I often describe "integrative medicine" as integrating quackery with medicine because that's what this inadvertently appropriately named branch of medicine in essence does. The reason, as I've described time and time again, is to put that quackery on equal footing (or at least apparently equal footing) with science- and evidence-based medicine, a goal that is close to being achieved. Originally known as quackery, the modalities now being "integrated" with medicine then became "complementary and alternative medicine" (CAM), a term that is still often used. But that wasn't enough. The word "complementary" implies a subordinate position, in which the CAM is not the "real" medicine, the necessary medicine, but is just there as "icing on the cake." The term "integrative medicine" eliminates that problem and facilitates a narrative in which integrative medicine is the "best of both worlds" (from the perspective of CAM practitioners and advocates). Integrative medicine has become a brand, a marketing term, disguised as a bogus specialty.
Of course, it's fairly easy to identify much of the quackery that CAM practitioners and woo-friendly physicians have "integrated" into integrative medicine. A lot of it is based on prescientific ideas of how the human body and disease work (e.g., traditional Chinese medicine, especially acupuncture, for instance, which is based on a belief system that very much resembles the four humors in ancient "Western" or European medicine); on nonexistent body structures or functions (e.g., chiropractic and subluxations, reflexology and a link between areas on the palms of the hands and soles of the feet that "map" to organs; craniosacral therapy and "craniosacral rhythms"); or vitalism (e.g., homeopathy, "energy medicine," such as reiki, therapeutic touch, and the like). Often there are completely pseudoscientific ideas whose quackiness is easy to explain to an educated layperson, like homeopathy.
Then there are modalities being "integrated" into medicine whose quackiness is not so easy to explain. Perhaps the most popular and famous of these is a specialty known as "functional medicine" (FM) whose foremost practitioner and advocate (in the US, at least) is Mark Hyman, MD, a man whose fame has led him to become a trusted medical advisor to Bill and Hillary Clinton. Perhaps Hyman's greatest coup came in 2014, when the Cleveland Clinic Foundation hired him to create an institute dedicated to FM, an effort that has apparently been wildly successful in terms of patient growth. Never mind that around the same time Dr. Hyman teamed up with rabid antivaccine activist Robert F. Kennedy, Jr. to write a book blaming mercury in the thimerosal preservative that used to be in vaccines for causing autism, an idea that was shown long ago to have no scientific merit. Unfortunately, elsewhere FM has been pretty successful as well, to the point where it has now even started to “integrate” itself with dentistry in the form of an emerging specialty of "functional dentistry."
The problem with "functional medicine" is that at its core it is close to being as nonsensical as the more "obvious" forms of quackery. It just hides it better, mostly behind a battery of fancy-sounding laboratory tests. It's also incredibly difficult to pin down just what the heck it even is, as I've discussed many times in the past. The late, great Wally Sampson's once wrote a post about FM entitled Functional Medicine: What Is It? It was a question he asked after referring to it as the "New Kid on the Block."
That's why I'm grateful to Jann Bellamy, who sent me a case study on the use of FM in oncology published in a journal that I had never heard of before, Integrative Medicine: A Clinician's Journal (IMCJ). Even better, the case is a woman treated for breast cancer, my area of expertise, which allows me to discuss the case presentation in even more depth. Before we do that, let's review a bit about FM as a prelude to diving into the specifics of this published case report. To be honest, I'm surprised that anyone would publish such tripe, as it's incredibly embarrassing. Or at least it would be to any competent oncologist. What really scares me is that FM is now specializing. What we are seeing here is the birth of "functional oncology," and it is terrifying to me.
Functional Medicine: What Is It?
I begin by asking the same question that Wally Sampson asked many years ago, just a bit more “insolently”: Just what the hell is functional medicine, anyway? It has been a long time since I’ve asked that question; so now is as good a time as any to ask it again. Indeed, I was curious to know just what has changed about functional medicine; so I even went back to the same source that Dr. Sampson used eight years ago, the Institute for Functional Medicine (IFM), an organization founded by the other big name in FM, Jeffrey Bland, PhD.
Like pretty much all of "integrative medicine" FM claims to look at the real cause of disease:
Functional Medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, Functional Medicine addresses the whole person, not just an isolated set of symptoms. Functional Medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, Functional Medicine supports the unique expression of health and vitality for each individual.
You could remove the word "functional," replace it with "integrative," and easily plop this paragraph down into just about any article written about integrative medicine by one of its advocates. It's the same weasel words of woo, different branch of woo. Or actually it's the same branch, just a different sub-branch. But what does this all mean? The IFM claims:
- Functional Medicine offers a powerful new operating system and clinical model for assessment, treatment, and prevention of chronic disease to replace the outdated and ineffective acute-care models carried forward from the 20th century.
- Functional Medicine incorporates the latest in genetic science, systems biology, and understanding of how environmental and lifestyle factors influence the emergence and progression of disease.
- Functional Medicine enables physicians and other health professionals to practice proactive, predictive, personalized medicine and empowers patients to take an active role in their own health.
You know, I really hate it when woo-meisters liken things to "operating systems" while referring to "outmoded acute care models." One thing you can be sure of, though, is that whenever someone like Bland refers to using the "latest in genetic science, systems biology, and understanding of how environmental and lifestyle factors influence the emergence and progression of disease," you will be in for a heaping helping of abuse of those new sciences. We've seen it time and time again with, for example, epigenetics (which doesn't do or mean what quacks think it does), placebo effects, the power of diet (which is often grossly exaggerated), and, of course, systems biology, which FM guru Mark Hyman himself abuses shamelessly in the service of his made-up specialty. Indeed, Hyman is an excellent example, as he's mangled science in the service of FM in many areas, including cancer, autism (of course, given his latest foray into antivaccine propaganda), and, of course, Alzheimer's disease and other forms of dementia. That's just a sampling, of course. What's worse, is that FM seems to value anecdotes over actual clinical studies. Basically, its form of "personalized medicine" appears to be a "bait and switch" designed to lower the standard of evidence required to justify a treatment.
Don't believe me? Read it right from the horse's mouth, so to speak. First:
Functional Medicine is an approach to health care that conceptualizes health and illness as part of a continuum in which all components of the human biological system interact dynamically with the environment, producing patterns and effects that change over time. Functional Medicine helps clinicians identify and ameliorate dysfunctions in the physiology and biochemistry of the human body as a primary method of improving patient health. Functional Medicine is often described as the clinical application of systems biology. [Emphasis in original]
But more tellingly, see what Bland says about the evidence base for FM:
When people ask to see the evidence for Functional Medicine, they often mean, "Where are your research trials, comparing Functional Medicine to conventional medicine in a clinical setting?" Unfortunately, current research models do not have a way to test each individualized, patient-centered therapeutic plan that is tailored to a person with a unique combination of existing conditions, genetic influences, environmental exposures, and lifestyle choices. Clinical trials do play a significant role in evaluating and comparing the efficacy of new pharmaceutical treatments, especially when it is important to rule out placebo effects, but they have many inherent limitations which constrain their ability to inform clinical decision making.
So let's not even bother doing clinical trials, then, amirite, guys? Basically, this is a manifesto for doing whatever the heck a physician wants in the name of "personalizing" care. Whenever I see such piece of utter nonsense used as a justification, I can't help but point out that real doctors and scientists are trying very hard to figure out new clinical trial methodology in order to test precision medicine (which used to be called "personalized" medicine) in a scientifically rigorous manner. Yes, in the early "wild west" days (which we are only now coming out of), a lot of physicians made it up as they go along with respect to interpreting the results of whole genome sequencing to select cancer treatment, but that is increasingly frowned upon. If scientists can put together a trial as clever and complex as the SHIVA trial, I laugh at Jeff Bland telling me that FM can't be tested because it's two "personalized." It's a lame excuse—the very lamest—and exactly the same excuse that homeopaths, acupuncturists, and the like make for not doing clinical trials testing their quackery, though FM tries to "science it up" by rationalizing it with these seven principles:
- Acknowledging the biochemical individuality of each human being, based on concepts of genetic and environmental uniqueness
- Incorporating a patient-centered rather than a disease-centered approach to treatment
- Seeking a dynamic balance among the internal and external factors in a patient's body, mind, and spirit
- Addressing the web-like interconnections of internal physiological factors
- Identifying health as a positive vitality—not merely the absence of disease—and emphasizing those factors that encourage a vigorous physiology
- Promoting organ reserve as a means of enhancing the health span, not just the life span, of each patient
- Functional Medicine is a science-using profession
That very first principle is FM's "get out of jail free" card for basically anything its practitioners want to do. They can always find ways to justify any form of treatment, be it science-based or quackery, simply by invoking the "biochemical individuality" of each human being. Here's the problem: Yes, human beings are individuals, and each human being is unique. However, we're not so unique that our bodies don't all work pretty much the same way. In other words, in terms of biology, physiology, and yes, systems biology, human beings are far more alike than they are different. If that weren't the case, modern medicine, developed before we had the tools to probe our genetic individuality, wouldn't work as well as it does. FM fetishizes "biochemical individuality," not so much because humans are so incredibly different that each one absolutely has to have a markedly different treatment. We're not. FM fetishizes "individuality" because it distinguishes FM as a brand from science-based medicine and, I suspect, because it makes FM practitioners feel good, like "total" doctors never at a loss for an explanation for a patient's symptoms or clinical condition. As for the last bit about FM being a "science-using" profession, I like to say that FM "uses" science the same way that an illusionist or magician uses misdirection: So that the audience can’t see how he pulls off his trick.
Overall, there are some things that FM gets right, although they are no different than the things every primary care doctor should be getting right, namely emphasizing healthy lifestyles, good nutrition, enough exercise, adequate sleep, cessation of habits known to be deleterious to health (e.g., smoking). They tend to spend more time with patients, which is something that primary care doctors have a harder time doing these days. They emphasize prevention, which is a good thing but again something that good primary care doctors do anyway; that is, except of course for the antivaccine FM practitioners (of which there are quite a few), who are the very antithesis of prevention.
Where they go wrong is in what Grant Ritchey described as a major unstated premise. That premise is that FM really does address the root causes of disease better than conventional medicine. FM also encompasses a lot of quackery, such as acupuncture, chiropractic adjustments, and especially "detoxification" programs. There also seems to be considerable overlap between FM and orthomolecular medicine, as FM practitioners seem quite enamored of high dose vitamin C infusions. Indeed, one of the quackiest of the quackademic medicine centers in this country, the University of Kansas, emphasizes FM and orthomolecular medicine and is run by a woman who is very much a proponent of high dose vitamin C infusions for cancer.
One of the most prominent identifying features of FM is its reliance on laboratory tests, lots and lots and lots of laboratory tests. They use these laboratory tests to seek out each patient's "biochemical" individuality and analyze his systems in these areas:
- Assimilation: digestion, absorption, microbiota/GI, respiration
- Defense and repair: immune, inflammation, infection/microbiota
- Energy: energy regulation, mitochondrial function
- Biotransformation and elimination: toxicity, detoxification
- Transport: cardiovascular and lymphatic systems
- Communication: endocrine, neurotransmitters, immune messengers
- Structural integrity: subcellular membranes to musculoskeletal integrity
This search for "biochemical individuality" leads FM practitioners to order incredible numbers of labs, as you will see, many of which, as are bogus and of no use, and many of which are routine lab tests that regular doctors order but often end up massively misinterpreted and abused. In particular, FM practitioners appear to like to order lab tests related to endocrinology. Of course, "normal" lab values are usually defined to be a certain number of standard deviations from the population mean, which means that by random chance alone a small percentage of "normal" people will have an abnormal value of a given laboratory test. When a clinician orders a bunch of laboratory tests on a patient, the likelihood that one of those tests will be "abnormal" will approach 100% the more tests are ordered. No wonder FM practitioners can always find lab abnormalities to chase. Of course, to correct those lab abnormalities, there are always many, many supplements to be sold. Indeed, arguably the IFM was founded as a means of marketing the supplements Jeffrey Bland sold. Mark Hyman, through his "Ultrawellness" brand, also sells a lot of supplements.
Functional oncology in action
This brings us back to the case report, and boy is it a doozy. The authors include Elliot T. Taxman, BA; Erin D. Conlon, BS; Alex Speers, BA; Kristin L. Dismuke, BS; Tonya S. Heyman, MD, FACOG; Thomas L. Taxman, MD, FAAP. It turns out that Elliot Taxman, Erin Conlon, and Alex Speers are all students at the National College of Natural Medicine, while Tonya Heyman is a gynecologist specializing in "integrated personalized medicine" and Thomas Taxman is a pediatric gastroenterologist and functional medicine practitioner. The physicians are located at the Cleveland Health Institute in Lyndhurst, OH, which is a suburb of Cleveland. Given that the authors are all affiliated in some way with an "integrative medicine" clinic, I wasn't sure where the patient discussed was treated for real. (I mean real cancer treatment, as opposed to the quackery she was subjected to in addition to her cancer treatment in a "complementary" fashion.) Perhaps it was at the Seidman Cancer Center at the University Hospitals of Cleveland, given that Dr. Taxman is an assistant clinical professor at the Case Western Reserve University School of Medicine.
Be that as it may, here is the clinical presentation as described in the case report:
An 80-year-old Caucasian female patient presented to an integrative medicine clinic in December 2012 with a 1-month history of a tender right breast. Her history was significant for arthritis, obesity, hypothyroidism, chronic gastritis, and hypertension. Her current medications included hydrochlorothiazide and triamterene, quinapril hydrochloride, levothyroxine sodium, and esomeprazole. Her family history was positive for breast cancer (daughter at age 46 y and sister at age 70 y). Physical exam revealed an erythematous, warm mass with irregular borders and localized skin thickening palpated across both upper quadrants of the right breast. The mass measured approximately 15 × 10 × 5 cm. In addition, a prominent 1-cm right axillary lymph node was noted.
This presentation sounds like that of an uncommon and particularly nasty form of breast cancer known as inflammatory breast cancer (IBC). IBC is characterized clinically by more than half the breast being involved with an inflammation-like reaction and pathologically by tumor cells in the dermal lymphatics (the lymph vessels right under the skin). The standard treatment for this aggressive form of breast cancer is neoadjuvant chemotherapy (chemotherapy before surgery), a modified radical mastectomy (removal of the breast and the axillary lymph nodes), followed by post-mastectomy radiation therapy to the chest wall. By definition, IBC is at least stage IIIB. On the other hand, IBC is a clinical diagnosis. Absent a skin biopsy showing tumor cells in the dermal lymphatics, its diagnosis is purely clinical so this woman might not have had IBC. Still, from the description, it looks as though neoadjuvant chemotherapy was appropriate:
Mammography revealed increased irregular density in the central upper quadrants of the right breast. A subsequent ultrasound noted a mass in the right breast that was highly suggestive of malignancy and the accompanying guided biopsy concluded invasive ductal carcinoma, grade 3, with involvement of a right axillary lymph node. A magnetic resonance imaging (MRI) on January 7 confirmed the previous diagnosis and indicated that a small mass was found in the left upper outer quadrant of the left breast. A follow-up sonogram and mammogram of the left breast confirmed the MRI findings. She was given a Breast Imaging-Reporting and Data System (BI-RADS) score of 6 and her cancer was concluded to be ER/PR negative and HER2 positive.
A tumor that lacks estrogen receptor and progesterone receptor but does have amplified HER2 almost always gets neoadjuvant chemotherapy consisting of a regimen of cytotoxic chemotherapy combined with Herceptin, which targets HER2. The patient underwent a bone scan and PET-CT scan, the latter of which is bit of overkill, because PET-CT has never been shown to be superior to CT alone in the setting of breast cancer. Both were negative, which means that the patient was not stage IV and the title of the case report, "Chemotherapy and Functional Medicine in a Patient With Metastatic Breast Cancer: A Case Report," shows that the people writing and reviewing it were clueless about breast cancer. This woman did not have metastatic breast cancer, at least not the way a breast cancer surgeon and oncologist look at it. Lymph node metastases are generally considered regional disease; we usually don't refer to "metastatic" disease until there are metastases to distant organs (i.e., stage IV disease). Be that as it may, this woman was potentially curable and was clearly in pretty good shape for an 80 year old if they were willing to give her chemotherapy, even though she did have a fairly typical litany of diseases and conditions of the elderly (arthritis, obesity, hypothyroidism, chronic gastritis, and hypertension). On the other hand, it's not as though there was much choice, given that the cancer was ER/PR-negative and therefore estrogen blocking treatments were not an option.
In any case, what sounded like fairly standard chemotherapy was initiated, including docetaxel (Taxotere), carboplatin (Paraplatin), and trastuzumab (Herceptin), and the patient underwent a right modified radical mastectomy after six cycles, followed by radiation therapy. She also underwent a left simple mastectomy (no evaluation of lymph nodes) for reasons that were unclear to me. She apparently had had something spotted in the right breast on her preoperative MRI, but it was never biopsied, as far as I can tell, and therefore never proven to have been cancer. Given that there is no survival benefit in doing it in the absence of a deleterious cancer-causing mutation, it's hard enough to justify a prophylactic mastectomy on the other side in much younger woman, say 50 years old, but to do this operation on an 80 year old, whose life expectancy (and thus time remaining in her life to develop another life-threatening invasive cancer) is so much shorter, is questionable. Yes, they did find a small focus of ductal carcinoma in situ, but that would have been very unlikely to have progressed to endanger this patient's life in her remaining time. Of course, the choice of surgery was on the conventional breast surgeon, not the FM doctors, but I felt obligated to point this out, given that we're talking about my specialty here.
Now get a load of this chart, which shows what she got overall (click to embiggen):
She received 97 infusions of vitamin C. Yes, you read that right. In the eleven months or so that her complete science-based therapy of her breast cancer required, this woman was subjected to 97 unnecessary and potentially harmful infusions of ascorbate. Afterward, she received "sporadic" doses of vitamin C up through to August 5, 2014, which was one year after her mastectomy. Fortunately, she was tumor-free. As I've written before many times, there is no good evidence that high dose IV vitamin C has a clinically useful antitumor effect. No, Linus Pauling has not been vindicated, although FM practitioners, naturopaths, and other believers have been trying for decades.
But that's not all this poor patient received.
She was placed on a dairy-free, gluten-free, low glycemic index diet. Why? Who knows? There's no good evidence that such diets have an anticancer effect. Why make the woman eat a diet that makes it harder for her to keep her weight up during chemotherapy? Again, who knows? She was also placed on the following supplements:
- Melatonin: 20 mg QHS
- Digestive enzymes AC
- Probiotics: 60 billion CFU BID
- Lactobacillus acidophilus NCFM
- Bifidobacterium animalis Bi-07
- Medical food shake bid
- Vitamin D3: 5000 IU QD
- EPA:DHA: 6000 mg QD
- Wheat germ extract: 5.5 g QD
- Oral vitamin C: 18-24 g QD
- Standardized herbal inflammation relief supplement
One wonders why she was taking 18-24 g (that's right, grams) of vitamin C per day in addition to the boatloads of vitamin C she was receiving intravenously three times a week. That’s enough to cause significant diarrhea. As for the rest, they probably don't hurt, but there's no reason to think they help, either. They add no detectable medical benefit, but they certainly do add cost. That's not even counting the labs ordered. Chemotherapy patients get a lot of labs done, but look at the additional unnecessary labs ordered on this patient. The results take up more than two pages of the case report, and include amino acid levels, "gut immunology" markers, secondary bile acids, parasite tests, pancreatic enzyme levels, heavy metal levels, and, of course, the most beloved lab tests of FM practitioners and autism quacks, oxidative stress markers like glutathione and coenzyme Q10.
And I haven't even listed them all. None of these tests were necessary. Almost certainly, none of them added any value to the patient's care. Equally certainly, they added a great deal of cost to this patient's care. They are almost all pure quackery.
In fairness, what the FM practitioners added wasn't all bad. An exercise program was started consisting of 10 minutes of bicycling a day working towards 30 minutes, Qigong classes, a sleep log, individual counseling and group support, and a part-time caregiver. None of these things, however, is the least bit "integrative" and could easily have been done by any oncologist.
The end result: Nothing
So what was the result after all of this? The patient survived two years, but the odds of her surviving five years were probably around 70% anyway with conventional therapy and probably 85% of surviving two years, based on her clinical presentation and final pathology, worse if she actually did have IBC. Try as they might, even the FM docs who wrote up this case report couldn't make a case that what they did added anything to this patient's care, other than getting her off of her hypertension medications, which could easily have been result of weight loss and exercise, coupled with a hypersensitivity reaction she suffered when her cardiologist changed her medications. Indeed check out the final paragraph:
This case is unique because of the integrated approach guided in part by nutritional and digestive evaluation (NutrEval) from a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory testing company (Genova Diagnostics, Asheville, NC, USA) that was used in the management of this patient with advanced ductal breast carcinoma.5 Because this is a case report from the real world practice of medicine, it is not possible to determine the responsibility of the treatments in this patient's success in achieving remission. Nevertheless, the patient survived her cancer with minimal side effects during treatment and is now in her third year of remission. This case study highlights the potential benefits of integrative therapy in the comanagement of patients with invasive ductal carcinoma of the breast.
No, we can say with a very high degree of certainty that the only benefits this patient experienced came from exercise, a personal care giver, counseling, and perhaps her sleep log. The high dose vitamin C, the dozens of lab tests, and all the supplements did her no good but certainly cost a lot of money. I can't help but shake my head at this. In particular, I am amazed that the FM doctors presenting this case actually seem proud of what they did. They should be ashamed. Very ashamed.
I am, however, glad they wrote up this case report, as horrifying as it is. It shows what FM really is when in actual use. All those high-sounding ideals and principles, all the claims that FM treats the "underlying cause" of disease are revealed to be delusions when you just look at what FM doctors really do when treating cancer patients. Harriet Hall's aphorism about CAM in general fits perfectly: What's good about FM is not unique, and what's unique about it is not good. My conclusion about FM is, in addition to Harriet's, that it takes "making it up as you go along" to a whole new level, and that's not a good thing in medicine.
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Those quoted paragraphs were a prime example of saying nothing with lots of words.
I always have to laugh when sCAMsters claim that they treat the underlying cause of disease.
They do anything but that.
Oh, Genova. We have more trouble with doctors ordering their "personalized panels" which are much ado about nothing (as you've noted from their results. Then patients get very upset when their insurance won't pay for the tests. What amazes me is that this lady must have spent thousands of dollars with the supplements, IV vitamin C and special diet. Because I sure hope Medicare wasn't paying for that junk!
I am still wondering why they don't integrate the machine that goes ping in their treatment.
Dr. David Gorski is an established pro-vaccine internet troll with ties to the Barbara Anne Karmanos Cancer Institute, notorious for experimental cancer treatments and drugs that have been fast-tracked by the FDA.
Karmanos is also where cancer fraudster Dr. Farid Fata had his clinic. Fata used aggressive chemotherapy treatments on cancer-free individuals, over-administered chemotherapy on people with no chance of survival, undertreated cancer patients, overbilled insurance, and defrauded the government out of $17 million.
Gorski consistently trashes holistic medicine and vaccine skeptics under the pen name "Orac" on the website ScienceBlogs, heavily sponsored by the drug industry.
In an effort to discredit "anti-vaxxers," Gorski's followers promote the use of "emotional warfare" on "anti-vax blogs." That ScienceBlogs post instructs other trolls to embellish sad stories full of tears and "unbearable grief and terror" about friends and family members who died of terrible diseases in an effort to push harmful vaccines.
The "more gross the better," the post reads. Gorski's followers claim that this tactic will work like advertising and influence the minds and decisions of readers on the fence about vaccinating. Make sure to add a few grammatical errors to make it believable, it continues.
Gorski's commenters tell their fellow trolls to use an untraceable email address so their manipulations cannot be tracked. "The way to fight it [vaccine skepticism] is by sabotaging the anti-vaxers with crazy stuff that drives away undecideds," one post reads.
Gorski is a surgical oncologist at the Karmanos Cancer Institute and an associate professor of surgery and oncology at the Wayne State University School of Medicine, where he also conducts research for drug companies. This is where the problem lies.
Gorski has said himself that conflicts of interest (COIs) weaken scientific research, even when the science is sound.
"A general principle is that undisclosed potential conflicts of interest (COIs) are of far more concern and potentially far more damaging to the scientific process than disclosed COIs," he wrote in defense of vaccine propagandist Paul Offit, who's made millions off vaccines but routinely conceals that COI.
Gorski has also said that a true shill who conceals his ties to Big Pharma and pretends to be objective should be exposed.
But Gorski will not come clean about his own COIs, reports Jake Crosby, writing for Age of Autism. While Gorski is extremely outspoken about autism not being caused by vaccines, he mentions little about what he has to gain from this position.
Gorski poised to financially benefit from autism drug
It turns out, Gorski's employer, Wayne State University, has a lot to gain from an ALS drug called riluzole that could be used to treat autism, reveals Crosby, adding that Gorski is experimenting with that same drug to treat breast cancer.
The world's largest vaccine maker, Sanofi-Aventis, has a partnership worth up to $39 million with Wayne State. Sanofi-Aventis also happens to be the developer of riluzole, marketed as Rilutek.
"Therefore... Gorski has a reasonable expectation to receive money from a vaccine maker, even if it is through a third party," wrote Crosby.
In his Wayne State laboratory, Gorski focuses on the research and development of prescription drugs. However, he's working not to create new medications, but rather new uses for existing drugs, a process far more lucrative than creating new drugs from scratch.
"The potentially profitable drug Gorski is in the process of conducting a clinical trial for is the ALS drug Riluzole.... Amplifying the conflict further is that the same drug is also being studied for the treatment of autism."
At Autism One, a non-profit educational organization that focuses on autism, "the National Institute of Mental Health was handing out recruitment pamphlets for children ages 7-17 to take part as subjects in a clinical trial of Riluzole for its effectiveness in the treatment of autism spectrum disorders, and repetitive and stereotypical behaviors in particular."
In 2008, Sanofi-Aventis announced that it would be collaborating with Wayne State (as well as other partners) and could be making up to $39 million in payments over a five-year period to these partners. Gorski was chosen as the guy to conduct a series of clinical trials involving the company's drug, riluzole.
In short, Gorski and his team stand to earn millions from riluzole medication for autism, illustrating a great incentive to quiet vaccine skeptics about the link between immunizations and autism. If this isn't a blatant conflict of interest, than we don't know what is.
"Gorski's denial of being in the pocket of the drug industry stretches so far beyond what he is even regularly accused of," wrote Crosby, who confronted Gorski with this information:
Dr. Gorski,
This is Jake Crosby. I am doing a piece about your acknowledgment that disclosure of conflicts of interest is important, yet your lab at Wayne State University stands to benefit from Sanofi Aventis money for the breast cancer research you are conducting on a drug the company manufactures and markets, Riluzole, which is also being studied for the treatment of autism. Why isn't any of this disclosed on your blogs? I await your reply.
To read about Gorskis response: http://www.ageofautism.com/2010/06/david-gorskis-financial-pharma-ties-…
It would've been nice if the integrative functional care team had assigned this patient a Pill Administrator so she had help in managing her zillion drugs and supplements. Or maybe they gave her a giant-size compartmentalized Pill Wheel so she knew what and when to take every day.
I have a hard time believing all of the added "functional" sludge they gave her helped her gastritis issues or contributed in any way to quality of life, much less her remission from cancer. At least they didn't prescribe twice daily coffee enemas like those poor patients with pancreatic cancer treated by Nicholas Gonzalez.*
A Gonzalez website (updated in mid-March) still promotes his regimen for cancer patients, including coffee enemas and up to 175 supplement capsules a day, and the Gonzalez Foundation lives on (despite the doctor himself having been eliminated by the Pharma Lizard Alternative Doctor Murder Conspiracy:
http://www.dr-gonzalez.com/treatment.htm
According to Hyman's book, Ultra Prevention, patients suffer from one of five problems ( not "elements" mind you *a la* TCM) of which the two I recall are "sludge" and "rust". I wonder what IBC is.
-btw- the diet/ supplement/ IV vitamin C treatments sounds a great deal like what prn's guru and chief enabler RN utilise.
Translation: "Our methods and procedures are too sophisticated for plebeian sensibilities to understand. If you cannot see the obvious superiority of them, then you cannot appreciate the finery of the emperor's new outfits, either."
They say this as if it were a good thing. Those of us who are familiar with the Blue Screen of Death (Windows) and/or the Spinning Beach Ball of Death (Mac) might beg to differ--and that would be most of us. How do we know that the Functional Medicine OS doesn't have a BSOD equivalent? With nasty results for the patient if--or should I say when--the BSOD equivalent appears.
Daniel @3 -- I think that should be "the machine that goes ka-ching!
@ Eric Lund:
And what exactly would the FM OS's BSOD look like?
does it occur as the patient turns blue or spins or is it purely in the FM Dr's imagination? ( like the rest of FM)
The high dose vitamin C, the dozens of lab tests, and all the supplements did her no good but certainly cost a lot of money.
An idle assertion with apparently zero experience and capable work effort behind it. The experience of my cancer acquaintances is pretty much about vastly improved quality of life, otten within minutes or hours in terms of overwhelming pain, nausea and/or fatigue.
Also in a short term, stomatitis is reduced or disappears.
On an integrative tx basis, including IV vitamin C too, I've observed long term ESR drop by a factor of 3-4, like 40+ to <10. Various cancer markers improve to a favorable baseline or some optimum rather continue to deteriorate as conventionally expected. In favorable situations, the extra supplements with chemo are better cancer killers than SOC. I seen some good kill data the literature, I've invested in lab results I arranged for where the was new and surprisingly so to them, and in the subsequent blood data. In the literature, the comparable patients are ***all*** simply extinct several times over, after an unpleasant journey.
In the CRC world, you folks don't know [cough] squat about vitamin C even though it is just a multifactor tool rather than a silver bullet.
My comment on this article's "waste spending premises" is that the CDSA used to cost about $300-$400, not sure now since the Genova merger. Doing it 1-2 times would be pretty minor in the $50,000-60,000 per month standard of care I see others wasting away on with mCRC Std of Care.
Also in the US, blood test prices are fixed very high. In high volume international areas, $1-5 per panel is possible, sometimes offered retail. I've found more data, based on literature, very useful.
@prn: So why don't you have peer-reviewed publications about the magic of IV vit C? You keep posting how wonderful it is. So prove it. There's tons of money available from NCCAM (or whatever it is now) available for studies. Get some proof.
Standards of care are paid for by insurance because they are proven to work and are cost effective. If you could give insurance company proof that a less expensive treatment : 1. Is AS EFFECTIVE OR BETTER than the current treatment 2. Has the same or fewer side effects and 3. Is more cost effective they would be ALL over it, believe me.
But yammering from the peanut gallery and testimonials just don't cut it. Proof does.
Clean up needed on comment #4 from a troll copy/pasta from AOA. If they are going to post stuff, I wish they'd research the proof of it first... (for example, as far as I can find, Dr Farid Fata was never associated with WSU and the Karmanos Cancer Institute).
And quoting Jake Crosby's droppings is just proof that the troll is unable to do any independent thinking.
@Sulli - we are aware that Jake wrote an article attempting to prove someone has an unstated conflict of interest because of an 11 degrees of separation problem.
BTW - an internet troll is defined as someone who deliberately tries to "stir the pot" online by writing inflammatory or off-topic messages. Jake's use of the term does not appear accurate to me.
@ MI Dawn:
That quoted by # 4 is also at Natural News today as I noted on the BS 2 thread so even less thinking was involved by # 4
Is that all they have? Jake?
And the minions are mentioned a little in her NN article.
Orac's place is THE place to be!
Shills, minions, even Brian Deer stops by.
We the cat's pyjamas and the bees' knees.
I think Jake knows about the NN piece. I wonder what he thinks about AoA using his material?
Have they got any evidence that Orac want to do a clinical trial on autistics subjects? I mean, Orac is a surgical oncologist, not an academic shrink or neurologist ?!
Alain
"We treat/the underlying cause with personalized care."
-All sCAMsters ever
Then they proceed to "prescribe" many supplements, often similar for every patient. How is that different from a doctor prescribing medicine? Other than the evidence base of course.
If we ever need to illustrate what we mean by "word salad", the functional medicine site seems to be the place to go.
Didn't there used to be a competition for the most inane/contentless powerpoint slide? Functional medicine is going for it.
It is mildly hilarious that the same NN "staff writer" (Julie Wilson) who authored the article outing Orac et all as corporate shills, has another current article on NN proclaiming that "Women with larger behinds are healthier and more intelligent, study finds".
In the first article, we're told that any time Science upholds something that benefits big corporations, it's not to be trusted. Yet promoting fat a$$es (which obviously puts money in the pocket of Big Agriculture, Big Processed Food and Big Ice Cream) is unimpeachable science.
I suspect the reason for this dichotomy is a high incidence of massive rear ends among Mike Adams' followers, who like the idea that their lard-butts indicate higher intelligence and better health.
Mikey himself continues about our perspicacious host today in his post about Scientism ( sic) where the later enjoys rather illustrious company of Offit, Entine and Nye.
What up, anyway? Has Orac's visibility since the De Niro debacle increased his stature in woo-meisters' eyes?
Practicing doctors do not directly own pharmaceutical companies. Many of the alt-med doctors who "prescribe" these "supplements" actually do have controlling interest in the manufacturer of the prescribed supplements. This is a major reason why the "pharma shill" gambit is little more than projection on the part of the alt-med crowd.
That competition was long since won by the Gettysburg PowerPoint Presentation, a parody written when Bill Clinton was president (somebody discovered the hard way that <president@whitehouse.gov> was and is a real e-mail address), and still available at the original site if you Google "gettysburg powerpoint". In particular, slide #5, "Organizational Overview", turns, "Four score and seven years ago our forefathers brought forth on this continent a new nation," into a hilariously overdone Excel bar chart. Bonus points for using Lincoln's actual words, drained of their impact, in the parody. The author claims to have made only a few tweaks of PowerPoint's then default settings (via the too aptly named "AutoContent Wizard") to get this result.
Functional medicine doesn't have the luxury of starting with such great material, but they are certainly giving it a good try anyway. The slide displayed in the OP manages to say nothing and to do so at great length.
Ashamed all the way to the bank.
prn @11: What blood test are you getting for $1? Every time I run a CBC/diff it's $1.50 in reagents alone, not counting the instrument, the printer paper, the tube the blood is in, or any of the people involved.
@Justa #24 - Since you already know you're going to be selling a ton of crap to your patient, all you have to do to get a lab result is throw a dart.
Sulli @#4....ha
Ha ha
Ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha
What a load of
Justatech: Not to mention, prn seems to be doing blood tests very frequently. Maybe PRn meant a blood sticker- you know, whatever those things diabetics use to test their insulin are called. (And what level of insane do you have to be to want to do a full onblood test? I've hated every single one that I've had to do, mostly because I end up very shaky after.)
Homopathic classes are now taught at most major university's. I guess they believe it's science. If big pharma can't get people well, they will turn to something else that will, sorry Orac, your wrong about this one. Or should I call you by your first name, David Gormski?
X-Pac - could you please list of the universities that offer courses on homeopathy? Thanks in advance.
Many universities offer courses on English literature. Is that a science too?
You're missing the nuance. "Xpac" wrote homopathic.
#4 Thanks- for the info
JT@24 everything in the US is high priced. Here's a 2012 "Chem-26" for $1.33/panel for profit walk-in retail (AFAIK) - look at the bottom for "Pacer-26"
http://www.aminspathlab.com/Pricelist_01Aug_2012.pdf
In another country, the international test makers were quoting to beat $1 in 2010 at the hotel expo down the street.
PGP@26: mCRC patients on chemo are usually blood tested every chemo cycle, every 2-3 weeks
You’re missing the nuance. “Xpac”
...thinks "David-Gormski" is a first name.
The bottom line for Big Pharma is profit but there is some hope for the development of antibioics.
http://www.wsj.com/articles/SB10001424052702303465004579322601579895822
"Even if antibiotics make it to market, oncology drugs are on average three times as profitable, and musculoskeletal drugs produce more than 10 times the returns, according to estimates from a 2009 London School of Economics report."
2 answers still in moderation at 1125 pm CST 4-18-16.
cont....."For example, ceftaroline fosamil, an antibiotic approved in the U.S. in 2010, costs around $600 for a seven-day course. Contrast that to yervoy, a new drug to treat melanoma, that costs $120,000 for a 12-week course."
How ironic- right under his nose- Farid Fata- https://www.justice.gov/usao-edmi/file/623461/download
This is what the patient reported about her treatment with CAM.
(Read the report) Patient Perspective
“I was worried about the side effects of chemotherapy but I
never had to have a blood transfusion, I only had diarrhea
once, and no nausea and vomiting. I had a little bit of fatigue
but stayed active and did not have to change my lifestyle
very much. I was able to be with my friends and family, and
to taste and eat food while I was being treated. I thought
that I looked better than the other chemotherapy patients I
saw when I went to get treatments. They all looked so sick
and so much older than me! The worst thing was losing
my hair! I knew that the medications had a long list of side
effects and at the beginning I did not understand that they
could be minimized, but they were! I had chemotherapy
and surgery but never had any radiation. Two years later, I
am still cancer free and feel great. I may be healthier now
than I was before my diagnosis and treatment.”
It's hard to carry a conversation here with the filter, 2 still waiting above here, and minus two last week.
Denice@6
...prn’s guru and chief enabler RN utilise.
I'm mystified. Who's RN ?
The question the people pushing this are evading is, if there's no way to test the regimens they're giving their patients, what are those regimens based on? What makes them think that (for example) all that vitamin C isn't worse than useless? Even the "in my experience" argument for using something without clinical trials falls down if the claim is that what works for me isn't going to work for you because we're all different.
How do they know they aren't just coming up with expensive, "personalized" ways to kill their patients quickly?
@ prn:
Hello, I hope you're well.
Not 'prn' meaning you but the radio station that transmits woo over the internet- its guru is Gary Null and the 'RN enabler' is an actual nurse who assists him by recruiting patients and setting up treatments through her business, Metropolitan Wellness ( see website). The two are partners in several ventures providing so-called health care in at least 3 US states, ultimately aimed at creating a health retreat resort ( The Texas Villa) that will work with seriously ill people which is now in its first stages of development in Mineola, Texas.
@ Vicki
One would also be arguing about the "personalized" part.
OK, so all these tests are run, and at the end it's surprisingly the same usual suspects - vitamin C injection and ingestion, gluten-free diet, colonics, juicing... The new post about the poor Australian lady with cancer shows this.
As Brook #25 implied, it's as the regimen was already established before getting the results of the biochemical tests.
That's actually how the tests could be so cheap: since the conmen are expecting a big business deal after the mark has been provided with the tests' results, they could afford the risk of losing money on the tests.
They are not the only ones with this business model.
Also, to emphasize, this argument of "we can not test our medical approach because it's personalized" is pure bullshit.
Alt-meds quacks, if they were honest, could test a procedure by measurable endpoints, like everybody else.
ken surely by now you can grok that anecdotes =/= data.
trying to get past filter, part 1:
@prn: So why don’t you have peer-reviewed publications about the magic of IV vit C? You keep posting how wonderful it is. So prove it. There’s tons of money available from NCCAM (or whatever it is now) available for studies.
uhhh, MID. I am the customer, not the seller or some young Turk that doesn't mind killing lots of rats and patients.
"Hey prn, before we operate we'd like you to prove the 4 color map theorem more elegantly" I just happen to be better at improvised research results from scratch than most drs, like little PhDs. I was never much a paper pusher, somebody else has to plow that s---.
trying to get past filter, part 2:
Standards of care are paid for by insurance because they are proven to work and are cost effective. If you could give insurance company proof that a less expensive treatment : 1. Is AS EFFECTIVE OR BETTER than the current treatment 2. Has the same or fewer side effects and
3. Is more cost effective they would be ALL over it, believe me.
Somebody here may be fool enough to believe in an efficient market hypothesis for Sci/Tech, not me. The patent bureau is littered with unused good technology as well as duds. Marketing is all about ignoring, or destroying, products or technologies your company doesn't own or want to sell.
The IV vitamin C story for acute viruses is a great example of that. The most thorough summary is Tom Levy's Curing the Incurable: Vitamin C, Infectious Diseases, and Toxins. An interesting historical sampler is McCracken's Injectable Vitamin C
PRN: mCRC patients on chemo are usually blood tested every chemo cycle, every 2-3 weeks.
But didn't you say you weren't on chemo? My point is, normal healthy people do not voluntarily get blood tests that often. Also, that seems kind of like a short interval. Wouldn't once a month be better, if the cancer seems to be holding steady?
prn @32: I don't know what being in the US has to do with how much the reagents for the machine cost. I mean, based on the number of languages on the box this machine is used all over the world. Then again, it does require more than a drop of blood. Usually a whole tube. But then again I'm doing a complete blood count with cell differentiation.
PGP @26: Have you tried asking to lie down for draws? I'm a terrible fainter (it's not the sight of blood, it's having someone deliberately take it away) so I always ask to lie down. I might have to wait a few minutes more, but it really helps not feeling terrible. Also, pointless chit-chat with the tech helps too.
Justatech: I'll try that next time. I'm not big on pointless chitchat, unless it's about birds.
As a former phlebotomist, I can tell you we'll do anything to keep our victims from fainting.
Nobody likes getting their blood drawn, some of us just don't mind it. (Although I had a hard time believing the folks tattooed all over - and I mean in their ears all over - telling me they're afraid of needles).
Trust me, I have talked about professional sports (and I am so not a sports fan this was really hard), prayer and faith healing (patient's fear trumps my beliefs), dogs, books, mean siblings, favorite halloween costumes, music and birds. Please please please tell the phlebotomist you get queasy. So much easier to have you lying down than do the paperwork if you faint/throw up.
The important thing for me is not seeing ANYTHING: not the needle (before OR after they go in), tubes, vials, anything. I just have to face away from all that stuff.
Brook: That's good to know. I don't get queasy* thankfully, but I do get a little faint, and it doesn't help that I have skinny veins, so they have to do a lot of poking. I should also schedule tests in the middle of the month, since that should give my iron levels time to go up.
*My inner ear is ridiculous. I have been known to go on three spinning rides in a row and never throw up. I've also never been seasick or motion sick.
systems-oriented
The guys I confront have taken to sneering that they "like to use a systems approach," not the fuddy duddy old reductionist science that gave us DDT and Subaseals and oral polio vaccines. Allow me to roll my eyeballs as these people would not recognize a system if Chestnut hisself return from the grave to get funky in their ears.
@Brook
One time when I was sick with Cthulhu-knows-what I, for some reason lost to me to this day, needed to have my blood drawn. Not only did I pass out for a second or two, but in doing so I apparently lost whatever control I had over my stomach and up-chucked all over myself and the poor lady drawing my blood.
I don't have a problem with needles in general nor do I ever faint (this was the one and only time) but being sick with flue-like symptoms combined with the drawing of blood was a bad, bad combo!
PGP@47: ...didn’t you say you weren’t on chemo?
No.
My point is, normal healthy people do not voluntarily get blood tests that often. Also, that seems kind of like a short interval. Wouldn’t once a month be better, if the cancer seems to be holding steady?
Cost, convenience, predictive qualities, and response options, have an impact an independent, rational maximizer's decision for blood testing.
If the Theranos single drop concept had matured, and if I were a wealthy CRC stage III with biomarkers indicating proneness to metastasis, I might do a fingerstick every week at a Walgreen'sif it was around a corner, then reviewed monthly or monitored by an expert outside provider to maximize sensitivity, statistical power and medical responsiveness without disturbing me everytime.
However, I deal with a case of mCRC that had somewhat disseminated targets - many lymph nodes and other organ locations ranging 2-30mm, along with biomarkers that correlate with a metastatic character.
That typically means "chemo forever", something I probably view more literally than oncologists.
JustaTech@48:
prn @32: I don’t know what being in the US has to do with how much the reagents for the machine cost. I mean, based on the number of languages on the box this machine is used all over the world. Then again, it does require more than a drop of blood. Usually a whole tube. But then again I’m doing a complete blood count with cell differentiation.
I assume regional price variations or cost cutting practices for consumables.
Also, I've paid ca $1.75 - $2.10 per CBC with dif from a retail lab outside the US with same day turnaround during these years.
PRN: I hate to break it to you, but internal vitamin c doesn't count as chemo. Besides, I thought you hated and despised actual medical doctors? Why bother with medical treatment?
" However, we’re not so unique that our bodies don’t all work pretty much the same way. In other words, in terms of biology, physiology, and yes, systems biology, human beings are far more alike than they are different. If that weren’t the case, modern medicine, developed before we had the tools to probe our genetic individuality, wouldn’t work as well as it does."
What an interesting statement. If we are so much alike in terms of biology, physiology, and yes, systems biology, why do some get cancer, whilst others do not? Why do some get auto-immune disease and some not? Why do some become addicted?
And just how well does modern medicine perform? How do we establish the parameters by which we adjudge that performance and compare it to other forms of medicine?
Gus@58:
Why yes, if only we all had some sort of methodical, objective, reliable system for repeatedly testing stuff to determine if it's any good or just a giant steaming load of horseshıt. We could even call it something like "science" and make more progress in a couple short centuries than blind faith and superstition could achieve in ten millennia.
Perhaps if we pray really hard to the gods of homeopathy they will one day tell us how.
PGP: PRN: I hate to break it to you, but internal vitamin c doesn’t count as chemo.
Even the hardest core here will count 5FU as chemo. I suspect there will be multiple opinions about various off label adjuncts in combination. Don't forget leucovorin is a vitamin too.
Besides, I thought you hated and despised actual medical doctors?
That's just what less sophisticated readers here may presume.
Yes, I can be annoyed if someone is rude, nasty or obstructive despite careful request or presentation.
Yes, I can be critical.
Yes, I may not spend more money on drs that don't contribute much value to the project.
I do several drs consults on various items and tasks every year, just not medical oncologists.
Why bother with medical treatment?
You may mistake a discussion over technologies, approach, insistence on measurable performance, and cost effectiveness for total rejection of medicine. I don't.
Your own preconceptions may be distorting your views.
has@59
I acknowledge what your are inferring with your response here. However, my first question remains unanswered. Not just by yourself, but by all who enter this debate. And this question MUST be answered before one quotes "a sound methodology" by which we judge the validity of that knowledge.
I could have asked why those who are the proponents of science (both sides here purport to argue from this perspective), only use the scientific method to furnish proof of their conviction. And no disrespect to those who carry the burden of the belief theirs is the correct conviction.
Let me ask this then; How much does modern medicine know about breast cancer? About any cancer for that matter? What does FM know about breast (or any) cancer?
I know that is not the subject of the article, but it is the very core of the disagreement between two apparently opposing schools of thought, (the very core of why there is debate where there should not be). Neither side is offering anything of value to the argument because all they do is bicker about who is right or who has the right to be right. By doing this, everyone loses sight of what is REALLY important here.
What mindset lays the foundation for such loss of direction?
Let;s say I have cancer. For my doctor, what is the most important thing to consider when I am first diagnosed and first presented? If you think this is an obvious question, then you have no right arguing this topic, let alone arguing the correct course of treatment, no matter how many and what type of letters follow your name.
At this point I am willing to wager very few people here could answer me (just me, not the next cancer sufferer) correctly.
Gus@61: No need to infer: I'm calling you out as a disingenuous JAQ-off asking bad-faith extremely trivial questions that anyone with a room-temperature IQ can quickly and easily answer for themselves instead of demanding others do all the work. (Or a several nights' reading, if you fancy a longer pop sci rundown.)
But okay, I'll play a little. IANAD, but straight off the top of my head: some folks get cancer while others do not because: random chance (particular combinations of genetic mutations accumulated during cell division), aided and abetted by lifestyle choices, parental genes, and increasing age.
Now go do your homework for yourself, and then come back and tell us what the rest of those answers are**, and if there's specific points on which you'd like clarification or wish to discuss further then perhaps folks here will be a bit more disposed to engage with you on a good faith basis.
(** Protip: This does not mean spamming us with Natural News/Whale.to/GreenMedInfo excreta, as those are well known and repeatedly debunked lying liars who are not a reliable source of anything except Big Alt Med profiteering, so quoting those as sources will get you laughed out the room. Ditto dangerous loons like Simonici and Young who've been torn apart here and elsewhere for their lethal BS.)
Gus@58:
"What an interesting statement. If we are so much alike in terms of biology, physiology, and yes, systems biology, why do some get cancer, whilst others do not? Why do some get auto-immune disease and some not? Why do some become addicted?"
Because while we are more similar than different we aren't all exactly the same. Also, we do know some things that increase the risk of developing certain cancers like smoking, HPV, gene mutations like in BRCA1 & 2, etc.
PS How do I format block quotes on this site?
@Secret Cisco:
Use HTML tags:
<blockquote>How do I format block quotes on this site?</blockquote>
Then pray to the gods of SB IT that you typed them right too, cos Preview and Edit is for weakings only.
Editing is for the weak, I only write in ink.
has@62.
Please let me be clear with you. I have no bias toward scientific-based, modern medicine, ANY alternative medicine, in fact ANY form of activity which espouses ANY method of treating the ill. Perhaps if you explained to me why you think I denigrate one and worship another, I can explain to you why you are wrong. But you are wrong.
(My reference to scientific debates using science methodology to justify the the credibility of the knowledge being argued,: The scientific method is based upon both positivism and empiricism, meaning; the only knowledge humans can have is based on experience, and it is susceptible to unintended bias because of frequent skepticism and a sometimes contentious tendency to deny, oppose or resist possibilities which contradict the paradigm in question.
When I asked by what parameters we should adjudge any particular form of medicine, and your answer is "the scientific method", I have to ask how can you justify using the method by which you come to your conclusion as proof your conclusion is correct. That is somewhat, at the most basic level, the same as devout Christians claiming the existence of the bible as proof of the validity of events chronicled within. I am not saying scientific proof is invalid, I am saying using the theory of it's own method to qualify data means it lacks bias.)
I'm simply asking questions, so I'm a little disappointed in your responses. I don't know who anyone here is. I followed a link to the story whilst researching for facts myself.
"But okay, I’ll play a little. IANAD, but straight off the top of my head: some folks get cancer while others do not because: random chance (particular combinations of genetic mutations accumulated during cell division), aided and abetted by lifestyle choices, parental genes, and increasing age."
In my opinion, only some of the things you mention here are valid and, for me, your answer is incomplete. I'd like to discuss this further, along with a couple of your other points, so I can try and understand where our differences are. But only if you are inclined to the discussion.
"Now go do your homework for yourself, and then come back and tell us what the rest of those answers are**, and if there’s specific points on which you’d like clarification or wish to discuss further then perhaps folks here will be a bit more disposed to engage with you on a good faith basis."
I could be a bit wrong, but I am struggling very hard with the temptation to maintain the sarcastic level of this conversation. Common sense and experience dictates I am bound to get nowhere if I do. I'm honestly just seeking answers and this response is plain rude and incredibly condescending.
Having said that, I guess I must apologize here, because you have the impression I was asking a rhetorical question regarding how much each of the medical "camps" know about cancer. I was asking the questions of both parties and I'm asking because I don't know the answer. No disrespect, but your answer shows me not how much you know, but how much you don't.
I am more than happy to "go do my homework" elsewhere. Have been for a number of years prior to this conversation. I certainly would not be able to match most here on subjects such as biology, genetics, pathology, immunology, oncology, chemistry, nutrition/diet etc. I am no expert, but I could certainly engage on these subjects and more.
And I'm still asking "The Why" question because I have not found the answer.
I, perhaps erroneously, expected if I asked questions of people who appeared to have a level of intelligence which would equip them to help educate me, I was on the right track. It appears to me the possibility there is some serious conflict here between intelligence and intellect.
I'm sorry, I do not know who these dangerous loons are. Nor would I try and quote you from sources you clearly hold, carry no credence. Just as I have read this article, these comments, I have read opposing points of view with as much an open mind as I can muster and I have done so from the prospective of a relevant ignorant.
"No need to infer: I’m calling you out as a disingenuous JAQ-off asking bad-faith extremely trivial questions that anyone with a room-temperature IQ can quickly and easily answer for themselves instead of demanding others do all the work. (Or a several nights’ reading, if you fancy a longer pop sci rundown.)
[With respect, the google results for "causes of cancer", at least the first 4326 of them ( I haven't got any further because the links just got further from the question), have not answered my question. If you think they do, you have not understood my question.]
Again, incredibly rude. Perhaps my expression of doubt about whether any of you could answer my question, (what the most important thing my doctor should consider), has hit a nerve. I am in no way surprised if this has upset you and given you the impression I am some crank, quack, know-it-all who is set to rub some alternative, harsh quackery truth in your face. Most in their respective fields have reacted the same. I'm sorry to disappoint if that is indeed what you think, but this is MY question. Relating to me. So be very careful what you refer to as "bad faith, extremely trivial questions". As I have said, I have been looking for answers for a number of years. If you can supply what I asked in "several nights reading" please point the way.
I have asked that question so many times. Of doctors. My doctors. Doctors trained in scientific-based medicine, homeopathy, acupuncture, osteopathy, iridology, reflexology, psychology, psychiatry, palmistry, even astrology and some other "ologys" I don't remember. No one has been able to answer me. I have asked that question as a patient who is reduced to doing my own research into my illness because no one has answers.
I don't really give a damn about who has the better "ology". I'm tired of having medical experts treat me with a sneering disrespect because I do not hold the same opinion nor level of education as they. I'm tired of sifting through literally thousands of articles, research papers, feedback and forums trying to discern any worthwhile information.
If this is a "wrong" place to search for answers, if my questions are deemed somehow inappropriate, offensive or if you just plain don't like me, just say it. But don't drag me into a contest about who has got it right and who has not. In my opinion, (one you have elegantly and with great linguistic wit pointed out is of no consequence), if you consider my questions trivial, if you all have to argue your side of medicine and belittle another, rather than answer a question or pursue a truth (even if it contradicts an established paradigm),perhaps you should consider another vocation..
Gus: "I, perhaps erroneously, expected if I asked questions of people who appeared to have a level of intelligence which would equip them to help educate me, I was on the right track."
Gus: "I’m tired of having medical experts treat me with a sneering disrespect because I do not hold the same opinion nor level of education as they."
Based on these conflicting statements I gather that you have a great deal of resentment towards medical experts and evidence-based standards of care.
Unfortunately, you'll find that most everyone here is familiar with the Just Asking Questions meme (from people who are convinced that woo is equal to or better than science-based medicine), and equally, nauseatingly familiar with Tell Both Sides (as if there was any remote equivalency between quackery and medicine) and You're A Bunch Of Meanies.
If you (as is evident from your "research") think there are diagnostic methods and treatment successes used by wooists that work as well or better than the standard of care in medicine, present them and the evidence you think supports them. Can you do that?
Just asking the question. :)
Kuhn has a lot to answer for. His stuff was just a couple of commonplace ideas dressed up in pretentious language. How it ever became mainstream defeats me.
The myth of the unsung hero battling against the establishment is the daily bread of frauds and charlatans everywhere.
I'm not sure how you see those as conflicting statements. Let me explain.
I expect people who have studied at university and continued education in the medical field, practiced the medicine, possibly researched and become a specialist in their chosen field (add the fact they place themselves in the public domain as a representative of authority on a given subject) to be equipped to answer questions about their field. I chose to ask the questions here, because there is evidence of intelligence in those who are making comments. This was in response to a suggestion "I go do my homework and come back..."
The second statement has nothing to do with the first. It is reference to the medical experts (in any area/discipline/branch/fairy tale of medicine, and I've been to a lot, not just your quacks, but also your medical doctors who practice evidence-based standards of care) who have extended this attitude. I do not direct the comment at the many in all those fields who have treated me with respect. I'm sorry I did not qualify this. But as I said, I'm sick of swimming through the ego shit. It comes from all sides of medicine. The negative connotation of this statement is echoed in the rude and condescending response which comes from someone in the modern medicine field. I do not judge this person's colleagues and the validity of his medical belief by basing my judgement on his attitude toward me or his response.
And I'm sorry, but you are making the same sort of assumption has@62 made when he accused me of denigrating modern medicine. I'm not sure how you can conclude from my "research" my opinion of anyone's diagnostic methods and treatment successes, quacks or MD's. You have no idea what I have researched. I'm not questioning diagnostic methods or treatment successes either.
At no point have I suggested I know of any diagnostic methods and treatment successes used by "wooists" that work as well or better than the standard of care in medicine. I do know of many with the claim, but have failed under scrutiny. So, just answering your question :- ) , no I won't post any links, nor would I insult your intelligence and bang my head against the proverbial, by doing so.
Gus: "I am more than happy to “go do my homework” elsewhere. Have been for a number of years prior to this conversation. I certainly would not be able to match most here on subjects such as biology, genetics, pathology, immunology, oncology, chemistry, nutrition/diet etc. I am no expert, but I could certainly engage on these subjects and more."
The first thing you need to do is log on to your community's library website. If you do not have a library, then apply for one. Then put a hold on The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee.
It is a big book, so there no reason you should be forced to buy it. The reason it is a big book is that cancer is not one disease, but thousands. In other words, you question is more complicated than can be answered in one blog comment. It is a well written book.
Well, there are somatic hypermutation and molecular mimicry, off the top of my head. The immune system was slapped together out of different bits and pieces over time, after all.
Gus:
Pray tell, what particular issues do you have with this statement?
Merely saying, "I don't agree" isn't something that can really be responded to effectively.
Gus: For my doctor, what is the most important thing to consider when I am first diagnosed and first presented?
How is 'what kind of cancer is it?' not the obvious and intelligent answer? Just saying 'cancer' doesn't work, as others have pointed out elsewhere. It's a classification of literally hundreds of different diseases, just as influenza serves as a catch-all description for everything from a seasonal nuisance to the 1918 pandemic.
A doctor who prescribed the same course of treatment for a leukemia patient and a breast cancer patient would probably lose his license, and rightly so. Why? Because despite both being cancers, they behave differently. Again, 101 stuff. No wonder you get rudely treated by doctors if you insult their intelligence with this stuff.
Gus:When I asked by what parameters we should adjudge any particular form of medicine, and your answer is “the scientific method”, I have to ask how can you justify using the method by which you come to your conclusion as proof your conclusion is correct.
So, what method do you think is superior and more likely to yield a better result? Divination? Reading entrails? Prayer?
Thanks to you all for your replies.
Gus,
Perhaps you'd be better served by asking a philosopher teaching about the philosophy of science. They are the ones working on the method themselves and we use it in science because, so far, there's no better method for doing science. The specifics, they know it why.
Alain
here's your referal, Gus:
http://www.forbes.com/sites/janetstemwedel/
Many thanks, Alain.
Gus@66: Okay, now you sound like a postmodernist sophomore rehearsing for his first exam. Just because you are ignorant of how things work or how knowledge might [and might not] be reliably acquired, it does not mean that nobody else does either. Frankly, the only way your claim of impeccable neutrality holds up is if you've dedicated your entire life to scrupulously not educating yourself in any of the intellectual or practical tools that would equip you to make any sort of qualitative judgement on the world around you.
So which is it? Either you're being deliberately deceptive about your true motives, or – despite an apparently perfectly good set of neurons – you intentionally keep yourself dumb as a sack of spanners.
Never mind Mukherjee's cancer book for now; I recommend you start on the fundamentals: something like Philip Ball's Curiosity that lays out exactly why and how the knowledge-finding system we now call "science" evolved in the first place, raising humanity from watching the shadows in the cave to golfing on Fra Mauro. (Or: "If Science evolved from Philosophy, why are there still Philosophers?")
Because until you understand simple things the distinction between knowledge acquired by divine assertion and knowledge acquired through rigorous testing, failure, and self-correction – and have a basic awareness of the tools and techniques for the latter – intellectually you ain't going anywhere. And folks round here generally have better things to do than play comfort blankey to children who never grow up.
has: "Never mind Mukherjee’s cancer book for now; I recommend you start on the fundamentals: ..."
Or perhaps he could go really old school and start with Paul de Kruif's 1920s era book Microbe Hunters, mostly for the lengths Pasteur had to go to disprove spontaneous generation. I actually suggested Mukherjee’s book because it was specific to cancer and very thorough.
Thanks letting us know about Curiosity, it looks interesting.
@ Gus
There is a joke about engineers and scientists: if you ask them a question, any question, their answer will take the form of a standard 20-min* long conference lecture.
It's in part a self-derogatory joke about our tendency to pontificate.
It's also a
* or 30 min or 40 min. Whatever.
@ Gus
Continued...
(hit the submit button by accident)
This joke is also a wise reflection on how our fields are complex and a complete answer to most questions is difficult to summarize in layman terms into a simple paragraph.
We have to explain the context,the variations, and so on.
So, when hoping of finding easy and complete answers here, you are asking too much.
But try to meet us half-way.
Because throwing drugs at people fixes everything...functional practitioners take time to listen to patients and see what is going on under the surface, including toxicities, nutrient deficiencies and food sensitivities, among others. The 5-10 minutes you get at a regular MD doesn't compare to the hour or more at a time a funcitonal MD will spend with you - there can't be any individualization as there is not enough time. I don't agree with everything every functional doc does (e.g. treating exclusively based on genetic testing, which I have seen NDs do), but see the biggest value in its mindset. As a dietitian, I've seen the greatest overall impact on health with eliminating food sensitivities using LEAP MRT testing. Another huge area is vector-based diseases, which can take decades for regular MDs to find with lots of prodding, if they ever do. TriLife Health in Colorado is well-known largely on the work they do with vector patients. I want to see more research in the area of functional medicine, but most of it does not get funded because it doesn't fit the goals of the health industry.
Helianthus@82: This is true: modern knowledge is complicated; but I think the problem is it's so easy to get lost in the complexities of specific information set that one forgets the importance of having a basic understanding of how that information was arrived at in the first place. Because until you've got that you've got nothing, and – as comments like Gus's demonstrate over and over again – this is an appallingly common failing in our so-called modern educated world.
I'll happily give anyone who wants a 20-hour lecture on the failings of modern junior and high school science and math education that teaches students to master the form without ever explaining how that form was arrived at or why they should give a damn. Thus a hard-won scientific insight like "V=IR" becomes nothing more than a cheap mindless party trick: a means to an end where a student obediently punches in numbers and gold stars come out; instead of being recognized as an answer itself: an elegantly concise and robust description of how one part of our universe actually works.
Understanding the history of science – how and why it came to be in the first place, and thus why it is the shape it is – is infinitely more valuable than rote reciting its answers, not least for the personal insight that comes from seeing all the ways in which our predecessors got it tragically or hilariously wrong, only to check themselves and work painfully and slowly towards being less wrong over time.
But alas, I guess that sort of approach to learning doesn't slot neatly into standardized testing or popular political soundbites so, as I've already said to Gus, if he really gives a damn and isn't just out to make us dance a merry jig for his own entertainment, he's going to have to roll up his sleeves and make some effort to teach himself first, because the rest of the world ain't going to do it all for him. As someone who breezed through high school science lessons and exams without ever learning a single damned thing, only to discover decades later a genuine, if no more than pop-sci, desire to learn how and why it all works in the first place, it's never too late to start.
HDB:As someone who breezed through high school science lessons and exams without ever learning a single damned thing, only to discover decades later a genuine, if no more than pop-sci, desire to learn how and why it all works in the first place, it’s never too late to start.
Most of what I learned in high school is conveniently non-applicable to real-life, except for the hours of programming powerpoints and finding out ranch dressing can in fact, get grosser. (My health teacher had a bottle he'd been culturing for years.) It is nice to know that the fire department will show up when people play with magnesium, but finding out that songbirds should not be flung is not very useful as an adult.
I still would like to know what Gus thinks is more useful than the scientific method.
Looks like main stream medicine is feeling the pressure from the success of FM. It doesn't treat symptoms it treats the cause of symptoms. Lab work and body chemistry adjusted with pure supplements.
It looks like Heather has severe reading comprehension issues.
OK Heather, please tell us how "functional medicine" treats cancer better than medicine and provide the literature to support your claim.
I wonder if Heather could tell us what lab work and body chemistry would provide the information on which pure supplements would help obstructive hypertrophic cardiomyopathy.
As someone who is a student in a traditional academic medical program, let me say that the editorializing of this "scienceblog" does not make me inclined to take you seriously. Why not leave the name-calling behind and just state your case if it is so clearly right? It scares me to think that a respected physician provided me with a link to this site as EVIDENCE to support his judgment.
Could you be more specific? Did you notice the title of the blog? C'mon, get out the blue pencil.*
* I have no idea where this trope came from; I started editing in the paper-and-pencil days, and there was no blue involved until proofs, to distinguish ee's from aa's (red).
Narad, many decades ago blue pencil were where notes could be made, but not copied on a copy machine. I knew this happened with some reports done in our engineering group during the early 1980s, and then the copiers got better and the blue showed up.
Then the Wang workstations staffed by the typists disappeared, and we were supposed type our own reports in what was a very pitiful word processor that existed on a VAX minicomputer. I did learn LaTex over thirty years ago, but did not need it after giving birth to a child with multiple medical issues.
Jack's comments reminded me of a review in the Wall St. Journal this weekend of a new book on Lysenko (the scientist* who set back the study of genetics in Soviet Russia by many years and aided in the persecution and jailing of scientists who disagreed with his tripe about inheritance of acquired characteristics).
https://www.amazon.com/Lysenkos-Ghost-Epigenetics-Loren-Graham/dp/06740…
The reviewer held up the Lysenko case as an example of how scientists should never become impassioned advocates for a cause (the not-so-subtle undertone being that Experts Can Be Wrong, and thus it's wrong for climate change scientists to become involved in public advocacy because it compromises their scientific objectivity or somesuch).
By that logic, it's wrong for Dr. Paul Offit to have become a strong advocate for vaccines (he should've just stayed in the lab and invented them), and early nuclear scientists should've avoided warning about the dangers of nuclear proliferation.
Since Jack is averse to editorializing and taking a stand on important scientific issues, he should probably stick to his textbooks, and whenever he gets a degree in his chosen field, be very very careful not to attempt to be influential about any aspect of it. Just a neutral recitation of facts, please.
*resisting the temptation to put "scientist" in scare quotes. Ooops.
Jack,
There is a number of people on this planet who have visited this blog and commented their opinion of most subjects with a view contrary to the science included in said post. We tend to use appropriate language and tone for such commenters to get our point across. If you have evidence that a more cautious tone should be used to successfully get our point across, please do post that evidence (from the psychological science body of knowledge, that is); otherwise, we might be inclined to think that you posted such tone trolling comment for your own benefit without considering the net benefit of using the appropriate tone to get across fence-sitters and have the regular laughing from time to time.
It's a big bad world out there ;)
Al
Jack Henly,
To paraphrase the usual response from Fark.com:
Welcome to Respectful Insolence.
Fair enough. I concede that this blog is a place for those who already hold a certain opinion, and therefore my comment should be met with a certain amount of indignation by the regulars. We're clearly all trying convince one another of something and will end up turning in circles.
Mr. Henly: "Fair enough. I concede that this blog is a place for those who already hold a certain opinion..."
Usually an opinion based on evidence. If you have actual factual evidence that the modalities being criticized above actually are safe and effective then present the PubMed indexed studies by reputable qualified researchers.
"...therefore my comment should be met with a certain amount of indignation by the regulars."
You do have a rather high opinion of yourself, and seem to be armored with a very very thin skin covering a noodle spine. The reaction was not indignation, but a bored invitation for you to present your evidence. Bored because you are one of many who make the same lame name calling claim, and think we would just acquiesce to your tone trolling.
"We’re clearly all trying convince one another of something and will end up turning in circles."
If you present some actual evidence that the protocol used on the case report had any proved efficacy on breast cancer, we would be convinced. Until then go whither in the corner and whine about how asking for evidence is bullying, mean and full of indignation.
Because most of us really think that protocol amounted to just torturing the elderly sick patient for no reason (giving the woman diarrhea with massive Vitamin C really is torture). That is something that makes us indignant, not your whiny tone trolling.
And that is your Respectful Insolence for the day, I hope you found it useful.
“…therefore my comment should be met with a certain amount of indignation by the regulars.”
A slight twitch in lieu of eye-rolling should not be mistaken for indignation.
If you'd care to expand on your apparent belief that scientists should not engage in advocacy, a conversation might be possible. On the other hand, hitching up your metaphorical skirts and scurrying away while making tch-tch noises would not be productive.
@Jack (100),
Thanks for stopping by again.
Most of the readers here already have an opinion that we should make medical choices based on the best information available, which is science. They are also opposed to attempts to replace that with centuries old hearsay and similar handwaving arguments.
Nevertheless,we find this a valuable forum for sharing evidence, discussing the pros and cons of various approaches,and educating our BS detectors.
And sometimes we even learn something that changes our preconceptions.
But, first of all, thus us a blog, jot a science journal and not even a formal op-ed column. It reflects the interests and opinions of the primary author.
So, please, stick around, read some more articles, and participate in the discussion.
I am perfectly happy to believe that Jack Henly is a student in a traditional academic medical program, in the sense that "traditional academic medical program" is a euphemism for "has locked himself in a cave and actually believes himself to be fed filet mignon every day by his loving professors." Low level munchkins are fond of their self congratulatory delusions.
Anyone think we should tip him off about life in the wild? He doesn't appear to understand that crazy people really do exist in this world, stupid and dishonest but ever so persistent, and the day is fast approaching when his first kook steps up to declare "Johnny Weissmuller is not really dead." The more documentation he presents that Weissmuller really did pass away, thirty years ago, the more impassioned his buddy will become on the secondary thesis that Jack Henly is a bought and paid member of the Government/Pharma/Big-Bleach conspiracy to poison our children and control our minds.
Mr. Bell: "Anyone think we should tip him off about life in the wild?"
Ah, yes. This is making me remember when I first stumbled onto UseNet and encountered John Scudamore about fifteen years ago. I got a wee bit of a shock.
The real revelation of how far Scudamore was removed from reality was when he linked to something that had to do with smallpox, and I read a 19th century screed from some Army doctor that referred to the Native Americans as "savages." And then it got worse.
I learned, and earned my whale.to tribute page.
Jack Henly@100: "therefore my comment should be met with a certain amount of indignation by the regulars"
Protip: Don't bring glittery unicorns to a knife fight. Them scientists, they will slash you up real bad.
@ Dangerous Bacon
Tangentially related, a non-scientific* very recent case is the Brexit.
* well, mostly non-scientific.
The "Remain" parties were more about facts, the "Leave" parties were more (if not all) about emotions. The "Leave" won.
These buses with the lying slogan about funding NHS with the EU contributions? The information was available that it was a lie before the vote. The voters didn't care.
Maybe more impassionate advocates would have tipped the balance the other way.
It's funny how, when you dig it up, tone trolling amounts to "shut your clap".
OK, to be fair, I get it. A number of people, me included, will react negatively to acerbic comments about them being wrong.
That will alienate some. OTOH, for some people, and sometimes me included, they need to be shocked to start the process of re-evaluating their opinions.
Impassioned advocacy is not quite the same as encouraging the authorities to have your scientific opponents killed or imprisoned. Dr. Offit is in no way similar to Lysenko.
reading the comments in this article its obvious that most people are just here to feed into their confirmation bias
it seems the author stacks everything against ONE WAY of info gather/result manifestation and clearly has not looked at alternatives forms with any objectivity
Go ahead and stack up your evidence, Roland. Whatcha got?
There is a Roland Pankewich who teaches at the Toronto campus of the "Institute of Holistic Nutrition".
This outfit offers courses involving such subjects as Ayurvedic mind-body medicine, holistic food preparation, herbal medicine and "detoxification". Here's a course that sounds especially valuable:
"Professional Co-op Placement
A 100 hour co-operative placement is part of the diploma program. Students are placed in settings where they have a keen interest. Settings include, but are not limited to, holisitic nutrition clinics, chiropractic offices, spas & other fitness organizations, health food stores, homeopathic/naturopathic clinics and senior facilities* involving individual and group therapy. The Co-operative placement allows students to build confidence and become familiar with a clinical/practice setting in the alternative health field."
http://www.instituteofholisticnutrition.com/our-program/faculty/faculty…
Maybe Roland could share with us the insights he provides to prospective homeopaths and naturopaths (in a completely unbiased fashion, of course).
*(shudder)
#20 from Dangerous Bacon :...the same NN “staff writer” (Julie Wilson)..., has another current article on NN proclaiming that “Women with larger behinds are healthier and more intelligent, study finds”.
Bad news for Sir Mixalot.