Cancer Medicine Quackery Surgery

Holiday weekend reader mailbag: In which Orac is chastised for “condemning someone who helps people”

The Thanksgiving holiday weekend continues here in the U.S., and, believe it or not, I plan on taking it fairly easy, hanging out with my wife and (hopefully) going to see the new Harry Potter movie later today or tonight. However, even so, I can’t resist doing a bit of holiday mailbag fun, first because it’s easy, but more importantly because this time around it’s instructive. A new reader, who obviously found this blog through a Google search on something or other writes:

Hello Orac, I stumbled across one of your blog pages and I felt compelled to share my story with you.

Seven years ago I noticed a huge lump on my left breast that sprang up quickly and went in for a mamogram. I have really dense fibrocystic breasts so it all looked like a huge mass, the radiologist couldn’t really see anything so they did an ultrasound. What they found was a really huge mass growing on my chest wall (stage 4 – 95% chance of it being malignant) and they told me I needed emergency surgery and I would most likely lose my entire breast. Having no insurance and parents who were ill and counting on me to help them and knowing that even with the best treatment survival for a stage 4 breast cancer would only be 5 years anyway, I opted to do the parasite cleanse. I was terribly frightened but had no choice.

Six weeks later I returned for another ultrasound and the Surgeon yelled at me accusing me of doing something “Where the hell is it – what did you do?” !!!!! I told her nothing but meditation and prayer but actually it was whole food nutrition, the parasite cleanse, meditation, prayer, faith and the sincere desire to get well enough to continue to be of service to others. She was pissed! Why? Because I was WELL !!!!! Of course she lost a huge amount of money by me not following her treatment plan!

So tell me Dr. Orac, how can you condemn someone who helps people. I know people who have had cancer over and over again with conventional treatment and it keeps coming back, time and time again and yet you don’t condemn those doctors? I can only say that any doctor, conventional or alternative, that does not support thier patients beliefs is who operates as a Quack! Here it is 7 years later and I still have my life and my breasts. I sincerely hope you never have to live through the mental torment that a cancer diagnosis brings or the humiliation of being treated by someone who finds it more important to be right than whether thier patient is still alive and in one piece.

Regular readers, I ask you to evaluate this story. I will evaluate it as well, but below the fold. Try not to peak at my answer before coming up with yours.

I had two immediate reactions to this testimonial. My first reaction was, if her story was true, that her surgeon was not only incompetent but an asshole. The first thing any decent breast surgeon (or any general surgeon or surgical oncologist who does breast surgery as part of his or her practice) would want in this clinical situation would be a tissue diagnosis. Given that the mass was large, it would be a chip shot to get a tissue diagnosis using a core needle biopsy. No need for extensive surgery! If the mass is palpable, it wouldn’t even be necessary to use ultrasound to guide the biopsy. Of course, I strongly suspect that my critic is either exaggerating or telling a highly biased version of the story. It’s pretty rare in my experience for a surgeon to yell at a patient in this manner, although it is not uncommon for us to try to persuade a patient who is undertaking a potentially harmful course of action not to proceed with her plans. My guess is that the surgeon would have a very different story to tell. My second reaction was that “stage 4” is a meaningless term when applied to a mass that hasn’t even been shown to be cancer yet. My guess is that this woman confused “stage 4” with “category 4.” You see, radiologists score mammogram and ultrasound studies according to the Breast Imaging-Reporting and Data System (BIRADS). The BIRADS classification system is designed to force radiologists to come up with an estimate of what the likelihood of malignancy is based on imaging studies alone. Scores are as follows:

  • BIRADS 0: More imaging is necessary to make an assessment
  • BIRADS 1: Normal. No evidence of malignancy.
  • BIRADS 2: Benign findings.
  • BIRADS 3: Probably benign. Basically, the standard of care for BIRADS 3 mammogram/ultrasound studies is to recommend a repeat study in 6 months. The rate of malignancy in such studies is well under 1%, and virtually all such malignancies found are stage 0 or 1. That’s why it’s safe to wait 6 months and re-image.
  • BIRADS 4: Suspicious for malignancy. Approximately 20-25% of BIRADS 4 studies turn out to be malignant. We recommend a biopsy for almost every woman with a BIRADS 4 study.
  • BIRADS 5: Very suspicious for malignancy. Approximately 70-90% of BIRADS 5 studies turn out to be malignant. We recommend a biopsy for every woman with a BIRADS 4 study. We also warn them that they have a high probability of having breast cancer–although not 100%.
  • BIRADS 6: Known biopsy-proven cancer.

What almost certainly happened is that my critic had a BIRADS 4 imaging study, in which case she had a 3/4 chance of not even having a malignancy at all! Given that her lesion disappeared, the most likely explanation for her testimonial is that she never had cancer at all, particularly given that she never had a biopsy. This is quite consistent with several other testimonials I have discussed over the years. In general, the explanations for such testimonials fall into a few well-defined categories. Either the woman never had cancer at all, which is most likely what’s going on here. After all, to emphasize the point, in my critic’s case there was never a biopsy to prove that she had cancer, and not all breast masses are malignant. Alternatively, in other testimonials, the woman did have cancer that was properly diagnosed but also had some conventional therapy (such as surgery) and only refused some therapy (such as chemotherapy or radiation, or the woman doesn’t understand the inherent variability in breast cancer biology that produces a subset of breast cancers that have a very slow-growing, indolent course. Often the cancer patient giving the testimonial has serious misunderstandings about her disease and prognosis, often confusing terms like “category” and “stage” or “grade” and “stage.”

As for the last bit. I’ll tell my critic how I can condemn someone who helps people: They don’t. The “parasite cleanse” and prayer might have made this woman think she was feeling better, but neither did anything for her breast mass, which almost certainly was not malignant and almost certainly resolved on its own, as, for example, cysts sometimes do. Breast cancer is not caused by parasites, and, unless a practitioner advocating such quackery can produce scientific evidence sufficiently compelling to make me doubt our current understanding of breast cancer, there is no reason to suspect that such quackery does anything other than put my critic at risk for dehydration and other potential complications. As the saying goes, the road to hell is paved with good intentions, and a quack’s allegedly good intentions do not excuse him for pushing therapies that do no good and have the potential to cause harm, either through delay in seeking known effective, science-based therapy or direct harm from the quackery itself.

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]

58 replies on “Holiday weekend reader mailbag: In which Orac is chastised for “condemning someone who helps people””

Thanks for writing posts like this, Orac. It must be tedious to do, but when all the alt-med people have is testimonials, we need deconstruction after deconstruction. Your point about misunderstanding the very important differences between technical terms that may seem synonymous to a layman, and the two most likely situations in these testimonials, should be shown to everyone who wants to support their favorite “alternative” treatment with an anecdote.

To defenders of the anecdote: note that Orac’s first comment was:

My first reaction was, if her story was true, that her surgeon was not only incompetent but an asshole.

All professions have assholes, including medicine, and their existence does not invalidate science.

What almost certainly happened is that my critic had a BIRADS 4 imaging study, in which case she had a 3/4 chance of not even having a malignancy at all! Given that her lesion disappeared, the most likely explanation for her testimonial is that she never had cancer at all, particularly given that she never had a biopsy.

Pseudoscience thrives on ignorance. Period. Quacks who encourage and take advantage of that ignorance are far from helping people. I echo Madder above in giving thanks to you, Orac, for educating people is possibly the only lasting way to battle pseudoscience, and the educators have to relentless because pseudoscience is a Hydra-headed monster.

There was a letter to the editor of my local paper recently, about a case of similarly miraculously cured prostate cancer. The testimonial followed a nearly identical script: man is diagnosed with prostate cancer, follows healthy diet and exercise plan (fortunately, he didn’t claim to use parasitic cleanses, just the usual lifestyle modifications we encourage at any typical office visit), cancer miraculously disappears, his doctor who he claimed was pushing for immediate surgical intervention is astounded by this result. Of course, a few things were left out: his age, ethnicity, family history, and most importantly, whether the “diagnosis” was actually just an elevated screening PSA level.

One example from my life about an incompetent doctor: My mother was having bladder troubles, blood in her urine, trouble with pain caused by acidic foods (like orange juice or cola), along with always being too hot or too cold. She ended up going to the hospital where she got care with a doctor who performed a quick surgery that pretty much gave her a device she could wire into herself to control her bladder. Despite the doctor’s assurances, it wasn’t helping.

So my mother did the sensible thing: She changed doctors. The new doctor ran a test that even laypeople like us should have considered: He looked for a bladder infection, found it, and treated it. The reason it wasn’t immediately expected was because she didn’t have a regular fever. Diseases don’t have rigidly fixed symptoms, and this one managed not to cause a standard fever. Thanks to some appropriate antibiotics, she was back to normal in a week. If the infection wasn’t treated, she could have died.

I’m sure that being able to remote control your bladder has reasonably well documented uses and has probably made some people’s lives easier by solving their particular form of bladder problems. But I think that first doctor was so enamored by his skill with that particular hammer and his success stories of helped patients, he didn’t stop to think that the problem might not be a nail.

That’s a danger that can happen if you’re so focused on the idea that you’re helping that you don’t bother to see if you actually are helping. Even real doctors who use actual, useful procedures can lose their objectivity, overlook clues, or fail to consider other possibilities. Even compassionate people who sincerely want to help can fall victim to their own egos.

Now imagine if that story involved a quack using an unproven procedure.

It’s *very* easy for me to “condemn” those who “help people” by offering illegimate medical advice – or discouraging SBM – whether they are sincerely mistaken or the most mercenary of quacks : because the results can be the same.If you scan websites I frequently bash, you’ll notice a cavalier attitude, a lack of concern about consequences, as well as the arrogance – and lack of self-awareness- of ignorance, that lead me to suspect that we are not only dealing with negligent business practices but with mental health issues as well. Recently web woo-meisters Adams and Null have been venomously attacking the DSM V’s additions: ( paraphrase) ” Now they are calling people who want to *eat healthily* and *oppose authority* mentally ill!” ( Not exactly the first two diagnoses that would cross my mind for those two). It appears that their vitriol is without bounds when discusing pharmaceuticals for mental illness and cancer. I wonder why ? Possibly, their greatest fears ? Interestingly enough, their prescriptions for those two categories of illness are pretty much the same -diet, supplements, exercise, meditation- DIY therapy to negate helplessness unrealistically.

There is only one answer to this. SECOND opinion.

Posted by: Fang of Darkness | November 26, 2010 12:33 PM

NO, there is a second answer, continue with the original workup. I can’t imagine that an ultrasound followed by biopsy, if indicated, was not recommended. But the cost of that may have been more than prayer and a parasite cleanse, whatever that is (do you end up with really clean parasites?).

Great post. The only thing I would note is that this woman had NO INSURANCE. Having lived in a couple of very woo-prone communities (where every other person was a practitioner of some kind of woo), I can’t tell you how many people got into it because they couldn’t even go to the doctor to begin with, let alone follow up with expensive lab tests. I didn’t have insurance at the time and whenever I would get the money together to pay for an office call, I would then have to try to figure out how much I could scrape up for lab tests. This leads a lot of people straight to the health food store–where they will find ample sympathy about “evil allopathic medicine” and “money-grubbing doctors, to say nothing of a boatload of anecdotes about “miracles” like the one described in your post. They forget all about the woman next door who died in spite of all these “remedies” or insist that she lived longer because of them. I realize that woo is pretty strong elsewhere in the world, even when “socialized” medicine is in place, but at least in those countries, people can do BOTH and may, therefore, reap the benefit of SBM while dabbling in woo (not that I recommend that).

In one of these communities, I was referred to an agency that helped out with the medical, but in the other, nothing of the sort was forthcoming and I, too, stopped off at the health food store and dabbled (briefly) with a bit of woo, mostly because I knew the woman who ran the place. Lack of access can lead even a skeptic to desperate measures, and then if the problem resolves itself, well–anyone without sufficient science knowledge might easily credit the woo. Luckily, my science training soon came to the rescue, and then I was promptly ostracized by the New Agers all around me. Oh well.

Obviously this woman did not have cancer in the first place.

Odds are extremely high that the “emergency surgery” she claims to have been offered would not have been undertaken without prior biopsy confirmation of malignancy, and nowadays most surgeons don’t even contemplate mastectomy with intraoperative (frozen section) diagnosis to confirm malignancy.

Odds are also high that this person is severely mischaracterizing (or completely misunderstood) what her physician(s) told her, including the claim of being yelled at for no longer having a mass.

I see from Orac’s response that he has come to similar conclusions, though we may differ slightly on the odds of running across a surgeon who is an asshole. In my experience as a pathologist, this phenomenon is not extremely rare, but even the ones who are assholes seem to be much nicer to their patients than to the pathologist. 😉

Maybe the “emergency surgery” *was* the biopsy. And maybe “losing the whole breast was “what might happen if this thing turns out to be malignant”.

We offer your child the opportunity to be part of this project and to access to the Montagnier Infection Screen protocol. There will be medical follow up from Dr. Skorupka. The details of the project are outlined below. The total cost per child is likely to be around £1800, spread over a six-month period (details below). The antibiotic treatment is not included and may cost some £30- £60 a month, depending of the particular antibiotic selected. Every two months each child’s progress will be reviewed by Dr. Skorupka and Dr. Amet at ATT with interim progress reviews carried out by phone.

“What the heck is a “parasite cleanse”?”
A very important question. It sounds to me like some kind of variation on the delusions of self-described “Dr.” Hulda Clark, who claimed that cancer was somehow caused by intestinal parasites, which could somehow be killed by her “zapper”. The “cleanse” might have been a laxative, which would actually help someone who DID have an actual parasitic worm infection. Then again, it may be that the patient fell for a form of Clark’s “zappers”, which certainly had no conceivable value against actual parasites, and as far as I can tell were never established to have any function whatsoever.
Clark died of cancer, but unfortunately, her work is still promoted, and her former publicist Tim Bolen is still ranting away.

Maybe while on her “cleanse” she cut out drinking coffee. With those fibrocystic breasts, coffee can make them even lumpier.
Went into the doctor’s office many years ago sure that I had breast cancer and the first thing she asked me was “how much coffee do you drink in a day”. Needless to say, I cut right back to only 2 cups/day (yes, I drank an unhealthy amount of joe) and within a couple of days there was a dramatic decrease in lumpiness. Cancer cured!

There are roughly a billion “cleanses” being promoted on the Internet these days, guaranteed to rid your body of parasites (real and imaginary), cancer, nagging zits, bad humors etc.

Sometimes the recommended “cleanses” are herbal. Often they involve enemas and purges, based on the idea that nasty nasties are living in your G.I. tract and even if they aren’t there is actual STOOL and TOXINS in there which are really yucky and need to be cleansed, otherwise you will wind up like John Wayne with 200 pounds of poop clogging your bowels and making you feel sluggish and cranky or even dead.

More info here for the parasite-ridden who would like to purchase relief but can’t afford a biopsy. And even if you turn out not to have parasites you are guaranteed to have your wallet cleansed of bacteria-ridden cash which could be making you sick.

The testimonial said:

I told her nothing but meditation and prayer but actually it was whole food nutrition, the parasite cleanse, meditation, prayer, faith and the sincere desire to get well enough to continue to be of service to others. She was pissed!

You’ve got to love how these testimonials wrap themselves in appeals to religious faith and “genuine intention” of getting better. Apparently, those who died didn’t pray and didn’t really want to get better. Why not call their patriotism into question too?

The “why me?” element is usually palpable in these testimonials. There’s a guilt trip here. Emotions and social pressure are used to goad people into following quacks.

From the sounds of the story, the woman has never had cancer nor any serious illness requiring repeated and/or prolonged interaction with physicians of any kind.

Moreover, were her story to be true I would not be angry with the “science based medicine” establishment–I would be angry with the person who figured out how to make cancer go away in six weeks and yet failed to properly communicate their finding to the world.

It’s my impression that “cleanses” tend to have at least plausible value, for those who might have GI/bowel problems. It also seems plausible that such problems might accompany a purely psychosomatic “illness”. In such a case, having the more or less objective (if psychologically induced or aggravated) problems relieved might convince the person that the perceived root “illness” has been cured.

Incidentally, as a Christian, I rather resent having “prayer” mentioned alongside what is clearly a “quack” cure. Personal religious exercises have a place in medical discussions, at least as part of the psychological end of the mind/body interplay. Pseudoscience which would clearly have no value for a specific illness even if it did what it is supposed to only muddies the waters.

This does bear some of the features of an “urban legend” narrative. It could just be a person’s memory arranging itself according to literarary archetypes. Or, it could be that this is a “faxlore” phenomenon, one of those fake but untraceable stories copied and circulated by people who seem sincerely fooled.
Putting chuks of the text in advanced searches would be a good way to test the latter model.

The psyllium husks, mentioned in DB’s link for parasite cleansing, are taken by mouth. They are usually passed and can be mistaken for small whitish parasites in the fecal matter. When people swear they’ve seen the parasites come out in the cleanses, it is usually because of something like this.

A grapefruit-based enema will also make people think they’ve flushed out parasites.

Sort of reminds me of the gall bladder cleanse where people drink a large amount of oil and then think they’ve passed gallstones with their fecal matter, when what they’re looking at is the product of the oil going through the body to make solid globules. Those globules float in water (gallstones sink), can be cut in half with a knife (gallstones usually a whole lot tougher/stonier), but people don’t realize that so promote gall bladder cleanses (and parasite cleanses) because they work (and they often have the pictures to ‘prove’ it–ugh!).

The first thing any decent breast surgeon (or any general surgeon or surgical oncologist who does breast surgery as part of his or her practice) would want in this clinical situation would be a tissue diagnosis. Given that the mass was large, it would be a chip shot to get a tissue diagnosis using a core needle biopsy

Yep, thats what I was thinking too. Clinical laboratories get that kind of stuff all day and night.

I have seen a lot of similar stories on pro lifer sites about how “the doctor said” or “the tests said” about birth defects (when the initial tests are not absolute positive or negative but instead give an estimate of the CHANCE of having certain defects). Then their kid was born perfectly healthy, and the people telling the story pose it as though it was in defiance of medical technology. I think that the lack of understanding of science in the general public makes it hard for people to genuinely understand what the doctors are trying to tell em, and what the lab results say. The medical people are coming from a totally different knowledge base so miscommunication is common.

Like with the second visit making the surgeon angry- there are plenty of doctors who get FURIOUS when they are wrong for whatever reason (and non doctors too). Anyone who has worked with doctors knows the god complex that crops up- people who believe themselves to be infallable, and take it out on everyone else when they make a mistake. Its happened to me plenty of times, where the lab was given completely ridiculous requests of various sorts. I doubt the outburst had anything to do with money. Its not like surgeons are hurting for patients or something.

I don’t know enough about breast lumps to say what could have happened with hers. It is really impossible for anyone to say without having the *actual* information about her available. Its not like medical history and data from her case are soooo relevant to determining what happened.

i’ll bet the story is total BS made up by a group of people and the lady in question does not exist.all these read like those “make a story” magnets you stick on the refrigerator.

Saying that the problem with testimonials like this is the potential false positive case where the disease wasn’t actually present is only half the story. The other half is that the women who had their parasite cleanse(whatever that means) who really had cancer are likely too dead to provide contradictory testimonials. No medical intervention is 100% effective–where are the ones who failed and what were their results?

My reactions to this story, as someone who is in remission from stage 3 breast cancer:

No biopsy? Cancer diagnosed on the basis of a mammogram and an ultrasound scan, and not only diagnosed but staged?

No mention of where the cancer had metastasised to…

And the absurd caricature of a furious surgeon yelling ‘where is it?!’ when she presented with no tumour six weeks later…

My evaluation: pack of bloody lies.

Now I’ll look at yours 🙂

Ah. I didn’t read the story thoroughly enough.

There was never any diagnosis of cancer, simply a concern that the mass may be malignant, and if the story were true the woman would indeed have confused her breast imaging category and staging.

I still say it’s a crock; but I bet this isn’t the last we see of the story and it will reappear all over the internet

#26, a lot of people don’t understand when doctors tell them that something is the most LIKELY result. A number of doctors have complained that women who took the HPV vaccine thought they didn’t need a pap smear anymore- the women did not understand that the vaccine is not 100% protection against cervical cancer. I’m not sure if the problem is the doctors not explaining things clearly, or the patients not understanding what they’re told, or both. (Probably both.)

Anthro… you and I must live in the same neighborhood.

Another gem of a post Orac. Really good. Thank you.

Me and the ‘ol lady are both survivors. No insurance anymore either. Next time, if there is one, we’re both toast. California. No options.

But woo… never.

Thank you for de-constructing this Orac. I’m presented with woo stories like this almost once a week from friends and family, and your website is my primary source of education for use in picking apart the nonsense.

This story, if Orac’s assessment is right, perhaps highlights the need to rethink the category and staging nomenclature. Perhaps instead of BIRADS 0-6 it should be BIRADS A-G?

I went through the exact same thing with one of my aunts. She had a mass on her breast which she refused to have biopsied because of her fear of what the diagnosis could have been. Weeks later, the mass grew and eventually burst through her skin in what I, as a microbiologist, can only describe as an anaerobic infection of a cyst. The smell was foul, and it filled up the room.

Of course, she says this was cancer, and that her prayer and fasting took care of it. The statistical likelihood of that is negligible. But, like someone else wrote above, no biopsy = no cancer.

Anyone seen this before? This guy claims to have the cures for cancer, and to have discovered the causes of cancer. It’s unusual in that he seems to have absolutely everything at the one time- you have to eat organic, raw, live foods; you should take colloidal silver for infections/cancer; cancer’s caused by acid; diseases (including cancer) are caused by stress; cancer’s caused by eating too much sugar which ferments in the body and makes gas go into the bloodstream; lack of oxygen (caused by processed foods) causes cancer; ‘dead foods support death’; herbs cure cancer; “sun does not cause cancer!”; fungus causes cancer; vitamin B17/Laetrile prevents cancer…

Sorry, long sentence. It’s like he went through Orac’s blog posts and took a bit of everything. Well worth a look.

We had something similar happen with mom (who also had dense breast tissue)

She was sent for a needle core biopsy based on a suspicious mammogram.

Even though the results were not malignant, the (young) surgeon still wanted to remove about 1/2 of that breast.

At the time mom had already been confined to a secure assisted living facility (for her own safety) after diagnosis around age 50 with frontal-temporal lobe dementia (FTD).

Fortunately, I found her (old) doctor, head of clinic at the local hospital, who noted that given her advanced dementia, we really didn’t need to worry about breast cancer.

We couldn’t find that ‘suspicious’ whatever it was on the next (and her last) mammogram.

All I can say is: surgeons want to cut. 🙂

Perhaps her second visit went something like this,
“Hi doc! Great news! I prayed and cleansed all the parasites from my body, and I’m absolutely positive that the cancer has been removed by Jesus! I just wanted you to double check, my knees are a bit sore from all this praying and I want to know if I can stop.”

And then the doctor sounds annoyed, for some strange reason. Can’t imagine why. He probably bought a new car and needs the chemo $$$ to make payments.

Marilyn Mann asked

What the heck is a “parasite cleanse”?

It occurs when an alt-med parasite cleanses your wallet.

Just thought I’d add: 6 weeks of alt-care? I don’t know if even the quacks say that’s enough to see a difference in one’s condition.
A complete reformation in one’s diet?
A complete reformation of one’s religious belief?

Joseph —

It is, but only by accident. There’s a spammer (or spammers) who grab paragraphs from existing posts and comments on the blog and repost them. The poster’s name is a link to whatever it is they’re spamming.

Bill in NC says: “We had something similar happen with mom (who also had dense breast tissue)

She was sent for a needle core biopsy based on a suspicious mammogram.

Even though the results were not malignant, the (young) surgeon still wanted to remove about 1/2 of that breast.”

What’s most similar to the story recounted in Orac’s article is that we have no idea what the actual diagnosis was, and so can’t begin to judge whether the supposed treatment plan was appropriate.

Apart from the diagnostic uncertainty, Bill‘s account raises the question of what treatment is appropriate for a demented patient. Should potentially life-saving cancer therapy be withheld from such a patient? What if they are relatively young (as in Bill‘s mother’s case)?

These aren’t easy questions to answer, and probably not with the simple assertion that “surgeons like to cut”.

@marilyn #1: A parasite cleanse is when a quack cons you into handing over your money.

“What’s most similar to the story recounted in Orac’s article is that we have no idea what the actual diagnosis was, and so can’t begin to judge whether the supposed treatment plan was appropriate.”

You also have no idea whether the anecdote is true to begin with, yet believe it to be on faith. That’s called bias, you just can’t see it.

Yes, how dare you, oh Heartless and Cruel Box fulla lights, critique someone who’s “Just Helping People” !!!eleventy-eleven!
Helping themselves to the client’s money.

I’ll go with BS. Doctors simply do not behave like that – and certainly don’t get “pissed” at a patient’s recovery.

My experience with christians is that they tend to uncritically circulate urban legends that reinforce their ideas. Certain christians are also liable to retell these as happening to themselves. A fine example is Harold Hill’s “How to live like a King’s Kid”.

The story above seems very much to be from that genre – miraculous cure, unbeliving doctors, etc etc. Hmm. I wonder if Google has seen this particular story before?

Oh here we go –

A story by

So a month ago, my mom had a biopsy which confirmed uterine cancer. She initially had surgery (total hysterectomy), then decided not to do chemo or radiation. She decided a trip to Maui would be quite healing. And guess what? Her doctor now says she is now cancer-free. So is the moral of the story go to Maui to heal cancer? As appealing as that might be for those of us in Minnesota in the winter, NO! The reason she is for now cancer-free is because her cancer was surgically removed (she knows this, her surgeon was pretty confident he got it all, and the biopsy came back confirming that it hadn’t avanced past the uterus). But imagine the testimonal she could write.

Maybe I should have said _young_ surgeons want to cut. 🙂

Between the guy with 3 years and the one with 30 years clinical experience I went with the latter.

As for dementia patients in general, remember once diagnosed their lifespan is under a decade (even if they are as young as was my mom)

IMHO the kindest thing one can do is get them qualified for Hospice ASAP.

While you can do many invasive medical interventions TO them, rarely do those procedures do anything FOR them.

Bill in NC:

Local surgical removal of a breast cancer may be a good idea even if the patient is expected to die of dementia (or some other progressive illness). If left alone, it may advance to the point where it breaks through the skin, resulting in a painful rotting ulcer that is difficult to care for. More aggressive treatments, as you mention, would be of little or no benefit.

Another vote for total bullshit. The story reads like a thirdhand account of something that was made up to begin with. The characters within bear no resemblance to denizens of the real world.

Complaints of prayer being misused are as silly as complaints of reiki being misused. If you don’t want quacks and cranks to co-opt your methods, don’t believe in fantastical BS. They have as much of a right to believe whatever they want about prayer as you do, since it’s a completely evidence-free treatment (except for studies showing no effect, of course).

BTW, this is only marginally on topic, but it somewhat relates and I wanted to post it somewhere because it is awesome. XKCD sums up the problem with attributing health to positive attitude:

T. Bruce McNeely-

You’re assuming the patient can co-operate in post-surgical care, and instead of doing their best to rip off the bandages.

Unfortunately, most dementia patients are well along in the disease before ‘official’ diagnosis, and lack the capacity to understand why strangers are doing (often painful) things to them.

Remember physical or chemical restraints are heavily restricted under federal guidelines, even if the patient persists in pulling out their PEG tube (or IVs).

I suspect that you have misunderstood my point. I think, for purposes of discussion, prayer and other religious practices should be considered as PSYCHOLOGICALLY benificial, which could plausibly translate into significant health benefits (or occasionally,as in the “voodoo” doll, harm). I would guess that you can agree with this. Why psychological and physiological effects are so interrelated is something I consider open to inquiry and interpretation from various religious perspectives.

The problem I see with mixing religion and pseudoscience is that, where the former can be open in admitting spiritual, psychic and/or psychological agencies and effects, the latter seeks to rationalize itself with a supposed physical agency. One can complement or at lease coexist with conventional science, the other only misappropriates it.

Bronze Dog, I once had a doctor, when a particular acid reducer didn’t fix my stomach problems, told me I was lactose intolerant. Without asking anything about my dietary habits. As it was, only to combination of calcium and protein from dairy products could ease my frequent pangs.
But while I never went back to that doctor, I did give my eating habits closer scrutiny, and realized I was allergic to the ubiquitous garlic.
And a *good* doctor found me an acid reducer that worked for me.

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