill that “could put diet industry out of business by 2016.” I have seen a lot of ridiculous ads for weight loss products, but this one takes the cake. It’s arguably even worse than the one that proclaimed “we couldn’t say it in print if it wasn’t true” and then proceeded to say things in print that weren’t true.

It’s called Shred360. Here are some of the claims:

  • It shook up the fitness industry because it DOUBLES your fat-burning potential.
  • It allows anyone to LOSE INTENSE AMOUNTS OF FAT without grueling workouts or tasteless diet foods.
  • It breaks your fat cells apart and disintegrates them, even while you sleep.
  • Speeds your metabolism by 43%.
  • It vaporizes fat without effort.
  • Its proprietary blend of 16 potent ingredients is scientifically proven.
  • Burns stored fat through thermogenesis and lipolysis.
  • Increases energy and mental clarity almost immediately – guaranteed.
  • Fools your body into feeling full: the ultimate appetite suppressant.
  • Unconditionally guaranteed to make every surplus bit of your unwanted fat disappear effortlessly.
  • Analysts think it will put Jenny Craig and Weight Watchers out of business by 2018 (which doesn’t even make sense if it has already put the entire diet industry out of business by 2016).
  • You can eat like a normal person, skip the gym, and lose the fat you want while you sleep.
  • Produced under highly controlled environmental conditions in small batches, so supplies are very limited.
  • Free samples available for 100 customers – don’t wait to call.
A screenshot from the Shred360 product website. Lots of claims!

A screenshot from the Shred360 product website. Lots of claims!

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Posted in: Herbs & Supplements

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Mind Over Matter: The Brain’s Way of Healing

The Brain's Way of HealingIn 2008 I wrote about neuroplasticity as presented in Norman Doidge’s book The Brain That Changes Itself. I urge you to click on the link and read what I wrote there before you continue. The science is fascinating. The brain is far more malleable than we once thought. Areas of the cortex devoted to a sensory input shrink when that input is lost. Neurons from other parts of the brain can be co-opted to take over lost functions. Learning a new skill actually changes the structure and function of the brain: the areas of the cortex devoted to that skill enlarge as the new skill is practiced and perfected.

This is exciting stuff, with potential therapeutic applications in chronic pain, brain damage, and chronic illness. When I reviewed that book, I said I thought Doidge was a bit overenthusiastic; and now he has written a follow-up book that is even more overenthusiastic. In The Brain’s Way of Healing: Stories of Remarkable Recoveries from the Frontiers of Neuroplasticity, he slips into unscientific speculations and relies on anecdotes about patients who have allegedly benefited from practical applications of brain plasticity science. The title is accurate: these are stories, not scientific studies. I continue to find the subject fascinating and to believe that neuroplasticity offers a lot of potential for human healing, but I don’t believe we have learned much about practical ways to accomplish that. Doidge’s book goes beyond the science. (more…)

Posted in: Book & movie reviews, Neuroscience/Mental Health

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IOM Recommends Replacing CFS with SEID

Exertion intolerance

Exertion intolerance

Chronic fatigue syndrome (CFS) is a controversial diagnosis that has also been called myalgic encephalomyelitis (ME or ME/CFS), post-viral fatigue syndrome (PVS), chronic fatigue immune dysfunction syndrome (CFIDS), Iceland disease, “yuppie flu,” and many other names. A new report from the Institute of Medicine (IOM) says that none of those names really fit the disease and recommends it be re-named systemic exertion intolerance disease or SEID.

ME/CFS is thought to affect as many as 2.5 million Americans. The cause remains unknown, but in many cases it appears to have been “triggered by an infection or other prodromal event, such as immunization, anesthetics, physical trauma, exposure to environmental pollutants, chemicals and heavy meals, and rarely blood transfusions.” Some doctors question its very existence and interpret the symptoms as imaginary or psychological.

The IOM examines the evidence base

At the request of several government agencies including the NIH and the FDA, the IOM convened a committee of 15 experts to examine the evidence base for ME/CFS. They reviewed over 9,000 published studies and heard testimony from patients and advocates. Before publication, an additional 15 experts were asked to provide peer review. The full text of the report is available free online. (more…)

Posted in: Science and Medicine

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Placebo, Are You There?

By Jean Brissonnet, translation by Harriet Hall

Note: This was originally published as “Placebo, es-tu là?” in Science et pseudo-sciences 294, p. 38-48. January 2011. It came to my attention in the course of an e-mail correspondence with the editors of that magazine, where one of my own articles was published in French translation in January 2015. I thought this was the best explanation of placebo that I had ever read. It covers the same points my colleagues and I have addressed and more. It describes the pertinent research and uses particularly effective graphs to illustrate the principles (a picture is worth a thousand words). The author, Jean Brissonnet, kindly gave his permission for me to translate it and share it with our readers.


In fact, you don’t need to give a placebo to get a placebo effect and therefore we can now think about how we can maximize the placebo component of routine care.

~ Damien Finniss, 2010

The scene takes place in a surgical suite where they are preparing to do a cataract operation. The patient is lying on the operating table. A few minutes earlier the anesthetic gel was applied to the cornea to permit an operation under simple local anesthesia. The surgeon arrives in the company of the anesthetist. They are engaged in a spirited discussion and don’t seem to be agreeing.

“It has been proven,” says the surgeon, “that 30% of the action of a medical treatment is due to the placebo effect.”

“I doubt that,” retorts his interlocutor, “I think that placebo story is one of those medical myths on a par with the idea that we only use 10% of our brain, that nails and hair grow after death, or that cellphones create interference in hospitals.”[1]

“No,” insists the surgeon with a superior tone, “the fact is established and has been proven by numerous studies.”

The anesthetist shakes his head with a slight smile, but he doesn’t reply. As for the patient, who might have much to say on the subject, he keeps quiet, because it would not be prudent to argue with someone who is about to suck the lens out of your eye.

This true anecdote would not be of interest if it didn’t concern two members of the medical profession. Why such uncertainty? Why such lack of knowledge about such a fundamental subject? This faith in an all-powerful, magical, and mysterious placebo is common among the general public and it serves as justification for resorting to unconventional medicines that have never been able to show solid proof of efficacy; but we see that it still persists among the medical profession.

To know whether the placebo effect is real or should be relegated to the same category as poltergeists, it will help to go back in history.

cartoon

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Posted in: Clinical Trials, Science and Medicine

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Glucosamine Update

 Stick-and-ball model of the glucosamine molecule (from the Wikimedia Commons, image by Benjah-bmm27)

Stick-and-ball model of the glucosamine molecule (from the Wikimedia Commons, image by Benjah-bmm27)

Osteoarthritis, the “wear-and-tear” type of arthritis, affects a great many of us as we grow older. Knee pain is a common symptom. The diet supplements glucosamine and chondroitin have been proposed as a more “natural” treatment than pharmaceuticals, and they are components of a number of proprietary “joint health” formulations like Osteo Bi-Flex. The GAIT study (Glucosamine/Chondroitin Arthritis Intervention Trial), compared glucosamine, chondroitin, a combination of the two, and a pharmaceutical (celecoxib) to a placebo in patients with knee pain from osteoarthritis. The only one that worked better than placebo was celecoxib. I wrote about the GAIT trial in 2008. The study was reported in the media as both negative and positive. The positive reports emphasized the subgroup analysis: in one of ten subgroups, patients with moderate to severe pain, the combination of glucosamine and chondroitin outperformed placebo. But in the subgroup of patients with mild to moderate pain, it did not. The authors themselves commented that their study was not powered to draw any conclusions from subgroups and that further studies would be required. (The “power” of a study is a measure of its ability to show an association or relationship between two variables if such a relationship exists.) Now a further study with sufficient power claims to have confirmed the subgroup findings. This may encourage some people to try glucosamine/chondroitin, but I remain skeptical.

(more…)

Posted in: Clinical Trials, Herbs & Supplements

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