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A ghoul descends upon Christina Applegate’s “maimed” body

i-dafc39d1d2dec2fae5bf2bb0862535c3-applegatex.jpgThis is getting to be nauseatingly frequent.

As my blog bud Mark Hoofnagle pointed out, the hard-core “alternative medicine” mavens, in particular that despicable promoter of quackery and distrust of scientific medicine who runs one of the two or three largest repositories of antiscience and quackery in existence, Mike Adams, seem to have decided that a lovely new tactic would be to descend upon every celebrity death or battle with serious disease, ghoul-like, and blame their deaths or suffering on conventional medicine rather than disease. Both PalMD and I noted this particularly vile tactic applied to the recent death of former White House Press Secretary Tony Snow, and Adams has done the same thing in response to the deaths of Tim Russert (whose death he blamed on the heart medications Russert was taking), Heath Ledger, and Bernie Mac as well. Oddly enough, the ghoul appears not to have descended upon the corpse of Isaac Hayes yet, even though every indication is that Hayes, having suffered a stroke a while back, died of another stroke. Maybe it’s because Hayes was a prominent Scientologist, and even Adams is afraid of messing with the Church of Scientology. Maybe it’s because, before his turning to Scientology, Hayes was so über-cool that even Adams fears messing with his memory. Who knows?

In any case, I don’t know if dancing on the graves of celebrities as “evidence” that conventional medicine killed them is a new tactic, but I do know that I seem to be seeing it more and more. Whether that’s confirmation bias on my part or a true increase in the use of this particularly condemnation-worthy ghoulish gloating I don’t know. What I do know is that Mike Adams and others of his ilk seem to be hovering, waiting for celebrity deaths that they can blame on “conventional” medicine, no matter how much torture they must inflict on science, medicine, and even reason itself to pin these deaths on their hated “allopathic” medicine.

Last week, it turned out that Mike Adams, at least, doesn’t even need to have a dead celebrity as an excuse to torture science. All he needs is a celebrity with cancer who decided to pursue science-based therapy. This time around, in response to Christina Applegate’s battle with breast cancer and decision to undergo bilateral mastectomies, Adams has published yet another of his spittle-flecked screeds, this time charmingly entitled Christina Applegate Maimed by Surgeons with Double Mastectomy Following Breast Cancer Diagnosis. This article is yet more indication that Mike Adams is about as low as they come. The word “scum” is too good for him. Just check out how his article starts out:

(NaturalNews) Following her diagnosis with breast cancer, actress Christina Applegate decided to have both of her breasts surgically removed, believing that physically removing her breasts would save her from cancer. The double mastectomy procedure is an all-too-frequent choice by women who have been scared into limited treatment options by mostly male doctors who think nothing of physically maiming a woman and cutting away organs that are often closely tied to a woman’s self identity.

Of course, Adams has done this sort of thing before with regards to Breast Cancer Awareness Month, and I expect he’ll do it again come October. One of the most obvious and egregious omissions from Adams tirade is the most important fact that you need to know in understanding why Applegate decided to undergo this procedure. It’s that Applegate’s mother battled breast cancer and that, after Applegate herself developed breast cancer at the tender young age of 36, she underwent genetic testing and tested positive for a mutation in the BRCA1 gene, which results in a very high lifetime risk of developing breast cancer. Depending upon the specific mutation (not all BRCA1 mutations produce the same lifetime risk for breast and ovarian cancer), the lifetime risk of developing breast cancer can be as high as 85%.

This is not a case of evil “allopathic” male physicians chuckling and rubbing their hands together lasciviously as they contemplate the opportunity to rip the beautiful breasts off of a beautiful woman just because they can, as Adams implies. (Never mind that many, if not most, breast cancer surgeons these days are women.) No, it’s a rational, science-based approach to trying to obviate the very high risk of breast cancer that possessing this mutation portends. The choices involved when a young woman with breast cancer is found to have this mutation are hard, both for the woman, her surgeon, and her oncologists. By their very nature they involve tradeoffs: “maiming” to decrease the risk of cancer versus, for example, close followup after treatment for her cancer in order to detect new cancers early at the price of living with constant fear of a new primary cancer or that her cancer will recur (more on that later). These are the real issues that must be discussed with women and later agonized over by these same women as they try to decide what to do, and there’s no reason to think that Applegate was any different. Of course, in Mike Adams’ fantasy world, the issues that we practitioners of science-based medicine know to be incredibly difficult to deal with are fantasized to be simplicity itself:

When pushing that high-profit double mastectomy procedure to Christina Applegate, what cancer doctors did not tell her is that breast cancer has many natural cures, and none of them require surgery. In fact, breast cancer is one of the most easily cured forms of cancer, and had Applegate been informed about her options, she might have chosen to avoid being surgically maimed, and she could have lived out her life with her natural-born breasts

.

First off, double mastectomies are not “high profit,” at least not for breast surgeons like me. Plastic surgeons’ reimbursement is far higher. Indeed, breast surgery is, alas, one of the lower-reimbursed surgical specialties. I suspect it’s because the surgery itself is not (usually) that technically difficult (although with skin-sparing mastectomies and sentinel lymph node biopsies it has become more difficult), but, as is the case with our primary care colleagues, the level of reimbursement doesn’t take into account the large amount of time it takes to counsel women on these very issues. But that’s just me whining. What’s more egregiously stupid in the above quote is Adams claim that there are “natural” cures for breast cancer that do not require surgery. That’s a lie.

Naturally, to Adams, like woo-meisters ranging from Ryke Geerd Hamer to Robert O. Young, believes that cancer is not the disease itself but rather a “manifestation” of something else wrong, be it a “psychic trauma” a “pH imbalance,” or a liver fluke, except to him it’s much more vague:

Cancer is not defined by a physical tumor. Cancer is a systemic failure of the immune system and cellular communication. You can remove a tumor from one area of the body, but unless you eliminate the underlying causes of cancer, tumors will likely reappear somewhere else.

Thus, by surgically removing Christina Applegate’s breasts, cancer surgeons have misled her into thinking she’s cured, when in reality, she now has the exact same risk of cancer coming back as she did before the surgery.

In other words: She gave up both breasts and still didn’t cure her cancer!

Such is the “treatment” offered by the fraudulent cancer industry.

Such are the lies offered by the fraudulent and vile Mike Adams.

First off, when surgeons and oncologists counsel women about cancer, they rarely, if ever, use the term “cured.” Rather, they talk about long term survival rates. It’s the same when they discuss prophylactic mastectomy or oophorectomy, they do not tell women they are “cured.” They tell women, based on science, that their risk of cancer will be decreased by surgery. How much? First, understand that prophylactic surgery will not reduce the risk to zero, just as a mastectomy with curative intent never reduces the risk of local recurrence to zero. The reason is that it is impossible to remove 100% of breast tissue. If a thin layer of fat, which will contain a small amount of breast tissue as well, isn’t left under the skin flaps left after a mastectomy, the skin flap will die because its blood supply is located in a plexus of blood vessels in the tissue directly underlying the skin. Consequently, for a mastectomy it’s always a balance between making the flap as thin as possible without compromising its blood supply. In the case of women already diagnosed with breast cancer or preinvasive breast cancer (we don’t know which one Applegate has, other than that it’s early stage), there is also always the chance of the tumor recurring, either in the breast or elsewhere in the body, strictly based on its biology. When appropriate, radiation and chemotherapy can reduce this risk further than surgery alone.

How much does prophylactic mastectomy reduce the risk of breast cancer? That’s a tough question. Older studies provide risk reduction estimates between 50-100% at the 95% confidence level. More recent studies suggest a roughly 90% decrease in the risk of breast cancer, and a study presented at the 6th European Breast Cancer Conference in Berlin, Germany earlier this year estimated that the risk of breast cancer in women carrying cancer-associated BRCA1 mutations could be reduces from 85% to 1% by prophylactic surgery. This study probably doesn’t strictly apply to Applegate’s case because she already has cancer and, even if she has stage I disease, her risk of recurrence is greater than 1%. Nonetheless, whatever the true risk reduction, it is true that data from the last ten years or so have demonstrated a very real and very marked reduction in risk for breast cancer in women with BRCA1 mutations who undergo bilateral prophylactic mastectomy, either as part of treatment for breast cancer (in which case one mastectomy is with the intent to treat and cure and the other is with the intent to prevent cancer) or as a preventative measure. Even given the efficacy of bilateral prophylactic mastectomy, only a minority of women with BRCA1 mutations undergo the procedure, which leads in to a brief discussion of other options:

  • Surveillance. This involves very close surveillance for cancer in the hope of catching it early. The up side is that the woman can keep her breasts. The down side is that it is labor-intensive, expensive, and leaves the woman with long-term emotional distress due to worry over the specter of breast cancer that is always haunting her life. Although the exact regimen varies, generally these days it involves yearly mammography and MRI, often staggered so that the woman is getting a screening test every six months, along with physical exaination every six months and monthly self-breast examination. In the long run, especially for young women, this option is very difficult and, now that MRI is routinely recommended on a yearly basis for women at high risk for breast cancer, expensive.
  • Chemoprevention. This generally involves taking either estrogen-blocking drugs such as Tamoxifen or an aromatase inhibitor for five years to decrease the risk of developing breast cancer. This is not as effective as surgery, and the medications are not without side effects. However, they can reduce the risk of estrogen receptor (ER)-positive tumors, which is the type of tumor that can be treated with estrogen blockade. The problem is that approximately 70% of tumors in women with BRCA1 mutations are ER-negative compared with approximately 30% of breast cancer in the general population, making chemoprevention less effective.
  • Risk avoidance. Avoid risk factors for cancer by exercising regularly and minimizing alcohol consumption. Obesity and alcohol are weak risk factors for cancer (far weaker than BRCA1 mutations or reproductive history), but the NCI recommends this.

Also remember that none of these options deals with another aspect of BRCA1 mutations: The greatly increased risk of ovarian cancer. It’s not as huge as the risk of breast cancer, but it’s quite elevated, and, unlike the case for breast cancer, there is nowhere near as good a screening test for ovarian cancer. The question of prophylactically or “pre-emptively” removing the ovaries thus comes up, and that question is fraught with difficulty in timing, given that women diagnosed as BRCA1 carriers before they have borne children will have to decide whether to have their ovaries removed and give up their chance of bearing children or to wait until after they have children and take the chance of developing ovarian cancer. There’s also the issue that having the ovaries removed is in essence the same thing as the chemopreventative drugs and renders the need to take them moot.

But, hey, Mike Adams tells us it’s all really, really easy! All Applegate has to do is to exercise, take Vitamin D, eat an “anticancer” diet, and take “anticancer herbs,” and she could have cured her cancer without all that nasty surgery. I really, really hope that women who read Adams’ nonsense who might have breast cancer, or even a BRCA1 mutation, don’t fall for his lies. It could mean the difference between life and death, and I personally view Adams as being just as responsible if women with BRCA1 mutations listen to him and don’t undergo appropriate surveillance or preventative surgery, thinking that they will never get cancer if they just follow Adams’ quackery, as I view antivaccinationists as being responsible for the resurgence of measles and every case of encephalitis and death that will occur in the future because they have frightened parents into not vaccinating. Adams will have deaths on his hands. He probably already has.

While oozing slime as he condenscendingly–even sarcastically–concedes that Applegate is courageous, Adams in his typical fashion of dismissing anyone who decides upon pursuing scientific medicine makes it clear that he views Applegate as hopelessly duped by those same evil “allopathic” physicians–duped to the point that she would submit to being “maimed” by them:

Many women in America today look at Applegate and consider her courageous for making such a decision. She is, indeed, quite courageous. Allowing surgeons to physically maim your body in a desperate attempt to save your own life takes real courage. Applegate is to be commended for that attribute, at least.

But at the same time, Applegate is sadly misinformed, and she has now permanently damaged her body and yet achieved no lasting safety from cancer.

Not surprisingly, according to Adams, all is not lost. He goes on to say that, if Applegate “repents,” rejects apostasy, and converts to his religion of “natural cures,” she can still be saved–yes, saved!–from cancer (yes, I’m intentionally using religious language):

Of course, if she starts taking anti-cancer herbs right now, she can easily prevent cancer for the rest of her life. Preventing cancer is simple and straightforward: It only requires daily exposure to the right nutrients (phytonutrients, vitamin D, etc.) and protection from exposure to cancer-causing chemicals — especially endocrine disruptors like cow’s milk, conventional meats, plastics, pharmaceuticals and food additive chemicals.

I can tell you right now with near-certainty that Applegate is vitamin D deficient. This is what allowed her cancer to grow to the point where it was large enough to be diagnosed. Sufficient levels of Vitamin D in your blood prevent 77% of ALL cancers (including breast cancer). Read that story here: http://www.naturalnews.com/021892.html

That’s correct: One nutrient prevents 77% of all cancers. Yet I’d be willing to bet a substantial sum of money that Applegate’s doctors never even told her about this simple, powerful anti-cancer nutrient that she could get for free!

That’s right. “Repent and worship our natural religion,” urges Adams, “and you will be saved!”

I’ve discussed the claim that vitamin D can prevent “77%” of all cancers in detail before. Suffice it to say that, while there may indeed be a cancer-preventative effect due to vitamin D, it’s nowhere near 77% of “all cancers” and it’s not as crystal clear as Adams claims. He also makes the claim that mammograms cause cancer, which is another of his distortions, particularly in Applegate’s case. Even though cumulative exposure to radiation can increase the risk of cancer, the level of of radiation from mammograms is too low for it to make a significant difference except over many years of screening, and even then the slightly elevated risk of cancer is far outweighed by the benefit. By report Christina Applegate had begun having yearly mammograms at age 30 because of her family history; to think that six years worth of mammography caused her breast cancer, particularly given that she has a BRCA1 mutation, is such a distortion of reality that it’s hard to describe just what a deceptive scumbag Mike Adams is for even making that claim.

Of course, with Adams it’s about ideology akin to a religion, not science. It’s about his hatred of “conventional” medicine, as represented by his finishing with a “greatest hits”-style flurry of claims:

  • “Cancer doctors, you see, are really in the business of keeping patients ignorant and uneducated, corralling them into barbaric treatments that benefit themselves, not their patients. While Applegate has now lost both breasts and undergone an extremely painful, barbaric surgical procedure, her cancer doctors have collected enormous sums of cash that they charged her. The doctors walk home rich, but women walk home maimed and still susceptible to recurring cancer. Is that really the best modern medicine can offer? The answer is yes! — if you limit yourself to drugs and surgery. To get something better, you have to turn to advanced natural medicine, where anti-cancer nutrients are found everywhere in foods, herbs and nature.”
  • “The cancer industry today operates like society in the 1850’s — it’s a male-dominated system run by people who exploit women for their own selfish reasons. Following the Women’s Suffrage Movement, as new rights started to become available to women, more and more women began to attend universities. Education empowered women with new choices, and with that power, they were able to rise to new positions of power, both in the home and the workplace.”
  • “Modern medicine wishes to keep women trapped in a system of ignorance and enslavement. Telling women they need to cut off both breasts to treat cancer is like demanding they stay at home, barefoot and pregnant, serving as little more than servants of their men.”

The stupid, it sears me to my very bones. I do have to doff my hat to Adams for one thing, though. I’ve never seen a “health freedom” rant that likened the freedom to choose quackery to the the women’s suffrage movement. Just when I think Adams has reached the limit for torturing logic and historical analogies, damn if he doesn’t go and prove me wrong by going even further into Woo Land! He also really, really hates that Applegate apparently looked at the evidence, listened to her doctors, and made a very rational decision:

Applegate called the operation a logical decision. Her mother battled breast cancer, and she tested positive for the BRCA1 gene mutation linked to breast and ovarian cancer.

“I just wanted to kind of be rid of it,” she said. “So this was the choice I made and it was a tough one.”

Fortunately, I think that Applegate will probably do just fine. Is she out of the woods? Of course not. She still has to deal with the very thorny issue of what to do with her ovaries, and there is still a chance her cancer will recur or that she will develop a new breast cancer. Moreover, BRCA1 mutations also predispose to other forms of cancer that can’t be prevented at acceptable cost with prophylactic surgery. Despite all that, she does have a great attitude:

Speaking on ABC News’ Good Morning America in her first interview since announcing her diagnosis earlier this month, the Samantha Who? star said she had a double mastectomy three weeks ago. She’ll undergo reconstructive surgery over the next eight months.

“I’m going to have cute boobs ’til I’m 90, so there’s that,” she joked in the interview, which aired Tuesday. “I’ll have the best boobs in the nursing home. I’ll be the envy of all the ladies around the bridge table.”

And:

The Emmy-nominated Samantha Who? star has kept her sense of humor intact.

“I’ve laughed so much in the last three weeks,” she said. “I love living, and I really love my life, and I knew that from this moment on it was only going to be good that was going to be coming. Yeah, I’ll face challenges, but you can’t get any darker than where I’ve been. So knowing that in my soul gave me the strength to just say, ‘I have to get out there and make this a positive.”‘

That’s not to say that her decision hasn’t caused her the normal emotional difficulties that any decision like this will cause, but she’s appears to be dealing with it quite well in public. No one can know what anguish she endures when she is alone, away from reporters, photographers, and the public.

Perhaps what irritates me the most about Mike Adams and his ghoulishness in pouncing upon every story of celebrities dying or dealing with with life-threatening disease is the sheer opportunism of it all. To him, apparently, suffering and death exist only to validate his belief that all “natural” medicine (whatever that means, given that some of the idiocy on his site isn’t exactly “natural”) is good and all scientific medicine is the darkest of evils. He views them and everyone else through the prism of his never-ending war against scientific medicine. Worse, he runs one of the three or four largest and most heavily-trafficked “natural medicine” sites on the Internet. He is widely read and linked to, with far more reach and influence than all the blogs of all the skeptical docs out there combined, and what he preaches is in essence a religion that is unaffected by data, a religion of quackery of which antivaccinationism is only a part. As with antivaccinationists like Jenny McCarthy, I agree with Mark that it’s time to hold Adams responsible for his contribution to frightening people away from effective scientific medicine. If Adams doesn’t have blood on his hands yet from persuading cancer patients to follow quackery instead of science, he will.

It’s only a matter of time.

MORE INFORMATION:

  1. Why an actress would remove her breasts
  2. Christina Applegate’s Breast Cancer: FAQ
  3. Prophylactic Mastectomy in Women With BRCA Gene Mutations Reduces Risk for Breast Cancer to Less Than 1%
  4. Genetic testing for breast cancer: What the results mean
  5. Genetic Testing for BRCA1 and BRCA2: It’s Your Choice

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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