Thursday, 23 June 2011

Miracle Cures

Beware Of False Prophets
It is tempting for cancer sufferers, and their friends and family, to look around at other treatment options, particularly if current treatments start to fail. In some cases people want to complement what they are getting from their oncology team – either because they want to lessen some of the horrendous side-effects of chemo or radiotherapy or because they want to boost the effectiveness of the protocol they are on. There are some people who simply don't want to go the conventional route – though this is a very high-risk strategy to adopt and is not one that is recommended (this is a topic that I will come back to in a future post). In other cases conventional treatments fail, the disease progresses or recurs, and there are few standard options available so the search for something new takes on a particular urgency. The first port of call for people in these different situations is the internet. And this too, can be dangerous, as you soon discover.

The last time I looked, the search term 'cancer cure' came up with 103,000,000 hits. Yep, 103 million hits. That is an unimaginably huge cache of information to process. And, unfortunately, a lot of that information is both dangerous and worthless. In our search for treatment options, (particularly once George's treatments started to fail), we came across plenty of sites that were offering miracle cures for cancer. No matter what type of disease, or at what stage, there were people out there who were promising to both treat and to cure. That alone should be setting alarm bells ringing in any sane person.

In general there are two distinct subsets of these promised cures, with some more credible looking than others.  On the one hand there are the promised cures that appear to be based on science and those that are decidedly, and in some cases proudly, unscientific.

This is the 'new age' realm of crystals, healing hands, secret chants or spells, spiritual approaches and so on. This is obviously at the extreme end of the scale and is easily spotted. There is little appeal to science or research, but there are lots of anecdotes (including death-bed cures) and hints of secret lore. There's a degree cross-over with herbal medicine and or homeopathy and similar sometimes, which may have a bit more of a link to research, but this too is tinged with magical thinking. Basically this is as far away from conventional treatment as you can get.

This isn't to dismiss the spiritual side of things completely – there is plenty of evidence that meditation, for example, can help relieve stress and can have some positive physiological effects, but that isn't what is being offered here.

At the other extreme are those miracle cures that, on the face of it at least, appear to be based on a solid scientific rationale. In many ways these are the more dangerous therapies because they can appear to be so convincing. In some cases the people promoting these treatments can even point to scientific papers that seem to support what they are saying. Examples include proponents of high-dose oral vitamin C or other supplements, alkalizing, special diets, herbs or purveyors of special machines (normally some kind of electromagnetic device).

Very often the papers that support these therapies are either very old and/or published in obscure journals (and often not followed up by newer research). Often they are in vitro studies (and please read the article on 'How To Read A Cancer Paper' to see why this is of limited value) with no evidence of animal or human trials. There may be a germ of a good idea in the research – for example tumours create highly acidic microenvironments in which they thrive, so there's a rationale for alkalizing – but that is a long way from a fully researched and effective treatment (let alone a cure).

Similarly with vitamin C, sodium bicarbonate, caesium chloride, curcumin, quercetin, methyl jasmonate, glutamine, Chinese mushrooms and so on. Many of these have proven anti-cancer properties, not just in the test tube, but in rats and mice, and often for more than one type of cancer. But these are not cures, and they are certainly not worth betting your life on as a mono-therapy (i.e. as the only therapy). Very few of them have been tested in patient trials, and yet there are people on the internet promising to cure cancer with them. Investigate as potential supplements to existing treatments by all means, but never as the sole thing.

No Miracles
The sad truth is that there are no miracle cures. There are no secret answers that the drug companies are stifling. Anyone who promises a cure is lying. At best some of these things might be worth adding to existing therapies – a complement rather than an alternative. Even then, care has to be taken not to interfere with existing treatments, and to make sure that what you take is in safe doses and comes from reputable sources.

Existing treatments are often horrible. Chemotherapy drugs are highly toxic and dangerous. Radiotherapy is barbaric and can cause painful side effects. But for the moment they are best we have and no matter how horrible it's madness to ignore them in favour of magic crystals or dietary supplements. With the best of the suggested alternatives – such as anti-inflammatory supplements like curcumin or quercetin – it is worth looking at how they can support treatment but not as a standalone treatments.

One of the many questions that needs to be kept in mind when researching this stuff is 'what does the person proposing this treatment get out of it?' In many cases there are people advocating for alternative treatments for entirely honourable reasons. They genuinely believe that what they are doing is helping people (and who knows, the placebo effect is powerful enough for just about anything to have a positive effect for a while in some people). In some cases there’s an almost ideological or theology fervour but it seems to be based on a genuine desire to help people, not to defraud.

However, it's also clear that there are some very mercenary individuals out there who are ready to prey on sick and desperate people. They may be selling expensive supplements or herbs, expensive clinic time or untested technologies and treatments. Some of these will be outside the UK, but there are people in this country doing it too. I know of people who have paid thousands for worthless treatments in Harley Street from qualified doctors selling little more than what you can buy from a high street health food shop. It’s fraud of the worse kind, and can end up killing not curing the patient.

The Rules
The bottom line has to be this: do not take things on trust. Whether it's dire predictions of environmental catastrophe, the effectiveness of fad diets, the ability to second-guess the stock market or a proposed cure for cancer, it is essential to retain a high degree of scepticism. You need to demand some evidence of effectiveness – even if there's an absence of clinical trials, what does the experience in animals show? What is the underlying scientific rationale? Is anyone actively researching and publishing in this area? What is the evidence for how this treatment interacts with other treatments (like chemo, radiotherapy etc)?

All this is not to say that everything is hunky dory in the world of conventional oncology. Far from it, if things were OK then we wouldn't need to resort to looking for alternatives or complements to the therapies that exist and are in common usage. And just as there are quack cures that do more harm than good, there are plenty of  conventional treatments being researched that will turn out to be dangerous and ineffective. While I don't hold with the conspiracy theories that say the drug companies have stifled a cure for cancer for commercial reasons, there are criticisms that need to be made about the whole research process – again this is something I will come back to in the future.

What Is The Web Good For?
Where the internet comes into its own is in offering the ability to see what new treatments are being used in other countries and what the results are. It offers the chance to talk to doctors abroad, and sometimes to track down such new treatments in a different part of this country. It gives a picture of what treatments are in clinical trials or what has strong pre-clinical evidence of efficacy. There's the chance to contact researchers directly, including those running trials, and to ask questions (this was something we did a lot).

There's a wealth of information out there, good and bad. The important thing is to remain sceptical at all times but also to retain hope that there are things that you can find that help your existing situation, or which offer new options in other parts of the country or abroad.

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