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.

Ethics, religion, and the right to die

One of my failings is that I never seem to be able to see ethical questions in black-and-white.

Life would undoubtedly be easier if I did.  Humans, myself included, appear to me to be impossibly complex, full of competing motives, attitudes, thoughts, and prejudices, with an incomplete access to the facts (and a fallible machine with which to process those facts).  Given all that, a lot of the time I really don't know how to make decisions on ethical matters -- I can too easily see the arguments from both sides.  All of which makes it all the more baffling to me how people can seem so sure of themselves in (for example) politics.

Maybe it's why I'm comfortable in the realm of science.  There, there's a clear decision-making protocol, and rules of logic that govern it.  Things may not always be simple in science, but they sure are a hell of a lot clearer.

I ran into an especially good example of this yesterday, with the story of the seventeen-year-old Sydney, Australia boy who is fighting in court for the right not to be treated for his probably-curable Hodgkin's lymphoma.

The boy is a Jehovah's Witness, and they believe that you are showing a lack of faith in god if you seek medical care when you're ill.  You should, they say, pray for healing.  If you die, then (1) you didn't pray hard enough, or in the right way, or (2) it was god's will that you died.  Either way, they're insulated against criticism of the claim, which strikes me as pretty convenient.

The case was in the courts in April, and was characterized as a situation of neglectful, ultra-religious parents victimizing an ill child by denying him treatment.  Supreme Court Justice Ian Gzell agreed, stating in his ruling that, ''The sanctity of life in the end is a more powerful reason for me to make the orders than is respect for the dignity of the individual.  X is still a child, although a mature child of high intelligence.''  The boy was ordered into Sydney Children's Hospital, where he began chemotherapy.

But the case jumped back into the news when it was reported that the boy himself is threatening to rip the IV needle out of his arm -- after his father wrote a line from the bible on a whiteboard in the boy's hospital room that allegedly supports the contention that it is against god's will to have a blood transfusion.

A spokesperson for Sydney Children's Hospital said the boy had a ''cocooned upbringing'' and his family had ''little exposure to challenges of their beliefs from outsiders''-- implying that he and his family were simply wrong, and therefore incapable of making a responsible decision.  The boy himself expressed horror at the thought that he might be sedated and treated against his will -- likening it to being raped.

So, what's the answer?  I teach seventeen-year-olds, and a good many of them are highly mature, sensitive, and intelligent.  Some are less so.  Even the less mature ones feel strongly that they should be able to make their own decisions.  In the eyes of the law, however, they are still legally their parents' responsibility.

Then we have the religious aspects.  It's easy enough to ridicule the beliefs of these folks from the outside -- but put yourself in their places.  What if you really, truly believed that death was not final, that your soul lived on -- but that you might end up in eternal torment if you sought out medical care?  You are in pain now, but that's temporary.  Hell, on the other hand, lasts forever.  Wouldn't you choose a few months' discomfort over an eternity in agony?

Then there's the aspect of "brainwashing" -- as it's been widely characterized.  I agree to the extent that the Jehovah's Witnesses' view of the world is unsupported by everything I know about science, logic, and nature.  There is, in my opinion, not a shred of evidence for their claims.  Still -- shouldn't we all be allowed to make those decisions for ourselves?  Why should my reliance on science and logic dictate what someone else does?  I sure as hell would resent that if the situation were reversed -- which it sometimes is.

It's not an easy thing to decide, is it?  It would be different if the boy were younger; but even that is an ethical conundrum, because there's no on/off switch for maturity.  Are you capable of making this sort of decision at sixteen?  Fourteen?  Ten?  In most places, you become the master of your own fate at eighteen, but even that is an arbitrary number.  I know some people who are more mature at fifteen than others are at twenty-five.

So I'm left with a question.  We have a boy who is almost certain to die because of his, and his parents', religious beliefs, and a hospital that is desperately trying to stop that from happening.  And all I can say is that I'm glad I'm not the one who has to make the decision about what is best to do.