Read Trick or Treatment Online
Authors: Simon Singh,Edzard Ernst M.D.
Dr Wallace Sampson, who is now editor-in-chief of the
Scientific Review of Alternative Medicine
, was a cancer specialist in California at the time, and he became puzzled when three of his patients suddenly stopped appearing at his clinic. After a little investigating he learned that they had started visiting a cancer clinic in Tijuana where they had been receiving laetrile. All of them claimed to be experiencing remarkable recoveries, but within a few months they had all died. Sampson did not dismiss laetrile immediately, but instead interviewed thirty-three other patients who were taking this treatment and compared them with twelve of his own patients. After matching them for age, sex and type of cancer, he noted that on average the patients on laetrile died sooner than the patients receiving conventional treatment.
The American Cancer Society labelled laetrile as ‘quackery’ in 1974 and the therapy was discouraged in America. Nevertheless, many patients still sought out laetrile and travelled to clinics in Mexico, where doctors such as Ernesto Contreras were making grand claims and even grander profits. By 1979, Contreras boasted that he had treated 26,000 cancer cases, but his achievements appeared hollow when the Federal Drug Administration asked for details of twelve of his most impressive cases. It turned out that six patients had died of cancer and one still had cancer, two had turned to conventional therapy and three could not be located. Nevertheless, patients continued to flock to Mexico, including Steve McQueen, who died in 1980 within five months of turning to laetrile.
At last, in 1982, the
New England Journal of Medicine
published a paper which stated conclusively that laetrile was ineffective. Four prominent cancer clinics monitored 178 cancer patients taking laetrile and observed that their overall condition deteriorated in the way that would be expected if they were receiving no treatment at all. Worse still, the researchers suspected that patients might be poisoned by laetrile (also known as
amygdalin
): ‘Patients exposed to this agent should be instructed about the danger of cyanide poisoning, and their blood cyanide levels should be carefully monitored. Amygdalin (Laetrile) is a toxic drug that is not effective as a cancer treatment.’ An accompanying editorial noted: ‘Laetrile has had its day in court. The evidence, beyond reasonable doubt, is that it doesn’t benefit patients with advanced cancer, and there is no reason to believe that it would be any more effective in the earlier stages of the disease…The time has come to close the books.’
Despite such evidence, far too many patients continue to spurn conventional treatment in favour of laetrile and other plant-based medicines. The ultimate result is simply a lower survival rate. If academic studies are not enough to make this point, then perhaps the appalling case of Joseph Hofbauer might serve as a warning. Aged eight and suffering from Hodgkin’s disease, Joseph was taken off conventional treatment and instead was given laetrile. The New York State authorities had attempted to prevent Joseph’s parents from following this path, but a family court judge ruled against the State. Chemotherapy would have offered Joseph a 95 per cent chance of surviving five years and becoming a teenager. Laetrile treatment, however, meant that he was dead within two years.
An equally tragic case, this time concerning St John’s wort, also demonstrates what can go wrong when patients follow the path of herbal medicine and ignore the benefits of conventional medicine. The patient in question was Charlene Dorcy, a Canadian woman who had suffered severe depression and had attempted suicide several times since the age of thirteen. As an adult, she was diagnosed with paranoid schizophrenia. In the mid-1990s, however, she seemed to have turned the corner thanks to the antipsychotic drug
Tegretol
. Indeed, Charlene was described as a ‘success story’ when she was interviewed by the
Columbian
newspaper in Vancouver as part of an article on the stigma associated with mental illness.
Although Tegretol is known to have several potential side-effects, these are well understood and in Charlene’s particular case there were no signs of any significant problems. Nevertheless, Charlene became convinced that a natural alternative would be preferable to Tegretol and she switched to St John’s wort soon after her newspaper interview. We already know that St John’s wort can give rise to adverse side-effects and interact with other medications, but an equally dangerous hazard arises when it is used to treat an inappropriate condition. And Charlene’s condition was wholly inappropriate for treatment by St John’s wort.
St John’s wort can be effective for mild or moderate depression, but it does not seem to help with severe depression or other forms of mental illness. Worryingly, Charlene was not atypical when she used St John’s wort in an inappropriate manner, because a survey of 30,000 Americans published in 2007 found that the majority of those people who self-administer herbal remedies do so in a way that runs counter to the evidence.
When Charlene switched medication, this had the double effect of depriving her of the benefits of Tegretol and exposing her to the adverse effects of St John’s wort, which has been associated with aggravating psychosis in schizophrenics. Soon afterwards her condition deteriorated, and she exhibited volatility, intolerance, mood swings and repeatedly attempted suicide.
On 12 June 2004, after weeks of particularly erratic behaviour and further suicide attempts, Charlene Dorcy drove her two children to an abandoned quarry. She made two-year-old Brittney and four-year-old Jessica sit on the ground and then shot them with a .22-calibre rifle. She drove back to Vancouver, called the police and then led detectives back to the quarry where they found the children’s bodies.
Why do smart people believe odd things?
We have drawn upon the results of hundreds of scientific papers in order to examine the four major strands of alternative medicine: acupuncture, homeopathy, chiropractic therapy and herbal medicine. While there is tentative evidence that acupuncture might be effective for some forms of pain relief and nausea, it fails to deliver any medical benefit in any other situation and its underlying concepts are meaningless. With respect to homeopathy, the evidence points towards a bogus industry that offers patients nothing more than a fantasy. Chiropractors, on the other hand, might compete with physiotherapists in terms of treating some back problems, but all their other claims are beyond belief and can carry a range of significant risks. Herbal medicine undoubtedly offers some interesting remedies, but they are significantly outnumbered by the unproven, disproven and downright dangerous herbal medicines on the market.
In general, the global multi-billion-pound alternative medicine industry is failing to deliver the sort of health benefits that it claims to offer. Therefore millions of patients are wasting their money and risking their health by turning towards a snake-oil industry. Also, bear in mind that we have concentrated our book on the more respectable end of the alternative medicine industry. It is shocking to think that there are dozens of even more dubious alternative therapies, which make even more outlandish claims in order to extract even more money from their patients.
These wacky therapies are among those included in the appendix, where we devote one section to each of over thirty forms of treatment. We examine each therapy’s history, practice, claims and dangers. A few, such as yoga, do seem to offer genuine medical benefit, but the majority are unproven or disproven.
For example, magnet therapy is at the more negative end of the spectrum. Healers throughout the centuries have claimed that magnets have curative powers. Cleopatra supposedly wore a magnet to preserve her youth, the sixteenth-century Swiss physician Paracelsus declared that ‘all inflammations and many diseases can be cured by magnetism’, and in 1866 Dr C. J. Thacher’s catalogue offered a complete body suit with 700 magnets, which provided ‘full and complete protection of all the vital organs of the body’. Today the annual global market for therapeutic magnets is over $1 billion, which includes magnetic bracelets, shoe insoles, neck braces and even pillows. The manufacturers boast that magnets placed close to the body can treat various ailments, such as helping to heal bones, improving blood flow and relieving pain. Unfortunately, the rigorous research conducted on magnet therapy does not back up any of these claims. Magnet therapy would not be a very serious issue if it were merely a matter of arthritis sufferers wasting £10 on a useless magnetic bracelet, but the problem extends to dozens of websites offering products costing up to £2,500, including mattresses that can supposedly treat cancer.
A quick internet search will reveal crystal healers, reflexologists, aura cleansers and all sorts of other peculiar practitioners who make ambitious claims with no scientific evidence to back them up. For instance, when we searched Google, the first link took us to a clinic offering
tachyon therapy
, which can apparently heal broken bones and torn ligaments. Tachyons are particles that can travel faster than the speed of light and were hypothesized half a century ago by physicists. Bearing in mind that nobody has yet proved their existence, it is surprising to learn that somebody has been able to exploit them for medical purposes! Moreover, this clinic also offers an even more bizarre and sensational therapy: ‘Multi-dimensional DNA Surgery is a channelled technique for clearing dysfunctional patterns at the level of the DNA and replacing them with Divine qualities’.
Many of these websites contain buzzwords such as energy, waves and resonance. These words certainly have scientific significance when used appropriately, but they are largely meaningless when used in the context of alternative medicine. For example, therapeutic touch is a form of alternative medicine that works by supposedly manipulating a patient’s ‘energy fields’ to treat a range of conditions, including pain relief, healing wounds and cancer. The practitioner usually does not even need to touch the patient, which is why the treatment is also known as ‘non-contact therapeutic touch’ or ‘distance healing’. Therapeutic touch has much in common with
reiki therapy
, inasmuch as energy fields are supposedly manipulated, often without needing to touch the patient. Although therapists charge up to £100 for a single session of therapeutic touch or reiki, it is worth noting that nobody has ever properly defined what they mean by these human energy fields, demonstrated that they actually exist or proved that they can be manipulated to improve health.
In fact, there is plenty of evidence that such human energy fields are just a myth. In 1996 a scientist based in Colorado decided to investigate therapeutic touch by testing the abilities of twenty-one healers. Emily Rosa simply asked each healer to place both hands through two holes in a screen. She would then flip a coin to decide whether she would place her own hand close to the healer’s left or right hand. The healer then had to sense Emily Rosa’s energy field to decide where she had placed her hand. The twenty-one healers had 280 attempts in total and beforehand they were confident that they would consistently be able to sense the location of the scientist’s hand. Chance would predict a 50 per cent success rate, but in fact the therapeutic touch healers could guess correctly only 44 per cent of the time. The experiment showed that the energy field was probably nothing more than a figment in the imaginations of the healers.
At this point, it is worth pointing out that Emily was only nine years old when she conducted this experiment. It was originally her school science fair project, but two years later she wrote up her research with the help of her mother, a nurse, and it was published in the highly respected
Journal of the American Medical Association
, making Emily the youngest person (as far as we know) ever to have a research paper published in a peer-reviewed medical journal. Not surprisingly, there were some critics who remained unimpressed with Emily’s paper, which was entitled ‘A Close Look at Therapeutic Touch’. Dolores Krieger, who formulated the principles of the therapy, accused the research of being ‘poor in terms of design and methodology’. In fact, Emily’s protocol was simple and clear and her conclusion was hard to fault. Moreover, nobody has ever come up with an experiment that has overturned her findings.
According to Emily’s research and other trials, therapeutic touch, reiki and many other related therapies are based on nothing more than wishful thinking. Any benefit that they offer seems to be entirely attributable to the placebo effect. Nevertheless, these therapies are part of a massive, global industry – according to Emily’s paper there are 100,000 trained therapeutic touch healers worldwide, presumably treating millions of patients, and earning several £100 million every year. The typical patients for these so-called energy therapies and other ineffective alternative therapies are neither stupid nor naïve. This raises an interesting question – why is it that a nine-year-old child was capable of testing and disproving the claims of therapeutic touch, while grown adults are completely fooled by these healers?
This section is devoted to looking at the reasons why smart people believe in alternative medicine, when we have shown that so much of it is ineffective. The reasons must be compelling in order to persuade millions of people to part with billions of pounds in a misguided attempt to protect their most precious asset, namely their health.
The initial reasons why people find alternative medicine appealing are often related to the three core principles that underlie so many of the therapies – they are said to be based on a more
natural
,
traditional
and
holistic
approach to healthcare. Advocates of alternative medicine repeatedly cite these principles as strong grounds for adopting alternative medicine, but, in fact, it is easy to show that they are nothing more than clever and misleading marketing ploys. The three principles of alternative medicine are really fallacies: