Alternative health treatments should be subject to scientific testing, regulation, and oversight. But who is who is doing the testing and regulating and are the methodologies applicable to alternative health?
Medscape periodically runs “mythbuster” articles, where they take on a topic and pass judgment on commonly held beliefs. Recently, they decided to take on Complementary and Alternative Medicine (CAM) in regard to what role they can play in dealing with cancer, and their conclusions were fascinating to say the least.1 Victoria Stern. “Mythbusters: Complementary and Alternative Treatments in Cancer.” Medscape. September 02, 2014, (Accessed 30 Mar 2015.) http://www.medscape.com/viewarticle/830552 As they pointed out, over the last ten years, CAM “has grown into a multi-billion-dollar industry in the United States,” with the use of CAM interventions becoming increasingly popular among cancer patients. Amazingly, we’re only one sentence into their article, and already we have an interesting prejudice dominating this supposedly “fair” discussion. That billions of dollars are being spent on CAM in the US is not an issue; that’s true. But referring to it as an “industry” indicates a high degree of bias before the article has even started. Nowhere in the article do they refer to what doctors participate in as the “medical industry.” Instead, they refer to “mainstream care” and “conventional medicine.” There’s a huge difference between the positively slanted “care” and “medicine” versus the more make-a-buck sounding “industry.” None of this is surprising as the Medscape article is representative of the medical community’s opinion of alternative medicine in general, and that’s why it’s worth exploring in detail. In any case, now that we understand that the article is not a neutral arbiter, but rather, a highly biased advocacy for conventional medicine, let’s take a look at what it had to say.
Background on CAM
The article goes on to explain that although the term “CAM” combines complementary and alternative medicine, distinguishing between the two is important. “Complementary interventions are only intended to supplement mainstream care and are used primarily to control symptoms and bolster physical and emotional well-being throughout treatment.” Alternative therapies, by implication then, are meant as an “alternative” for mainstream care. In an interesting use of word play, the article then says, “Both supporters and skeptics of complementary treatments agree that alternative modalities are not viable substitutes for mainstream care and that using any in lieu of conventional medicine is dangerous.”
Here again, we see bias, not so subtly in this case, changing the course of the argument. By limiting the opinions expressed to exclude anyone who considers alternative medicine a viable alternative, in some cases, to many conventional cancer treatments, they’ve made it appear that “everyone” agrees with them that, at best, CAM is only useful as a supplement to conventional care–and even that usefulness is debatable.
“Although we can’t rely on complementary therapies to shrink a tumor, if given together with chemotherapy or radiation therapy, such interventions may improve quality of life and possibly survival as well,” said Gary Deng, MD, PhD, interim Chief of Integrative Medicine at Memorial Sloan Kettering Cancer Center in New York City. ‘It’s a common misconception that cancer treatment is all about shrinking the tumor. Reducing anxiety or pain can make an enormous impact on a patient’s day-to-day quality of life.'”
A backhanded compliment–like a Congressperson referring to their “learned colleague” before announcing to the world how ignorant, unpatriotic, and wrong they are in every aspect of their position.
As Gary Deng, MD, PhD, interim Chief of Integrative Medicine at Memorial Sloan Kettering Cancer Center in New York City says, “We discourage our patients from using alternative interventions instead of mainstream therapies because they will miss the opportunity for proper care. Even the best chemotherapy does not cure cancer. Surgery is the only cure.” Actually, this statement is misleading on multiple levels.
Yes, for some cancers such as colon cancer, if detected early enough, “proper care” (i.e. surgery alone) can indeed give you a good chance for long term survival, but if you have metastatic pancreatic cancer, “proper care” (surgery plus chemotherapy plus any other form of medical care your doctor can think of) still means you have a 90% chance of dying in the next few months. And it’s not just pancreatic cancer. Five year survival rates for metastatic lung cancer are less than 4%, and with metastatic liver cancer they can run as low as 2%. Surgery is almost meaningless, and although chemotherapy in these cases may extend your life by a few months, it comes with a huge cost to your physical and mental wellbeing as the chemotherapies commonly used in these cases inflict major damage to your neurological system–both body and brain. “Missing out on proper care” in these cases, might actually be considered a major positive. And, in fact, in surveys, most physicians, because they know the score, have indicated they would turn down “proper care” if they found themselves in one of these situations. All things considered, in “these situations,” even unproven alternative therapies look like a better option.
And what if your physician has said there’s nothing more she can do and has told you to go home and put your affairs in order? What “proper care” are you missing out on then if you choose an alternative?
And finally, saying that “surgery is the only cure” is simply not true. If your cancer has metastasized, surgery isn’t going to cure you. That’s why doctors use chemotherapy when cancer has metastasized. Unfortunately, it happens to have major side effects. And there’s also the fact that If you’re living in a toxic environment that is continually accelerating the degradation of cellular DNA, then no matter how many surgeries you have–or how much chemotherapy you have, for that matter–you’re still screwed. Unless you remove yourself from the toxic environment and remove the toxins circulating inside your body, there is no cure.
David Rosenthal, MD, Medical Director of Integrative Therapies at Dana-Farber Cancer Institute and a professor in the Department of Medicine at Harvard Medical School, agrees about the harms of alternative medicine. “A major problem is there are still quacks claiming alternative cures,” he said.
The definition of a quack is someone who sells you a false curative for a disease. So if someone sells you a cure for metastatic pancreatic cancer that offers less than a 10% chance that you will survive for even five years and will totally destroy the quality of life during that time, how much more quacked can you get?
Oh, my bad!
As it turns out you can get a whole lot more quacked. Did I mention that for the privilege of having the final months of your life destroyed by this medical quackery, your doctor will make sure that your family is left bankrupt in the process?
“That is why a growing number of oncologists and policy makers want to abandon the term “CAM” in favor of “integrative oncology,” which focuses solely on combining mainstream and complementary care.”
I’ve talked before about how important words are when it comes to labeling various forms of medicine. Doctors like to refer to what they practice as “evidenced based” medicine, despite the fact that studies have shown that 90% of doctors don’t practice it. And in the same way, they like to denigrate holistic medicine by using terms such as “quackery” to downgrade it. Likewise, the term “integrative oncology” is such a downgrade. Its true meaning is that when it comes to serious illness, holistic healing can’t stand on its own. The best it can do is help ease people’s minds, or possibly ease some of the discomfort caused by the “real” medicine–keeping in mind that, in most cases, it’s really just quackery and will harm people, not help them. But most importantly, by “integrating” holistic medicine into oncology, the doctors get to control it.
“These integrative services facilitate communication between oncologists and patients, providing an environment where patients can share their concerns and disclose any complementary interventions they already use or would like to try. Disclosing this information is particularly important because some complementary modalities can interact with chemotherapy drugs. ‘Many patients don’t realize that herbs and supplements — one of the most common complementary interventions — are drugs, and that some have been shown to interact with chemotherapy and can be harmful to patients,’ said Steven Novella, MD, a neurologist and assistant professor at Yale University School of Medicine who is executive editor of the blog Science-Based Medicine.”
Again, we see the curious position that doctors keep taking that nothing in nature can help you if you have a serious disease; it can only harm you or, at best, provide no benefit at all. How very inconsiderate of nature. Thank goodness we have pharmaceutical companies who only make things that help us.
And at this point, it’s probably worth taking a look at the “complementary interventions” that Medscape deigned to examine–keeping in mind that what they said is much less important than what they didn’t say.
In the end, Medscape looked at seven “interventions:”
- Sugar-Free Diet
- Dietary Supplements
If you were seriously looking to evaluate “alternatives” for treating cancer, this would be an odd assortment. Then again, considering that the article as much as said that alternative therapies cannot stand on their own and wanted to literally change the definition of complementary medicine to “integrative oncology,” perhaps it makes sense. Essentially, what they’re saying is that they want to transform alternative medicine into “holistic light”–as in lightweight.
In the end, after citing a number of studies, Medscape said that they were for it–that the evidence showing that regular, moderate-to-vigorous exercise improves survival for men and women diagnosed with a range of cancers is compelling.
They said that study results were conflicting, but that, for some patients, it does appear that acupuncture reduces pain and nausea when dealing with cancer. And then they came to a rather fascinating conclusion. They said that some experts felt that since acupuncture was a low-risk intervention, perhaps its “placebo effects” just might trump its lack of clinical benefits. That’s just fascinating on so many levels. It’s a dismissal of acupuncture as placebo (despite studies clearly demonstrating that it works), an acknowledgement of the importance of the placebo effect (which applies to a number of medical therapies too), and a weighing of risk vs reward that they seem unwilling to apply to medical treatments (remembering that crippling chemo for metastatic cancer has a 2% success rate).
They said that the evidence points to massage being an effective tactic to control the symptoms associated with cancer treatments and can improve quality of life if done carefully to avoid injury and if shaped to the needs of each patient. According to David Gorski, MD, PhD, a surgical oncologist at the Barbara Ann Karmanos Cancer Institute in Detroit who specializes in breast cancer surgery, “Massage is perfectly fine for patients who enjoy it, and if massage makes cancer patients feel better and improves their quality of life, then it is worthwhile.” But, he noted, “I take issue when massage is co-opted and turns into massage therapy. Medicalizing the things we do normally to feel good can lead to exaggerated or false claims about their benefits.”
This is just an odd consideration in an article on mythbusting CAM vis-à-vis cancer! I’m not sure why you would classify reducing sugar in your diet as a CAM choice. Most medical experts would now, after decades of resisting the evidence, consider cutting way back on sugar as simply a pro-health choice. In any case, Medscape felt that although any anticancer benefits associated with eliminating sugar were unconfirmed–demonstrated in test tube studies but not yet in RCT (randomized control trial) human studies–it was nevertheless important to minimize excess sugar intake as part of maintaining a generally healthy diet.
Grouping “dietary supplements” as a catchall category is, quite simply, irritating and ignorant. If anyone tried to lump all blood pressure medications together in evaluating their efficacy and/or safety, the medical community would go ballistic. As they would justifiably point out: diuretics, calcium channel blockers, and beta blockers are categorically different both in how they work and in their effects on the body. You can’t lump them together! They are distinctly different options for dealing with high blood pressure.
That said, let’s jump to Medscape’s conclusion concerning the proposition that “consuming antioxidant-rich supplements may protect against cancer and prevent tumor growth” and then backtrack to see how they got there. As they said:
” ‘Busted’ for supplements, though it is plausible that antioxidants from food may be beneficial.”
This is actually a surprisingly illogical pronouncement resulting from fuzzy thinking. First, let’s see what they’re including in this category called “dietary supplements.” As it turns out they’re talking about everything from vitamins to minerals to antioxidant rich foods to antioxidant supplements–both synthetic and natural. As a category, it’s so all inclusive, it’s meaningless. And then, considering how broad the category is, notably missing are any herbs or herbal supplements and any nutraceuticals that have demonstrated any anti-cancer properties both anecdotally or in studies..
Then, having ignored most of the key alternative anti-cancer therapies and lumped everything else together as “dietary supplements,” they then focused their entire analysis on antioxidants–and here’s where it gets interesting.
They did a minor tip of the hat to antioxidant rich foods and acknowledged that a 2004 meta-analysis published in Lancet indicated that consuming fruits and vegetables, which are rich in antioxidants, “may” lower the incidence of cancer and heart disease and prolong life. But then they pointed out that research on the role antioxidant supplements might play in cancer prevention has been largely disappointing. “The bulk of studies found that antioxidant supplements do not reduce the risk for cancer or prevent tumor growth, and that antioxidant supplementation may actually increase people’s likelihood of dying from cancer.” Again pointing to the 2004 meta-analysis, they said that consuming vitamins A, C, E, beta-carotene, and selenium supplements actually increased overall mortality when it came to esophageal, gastric, colorectal, pancreatic, and liver cancers.2 Bjelakovic G, Nikolova D, Simonetti RG, Gluud C. “Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis.” Lancet. 2004;364:1219-1228. http://www.ncbi.nlm.nih.gov/pubmed/15495084
Ouch! Then, to make their case, they went back to the well and cited the oft referenced 2009 SELECT study published in JAMA that explored the effects of selenium and vitamin E supplementation on prostate cancer risk. Not only did that study find that these supplements produce no benefit, but, in fact, the study uncovered an increased risk for prostate cancer in participants who consumed vitamin E (although it should be noted that risk was identified as “statistically insignificant”).3 Lippman SM, Klein EA, Goodman PJ. “Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the selenium and vitamin E cancer prevention trial (SELECT).” JAMA. 2009;301:39-51. http://www.ncbi.nlm.nih.gov/pubmed/19066370 A follow-up to this trial, also published in JAMA, again revealed that vitamin E supplements increased the risk for prostate cancer in healthy men.4 Klein EA, Thompson IM, Tangen CM, et al. “Vitamin E and the risk of prostate cancer: the selenium and vitamin E cancer prevention trial (SELECT).” JAMA. 2011;306:1549-1556. http://www.ncbi.nlm.nih.gov/pubmed/21990298/
Finally, they cited a 2006 trial in which patients who consumed vitamin E and beta-carotene supplements while undergoing radiation treatment for head and neck cancer had a significantly increased likelihood of dying compared with those who took a placebo.5 Bairati I, Meyer F, Jobin E, et al. “Antioxidant vitamins supplementation and mortality: a randomized trial in head and neck cancer patients.” Int J Cancer. 2006;119:2221-2224. http://onlinelibrary.wiley.com/doi/10.1002/ijc.22042/epdf
So what’s the problem with all of these studies?
They are all seriously flawed. They have no understanding of, and make no distinction in regard to, the differences between the natural and synthetic forms of antioxidants. The 2004 meta-analysis simply makes no differentiation at all between the different forms–largely because the individual studies contained in the meta-analysis made no distinction–and lumps all the results together, totally contaminating said results. In other words, the study could not tell you if there was any difference in outcomes between those patients who took synthetic supplements and those who took natural supplements. Everything was lumped together. And as for the SELECT study and the 2006 radiation therapy, they did indeed exclusively use synthetic dl-alpha-tocopherol and synthetic, crystalline, all-trans ß-carotene–for their evaluation, both supplied by Roche Vitamins, a division of F.Hoffmann-La Roche Ltd.
How different are the synthetic and natural forms? As we have pointed out on numerous occasions, they are hugely, hugely different! True natural E (100% d-alpha-tocopherol) may be as much as 500% more effective than the synthetic dl-alpha-tocopherol. And if you actually use a full-complex E that contains all four tocopherols and all four tocotrienols, then the difference is probably tenfold. As for beta-carotene, the differences between natural and synthetic may be even more pronounced–considering that some studies (such as the 2006 radiation therapy study itself) have actually shown the synthetic form may actually be toxic.
Bottom line: Medscape’s conclusions based on these studies is absolutely meaningless–other than to say that taking non-bioidentical, synthetic supplements is probably a bad idea.
One final note: Medscape quotes Cheryl L. Rock, PhD, RD, a professor in the Department of Family and Preventive Medicine at the University of California, San Diego, who did say one thing that was absolutely correct–something that we have talked about before. “Chemotherapy creates oxidative stress that kills cancer cells, so taking antioxidants may interfere with that process, making it more likely that the therapy won’t work.” That is correct. Whereas free radicals may play a significant role in causing you to get cancer, once you actually get it, those same free radicals may play a major role in getting rid of it. Taking “certain” antioxidants at that point may actually work against you. As we have discussed previously, what you do with antioxidants to lower your chances of getting cancer is very different from what you do if you actually have cancer.
When it comes to curcumin, Medscape is a bit schizophrenic. They identify some of the studies that have put curcumin on the anticancer map such as the 2002 colorectal cell culture study6 Chauhan DP. “Chemotherapeutic potential of curcumin for colorectal cancer.” Curr Pharm Des. 2002;8:1695-1706. http://www.ncbi.nlm.nih.gov/pubmed/12171541 and the 2011 curcumin/chemotherapy colorectal cancer study that showed that curcumin supplements given prior to surgery appeared to exhibit enhanced anticancer activity as well as improved general health.7 He ZY, Shi CB, Wen H, et al. “Upregulation of p53 expression in patients with colorectal cancer by administration of curcumin.” Cancer Invest. 2011;29:208-213. http://www.ncbi.nlm.nih.gov/pubmed/21314329
Nevertheless, their overall assessment of curcumin was tepid at best. They quoted Dr. Rock again, whose main complaint was that although curcumin does have biological activity, we don’t know how the body reacts to curcumin supplements, which provide very high concentrations of the compound. But Dr. Rock is wrong. We do know how the body reacts. Studies have shown that curcumin supplements are both cancer protective and can support chemotherapy treatments. Which brings us to the assessment by David Rosenthal, MD, Medical Director of Integrative Therapies at Dana-Farber Cancer Institute and a professor in the Department of Medicine at Harvard Medical School that “In pharmacologic doses, curcumin may interfere with some chemotherapy agents. I think we put too much onus on herbs, botanicals, and supplements before we know their true safety and effectiveness. I believe we should focus on getting the bulk of our nutrients from food.” Incidentally, his position as Medical Director of Integrative Therapies at Dana-Farber is probably more Orwellian8 “What were the four ministries in Orwell’s 1984 and what were they responsible for?” ArcaMax. (Accessed 29 Mar 2015.) http://www.arcamax.com/knowledge/trivia/s-113740-659647 than actually supportive of alternative medicine–saying of the practice, “A major problem is there are still quacks claiming alternative cures.” I wonder what he thinks of some of the medical treatments for cancer that not only have less than a 2% effectiveness rate, but are also devastating to quality of life?
When it came to Reiki (a form of energy healing, not the reishi mushroom which actually has studies backing its anti-cancer properties9 Chan WK, Cheung CC, Law HK, Lau YL, Chan GC. “Ganoderma lucidum polysaccharides can induce human monocytic leukemia cells into dendritic cells with immuno-stimulatory function.” J Hematol Oncol. 2008 Jul 21;1:9. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2517069/ , 10 Yue GG, Fung KP, Tse GM, Leung PC, Lau CB. “Comparative studies of various ganoderma species and their different parts with regard to their antitumor and immunomodulating activities in vitro.” J Altern Complement Med. 2006 Oct;12(8):777-89. http://www.ncbi.nlm.nih.gov/pubmed/17034284 , 11 Dai S, Liu J, Sun X, Wang N. “Ganoderma lucidum inhibits proliferation of human ovarian cancer cells by suppressing VEGF expression and up-regulating the expression of connexin 43.” BMC Complement Altern Med. 2014 Nov 5;14:434. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232730/ ), Medscape was not especially kind.
According to David Gorski, MD, PhD, a surgical oncologist at the Barbara Ann Karmanos Cancer Institute in Detroit who specializes in breast cancer surgery and is quoted by Medscape, “The evidence for the efficacy of Reiki, and energy-based medicine in general, is weak to nonexistent. Training yourself to relax, on the other hand, can be evidence-based, but a lot of other modalities get thrown into the mind-body wastebasket. The claim that Reiki practitioners can manipulate patient’s energy field [sic] is nonsense.”
And finally, when it came to meditation, they were more positive, stating, “Meditation as a complement to cancer treatment does appear to improve patients’ quality of life and reduce anxiety and pain.”
However, even though Medscape cited studies in support of mediation’s effectiveness in dealing with some of the side effects associated with cancer and its treatments, it turned out to be somewhat of a backhanded compliment as they quoted Gary Deng, MD, PhD, interim Chief of Integrative Medicine (another Orwellian title, perhaps) at Memorial Sloan Kettering Cancer Center in New York City, who said that it was pretty much a case of why not–whatever works for you. More specifically, he said that when it comes to integrating mind-body interventions, such as meditation, into mainstream care, the burden of proof doesn’t need to be high. “With chemotherapy, we have to be very certain that it will help patients because it is a high-risk treatment that needs to be tailored to a patient’s particular pathology and genome. Meditation, however, won’t hurt patients so the requirement for trying it is quite low. Research shows that mindfulness meditation, yoga, and other relaxation techniques reduce stress and improve quality of life. Whether a patient chooses to do meditation, yoga, or tai chi to relax is a choice that depends on a person’s belief system, personality, cultural background, and general likes and dislikes. Mind-body techniques are essentially different tools that serve the same purpose, so it is a moot point to compare their effectiveness. It’s more about what works for each person.”
What Medscape Didn’t Say about Alternative Cancer Treatments
Before we get into exactly what Medscape lost in translation, we need to understand why they lost it.
Medscape is an information service from WebMD for specialists, primary care physicians, and other health professionals. Its purpose is to offer original, professional medical content, including review articles, journal commentary, expert columns, patient education articles, book reviews, and more–all customized to fit each professional’s profile. It’s a great service, but the important thing to understand is that it really is a service by medical professionals for medical professionals. It serves as a fairly accurate barometer of the medical community’s feelings on any particular issue, and that explains why they get so many things wrong when they seek to extend their expertise into the realm of alternative medicine.
When it comes to medical professionals and their qualifications in alternative medicine, I always think back to a physician I met when I was giving a talk in Houston some years ago. During the Q&A session, he stood up and was aggressively hostile until the audience booed him down. In any case, after the talk was over, he came up to say hello while I was sitting alone in the lobby waiting for the airport shuttle. He was actually very pleasant and even apologized for his behavior at the session. I invited him to sit down and we continued to talk until I had to leave for my flight. But it was during that 10 minutes of conversation that he said something I will never forget. He suddenly announced, “You’ll never guess how I became an expert in alternative medicine last weekend.”
I was quite stunned by his statement, since I had been working in the field for almost four decades at that point and felt that I had only a reasonable understanding of the field as a whole, and an expertise in just one or two very defined areas. To become an expert in the entire world of alternative health in just one weekend was indeed impressive. “I would love to hear how you did that. Please explain.”
He responded with great self-assurance. “To tell the truth I knew nothing about alternative medicine two weeks ago, but our hospital’s medical director called me into his office last week. He was planning to come hear you speak here today. He read your book and is a fan, but something came up which prevented his coming. He told me I should come in his place and take notes for him on everything you said. Well, not wanting to look foolish, I read everything I could over the next two days and became an expert in alternative health so I could converse with you as an equal today. And that’s how I became an expert last weekend.”
And that’s the problem that Medscape and all the doctors associated with it have with alternative medicine; they don’t understand it (especially the doctors with the Orwellian ” Director of Integrative Medicine” job titles); they underestimate it; and they think they can pass judgment on it without ever working with it in the real world. Of course, if anyone without a medical degree tried that process in reverse–to claim expertise in medicine after a weekend of reading–they’d have them thrown in jail for practicing medicine without a license.
The bottom line is that this leads to four great “medical” misunderstandings about alternative medicine that totally undermine any studies their followers conduct and any judgments they pass.
- Synthetics VS natural
- Subtractive VS Additive
- Magic bullets VS protocols
- Thinking that the same study methodologies are applicable
Synthetics VS Naturals
As we’ve already discussed, when researchers choose to evaluate “supplements,” they overwhelmingly opt to test the synthetic versions as opposed to their natural equivalents–primarily because they are supplied by the people they know in the pharmaceutical industry, such as Roche, and they come with their imprimatur. But as we’ve discussed, synthetic and natural versions are not necessarily equivalent; in fact, the differences are often monumental. Do unaware customers buy synthetics? Absolutely! But that’s because the medical community has pitched them as equivalent, and the large pharmaceutical companies and their vitamin subsidiaries like Roche Vitamins have sold them to large corporate purveyors of supplements (supermarkets, drug stores, etc.) as equivalent. Just because Centrum and One-a-Day use synthetics in their supplements does not mean that any serious alternative health practitioner does. Any conclusions that medical researchers come to when testing such synthetics do not apply to the natural versions, or to alternative health for that matter–only to the researchers’ pharmaceutical partners who are providing them with the synthetics they are testing. But any alternative health practitioner who has extensively worked with supplements for real patients and real conditions knows the difference between synthetic and natural. They’ve seen the different results first hand. They would never use a synthetic supplement.
Subtractive VS Additive
I’ve discussed before how medicine is “subtractive” by definition. By subtractive, I mean that all medicine is based on the idea that you need to “subtract” out anything that is irrelevant until you can isolate the “one thing” left that “works.” All drug development, all drug patents, all efficacy testing are designed to reinforce this concept.
For example, the star anise plant has a long history as a healing herb–for digestive problems, women’s health, and for treating colds and flus. The Swiss pharmaceutical company, Roche, focused in on the cold and flu benefit associated with star anise and then “subtracted out” all of the “extraneous” biochemicals in the plant until they settled on one component, shikimic acid, that they said was responsible for the star anise plant’s ability to help with colds and flus. From shikimic acid, they synthesized oseltamivir (for patent purposes), and thus was born Tamiflu. This is the subtractive process. You eliminate everything “extraneous” and get down to the one single active ingredient. Of course, there are major problems with the magic bullet approach — in this case, that Tamiflu doesn’t really work that well and that flu viruses are easily able to mutate around the single magic bullet ingredient in Tamiflu.
In any case, everything in medicine is built around the “subtractive” concept. Drugs, such as Tamiflu, are developed using it. Patents are issued based on it. And all drug testing depends on it. But, although it works for drugs, this is not the only way, nor necessarily the best way, to develop and test effective treatments. You can, for example, try an “additive” approach. This is the approach used in most holistic treatments. Instead of using a single “drug,” most alternative therapies involve multi-part protocols (combining diet, supplements, treatments, etc.).
And speaking of the additive principle, its power was proven this week, coincidentally, when scientists announced that they had recreated a 9th Century Anglo-Saxon remedy using onion, garlic and part of a cow’s stomach.12 Justin Wm. Moyer. “MRSA superbug killed by 1,100-year-old home remedy, researchers say.” The Washington Post. March 31, 2015 (Accessed 31 Mar 2015.) http://www.washingtonpost.com/news/morning-mix/wp/2015/03/31/mrsa-superbug-killed-by-1100-year-old-home-remedy-researchers-say/ They used fresh ingredients according to the original instructions and exposed populations of Staphylococcus aureus, the antibiotic-resistant bacteria MRSA, to the potion both in lab cultures and on infected wounds in mice. The researchers found that although the ingredients on their own are known to have antibacterial properties, individually they are not sufficient to kill MRSA. But when they tried the formula, taken as a whole, they were “absolutely blown away” to find that it obliterated the MRSA, killing 999 out of 1,000 bacterial cells. The multidisciplinary “AncientBiotics” team will present their findings this week at the annual meeting of the Society for General Microbiology. They plan to keep exploring the future potential of potions from the past.
Magic Bullets VS Protocols
Alternative practitioners don’t care which component does what, or even if one or more of the components ultimately prove to be non-essential when tested in isolation, as long as the overall protocol itself produces the desired result. This approach makes medical doctors apoplectic. For doctors, it doesn’t matter if an alternative protocol produces clear results. If you can’t isolate it down to a single component and explain exactly why it does what it does and in a way that fits within already defined scientific parameters, then “results be damned.” The protocol cannot be acknowledged to work–even if the results might indicate that it does. This leads to some bizarre contradictions when it comes to testing alternative therapies.
Thinking that the Same Study Methodologies Are Applicable
The whole subtractive/additive distinction doesn’t mean that alternative therapies can’t be tested scientifically; it just means that you have to use a different methodology that recognizes that difference. Quite simply, all you have to do is change the order of testing. Instead of eliminating everything from the get-go and testing each piece of a holistic protocol one-at-a-time in isolation, start by testing the entire protocol as a whole without worrying about what part does what. Verify that the protocol as a whole works or doesn’t work, then, if it works, start removing pieces one at a time to see which parts are essential and which parts are not. Then you can figure out which of the components need to be present and which components complement each other and are thus essential to obtain the desired results.
And to be sure, when tested this way, many alternative therapies and supplements, as currently offered, will turn out to be totally ineffective for a particular ailment, but at least they will have been evaluated properly, on their own terms. I fully understand that much of what is available in the world of holistic medicine is pure woo woo claptrap, but then, as we’ve already seen, so are many “accepted” medical treatments (e.g., chemotherapy for metastatic liver cancer). Beyond that, though, it also needs to be understood that much that “appears” to be woo woo claptrap actually works–just not for any reason currently understood…by anyone. That doesn’t mean it doesn’t work, or can’t work–just that we don’t yet know why it works. Our “science” is not yet wise enough to understand it. But is that really any different than much of medicine? Take electroconvulsive therapy (aka electroshock therapy) which has been around since the 1930’s. No one knows for sure why it does what it does — only that it does it. There are theories, of course, that have appeared and been discarded over the years. And yet, with no understanding of why it works, electroconvulsing continues apace as an accepted part of science-based medicine. How is that any different from acupuncture? Just because medical researchers can’t find the “meridians” central to acupuncture, doesn’t mean it doesn’t work. In fact, studies indicate that it does.13 Vickers AJ, Cronin AM, Maschino AC, et al. “Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis.” Arch Intern Med. 2012;172(19):1444-1453. http://archinte.jamanetwork.com/article.aspx?articleid=1357513
My intent is not to beat up on Medscape, and I’m not opposed to their fundamental premise that alternative health treatments should be subject to scientific testing, regulation, and oversight. Indeed, I think those things are absolutely necessary. However, what I do question is who is doing the testing and regulating and if the testing methodologies are actually applicable to alternative health. As we’ve seen, alternative treatments and protocols are not the same as drugs and surgical procedures. The same methodologies and standards are simply not applicable. It’s like trying to evaluate a draft horse by thoroughbred standards. The draft horse is going to fail every time. But that doesn’t make the thoroughbred better–just different. Just because they’re both horses doesn’t mean that the same methodologies for evaluating them apply. If you were to reverse things and apply draft horse standards to thoroughbreds, the thoroughbreds would lose every time. Thoroughbreds might be faster, but they don’t have the strength or the endurance of a draft horse. And for that matter, an expert in thoroughbreds would be lost when evaluating a draft horse and vice versa.
In the future, if a research team is testing, as an example, antioxidants to pass judgment on their use in treating cancer, then they need to bring someone onboard who is an actual “working” expert in the field to be part of their study team. Having one of your team cram for a weekend to become an “expert” doesn’t count. Relying on book learning doesn’t count. Giving someone an Orwellian title doesn’t count. You need to have someone who has actually used the supplement in question as part of healing protocols to help massage the study’s methodologies in order to get a real understanding of what’s going on. Expecting medical doctors and government agencies run by medical doctors to give a fair hearing to alternative therapies is like asking Republicans to evaluate legislation proposed by the Democrats. Yes, they both claim to love America and are working to make the country better, but the rank and file in each party really no longer understand each other, don’t particularly like each other, and in fact view the other party as a competitor (both for money and political influence) — to be kept marginalized and, as much as possible, outside of government. In truth, that bill has been rejected before even one word of it has ever been read. If alternative health is to be regulated, it needs to be regulated by those who understand it and appreciate it–not by those who have already determined that it doesn’t work.
For more information about natural alternatives for cancer, check out: /tags/cancer-alternative-cancer-therapies.
References [ + ]
|1.||↑||Victoria Stern. “Mythbusters: Complementary and Alternative Treatments in Cancer.” Medscape. September 02, 2014, (Accessed 30 Mar 2015.) http://www.medscape.com/viewarticle/830552|
|2.||↑||Bjelakovic G, Nikolova D, Simonetti RG, Gluud C. “Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis.” Lancet. 2004;364:1219-1228. http://www.ncbi.nlm.nih.gov/pubmed/15495084|
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|12.||↑||Justin Wm. Moyer. “MRSA superbug killed by 1,100-year-old home remedy, researchers say.” The Washington Post. March 31, 2015 (Accessed 31 Mar 2015.) http://www.washingtonpost.com/news/morning-mix/wp/2015/03/31/mrsa-superbug-killed-by-1100-year-old-home-remedy-researchers-say/|
|13.||↑||Vickers AJ, Cronin AM, Maschino AC, et al. “Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis.” Arch Intern Med. 2012;172(19):1444-1453. http://archinte.jamanetwork.com/article.aspx?articleid=1357513|