Tuesday 18 December 2012

The (pseudo) science of desperation

This is probably a foolish thing to blog about as it is serious and emotive but this ongoing story of the mother who “abducted” her son rather than allow him radiotherapy has caught my attention due to it involving a) twins b) brain cancer: http://www.telegraph.co.uk/health/healthnews/9738778/Sally-Roberts-runaway-mother-in-despair-as-boys-cancer-returns.html

Now I am not going to pretend to imagine what it must be like to have one of your children diagnosed with an aggressive stage 4 cancer. It must tear a family apart. And the choices that a parent in this situation faces on behalf of their child hardly seem like choices at all. Rocks and a hard places spring to mind. But this story, along with another from my local area, have made me want to both weep and scream. It is not my place to comment on this poor family’s plight or to judge their actions – I truly think the parents are doing what they believe to be best. But in articles I have read there have been mention of the use of alternative therapies such as homeopathy and special diets instead of conventional radiotherapy. To me this epitomises why pseudoscience can be a dark and dangerous thing.

While flicking through my local paper a few months ago I came across an article about a fund raising campaign for a 4 year old girl with brain cancer [1]. Her family has so far raised an incredible £200,000 for her alternative cancer treatment at the Burzynski Clinic in Houston, Texas. I now need to add some context: my gorgeous, vivacious Mum was diagnosed last year, at the age of 55, with grade 4 glioblastoma multiforme (in layman's terms a f*cker of a brain cancer with a median life expectancy of 12-18 months and a 5 year survival rate of less than 10% [2]). So have I spent the last year jumping out of planes, scaling mountains and shaking a tin to raise money for her treatment in America? Or did she forgo “brain frying” radiotherapy in favour of crystal healing, a naturopath's diet and a foot massage? No, for the simple reason that the NHS has (so far) thrown all the resources they can at her and she has been doing better than can be expected considering her prognosis.

So it made me question why, with a local hospitable which has been publicly praised for its care of cancer patients and the pioneering, world leading Great Ormond Sreet Hospital just down the road, was this little girl sent to be part of a drug trial in Texas? I googled the Burzynski Clinic and soon my hackles were well and truly raised. It became apparent that I have been very slow to jump on this particular band wagon: the Burzynski Clinic is extremely controversial. I will try not to go into too much detail as there is a wealth of information (see links below) for you to peruse at your leisure. Many of our best contemporary science writers and bloggers (Simon Singh for example) have written about Dr Burzynski's methods and they have convinced me that at best this doctor is desperately trying to help but is sadly misguided.

Dr Burzynszki discovered the peptides he named “antineoplastons” in 1967 [3]. The Burzynski Patient Group refers to their use as “non toxic” and a “break through” treatment[4]...so why hasn't it broken through yet? If it is “non toxic” why are some of the reported side effects (such as seriously elevated sodium) so dangerous? Why are the interactions of antineoplastins with other traditional chemotherapeutic agents (some of which Dr Burzynski also administers to his patients) unknown? If these antineoplastons are so brilliant why has the medical profession not been using them for 43 years? Why has he published so little in peer reviewed journals? Why do both the American Cancer society and Cancer Research UK advise against this treatment[5]? Why have other scientists struggled to replicate his results? Why has he not conducted randomised, controlled clinical trials (considered the gold standard in clinical research)? Why hasn't he got a bloody Nobel Prize?! Could it be because, just maybe, antineoplastons aren’t actually very effective? Houston, you may have a problem.

Oh but I can hear it now....like thunder in the distance are the cries of the conspiracy theorists “it is the sole, brave maverick against the evil Big Pharma and the FDA”. Yes, the marverick who tries to use libel laws to prevent the freedom of speech of bloggers. And yes, there is a lot wrong with conventional medicine (I could probably discuss it with you when I put down my chick lit and finally get round to finishing Ben Goldacre's Bad Pharma). And yes, sometimes doctors do not explain risk and benefits clearly in layman's terms to terrified families. And yes, informed consent is a nice idea in principle but in reality can be difficult to achieve. And yes, cancer treatments (although better than they were) are still bloody scary with seriously shitty side effects.

Now I don't have a problem with patients using complementary methods in addition to their conventional ones. Some reflexology or reiki may be an enjoyable way to relax and feel better. But if they are used instead of, or interact negatively with, conventional treatment surely they must be considered dangerous. As hard as it is when a loved one may not celebrate another birthday it is important to remember that a patient testimonial is not the same as hard clinic data, however heartfelt it may be. Unproven remedies are just that, unproven: that means they may not work and could cause harm (either directly or because other treatments, with known efficacy and levels of risk, are ditched). Sometimes life deals a curve ball and the choices we are forced to make are not black and white between hope or non hope but the grey area between quality of life and longevity.

Science and technology defines us as a species. It is the questions “how”, “why”, “what if...?” that allow us to increase our knowledge and understanding of the universe and in turn manipulate our own environment and destinies. When done well it epitomises the best of humanity: observant, empirical, creative and solution-focussed. It is the sharing of resources and data, openness to new ideas, international collaboration and well designed and well conducted research that allow us to make evidence based decisions for the benefit of both individuals and society. The alternative medicine industry appears to be directly at odds with this, giving false hope to people at their most vulnerable.


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