You’ve probably seen their commercials spread over all of the major TV networks. Beautiful scenes. Well-kept hospitals which often to appear to be near empty. And an anecdote or two or three from presumably real patients who describe their experience at Cancer Treatment Centers of America (CTCA), a private, for-profit operator of cancer treatment hospitals and outpatient clinics which provide both conventional and alternative medical treatments. Included in their treatment plans are chiropractic and naturopathy, neither of which have any evidence whatsoever in providing any healthcare benefit to patients, let alone those suffering from cancer.
Reuters recently published an in-depth report on the validity of the claims that are made by CTCA in its advertising. Here are some of the ones specifically mentioned:
For breast cancer, CTCA claims that its survival rate after 3.5 years post-diagnosis is about 42%, compared to the National Cancer Institute’s SEER (Surveillance Epidemiology and End Results) Program result (more or less a nationwide average) of about 29%. That’s a 13% improvement.
Potential causes for cancer are numerous. Infections. Radon gas. Cigarette smoking. Sun exposure.Obesity. With over 200 types of cancer, each with a different pathophysiology, there may be an equal (and probably greater) number of causes for “cancer.” Although many causes of cancer can be easily avoided, such as stopping smoking, testing your house for radon, getting an HPV vaccine to prevent human papillomavirus infections, and wearing sunblock to reduce the risk of melanomas, the sheer complexity and number of types of cancer means that there is probably not going to be any simple panacea to preventing (or even curing) cancer.
I’ve never been a fan of vitamin supplements. Aside from a very few supplements intended for a few specific clinical conditions, like vitamin C and scurvy, they have little use in preventing or treating diseases. In fact, because mammalian physiology has evolved a homeostasis for these chemicals, any excess amount that can’t be stored in the fat or other tissue is cleared by the kidneys and becomes part of your urine. I’m willing to venture that the urine of many Americans is quite expensive, with all of the cleared vitamins and other micronutrients. A balanced diet over several weeks is sufficient to provide the body with all of the nutrients and vitamins to be healthy and strong. You are not even required to have all vitamins and nutrients every day, as storage of a few nutrients will be released as necessary, and clinical manifestations of nutrient deficiency may take weeks or months.
The US Food and Drug Administration recently announced (pdf) that it had cleared 35 new drugs during 2012, of which 31 were novel therapies. This is in addition to the literally hundreds of approvals for changes in already approved drugs for changes in packaging, manufacturing, and dozens of other reasons.
In no particular order, here are the top 10 most interesting of the approvals based on my subjective viewpoint, which includes innovativeness, seriousness of disease, and other random factors. In others, no different in importance than all those end-of-year top 10 movie lists. So here we go: Continue reading “2012 Top Ten list for new drug approvals”
A new article published in the American Journal of Clinical Nutrition, by JD Schoenfeld and JP Ioannidis, examined the conclusions, statistical significance, and experimental reproducibility of published articles that claim an association between specific foods and the risk of cancer. The found 50 common food ingredients, taken from random recipes found in a typical cookbook. They then searched PubMed for studies that examined the relationship of each ingredient with a risk of cancer. (If they found a more than 10 articles for a particular search, the only evaluated the most recent 10 articles.) This study didn’t just examine increased risks but potential reduced risks of cancer.
According to Shoenfeld and Ioannidis, 40 out of the 50 ingredients had articles describing a relationship with cancer, which were published in 264 single-study assessments. Among the 40 foods that had been linked to cancer risks were flour, coffee, butter, olives, sugar, bread and salt, as well as peas, duck, tomatoes, lemon, onion, celery, carrot, parsley and lamb, together with more unusual ingredients, including lobster, tripe, veal, mace, cinnamon and mustard.
This is a story about clinical research, misinterpreting said clinical research, an overaggressive Public Relations department, honest scientists, and good scientific journalism. Let’s start at the beginning.
Men who had greater than 1 daily serving of diet soda had increased risks of NHLs and multiple myeloma. Women had no observed increased risks.
They also observed an unexpected elevated risk of NHL with a higher consumption of regular, sugar-sweetened soda in men but not in women.
Neither regular nor diet soda increased risk of leukemia but were associated with increased leukemia risk when data for men and women were combined.
Based on these results, you might think that diet sodas are dangerous, at least for men. Or maybe just sodas (or pop), whether sweetened with sugar or artificial sweeteners, are dangerous. Or maybe not. The authors themselves conclude:
Although our findings preserve the possibility of a detrimental effect of a constituent of diet soda, such as aspartame, on select cancers, the inconsistent sex effects and occurrence of an apparent cancer risk in individuals who consume regular soda do not permit the ruling out of chance as an explanation.
In other words, there’s really not much there. And that’s not bad in science. They tried to look for something, and they didn’t find anything. Maybe those men who drank sodas heavily had other confounding risk factors like obesity, diet, or other environmental factors. Or it may just be random.
At this point in the story, it’s just one of those published articles that really isn’t much of anything. No one would make much of it, because it really doesn’t provide much evidence that aspartame or sodas are that dangerous.
Then Brigham and Women’s Hospital puts out a press release with an attention grabbing headline of “The truth isn’t sweet when it comes to artificial sweeteners.” Now, if you saw that headline, you would have assumed that the article provided a solid conclusion that there was a direct causal link between artificial sweeteners and certain cancers. But the article said no such thing, it showed a very weak link, if one at all.
I guess the real scientists at Harvard saw the press release and decided their reputations mattered more than marketing the hospital in an unethical way. But whatever the real story, the hospital issued an “apology”:
It has come to our attention that the scientific leaders at Brigham and Women’s Hospital did not have an opportunity, prior to today, to review the findings of the paper entitled “Consumption of Artificial Sweetener and Sugar Containing Soda and the Risk of Lymphoma and Leukemia in Men and Women”, to be published in today’s Journal of Clinical Nutrition (sic). Upon review of the findings, the consensus of our scientific leaders is that the data is weak, and that BWH Media Relations was premature in the promotion of this work. We apologize for the time you have invested in this story.
Uh, it’s actually the American Journal of Clinical Nutrition, shocking they can’t get that right. Maybe I’m just being picky, but Public Relations should represent the organization better than that.
Robert Bazell, NBC News reported that “the situation is a great example of why the public often finds science confusing and frustrating. After being asked some hard questions – and just before the report was to be released — the hospital changed its tune.”
Bazell further reports that “the conclusion was so weak that the researchers had to submit it to six journals before they found a seventh, the American Journal of Clinical Nutrition, that would publish it. Few reporters read that journal. If it was not for the frightening headline no one would have known about this study.”
This study was a well-intended one that could have found a causal link if there was one, because of the way it sought out information. But it did not find the link, and that is how research is done. Sometimes, you find evidence of the null hypothesis, that artificial sweeteners don’t do anything.
And just in case there’s any confusion, Bazell reported that the lead author Schernhammer, when asked whether the published “research proves that aspartame is dangerous, she answered emphatically, ‘No, it does not.'”
Over the past couple of weeks, I have discussed a study by Gilles-Eric Séraliniet al. published in Food and Chemical Toxicology that concluded that glyphosate-resistant NK603 GMO corn developed by Monsanto causes severe diseases such as tumors in rats. Of course, the study was picked up by many anti-science groups and broadcast widely as “GMO foods cause cancer.”
The biggest criticism from both reviews is that Séralini and his team used only ten rats of each sex in their treatment groups. That is a similar number of rats per group to that used in most previous toxicity tests of GM foods, including Missouri-based Monsanto’s own tests of NK603 maize. Such regulatory tests monitor rats for 90 days, and guidelines from the Organisation for Economic Co-operation and Development (OECD) state that ten rats of each sex per group over that time span is sufficient because the rats are relatively young. But Séralini’s study was over two years — almost a rat’s lifespan — and for tests of this duration, the OECD recommends at least 20 rats of each sex per group for chemical-toxicity studies, and at least 50 for carcinogenicity studies.
Moreover, the study used Sprague-Dawley rats, which both reviews note are prone to developing spontaneous tumours. Data provided to Nature by Harlan Laboratories, which supplied the rats in the study, show that only one-third of males, and less than one-half of females, live to 104 weeks. By comparison, its Han Wistar rats have greater than 70% survival at 104 weeks, and fewer tumours. OECD guidelines state that for two-year experiments, rats should have a survival rate of at least 50% at 104 weeks. If they do not, each treatment group should include even more animals — 65 or more of each sex.
“There is a high probability that the findings in relation to the tumour incidence are due to chance, given the low number of animals and the spontaneous occurrence of tumours in Sprague-Dawley rats,” concludes the EFSA report. In response to the EFSA’s assessment, the European Federation of Biotechnology — an umbrella body in Barcelona, Spain, that represents biotech researchers, institutes and companies across Europe — called for the study to be retracted, describing its publication as a “dangerous case of failure of the peer-review system”.
The numerous issues relating to the design and methodology of the study as described in the paper mean that no conclusions can be made about the occurrence of tumours in the rats tested.
Therefore, based on the information published by the authors, EFSA does not see a need to re-examine its previous safety evaluation of maize NK603 nor to consider these findings in the ongoing assessment of glyphosate.
“The design, reporting and analysis of the study, as outlined in the paper, are inadequate,” said the EFSA in a press release, and added that the paper is “of insufficient scientific quality to be considered as valid for risk assessment”.
On the basis of the publication, the BfR has come to the conclusion that the authors’ main statements are not sufficiently corroborated by experimental evidence. In addition, due to deficiencies in the study design and in the presentation and interpretation of the study results, the main conclusions of the authors are not supported by the data.
Séralini refuses to release any of his data for public scrutiny, which is highly unusual for peer-reviewed research. One of the most important features of science is being open to the bright lights of criticism, which means review of data. I guess Séralini isn’t really happy that his research is being blasted by scientists worldwide, since the design, analysis, statistics, and conclusions barely met the standards of a high school science fair.
There are many reasons to loathe the anti-vaccine lunatics. Their decisions are based on pseudoscience and uninformed opinions. They listen to uneducated individuals instead of researchers who spend their lifetimes trying to understand the nuances of vaccines, the immune system and infectious diseases. They look for nonexistent conspiracies to such a point that they sound like a schizophrenic undergoing a psychotic break. They pretend to be interested in their children, and you almost want to believe them, but their conclusions are based on so little evidence, you begin to think that it’s all about the hype rather than the children.
The Charleston (SC) Post and Courier reports that Republican South Carolina Governor Nikki Haley vetoed a bill that would have provided sixth- and seventh-graders with information about the HPV vaccine. The vaccine would have been provided at no cost to all seventh-graders whose parents allowed them to have the vaccination. The bill had strong support from both Democrats and Republicans in the South Carolina legislature.
The HPV vaccine provides immunity to men and women against several types of human papilloma virus which is associated with with over 20,000 cancers in women and 11,000 cancers in men every year. Governor Haley defended her veto by calling the bill unnecessary and a “precursor to another taxpayer-funded healthcare mandate,” the Charleston Post and Courier reports.
State Rep. Bakari Sellers (D-Bamberg, S.C.) sponsored the bill and blasted Haley’s move, calling her decision one that…
puts her own selfish political ambitions ahead of the people of South Carolina. This bill had bipartisan support and gives optional education and preventative vaccines to adolescents in an effort to thwart cervical cancer. This is a common sense approach to a very serious problem. To call this measure unnecessary is demeaning and insulting to the heroic women who fight this cancer everyday. I am deeply disappointed that politics once again has prevailed over women’s health.
In 2007, Haley actually co-sponsored a bill that would provide mandatory HPV vaccinations. It failed to pass through the legislature because it failed to provide opt-outs, which was corrected in the 2012 version.
Let’s be clear here. Haley did not veto this bill because of bad medicine or bad science. She vetoed it purely for political expediency and by doing so, she stands firmly against a simple inoculation that would prevent a deadly cancer. This is not a political issue, it is an anti-cancer issue.
Vaccines save lives. I guess Nikki Haley doesn’t understand that! Maybe she’ll provide cigarettes for free to the school children of South Carolina.
Potential causes for cancer are numerous. Infections. Radon gas. Cigarette smoking. Sun exposure.Obesity. With over 200 types of cancer, each with a different pathophysiology, there may be an equal (and probably greater) number of causes. Although many causes can be easily eliminated, such as stopping smoking, testing your house for radon, getting an HPV vaccine to prevent human papillomavirus infections, and wearing sunblock to reduce the risk of melanomas, the sheer complexity and number of types of cancer means that there is probably not going to be any simple panacea to preventing (or even curing) cancer. In fact, some hereditary cancers, such as those individuals who carry genes that are implicated in breast and ovarian cancers, may not be preventable at all. Continue reading “Cancer prevention–supplements”