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Vaccine clinical trials – the anti-vaxxer pseudoscience is wrong again

Of all of the ridiculous tropes, memes, and lies about vaccines pushed by the pseudoscience of the anti-vaccine religion, vaccine clinical trials are the most annoying. They simply get it wrong on so many levels.

The anti-vaccine myths have popped again in a letter to the US Department of Health and Human Services (HHS) from Del Bigtree, the producer of the fraudmentary Vaxxed, who has approximately zero credibility on vaccines. He, and his anti-vaccine organization, Informed Consent Action Network, is nothing more than a sycophant to Mr. Andrew Wakefield, serving to push Wakefield’s fraudulent claims about vaccines for money and profit.

The aforementioned letter is an 88-page, yes, 88-plodding-pages, treasure trove of cherry-picking, pseudoscience, appeals to authority, other logical fallacies, lies, ignorance, misinformation, and delusion about vaccines. This is a letter is a follow-up to a response from HHS to Bigtree’s original laughable letter to HHS from January 2018.

Since my tearing down an 88-page rant would take 100,000 words, unless I showed some brevity and simplified my response to “Bigtree is a dumbass,” I thought I’d focus on a few key points over a few days. Of course, I might get bored and give up after this one article.

Given all that, I’m going to focus on Bigtree’s vast ignorance of vaccine clinical trials. He gets it all wrong. He doesn’t understand it. And, he is a dumbass. Not necessarily in that order. Continue reading “Vaccine clinical trials – the anti-vaxxer pseudoscience is wrong again”

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Cancer cures with complementary medicine? No, it’s ineffective and can kill

cancer cures

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?

Medicine.

Cancer primer

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.

Notes

  1. 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.
  2. 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.

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