Junk Science Number 9: All Alternative Treatments are non-evidence based, by definition
I have read an argument, put forward by several quite eminent scientists on their web sites and blogs, that all ‘Alternative treatments’ (for example in cancer) are by definition not evidenced-based. For, once there is evidence to prove they deliver, they cease to be alternative and become mainstream and adopted by the scientific community. Thus the rump left behind must all be non-evidence based mumbo jumbo. QED.
Unfortunately, life just ain’t like that. This argument is tosh.
Alternative therapies – it’s not enough to have good research results
Take Hyperthermia as an example.
It has long been known that one of the few things to kill a cancer cell is heat. Cancer cells die at temperatures where healthy cells are still able to survive. A chap called Coley at American Cancer Hospital Memorial Sloan-Kettering noted that cancer patients who contracted another illness and developed a fever, sometimes went into remission. He created Coley’s Toxins to try to bring this about but it only met with limited success.
Fast forward 30 years or so and a chap in Australia called Holt did the unthinkable – he left his post at the top of one of the regional cancer boards to become an ‘Alternative’ Doctor, claiming there had to be a better way than drugs to treat people. At his clinic he used Hyperthermia.
A TV team sent to expose him actually failed as over 2000 patients claimed he was doing a great job.
Hyperthermia can be used at two levels – there’s the all over the body approach; and there is localised hyperthermia.
Fast forward to 2003 when I received a letter signed by 7 Urologists from the UK and Europe. They told me about HIFU, claiming that this could cure prostate cancer when the tumour was still confined to the prostate. They asked me to give the treatment the publicity it deserved as they feared the threat to the drugs industry (the loss of so many potential patients and thus income) would be enough to guarantee opposition, and even kill the treatment off. I looked into the treatment and found it was already being used in over 60 centres in Europe. I talked to patients. An overnight stay, a 3,000 euro bill, no side effects and three years success so far from all. So at icon we have championed this ‘alternative’ to prostate surgery.
Finally, in 2008/9 there were clinical trials in Britain (and America). Almost begrudgingly the powers-that-be reported success. The Daily Mail, that well-known medical journal, carried the front page headline ‘Breakthrough in Prostate Cancer Treatment’. The research only compared surgery to HIFU for very early stage prostate cancer – it concluded that the outcome was the same but less side-effects were observed with HIFU. Now 2 years on, Professor Mark Emberton at UCH reports total success in 19 out of 20 patients, less expensive machinery, less cost to the NHS etc etc. (See our article on hyperthermia by clicking here) (http://www.canceractive.com/cancer-active-page-link.aspx?n=3125&Title=Professor Emberton explains benefits of HIFU for prostate cancer)
So, at this point you would assume if the tractor boys are correct, that localised hyperthermia would make it off the alternative list onto the mainstream list and leave the rest of the alternative therapies in their non-evidenced state.
Alternative Therapies wreck the cosy status quo
Sadly, I have 6 personal friends at ages 57- 63 all with early stage prostate cancer. All asked about HIFU and all were told no. Three were told they needed urgent surgery as their cancer ‘may have spread’. (If it has spread why is surgery needed urgently? If it hasn’t, then HIFU could be the perfect answer.) All three operated friends had no spread but are now in serious trouble with complications, side-effects and spread. The other three have done nothing so far except change their diets, take exercise and explore their options. Each is under a different oncologist from different backgrounds (surgery, radiotherapy, drugs). Each oncologist recommends his expertise as the first step of treatment. Asked about HIFU, all have bluntly refused to discuss it – one simply replied ‘No’. When my friend pushed for a view, the oncologist Professor simply said, ‘You’ve had my view – No’.
A real Breast Cancer treatment breakthrough!
Three months ago the Karolinska Institute presented the results of three small scale clinical trials involving 80 women in total and the use of localised Hyperthermia to treat breast cancer. The methodology involved small electrodes and local anaesthetic and the Karolinska were saying the operation could be done in 10 minutes during a lunch break! A breakthrough beyond all doubt and a complete success in research terms. See http://www.canceractive.com/cancer-active-page-link.aspx?n=3155 &Title=Hyperthermia breakthrough treatment for breast cancer).
The Karolinska’s PR release says that localised Hyperthermia is also sometimes used around the globe on bone cancers and kidney cancer.
So will this ‘Alternative Cancer Therapy’ of Localised Hyperthermia now become mainstream? Will the evidence cause its promotion from the ranks of the unwashed?
No, it will remain an alternative to surgery, a threat to jobs, profits and the status quo in Britain’s medical community for quite some time yet.
Could Hyperthermia part of the cancer industriy’s demise?
Worse is yet to come for the Pharma Industry – but it’s very good news for cancer patients. A Nottingham/Kansas scientific axis is developing a new diagnostic test that will detect cancers before they develop into tumours. That would be the death knell for those dreadful screening mammograms, for example, which if they do not harm you first, can only detect a tumour after about 20 cancer cell divisions (at 40 you’re dead).
But more than that – imagine that breast cancer, prostate cancer, colon cancer, indeed any solid tumour cancer could be detected at just a millimetre in size or less and that localised Hyperthermia was an adopted technique in all cancer centres. It could save the nation a fortune. The whole industry would change overnight.
The bottom line, to go back to the issue in the opening paragraph, is that the furnishing of sound evidence is actually not enough to gain promotion to the ranks of the mainstream. In order for an ‘Alternative Therapy’ to become mainstream it has to have the research credentials AND it then has to be ‘accepted’ rather like jolly good chaps join a gentleman’s club in London. Even then it also has to be ‘adopted’ as standard practice to become mainstream. New members have to pay their dues for a good few years before the hierarchy will acknowledge them and talk to them.
And so, rightly or wrongly, whatever your opinion, I still include ‘Localised Hyperthermia’ as an Alternative Cancer Therapy on the CANCERactive web site. But please don’t say that this means there is no evidence that it is of benefit. That is just not true. The generalisation borders on ignorance and/or a failure to be able to read.
What is acceptable evidence?
There are other issues too. I am on record as criticising both Homeopathy and the Gerson Therapy for lack of evidence – they have both had quite long enough to get sensible research numbers together, even a quantified record of treatments and patients would be a start. But if lack of research numbers is the criterion for saying something is ‘Alternative’ (implication: worthless) , then virotherapy remains firmly in the Alternative therapy camp. So too does Dendritic Cell therapy.
However, the MD Anderson Cancer Center web site chronicles their success using virotherapy with two lung cancer patients 6 or more years ago. Dukes Medical Centre in America have case studies using Dendritic Cell therapy with brain tumour patients. Both Hospitals see these developments as clever new treatments although they clearly are not yet the finished article.
So are we now to accept the anecdote? If it’s acceptable for Virotherapy and Dendritic Cell Therapy, why not for Gerson and Homeopathy? Double Standards must not apply.
For me, there is little difference between a survivor who had Virotherapy, and one who had Gerson Therapy – but until there are solid numbers all these stay, equally judged, in our Alternative Treatments section at CANCERactive along with Hyperthermia, Intravenous Vitamin C, PDT, Burzynski, Gonzalez and Ketogenic Diets.
Advancement with technology such as lasers and the extraction of natural compounds may well make some of today’s alternatives tomorrow’s mainstream. In the latest edition of icon, the Royal Marsden’s Mike Brada covered alternative treatments; in the previous magazine it was Dr Henry Friedman of Dukes. Should we really be ignoring their work because some or all of it is new and ‘alternative’?
As long as a cancer patient can find the information on the web, at CANCERactive we have a social responsibility to try to cover the treatment objectively, pointing out the strengths and weaknesses and where there is research, and where there is not. We don’t work for the Government, the Hospitals or Big Pharma – we are the ‘People’s Champion’. We provide information, with no vested interests for people who want to beat cancer. Full stop.
And judging by the mail we receive this objectivity and coverage is exactly what people with cancer need.
Many ‘Alternative’ Therapies have numbers behind them; the current status quo and a strong moment of inertia to avoid change is what makes them alternative and they will remain there until attitudes change.
For Hyperthermia – CLICK HERE http://www.canceractive.com/cancer-active-page-link.aspx?n=3078