Cancer Complementary and alternative medicine Medicine Quackery

A ghoul descends upon the corpse of Tony Snow

I was contemplating how to get back into the swing of things as far as getting the blogging juices flowing again after the unfortunate events of the last few days, given how much my last post drained me. I suppose I could have dived into the infamous PZ versus the cracker incident, but, quite frankly, the utter ridiculousness and childishness of the whole affair bored and disgusted me too much, although I don’t rule out a brief post about it later today or tomorrow (that is, if anyone even still cares). If I do, I guarantee that my take on the whole kerfluffle will make no one happy, but it would get something off my chest that managed to bug me even last week.

Then I visited Mike Adam’s militant house of insanity known as to catch up on what “exploits” he had been up to during the days when I had been paying very little attention at all to my usual blogging pursuits. Rarely have I been as infuriated by an article I found there. My outrage, no doubt, was stoked by what had just happened. Even though Echo was a dog, cancer had just claimed a member of my family mere days ago. There I was, hating cancer more than ever because not only had one of my aunts died of it a few months ago but now my beloved dog had fallen victim to it, and then what should I see, but an “alt-med” cultist in essence pissing on my entire profession just because he saw an opening given him by the death of a famous person.

You may recall that last year I wrote about Tony Snow, the news pundit who served a brief stint as President Bush’s Press Secretary, at least until his colorectal cancer came back about 15 months ago. It turns out that Snow died of his disease over the weekend at the too-young age of 53, as I found out when several people e-mailed me links to stories about it. Indeed, he lasted about as long as one would expect a person with a presentation of metastatic colorectal cancer such as his to last, and from what I can tell he died of liver failure due to metastases. Regardless of what I thought of his politics, I felt bad for him, given his relatively young age and particularly knowing right from hearing his announcement about the return of his cancer last year that his prognosis was almost certainly quite dismal, given the information I could glean from the news reports at the time.

What irritated me is what happened next. Just as surely as day follows night and night follows day again, whenever a famous person dies of cancer soon afterward will appear the despicable ghouls looking to make score points against “conventional medicine” through the death. Sadly, Tony Snow’s death was no different, and his body was not even room temperature before the “alternative” medicine anti-chemotherapy ghouls were given voice at Mike Adam’s repository of pseudoscientific lies and misinformation in an article entitled Tony Snow Dies Following Chemotherapy for Colon Cancer (opinion), written by the lying webmaster of craziness himself, Mike Adams. Adams couldn’t even at least wait until Snow had been given a decent burial to try to spin Tony Snow’s death as “evidence” that chemotherapy “doesn’t work” and that there is a vast government-big pharma conspiracy to “poison” cancer patients and hide from them “natural cures” that do “work.” Indeed, it was eerily similar to the way he and Dr. Joseph Mercola tried to use Tim Russert’s sudden death from a heart attack as “evidence” that prescription medications for heart disease “don’t work,” either. You’ll get the idea from the very first sentence:

To anyone keeping count, the number of high-profile personalities and celebrities dying while under the care of conventional doctors and oncologists is truly staggering. Some of the more notable deaths in recent memory include actor Heath Ledger’s death following the consumption of doctor-prescribed medications, CNBC anchor Tim Russert’s death while on cardiovascular medications, and even Anna Nicole Smith’s death caused by a lethal combination of FDA-approved prescription medications.

Now, former White House press secretary Tony Snow has died at the young age of 53 following chemotherapy treatment for colon cancer. For reasons we will never know, Tony Snow chose the chemotherapy route in an attempt to treat his colon cancer, subjecting his body to systemic poisons that all the evidence shows produce absolutely no improvement in the five-year survival rate of colon cancer patients. And depending on the type of tumor, chemotherapy can actually accelerate the death of patients, killing them far more quickly than if they had done nothing(1).

There is, of course, no evidence that celebrities and politicians (or, as Adams put it, “high-profile personalities)” suffer from or die of cancer at a rate any more frequent than that of the general population, adjusted for age, race, and other risk factors. Arguably, they probably do better because they tend to be at a higher socioeconomic status and to have access to the best health care in the world. The reason they’re more noticeable when they die of cancer because, well, they’re famous people. The media reports it when they are diagnosed with cancer, reports it if they appear to have survived, and reports it when they die. Sometimes, like Tony Snow, cancer-stricken celebrities show up on TV and radio talk shows to discuss their struggle with cancer. There’s nothing magical about this appearance that lots of celebrities get cancer and nothing to suggest that celebrities are more prone to cancer or likely to die from it than anyone else. Let’s put it this way. It certainly seems that celebrities are dying all the time, but most people don’t rate a news report or a write-up in the New York Times after they die. When I die, there won’t be tributes from celebrities being televised, and no one but my family, friends, and coworkers are likely to care.

As for Tony Snow’s choice of chemotherapy, there really wasn’t any other treatment that had a chance of slowing down his cancer and modestly prolonging his life. I’m sure his doctors probably told him that his disease was almost certainly incurable. I say “almost” certainly because I didn’t (and still don’t) know enough about the anatomic extent of his recurrence. My interpretation from what I could read at the time his recurrence was announced was that he had tumor in the abdominal cavity near his liver and growing into his liver. If that was true, his disease was almost surely incurable by any means. If it was metastatic only to the liver and nowhere else, he might have had a chance of long term survival through surgical resection of the metastases. Indeed, that Snow apparently never underwent a liver resection strongly suggested to me that he did have carcinomatosis; i.e., tumor growing in his abdominal cavity, having spread along the peritoneal membrane. While there are surgeons, such as Dr. Paul Sugarbaker, who will attempt incredibly aggressive surgery to resect all visible tumor deposits and then infuse chemotherapy directly into the peritoneal cavity to try to kill any leftover deposits of tumor, long-term survivors undergoing such procedures are rare and, in my opinion, good results from such radical and aggressive procedures are very likely more a matter of careful patient selection than a reliable increase in survival. These were the same issues that I discussed when examining the unfortunate case of Karen Pasqualetto, an even younger woman with the same type of cancer and a similar dire prognosis.

If you want to see how mendacious, how deceptive, how disingenuous, how utterly vile Mike Adams is, though, look no further than the article he cites to demonstrate that “chemotherapy is useless.” Not surprisingly, it shows nothing of the sort. Equally unsurprisingly, Adams does not provide a link to the study, only a cryptic list of authors and a title. Anyone who wants to find out what the study really concludes would have to do some work, and Adams knows that most people won’t.

I will, however.

The study in question was actually reported reasonably well in this article, and the study was presented at the American Society of Clinical Oncology meeting a month and a half ago. It hasn’t been published as an article yet. From my perspective, there are three reasons why citing this study to support an argument that chemotherapy is useless against colorectal cancer is about as deceptive as it gets. Here’s the first reason: It shows no such thing, and in fact, except for a subset of patients, it shows exactly the opposite. Basically, what the study found is that if there is a defect in the DNA mismatch repair system in colorectal cancer (labeled dMMR for “defective mismatch repair,” as compared to tumors with an intact DNA mismatch repair system, which were labeled pMMR), then there is no benefit due to one kind of chemotherapy when it is given as adjuvant therapy. Moreover, part of the results of the study show that chemotherapy does in fact prolong survival in the vast majority of patients (84%) who do not harbor the genetic defect under study:

For their study, the researchers analyzed data from more than 1,000 men, 16 per cent of whom had dMMR tumours.

They found that the patients who had the chromosomal instability type of tumour and who were treated with chemotherapy had a five-year survival rate of 74 per cent. Those who did not receive chemotherapy had a five-year survival rate of 66 per cent.

For patients who do harbor the dMMR-type of tumor (the tumor defective in DNA mismatch repair):

However, among those with dMMR tumours, the five-year survival rate with chemotherapy was 75 per cent compared to a 93 per cent survival rate among those that did not receive chemotherapy.

“We think it is very important for patients and their doctors to have this information before considering treatment in a patient with stage II colon cancer,” Daniel Sargent, a Mayo Clinic biostatistician, said in a statement.

“It could save patients the toxicity, inconvenience and expense of treatment from which they will receive no benefit.”

The study says that before diagnosing a treatment regimen, doctors should test stage II colon cancer patients to determine which tumour subtype they have. In stage II cancer, the disease has not yet spread to the lymph nodes.

Note that the difference between 75% and 93% was not statistically significant due to small numbers. In essence, the study found that for patients with dMMR tumors successfully resected surgically chemotherapy provides no additional benefit in terms of improving survival. But for the vast majority of patients, this study confirmed that adjuvant chemotherapy prolongs survival in appropriately selected patients with colorectal cancer.

Now here’s the second aspect of this that shows that Mike Adams is either a liar or utterly clueless (take your pick). This study looked at only one form of chemotherapy. True, it was the predominant chemotherapy regimen until a few years ago, and the drug 5-FU is still the mainstay of most chemotherapy regimens, but at worst this study shows that 5-FU-based chemotherapy regimens don’t help in the adjuvant therapy of dMMR-type colorectal cancer. Other chemotherapy regimens, such as the newer ones being used with reasonable success these days may well be just as effective in these tumors. Indeed, drugs designed to target the repair defects in dMMR tumors might actually be more active against these tumors and result in a significant prolongation of survival. We won’t know until we do more research.

That’s what scientists do. We try to find out where our therapies are doing good and where they’re not doing so good and then try to make them better. In this case, it means identifying a molecular subtype of colorectal cancer that makes it resistant to standard adjuvant chemotherapy regimens. Good scientists then try to use their evidence to persuade physicians to adopt their method to improve the care of cancer patients. Meanwhile, they are also frank about the limitations of their studies and point to new unanswered questions that require study.

The final nail in the coffin burying what little integrity Adams may have had is that he confuses different uses of chemotherapy. The study Adams cited examined adjuvant chemotherapy. Adjuvant chemotherapy is given to cancer patients after successful surgical extirpation of the tumor. Its purpose is not primary treatment, but rather to “clean up” any microscopic deposits of tumor that may have spread from the primary tumor mass and thereby prolong overall survival and disease-free survival. This is very different in intent than the chemotherapy given to Tony Snow, who already had stage IV disease involving more than just the liver. In that situation, chemotherapy is the primary treatment, and the intent tends to be palliative from the beginning, because we know the disease is no longer curable. However, time of survival and quality of life can both be significantly improved by the new generation of chemotherapeutic, antiangiogenic, and targeted therapies, as The Cheerful Oncologist pointed out last year. In fact, I liked The Cheerful Oncologist’s posts so much that I’m going to steal the graph that he stole from this article to drive the point home:


As one can see, the survival for untreated metastatic colorectal cancer (mCRC) is in the range of 4-6 months. Older adjuvant chemotherapy regimens could result in median survivals of approximately 12 months. Over the last decade or so, recently developed chemotherapy regimens have pushed the median survival to nearly two years. In fact, my best friend’s father is evidence of that. He has metastatic colorectal cancer but has been doing well for quite a while now. He even still plays golf regularly. He knows that sooner or later his cancer will claim him, but in the meantime he’s enjoying his life for as long as possible, which is all that any of us can really do. As the authors conclude:

FU has been the cornerstone of treatment for mCRC for over 40 years. In the past few years, the introduction of more effective chemotherapeutic agents and targeted agents with their promising activities and mild toxicity profiles has pushed the overall median survival time from 12 months to 2 years. However, as discussed, there are still many challenges facing oncologists. Research is ongoing to understand these issues, and significant advances are expected through the implementation of well-designed clinical trials and continued preclinical investigation.

It was science that accomplished this. Not the outrageous quackery that flows from the servers holding Mike Adam’s gigabytes of anti-science blather. Science. Not homepathy, reiki, herbal remedies, vitamin concoctions or any other manner of cancer quackery. It was science. That we can’t cure colorectal cancer once it’s metastasized is a remaining challenge to be overcome. If this challenge is to be overcome, it is science that will overcome it, not woo. To argue that chemotherapy never works and kills more cancer patients than it saves, as Mike Adams does, is a lie. Remember, Adams isn’t just saying that chemotherapy sometimes does no good or that it’s too often used in situations where we know it won’t do any good. Those would be reasonable criticisms, but Adams is not a reasonable man. In fact, if Mike Adams truly believes this stuff, he is deluded. If he doesn’t, he’s a liar. Either way he’s wrong, and his propaganda is dangerous to cancer patients in that he frightens patients away from therapies that might actually prolong their lives and improve the quality of life of the remaining time they have left, while trying to lead them down the same sort of pursuit of quackery that has resulted in cancer patients dying who might have survived.

Of course, this is Mike Adams. Just when you think he can’t get any more stupid, he straps on some stupid-fueled rockets and blasts his stupid into the stratosphere and beyond. Indeed, after this article, no doubt Adams’ stupid is still orbiting the earth, lowering the IQ of people unfortunate enough to live directly under where it passes.

Sadly, Mr. Snow was apparently unaware that colon cancer is rather easily cured with plant-based medicines. By avoiding toxic chemicals, animal products and dangerous prescription medications while switching to a nutrient-dense diet of raw, living green juices from fresh vegetables, virtually anyone can reverse colon cancer (unless, of course, they’ve already gone through chemotherapy, which causes permanent damage to their immune system).

Fresh vegetable juices are absolutely loaded with anti-cancer phytonutrients: Broccoli, cabbage, kale, spinach, celery and even citrus fruits and berries have such powerful anti-cancer properties that Big Pharma’s highly toxic chemicals, by comparison, don’t even compare ( Had Tony Snow adopted a raw, vegan diet and engaged in high-volume vegetable juicing immediately upon learning of his colon cancer diagnosis, I have no doubt he would still be alive today.

How convenient. If you’ve already tried effective therapy, according to Adams, there is no hope that plant-based medicines can help you. It’s also a lie that any of the things Adams mentions can reliably reverse or cure colorectal cancer. If this were true and it was so straightforward to cure colorectal cancer, where, I ask Adams, are all the survivors? The crickets chirp loudly, don’t they? Either that, or Adams will point to people who had successful surgical resection of their tumors but eschewed chemotherapy, which is nothing more than the same sort of deception that is frequently used in breast cancer testimonials for alternative therapies. Just as with breast cancer, the surgery cures the cancer, and chemotherapy is the icing on the cake that decreases the chances of the cancer coming back. In any case, there is no evidence that any of the modalities mentioned by Adams would do one whit against full-fledged metastatic colorectal cancer or that Snow would still be alive today if he had only listened to Adams and followed a raw vegan diet.

What twaddle!

You’re probably wondering if Adams can sink any lower in this article. That would be the sort of question a reasonable person would ask, but, as I pointed out earlier, Mike Adams is not a reasonable person. There appear to be no depths to which he would not sink if doing so would allow him to attack “conventional” medicine. Not content with mere stupidity, he has to turn utterly vile. First he mentions that the President of the American Medical Association was diagnosed with pancreatic cancer and chose to undergo palliative chemotherapy, which is true. It is well known that pancreatic cancer is deadly, and in essence no one survives if the cancer cannot be completely removed by surgery. That does not imply that chemotherapy is useless, as it can provide palliation and a slight prolongation of life, even in pancreatic cancer. Not that that stops Adams from waxing wroth:

Chemotherapy is quackery, too, and those who choose to poison their own bodies with extremely toxic synthetic chemicals are blindly following nothing more than the lies and deceptions of the cancer industry (which preys upon consumers, invoking fear to convert human beings into corporate profits).

People who die from chemotherapy are, in fact, collectively winning the Darwin Award. To poison your own body with dangerous chemicals isn’t “medicine” or “treatment.” It’s not courageous or considered. It’s just plain stupid. As is most of modern medicine.

Stabbing your eye with a fork is stupid. X-raying your feet to see if your shoes fit is stupid. Drinking mercury to cure “evil spirits” is stupid. And shooting up your veins with extremely toxic chemicals is stupid, too. Oncologists can wear the costumes of doctors; they can speak a high-brow-sounding language of technical jargon; they can even be licensed by the State; but in the end, they are just as stupid as a guy who bungie jumps off a bridge with cord wrapped around his neck. (Bungie jumping has far fewer fatalities than chemotherapy, by the way…)

No, taking Mike Adams’ word seriously about anything having to do with medicine is stupid, as would be relying on any therapy advocated by Mike Adams. It’s a good rule of thumb, at least, though. I have yet to find an exception. Mike Adams even has a hard time getting it right about whether or not vitamin D supplementation might be beneficial. Indeed, if you want to win the Darwin Award, listening to Mike Adams about health would be a far better way to go about doing it than almost anything I can think of, short of a spectacular flaming end in a real life version of the the infamous JATO urban legend.

What is left? How low can Adams go, you might ask? Surely you can guess. When someone like Adams gets this low, there’s only one path left that he can travel to sink even lower:

It’s silly to honor someone just because they’ve died. What matters is what they did when they lived. Would you honor Hitler at his grave? Of course not. People like Hitler deserve condemnation long after they’ve passed away. So what about Hitler press secretary? Does that person deserve honor upon passing, or is scorn more appropriate?

Having read this article, I had considered doing a Hitler Zombie attack on Mike Adams, except that he’s used overblown Hitler analogies so often that I can only conclude that the fetid Führer has chomped so much of his brain that there’s nothing left–except perhaps the hypothalamus (so that he can keep breathing) and perhaps a reflex to his typing hand sufficient to let him churn out his spew in much the same way that the proverbial millions of monkeys could produce the works of Shakespeare if given enough time. Fortunately, this isn’t the work of Shakespeare; all Adams’ work requires is the ability to type terms like “allopathic,” “poison,” “natural cures,” and “big pharma conspiracy” at random, with the occasional verb. In any case, in so enthusiastically invoking Godwin’s law, Adams shows just how intellectually bankrupt he is.

Finally, in a statement that utterly shattered my irony meter, leaving nothing more than molten plastic and rubber, bare coppery wires, and a vaguely quivering needle begging for mercy, Adams finishes:

What, I ask you, did Tony Snow ever do to benefit humankind? I can’t think of a single thing. In fact, his actions actually went a long way towards deceiving humankind.

I don’t believe in a literal place called Hell, but from listening to some of George Bush’s religious comments, it’s pretty clear that he does. And that means he and Tony Snow will someday be meeting there in a new, fiery briefing room. Maybe Tony Snow can serve as the press secretary for Satan himself!

Of course, for Mike Adams, whose actions go a long way towards deceiving mankind himself, to accuse anyone of lying or deception is a case of “pot, kettle, black.” So is his question of what Tony Snow ever did to benefit human kind. After all, I can’t think of a single thing that Adams has done to benefit humankind, but I can think of a lot of things he’s written and promoted that are harmful to anyone seeking care for serious medical conditions. If Adams thinks that Tony Snow can be the press secretary for Satan himself, I submit to you that if there’s a Hell, Mike Adams after he finally dies will be serving in it as the medical advisor “for Satan himself.”

It would certainly be appropriate. After all, if you believe in ghouls, you already know that Hell is where they come from and Hell is where they end up.

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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