The natural way

I'm always hesitant whenever I am considering posting something negative about alternative medicine.

I mean, sometimes it's clear.  I have no problem saying homeopathy is grade-A bullshit.  A meta-analysis of 1,800 studies intended to determine if there are positive effects from homeopathic "remedies" found no results -- as one would expect from a "medicine" that has been diluted past Avogadro's limit and which relies on nonsense like "frequencies" and "energetic imprints" to explain how it could work.

I always feel a little shakier when the target is naturopathy.  A great deal of what you hear from this branch of alternative medicine seems to me to rely on the naturalistic fallacy -- if it's natural, it must be good for you.  (And the converse, if it's artificial, it must be bad.)

That said, there are a great many therapeutically useful medicines that do occur naturally.  Aspirin (acetylsalicylic acid) is found in willow bark, vincristine (used to treat Hodgkin's disease) in the sap of the Madagascar periwinkle, and an extract of the venom from the deadly cone snail shows great promise for treating intractable pain.

But to disabuse yourself of the notion that natural = good for you, look no further than the quack remedy "laetrile" made from apricot pits that supposedly destroyed cancerous tumors -- and which contained dangerous amounts of cyanide.

So I'm definitely of two minds regarding "natural medicine."  Just taking something because it's "natural" could have no effect on whatever's ailing you, or worse, might kill you.  But ignoring a potentially valuable substance because it comes from the annals of naturopathy is no better.

Of course, the good thing is that science has a way of evaluating claims of this type.  It's called a "controlled study" and it's the gold standard for testing this sort of thing.  Many naturopaths, however, claim that the game is rigged -- any substance that could be therapeutically useful that was not developed by the pharmaceuticals industry (or, in their lingo, "Big Pharma"), or which wouldn't make them lots of money, gets summarily ignored.

Myself, I've always thought that objection was a little dubious, given the fact that medical researchers have done 1,800 controlled clinical trials of freakin' homeopathy.  If they're willing to give something ridiculous like that close to two thousand tries to prove itself, it's hard to see why they'd balk at testing some potentially useful plant extract.

What I didn't realize, however, was that the naturopaths themselves have their own problems with dubious practice.  A long-time reader of Skeptophilia sent me a link a couple of days ago to an article in Vice about a former naturopath who has completely flipped her perspective -- and become a whistleblower for cases where naturopaths have used unapproved drugs, suggested useless therapies for ailments, and worst of all, conspired to cover up their own failures.

The article, "The Former Naturopath Who Became a Whistleblower on the Industry" by Kaleigh Rogers, is an interesting if disturbing read.  The naturopath in question, Britt Marie Hermes, was trained at Bastyr University, one of the best known naturopathic medicine teaching facilities.  She threw herself into it full-throttle -- until what she was seeing around her pulled her up short.

"It was world-crushing," Hermes said.  "I came to the conclusion that naturopathy is rife with unethical practices and undertrained professionals.  It was really hard to process...  I guess I have become a thorn in the profession's side."

Which highlights what I was saying earlier; we do have the means to test claims, it's just that the naturopaths often don't do that (or, as with homeopathy, don't believe the results even when we do).  It's a shame, because that means that any potential good discoveries -- the next generation of substances like vincristine -- gets lost under tons of confirmation bias and defensiveness.

It's why we need people like Britt Hermes.  It keeps us honest.  It keeps us from trusting our gut instead of peer-reviewed science.

But it does raise hackles.  I get more hate mail when I criticize alternative medicine than I do when I criticize young-earth creationism, and that's saying something.  People feel strongly about this, which is why Hermes herself is facing a defamation lawsuit by a German naturopath who took exception to her slamming dubious and poorly-tested "cures" (such as intravenous baking soda to treat cancer).  The bottom line is that we have a tried-and-true method for determining the efficacy of potential drugs.

It's better known as "science."

Or, as Tim Minchin put it, "There's a name for alternative medicine that works.  It's called... medicine."

Chemotherapy lies

A musician friend of mine, a flutist of tremendous talent, drive, and skill, was diagnosed with leukemia when she was seventeen years old, only months before her high school graduation.  This was (of course) a devastating blow to a young woman with aspirations to head off to college and pursue a career as a professional musician, but fate often intervenes in the best-laid plans (as Robert Burns said much more eloquently).

She began chemotherapy almost immediately after the diagnosis.  The process was excruciating.  She experienced all of the familiar awful side effects -- hair loss, weakness, nausea, headache.  She lost weight, and felt fatigue so crushing that it was hard for her to do anything other than sleep.  Her family and friends rallied around her, and she called on her own strength of spirit to get her through the pain.

And she made it.  The leukemia went into remission.  She was able to resume normal activities, including playing her beloved flute.  She's been cancer-free for over five years now -- and is soon to release her first album.

[image courtesy of the Wikimedia Commons]

It's stories like this that are why I become apoplectic with rage when I read things like a post that came out at The Mind Unleashed last week.  Entitled, "Chemotherapy Proven to Spread Cancer, Cause Lethal Tumors in Groundbreaking New Study," the writer begins with a bang by saying, "Albert Einstein College of Medicine proves chemotherapy is a cash machine for Big Pharma."  The post goes on to say:

In a groundbreaking new study, they’ve proven that chemotherapy causes cancer cells to spread throughout the body – to replicate themselves, making your cancer worse, not better...  The researchers, George S. Karagiannis, Jessica M. Pastoriza, Yarong Wang, Allison S. Harney, et all, suggest that though chemotherapy may shrink a cancerous tumor, but it simply sends the cancer cells off into other parts of the body to rebuild into yet additional destructive tumors. 

This study makes a massive move in exposing the perpetual fraud of the chemotherapy/cancer industry. In American alone, it’s a $200 billion-dollar industry. It’s part of the reason why our insurance premiums are ridiculously high, and unassuming cancer sufferers, keep suffering.

Of course, the Karagiannis et al. paper, released earlier this month in Science, says nothing of the sort.  Here's the summary of the study the editors of the journal wrote:

Breast cancer is one of the most common tumor types, and metastasis greatly increases the risk of death from this disease.  By studying the process of intravasation or entry of cells into the vasculature, Karagiannis et al. discovered that, in addition to killing tumor cells, chemotherapy treatment can also increase intravasation.  Groups of cells collectively known as tumor microenvironment of metastasis (TMEM) can serve as gateways for tumor cells entering the vasculature, and the authors discovered that several types of chemotherapy can increase the amounts of TMEM complexes and circulating tumor cells in the bloodstream.  The researchers also determined that a drug called rebastinib can interfere with TMEM activity and help overcome the increased risk of cancer cell dissemination.

Two things stand out.  The researchers studied one type of cancer -- breast cancer.  Chemotherapy differs greatly depending on cancer type, so it's highly unlikely that all chemotherapy increases TMEM production.  Second, and most important: did you catch the last line?

They showed that the drug rebastinib acts to prevent metastasis, thus removing any increased risk of TMEM formation resulting from the chemotherapy.

So basically, it's the opposite of what the people over at The Mind Unleashed claimed.  If "Big Pharma" wants us all to stay sick and keep suffering, they're doing a pretty lousy job.  Humans in industrialized countries have the highest overall life span, and (more importantly) the best health, of any society the world has ever seen.  A lot of the credit for this goes to the medical establishment -- especially the development of vaccines and antibiotics.  And the cancer sufferers who owe their lives to chemotherapy far outnumber the ones whose cancer recurred or metastasized due to the drugs they were given.

In other words: the article at The Mind Unleashed is misleading at best, and an outright bald-faced lie at worst.  They took a study whose title seemed to give some vague support to their anti-science stance, and (apparently without reading the actual paper itself) claimed that it proved that "Big Pharma" is engaging in some kind of giant conspiracy to make us all sick.

And this is not just an ordinary lie; it's a downright dangerous one.  Most of us aren't scientists, and a paper like Karagiannis et al. is beyond our ability to comprehend in anything more than a superficial manner.  On the other hand, bullshit alarmism like what I found over at The Mind Unleashed is easy to read -- and easy to swallow whole.  As we've seen more than once here at Skeptophilia, emotional appeals usually work better than intellectual ones.  If you hook into people's fears, you're likely to convince them even if what you're saying makes no rational sense whatsoever.

So what we have here is a claim that could very well make cancer patients -- who are already likely to be in a maelstrom of worry, doubt, and anguish -- decide that what their doctors are recommending is just going to make them worse.  Add to that the fact that even the best chemotherapies cause pretty unpleasant side effects, and you get a toxic combination that could well persuade someone to forgo treatment, or opt for some useless quack "alternative medicine" instead.

The case of Steve Jobs bears remembering -- who, when he was diagnosed with pancreatic cancer, delayed conventional treatment for nine months, opting instead for "alternative medicine" and changes in diet.  Jobs realized his mistake, but too late.  "He wanted to talk about it, how he regretted it," his biographer, Walter Isaacson, said.  "I think he felt he should have been operated on sooner...  I think he felt: if you ignore something you don't want to exist, you can have magical thinking.  It had worked for him in the past.  He did end up regretting it."

In the case of my musician friend, the situation is crystal-clear.  If she had chosen to ignore the advice of her doctors and avoid chemotherapy, she would have died.  Pure and simple.  We are fortunate enough to have a fine person and truly talented flutist still with us, living a healthy and productive life, because of "Big Pharma's chemotherapy/cancer industry."

And the biased, anti-scientific ignorance the people over at The Mind Unleashed are peddling is 100% USDA Grade-A bullshit.

Pandering to anti-science

Is it too much to ask for that we have some political candidates who unequivocally respect science?

In casting about for who else might be out there running for president other than The Big Two, I initially considered Jill Stein, nominee of the Green Party.  Stein has attractive ideas about fracking (against) and renewable energy (for), and I thought she might be worth supporting, not that she has a snowball's chance in hell of winning.  But a closer look indicated that either she's pandering to the anti-science cadre on the far left, or else she's an anti-science loon herself.

Dr. Jill Stein [image courtesy of photographer Gage Skidmore and the Wikimedia Commons]

Let's start with her attitudes toward vaccines.  Here's a direct quote from Stein on the topic:

I don’t know if we have an “official” stance, but I can tell you my personal stance at this point.  According to the most recent review of vaccination policies across the globe, mandatory vaccination that doesn’t allow for medical exemptions is practically unheard of.  In most countries, people trust their regulatory agencies and have very high rates of vaccination through voluntary programs.  In the US, however, regulatory agencies are routinely packed with corporate lobbyists and CEOs.  So the foxes are guarding the chicken coop as usual in the US.  So who wouldn’t be skeptical?  I think dropping vaccinations rates that can and must be fixed in order to get at the vaccination issue: the widespread distrust of the medical-indsutrial complex. 

Vaccines in general have made a huge contribution to public health.  Reducing or eliminating devastating diseases like smallpox and polio.  In Canada, where I happen to have some numbers, hundreds of annual death from measles and whooping cough were eliminated after vaccines were introduced.  Still, vaccines should be treated like any medical procedure–each one needs to be tested and regulated by parties that do not have a financial interest in them.

Which sounds like waffling to me.  How about coming right out and saying, "Vaccines are safe, effective, and have saved thousands of lives.  End of discussion."  Worse still, as was pointed out over at SkepticalRaptor, she's wrong about the regulation of vaccines:

The FDA advisory committee for vaccines contains 17 members, all but two are academics with impeccable research and science credentials.  The other two, admittedly are from Big Pharma, but they also have impressive scientific backgrounds, and to impugn their character or any of the 17 others, is borderline libel. 

Does Jill Stein have any evidence whatsoever that those 17 scientists are all handed bribes by Big Pharma to vote against the safety of American children?  Well, does she? 

Then, there's the Green Party's official platform, which explicitly supports homeopathy and other useless treatment modalities:

Chronic conditions are often best cured by alternative medicine.  We support the teaching, funding and practice of holistic health approaches and, as appropriate, the use of complementary and alternative therapies such as herbal medicines, homeopathy, naturopathy, traditional Chinese medicine and other healing approaches.

But in the words of the infomercial, "Wait... there's more!"  In a recent forum, Stein went on record as saying that wifi should be removed from schools because of its effects on children's brains:

We should not be subjecting kids' brains to that.  We don't follow that issue in this country, but in Europe where they do, they have good precautions around wireless.  Maybe not good enough.  Because it's really hard to study this stuff.  You make guinea pigs out of whole populations and then we discover how many of them die.  This is the paradigm for how public health works in this country.  This is outrageous.  This is why we need to take back not just our schools, but take back the whole system of how we create health, how we protect health, and our research institutions as well, to be publicly funded and publicly accountable as well.  We've lost trust in our regulatory agencies, when the vice president of Monsanto is in charge of the... not the DEA, which is it... the FDA.

Well, no, it's actually not hard at all to study this stuff.  There have been dozens of well-controlled studies of the dangers of wifi, and all of them have found... nothing.  According to the World Health Organization:

From all evidence accumulated so far, no adverse short- or long-term health effects have been shown to occur from the RF signals produced by base stations.  Since wireless networks produce generally lower RF signals than base stations, no adverse health effects are expected from exposure to them...  Considering the very low exposure levels and research results collected to date, there is no convincing scientific evidence that the weak RF signals from base stations and wireless networks cause adverse health effects.

 And once again, her defense for her views jumps to claiming that Evil Corporations Run Everything, so q.e.d., and (of course) finishes up with the argumentum ad Monsantum -- which in this case isn't even correct.  The current commissioner of the FDA is Dr. Robert Califf, who does have ties (as a paid consultant) to the pharmaceuticals industry, but has no connection whatsoever to Monsanto.

Worse still, did I mention that Jill Stein is a doctor herself?

Look, it's not that I expect a political candidate to be perfect, or to line up exactly with my own views on how things should go.  All of politics is a compromise.  But one thing I'm not willing to compromise is that anyone I support needs to respect science.  The fact that Dr. Jill Stein is not willing to go on record as declaring support for scientific findings that have been verified over and over smacks either of pandering to a vocal minority of far-left anti-science types, or of willful ignorance.  And in neither case can I vote for her in good conscience.

The Sesame Street vaccination conspiracy

A lot of you might have heard about the newest character on Sesame Street -- a little girl named Julia who is autistic.

It's a gutsy move by a show long known for its efforts to teach children about fairness and compassion and the effects of social stigma.  Its goal statement has included right from the beginning the intent to encourage children to "appreciate cultural diversity by modeling people who differ in appearance, action, or point of view playing together, working together, making friends, and resolving conflicts."  From its inception, there was a deliberate decision made to have minorities and people of various ages deeply represented, and not simply to have a token minority character or two.  They also never shied away from helping children to deal with difficult topics -- unusual in a kids' show.  For example, Sesame Street deliberately (and tactfully) addressed the concerns and fears children had after 9/11 and Hurricane Katrina.

So the move to include an autistic character was perhaps to be expected from the directors of such a thoughtful and forward-thinking show.  The author of the story introducing the character, Leslie Kimmerman, wrote, "More than 20 years ago, my beautiful son received the diagnosis of autism, and my world changed instantly and profoundly.  I knew nothing about autism, and it seemed that those around me — even the professionals — didn’t know much either.  Today, happily, that has changed."

She and the others involved in the creation of the character hope that this will bring awareness and understanding, given that non-autistic children watching the show will inevitably interact with autistic children in school, and also to help autistic viewers to feel more accepted.  Jeanette Betancourt, Sesame Street's senior vice president, said, "Children with autism are five times more likely to get bullied.  And with one in 68 children having autism, that’s a lot of bullying.  Our goal is to bring forth what all children share in common, not their differences.  Children with autism share in the joy of playing and loving and being friends and being part of a group."

Hard to see what's to criticize about that.  I have several friends with autistic children, and the response from them has been uniformly positive.  So imagine my surprise when I found out that the anti-vaxxers are saying that the move is actually an end run by "Big Pharma" to make autism seem normal, so that we'll continue to get vaccinated.

It'll probably come as no surprise that the person spearheading the claim is Mike "The Health Ranger" Adams, founder of Natural News.  Adams has repeatedly demonstrated that he doesn't have a very firm grasp on reality -- a quick perusal of the headlines on Natural News is usually sufficient to confirm that.  But this has revealed an uglier side of his narrative, one which the glitzy, health food polish of the site might hide.

Adams writes, "The rollout of autistic Julia is Sesame Street’s attempt to ‘normalize’ vaccine injuries and depict those victimized by vaccines as happy, ‘amazing’ children rather than admitting the truth that vaccines cause autism in some children and we should therefore make vaccines safer and less frequent to save those children from a lifetime of neurological damage."

Well, Mike, let's start out with the obvious.  (The more sensitive members of the studio audience might want to plug their ears.)

VACCINES DO NOT CAUSE AUTISM, YOU ANTI-SCIENCE, IRRATIONAL, WILLFULLY IGNORANT LOON.  What they do is they protect children from devastating diseases that used to kill or permanently injure thousands every year.  Just because every scientific study done on the topic has confirmed results that run counter to the mission statement of your company does not mean that there's a conspiracy to discredit you.

It simply means that you are wrong.

But second, and more encouragingly, I think Adams may have miscalculated this time.  To discredit an attempt to "normalize" autistic children -- his words, not mine -- puts him in serious danger of alienating the very people he's dependent on for support, namely parents of autistic children whom he has hoodwinked into believing that their kids' health issues were caused by vaccination.  Even if you are a parent of an autistic child who believes that modern medicine is responsible for autism, calling a television show that is trying to heighten awareness and understanding of your child's condition a conspiracy by the pharmaceutical companies doesn't seem like it would strengthen the anti-vaxxers' credibility.

More likely, it would bring up thoughts of, "Wait, I thought he actually cared about autistic children.  If so, why is he condemning a show that is working towards seeing them treated fairly?"

So as a PR move, it stands a good chance of backfiring, which is all to the good.

But it's also a bit puzzling, even coming from a guy who shows every evidence of having spent too much time doing sit-ups underneath parked cars.  Okay, in Adams's BizarroWorld, "Big Pharma" has fucked things up royally by creating vaccines that cause neurological damage in children.  If so, then why on earth would they respond by spending millions of dollars on a campaign to "normalize autism" on a children's show instead of simply making the vaccines safer?

Maybe it's because the vaccines are already safe, the scientists are right -- and Mike Adams has gone even further off the deep end than he was before, however impossible that sounds.

"Big Pharma" and the package-deal fallacy

My post from a couple of days ago about the fraudulent psychic who convinced Latina singer Jenni Rivera's family that she had survived a plane crash (she didn't) elicited a curious comment from a reader.

I had prefaced my comments about Rivera and the psychic with a statement that woo-woo beliefs cause a lot of harm -- and I cited homeopathy as one example.  The commenter ignored the main gist of my post, and leaped upon the homeopathy comment, responding, "Does this (harm) include fraudulent behaviour by clinical scientists who are paid by the big pharmaceutical companies to fudge their data?  Typical double standards by pseudosceptics!"

Well.  I could call "red herring" on this and be done with it, but I thought it might be more interesting to look at the question a little more closely.

First, let me say at the outset that I am neither a medical professional nor a specialist in corporate law.  I am, however, trained to do biology, and I understand anatomy and physiology pretty well.  And whatever else you might say about most medications, they do, for the most part, what they're intended to do, and we understand how they do it.  To take two examples from my own health: (1) I am currently recovering from a sinus infection, and have been taking amoxicillin; and (2) I have moderate chronic high blood pressure, and am on two medications (nifedipine and hydrochlorothiazide), and I am pleased to report that at my last checkup my blood pressure was a healthy 118/80.  And all three of those drugs have mechanisms of action that are thoroughly researched and well understood.

So, here's the deal.  While "Big Pharma" is composed of a group of huge corporations, which (like all corporations) exist to make money for stockholders, they do have one thing going for them; the drugs they make seem to work pretty well.  It's kind of funny, don't you think?  All the fraudulent, on-the-take clinical scientists fudge their data, and evil old "Big Pharma" continues to churn out medications that have made us one of the overall healthiest societies ever.  We have virtually eradicated childhood infectious diseases because of vaccination; we have nearly eliminated deaths from bacterial infections because of antibiotics; cancer survival rates have improved significantly because of chemotherapy.  I know personally at least a dozen people who owe their lives to "Big Pharma."

Now, of course, the commenter was right in one sense; when corporate interests and the profit motive get mixed up in anything, there is always going to be some degree of corruption.  Human greed is as insidious, and harder to cure, than human disease.  And while the survival rate from most of the ills that have plagued humanity from the get-go has increased, there are a few conditions that have become more common since the advent of modern medicine, for reasons unknown (allergies, asthma, and autism come to mind).  But the idea that because we haven't cured everything, and because there have been some examples of bad science, fudged data, and coverups, all pharmaceuticals should be avoided, is blatant foolishness.  This is the "package-deal fallacy" in a particularly dangerous guise.

Because, after all, what does the alternative medicine crowd propose as a replacement?  Homeopathy (which I beat on frequently enough that the phrase "'nuff said" comes to mind).  "Colorpuncture," about which I wrote last week.  Crystals, smudging, aromatherapy, flower essences, chakra manipulation.  Oh, yeah, and one other one, that I just found out about last week because of a student in my Critical Thinking class: "Auto-Urine Therapy."  Yes, folks, this is exactly what it sounds like; improve your health and cure disease by drinking your own urine.  What's it supposed to do, you might ask?  I know that's what I asked, after I finished gagging.  "This diet minimises toxins and further enhances the power of the immune system. Ojas [the essential energy of the body] is increased and thus the urine contains more valuable biochemicals," the website says.  "Urine can also be used to cleanse the stomach, lungs, sinuses and nasal passages in the Yoga practices of Neti and Kunjal Kriyas."

Apparently it can also be used as a "skin tonic."   Um, yeah.  I'll just stick with lotion, okay?

Now, don't get me wrong; there are some "natural medicines" that have shown efficacy in treating human diseases.  Digitalis, aspirin, atropine, vincristine, the opiates, and a variety of other medically-useful compounds, now found routinely in standard medicine, are plant compounds.  Others are still being investigated -- the jury is still out on echinacea and turmeric, for example.  Others still (such as ginkgo biloba, supposed to be useful to improve memory) have been shown in controlled studies to be useless.

The point is, doctors and medical researchers are constantly looking for new ways to approach treatment, and they have nothing against herbals as a source of new, more effective drugs.  But, as Tim Minchin said, in his wonderful piece "Storm" (you should all watch it, but be forewarned -- there's some inappropriate language, should you be sensitive to such things), "There's a name for alternative medicine that's been proved to work.  It's called... medicine."