One of my ‘go to’ medical information and discussion sites is one called ‘Science Based Medicine’. Whilst I may not always agree with them on some issues such as gender transition medicine, they are very very solid on promoting medicine that has its basis in empiricism.
They’ve recently been speaking about a book by Edzard Ernst about the value of alternative medicine in cancer treatment and I’ve got a feeling that this might be a book on my future reading list. This is because I’ve recently read ‘Snake Oil’ by the late John Diamond which was excoriating about alternative medicine and how it is so poorly based in reality that it can barely be called medicine.
Of course some medical effect on some conditions can be explained away by the placebo effect. For example, the dilutions used in Homeopathy are so infinitesimally small that the ‘medicine’ that is given to the patient hardly contains any active ingredient in it at all. Because the patient believes that the homeopathic potion will make them better then they start to feel better.
This sort of alternative medicine is relatively harmless. It’s no different from a doctor giving a sugar pill to treat a plainly psychosomatic condition. However where things go wrong and end up doing great damage is when those being treated for cancer fall into the hands of alternative medicine quacks and put their faith not in the evidence based medicine of the chemotherapy, but in woo.
The Science Based Medicine article said:
The introductory section explains what evidence is, why it is important, common misconceptions about , why people are attracted to it, ethical concerns and truly informed consent, science vs. pseudoscience, and why clinical trials can reach false conclusions. Then he proceeds to briefly describe the various modalities that have been offered to cancer patients in separate sections covering cancer prevention, cancer treatment, and palliative/supportive care. He grades each modality on five factors: plausibility, effectiveness, safety, cost, and risk/benefit balance. He uses the same simple system of colored thumbs that he used in his earlier book Alternative Medicine: A Critical Assessment of 150 Modalities: a green thumbs-up symbol for positive, a horizontal yellow thumb for debatable, and a red thumbs-down for negative.
In two final chapters, he covers the risks of , interactions between SCAMs and conventional cancer drugs, and published evidence showing that cancer patients who use SCAMs don’t have improved quality of life, are less compliant with prescribed pharmaceuticals, and don’t live as long as patients who don’t use them.
This book appears on the face of it to be fair minded and evidence based, the author accepts that some alternative therapies could be helpful in treating some of the awful side effects of chemotherapy such as nausea. But looks as if the author is much more critical of woo peddlers who claim to be able to treat or prevent cancer.
As I enjoyed the justifiable dig that Mr Diamond took at the woo peddlers of the alternative medicine crowd, I might see if this book is available and affordable where I am. If I do get this book then of course I’ll do a review.
