By Robert Verkerk PhD, founder, executive & scientific director, ANH-Intl

Did you hear that cancer patients who refuse conventional cancer treatment and opt for alternative medicine are twice as likely to die than patients who use only conventional treatments (chemotherapy, radiotherapy, surgery or hormone therapy)?

The news is out and about, on BBC News in the UK and Medical News Today in the USA to mention just two of the media channels. But you’ll find out here that the news is fake. You could say the research article by a Yale team with declared conflicts of interest published in JAMA Oncology provided an ideal opportunity for bit of timely CAM (complementary and alternative medicine) bashing.

A piece in the Guardian by Matthew d’Ancona was given the irresistible title, “From Andrew Wakefield to Brexiteers, snake-oil salesmen are keeping us sick.” Why not go for a three-in-one when you think the opportunity is there!

How was the study conducted?

Firstly, let’s remember the study was an observational one. When these are done in the field of complementary or alternative medicine and they yield positive results, authorities generally say they’re not worth the paper they’re written on. Observational studies, they say, subsist one step from the bottom of the pecking order in the evidence hierarchy of ‘evidence-based medicine’ and therefore have little or no authority. When the shoe’s on the other foot, it’s a big research group from a well-established US university and the findings can be used to bash CAM (even in the absence of direct evidence), the ‘rules’ appear different.

The Yale team went to the US National Cancer Database which includes an impressive almost 2 million cases. But it’s made up only of data derived from Commission on Cancer–accredited hospitals in the USA. It absolutely doesn’t include any of the leading centres or clinics specialising in complementary or integrative medicine in the USA.

Of this very large number of nearly 2 million, the researchers could only find a tiny number of cases (281 or a miniscule 0.014%) who fitted the criteria of being cancer patients with stage I, II or III cancer who had also used one or more so-called “unproven therapy delivered by nonmedical personnel” along with one conventional treatment (chemotherapy, radiotherapy, surgery or hormone therapy). Amazingly, the unproven therapies are not coded sufficiently to allow any further information to be gleaned about which therapies were used. But the authors made mention of them as “including herbs and botanicals, vitamins and minerals, traditional Chinese medicine, homeopathy, and naturopathy, as well as specialized diets”.

They also cite other research that shows “Patients with cancer choose to use CM to improve their quality of life and feel more hopeful”, that “Past research has shown that CM therapies such as massage, acupuncture, yoga, and meditation can improve quality of life” and “it is estimated that between 48% and 88% of patients with cancer have reported the use of CAM as part of their therapy“. These figures a stunning 3,500 to 6,300 times greater than the proportion of complementary medicine users found in the National Cancer Database – so there is a very strong chance the 281 subjects on which the conclusions are based are not representative.

So what did the researchers find? Firstly, this tiny group of complementary medicine users were more likely to be female, were likely more educated, and had higher incomes than those who used conventional treatments only. Wait for it, they were also more likely to have breast or colorectal cancer, the two cancers that kill most women, while having private insurance, stage III (vs stage I) cancer and lower levels of comorbidity (other illnesses). Geography played its hand as well: they were more likely to live in the Intermountain West or Pacific West of the USA.

The researchers used well-established techniques of survival analysis including Kaplan-Meier plots and a Cox proportional hazards model to compare this group of complementary medicine users with a matched group that only used conventional treatments.

They found what?

The principle finding was that when monitored over 7-years, patients who used complementary medicine had a marginally worse 5-year survival for all cancers studied (breast, prostate, bowel, colorectal, lung) at 82.2% versus 86.6%, the difference being statistically significant. Most of this difference was caused by slightly higher risk of death in users of complementary medicine with breast cancer, the difference being only marginal with colorectal cancer. There were no significant differences among those with lung or prostate cancer.

The second major finding – downplayed by the media – was that when the researchers statistically adjusted the model for treatment refusal and delay from diagnosis to treatment, they found no association between use of complementary medicine and risk of death. This is what delivered their headline that it was conventional treatment refusal that caused an increased risk of death. Crucially, what this means is that there was no evidence whatsoever that the use of complementary medicine itself increased risk of death. Sadly, many who will have read the title of the paper, the abstract or the news articles emanating from the PR spin will have been given the impression that complementary medicine itself will reduce a cancer patient’s survival.

Why we don’t rate the study (or its interpretation)

We could descend into a very long rebuttal of the study, but felt a shorter list of key points of concern would be useful. So here they are:

  • The sample of complementary medicine users is unlikely to be representative of most people who use both conventional and non-conventional methods. It is well known, as cited by the authors themselves, that 48% to 88% of all cancer patients engage in the use of some form of alternative treatment.
  • The around 4% increased risk of death among those who engaged in complementary medicine might have been statistically significant, but it is not necessarily very biologically or socially significant, especially given this small variance was down to delays in receiving treatment.
  • There is no information at all available on the types of “unproven” therapies provided; not the type, the timing, the amount, who delivered it, was it self-administered, etc.
  • The study evaluated 5-year survival across the most common forms of cancer and in whether or not complementary therapies were involved, the survival rates were high (>80%). It would have been more informative to evaluate 10-year survival (where data are available) given on average this is typically only around 50%.
  • The study failed to look at effects of alternative treatments on quality of life, emotional health or other parameters that were independent of survival, despite evidence for their positive role, one acknowledged in the introduction of the paper.
  • As the authors concede, the study is an observational study based on historic data from a pre-existent database and contains vast amounts of ‘noise’ in the form of uncontrolled and unknown sources of variance and confounding.
  • The health status of individuals that chose complementary versus only conventional treatments is entirely unknown and unstudied. Who is to say that those who chose complementary medicine were not in a generally worse state of health, especially given that they were more likely to have stage III (than stage I) cancer.
  • The abstract of the study (and hence the media reports about it) did not mention that the effect was not found at all with prostate and lung cancers and was mainly the result of differences with breast cancer and only to a slight extent with colorectal cancer.
  • Three out of four of the authors had declared conflicts of interests, as follows: “Dr Park reported receiving honoraria from Varian Medical Systems Inc and RadOncQuestions LLC. Dr Gross reported receiving research funding from 21st Century Oncology, Johnson and Johnson, Medtronic, and Pfizer. Dr Yu reported receiving research funding from 21st Century Oncology and serving as a consultant for Augmenix”.

Final note: the same authors published another study (“Use of Alternative Medicine for Cancer and Its Impact on Survival”) in 2017 based on the same dataset that attempted to ‘can’ alternative medicine treatments. It has many of the same limitations as the present study so the findings are in our view worthless and do not reflect what benefits or risks alternative medicine approaches might have for patients who select them diligently. What’s more the title is deeply misleading. The paper cannot establish “impact on survival”. A more appropriate title might have been: “Use of Alternative Medicine for Cancer and Its Association with Survival.” But that’s another story.

Given it’s #ThrowbackThursday, we thought you might be interested in the following stories…

Cancer orthodoxy takes note of alternative treatments

Has the time come for mainstream medicine to acknowledge the benefits of ‘alternative’ cancer therapies?

Here’s a compelling and emotional argument, published in June 2017, for trying a non-conventional cancer treatment on a patient who has run out of options from the official armoury.

Only someone who is lucky enough to have never experienced the panic and angst generated by a diagnosis of cancer (or other life threatening condition) can contemplate ignoring complementary and integrative medicine.

It is easy for a doctor to dismiss it as unproven quackery, but very difficult then to give an answer to cancer patients in pain, with impossible nausea and vomiting, with drug-resistant permanent insomnia, with weight loss and cachexia, who are open to any reasonable solution in the hope of feeling better.”

So where do you think it came from. A reasonable guess would be the website of some site devoted to CAM (Complementary and Alternative Medicine) or maybe an American centre at a large hospital that takes a CIM (Complementary and Integrated Medicine) approach, using both drugs and natural treatments.

Read more …..

Censorship, quackery and the dissing of unproven cancer therapies

Why the status quo no longer serves cancer patients and what can be done to encourage research and trialling of promising, integrative cancer therapies

UK cancer conference attacked

Medical freedom of choice remains an aspiration rather than a reality for many. In no area is this more true than in cancer therapy. On Monday, the UK’s Telegraph newspaper lambasted a meeting held near Brighton on England’s south coast, in which various views about alternative cancer treatments were put forward. ANH-Intl’s Rob Verkerk also delivered a lecture at the request of the meeting’s organisers.

We are unable to comment on the nature or quality of other speakers as Rob’s presence at the meeting was restricted to his delivery of a presentation on major challenges facing orthodox medicine linked to its excessive reliance on pharmaceuticals and the limitations of methods used to prove efficacy. Proof of efficacy is reliant almost entirely on the gold standard of randomised controlled trials (RCTs), these increasingly being viewed as of limited value in evaluating multi-modality, integrative approaches that also attempt to maximise the effects of the therapeutic relationship (between practitioner and patient).

Read more …..

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Comments

  1. I read this article with great interest having used an integrative approach to my own cancer 8 years ago.
    Why does mainstream medicine constantly feel the need to dismiss complementary therapies….why are they so afraid of them, moreover whatever happened to freedom of choice??
    All I know is that as a result of my own programme, I did not need the 2nd bout of my prescribed chemo, & did not get 80% of the unpleasant side effects of radiotherapy & chemo.
    Why cant we all work together, why is it a constant battle between the two? Surely the most important thing is the survival & health of the patient??

    1. “Surely the most important thing is the survival & health of the patient??”

      If only that were so.
      When it comes it is a rude (shocking) awakening to uncover power politics and business using ‘medical’ masking. But then if you try to tell anyone you are a ‘loony’.
      Transparency and accountability and a culture of support for educated choice – which relies on freedom of information. These are all being rolled back – insofar as we ever had it.
      Thanks for your testimony.

    2. Miranda – great that you’ve had such a good experience, as so many others have too. The trouble is that researchers who’ve been tasked with creating the so-called ‘evidence base’ don’t get to see any data from people like you – you and thousands of others are invisible to them. That’s why we need a new way of evaluating clinical experience – and that’s another ANH project! In the meantime, it’s so important you and others like you keep telling others about your story! Warm rgds, Rob

  2. Thank you for this detailed insight, Rob.

    So are you saying that this study is not science as we would expect and hope, it is just Big Pharma propaganda? The propaganda question is something that should be carefully considered when studies are published – there is too much politicking that goes on in health; agendas are everywhere. Unfortunately, clinical studies have been put on a pedestal of truth, but that pedestal has become very tarnished.

    What shouldn’t be forgotten is that we are human systems, not isolated biochemical reactions. Clinical studies only measure outcomes on isolated biochemical outcomes because of the nature of Big Pharma product development that is often the source of their funding. The real value of anecdotal evidence and real doctoring is often completely overlooked.

    As someone who took a more natural route through cancer back in 2001 one thing I do know is that the drugs and radiotherapy offered to me were both carcinogenic. I chose to focus on being healthy and living because I know that my body is the most complex biochemical factory beyond man’s imagination or comprehension. It demonstrates frequently through ‘spontaneous remission’ that it can heal and whole. Remember that healing comes from the inside, whereas curing is an external process (often misunderstood).

    1. Alyssa – great to have your feedback. Your story is so symbolic of the problem – like Miranda’s above. In answer to your question, there’s good science in the Yale study published in JAMA Oncology, but there’s also some real manipulation and distortion. That’s especially in the spin that goes out to the media. The paper doesn’t include any evidence of harm from CAM, yet it’s spun in such a way that CAM causes harm. The survival analysis, probably on a non-representative group, suggests only that delay in treatment causes harm. And then only for breast cancer, marginally for colorectal and absolutely not for lung and prostate cancers. If the journals are to maintain any kind of integrity they’ve got to clamp down on this kind of spin in interpretation, abstracts and titles of papers. There should be at least two gatekeepers – the peer reviewers and the editorial staff. That should stop most of the dross – but it just doesn’t work well enough especially when there’s any possibility of getting some CAM bashing out of it. There’s no doubt in my mind that Pharma and other business interests related to the medical establishment are the real drivers in the distortion of science. We need to keep calling them out. Warm rgds, Rob

  3. I made sympathetic contribution on the Guardian site when Angelina Jollie double mastectomy was being commented on . I mentioned my wife dealing with early breast cancer using alternative methods and referred to ‘big pharm’ one size fits all domination of the NHS. For a couple of hours there were sympathetic responses then I had an email threatening me that I would be banned from any futher contributions as I had used unacceptable comments,my posting was removed. Ten years on my wife remains well,her NHS doctor wont even discuss cancer says my wife has an oncologist, my wife gave up trying to communicating with her years ago. We thought they should be interested in the outcome of the alternatives my wife chose,they could not be less interested so those who chose alternative approaches or adjuvant additions are simply ignored;so much for ‘statistics’!

    1. Power reveals itself in what can not be openly discussed. I hold that it really is that stark.
      Most of us – including doctors – are able no not see, learn or do what would bring heavy penalty for see, learn or do.

      Recently Tessa Jowell made an appeal before she died in the Commons – I expect it is online. The elephant in the room for me is the question “to whom exactly is she pleading?” because parliament is supposed to be a seat of power but MP’s are subject to such power as doctors.

      It isn’t just profit, but subjection of peoples to terrors that they effective control the narrative of.
      While the internet is still open, there is a lot of information that ‘we should all be interested in’ -especially those serving the health of their fellow human beings – not only on cancer – but across the board.

      It is always possible that a study may be valid – but there are many ways in which it can be manipulatively set up or interpreted. Malcolm Kendrick’s Doctoring Data is a good read.
      He doesn’t go so far into the corruption as he might – but then he is a practicing doctor in the UK.

      News reporting of anything these days is at best without substance and often running corporate or gov PR – such as is regular fare with regard to the disinfo and undermining of ‘threats to National Security’ – which expands to include anyone who doesn’t conform or comply. There is no security to be had under secrets and lies.

  4. This is yet more propaganda to confuse and divide the public from the media who are controlled by the medical/industrial complex.
    Chemotherapy kills – period. It spreads cancer. But it is the biggest money maker for Big Pharma and they continue to get people into their system by so called “preventative screening” of mammography. Many women are misdiagnosed and then mis-treated with chemotherapy often resulting in their rapid death. Even surgeons are now admitting that mammography is outdated and harmful. And, in fact, in test, may actually be harmful to the bodies of the women who receive it, according to research. In a study of 1000 women screened over a 10 yr period only ONE breast cancer would be prevented, while 460-670 women would be given FALSE positive diagnosis, 70-100 would undergo unnecessary biopsy. The exceptionally poor track record has doctors wondering why mammography is still being used when it clearly doesn’t work! Living in Italy the practice is for women to be coerced into mammography every TWO years which must in the end produce some cancer from the excessive radiation. I have only had two mammograms during the whole of my life and would never have one again because of the damage it did. It serves the media NOT to report on those people who cure often terminal cases of cancer with cannabis or nutrition etc. They want as many people in “the system” as possible to keep the profits rolling in for Big Pharma. It is disgusting that we are being allowed less and less choice in healthcare because “the powers that be” want it that way.

  5. The issue I see is a mind capture, often called mindshare or branding. Belief and identities operate self-defensively against perceived threats in new information or even the uncovering and sharing of true account.

    The social engineering that was to some degree lauded as ways to make a ‘better world’ is persistently and pervasively used to map out and manipulate us – not least by the setting up or capture of authorities or institutions of trust.

    Opening more of how our minds, bodies and world truly work is undermining to corporate investment and control of the old paradigm. So of course its a messy business.

  6. Chemo is quackery developed from mustard gas. Very ineffective and actually dangerous.

    Big Pharma is desperate and their shills are pathetic.

  7. Complementary and Alternative Medicine therapies were only 1 of 16 points that I made in a recent formal submission to NICE regarding Early Stage Breast Cancer

    More specific comments included Vitamin C, Vitamin D and Omega-3

    You can see these submissions if you explore the History here:
    https://www.nice.org.uk/guidance/NG101

    In most cases they responded: “We shall not be considering Vitamin C etc”

    I specifically asked them to consider the effect of Complementary and Alternative therapies, and this commentary by Rob Verkerk reflects how significant this is.

    When I questioned their rejection, the comments were: “We could not find the evidence”
    – despite me having given links to strong evidence !

    I have had similar experiences regarding Rheumatoid Arthritis ( surely not caused by the absence of a drug ) and Macular Degeneration

    I do not think that this is influenced by the drug companies, but rather from a narrow blinkered view by their experts who really do not understand the effect of diet & lifestyle on health.

    I have been doing this for 5 years and I have now come to the view that NICE really cannot cope with “Diet and Lifestyle” – and as a result this is reflected in the knowledge and advice given by doctors.
    .

    1. Thanks for this Rufus.

      I think it’s so helpful for people to see how much is being done constantly behind the scenes to move effective, sustainable and cheap preventative healthcare forward and how strong the resistance is. It’s not conspiracy theory or thinking, it’s just stark reality. But that’s why it’s imperative for everyone to empower themselves with education and information on how to support their own health, and the health of their families. It doesn’t really matter where the resistance is coming from, the point is that radical change is not going to come from the top down. We need to drive that change. It’s what our blueprint for a sustainable health system [https://anhinternational.org/2018/06/13/anh-intl-sustainability-blueprint-pre-release-us-airing/] is all about – placing the locus of control for one’s health back where it belongs, in the hands of the individual. Of course, all modalities are then naturally included, which will take a lot of pressure off the NHS and NICE will no longer be such roadblock for proper, effective, diet and lifestyle advice.

      Roll on September and the release of the blueprint!

      Warm wishes
      Meleni

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