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CAM >  Red Flags and Free Speech 

Last update: 11/07/2016

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Red Flags and Free Speech

Text Box: NOTE: While eating well and regular exercise will not cure or treat cancer, these CAN improve your general health and quality of life, providing indirect benefits associated with improved survival

Shouting "fire" in a crowded theatre – when no fire exists is a criminal act.  Yet misleading books and websites selling “cures” for cancer are abundant, protected we suppose by “free speech.”   Harm can follow when a false belief leads to the avoidance or delay of a proven therapy.

The message is most appealing when it provides us with what we want and wish to be true. 

Being smart does not protect you from such claims (e.g., Steve Jobs).  The conspiracy and theories can sound compelling to those who lack background in the field … most of us, when first diagnosed with a cancer!

Conspiracy Theories

Consider that a conspiracy to hide cures for cancer would require the complicity of doctors and scientists world-wide.  The secret would have to be kept when their child, spouse, or dear friend gets cancer.  Competing drug companies would have to intentionally undermine the products they test and submit to FDA for approval.

Natural is better?

Toxins and medicines can be man-made or derived from natural sources – from plants and animals.  Vincristine, Etoposide, and Taxane are examples of cancer drugs derived from plants.  The molecular structure of a compound will be identical, whether made by a plant or synthesized by man.  Being natural does not determine how effective or safe it will be.

For cancer drugs, what counts is the affinity of the compound to the disease process.  Does it bind well to the target like a key fits a lock?  How it’s derived will not alter its bioavailability, its affinity to the target, or its good and bad effects.

Cures for cancer that are free of side effects – natural and food-based, kept from us by doctors and the drug industry, “supported” by science, “proven” by testimonials.


 Random screen capture of search results for "natural cures"

Recognizing junk science

Theories promoted to self-treat cancer are often hijacked from the literature then applied prematurely or distorted … often from preclinical studies:  cell culture and animal experiments. 

cell culture experiments

·         Cannot account for the dose that's needed to have a similar effect on cancer cells in the body

·         Cannot tell us if the compound is absorbed into the blood when taken orally... or if it is merely excreted

·         Cannot inform about the side effects of the compound when given at the dose showing activity in the test tube   (Is it feasible or safe to take that much of it?)

Even if active against disease … the compound given at the wrong dose can do harm: 

·         Tumor cells can adapt to low or subclinical doses of treatment compounds – leading to resistance.   The first step in the clinical development of a cancer treatment compound is to get the dose right and to determine the safety of the agent at the active dose (therapeutic window). 

Cancer cells in a test tube are very poor models for the treatment of cancer cells in the body.

·         Unlike bacteria, many kinds of tumor cells are challenging to keep alive in cell culture medium.  

 animal experiments:

·         Cannot account for the differences between the mouse and human host environment.  The mouse immune system is different.  The tumor cell line is different from cancers that emerge in humans. 

·          The toxicities and activity of the compound in the mouse rarely predict what happens in humans.
  

What is Cancer?  Is it treatable with diet, or other life style changes …

What is plausible as a treatment depends on the nature of the disease. 

The beginnings of cancer: 

Cell behavior is controlled by genes that are located in the cell nucleus. Genes function like an instruction manual telling the cell what proteins to make.  These proteins in turn control the behavior of the cell. Some proteins direct the cell to divide; others how long it will live; and others begin cell death - a normal process by which the body rids itself of old, unneeded, or damaged cells. 

Usually there is a balance in which new cells replace old, and each cell carries out tasks specific to its kind.  The balance of cell division and death ensures that the organs and systems function properly and serve the needs of the body.

In any cell the genetic code can get damaged so that the instructions in the "manual" are altered in ways that make abnormal types and amounts of proteins that can lead to the abnormal behavior of the cell. 

... Instead of resting, cancer cells continue dividing; instead of dying the cells stay alive.  Mutations may also turn off genes that can repair damaged DNA, or that can induce cell death when mutations in the cell are detected.

The mutations that lead to cancer are numerous and often unique to each type of cancer.  Interventions that have meaningful treatment effects will also have side effects.

Observations and testimonials are not reliable

"For centuries doctors used leeches and lancets to relieve patients of their blood. They KNEW bloodletting worked. EVERYBODY said it did. When you had a fever and the doctor bled you, you got better.  EVERYONE knew of a friend or relative who had been at death’s door until bloodletting cured him. Doctors could recount thousands of successful cases."

Today we know that patients did well in spite of bloodletting, a practice based on primitive notions about the nature of diseases - attributed to bad elements in the blood.  The lesson from history is that observations are not reliable as evidence. 

In any observation or case report, even when from a reputable source, you can't tell what would have happened if something else – or nothing was done; you can't predict if others are likely to be helped or harmed by the same approach.

In modern clinical research the number of participants in a study is pre-specified and assessments are made in the same way. One approach is compared to another in late phase testing – the patients assigned to study groups randomly.  In all clinical studies you have a predefined denominator (the number of participants) that informs about the rate of good and bad effects.  These methods tell us what others (YOU) can expect … and how it compares to another established treatment. 

Testimonials have all of the limitations of observations  … with much less certainty about the facts: 

Did the person really have the medical condition?  
Was it a false diagnosis of a cancer?  You don't know how the outcome was measured: Was it that the patient felt better?  What tests were used to measure it?  Did the benefit last a week or 2 months?  You can’t know what other medical treatments were given shortly before or after. Finally, people who provide testimonials and later die or get very sick cannot provide updates. 

Red flags for medical claims

1)    Relies on testimonials (stories that cannot be verified or account for how the reported “benefit” was measured, and how long it lasted)

(Reliable reports come from prospective studies -- predefining the number of persons that received the compound, which provides the denominator needed to estimate a rate of good and bad effects in others)

2)    Cherry-picks statements in medical literature out of context

(such as reasons to fear and avoid “poisonous” regular treatments )

3)    Appeals to wishful thinking - easy (non-toxic / "natural") solutions

(My magical remedy will make you whole again. It has no side effects, only good effects)

4)    Fear mongering

(citing and focusing on the side effects of the approved treatments, out of context -- cherry picked from the literature)

5)    supported by pseudoscience or preclinical science -- cell culture research

(Cell culture citations can sound convincing.  But preclinical research cannot account for the dose, or the safety of dose needed to have an effect on the cells in the body. Salt will kill cancer cells, and you if you are given enough.

It’s challenging to keep cancer cells alive in a test tube. They tend to die without adding anything to the medium. The cell lines used in test tube studies are also very different from cancer cells that arise in the body)

6)    Advances a conspiracy theory

(to explains why your doctor is not telling you about my cure that will make you whole again without risk … and why you can't trust the experts.)

On the last item, consider that three in five of us will develop a serious cancer in our lifetime. … Regulators, scientists, and doctors also get cancer – so do their loved ones, their spouses, parents, and children).   

There is NO conspiracy to keep cures from you or from your spouse or child. 


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Conspiracy Theory? | Slide

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