Andreas Moritz and trying to shut down valid scientific criticism: A sine qua non of a quack

What is it with cranks and trying to shut down criticism?

I know, I know. I’ve written about this before, but this week has been a banner week for a phenomenon that I consider a sine qua non of a crank or a quack, namely an intolerance of criticism. Seemingly, whenever a quack or a crank encounters serious criticism, the first reaction is almost never to try to argue based on facts, reason, and science, but rather to try to silence the person doing the criticizing. The tactics are many and varied, but the end goal is always the same: Suppress the criticism by any means necessary. The very first example I ever became interested in predates this blog and was David Irving’s attempt to silence Holocaust historian Deborah Lipstadt in the late 1990s. I’ve blogged about numerous examples of cranks trying to silence their critics, including the Society of Homeopaths or the quack Joseph Chikelue Obi using legal threats to silence Andy Lewis and, just last year, the British Chiropractic Association abusing the U.K.’s notoriously plaintiff-friendly libel laws to silence Simon Singh.

I experienced this problem very early in my blogging “career.” In April 2005, a mere five months after I started this blog, a cancer quack by the name of William O’Neill of the Canadian Cancer Research Center “outed” me and started sending legal threats to me, my division chief, my department chair, and my cancer center director. One thing I learned from that incident was that my superiors were far more tolerant than I had feared of my little hobby. Even so, it gave me a scare. My young blog very well may have died that month, but fortunately my department chair had some rather scathing things to say about Mr. O’Neill. From then on out, whenever he sent me a legal threat, I replied unctuously but making it a point to cc:–you guessed it–my department chair, division chief, and cancer center director.

A few months later, anti-vaccine maven Pat Sullivan followed suit. Since then, several times cranks have “outed” me. One crank in particular, J.B. Handley of Generation Rescue and Age of Autism, has become almost predictable in his antics, having launched at least three broadsides against me. Last year, in response to one of J.B.’s semiregular broadsides against me someone e-mailed my cancer center director. Most recently, Morgellons disease crank Marc Neumann (who, it appears, has blocked my IP address) has been making vacuous legal threats against me because I applied a bit of insolence to his crankery. I must admit, he’s actually a little scary because he strikes me as being rather disturbed. Be that as it may, after five years in the blogosphere, another six or seven years before that on Usenet, and a few years before that on various online discussion forums, if there’s one thing I’ve learned, it’s that cranks despise criticism and will often do anything to stop it. True, it’s not just cranks who will sometimes try to shut down criticism, but cranks are particularly prone to it to the point where I consider it one of the diagnostic criteria for quacks, pseudoscientists, and cranks.

Because I’ve had a few scares myself over the year and because, valuing free speech, I really, really despise people who try to shut up legitimate criticism with intimidation, legal threats, or threats of “outing.” I mean really, really despise them. They induce a simmering, white hot rage in me that occasionally bubbles over into this blog. That’s why I really, really despise cancer quack (in my opinion, of course) Andrea Moritz. However, I despise him all the more because I take care of cancer patients, and Moritz preys on the patients whose care I have dedicated my life to and to improving. As PZ Myers points out, Moritz reacted to criticism of his quackery by a student named Michael Hawkins by getting WordPress to pull his blog. WordPress, in an act of pure cowardice, obliged Moritz initially, although the site appears to be up again under a different name. The specific reason that Moritz stated as his reason for complaining to WordPress was–well, let’s hear it from the quack himself:

Michael Hawkins,

You may blame me for having your blog pulled. WorldPress had to remove your blog because otherwise it would have faced a hefty lawsuit, given the nature of the defamation campaign you had launched against me, and having positioned your blog link second place on the search engines.

http://www.google.com/search?q=Andreas+Moritz&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a

I have not yet decided whether to sue you for defamation. I have asked my attorneys to assess the damages your defamation campaign has done to my work, business, and reputation since your blog has been up. I know that they are significant, but if they turn out to be an excessive loss of revenue and reputation and/or if I see any more defaming publications by you or your blog friends against me or Dr. Makoney, I will not hesitate to launch an expensive lawsuit against you that you will not forget for a long time. I have collected all the data of your blogs and publications involving me. Your last email to Dr. Makoney clearly shows that you are instigating a new defamation campaign, at least against him.

My investigations show me where you live and where you study (Augusta, Amine), and if I hear or see any further activities that involve me or Dr. Makoney you will need to hire a good attorney to defend your slanderous actions and campaigns.

My close friend, Dr Deepak Chopra, who in addition to Dr Makoney and myself have been viciously attacked by your friend, the fish zoologist, PZ Myers, are considering a lawsuit against him. Slander is slander, whether it is done online or offline. If your friend is wise, he will immediately remove those blogs from his site.

Just in case you are not aware of it, below are stated the laws that protect people like me against people like you.

Sincerely,
Andreas Moritz

That’s right, Moritz is threatening a lawsuit against a student because a blog post by that student criticizing his quackery reached number two on google searches for his name. Still, I’m disappointed. Apparently my post about Moritz from two years ago didn’t register. I never got a complaint from Andreas Moritz. I’m hurt. Clearly, one doesn’t get the attention of cancer quacks like Moritz unless one’s post makes it to the first page of Google searches on his name, thus threatening his business Looking back over my old post on Moritz, though, I’m appalled. He’s among the most dangerous of “practitioners” pushing woo on cancer patients. He clearly believes in a variant of Ryke Hamer’s German New Medicine in that he postulates a “wisdom of cancer cells” and that cancer is not a disease but a reaction to some other insult a “healing mechanism” that kicks in only after all the other healing mechanisms of the body have failed. Like Hamer, Moritz blames “unresolved conflicts,” of which the cancer is somehow a manifestation.

If you want to get a good idea of the depth of Moritz’s ignorance, check out this article on his website Can You Trust Chemotherapy to Cure Your Cancer? It’s chock full of the most common misinformation about chemotherapy out there presented in a style of which Mike Adams would be proud. Indeed, he shows an astounding ignorance of the basic biology of cancer in discussing the death of Tony Snow:

The media headlines proclaimed Snow died from colon cancer, although they knew he didn’t have a colon anymore. Apparently, the malignant cancer had “returned” (from where?) and “spread” to the liver and elsewhere in his body. In actual fact, the colon surgery severely restricted his normal eliminative functions, thereby overburdening the liver and tissue fluids with toxic waste. The previous series of chemo-treatments inflamed and irreversibly damaged a large number of cells in his body, and also impaired his immune system — a perfect recipe for growing new cancers. Now unable to heal the causes of the original cancer (in addition to the newly created ones), Snow’s body developed new cancers in the liver and other parts of the body.

Moritz’s flaming stupid threatens to incinerate the earth. Did he wonder where the colon cancer could have come from even though Snow had had a colectomy? Apparently Moritz is unaware that cancer can spread as microscopic tumor deposits that serve as the basis of metastatic disease. That’s why surgery is not always curative; if there weren’t metastatic deposits in other organs some percentage of the time, then there wouldn’t be any need for adjuvant chemotherapy to try to wipe them out. It is from these deposits that metastatic disease can sometimes blossom months or even years after apparently curative surgery. Also note how Moritz, true to most “alt-med” anti-chemotherapy rants, blames Snow’s cancer on “toxins,” this time because somehow his colon surgery had caused him to accumulate “toxic waste” and–of course!–damaged his immune system.

But, wait. I thought that Moritz claims that cancer is actually a reaction to unresolved conflicts and is in fact a healing mechanism. Oh, well, consistency isn’t among most quacks’ virtues.

But back to Moritz’ quackery. Next, he uses an anti-chemotherapy trope so old and tired that it was probably around when the dinosaurs were around; that is, if dinosaurs used chemotherapy:

An investigation by the Department of Radiation Oncology, Northern Sydney Cancer Centre, Australia, into the contribution of chemotherapy to 5-year survival in 22 major adult malignancies, showed startling results: The overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA.” [Royal North Shore Hospital Clin Oncol (R Coll Radiol) 2005 Jun;17(4):294.]

Wrong again. I discussed this gambit with my usual attention to detail. At the time, I pointed out that this particular study is beloved of woo-meisters everywhere, but it is not a very good study. Indeed, if I were more cynical, I’d say that it appears almost intentionally designed to have left out the very types of cancers for which chemotherapy provides the most benefit. Also, it uses 5 year survival exclusively, completely neglecting that chemotherapy can prevent late relapses. Adding to the impression that the study was custom-designed to minimize the apparent benefit of chemotherapy found, there were also a lot of inconsistencies and omissions in that leukemias were not included, while leukemia is one type of cancer against which chemotherapy is highly efficacious; indeed, leukemia is treated with and, when it is cured, cured by chemotherapy. The very technique of lumping all newly diagnosed adult cancers together is guaranteed to obscure benefits of chemotherapy among subgroups because it lumps in patients for whom chemotherapy is not even indicated! A letter to the editor listed these problems in detail, as well as pointing out that even in advanced cancer chemotherapy can be palliative and prolong median survival.

Another aspect of the study that always bothered me is that it appeared to lump patients undergoing adjuvant chemotherapy in with those undergoing chemotherapy for cure or palliation. Adjuvant chemotherapy is given after surgery in order to decrease the rate of recurrence, but the truly curative modality is the surgery itself. In early stage cancer, the absolute benefit of chemotherapy in terms of prolonging survival tends to be modest, often single digit percentages. Lumping adjuvant therapy in with other uses of chemotherapy again appears custom-designed to decrease the apparent survival benefit due to chemotherapy.

Next, Moritz pulls another study out of his nether regions:

In 1990, the highly respected German epidemiologist, Dr. Ulrich Abel from the Tumor Clinic of the University of Heidelberg, conducted the most comprehensive investigation of every major clinical study on chemotherapy drugs ever done. Abel contacted 350 medical centers and asked them to send him anything they had ever published on chemotherapy. He also reviewed and analyzed thousands of scientific articles published in the most prestigious medical journals. It took Abel several years to collect and evaluate the data. Abel’s epidemiological study, which was published on August 10, 1991 in The Lancet, should have alerted every doctor and cancer patient about the risks of one of the most common treatments used for cancer and other diseases. In his paper, Abel came to the conclusion that the overall success rate of chemotherapy was “appalling.” According to this report, there was no scientific evidence available in any existing study to show that chemotherapy can “extend in any appreciable way the lives of patients suffering from the most common organic cancers.”

I looked for this study. In fact, I went to The Lancet‘s website and looked up the August 10, 1991 issue. I could find no study by Ulrich Abel or anything about chemotherapy other than this study on stroke after chemotherapy for testicular cancer. So I went to PubMed and searched on Ulrich Abel’s name for 1991. All I could find were two articles, one on common infections in chemotherapy patients and another on Crohn’s disease. So I started searching other years, and then I found what appears to be the paper to which Moritz referred, only it wasn’t published in 1991 but rather in 1992 and it wasn’t published in The Lancet but rather in Biomedicine & Pharmacotherapy, a much lower tier journal. Unfortunately, my university’s access to this journal only goes back to 1995; so I don’t have access to the full article. However, the abstract is very odd. Dr. Abel states that “as a result of the analysis and the comments received from hundreds of oncologists in reply to a request for information, the following facts can be noted.” This is indeed very odd. This appears neither to be a meta-analysis or a systematic review, and it’s not clear to me what Dr. Abel did. If anyone has access to the article, please send it to me. (ADDENDUM: Thanks to the two of you who sent me a copy of the paper. It’s even thinner gruel than I had guessed. I can now see why it wasn’t published in The Lancet.) I also note that since 1992, Dr. Abel has been co-author on a number of studies involving chemotherapy, for instance, a trial in nephroblastoma and a clinical trial of high dose chemotherapy in aggressive lymphoma. As recently as 2009, Dr. Abel was co-author on a randomized multicenter study comparing two different chemotherapy regimens in pancreatic cancer. Yes, pancreatic cancer, that most intractable of cancer problems with a five-year survival rate of only around 20% in the most favorable cases; i.e., the ones that can be completely resected surgically. Clearly, Dr. Abel buys into the evil big pharma propaganda that chemotherapy can cure at least some forms of cancer and, as far as I can tell, has never written a followup to his 1992 paper. I’m half-tempted to send Dr. Abel Mr. Moritz’s article and other examples of the abuse of his work by quacks and see what he says.

I also can’t help but wonder: If Moritz is either sloppy with or lying about this citation, what other information is he playing fast and loose with? After all, he made up cited a date of publication to make it sound very authoritative that Abel’s paper appeared in The Lancet, knowing that few, if any, of his target audience would–oh, you know–actually go and try to look up the primary source. Unfortunately for Mr. Moritz, Orac almost always tries to look up the primary source when he sees a woo-meister cite a study in support of his claims. In any case, even if Mr. Moritz represented Abel’s study accurately, it’s an 18 year old article, and its methodology is unclear to me, at least now. Besides, few oncologists would disagree with this statement, “With few exceptions, there is no good scientific basis for the application of chemotherapy in symptom-free patients with advanced epithelial malignancy.” And, indeed, most oncologists do not recommend chemotherapy for patients with stage IV disease who are asymptomatic, because at that point all treatment is palliative and chemotherapy is, in most cases, reserved for when tumor progression leads to symptoms. Morover, this study only examined epithelial malignancies. These are cancers for which surgery can be curative if the tumor has not metastasized. Since 1991, also, we have made huge strides in improving survival using chemotherapy. I’ve used the example of colorectal cancer before, where, thanks to newer and better chemotherapy regimens developed over the last couple of decades that have improved survival in patients with liver metastases from 6 months to close to two years.

After this, I thought that Moritz couldn’t go any further off the deep end, but he does:

Chemotherapy has never been shown to have curative effects for cancer.

This is a either a lie or so wrong as to be not even wrong, pure and simple. If Moritz actually believes this, he is too stupid to be allowed near a patient. Strike that. He is too stupid to be allowed near a patient, period. Chemotherapy, sometimes with radiation therapy, can cure Hodgkins lymphoma, non-Hodgkins lymphoma, leukemia, testicular cancer, and other malignancies.

But, no, Moritz still subscribes to a variant of the German New Medicine, leading him to lay down a blistering barrage of lethal (to cancer patients) stupid:

By contrast, the body can still cure itself, which it actually tries to do by developing cancer. Cancer is more a healing response than it is a disease. The “disease” is the body’s attempt to cure itself of an existing imbalance. And sometimes, this healing response continues even if a person is subjected to chemotherapy (and/or radiation). Unfortunately, as the previously mentioned research has demonstrated, the chances for a real cure are greatly reduced when patients are treated with chemotherapy drugs.

The worst thing about the German New Medicine is that, like so much “alt-med,” it blames the patient. If the patient can’t “resolve his conflict,” the “healing process” of the cancer will kill him. If a patient undergoes chemotherapy, in Moritz’s world not only will it not save his life but it will prevent Moritz’s woo from working. It is truly despicable, and it is why Moritz, like Ryke Hamer, is a cancer quack. Hell, he’s just a quack. After all, he is into liver flushes:

Colon cleansing and liver flushes, it doesn’t get much more quacky than that. Or HIV/AIDS denialism. Or antivaccine pseudoscience. Or this:

Before committing themselves to being poisoned, cancer patients need to question their doctors and ask them to produce the research or evidence that shrinking a tumor actually translates to any increase in survival. If they tell you that chemotherapy is your best chance of surviving, you will know they are lying or are simply misinformed. As Abel’s research clearly demonstrated, there is no such evidence anywhere to be found in the medical literature. Subjecting patients to chemotherapy robs them of a fair chance of finding or responding to a real cure and deserves criminal prosecution.

Project much, Mr. Moritz?

Actually, I’d say that, if Mr. Moritz is really treating cancer patients according to the principles he espouses in his two articles on cancer on his website, then it is he who deserves criminal prosecution. Where’s the South Carolina medical board when you need it? Or where’s its attorney general, given that Moritz appears to be practicing medicine without a license? After all, I don’t see any medical degree, medical license, or even a naturopathic medical license listed anywhere on his website. All that is there is a description of Moritz as a “medical intuitive; a practitioner of Ayurveda, iridology, shiatsu, and vibrational medicine; a writer; and an artist.”

As I’ve said before, I treat breast cancer patients. As with all practitioners of science-based medicine, we have data for our treatments, and it’s data that stretches back to the 19th century for surgery and back to the 1940s for chemotherapy. One study using unclear methods published in an obscure journal 18 years ago or another study seemingly custom-designed to decrease the apparent benefit of chemotherapy does not change that, nor are these studies enough to cast doubt on what we do know about chemotherapy. What data does Moritz have? None. Zero. Nada. Zip. All he has is a claim that he has had “great success with cases of terminal disease where conventional methods of healing proved futile.” No doubt he has data that document his 5- and 10-year disease-free survival and overall survival rates by cancer type and stage to back up that statement. After all, if he does have that data, and his results really are far superior to science-based medicine, he could publish them in The Lancet. (Sorry, couldn’t resist–maybe he should try for Biomedicine & Pharmacotherapy first.) Sure he does. Sure he can make me and others who call him a quack choke on our words. I’m sure he can produce scores of 10 year survivors of stage IV cancers with well documented case histories to back up his claims, right?

Yeah, right.

I know the reason that cranks like Moritz can’t stand criticism. It’s because they fear it. They are not used to defending their practices against informed, science-based criticism, as real scientists and science-based physicians have to do all the time. Worse, when the criticism starts muscling in on their Google search results, it threatens their ability to take advantage of desperate cancer patients. So their reaction to criticism is to lash out, to try to make it stop. They don’t have the goods, as science-based medicine does, and I suspect that at some level most of them know they don’t. All that leaves is threasts, bullying, and intimidation to try to shut down critics.

A sine qua non of the true crank.