Cancer Complementary and alternative medicine Integrative medicine Quackery Skepticism/critical thinking

The Fred Hutchinson Cancer Center shows us how to write a press release on integrative oncology

Last week, the Fred Hutchinson Cancer Research Center issued a press releast touting its integrative oncology program. It’s a perfect example to demonstrate the formulaic nature of such press releases and the distortions behind them used to sell the “integration” of quackery into medicine.

If there’s one thing about the proponents of “integrative medicine,” it’s that they delude themselves into thinking that what they are doing is all about “rigorous science.” Of course, sometimes it can be, such as when integrative medicine claims modalities like diet, exercise, and lifestyle interventions for which there is a scientific basis as its own, even though a separate specialty isn’t needed for medicine to “integrate” treatments and interventions like this. No, the real rationale for a separate specialty such as “integrative medicine” is to “integrate” pseudoscience and quackery with medicine. Examples abound, including acupuncture, traditional Chinese medicine, “energy medicine” like reiki, and a number of other pseudoscientific, unscientific, or mystical treatments, all of which are “integrated” into m real medicine. Of course, as Mark Crislip once put it, when you mix cow pie and apple pie, you don’t make the cow pie better. You make the apple pie worse. None of this stops integrative medicine propaganda, however, some of which comes from very prestigious hospitals and cancer centers. An example is the Fred Hutchinson Cancer Research Center, which is affiliated with the University of Washington, whose clinical care partner, the Seattle Cancer Care Alliance is introducing an integrative oncology program, and it’s issued a press release announcing it.

I can picture what regular readers might be thinking now. They could well be thinking: Why is Orac bothering with this? It’s just another example of quackademic medicine, another pebble in the integrative medicine avalanche. It’s just another press release announcing yet another program integrating quackery with real medicine. Patience, my minions. There is, as always, a method to Orac’s madness. You see, reading this particular press release, entitled Integrative oncology program opens at SCCA caused the proverbial lightbulb to go on in my head, specifically when I read the subtitle, Research and rigor will guide integrative therapies that help cancer patients tolerate standard treatment. You see, there is a template that these press releases follow, and it occurred to me that I’d never discussed it before. Even better, this particular press release followed the template so closely that it’s a perfect example to use as an educational example. When I’m through with this press release, I predict that you’ll never read such a press release the same way again. So let’s dig in to this Fred Hutchinson masterpiece.

The first element is nearly always, a patient anecdote:

When Yetta Marcus Jaworski was diagnosed with breast cancer back in 2009, she decided to try a blended approach to treatment. Along with standard therapies like chemotherapy and radiation, she sought out the traditional Chinese practice of acupuncture to combat her treatment’s side effects.

“I’m a huge fan of acupuncture and massage, which helped with side effects of chemo and radiation,” said the a 57-year-old project manager from Indian Rocks Beach, Florida. “When I was first diagnosed, I had to go to my own acupuncturist, but now I have one that comes to the oncology office.”

Read this passage and ask yourself: How many articles have you seen that start with a passage very much like it? It’s almost always someone with cancer who wants to try a “blended” approach or who wants to pursue the “best of both worlds.” Not infrequently, the patient sings the praise of whatever quackery she used and expresses how happy she is that it’s now available at the cancer center.

Next up comes the argument from popularity:

Like many cancer patients today, Jaworski doesn’t have a problem using what are often referred to as complementary or integrative therapies to help her tolerate the pain, nausea, fatigue and other toxic effects of standard treatments. She appreciates the integrated approach her cancer center in Florida and others across the country have come to embrace.

This approach to oncology can now be found at Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center’s clinical care partner, with the launch of its new Integrative Medicine Program.

That’s because the anecdote that introduces the press release has a purpose, and that purpose is to set up the appeal to popularity used by the cancer center to justify the integrative medicine program. In this case, if you follow the link to the integrative medicine program you’ll find that Seattle Cancer Care Alliance offers acupuncture, massage, and yoga, among other things, and there’s a naturopath there to provide the usual cornucopia of quackery that naturopaths provide. (Obviously, it’s not described that way, but any facility that offers naturopathy is basically going to offer quackery, perhaps even homeopathy, given that you can’t have naturopathy without homeopathy.)

Next up, after the appeal to popularity, comes the claim that the therapies being “integrated” into medicine are rigorously science-based. First, we learn that an “authority” is leading the program, in this case, Heather Greenlee, ND, PhD, who is described as “Dr. Heather Greenlee.” Greenlee, however, is not a physician, as regular readers will immediately realize seeing the letters after her name. ND means “naturopathic doctor,” or, as I prefer to read it, “Not-a-Doctor.” So, yes, Greenlee can use the title of “Dr.,” given her PhD, but she is not a physician; i.e., not a doctor. So here comes the appeal to science:

Only therapies that are evidence-based will be used; integrative therapies will only be used as an adjunct to traditional cancer treatment.

“Patients have been using these tools for a long time,” said Greenlee, a Fred Hutch epidemiologist, SCCA naturopathic physician and former president of the Society for Integrative Oncology. “But we want patients to receive state-of-the-art, consistent information, and we want to provide education to both patients and clinicians. We want to be very honest with patients where we do and don’t have evidence and maximize their resources, time and energy using therapies where there’s good evidence that the therapies can achieve what they want them to achieve.”

Actually, there are two parts to this part of the sales pitch. First is the claim that these treatments are science-based (which most of them are not), but there’s also the appeal to antiquity, as though just because a treatment is ancient there must be something to it. In this case, the appeal is not as blatant as I often see it, but it’s nonetheless there.

After this long preamble, we finally get to the pitch for this integrative oncology program, what supposedly makes this program better than all the other programs out there integrating quackery with medicine. This part of the pitch is more variable than the elements that precede or follow it, because it’s tailored to the specific program. Various programs have different setups and varying reasons for wanting to embrace pseudoscience. One common reason is the very reason SCCA proposes: It had been using other practitioners but now wants everything in-house:

SCCA has been working with integrative medicine practitioners in the community for several years, Greenlee said, but decided to create the in-house program to provide patients with more seamless care.

“Now patients can receive services from our integrative clinicians who can easily confer and consult with the full oncology care team,” she said. “The idea is to provide ‘integrated integrative medicine’ to cancer patients.”

Housed on the third floor of SCCA’s main clinic near South Lake Union, the Integrative Medicine Program is part of the Division of Wellness and Supportive Care Services, which includes palliative care, physical therapy, nutrition, pain management and other psychosocial services. Currently, the staff consists of a naturopathic physician (Greenlee); an acupuncturist (Jonathan Siman); and a nurse practitioner trained in mindfulness-based stress reduction, mindful eating, guided imagery and integrative medicine (Kathleen Sanders). Greenlee said the team will grow over time.

While there are other integrative oncology programs at academic cancer centers, Greenlee said the new program at SCCA will be one of the only, if not the only, program in the region to offer these services within a cancer treatment center.

I’m not so sure this is actually true, nationwide, but I’m guessing that it’s probably true for the Pacific Northwest. In any case, the justification here appears to be more about not using outside quacks and instead developing SCCA’s own quacks. Now, don’t get me wrong. There is value in having a dietician, a health coach, and the like available to cancer patients. That, however, is the boring stuff that could easily be encompassed in standard oncology. (In fact, it increasingly is.) I also have little objection to mindfulness, even though it is unclear what that is and the evidence for it is conflicting at best. What provokes my ire is having quacks like acupuncturists and naturopaths treat cancer patients—any patients, actually.

No such invocation of uniqueness is complete without citing an example of the institution’s own research. In this case:

Last year, Greenlee co-authored a paper on the first-ever randomized controlled trial assessing acupuncture’s efficacy in reducing pain in breast cancer patients, based on research she did with Dr. Dawn Hershman at Columbia University, where Greenlee retains an adjunct appointment as associate professor of clinical epidemiology. Their study, published in JAMA, showed acupuncture was effective at relieving the arthritis-type joint pain caused by a common class of breast cancer drugs called aromatase inhibitors.

Greenlee also led the development of clinical guidelines for the use of acupuncture and other integrative therapies with breast cancer patients with the Society for Integrative Oncology. Those guidelines were recently endorsed by the American Society of Clinical Oncology, or ASCO.

I’ve written about both of these before. For instance, the JAMA study does not show what its authors are claiming that it does. It was basically a negative study. And don’t even get me started on the Society for Integrative Oncology breast cancer guidelines and the travesty of their being endorsed by the American Society of Clinical Oncology.

Then of course, there’s the part about “separating snake oil from science” at Seattle Cancer Care Alliance. It’s mandatory in all press releases of this sort about any new integrative medicine program. At one point, reading this press release, I must admit that the Fred Hutchinson Cancer Research Center fried yet another irony meter of mine, leaving that sucker bubbling in a pool of plastic and metal goo, sparking plaintively:

“While many of these approaches, such as yoga and mindfulness, are beneficial and are unlikely to cause harm, others can cause side effects or interactions with standard therapies,” he said. “The integrative oncology program will provide expert, evidence-based guidance as to what is likely to work and what may even cause harm, financial and otherwise. Supplements and other integrative approaches are a multibillion-dollar industry in the U.S., and it’s extremely important that patients and their providers be properly informed.”

Both Lyman and Greenlee said cancer patients are particularly vulnerable to misinformation in the realm of dietary or herbal supplements. Oncologists frequently report patients coming in with dozens of supplements, recommended not by doctors or dieticians but friends, family, coworkers and shop clerks. Patients will use the supplements in combination with, or at times in lieu of, traditional cancer treatment, which can cause them harm. One recent study found patients who used supplements during cancer treatment frequently experienced drug-drug or herb-drug interactions.

Yes, be sure to cast yourselves as the defender of science against Big Supplement. Just be sure not to draw attention to all the pseudoscience that falls under the rubric of integrative medicine, whose very purpose is to integrate quackery into medicine. Sure, they mention the popular quackery like acupuncture, but forget the mystical nonsense like the mystical magical woo that is “energy healing,” such as reiki. Then brag about how we’re doing real research, ma-an, which this press release does, and then serve up this pièce de résistance of press release verbiage for these press releases. It’s another mandatory assurance for an academic medical center touting its offerings in quackery:

The key takeaway, Greenlee said, is that the Integrative Medicine Program will only offer therapies that Fred Hutch stands behind.

“We want to be leaders in conducting the trials of promising new therapies, and we’re very open-minded as to potentially what that could mean,” she said. “But we want data to support their use and we’re not offering anything in lieu of standard of care to treat the cancer.”

Sure you do. That’s why you offer acupuncture, even though it’s nothing more than a theatrical placebo. That’s why Fred Hutchinson Cancer Research Center promotes a negative study on the use of acupuncture to relieve joint pain caused by aromatase inhibitors as somehow being positive.

But let’s bring it on home, “Fred Hutch.” Let’s bring it on home with—of course!—another appeal to popularity:

SCCA breast cancer oncologist and Hutch clinical researcher Dr. V.K. Gadi seconded that emotion.

“The patients love it,” he said. “It’s great to be able to offer them these tools and offer them here on site.”

Monroe, who has been getting acupuncture to ease symptoms from treatment outside of SCCA, agreed.

“It just makes sense to me, especially with cancer,” Monroe said. “It’s one-stop shopping. You can get all the care right there for your mind, body and soul.“

And that’s how you finish a press release touting your integrative medicine or integrative oncology program.

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]

40 replies on “The Fred Hutchinson Cancer Center shows us how to write a press release on integrative oncology”

Long time fan, first time commenter:)
“Greenlee said cancer patients are particularly vulnerable to misinformation in the realm of dietary or herbal supplements.” What hypocrisy! Misinformation about dietary and herbal supplements is the financial model upon which naturopathic practice is built. Selling supplements they recommend to patients based on scanty-to-no evidence of safety and effectiveness is a major source of income to naturopaths.

I read the article a couple of times but saw nothing about this particular naturopath promoting any useless herbs, or profiting from it. Are you absolutely certain all naturopaths are identical in all respects? If she’s a fulltime hospital employee and practices nowhere else, she may be strictly limited in what she’s allowed to do or promote.

“Various programs have different setups and varying reasons for wanting to embrace pseudoscience. One common reason is the very reason SCCA proposes: It had been using other practitioners but now wants everything in-house”

There may well be a desire on the part of the cancer center to have better oversight of “integrative” therapies in order to minimize potential for patient harm, by bringing alt practitioners in house. It might also lower the risk of profound embarrassment to SCCA through the discovery that unsupervised outside practtitioners are using especially ludicrous/dangerous nonsense or espousing crank (i.e. antivax) ideology.

Above all, it’s about money. Draw in gullible patients with this stuff and you improve the bottom line.

Integrative Medicine programs don’t treat the cancer, but, they may comfort some cancer patients. Therefore, the Seattle Cancer Care Alliance should, in good faith, change their name to the “Seattle Cancer and Patient Care Alliance.” If a person chooses to participate in the Fred Hutchinson Cancer Center show, such an the integrative oncology approach may be beneficial in that it provides professionally managed patient-care options.

There are lots of interventions that are helpful to patients. Cognitive therapy, diet advice, home care, counseling for patients and families, specialized exercises, reclining chairs and lowering beds, child care, financial advice, Meals on Wheels, and help with everything from cooking to sexual relations.

As they say, a pair of deuces beats nothing.

As a cancer survivor who has struggled to find ANY oncologist willing to help with side effects, I strongly disagree. I’ve been forced to fend for myself for 10 years and have read hundreds of respected medical journal articles documenting the widespread failure of cancer clinics to meet serious needs of current patients and past survivors. MANY clinics still provide grossly inadequate therapy for side effects. Now, clinics are supposedly “required” to offer comprehensive “survivorship plans” once treatment is complete, but most still don’t and no one enforces the requirement.

According to many medical articles and several clinic websites I’ve studied, it appears that the so-called “Cognitive Therapy” currently offered at many oncology clinics is nothing more than generic emotional counseling (talk therapy), usually of the type called “Cognitive Behavior Therapy” (CBT).

CBT isn’t true cognitive rehab. It does little or nothing to HEAL brain tissues, or to promote neurogenesis to strengthen hippocampal functions, or to force the brain to rewire to bypass damaged areas (plasticity). CBT doesn’t employ occupational therapists to push patients through heavy brain-training protocols to fully overcome their specific deficits and dysfunctions. No physical brain stimulation technology is used.

CBT is just endless meandering talk about feelings and alternative perspectives, to convince brain injured patients to just ACCEPT and ADAPT to their losses (… even though they often don’t need to yet and shouldn’t be forced to).

Many TRUE cognitive rehabilitation techniques already exist and are proven to be at least partially effective in clinical trials. Several types result in seemingly miraculous improvements in some patients. It’s tragic that a large percentage of brain injured patients are never told this or given a chance to try therapies that could dramatically improve their brains and lives.

Doctors everywhere need to catch-up and keep-up with the rapidly expanding fields of cognitive rehabilitation and cancer survivorship. MANY patients need this help.

From a citation in the above article:
““The integrative oncology program will provide expert, evidence-based guidance as to what is likely to work and what may even cause harm, financial and otherwise. …”

Both Lyman and Greenlee said cancer patients are particularly vulnerable to misinformation in the realm of dietary or herbal supplements.”

One wonders if Heather Greenlee, ND, PhD, prescribes supplements and if there is any, any, evidence they have any beneficial effect beyond placebo.
While high doses of unnecessary vitamins and minerals probably won’t cause physical harm they do “cause harm, financial and otherwise.
In agreement with Jann Bellamy, I think the whole business model for NDs (and chiroquacks, etc.) involves getting the patient to use expensive treatments and supplements that neither help nor hurt – they don’t do anything except transfer $$ from the patient to the quack.
The hypocrisy knows no bounds in the quack community.
It looks like Seattle Cancer Care Alliance (SCCA) has a marketing winner in Not-a-Doctor Greenlee.
The unfortunate marks patients however…

It’s not accurate to label ALL herbalism “quackery.” Herbalism was the original pharmacology industry, and many currently used drugs still include, or are patterned after, botanical extracts originally discovered and used by herbalists. A significant percentage of traditional herbs cause physiological effects in the human body.

I’m not an herbalist. I just grow herbs in my garden for flavoring, fragrance and decoration.

Nevertheless, I’ve experienced firsthand the natural relaxation of chamomile tea and valerian, the stimulation of coffee, the stomach settling effects of ginger, the refreshing aroma of mint tea, and the soothing effect of lavender fragrance. And I haven’t had a sore throat for decades, despite many head colds, because I drink “Throat Coat” Tea (a commercial product from “Traditional Medicinals” with slippery elm bark) as soon as my throat feels scratchy. It works every time.

So I’m not as hostile as the rest of you to the idea that cancer patients might get significant benefits from pleasant herbal experiences, so long as the herbs don’t interfere with their cancer therapies.

I’ve never studied herbalism in depth, but I assume herbalist skills and quality controls vary widely, because people and plants vary widely … so herbalists should be vetted before trusting them. I also assume many mild herbs can be used in reasonable quantities without hyperventilating over high-precision “dosing” constraints, or obsessive adherence to strict “evidence-based medicine” rules.

If patients find comfort or pleasure in herbal therapies, do the effects ALWAYS have to be fully quantified, double-blinded, randomized, and replicated endlessly in advance, and proven beyond any doubt, before you’ll be willing to lighten-up and respect their choices?

So you don’t know why controlling for dosage is important. You obviously do not understand the many claims for “herbs”, and that sometimes they do not know what they are getting, and that some herbs (not the ones you grow for flavoring food) are “prescribed” that have actual interactions with real medicines.

I’m not a blind fool when it comes to alternative medicine claims and obvious quackery. I’m aware of the information war being waged around the herb and supplements issue. I hate health frauds too, but not to such an extreme that I believe ALL sellers and promoters of herbal supplements are evil dangerous frauds. I’m certain there are many good, decent, CAREFUL herbalists out there who work hard to give their customers as much health benefit as herbs can safely provide at a reasonable price, with proper warnings and precautions.

(But I also think all health supplement manufacturing and labeling should be subject to regular inspections and oversight to ensure label accuracy and product quality, prevent dangerously high doses, and prevent contamination.)

Of course dose matters when strong herbs are involved, and of course patients should ask their oncologist first before taking or continuing ANY supplement.

I tend to be very skeptical and cautious, especially when my life and a lot of money is involved, so during cancer treatment, I did exactly as I was told and trusted my oncologist completely (… until he utterly failed me afterwards. Now I wonder.)

I was a biology major in college and spent 30 years learning and endlessly debating the fine points of toxicology while leading community efforts to force 7 multinational corporations to clean up the massive quantities of PCBs, dioxins, furans and mercury they dumped in the Fox River, Green Bay and Lake Michigan.

So I understand the value of the scientific method and try to make strictly evidence-based arguments when good evidence is available.

But over the past 10 years I’ve been shocked by how often the term “evidence-based medicine” is used as a weapon to dismiss basic common sense and discard ALL non-experiment-based clinical observations of even the most experienced and sincere MDs and medical researchers.

Strict “Evidence-based Medicine” advocacy seems to have morphed into a powerful extremist cult. It’s strangling innovation, stifling research, and delaying medical progress for decades, because doctors no longer feel comfortable trying anything new to help desperate patients, until some industry-dominated national power group has FINALLY labelled it “evidence-based” and “cost-effective.”

There’s no room for doctors to use their individual experiences, personal insights or best judgments to even briefly try ANY new treatments. They only feel safe and respectable doing cookbook medicine. If a treatment isn’t listed in their App, their minds are firmly closed to it. Patients will just have to WAIT indefinitely for new, potentially life-changing therapies to ever-so-gradually crawl through endless research trials and infuriatingly-slow regulatory approvals. “That’s the way it is.”

Patient’s aren’t respected, or allowed any voice or choice. We’re not allowed ANY freedom to accept risks and try promising therapies NOW when it matters. Patient’s are being cruelly tortured, forced to helplessly watch perhaps dozens of unreasonably slow, underfunded approval processes, year after year, while their conditions worsen irretrievably, their lives unravel, and they die.

It’s not humane or ethical to force patients to wait 10 or 20 years just for access to TRY therapies that exist NOW. It’s extreme and unreasonable, particularly for brief trials of new therapies that pose low risks and for desperate patients who have little or nothing to lose.

I tend to be a skeptic, so I suspect that insurance and pharmaceutical companies, and already-licensed medical equipment manufactures, plus all the huge medical bureaucracies nationwide, are all working together to use “evidence-based medicine” to save them from paying reasonable insurance claims, to protect them from potential new strong business competitors, and to avoid any risk of devastating obsolescence. This cruel and extreme “evidence cult” heavily favors only existing big players in U.S. medicine. Small, independent innovators often lack the funds and endurance to complete enough large repetitive research trials to be allowed into the cult. And almost no one funds research to prove that cheap, unprofitable, non-patentable, open source therapies work.

[Just like the corporations who polluted my river, who always argued (for 30 years) that it wasn’t reasonable to make them clean up their toxins, because more research was needed to prove to their satisfaction that their toxins caused harm (… while ignoring all the deformed, gender-altered, non-reproductive wildlife in the river and bay.)]

Regulatory restrictions and penalties should only apply to blatant, provable quackery and fraud-for-profit therapies that create unreasonable risks of significant harm to patients who have better options available. The FDA needs to “rationalize” and streamline their standards and processes.

Bottom line: I no longer trust the “U.S. Medicine/Pharma/Insurance Complex” (like Eisenhower’s) to play fair and use scientific evidence in a reasonable, unbiased, honest way ONLY in the public’s best interest. They have too much concentrated political power, too much money is involved, they hide too much key information, most of their policies are developed behind closed doors with no outside input, and there’s far too little independent scrutiny and oversight. Also, U.S. laws are too weak or warped, and government regulatory agencies are too weak, misdirected, underfunded and politically vulnerable to protect the public from widespread rigging by the “Complex.”

So, I’m not willing to throw every form of disputed alternative therapy to these wolves. Alternative therapies never hurt me.

I feel MUCH more threatened by the “Complex” than by any naturopath, herbalist, acupuncturist, chiropractor or supplement seller … because I can choose to avoid any or all of those alternative providers if I don’t trust them. The “Complex” gives me very little choice and no opportunity for meaningful input. I’m forced to pay $1,000 a month for health insurance plus huge deductibles (… my monthly SS check is only $1,008 …) so I can only afford expensive essential assessments and treatments that this massive for-profit corporation ALLOWS me to have and, in many cases, only if a doctor DARES (or even wants) to provide a written prescription and justification, and then insists.

No vitamin salesmen ever threatened or frightened me as much as the COMPLEX repeatedly has over the past 10 years.

And the last 2 years of political wrangling over the ACA and “existing conditions” has been repeatedly terrifying and cruel.

So, I like the fact that this country still allows at least some medical free thought, differences, criticisms and experimentation. I appreciate the value of vigorous debates between wildly different viewpoints, for my personal education, and for democratically developing the best possible public health policies. As a patient, I absolutely NEED the freedom to investigate every possible medical option and provider for myself, and at least some freedom to make my own choices (… within reason, if no significant personal or public harm is likely.)

If the conventional medicine industry wants patients to use ONLY conventional medicine, they need to do better training, updating and oversight of individual providers, be much more respectful and considerate towards patients, and do a much better job of proving they can be trusted and relied on every time patients need professional health care.

And if the conventional medicine industry sincerely cares about patients and wants to earn patients’ loyal trust, it needs to IMMEDIATELY focus all of it’s enormous political clout on convincing the U.S. Congress and President to severely restrict the size and control of today’s unaccountable, uncompetitive, bloodsucking health insurance dictatorship … and to guarantee EVERY U.S. resident access to comprehensive, high-quality health care… with costs paid thru simple, fair, affordable taxes levied on everyone. Eliminate all the unnecessary for-profit middlemen and take employers out of it too.

Most Important: Make all costs, all government-funded medical research, and all health policy decision-making processes 100% transparent, honest, even-handed and accountable … subject to public scrutiny, public input, and, ultimately, voter oversight.

Then maybe the public could fully trust conventional medicine and cut back on alternatives.

Jeezums, you miss a couple of days, and this stuff floats up:

Alternative therapies never hurt me.

That’s something resembling nice.

Drinking water never hurt my. But it is cheaper if it comes from the tap, than when I buy it as homeopathic ‘medicine’. The effect is the same, but I don’t need a naturopath to prescribe the first thing.

Just to be clear, I’ve never used naturopaths or tried many other alternative therapies either. I’ve also never used homeopathic formulas, because their theory seemed weak and I was never interested enough to research them. Now I’ve read a little more and I’m nagged by distant memories that make me wonder if a few of their theories might be worth investigating.

I once worked on a committee with a government toxicologist who was very excited when he discovered that the health effects of pesticide contamination in groundwater varied oddly. Above a certain pesticide concentration threshold, the health effects (in mice, I think) followed a typical dose-response curve and, at first, the pesticide appeared to cause no health effects below that threshold.

But then he noticed a SECOND threshold concentration somewhere below the first “normal” threshold, where much lower concentrations began causing measurable health effects again. He theorized that the tiny concentrations were somehow able to “sneak under the radar” of the body’s anti-toxicity defense systems (because they were too dilute to trigger defenses) … or perhaps, these low concentrations were too weak to damage or destroy cell components outright, so the pesticide had time and the means (intact cells) to induce the cells to initiate damaging biochemical changes that led to cascading biochemical damage systemically.

This was in the 1980s, and I’ve lost track of where his specific research led, but I’ve seen variations of his ideas a few times since, in random science news.

I don’t know enough about homeopathy formulas to say much about them. But it seems possible, in theory at least, that there may be some special circumstances where unusually tiny chemical concentrations ingested or injected into the bloodstream COULD result in some types of health benefits.

Oh, Jesus, another wall of text with homeopathy and hormesis? You could have saved some grafs by not making a show of trying to teach your grandmother how to suck eggs.

gently bangs head on desk
Oh for Fox sake, SSCA.

The Hutch does real science, real innovative, ground breaking work in cancer (and other diseases). And then they go and do stuff like this. Uuuugggghhhh…..

Story time: My cancer-related company is just up the lake from the Hutch. It was Coworker 1’s last day and we were walking to a goodbye happy hour. Coworker 1 (PhD) was off to a TCM/massage therapy thing in Portland because he wanted more connection with patients. (Also, running away from the terrible end of a bad relationship.) As we walk past the Hutch Coworker 1 and coworker 2 (very experienced lab tech) are talking about how Western medicine doesn’t really help people, and Asian medicine is about listening to patients. They go on, and on, and on. Finally, I snap.

“Right, because no one has ever been helped by any of the treatments developed there (gestures at Hutch). No one has ever lived because they got a bone marrow transplant. No one has ever gotten Our Treatment and more months of life. No one has ever gotten even a little better from all the stuff they developed.”

They stop and look at me. “Well, we’re talking about more quality of life stuff…” I threw up my hands and walked away (mostly because I still had to work with Coworker 2).

But that’s the thing. As soon as “we can save your life!” exists, then some people want to open the door to nonsense and claim it’s equally important.

There is no quality of life if you are dead. Being alive is essential for having any quality of life. Everything else is something what is very personal. I don’t think my quality of life will be improved if someone sticks needles in me.

Renate writes,

I don’t think my quality of life will be improved if someone sticks needles in me.

MJD says,

Vaccine-hesitant individuals may struggle with similar thoughts. Either way, the search for truth is sometimes as difficult as finding a needle in a haystack.

You can’t get much lower quality of life than death.

This is especially cruel because cancer patients in treatment have a terrible quality of life, and acupuncture (herbs, whatever) is a costly hassle, not actually enjoyable, and has some side effects especially if you’re already full of nasty drugs. You’d be better off with splurging on pillows and a big screen TV.

Maybe it’s just the inherent contradictions of the human experience.
For example, the few times I had to go into the SCCA, I had to walk through a cloud of smokers standing the prescribed 25 feet from the front door. Smoking, in front of a cancer hospital! Weirdly, I never encountered crowds of smokers over at the Hutch (the research side).

Have you ever gone through cancer treatment? I have, 10 years ago, and it ruined nearly every aspect of my life, primarily because my doctors refused to acknowledge even the possibility that I had serious side effects, and failed to help when they could have made all the difference, early on.

Within 2 years, I lost my job, destroyed my career, lost all of my friends, alienated several relatives, nearly drove my husband away, and caused a major financial crisis for us because I was suddenly an uncontrollable shop-a-holic (out of nowhere). I was reduced to a small monthly cash allowance because I couldn’t be trusted with credit cards or bank account access. (I’d handled all bookkeeping before this.) My “life” has been a nightmare ever since.

Obviously, I was brain damaged by the cancer treatment (and/or concussion the first week of chemo) because ALL of my devastating behavior problems began during, or soon after, those 2 events. Nothing else happened or changed that could explain it.

Yet, despite the blindingly obvious cause of all this, not one doctor (out of 12) has been willing to openly say “of course that’s what happened.” Not even “yes, you have serious cognitive problems that need medical attention.”

Instead I’ve been punted from doctor to doctor to doctor, with none showing any enthusiasm or talent for helping me. None seem to know ANYTHING about any cognitive rehabilitation methods, let alone WHERE such therapies are available, what they cost or how well they might work. Most think it’s some other doctor’s job to know or figure out, but have no idea who that is, so they just shrug at me.

I’ve been forced to spend most of the past 10 years trying to figure it out for myself, from scratch … which brain areas are damaged and which treatments work best. My husband pays $1,000 a month for my insurance, but with huge deductibles, and the company refuses to cover nearly all types of the most promising healing therapies I’ve found, because they aren’t conventional and mainstream enough yet, even if they’ve gotten full FDA approval.

From my viewpoint, all these respected, conventional, expensive, USELESS doctors (and the insurance companies they collaborate with) are the real frauds and quacks. Many weren’t even capable of pretending they cared. My poor husband wasted HUGE sums of money sending me to recommended, but out-of-date, closed-minded, shockingly ignorant “experts” who just denied, dismissed, insulted and abused me, while making no effort to help in any reasonable way. At most, they patted me on the head and suggested anti-depressants and mindless “talk therapy” just to get rid of me.

If this naturopath was nothing more than KIND to me it would be an improvement, and an acupuncturist couldn’t be any worse than the doctors I’ve made the mistake of seeing (I’m used to needles.)

People go to alternative therapists because their prior MDs were arrogant jerks who refused to listen and refused to help. Even if the alternatives’ benefits are only due to a placebo effect, it’s still far better than the insults, demoralization, and worse-than-zero help they got from their MDs.

Patients are being DRIVEN to alternative therapies.

I’m very sorry you have had such a terrible time. It sounds awful and you clearly have been let down.
Have you considered joining or creating a patient advocacy group to advocate for more research into side-effect mitigation? I don’t know how much cancer research money is available for that kind of quality of life research, but clearly more is needed.

There are also some side effects that can’t be eliminated without negating the effect of the treatment. For example, androgen deprivation therapy for prostate cancer (testosterone elimination) has a lot of side effects that patients find very challenging. But the only way to fix this “man-opause” is to re-introduce testosterone, which would completely negate the whole treatment. So while the osteoporosis can be addressed, there isn’t much to be done for things like libido and emotional state.

Those are good suggestions, Justatech. Unfortunately, I won’t be an effective advocate until I fix my brain. I’m still trying to climb out of the mental glue-pit I fell in 10 years ago.

I’ve resolved now to give up on doctors, and stop researching to try to fully understand every tiny biochemical and neurological detail of what likely happened to my brain. No matter how many file cabinets I fill with research evidence to back my concerns and requests, it will never be enough to make an inch of headway in getting a doctor’s help.

Instead, I’m trying to focus now on just researching and doing the best possible brain therapies that don’t require a prescription, supervision, travel or more money than I can scrape together. (Health insurance is useless). I’m starting with greatly increased exercise and a healthier diet, circadian synchronization (1 mg melatonin at bedtime, consistent generous sleep, light regulation, distributed daylight eating only, no more night eating, and no more staying up until 4 am) … plus Tai Chi balance training using a CD, and vision exercises.

Also, I just bought my first major therapy after a year of research: The Listening Program, by Advanced Brain Technologies. (www.advanced It involves 6 months of listening (30 minutes a day) to neuromodulated sound frequencies folded into beautiful classical music. It stimulates the auditory nerves, which then stimulate the auditory network throughout the brain. Extensive research has documented a wide range of effects of music and different sound frequencies on brain function. The military has seen significant improvements in vets with brain injuries and PTSD.

(One of my deficits involves auditory attention and auditory processing, so I hope The Listening Program will push my brain to rewire and build new auditory connections that bypass my damage, and also reduce my vestibular balance problems. Plus, music is relaxing and anti-depressant.)

After 6 months of that, I hope to buy the Vielight system (, a type of transcranial Near Infrared Light Therapy (aka Low Level Light Therapy or Photobiomodulation) to stimulate other brain networks not reached by sound. Surface nerves convert light to electric stimulation, and mitochondria are induced to release anti-inflammatory and pro-healing compounds.

After that, PoNS Therapy should be FDA approved and available. (Helius Technologies). I’ve waited 4 years already. It involves mild electric stimulation of 2 cranial nerves through a small electrode held on the tongue. Stimulation transmits to the brain stem, then radiates through the rest of the brain. (More than 20 years of exciting, creative research at the Univ. of Wisconsin has been poured into this one.)

Once I’ve finished at least 1 of these 3 passive healing therapies, I’ll start the hard work of brain skills training using the best software and guides. And start playing piano and guitar again, and learning Spanish. And I may try neurofeedback, but haven’t studied it enough yet.

None of these therapies are as costly (or as ineffective) as years of talk therapy and life-long prescriptions of risky psychoactive drugs. I wish insurance companies would wake up to this fact.

PS: Helpful new (and old) rehabilitation therapies DO exist for nearly every side-effect or disability created by cancer treatment (even libido losses and drastic hormonal changes in both men and women). Many problems can be overcome completely with the right rehabilitation therapies, especially when combined with continued strong encouragement and guidance from up-to-date medical professionals.

But too many doctors don’t know this, so they tell patients “nothing can be done … you need to just accept and adapt.” It’s tragic.

Survival is useless and a mistake if your life isn’t worth living after cancer treatment. QUALITY of life is the only thing that really matters.

Besides, why should patients have to settle for only minimal survival, if oncologists are fully capable of helping them regain a worthwhile quality of life too? Why not aim for the best possible outcomes, using ALL the tools in the toolbox?

Greenlee said the new program at SCCA will be one of the only, if not the only, program…

What does the expression “one of the only” mean? Is it more than one of the few? Less? If only 113 million people voted in the US 2018 elections earlier this month, does that make me one of the only people who voted? Is a grain of sand one of the only grains of sand on the beach at South Padre Island? Since only stars naturally fuse hydrogen, is the sun one of the only fusion sources in the sky?

Because only people who have thought for a second about the expression would think that?

I’ve seen the phrasing “one of, if not the only” used in situations where the speaker/writer thinks they are the first or unique. The duplication might have been a verbal miscue, but who knows?

The whole statement, though, reminds me of ad-speak, which is carefully phrased to limit the comparison to make the product sound better than it really is.

The example I remember was the Ford Excursion which was described as largest in its class. But the Chevrolet Suburban, a competing vehicle, was actually larger. So it must be in a class by itself.

As an employee there, very disappointed to see this stuff infiltrating what is otherwise a great research institution. Seems like everyone is hopping on the bandwagon..

A cancer survivor isn’t being “ungrateful” when he assumes his oncologist will help him deal with side effects of cancer treatment. And even if ingratitude existed, it still would be no excuse for oncologists to do only PART of their jobs and ignore all the consequences of their treatments.

I’m not saying cancer clinics should do comprehensive rehabilitation on site for all side effects … but they should always know the best rehab therapies that exist, should ensure they’re available nearby, and should be ready to refer suffering survivors immediately for the best possible follow-up care. ( … and help them qualify for insurance coverage for it.)

Also, oncologists should always be willing to try side therapies that could make cancer treatment more effective and increase long-term survival rates. Stress reduction, exercise stimulation, heart damage avoidance, cognitive protection, marriage preservation, etc may all improve final health outcomes dramatically, so they really shouldn’t be considered “unnecessary frills.”

At least the cancer clinic in Houston is TRYING to catch and address the multitude of potentially serious side effects of cancer treatments, before, during and after therapy ends. It’s a good start that everyone should encourage.

Aren’t “integrated” healthcare efforts preferable to the usual disconnected, fragmented, CLUELESS healthcare systems that often leave survivors wandering for years in search of relief? Hundreds of respected medical journal articles have documented this as a serious problem at many cancer treatment centers.

You might have doubts about some of the individual therapies offered, but don’t throw the baby out with the bath water. You or a family member may need this help too some day.

If you aren’t going to post my last comment, please email it back to me. It took a long time to write.

This is a bit off topic, but how should you choose a cancer treatment center? Places like CTCA are obviously cesspools that should be avoided, but I was curious about places like Hutchinson which are legitimate clinics that use ridiculous marketing campaigns like this one?

I’m very conflicted about the ‘integrated’ approach. It’s nonsense, but I think it helps vulnerable people within the sphere of actual medicine. The preferred tactic of woo peddlers is driving a wedge between a patient and their care teams. I hate that it’s piggybacking on legitimate medicine, but if it maintains access to the legitimate care then for now I’m hesitant about booting them.

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