The Beautiful Truth

Guess what? A natural therapy can cure cancer, but evil doctors don’t want to tell you about it, because the medical establishment wants to make money with Mosanto and Dupont rather than cure your illnesses! Watch all about it.

Update: Sorry, I missed Orac’s successful attack on this thing. Thanks Science Pundit, for pointing it out.

Swayze on woo

Mrs. Pal just called me upstairs where she was watching Barbara Walters. She (Walters, not Mrs Pal) was interviewing actor Patrick Swayze who is battling metastatic pancreatic cancer, a disease which will certainly kill him. Walters asked him quite a bit about the disease and treatment, and Swayze, whose answers were earthy, but pretty accurate, gave a compelling interview. He is no graduate of Google U.; he spoke frankly about his suffering, his hopes, his fears, but didn’t claim to be any sort of expert outside of his own experience.

Walters asked him if he was using any alternative medicine. He unenthusiastically noted that he was taking a few Chinese herbs, but roundly dismissed alternative medicine as a hope for him:

If anybody had that cure out there like so many people swear to me they do, you’d be two things: you’d be very rich and you’d be very famous— otherwise shut up .

Patrick, thank you. I couldn’t have said it better myself.

Where do you get your mercury?

There is an ongoing discussion amongst our Sciblings regarding our German counterparts at scienceblogs.de. Apparently they have some odd folks as science bloggers over there, including people who think ayurvedic heavy metals are good for you. In the tradition of countering speech with speech, I’m giving you this repost. More to come, I’m sure. –PalMD

ResearchBlogging.orgThe Infectious Disease Promotion Movement (let by such intellectual luminaries as Jenny McCarthy) may be worried about “toxins” in vaccines, but the real problem may hiding in plain sight.

Today’s issue of JAMA has an interesting study of Ayurvedic (traditional Indian) medicines. It turns out that many of them contain a significant amount of toxic heavy metals.
Continue reading “Where do you get your mercury?”

Se Habla “woo-woo”

So, America is changing. We have an African American president. The Latino population continues to grow. How can the alternative medicine community adjust to this demographic shift? What are they to do?

I’m glad you asked! It turns out that immigrants are palomas ripe for the plucking. Now, we’ve talked about the ethics of alternative medicine, and how “meaning well” is not exculpatory. If you promote quackery, it’s wrong, even if you believe your own drivel.

One of the worst types of drivel is naturopathy. This “specialty” advertises itself as “medicine-plus”, but really it’s “healing-minus”: minus the evidence, minus the training, minus intelligent thought.

It should be no surprise that recent immigrants, who may have low educational levels, especially in English, and have less access to the health care system financially, culturally, and linguistically should be ripe targets.

And targeting these vulnerable individuals is a naturopathic “doctor” in Connecticut.

Continue reading “Se Habla “woo-woo””

The Adman Can Attack Afflictions!

The Times’ Amanda Schaffer covers a retrospective of public health posters on display at the National Academies until December 19th, 2008. The catalog (pdf) is online.

My favorite:

It reads:

“No home remedy or quack doctor ever cured syphilis or gonorrhea. See your doctor or local health officer.”

You could replace “syphilis or gonorrhea” with just about anything! Perhaps we should reissue this poster to deal with the modern quacks!

East meets West at Beth Israel—Cage Match!

When those of us who practice real medicine write about implausible medical claims, we are often accused of lacking compassion, as if offering false hope is the same as compassion. We are also accused of turning away from therapies that “couldn’t hurt”. After all, if someone wants to use aromatherapy, what’s the harm?

The truth is that improbable medical claims are dangerous, and not just for the obvious reasons (i.e. dangerous practices such as chelation therapy). They also turn people away from real therapy. I’ve previously introduced you to the concept that there is no such thing as “alternative medicine”. When the Chinese herb artemisin was found to cure malaria and became widely used by modern doctors, it became by definition not alternative. If something “altie” like massage makes someone feel better, it’s neither altie nor “mainstream”—it’s just nice; go and do it. Yoga probably falls into the latter category, of a practice that may give comfort to some people, but is unlikely to affect objective measures of health and disease.

As reported (quite well) by the Times:

A foundation run by Donna Karan, creator of…the much-imitated DKNY line of clothing, has donated $850,000 for a yearlong experiment combining Eastern and Western healing methods at Beth Israel Medical Center. Instead of just letting a celebrated donor adopt a hospital wing, renovate it and have her name embossed on a plaque, the Karan-Beth Israel project will have a celebrated donor turn a hospital into a testing ground for a trendy, medically controversial notion: that yoga, meditation and aromatherapy can enhance regimens of chemotherapy and radiation.

I’ll stipulate that by “Eastern and Western healing methods” they mean credulous Americans’ impression of what is done in “the East” vs. science-based medicine as it is practiced around the world (the Eastern and Western bits).

Why invest so much in bringing relaxation techniques to the hospital? According to Beth Israel’s CEO:

“While we are giving patients traditional medicine, we are not going to exclude patients’ values and beliefs,” said Dr. David Shulkin, the chief executive of Beth Israel, noting that a third of Americans seek alternative treatments. “To make care accessible to these third of Americans, we’re trying to embrace care that makes them more comfortable.”

What is 15% of cancer patients were seeking euthanasia? What if they wanted methamphetamine? Should we integrate these practices into our modern cancer centers? I suspect the motives are both financial and compassionate, but the compassion is misguided. Providing cancer patients undergoing treatments with relaxation techniques, treatment of pain and anxiety, spiritual care, and other comforts is hardly alternative. To claim that they help people with cancer get better is the big leap. (And let’s set aside the possibility that an “Eastern” outfitted cancer center may not groove with everyone’s sense of spirituality).

Some of Ms. Karan’s stated goals are worthy:

Continue reading “East meets West at Beth Israel—Cage Match!”

Why good medicine requires materialism

I don’t like to repost, but Steve Novella has some great pieces up right now, and this is directly related. –PalMD

s I’ve clearly demonstrated in earlier posts, I’m no philosopher. But I am a doctor, and, I believe, a good one at that, and I find some of this talk about “non-materialist” perspectives in science to be frankly disturbing, and not a little dangerous.
Continue reading “Why good medicine requires materialism”

I’m a holistic doctor

Ok, I know I’ve been digging up old posts lately, but it’s because I love them so darn much. Thanks for your indulgence. –PalMD

That’s apparently all it takes to be a “Holistic” practitioner. I’ve been searching online for their medical board, or for any consistent definition of “holistic medicine”. What’s involved? Where do I get my training? Is training standardized, and based on good standards of evidence?

According to the American Holistic Medical Association:

Holistic Medicine is the art and science of healing that addresses care of the whole person – body, mind, and spirit. The practice of holistic medicine integrates conventional and complementary therapies to promote optimal health and to prevent and treat disease by addressing contributing factors.

Sounds good; art and science of caring for the whole person…sound a lot like, well, non-“holistic” medicine. As to integrating “conventional and complementary therapies”, I’m not sure what that means (but I hope they will tell me). As I’ve written earlier\, there is that which works, and that which does not.

In practice this means that every person is seen as a unique individual, rather than an example of a particular disease.

Every person who comes to see me is, by definition, a person and a patient, but not simply one or the other. They are also both a “unique individual” and “an example of a particular disease”. To ignore the disease part leaves the “medicine” out of “holistic medicine”.

Disease is understood to be the result of physical, emotional, spiritual, social and environmental imbalance. Healing therefore takes place naturally when these aspects of life are brought into proper balance. The role of the practitioner is as guide, mentor and role model, the patient must do the work – changing lifestyel, beliefs and old habits in order to facilitate healing. All appropriate methods may be used from medication to meditation.

“Disease is understood to the be the result of…imbalance.” That’s nice. Warm. Pretty. And wrong. Disease is not understood that way, nor should it be. We know the pathophysiology of most disease, and “imbalance” isn’t part of it. Let’s take heart attacks. They arise out of complex set of factors: genetics, blood pressure, smoking, diabetes, stress, inflammation, cholesterol. We even know how to interrupt the march toward a first or repeated heart attack. To top it off, modern medicine knows how to effectively treat a heart attack.

To treat the the patient “holistically”, I must convince the patient that I understand these factors, and that they must work with me to change them—quitting smoking, changing diet, exercise, medications—all these things require the patient to trust in me and my judgement. Some of these modalities are more effective than others. Quitting smoking is more important that meditation (unless meditation helps you quit smoking). In a large percentage of people, diet and exercise cannot achieve the proven goals for blood pressure, cholesterol, and diabetic control. These folks need medicines. It’s not a failure, it’s science.

The whole thing is quite vague. All good doctors take into account “physical, emotional, spiritual, social, and environmental” factors affecting their patients. We already have a label for that—it’s “physician”.

If holistic medicine is to differentiate itself from “mainstream” medicine in a positive way, it will need to define itself very carefully. What are the goals? How do we measure achievement of these goals? Are we fumbling around in the dark trying to “achieve balance” or actually going about treating patients in a compassionate, evidence-based way?

Holistic medicine exists as a concept, perhaps, for two reasons. First, doctors are seen as lacking compassion for the whole person (actually a fallacy–most people like their doctors, but never mind that). Second, many doctors and patients wish to express this compassion through routes that are not proven, but seem nice, like “alternative therapies”.

We need to continue to train our doctors, especially our primary care physicians, to use knowledge wisely, and to exercise compassion.

That’s why I’m hanging out my shingle. I am a holistic doctor.

The Times on Woo: Covering the Basics

The Times is running a series of articles today that cover the basics on woo, wooish thought, and one of my favorite subjects, pre-pure-food regulation impure food. Not much new here for Sciencebloggers, but these are good resources to help individuals think through the bogus claims we see so often in the marketing of woo.

William Broad discusses the National Center for Complementary and Alternative Medicine at NIH, which is charged with bringing better standards to situations like this:

…a 2004 Harvard study identified 181 research papers on yoga therapy reporting that it could be used to treat an impressive array of ailments — including asthma, heart disease, hypertension, depression, back pain, bronchitis, diabetes, cancer, arthritis, insomnia, lung disease and high blood pressure.

It turned out that only 40 percent of the studies used randomized controlled trials — the usual way of establishing reliable knowledge about whether a drug, diet or other intervention is really safe and effective…

But an enduring problem for higher-quality studies is the Frankie Avalon argument, discussed by Gina Kolada. Kolada explains that marketers can take advantage of years of headline-grabbing, smaller studies even where a large clinical trial disproves the efficacy of some treatment. Frankie Avalon apparently did this when a large trial showed that beta carotene was ineffective in preventing cancer:

When the bad news was released, he appeared in an infomercial. On one side of him was a huge stack of papers. At his other side were a few lonely pages. What are you going to believe, he asked, all these studies saying beta carotene works or these saying it doesn’t?

And of course, marketers of woo are always gaming the holes in the FDA’s jurisdiction. PalMD has written extensively on the Quack Miranda Warning. The new representation, covered by Gardiner Harris, is the “registered with the FDA” claim:

…the sellers of quasi-medical devices or food products that claim their products are “registered” with the F.D.A. may have done little more than send a letter to the agency. The Bioterror Act of 2002 requires food manufacturers to register with the F.D.A., but the agency almost never inspects these facilities or products.

Adding to this problem is the nutritional supplement situation. Although supplements look like drugs and are marketed in similar ways, Harris explains that, “the F.D.A. does almost nothing to ensure that dietary supplements work as advertised. Only when supplements are proved to be unsafe or to contain regulated substances can the agency take action.”

* * *

And on to pure food.

“…it’s worth remembering that it has been far worse. China’s present is America’s past,” argues Bee Wilson in an article discussing the Swill Milk Scandal in New York City during the 1850s.

This one is really worth a read, even if you’re familiar with the more general topics covered above. The past is a grotesque animal:

In a city growing fast, but lacking refrigeration, it was hard to provide sufficient milk. Fresh milk was brought in from Westchester and Orange Counties, but not enough to meet demand. In 1853, it was found that 90,000 or so quarts of cow’s milk entered the city each day, but that number mysteriously increased to 120,000 quarts at the point of delivery.

Some of the increase was due to New York dairymen padding their milk with water, and then restoring its richness with flour — just like their latter-day Chinese counterparts, who increased the protein levels in watered-down milk by adding the noxious chemical melamine. But the greater part was swill milk, a filthy, bluish substance milked from cows tied up in crowded stables adjoining city distilleries and fed the hot alcoholic mash left from making whiskey. This too was doctored — with plaster of Paris to take away the blueness, starch and eggs to thicken it and molasses to give it the buttercup hue of honest Orange County milk. This newspaper attributed the deaths of up to 8,000 children a year to this vile fluid.