Comment by teekert | Hacker News Reader

Comment by teekert | Hacker News Reader

The study, which is planned for the spring, is designed to include three groups of 24 women with Stage 4 breast cancer who are in stable condition and undergoing hormonal therapy. Two groups will gather at resorts in San Miguel de Allende, Mexico, under the supervision of Langer and her staff. The experimental group will live for a week in surroundings that evoke 2003, a date when all the women were healthy and hopeful, living without a mortal threat hanging over them. They will be told to try to inhabit their former selves. Few clues of the present day will be visible inside the resorts or, for that matter, outside them. In the living areas, turn-of-the-millennium magazines will be lying around, as will DVDs of films like “Titanic” and “The Big Lebowski.” San Miguel de Allende, which has historically been a place known for its nearby healing mineral springs, is a Unesco World Heritage Site, and many of its buildings look as they did a few hundred years ago. “The whole town is a time capsule,” Langer says. (The other group at San Miguel will have the support of fellow cancer patients but will not live in the past; a third group will not experience any research intervention.)

WTF. And what happens when you had cancer in 2003 but got cured, would it come back? Better avoid The Big Lebowski in that case.

If this is a real effect, it does not necessarily involve magic. I find it quite easy to imagine an organism evolving to subtly alter it's physical state according to the function of it's nervous system. Why is it so hard to believe that the mind controls the body at a cellular level? Even if this is a magical effect, it can still be codified and brought within the bounds of scientific discourse.

First of all, "evolving" happens by selective pressures and over generations on a population level. But I see what you mean, you mean changing to accommodate to the environment. But here we are not talking about tanning to compensate for increased UV exposure, we are not even talking about changing to match our environment, we are talking about reducing an illness by evoking memories of the past by physical objects.

Unless this past environment was one that actually kills cancers cells (I don't know how the Big Lebowksi might do that) or perhaps reduces tumor growth I can't imagine any way how this can work.

What I can imagine is going on a time out, reducing stress and thus biological stress responses does have an influence on a tumor. I hope they are compensating for this effect. They should have a control group in a reduced stress environment (or something that mimics all evironmental variables of the back-in-time room but for the back-in-time aspect) perhaps with a bluray disc of Lucy.

Hey or perhaps dumbphones induce less stress. Perhaps you get better sleep in the 2003 environment, light/circadian rithm is known to influence cancer: http://en.wikipedia.org/wiki/Risk_factors_for_breast_cancer#...

Et cetera et cetera, et cetera

Evolve is a word much older than Darwin. It means "develop gradually". My opinion can evolve. My code can evolve. My body can evolve.

It does not now, nor has it ever, meant strictly the biological notion you limited it to above. The GP post used the word correctly.

If I assert that a man runs, I might mean that he flows under pressure, but you would probably interpret me to mean that he moves quickly on his feet. "An organism evolving" similarly tends toward one particular meaning. When you then say you mean to be "within the bounds of scientific discourse," how can you blame someone for thinking you are using the scientific definition?

When you then say you mean to be "within the bounds of scientific discourse,"

I said no such thing. I am not the person who used the word "evolve". I merely am capable of understanding that sometimes pedantry doesn't actually help anything.

So why did you respond to pedantry with more pedantry?

Evolve means gradual change to me. For the more sophisticated amongst us, we are able to take the root meaning of the word and understand it's implication in different contexts.

My statement sometimes pedantry doesn't actually help anything implies that sometimes it does help things. IMO this was one of those occasions.

"(The other group at San Miguel will have the support of fellow cancer patients but will not live in the past; a third group will not experience any research intervention.)"

>> Why is it so hard to believe that the mind controls the body at a cellular level?

Because modern medicine (and science) does not like to believe anything that it has no explanation for. You can show not only correlations, but causative action and a lot of people will reject the finding if it is unintuitive and has no known mechanism. IMHO this has become a problem.

Even though we claim science starts with observation, people still don't believe what is in front of them unless they have something conceptual to hang it on.

An important remark, but let me remind you that scientists are used to the 90% of the times where the current models are correct but observations/experiments are erroneous, specially when things deviate so much from known models. Of course, the 10% of times the models can't explain the observation are indeed crucial to science.

It is well known that stress can alter hormone levels as well as many other negative physiological effects. That seems like the mind controlling the body. Every movement you make is the mind altering the body via the nervous system if you want to be pedantic about it.

> Why is it so hard to believe that the mind controls the body at a cellular level?

It does, obviously. Contracting a voluntary muscle requires work that is done at the cellular level. A signal travels from the brain and ends up translated into a chemical message at the cellular level which contracts muscle fibers.

The brain is even able to address a specific set of cells that correspond to a bundle of specific nerve fibers for that muscle.

Nervous-system signaling involves the cellular level: changing electric potentials, ions flowing across cell membranes, and and such.

Yes I had this in my mind when I wrote the above post. I was trying to draw your attention to the fact that we already believe such things. (Two different accounts, two different pcs, lost password)

You would think that if a person's perceptions and belief could grant a much longer life span, at least one crazy person would have provided this by living to something like 200.

I think it will be close to impossible to make the participants feel like it is 2003 by doing things like placing turn-of-the century magazines around etc. It sounds silly. It almost seems to be mocking their intelligence (I know that's not what they are doing). IMO, they should stick to just telling these participants to try and put themselves in the mindset they were in before they ever faced cancer.

That's the whole point of the studies, though—they made people feel younger by doing everything possible to make it feel like they had stepped back in time.

The placebo effect is more complex than, intuitively, it should be. Otherwise, all you'd need to do was explain the placebo effect to someone, and the belief in the placebo effect itself would effect the desired results (in effect, the placebo effect would be the placebo<g>). Instead, we need to do tricks—sugar pills, simulated environments—to get it to work. It really defies reason.

I'm not sure it defies reason. If you take a child and place him in a blank room and tell him to play, they will have trouble playing and will get bored. If you take that same child and place them in a room with a bunch of complex toys they will probably use those toys in pretty normal ways. But if you take a child and put them in a place where there aren't "traditional" toys (toys they're used to, objects marketed as toys) they will use their imaginations to make a block of wood a car, or a house, or something else.

So in that same sense, if you take an adult and tell them to imagine it is 2003 in a blank room it's going to be difficult. And if you do the same in a room that is filled with things from today it will also be difficult because they will be trying to force objects from post 2003 to fit into a 2003 mindset. But finally, if you put them in a room filled with things from 2003 they will be able to use their imaginations much more effectively to enter a 2003 mindset.

For the record, these are just my thoughts on the matter.

> and the belief in the placebo effect itself would effect the desired results

Are there any studies saying that this precise trick, consciously invoked by people who understand the situation, doesn't work?

I don't have the exact studies and I'm too lazy to look for them now, but I recall seeing a controlled trial on placebo effect showing that people who are (a) informed about placebo effect as such (IIRC that group was all medical professionals) and (b) informed that the pills they're taking definitely are just a placebo with no active substance, they still showed a placebo response. It was lower than for "normal people" who were told that the sugar pill is a medicine for testing, but still significant.

Huh, interesting. Because for the longest time I've been going "I can cause the placebo effect on myself by believing that it works" whenever I feel bad, but I've never been able to find any studies that'd confirm the effectiveness. I guess that if the placebo effect sticks around when you tell people they're taking sugar pills, though, it should work with just the self-referential invocation.

Regarding placebos, the placebo effect is not, for the most part, "people magically get better.". People do magically get better sometimes, because we're incredible self-repairing organisms, but attributing those remissions to placebo or sham treatments is a post hoc fallacy.

The placebo effect is, the most part, a measurement error when collecting subjective measurements. When coupled with objective measurements, it is normal to see people subjectively reporting feeling better when objective measurements say they are doing awful.

There is some valid disagreement about whether a subjective improvement is good enough when it is a subjective condition being treated, eg, pain or depression or anxiety. On the one hand, if a person reports feeling better, great. On the other hand, reporting feeling better is very different from feeling better, as anyone who has ever tried to lie to themselves or others about how they feel knows.

Placebo effects include biological responses that can be measured in objective ways such as heart rate and blood pressure, observable allergic reaction, immune response in blood samples, or healing of tissue. For some drugs for psychological problems, we can measure the effects of a placebo medication/procedure/ritual causing release of dopamine in specific areas of the brain - again, an objective measurement of a real effect caused by the placebo treatment.

The effect of placebo's certainly is not limited to subjective feelings of improvement, it actually causes people to not only feel better, but be better up to a certain amount. Some medicines give significantly better results than a placebo, and some medicines, well, don't - so in that case they're probably placebos in essence.

I'm not even sure if what you describe would be called a placebo effect in medical literature - if objective measurements say they're doing awful, then we count it as a failure, period, and not an expression of the placebo.

Placebo effects include biological responses that can be measured in objective ways such as heart rate and blood pressure, observable allergic reaction, immune response in blood samples, or healing of tissue.

That's a very specific claim, and I would expect it to be published in a medical journal article that we can all look up if it is true. More than that, if this claim is generally accepted, it will be found in authoritative medical textbooks used to train medical practitioners. I have resources for looking up references like that--I go to my alma mater university library just about weekly to look up facts about things I read here on Hacker News. Do you have any references for anything you have read on this topic?

Meanwhile, I am sure that if any of our friends here on Hacker News are (may it never be) injured in a car crash, they are not going to go look for placebo treatments, but for actually effective treatments. The medical researchers who look at the issue with proper study designs and statistical controls know that placebos are essentially useless, as they at most have influence just on self-reported subjective symptoms, not on any sign that affects the progression of a disease or maintenance of good health.[1] This topic keeps coming up over and over and over here on Hacker News because most participants here have heard about this issue only in popular press reports or blog posts that are mostly wrong. I encourage you and all our friends here to take some more time and effort to learn more about the actual research base before assuming that a placebo can change your heart rate over the long term, reduce allergy symptoms (I know all about those), or heal tissue. (Which tissue?)

Findings on placebo effects by researchers who have considered the issue carefully include

"Despite the spin of the authors – these results put placebo medicine into crystal clear perspective, and I think they are generalizable and consistent with other placebo studies. For objective physiological outcomes, there is no significant placebo effect. Placebos are no better than no treatment at all."[2]

"We did not find that placebo interventions have important clinical effects in general. However, in certain settings placebo interventions can influence patient-reported outcomes, especially pain and nausea, though it is difficult to distinguish patient-reported effects of placebo from biased reporting. The effect on pain varied, even among trials with low risk of bias, from negligible to clinically important. Variations in the effect of placebo were partly explained by variations in how trials were conducted and how patients were informed."[3]

[1] http://www.sciencebasedmedicine.org/michael-specter-on-the-p...

http://www.sciencebasedmedicine.org/ted-kaptchuk-versus-plac...

[2] http://theness.com/neurologicablog/index.php/the-rise-and-fa...

[3] http://www.ncbi.nlm.nih.gov/pubmed/20091554

Is this really true? My understanding was that most of the reason the placebo effect is so interesting is that it does result in concrete objective improvements in people's conditions.

tokenadult has a lot of nice links; the individual study that sticks in my mind as a great exemplar was an asthma study which involved a subjective measurement ("how do you feel?") and an objective measurement of lung function (eg, blowing into a tube). Subjects receiving the real treatment would report feeling better and show significantly improved lung function. Subjects receiving the placebo treatment would also report feeling better, but show no improvement in their lung function.

I'm not sure the placebo effect is really interesting so much as it has a great PR guy. It's like the Kardashians of science.

best argument to use seamonkey I've ever seen.

If the experiment reliably produces the effect that they are investigating, then they have at least a million dollars in their future.

http://web.randi.org/the-million-dollar-challenge.html

But the sample size planned for this study is tiny, and the study won't really have the statistical power to demonstrate a true effect, even if the groups differ in outcomes (which I rather doubt they will).

AFTER EDIT: I see a downvote, presumably indicating disagreement, has come in. It would be a courtesy to onlookers here (and to me, for that matter) to explain what part of my comment you disagree with, if you please. To be clear, I genuinely think, based on much reading of medical research, that the effect the investigators are looking for will not be found as a replicable effect, even if their preliminary low-n study shows a difference in outcomes among the different study groups. Extraordinary claims require extraordinary evidence, and to claim that tricking people into thinking they live at an earlier time will reverse the disease progression of cancer is to make an extraordinary claim (which is why I think this claim may be within the scope of the James Randi paranormal challenge).

P.S. Has any onlooker calculated how large a difference in outcomes would have to be observed in a study with only 24 participants in each group to convincingly show that the treatment effect is genuine? Statistical power is an issue that is often neglected in published preliminary research.

Is this the sort of thing that's in the scope of JREF's challenge? It says "psychic, supernatural, or paranormal ability". If this experiment does show a result from manipulating mental age with a throwback environment, we wouldn't assume that result derived from a paranormal cause. It would be a new psychosomatic effect where the mind can affect the body, but it would be through normal biological and chemical means, not the supernatural evidence JREF is looking for.

Yeah, it sounds like this is talking about (effectively) a variant on the placebo effect.

I don't think the JREF would accept them as an applicant. The JREF specializes on much smaller scale tests where they can stop shenanigans and allow for very low p-values. For example, they'll task a dowser with determining which of ten boxes filled with sand contains a gold nugget and repeat that six or more times so they can hit a p-value of 0.000001 or lower. Requiring a medical study to achieve that kind of p-value would cost more than the prize, because there's so many more variables in play.

Also, they'll probably simply disagree that totally changing someone's environment counts as a paranormal way to influence cancer outcomes.

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