Cancer Complementary and alternative medicine Politics Quackery

Ron Rosenbaum on the Cherrix case

Ron Rosenbaum on Starchild Abraham Cherrix and his choosing the Hoxsey treatment over chemotherapy:

Young Cherrix has expressed his feelings this way to the Associated Press: “I’ll fight until I do die. I’m not going to let it go. I would rather die healthy and strong and in my house than die in a hospital bed, bedridden and unable to even open my eyes.”

It’s a moving and heartfelt plea, but a problematic one as well. My instinct to support young Cherrix on libertarian grounds is undermined by the not quite fully developed thought process this statement suggests.

Is the choice he faces really the one he poses? Does one die from cancer (or any illness) when one is “healthy and strong”? Or is the fact that he feels good now deceiving him? Is he thinking like an “adult” or like a “juvenile” who needs advice and protection? Of course, the thought processes of many adults are not necessarily “fully developed,” but that’s not because of their age.

Is Abraham capable of making a rational choice? Does the state have the responsibility or the right to step in and make what it thinks is the rational choice? (Especially when states are not notable for their record of “rational choice.”)

These are exactly the issues I’ve been discussing with regard to this case.

His description of a visit to the Hoxsey clinic that Rosenbaum himself made:

In shabby clinics cheek-by-jowl with auto theft/repair junkyards and in grand, deluxe, ocean-side playas, we had fascinating talks with some of the patients. We hit the historic Tijuana clinic hotspots, among them the Hoxsey clinic, a kind of relic of a charismatic “healer,” Harry Hoxsey, who in the first half of the last century peddled a mysterious “tonic” in clinics in 17 states before he was driven by the law beneath the border.

At the time I visited the clinic, it was being run by Hoxsey’s original nurse, a kindly-seeming woman who gave one particularly impoverished member of the carful of cancer patients I was traveling with a bottle of the tonic gratis. When I ventured that I’d like a taste, she poured out a little from a large brown bottle into a paper cup. It tasted like gnarly cough syrup. The problem with the Hoxsey tonic is that there has been a running dispute over its actual composition and thus, to my knowledge, there have been no clinical trials of its value. Indeed, in one of the paradoxes I found in the below-the-border realm, “value” is something these remedies are endowed with by the patients rather than vice versa.

Indeed, this is the magical thinking that I have described, where belief in these remedies gives them their value, rather than actual objective evidence of their efficacy, and I think that Rosenbaum comes closer to why the belief in these clinics is nigh religious in nature:

I’ve evolved a theory of the below-the-border “cancer cure” clinics, which is that the science, almost without exception, is bogus–but that the cancer patient’s decision to make the break with orthodoxy, to cross the border (a border that is not just geographic but psychological), to take control of one’s destiny and place one’s faith in a cure (however baseless its science), in the psychogenic power of hope (even false hope), might have had some hyped-up placebo effect in making a difference in the lives of those who went that route.

Maybe. However, no study that I’ve ever seen has ever actually shown that a placebo affect can increase survival in terminally ill cancer patients. Certainly the placebo effect can account for a decrease in pain or other symptoms, but, as far as we know thus far, it can’t prolong survival. Consequently, I find Rosenbaum’s postulate unconvincing in that respect, but I do agree that part of the appeal of these clinics is indeed the liberating effect that a “break” with orthodoxy can produce, that feeling of “taking control” of one’s own destiny.

And that’s part of the problem. That very feeling of empowerment is tied up with the false hope that the Tijuana clinics promise. That’s what makes such quackery so seductive.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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