A cancer quackery I had never heard of before?

After having blogged about cancer quackery for more than four years and having spent at least five years before that on the Usenet newsgroup misc.health.alternative seeing virtually all manner of quackery, cancer and otherwise, I thought I had seen it all. Indeed, I thought that there was no form of cancer quackery that I hadn’t head about at some point before.

I was wrong.

Perusing the Skepchick blog the other day I saw a wonderful story related by Masala Skeptic about how a group of skeptics in Mississippi attended a talk by a cancer quack named Robert Dowling, who apparently claims that dental pathology is the cause for all cancer and sells a “cure” for breast cancer called Quantum Health Management and triumphed. This is how:

After the steaming piles of pseudoscience flew right and left, the skeptics in attendance asked our questions: what bacteria cause this? Why would doctors cover up a cure for cancer? What studies have you done? Where were they published? How long have you followed your patients? Are you a doctor? We asked far more questions than the rest of the audience combined, even though they outnumbered us six or seven times. I doubt that Randi, Dennis, Brad, Don and I were the only ones skeptical of his claims – but we were the only ones voicing that skepticism.

Dowling did not have our answers. After claiming to have published studies, after claiming a 100% cure rate, after calling himself a doctor, he said that he had the proof. And when we asked for it, we got dodgy answers, evasions, and even the confession that he was not in fact a doctor. Of course, he was only a few semesters away from a medical degree in the Caribbean.

This is not surprising. What is surprising is the cultish, exploitative manner in which Dowling operates. In order to get the cure for cancer, you have to jump through a lot of expensive hoops.

Actually, there is nothing at all surprising about the cultish exploitive manner in which Dowling operates. That is par for the course for many quacks. He is also very much like cancer quacks in that he does something that makes me laugh out loud when I hear proponents of “complementary and alternative medicine” (CAM) when they claim that they “individualize” therapies–unlike, of course, that nasty, reductionist “allopathic” scientific medicine: He claims that cancer is caused by one thing and that one treatment will “cure all cancer.” Think Hulda Clark, who claims that a liver fluke is the One True Cause of All Cancer (and AIDS and many other diseases as well) and further claims that she can cure it with her “Zapper.” The only difference is that Robert Dowling claims that all cancer is due to something called “cavitations,” and boy does he lay down a lot of woo. It would be hilarious and worthy of being featured on Your Friday Dose of Woo, except that it isn’t funny to think that cancer patients may be taken in by this. More interesting (to me at least) is that it is an actual form of cancer quackery that I haven’t seen before–or, if I have, I don’t remember it. Given that I would be remiss if I didn’t take a closer look as only Orac can.

After having seen the account of this lovely slapdown on Skepchick and Living Better Skeptically, I headed straight over to Robert Dowling’s website, CancerCured.org, which forwarded me to BreastCancerCured.com. The website claims to be something called the North Carolina Institute of Technology, and, boy, oh, boy, is there some pseudoscientific woo there! However, showing that even quacks are glomming on to the whole “stimulus package” line of advertising that so irritates me:

Will South Carolina be given the honor of hosting the first International Breast CancerThe North Carolina Institute of Technology is investigating 7 sites, one of which will be chosen in 2009 to become the first international breast cancer cure center.

The Facility must be capable of handling 100 or more new breast cancer cases daily as women from around the globe seek the cure. The cure requires a minimum 5-day stay at the center with some requiring up to 30 days. The cure is generally accomplished during this short period of time because women are not subjected to traditional chemotherapy, radiation or radical surgery. Procedures are now FDA-cleared and many women have already participated in the technology. Presently, 100 percent of participants who followed the technology are now cancer-free. Case studies of these participants can be found inside the May 2009 issue of NCIT’s Journal of Applied Quantum BioPhysics.

It is estimated that the new center will create 1000 or more jobs for the area chosen by NCIT. Not only will the site benefit from increased employment, but additionally from tourism opening up opportunities for local businesses to meet the needs of families who accompany the patients to the cure center.

At present, four sites are under study in the USA and three in Latin America. Diplomatic missions are being planned for late-summer 2009 to potential off-shore sites under consideration. In the USA, two sites has been visited and toured and governors of the states involved have been notified.

Even in this advertising, note multiple red flags for quackery. First, there’s the usual claim for curing cancer “without chemotherapy, radiation, or radical surgery.” Then there’s the claim that “100% of participants” are now cancer-free. Then, of course, there’s the fake journal to publish the “results” of these “studies.” Then, of course, there’s the promotional video:

So what does QHM involve? Well, it’s actually rather hard to figure out exactly, at least from the NCIT website. It actually took me some searching, but the closest to an “executive” summary can be found under “10 steps.” The first thing I note is that QHM touts thermography as being far superior to mammography or other screening modalities in detecting early breast cancer. I’ve been meaning to do a comprehensive post on thermography because lots of purveyors of “alternative” breast cancer cures tout it as being so much better than mammography. Personally, I could never understand why thermography would even be considered “alternative,” given that it requires technology even more complex than mammography in order to work, but, then, hey, I’m not an altie. I suppose it has something to do with not using radiation, but ultrasound doesn’t use ionizing radiation,either, and I don’t see alties claiming ultrasound as being somehow “alternative” or natural. In any case, the bottom line is that thermography is no more “natural” than either of these technologies. It still involves a lot of electronics and scanners. But it sure does make pretty pictures. Whether those pictures actually tell us anything reliable about the presence or absence of breast cancer, however, is a matter of some debate.

Until I get around to doing a more detailed post on thermography, I’ll just summarize what it is. It is in essence infrared scanning of the breast, looking for signs of extra blood flow resulting in heat. It was considered a promising modality back in the 1960s and 1970s but was abandoned because the resolution of the scanners just wasn’t very good at all. Lately, with better technology, sensors, and computer imaging, there has been mild renewed interest in thermography, but in reality technology and time have passed thermography by. Specifically, breast MRI has become the dominant imaging modality that looks at blood flow. It has achieved that position because it shows everything thermography shows but in a lot more detail–along with actual anatomic detail that allows for detailed 3D reconstruction. True, it’s expensive, and it’s possible that thermography might be a cheaper, “poor man’s” (or “poor woman’s”) alternative to MRI, but the evidence just isn’t there. Certainly it’s not there for the claim is that thermography can identify cancer ten years before mammography. I’ve even had some direct experience with it, having been involved in a research project involving an infrared scanner that was in essence a modified thermography machine. Even the company that made the machine insisted that any of its images had to be correlated with mammography, as the intent of the machine was not to replace mammography but to complement it by predicting whether abnormalities found on mammography were more or less likely to be cancerous.

Moving on, looking at the series of photos there, one thing jumps out at me. Steps #5-7 show what appears to be CT scans and a CT scanner.

STEP 5
This step is taken by a QHM® interventional radiologist to verify the exact area of this early cancer mass which was missed weeks earlier by mammography. Prior to her appointment with the radiologist, she was sent for a breast MRI which also showed the mass that mammography had missed.

STEP 6
This step was taken solely for the benefit of those individuals who would try to discredit this technology. QHM doctors wanted to prove that the mass was, in fact, cancer — and, of course, it was. With QHM® technology, a biopsy is no longer necessary. A “guiding” CAT scan is used for the proper placement of the ablation device to kill the tumor. The CAT scan is a second proof of the cancer.

STEP 7
This FDA-cleared procedure destroys the breast mass in approximately 15 minutes without chemotherapy, radiation or major surgery. While other practitioners are performing this procedure, it is incomplete as a cure unless oral pathology is corrected. This explains why the majority of cancers return — except in patients treated according to QHM protocols. Correcting oral pathology and applying QHM® technology is the ultimate cure!

So what’s this about “oral pathology”? Well, Dowling takes thermography beyond the breasts. His “screening” also looks at the head and neck. The reason? Simple. To Dowling, The One True Cause of Breast Cancer is…dental cavitations. And, yes, that fancy thermography machine will not only detect your breast cancer but will detect the “dental pathology” that supposedly causes the breast cancer. More on that later. Suffice it to say now that, if this fancy “thermogram” sees “pathology” in the jaw on the right, then Dowling will claim that there will be pathology in the right breast. Why the all-purpose altie “toxins” leeched into the blood by these “cavitations” would confine themselves to only one side of the body is never explained.

But back to the photos. Look at the photos next to those steps. Those are CT scans, and the photo by Step #7 is a woman going through a CT scanner. Here’s a hint: We don’t use CT scanners to diagnose or identify breast cancer. The reason is that most early breast cancers don’t show up on CT scanners very well. In general, for a a breast cancer to show up on CT scan, it has to be at least 1-2 cm in size unless very thin cuts are done and IV contrast is used. Indeed, looking at the CT scans there I don’t see anything even resembling a breast cancer where the biopsy needle is being placed. That doesn’t mean that there isn’t necessarily one there, but from the images shown I’d be damned hard pressed to identify one. Of course, in this case, Dowell appears to “correlating” with thermography, but there’s no way to do that as far as I can tell.

So what are the QHM people doing to treat these “breast cancers” without surgery? I can’t really figure it out for sure. My best guess is that they’re doing something decidedly “non-alternative,” namely ablating whatever it is they think to be a “tumor” using a cryoablation (freezing the tumor) or radiofrequency ablation (cooking the tumor with radiowaves). I make that speculation on the basis of the frequent claims that QHM is using an FDA-approved device, and cryoprobes and RFA devices are FDA-approved–just not for breast outside the context of a clinical trial. I could be wrong, but that’s what it looks like to me. If that is the case, then any claims of a “cure” are highly overblown at best. While it’s true that various non-surgical ablation techniques, such as RFA or cryoablation, are under active study (including at my own institution), at best such ablation techniques would be the equivalent of the surgical removal of the tumor, which, as any breast cancer surgeon can tell you, doesn’t work “100% of the time” even for small tumors. That’s not even considering the fact that expensive CT scans aren’t needed for cryoablation or RFA. Rather, they are almost always done with inexpensive ultrasound as the guide. Ablation techniques are also anything other than “alternative.” They’re well within the realm of “standard” medicine but currently are experimental for breast cancer.

The cavitations part, however, is pure quackery, and the thermography scan is apparently meant not just to detect breast tumors but to find those nasty cavitations. As described by the Jackson Skeptical Society:

According to Dowling, oral pathology is the magic cause of all disease. He said it caused cancer, heart disease, and alzheimers. And when people asked what else might be caused by the bacteria in your mouth, well, Dowling was pretty sure that those pesky bacteria were the culprits. Lupus. Fibromyalgia. Parkinsons. Diabetes. Never mind that his brother is dying of Parkinsons and doesn’t trust Dowling to give him a treatment. Never mind that Dowling himself has diabetes. Never mind that these diseases have completely different causes, mechanisms, and treatments. If your doctor offers you blood pressure medication for your cancer and chemotherapy for your parkinsons – RUN.

When someone says something works every time, you should be skeptical, unless it’s Billy D. Williams with a Colt 45. And when the oral pathology that’s killing you is caused by cavitation in old dental work, well, sound the alarms.

Dowling claimed that neurotoxins from oral bacteria travel through the body, causing diseases. He has a simplistic manner through which he knows this: if his thermal cameras find this “oral pathology” in the right side of your head, then the cancer is on the right side of your body. If it’s on the left side, the cancer is in your left side. These pesky bacteria are literally killing you in a very symmetrical manner.

Hilariously pathetic is the “science” section of Dowling’s website where he tries to convince you with actual autoradiographs and graphs that his woo is true. How does Dowling do this? He cites “research” like this:

To distinguish which toxins in particular, we tested 36 lanes on Affinity Labeling gels. Specifically, as we set the protocols for this research project we used toxicity samples from over 900 extracted root canal teeth as a composite and over 4000 bone fragments obtained from biopsy samples as a separate composite. Root canal toxins and cavitation toxins were tested separately to determine how each toxin individually inhibited the binding ability of the protein. Establishing published cellular weights (amounts) of these proteins, we proceeded to inject Affinity Labeling gels with amounts of human protein as to the stated amount found in each individual cell. So, therefore, using toxins extracted from human samples and human proteins, we were able to exhibit extreme or severe inhibition of these individual proteins by chronic exposure to these toxins. We then ran additional lanes on the same Affinity Labeling gels to determine the effects of blio toxins (fungi) and also mercury from dental amalgam. As you will note during my lecture, the cavitation toxins from a composite of 100 or more cavitations was much more toxic than root canal toxins.

Here’s where the hilarity comes in for anyone with an actual scientific background. Robert Jones, the “researcher,” then shows a series of blots and graphs that, according to him, show that the “toxins” from the “cavitation extracts” and mercury from amalgams are inhibiting the binding of key cellular proteins known as tumor suppressor genes. As the name implies, tumor suppressor genes suppress tumors, and tumor growth is often associated with loss of function of different tumor suppressors. Naturally, Jones can’t resist looking at the granddaddy of all tumor suppressor genes, p53. He also makes all sorts of claims that “amino acids are inhibited from binding to the chromosome ladder and or just one of the examples of damage incurred by these dental toxins,” a nonsense that still has me scratching my head over exactly what he means. In any case, what’s unclear to me is why Jones used photolabeling to look at p53 “functionality.” The correct thing to do would have been to look at its ability to bind DNA, specifically the consensus DNA sequences that p53 normally binds to. He does the same thing with other proteins, including p21/H-ras, CDK2, and p27raf, which, while not DNA binding proteins, are not generally studied with photolabeling. Of course, the best part of this whole page is this:

Now we have noted that all 3 proteins are greatly inhibited at even 5ul from being able to function properly, and that we have produced 3 distinct markers for the start of cancer:

  1. Inhibition of P53 due to these dental toxins is unable to suppress tumor start or growth.
  2. Inhibition of P21 causes uncontrolled cell replication.
  3. Inhibition of CDK2 creates uncontrolled cell growth.

These 3 markers positively identify the diagnosis of any cancer!

Um, no they don’t. Not all cancers are driven by these three proteins. Mutations of these genes are very common in a wide variety of cancers, but by no means to all three of these markers “positively identify the diagnosis of any cancer.” Indeed, what’s more interesting to me is that p21/H-ras is an oncogene. That means it is protein that promotes cell growth and, indeed, mutations that turn on H-ras inappropriately drive many cancers, not “inhibition” of ras. In fact, if these “toxins” (which, of course, don’t exist) actually did inhibit H-ras, that would arguably be a good thing. Ditto CDK2, which promotes cell cycle progression. Of course, none of this “evidence” shows that dental “cavitations” cause cancer and that removing them “cure” cancer, but even if the “toxins” from “cavitations” did what Jones says they do, at least two of their actions would be inconsistent with “creating uncontrolled cell growth.”

But that’s not all. As I read this page, something bothered me. It’s something I should have caught immediately but did not, perhaps because I was reading too quickly and didn’t look closely at the illustrations. After I looked at his illustrations it appears to me that Jones is mixing up two different p21 proteins. He refers to his magic cavitation protein extracts and evil amalgam mercury as inhibiting p21/H-ras, which (as I mentioned before) is an oncogene and promotes cell growth (and, by the way, is not a target of p53). But in his illustrations showing various cell cycle pathways, what he appears to mean in actuality is p21WAF1/CIP1, which is a cyclin kinase inhibitor, a target of p53, and an inhibitor of cell cycle progression. (It’s also a protein that I have published on as recently as 2008.) In fact, I almost didn’t notice that that’s what Jones had done until I did a double-take looking at the illustrations. Here’s a hint: H-ras is a very different protein from p21WAF1/CIP1.

Not surprisingly, I don’t see any evidence that any of this “research” has been published in a peer-reviewed journal. But it sure does look and sound “science-y,” doesn’t it?

The beautiful thing is that this small band of skeptics, through relentlessly polite questioning, totally exposed this charlatan. It just goes to show that hot skeptical action can have an effect. They even got in touch with the authorities in Mississippi to get a cease-and-desist order in the state. Unfortunately, that’s unlikely to stop Dowling in other states.