A few weeks ago I wrote an article about Emma Mhic Mhathúna was a 37-year-old Irish mother of five who died in October 2018 from cervical cancer – an easily diagnosed and treated cancer if discovered early. She died because of a pap smear scandal in Ireland that led her to receive a false negative on her two pap smear tests in 2016. As a result of this scandal, HPV vaccine uptake has increased for preventing cervical cancer. Continue reading “Preventing cervical cancer – HPV vaccine uptake increases in Ireland”
The HPV cancer-preventing vaccine, especially Gardasil (or Silgard, depending on market), has been targeted by the anti-vaccine religion more than just about any other vaccine being used these days. So many people tell me that they give their children all the vaccines, but refuse to give them the HPV vaccine based on rumor and innuendo on the internet. This article provides all the posts I’ve written about Gardasil safety and efficacy.
As many regular readers know, I focus on just a few topics in medicine, with my two favorites being vaccines and cancer – of course, the Gardasil cancer-preventing vaccine combines my two favorite topics. Here’s one thing that has become clear to me – there are no magical cancer prevention schemes. You are not going to prevent any of the 200 different cancers by drinking a banana-kale-quinoa smoothie every day. The best ways to prevent cancer are to quit smoking, stay out of the sun, keep active and thin, get your cancer-preventing vaccines, and following just a few more recommendations.
The benefits of the vaccine are often overlooked as a result of two possible factors – first, there’s a disconnect between personal activities today and cancer that could be diagnosed 20-30 years from now; and second, people think that there are significant dangers from the vaccine which are promulgated by the anti-vaccine religion.
It’s frustrating and difficult to explain Gardasil safety and efficacy as a result of the myths about safety and long-term efficacy of the vaccine. That’s why I have written nearly 200 articles about Gardasil safety and efficacy, along with debunking some ridiculous myths about the cancer-preventing vaccine. This article serves to be a quick source with links to most of those 200 articles.
And if you read nothing else in this review of Gardasil, read the section entitled “Gardasil safety and effectiveness – a quick primer” – that will link you to two quick to read articles that summarize the best evidence in support of the vaccine’s safety and effectiveness.
Emma Mhic Mhathúna was a 37-year-old Irish mother of five who died on 7 October 2018 from cervical cancer – an easily diagnosed and treated cancer if discovered early. She died because of a cervical smear scandal in Ireland that led her to receive a false negative on her two pap smear tests in 2016 as a part of the CervicalCheck program run by Ireland’s Health Service Executive (HSE), which manages Ireland’s healthcare.
As a result of this cervical smear scandal, Ms. Mhathúna sued the HSE and the US clinical laboratory, Quest Diagnostics, which performed the tests. She settled in court for €7.5 million from HSE and Quest. Another US-based clinical laboratory, Clinical Pathology Laboratories (CPL) of Austin, TX, was involved in a similar lawsuit from another Irish woman, Vicky Phelan, who also received a false negative – they settled for €2.5 million.
Ms. Mhathúna’s death was both tragic and a cautionary tale about relying upon the results of this test. Continue reading “Cervical smear scandal – why the HPV vaccine is the best choice”
Subjectively, one the wilder claims one can find on social media is that marijuana cures cancer. Or cannabis prevents cancer. It doesn’t matter what form – smoked, eaten, hemp oil (which is manufactured from the seeds of cannabis plants that don’t contain much THC, or tetrahydrocannabinol, the active hallucinogenic agent of cannabis) – some advocates for cannabis will try to make the argument that it is some miracle drug for cancer.
But is it? Yes, there are systematic reviews that indicate that cannabis may be effective in reducing nausea and vomiting in chemotherapy. But research has generated negative results in some well done clinical trials and some positive results in others. But that has nothing to do with actually curing or preventing cancer itself, just dealing with the effects of the treatment.
So what has real research said about “marijuana cures cancer?” Well, not to give away the conclusion, but not very much. Let’s take a look.
Continue reading “Marijuana cures cancer? Scientific research says probably not”
As I have mentioned before, I occasionally answer questions on Quora regarding complementary and alternative medicine (CAM) cancer cures. Of course, there are few, if any, CAM cancer cures that actually do what they claim. If they did work, they’d just be medicine.
Of course, many of the answers provide answers that are supported by scientific evidence – CAM cancer cures do not work. Of course, there are a few scam artists answering the questions who make outlandish claims about cancer cures. And the number of times someone claims that cannabis is one of the best cancer cures is ridiculous – the evidence is extremely weak (see Note 1).
A paper was recently published that examined the survivability of individuals with curable cancers that refused conventional cancer treatments and chose complementary and alternative medicine. We will get to that article, but spoiler alert – CAM doesn’t work and may be dangerous.
What is complementary and alternative medicine?
CAM is any “medical” treatment that is not supported by robust scientific evidence or incorporated into evidence-based medicine. Most complementary and alternative medicine have no clinical effects beyond placebo (see Note 2), and it cannot treat any serious medical condition. CAM is pure pseudoscience.
CAM is known by its other names – quackery, quackademic medicine, snake oil, woo, or junk medicine. CAM quacks invent absurd pejorative names for evidence-based medicine just to create a silly false balance – terms like allopathy, conventional medicine, or Western medicine. You science-based readers will see through this nonsense, and understand what they really mean is “evidence-based medicine, but we prefer our pseudoscientific medicine.”
CAM includes traditional Native American remedies, traditional Chinese medicine (like acupuncture), chiropractic, homeopathy, New Age nonsense, and many other kinds of woo. Of course, many CAM scammers push their cancer cures, none of which have been shown to work.
CAM is popular because it provides false hope to those interested. These quacks can make outrageous claims about cancer cures because they can play to fears of cancer patients about surgery, chemotherapy, or radiation therapy. These scammers promise cures that are easy, but these “therapies,” in fact, don’t work.
As Tim Minchin famously said,
You know what they call alternative medicine that’s been proved to work?
Cancer is a group of diseases characterized by abnormal cell growth which can invade or metastasize to other tissues and organs. Although people use tumor and cancer interchangeably, not all tumors are cancer. There are benign tumors that do not metastasize and are not cancers.
The National Cancer Institute claims that there are over 100 types of cancer. Cancer Research UK states that there are over 200 types of cancer. The American Cancer Society lists over 70 types of cancer (although some are more classes of cancer rather than a single type). Wikipedia lists over 180 different cancers.
The variance in number results from the lack of precise definitions for some cancers. So researchers may group several different cancers into one heading. But clearly, there are up to 200 or more different cancers.
Furthermore, each of these cancers has a different etiology (cause), pathophysiology (development), treatment and prognosis. When someone is called a “cancer researcher,” they are rarely studying all cancers, but they’re studying one small part of the story of one of the 200 or so cancers.
Cancer usually requires numerous, up to 10, independent genetic mutations in a population of cells before it can become a growing, metastatic cancer. Each mutation is selected, as in natural selection, because it provides some benefit to the cancer cell, such as causing blood vessels to supply the cells for nutrition and oxygen, or the ability to divide rapidly, whatever the feature is.
A recent study published in the journal Science makes a strong case for random chance as the most important factor in cancer development. According to the study, the vast majority of cancers are just a simple error in DNA replication. If this is so, developing one of the 200 (or more) different cancers may be unavoidable, despite a “healthy lifestyle” or attempting to “boost” your immune system.
Geneticist Bert Vogelstein and mathematician Cristian Tomasetti, at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, conducted the study, a follow-up to an earlier one, which arrived at the same conclusion. The researchers wanted to know whether replications errors were behind most cancers, versus other factors, such as tobacco.
The researchers found, after examining 32 different kinds of cancer, that 66% of these cancers were a result of chance mutations in cells, 29% resulted from the environment, and 5% from inheriting a mutation.
These mutations aren’t “naturally” a part of the cell’s physiology. Moreover, these mutations can have a lot of different causes – environmental (like smoking or UV radiation), viral (hepatitis B and human papillomavirus are the most famous), heredity, and maybe other things. These mutations are more or less random, and they can’t be prevented by anything special–if only it were that easy.
There are a few things you can do to prevent cancer, such as quitting smoking, staying out of the sun, getting your hepatitis B and HPV vaccinations, not drinking alcohol, keeping a low body weight, and eating a balanced diet. But even if you are a paragon of healthy living, a random mutation in some cell in your body can lead to cancer.
One last thing. A lot of our ideas about what may or may not cure cancer is based on preclinical research, which very rarely is brought into clinical trials or is successful in clinical trials. In fact, there seems to be a lot of evidence that it is difficult, if not impossible, to repeat the preclinical studies, so it makes it difficult, if not impossible, to accept the results of them. Simply, a lot of research that is publicly touted often ends up meaning nothing.
Oh, one more thing. Big Pharma isn’t hiding a secret cure for “cancer.” But they have brought the world thousands of effective treatments, in combination with evidence-based oncology, that has led to a substantial reduction in the cancer mortality rate over the past two decades.
Now, that CAM cancer cures are dangerous paper
The study, by Skyler B Johnson, MD, of the Yale School of Medicine, was published in JAMA Oncology in July 2018. The researchers examined a huge database of cancer patients over a 20-year period of time – it included an impressive 2 million individuals. They sorted to through the records to compare patients who used alternative medicine to treat their cancer to a matched sample of individuals who relied upon evidence-based cancer treatments.
I also want to emphasize that the researchers specifically selected for individuals who had easily treatable cancers.
Let’s cut to the chase – after controlling for confounding variables, that is, variables that can influence both the cause and the effect, individuals who utilized CAM for cancer treatment were statistically much worse off.
- CAM users had a much lower chance of surviving 5 years after cancer diagnosis.
- They were 2X more likely to die of cancer.
- Less than 70% of CAM users were alive seven years after diagnosis. This compared to more than 82% of those who relied upon evidence-based medicine who survived seven years.
- The mortality risk for those individuals who used CAM increased every year that they avoided standard cancer therapy.
Now, this doesn’t mean that the study found that CAM had a negative effect on cancer patients. CAM is worthless, it has no effect on health. However, what the researchers did state is that those individuals who preferred CAM were refusing or delaying conventional cancer treatments that actually work.
Because CAM is worthless, it probably doesn’t matter if the patient uses it along with conventional cancer therapy. It is amusing that many patients will give credit to the CAM therapy rather than the conventional one when their cancer goes into remission. Of course, most of us know the scientific facts about it.
Like I wrote in a previous epidemiological study, this is an observational study. It cannot show causality, except when it does. Moreover, size matters – this is a 2 million person study which allows us to see small statistical differences.
Summary of CAM cancer cures
If you have a cancer diagnosis, use real evidence-based medicine to treat it, not CAM quackery. Despite patient fears of surgery, chemotherapy, and radiotherapy, the evidence has shown us that they work and that the mortality rate for many cancers continues to drop every year. The trope that Big Pharma, Big Hospital, and Big Oncology are hiding the one cure to cure them would be amusing if it weren’t so dangerous.
Let’s be clear – complementary and alternative medicine is worthless. The evidence that it provides cancer cures just doesn’t exist – the best, most robust, highest-quality evidence shows the way we treat cancer is best done by real physicians with real backgrounds in oncology.
- If any compound of the marijuana plant can actually treat cancer, it will be isolated by real medical researchers, they will create a method to deliver that component directly to the site of the cancer, they will test it for efficacy and toxicity, and then seek FDA approval. Anecdotes and weak pre-clinical studies for any of the claimed cancer cures are nearly valueless to real science-based medical treatments for cancer.
- Many people overstate the value of placebos – officially, a placebo means that the effect is nothing more that can be found by giving the patient a sugar pill. The effect is almost always psychosomatic, so placebos effects are more prevalent with neurological conditions like pain, although the evidence that CAM can treat pain is laughably inconsistent. However, placebos have never been shown to treat cancer, mend a broken bone, cure an infectious disease, save a trauma victim, or do anything for other serious medical conditions. In science, anything with a “placebo effect” is considered a failure, and it would never receive FDA approval. The placebo effect is simply a myth.
- Johnson SB, Park HS, Gross CP, Yu JB. Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable Cancers. JAMA Oncol. 2018 Jul 19. doi: 10.1001/jamaoncol.2018.2487. [Epub ahead of print] PubMed PMID: 30027204.
- Tomasetti C, Li L, Vogelstein B. Stem cell divisions, somatic mutations, cancer etiology, and cancer prevention. Science. 2017 Mar 24;355(6331):1330-1334. doi: 10.1126/science.aaf9011. PubMed PMID: 28336671.
- Tomasetti C, Vogelstein B. Cancer etiology. Variation in cancer risk among tissues can be explained by the number of stem cell divisions. Science. 2015 Jan 2;347(6217):78-81. doi: 10.1126/science.1260825. PubMed PMID: 25554788; PubMed Central PMCID: PMC4446723.
- Tomlinson I, Sasieni P, Bodmer W. How many mutations in a cancer? Am J Pathol. 2002 Mar;160(3):755-8. PubMed PMID: 11891172; PubMed Central PMCID: PMC1867158.
I am fairly certain that most of the feathered dinosaur’s readers have read articles about alcohol health effects. It’s bad. It’s good. It prevents heart attacks. It causes cancer. It reduces risks of Sasquatch attacks but increases risks of alien abductions.
I know some of you are thinking that science never gets this right. Who are you to believe? An ancient feathered dinosaur? Your favorite news website? Your next door neighbor? Alien Sasquatch?
Well, there was a recent article published that employed a powerful systematic analysis of the body of published evidence surrounding alcohol health effects. Spoiler alert – drinking any amount may not be good for your health. Continue reading “Alcohol health effects – drinking any amount is bad, but is the science convincing?”
Despite the robust body of evidence supporting HPV vaccine safety and effectiveness, the European Medicines Agency (the European Union’s version of the US FDA) began a review of human papillomavirus (HPV) vaccines “to further clarify aspects of their safety profile,” although the agency also points out that this review did not “question that the benefits of HPV vaccines outweigh their risks.” In other words, the EMA examined the HPV vaccine adverse effects, real or imagined.
After a few months of investigation, the EMA came to a conclusion about HPV vaccine adverse effects – there were no major ones. Let’s take a look at this story.
Continue reading “HPV vaccine adverse effects and the European Medicines Agency”
As I’ve written before, there are just a handful of ways to reduce your risk of cancer. Don’t smoke. Stay out of the sun. Keep a healthy weight. Don’t drink alcohol. And get vaccinated with the HPV vaccine to prevent HPV-associated cancers (see Note 1).
Too many people who discuss the HPV vaccine, especially among the anti-vaccine religion, tend to focus on HPV-related cervical cancer. But HPV is linked to several dangerous and deadly cancers, and a new report examines the details of those cancers. Continue reading “43,000 HPV-associated cancers annually – HPV vaccine can prevent most”
I’ve written about this many times before – courts do not get to decide what is good or bad science. Although courts and science may not necessarily be incompatible, attorneys, juries, and judges are generally not trained in scientific research, scientific methods, scientific publications, and/or scientific reasoning.
Two relatively recent cases are strong evidence that courts and science can be quite incompatible. In the first case, a jury ordered pharmaceutical giant Johnson and Johnson (JNJ) to pay US$4.69 billion in damages to 22 women who claimed that the company’s talcum powder products caused ovarian cancer. In the second case, a jury ordered chemical manufacturer Monsanto to pay US$289 million to a janitor who claimed that Round-Up (glyphosate) caused his terminal cancer.
The problem with both of these cases is that there is, at best, some weak, unrepeated scientific evidence that supports their claims. However, if you refrain from cherry-picking articles on PubMed, you’ll find that the vast majority of research either doesn’t support their claims or even shows that there are no links between talc or glyphosate and cancer.
Let’s take a look at the science in both of these cases, and then, let’s find out why courts and science are not necessarily compatible. And remember, this isn’t a recent problem – an American court once rejected evolution during the infamous Scopes Monkey Trial. So science has been skeptical of the involvement of courts and science for a very long time. Continue reading “Courts and science – talc and glyphosate probably do not cause cancer”
Although I have no poll numbers sitting in front of me, and certainly no scientific peer-reviewed research, I just have a feeling that if you scratch the surface of an anti-vaccine activist, you will find that if they could hate one vaccine, it would be Gardasil. And one of the arguments will be all about Gardasil effectiveness – they claim it doesn’t actually prevent cancer.
When you couple their false claims about the dangers of the vaccine with the claims about the lack of Gardasil effectiveness, you’d probably agree with the anti-vaccine crowd. Despite these false claims, HPV vaccine uptake has slowly grown in the US and other countries.
I’ve written nearly 200 articles about the HPV cancer-preventing vaccine, but most of those are focused on debunking myths and confirming the safety of the vaccine. I’m going to focus on a quick primer about Gardasil effectiveness in preventing cancer. Stay tuned for some interesting science. Continue reading “Gardasil effectiveness – yes, HPV vaccine does protect you against cancer”