Four misleading cancer testimonials and “reverse balance”

I was doing my usual browsing of the web yesterday in search of topics for today’s post when I came across an excellent article by a colleague and friend of mine, Dr. Rachael Dunlop, who nailed it in a post entitled Anti-vaccination activists should not be given a say in the media. In the article, Dr. Rachie nailed a point that I and other skeptics have been trying to make time and time again, namely how the press all too frequently inserts false balance in stories about medicine, particularly vaccines. As Dr. Rachie put it, we don’t give equal time to flat earth believers. My favorite example tends to be to point out that we don’t give equal time to moon hoaxers in stories about space exploration. So why do journalists so frequently give “equal time” to antivaccine cranks and quacks when writing stories about vaccines or influenza?

Sometimes, however, journalists go even beyond false balance by tilting that balance in the direction of quackery. Over the weekend I saw one of the most egregious examples of doing just that, a vile example of an article by someone named Anna Moore published in The Telegraph entitled ‘I feel empowered, in control of my body’: four women on fighting cancer with alternative therapies. When I saw that article, I knew I had to blog about it, because it’s one of the worst examples of everything that can be wrong about journalism with respect to quackery that I’ve ever seen, and that’s saying a lot. Now, I had never heard of Anna Moore before, but that’s not surprising given that I don’t live in the U.K. Be that as it may, reading her article depressed me greatly thinking of how many people with cancer it might imbue with doubts about science-based medicine or the idea that cancer quackery might cure them. Another reason I couldn’t resist is that the commenters there really, really don’t like me, which makes me hope that one of you will post a link to my not-so-Respectful Insolence directed at Moore in the comments after the article.

Moore goes wrong right from the start, with Moore spewing the usual cliches about cancer being on the rise and a survey from what appears to be a woo-friendly breast cancer charity in which a huge majority of patients viewed quackery as “essential” to their recovery. (OK, they didn’t call it quackery, but that’s what the modalities listed are.) She then proceeds to buy into the rebranding of “diet” as being somehow “alternative” rather than science-based. Of course, the “complementary and alternative medicine” (CAM) and “integrative medicine” version of diet resembles science-based diet recommendations usually only by coincidence. This leads her into a bit of “reverse balance” in which Moore quotes Martin Ledwick, the head information nurse at Cancer Research UK urging caution and trying to explain why testimonials are not good evidence for the efficacy of alternative cancer cures, which she then “balances” with four anecdotes, one of whom we’ve met before. Actually, Moore does more than “balance.” Her article crosses the line from journalism into promotion.

First up is Polly Noble, who was diagnosed with cervical cancer at age 24. Not coincidentally, she also runs a website that promotes raw food veganism and founded a store called DetoxYourWorld. Basically, as related in Moore’s story and Noble’s website, she had positive lymph nodes and underwent surgery, chemotherapy and radiation therapy, as well as brachytherapy. (Brachytherapy is a form of radiation therapy in which radioactive “seeds” are placed directly on the organ being treated; its advantage is a very direct, intense dose of radiation that doesn’t affect adjacent organs as much as beam radiotherapy can.) She recurred, as she described to Moore:

In February 2010 doctors found a growth in my neck: the cancer had come back. I was offered radiotherapy, but I said, “Give me six weeks to figure what I’m going to do.” I decided against conventional treatment. I wasn’t scared; I believed I could heal myself. I went 100-per-cent raw, upped my juicing regime and carried on with visualisation. Within two or three weeks I experienced amazing feelings. I was waking at 5.30am, raring to go.

For two years I felt great, but then the tumour started growing out of my neck and doctors found secondary cancer in my lungs. I was struggling to swallow, eat or breathe, and by August 2012 my consultant said I might not live to see Christmas. I didn’t want chemotherapy – I believe it’s a poison and it doesn’t deal with the root cause of cancer. I was worried I’d be judged if I went back to conventional medicine. But I do what I can to keep myself alive.

If I died because I was too stubborn or proud to do something I’d said I wasn’t going to do, then more fool me. Right now I’m using a two-pronged attack. I’ve had chemo to reduce the cancer and alternative therapies to get me through with virtually no side effects. It doesn’t have to be one way or the other. You can have the best of alternative and conventional medicine.”

That this story is being represented as a testimonial for alternative medicine is shocking. It’s obviously a failure of alternative medicine. To be fair, it’s also a failure of conventional medicine, given that she recurred, but no one claims that conventional therapy always works. In any event, Noble’s stubbornness is exactly what was driving her. She was afraid of being judged if she goes back to conventional treatment. However, clearly her symptoms must have been getting worse to the point of prodding her to overcome her aversion to effective therapies, because she decided that she would accept chemotherapy, rationalizing her decision to herself as using the “best of both worlds.” She isn’t, of course; it’s the chemotherapy that is providing palliation for her cancer and letting her swallow again. The alternative therapies are almost certainly doing nothing, given that the hated “conventional medicine” has become quite good at managing the side effects of treatment.

There’s one last thing before I move on to the next anecdote. Noble’s picture looks as though she has scar tissue on her neck and upper chest. To me this looks as though she’s had radiation therapy to the neck. It’s hard to tell, given the quality of the photo, but I bet that’s what happened. In any case, Noble’s case is not evidence for effectiveness of alternative therapy. She didn’t feel better until she agreed to accept chemotherapy. I also find it a journalistic failure that Moore never mentioned that Noble makes a living selling alternative treatments, mainly in the form of raw vegan foods and kitchen equipment like juicers, books, and supplements. She also buys into acid-base quackery.

Next up is a woman named Alyssa Burns-Hill. Again, Moore doesn’t mention that Burns-Hill makes a living selling alternative health modalities. She bills herself as a “leading Holistic Hormone Health Specialist” and she has clinics in Harley Street and Jersey. Hilariously, she represents herself as a “scientist and practitioner of health in its broadest sense.” One notes that she is not a physician, and her PhD “focused on ‘Holistic healing from breast cancer through the lens of hormones: Synopsis and synthesis.’”

Hers is a very easy testimonial to dispose of, because it is so typical. Indeed, I joked not too long ago that I really ought to try to come up with a pithy name for this variety of alternative cancer cure testimonial because it is so common. Basically, Burns-Hill had stage I breast cancer for which she underwent surgery. Afterward, she started radiation therapy but stopped it part way into the course of treatments and refused chemotherapy. Yes, as I’ve explained so many times before, the surgery is what cured her, not any combination of woo that she chose, including:

I call what I did a 21st-century version of Gerson therapy. I had four juices a day, 120 supplements, homoeopathic injections and four coffee enemas. I also did yoga, meditation, reiki – a holistic approach. It’s not an easy option. The treatment is a full-on, full-time job, and there’s no room for anything else.

After six months I started cutting down the coffee enemas and the number of juices. Now I eat healthily, maintain a high nutritional-supplement intake and love my job as a health specialist. I don’t go for check-ups or scans as I don’t want the stress. It has been 12 years now.

Pure quackery, and this article just keeps promoting it.

The fourth testimonial (I’ll come back to number three at the end, because she is the one I’ve written about before) comes from Sarah Shotton. Unlike the other women giving testimonials, Shotton does not appear to make a living selling woo. She is involved in fighting plans for a wind farm near her house, and in March she was featured in a story in The Journal, in which she was represented as having terminal cancer. In the photo accompanying Moore’s article, she definitely doesn’t look healthy, unfortunately. Yet she represents herself as feeling great, all because of the woo she follows.

Her story in brief is that she was diagnosed four years ago with HER2-positive breast cancer that required a mastectomy, after which she underwent six months of chemotherapy and five weeks of radiation therapy. Then this happened:

Then, in September 2012, a mass I’d noticed in my pelvis – which we first thought was an ovarian cyst – turned out to be a rare cancer: clear cell carcinoma, another primary site, unconnected to the first cancer. Apparently I was just “unfortunate”.

When I had a CT scan, doctors found two liver tumours – secondary cancers from the original breast cancer. The life expectancy isn’t good at all, and I was terrified of having chemo again, of putting my body through hell. I thought I’d have to refuse. My lovely friend who’d had breast cancer had now died; she’d taken every drug they’d offered and her suffering had been horrendous.

She discovered an “integrative” practitioner named Dr. Kate James, who mixed her up a bunch of Chinese herbs and recommended a bunch of dietary interventions while Shotton underwent chemotherapy. This in and of itself wouldn’t bother me so much, as long as Shotton kept undergoing palliative chemotherapy. It’s highly unlikely that all the acupuncture, raw vegan diet, and traditional Chinese medicine did one good thing for her. It isn’t cheap, either, £100 per week. Worse, she’s contemplating stopping chemotherapy and relying solely on the woo. Again, that in and of itself wouldn’t be so bad if she realized what she was doing, but she doesn’t:

I’m now at the stage where I want to stop the chemo, carry on with my diet and alternative treatments and just be monitored by my oncologist. He wants to keep me on the chemo indefinitely, my husband is absolutely terrified, and my sister used to be pharmacist, so there are intense discussions going on, but I feel empowered, in control of my body.

I would argue that true “empowerment” involves understanding the consequences of one’s choices. It would be one thing if she wanted to stop chemotherapy realizing that the end was near and opting for palliative therapy. That is often a very reasonable course of action. However, exhausting one’s life insurance to spend £400-500 a month on useless quackery thinking that it will prolong life is not “empowerment.” It’s being taken to the cleaners by quacks during what is, sadly, probably the last year or two of your life. This is particularly inexplicable in a country like the UK, with a national health care system paid for by taxes. I hope that Shotton keeps doing well, but right now it’s the chemotherapy that’s holding her cancer at bay. Moreover, because she is terminal, her oncologists probably chose a less aggressive chemotherapy regimen intentionally, because the intent is no palliation, not cure. The same is true of Polly Noble to treat her cancer recurrence. When the goal is palliation, side effects have to be minimized. Quack apologists who decide to use woo with conventional medicine don’t realize this. They tend to think of “chemotherapy” as a monolithic thing that’s always nasty, always toxic, always bad. It’s not. There are lots and lots of regimens whose toxicity varies a lot.

Which brings us to Hannah Bradley. I’ve extensively discussed her story before. She’s a young woman with a brain tumor who raised a lot of money to go to Houston and be treated by Stanislaw Burzynski. One thing that stands out is that it’s been a very long time since Hannah’s partner Pete Cohen has shown one of her MRI scans of her brain. Back in the day, about a year and a half ago, he proudly showed them off as evidence that Burzynski was curing her. Then, over the last several months, his video blogs with Hannah became more and more worrisome, with Hannah seemingly showing more of a left-sided facial droop and the both of them becoming more and more evasive about Hannah’s brain tumor. Indeed, I had considerable reason to believe that in November of last year it had appeared to come back, as Pete and Hannah admitted that they didn’t have the “best of news.” So what do we learn in Moore’s story?

This:

Pete and I learnt how to prepare and administer the treatment ourselves and it carried on in Britain for another 18 months. It’s not an easy option. My blood was checked twice a week, and I was scanned every six weeks at a private hospital. Most importantly, it seemed to be working. The tumour kept getting smaller, and in January this year it was all gone. I’m now off the treatment but still being monitored.

Indeed, as I pointed out back in March, in Pete and Hannah’s vlog of December 2, 2012, Pete was noticeably evasive when discussing her latest scan, and both Pete and Hannah appeared uncomfortable:

In their vlog of March 2, 2013, Hannah admitted that she still had a “really cystic area in my head” but insisted that there’s no enhancing tumor and wouldn’t say if what is there is increasing in size or stable:

In this vlog, dated April 1, 2013, Hannah says she’s due for a scan in two weeks, after which she might be able to come off of antineoplastons. Then, on June 6, 2013, Pete and Hannah posted a vlog declaring that Hannah had been taken off of antineoplastons:

I’ve said it before, and I’ll say it again. I wish Hannah and Pete no ill will. They genuinely believe that Burzynski saved Hannah’s life. I really hope that Hannah continues to do well and lives to a ripe old age. I just don’t see any evidence that Stanislaw Burzynski is responsible for her good fortune, for reasons that I’ve explained in depth before. It also disturbs me that there appears to be a discrepancy between what Hannah reports in Moore’s story and what she and Pete Cohen have been saying in their vlogs and in the media. For instance, after a BBC Panorama story on Burzynski, Pete Cohen showed up in the British media saying that Hannah was doing well and castigating critics of Burzynski. Then, in Pete and Hannah’s vlog of June 6, I can’t help but note that neither Hannah nor Pete actually say that her tumor is gone, just that she’s “doing really well.” Before that, in March, Hannah said that she had a “cystic area” in her head. Yet in Moore’s article, she says her tumor was “all gone” in January. Given Burzynski’s well known proclivity for misreading MRI scans and mistakenly telling patients that “cystic” areas are the tumor breaking down, as he did to the parents of Amelia Saunders, I remain afraid for Hannah Bradley. I just don’t know what is going on with her. The stories conflict, and her partner Pete Cohen is squirrelly. On the other hand, she is two and a half years out from her diagnosis, which is on the right side of the median survival for her tumor type. We can only hope this continues.

On the other hand, although I bear Hannah Bradley no ill will, the same cannot be said for Anna Moore. She wrote nothing less than a promotional article touting cancer quackery, and The Telegraph, in a fit of irresponsibility, published it as not just false balance but reverse balance.