Cancer: Diet ‘cures’ are killing young people, say top oncologist
news.com.au
news.com.au
[1] http://www.forbes.com/sites/alicegwalton/2011/10/24/steve-jo...
So I agree with you in spirit, but it's not accurate to say he had a treatable cancer that he allowed to kill him.
(source: https://en.wikipedia.org/wiki/Pancreatic_cancer#Outcomes)
Also I do recall Jobs ended up getting a new liver in 2009, so I'm pretty sure that prolonged his time on the planet by a pretty significant amount. I remember this because I looked into how he was able to get that liver...sort of like how he was being rebellious and clever to get a new Mercedes Benz every 6 months so legally he wouldn't need a license plate on his car, he managed to get himself on multiple lists and set up residency in a place that would be advantageous to get what he wanted...
I would assume the oncologist in OP has less of a problem with people also doing other stuff they believe helps them, vs not including "traditional" (aka scientific) medical procedures that statistically improve their chances of survival.
Not to mention the elephant in the room: Vegan diets are probably unhealthy. They lack selenium you'd otherwise get from meats. Low selenium and pancreas diseases go hand in hand.
There's also a link between drinking fruit juices and pancreatic cancers. Jobs constantly drank fruit juices as part of his vegan/fruitarian diet. Fructose megadosing is scary stuff. Healthy sugars and still sugars. They still have calories and still need to be processed.
61% of survival at five years. He survived longer than five years.
There is, for instance, some actual research generating interesting findings on ketogenic diets as an intervention for glioblastoma and astrocytoma. Unfortunately, "ketogenic diets" are also a mainstay of Mercola-ism, so it's hard to get good lay-reader summaries of what's going on.
I think a lot of good would come out of:
(1) more awareness of Cochrane Collaboration (& donations to)
(2) prosecutors and the likes of FDA aggressively pursuing people that lead others to reject life-saving treatment, esp. if conflict of interest is present (e.g book sales)
(3) stretch -- teach high school kids basic research evaluation skills (do a search on Google Scholar, consider number of papers, sample sizes, journal quality, author credentials, citations and existence of metastudies). Some version of rough smoke-test for this kind of stuff can probably be automated.
(I live in FL, it's hard to get enough potassium from just meat to offset the amount we sweat.)
I am sympathetic with the frustrated physician whose patients refuse to accept that there are any benefits to drug treatments. I am also sympathetic with the patient who has spent his entire life hearing nothing but rosy assessments of drugs pumped out by the manufacturers even though many are completely ineffective and many others have been removed from the market because they proved unsafe. There are ways to improve this, but all three parties (as well as the FDA, in the US) are going to have to give. Drugmakers need to stop advertizing their products to patients and physicians. Physicians need to leverage their professional associations to ensure that they are properly informed about new drugs, from impartial sources. Patients need to insist that their physicians follow these guidelines and then trust them, or find a different physician that they can and will trust. And the FDA needs to be at once much more demanding: many drugs are approved despite little evidence, or unreliable evidence, of effectiveness; and much less so: the interminable process of approval needs to be cut way down, especially for drugs that have a narrow base of potential patients.
Trust is gone, and needs to be repaired. You build or rebuild trust by being trustworthy, going far out of your way not only to show that you are worthy but to go well beyond what would otherwise be necessary. If you want patients to trust you, you need to do everything possible to earn it.
Yes there are many cases of people being over-prescribed, and drugs being approved with debatable benefits, but communication between pharma and doctors can be very helpful. Given proper oversight of course.
You're underestimating the level of professional interest in drugs that are genuinely effective. The reason it's become so hard to promote drugs is that most of them being introduced today are of little to no benefit, especially relative to side effects (and cost; poverty is a side effect). A drug that permanently and completely reversed Alzheimer's Disease in even 25% of patients would be an earth-shattering discovery and both clinicians and biologists would be lining up to study it. Likewise a drug that reversed its progress by 40% in 90% of patients for 10 years, etc. But most of what's coming out today is at best on the edge of statistical noise. When you've got a dozen companies spending tens of billions of dollars a year developing something that's 6% effective in 12% of the population and has serious side effects in 20%, according to a study with a 5% margin of error, it's going to be a very crowded, noisy market, because the noise is the only way to distinguish one very marginal treatment from another.
Make something great and this problem will solve itself. The need for the AMA and other professional societies to involve themselves directly and provide impartial education to their members still exists, however. Some new treatments may benefit only a small number of people, and if the evidence for their effectiveness is strong enough, those professional societies should help make sure their members are aware of them. The converse applies, as well: members should be made aware of new drugs that are ineffective as well, and discouraged from prescribing them in most situations.
The main point here is that the decisions physicians are making need be based entirely on the evidence of safety and effectiveness, not marketing hype or freebies. Again, I really don't see indications that genuinely great drugs are getting overlooked; if they are, it's probably because one overhyped drug is just like another to an overworked physician. A dramatic reduction in that noise will help with that.
An important question to ask a doctor is "what happens if we do nothing? What happens if we do watchful waiting?"
Doctors are human and they're subject to cognitive bias, so it's useful to check what they say against the science.
But that means using reliable, reputable, sources (eg the Cochrane Collaborations) and not some guy on the Internet making money selling goji berries as a cure for all cancer.
I've had success with trying to steer them into the thinking that they'll probably be just fine and if not, it really isn't as huge of a deal since we're all going to die. On top of that getting sick has a whole lot to do with luck and genetics so they should try to accept that no matter what they do it isn't going to be up to them in most cases anyway. Lastly, I help them focus on the great people around them instead of continuing to dwell on whether or not they have optimum health.
Of course, you can't just call them a selfish jerk, but instead try to guide them out of that loop of self obsession.
Hope you can work it out or work around it, stranger things have happened.
Just nod and learn the phrase "yes dear"
(Though it's very difficult to make people actually use this in decision-making.)
There is a great Perry Cox speech out there about a patient eating red peppers to cure cancer.
Found it...
"Dr. Cox: And now I have to take your laptop from you, as I've deemed you just too darn stupid to use it. You see, those bell peppers that you're munching, they aren't gonna do a truckload of jack against the cancer raging inside of your body. Of course, I've only been a doctor for some twenty years, and the person who wrote that Wikipedia entry also authored the Battlestar Galactica episode guide, so what the heck do I know? But if you feel like living, page me."
Yeah. Just a conspiracy theory. Nothing to it. Nothing at all. The pharmaceutical industry has no influence whatsoever.
Some people might say that doctors make far more money from doing traditional medicine, than they would from offering dietary advice, but this too has absolutely nothing to do with it. Just another conspiracy theory.
If alternate medicine worked, it'd just be medicine.
Just publishing a scientifically sound paper in ARXIV isn't enough.
AFAIK Tom Harkin is the main guy who pushed through the creation of the agency and in the past has expressed disappointment (around 2009/2010?) that they haven't been able to demonstrate alternative medicine modalities as being effective. That hasn't led to any defunding of the agency though. It keeps trucking along, spending over $120 million dollars annually demonstrating that things we already have a good idea don't work...still don't work.
> involves years, millions of dollars, and an insane amount of bureaucracy. Think about it--20 years, over $2 billion dollars. That's a lot of time and money. They should have results to show for it.
Alternative medicine has this image of being "the little guy," and given it is less than 1% of dollars spent on healthcare in the US, it kind of is. However, that small percent is a small percent of a giant, giant, pool of money. While alternative medicine is small compared to medicine, that doesn't mean there isn't a lot of money put towards it.
Just multi-vitamins is a billion dollar industry and apart from pregnancy or perhaps vitamin D most of the claims are bogus.
http://slatestarcodex.com/2014/06/15/fish-now-by-prescriptio...
So the companies selling common herbs are doing so at a loss?
Exercise, proper diet and losing weight helps with a lot of conditions (high blood pressure, blood sugar levels, sleep apnea, etc)
But of course it's easier to prescribe the latest (and non-generic available pills).
If you want to avoid getting cancer, then leading a healthy lifestyle is an excellent idea.
If you actually have cancer, whether because you don't lead a healthy lifestyle or you did but just got unlucky anyway, then it's too late for diet and exercise. They might still help, but what you need at this point is treatment.
Pharmaceutical companies may not do prevention so well, but this article is about what happens after prevention fails, at which point you need cures, and every pharma company out there is trying to be the next one to produce a big (and probably expensive) cure.
Pharma companies are a lot bigger on treatments than cures (how much of this is that treatments are easier to find than cures, and how much of it is that cures eliminate their own market and thus make less business sense is a matter of debate.)
Only in the sense that things aren't very easy to find when you aren't looking for them. Otherwise there really isn't much debate. Nothing brings home the bacon like chronic disease.
This is by far the number one complaint from doctors about patients: they only want drugs, not health.
Note also that if your theory were true, chemotherapy would always be the treatment of choice over radiation. Maybe you have another theory about Big Isotope you'd like to share?
It's not true to say they have no influence. Pharmaceutical companies constantly try to entice doctors to prescribe specific medicines.
But most mainstream medicine is backed by hard science. You can go out there and read the evidence. Trials are conducted and we know that, for example, chemotherapy can be effective in treating certain types of cancers, while, for example, Traditional Chinese Medicine is not. We know this because we've studied it, not because we've been bribed.
The pharmaceutical industry lobby's power is worrying, it's true. But that doesn't mean that pharmaceuticals are full of shit.
> Some people might say that doctors make far more money from doing traditional medicine, than they would from offering dietary advice
Actually, "alternative medicine" is incredibly profitable. There's a number of large companies which make massive profits off this stuff. It's incredibly profitable because there's no research involved, no expensive ingredients to source, no testing necessary. You can stick anything you want in a pamphlet or a bottle, and sell it at any price, and people will buy it if you have good enough marketing.
You were specifically talking about dietary advice, though. That's also profitable: many people make a very good living off quack dietary advice. People are willing to pay almost anything to get non-"traditional" medicine.
Heck, it might be more profitable than prescribing medication, because the pharma company isn't taking a cut!
We know the pharmaceutical industry has some influence on what treatments a doctor recommends. I don't think anybody is going to deny that.
The part where it gets ridiculous is when people think the pharmaceutical industry has puppet master like control over the entire field of oncology, from research to individual doctors. Somehow, they've managed to manipulate our brightest minds from asking simple questions like, "Can sodium bicarbonate cure cancer?"
I have family members who have refused cancer treatments based on these beliefs. One took cinnamon for his cancer and died last year. Another is convinced he's cured his own cancer taking sodium bicarbonate in lieu of early outpatient treatment.
> Some people might say that doctors make far more money from doing traditional medicine, than they would from offering dietary advice, but this too has absolutely nothing to do with it. Just another conspiracy theory.
This idea is utter shit. Every doctor I've ever gone to has emphasized good diet and exercise as the key to good health. No doctor omits dietary advice so you'll eat like shit and live a sedentary life for the sake of future profits.
You could argue that they could/should do more to promote diet/exercise and I'd argue you're wasting your doctor's valuable time. You don't need someone with medical school to dispense advice on diet and exercise on a personal level. See a nutritionist for dietary advice or a physical therapist for an exercise regiment.
If you really think diet is a key then you should lobby your representative to subsidize healthy foods and food programs rather than corn based products. If you think exercise is important, than bully your representative to push athletic incentives. For example, mandatory insurance discounts for people who can demonstrate a athletic proficiency on some type of scale. (Remember the athletic tests you took as a kid?)
It constantly amazed me that the same people who insinuate hand wavy conspiracies that doctors have sold their integrity and your health and for a modest boost in salary don't even question the ethics of companies that make billions of dollars selling untested "alternative medicines" and "herbal supplements" even after they're caught lacing their products with natural amphetamines so their customers can legitimately claim they feel better.
Why? It's hard to accept that one is taking an inferior solution due to economic constraint, so people fall into a sort of magical thinking/self-deception that leads them to reject modern medicine.
In a society with expensive private health insurance and extremely high medical costs, it makes sense that people would resort to false cures. Of course, it's not always about money. See: Steve Jobs. It tends to take on a life of its own, after a certain point, because the mind-virus that might start due to inaccessibility of care lives on and spreads.
Esoteric thinking and homeopathic medicine are extremely common in educated and high income circles outside of STEM fields - basically the middle class loves this.
Reasons that are often cited and that I've encountered are mostly due to more personal contact with the practitioner and some fear about big pharma.
It's getting so out of hand that a lot of children are not vaccinated - e.g. Berlin Prenzelberg - a place where high income, high educated folks are a majority is a major problem spot.
This is something different - at least in Western Europe.
The anti-big-pharma spiel is just a red herring that prevents people from worrying about whether or not they've made the right decision in rejecting real medicine.
Yes. Also very (very) popular with teachers. When I remember back I had dozens of teachers telling me (us) that alternative medicine is often better than conventional.
It's funny how many educated (university degree) and seemingly intelligent people I know who have that one idiotic quirk when it comes to medicine. Once that topic comes up they turn off their brain and get their tinfoil hats ready to tell me about the truth.
It's like that fluoride conspiracy crap in the US - only that it's very popular here through all social classes.
edit: I was in a supermarket where selling drugs is illegal not a pharmacy, where it is legal. Still my point stands, if you're in pain you'll go with whats easier. Putting up barriers to access is a problem. Tylenol should be at the grocery store, not homeopathic junk.
edit2: HN wont let me reply to some comments:
I never understood this knee-jerk defense of the nanny state. Most nations don't have a problem with this, but Germany does and that encourages homeopathic nonsense in that culture, to the point of government funding of it. Lets stop making excuses for failed policymakers.
I'm all for liberalizing drug laws in Germany, but just for completeness' sake:
Tylenol is a brand name for Paracetamol which is readily available over the counter without prescription in Germany, as is Ibuprofen (Advil), ASA (Aspirin), as well as other anti-inflammatories and analgesics. I believe a case could be made that on the heavier end of pain relief Metamizole (Novalgin) should also be transitioned to a prescription-free status, but there has been a widespread panic about its side effects at some point.
Also, a distinction should be made between herbal remedies which actually produce some effect, such as valerian or volatile oils, and pure woo such as homeopathic preparations.
The reason why supernatural "medicine" is so successful in Germany lies in the fact that "alternative practicioner" is considered an actual profession with deep ideological and historic roots in the country. Susceptible is pretty much anyone who strives to use only "natural" resources for living because they lack the scientific understanding to know that all substances are chemicals (a bad word in Germany), and they often don't have any capacity to even recognize the "alternative" treatment options are in fact based on magical thinking.
Also Tylenol (which is called Paracetamol here) is available over the counter. But only in pharmacies. Just like every other pain medication (ibuprofen, aspirin, etc) which you can buy in other countries - even in the EU - in super markets. Germany is a "little" over regulated here.
Also, the fact that you expected to find painkillers in a German supermarket just means you're an American. It doesn't say anything important about barriers to access there.
I think you mean Prenzlauer Berg (it's a neighborhood)
But yeah, similar to the US
They genuinely believe that mainstream medicine is outright harmful, and that the alternative stuff is better. This remains true even when the mainstream medicine is highly affordable, or even when the person in question has good health insurance.
I saw an interesting case recently. Somebody stepped on a rusty nail (I didn't know that was something that actually happened!) and of course they weren't up to date on their tetanus shot, since vaccines are deadly poison. They asked friends what to do and got a variety of answers, most being some variation on "whatever you do don't get the shot, it will kill you," with various crazy alternative cures proposed. Ultimately they went to an urgent care clinic and got the vaccine. This was described after the fact in a sort of "I know I shouldn't but I didn't have the willpower," the way a normal person might describe how they broke down and ate a tub of ice cream even though they're trying to lose weight. It seems that people still understand on some deeper level that traditional medicine really does work, even if they believe it's "bad" otherwise.
It ultimately looks to me like a variation on religion, where traditional medicine is seen as being sinful and alternatives are seen as righteous. You might come up with rationalizations about why, say, eating ham is bad for you, but ultimately a religious person with a pork prohibition will avoid it because it's just not right. And someone who believes eating pork is sinful can still easily end up wanting it, so it ends up being a weird internal struggle.
On another note, at least among the people I know there is vast overlap between people who use alternative medical treatments and people who believe in stuff like chemtrails. I'm pretty sure there's no financial basis for that one!
There's a big difference between distrusting drugmakers and thinking they want to kill you. The last thing they want is to kill you. It's bad PR, to say the least. But more importantly, killing you takes away one of the medical plan's customers. It's the only thing worse than curing you, because they'll never again get money for something prescribed to you. This position is totally unreasonable and no one who considers the situation for even 30 seconds can seriously believe it.
And yes, there are a ton of people who think that, for example, vaccines are deadly, and that they are being pushed by big pharma anyway because of profit motive.
No, it doesn't make any sense. That's not a prerequisite for being believed.
I'm not an "anti-vaxxer", but I find nothing more abhorrent than the government dictating that something go into your body. It's the darkest of the dark, makes V For Vendetta look like rainbows and unicorns, etc. I would almost certainly believe that vaccines are overwhelmingly beneficial and that the benefits outweigh the risks for nearly everyone, if not for the government's involvement. Once the government is involved, I simply can't trust anything.
Anyway, how is it different? You said above that it's a completely unreasonable position to think that big pharma wants to make big profits by killing us. Lots of anti-vaccine people believe precisely that, and now you're saying you don't find it unreasonable.
Once you have the government mandating that everyone buy your product, it doesn't really matter any more whether it's a good product or has good PR or is otherwise viewed as beneficial. A drugmaker selling something to the willing has an incentive to make sure it's not lethal, if for no other reason than that the most profitable business is repeat business. A drugmaker selling something the government mandates has no such incentive. This applies, actually, to anything of which purchase is mandated on threat of violence, not just drugs.
On that note, if someone you know gets cancer, please sit on your hands instead of sending them any lifestyle advice, however well-intentioned, and cut off the hands of anyone you know who does that. It's amazing how many people think it's appropriate to forward links about their pet cancer cure.