A naturopath’s got to know his limitations, but naturopaths never do

It’s no secret that I’m not a big fan of naturopathy. It is, as my good bud Kimball Atwood has said, a prescientific system of medicine rooted in vitalism, the idea that there is a “life energy” and a “healing power of nature.” Naturopaths invoke very simplistic concepts to explain the cause of disease, such as “toxins,” widespread food allergies, gluten, imbalances in qi (the life force energy), and many other pseudoscientific principles. To give you an idea of the kind of pseudoscientific quackery naturopathy encompasses, consider this: You can’t have naturopathy without homeopathy, which is a major component of naturopathic training and the naturopathic licensing examination (NPLEX). Indeed, one of my biggest complaints—albeit by no means the only one—about so-called “integrative medicine” is that invariably it so easily “integrates” naturopathy along with science-based medicine.

In particular, I do not like the specialty of naturopathic oncology, as I have documented in many posts (such as this one). I’m also not fond of the emerging specialty of “integrative oncology,” which does nothing more than integrate pseudoscience like naturopathy with science-based oncology. I’ve likened it to kudzu insinuating quackademic medicine into oncology and even managed to publish a single-author paper in Nature Reviews Cancer taking a critical look at integrative oncology. None of this has stopped the Society for Integrative Oncology from happily producing guidelines for the supportive care of breast cancer patients with the help of an editor who is a naturopath. Nor has it stopped that very same naturopath from scoring large grants to study the use of naturopathy in various cancers.

One of the retorts that advocates of integrative oncology make when skeptics like myself criticize the use of naturopathy alongside real medicine is that the “complementary and alternative medicine” (CAM) being used, including naturopathy, is not meant to be used instead of conventional medicine but rather to “complement” it. Naturopaths, we are assured, would never, ever overstep their bounds and try to treat cancer with their unproven remedies. Oh, no. Why on earth would you ever thing that?

One of my all time favorite movie quotes comes from the second Dirty Harry movie, Magnum Force, in which Dirty Harry says, “A man’s got to know his limitations.” Unfortunately, what makes naturopaths so dangerous to cancer patients is that they don’t know their limitations, their promises not to treat cancer patients alone notwithstanding.

This point was illustrated by a news report published last week in the National Post entitled Cancer patients are losing valuable time — and risking their lives — with alternative therapies, doctors say:

When a London, Ont., cancer patient was told she would need surgery to remove an oral cancer, then have a piece of leg or arm tissue grafted into her mouth, it seemed too much to bear.

So she turned to a natural-health practitioner, who for two years treated the malignancy with applications of rosehip oil.

By time the woman returned to hospital, “literally half her face had been eaten away by cancer,” says Dr. Leigh Sowerby, the ear nose and throat surgeon who was part of her treatment team.

“The family had been told by the alternative-health provider that it was a good sign, because it meant the treatment was drawing the cancer out of the body,” he recalls. “She ended up dying in hospital before we could do the surgery.”

OK, OK. This doesn’t say whether this particular “natural health practitioner” was a naturopath or not, although it’s a pretty good bet that it likely was. Not surprisingly, the article quotes a spokesman for the College of Naturopaths of Ontario (unfortunately, Ontario is right across the river from Detroit and a mere three miles or so from where I work) as saying that its members’ scope of practice does not include handling potentially treatable cancers on their own. Not surprisingly, though, because cancer is so common and because there is such a widespread myth that there exist “natural” treatments for cancer not involving surgery, chemotherapy, or radiation, it’s not surprising that there’s a lot of—shall we say?—looseness in how naturopaths interpret what that prohibition actually means in practice. Indeed, this article is basically a bit of an undercover sting operation in which naturopaths in Ontario were asked by a reporter posing as a cancer patient’s relative.

What do you think the National Post found? To be honest, it wasn’t as bad as I would have expected, but it was plenty bad nonetheless:

Posing as a patient’s relative, the National Post asked naturopaths in British Columbia, Ontario and Nova Scotia if they would treat someone newly diagnosed with B-cell lymphoma, with enlarged glands in the chest and groin, who refused to undergo chemotherapy. Thirteen of the 18 who responded said they would take on the patient solo — only one said no.

“This is exactly what I do,” said one Ontario-licensed practitioner.

“He has many specialized protocols that he has seen work well,” said an assistant to naturopath Neil McKinney of Victoria, “prolonging life, increasing quality of life, stabilizing tumours and the disease progression, and shrinking tumours.”

McKinney said in a followup interview he does advise patients to stick with conventional medicine if he thinks it would help them, and stresses to them there is little definitive science backing up what he does.

Anyone want to guess whether that assistant still works for McKinney? In any case, note how only one gave a definite “no” answer. I’m guessing the other four waffled, not wanting to commit until meeting the patient.

I took a look at McKinney’s website for his practice, Vital Victoria Naturopathic Clinic Ltd. Right off the bat, I noticed that the clinic offers reiki, which, as I have said so many times, is nothing more than faith healing that substitutes Eastern mysticism for Christian beliefs. He also offers what he describes as an “alternative to the standard flu shot,” consisting of “homeopathic injectable and oral remedies for influenza prevention called Engystol and Gripp Heel.” Heel itself is known for marketing some of the most ridiculous homeopathic remedies out there (and that’s saying a lot, given how ridiculous the concepts upon which homeopathy is based are).

I also call BS on McKinney’s later denial. For instance, on his testimonials page, there are testimonials like this:

I wanted to share with you a success story with a rare and difficult cancer which I credit to your book, Naturally There is Always Hope.

Patient is a 52 yr old female, she came after surgery for retroperitoneal leiomyosarcoma grade 3, 14 cm in dimension, diagnosed May 2009. Metastasized to the lungs. After surgery I put her on your supplements.

Since the surgery and the protocol has shown no interval change in size or growth. She will remain off of chemo as long as disease remains stable. She is otherwise healthy and leading a fulfilling life.

In other words, this naturopathic resident is using McKinney’s protocol to treat cancer without further conventional therapy and McKinney is using this testimonial on his website for advertising purposes. Then there’s this testimonial:

My daughter J, of Northern California dropped life to look after me. The cancer clinic of Victoria, BC gave me a long list of caveats about my taking their only panacea; chemotherapy. At best they gave me a 33% chance of living between 6 to 12 months if I were to take the therapy. The cancer clinic gave no nutritional advice. What to do? J did an enormous amount of research online and in books. Vitamin C intravenous treatment led her, indirectly, to Dr. McKinney, of Victoria. We agreed to try this holistic, natural approach to healing.

He was open on the choice to take or not to take chemotherapy. We declined. Dr. McKinney’s book “Naturally There is Always Hope” and Dr. McKinney himself gave me assurance and confidence that I could get healed.

I had the vitamin C therapy, twice a week for 6 weeks. It provided, along with a complete dietary revolution and adherence to the Glycemic index, the way to my recovery. I took nutritional advice and supplements from Dr. McKinney’s naturopathic clinic; I have my blood tested through the cancer clinic and am fortunate to lead a full and energetic life. In short, I owe my life to my daughter who supported me in my wish to take a natural rather than a drug approach, and to her for finding Dr. McKinney who started me on my healthy, confident way. I have also furthered my spiritual journey, which includes believing in miracles, or the impossible.

In other words, McKinney treated this woman with intravenous vitamin C and diet, without conventional therapy. There’s also a testimonial that isn’t exactly using naturopathy for cancer without conventional medicine but is equally reckless. In addition to reiki, during her radiation treatment for brain cancer this patient did this:

During my radiation treatment I made a decision not to use dexatron, a steroid to reduce brain swelling from the radiation. This decision was not made lightly but given the side effects of the steroids I spoke to Neil about alternatives and consistant with my integrated approach I took a naturopathic product that proved amazing. While taking this supplement I was able to go through my sessions of radiation without the headaches common with this treatment.

I am also taking other supplements as recommended by Neil and my tumour and cancer are currently in remission. I know your clinic has played a major role in this along with the traditional biomedicine of surgery, radiation and chemo.

This patient was lucky, as this was a decision that could easily have killed her. There’s a reason why oncologists administer steroids while doing radiation therapy for brain cancers. As tumor cells die in response to radiation, the tumor and nearby brain tissue can become inflamed and swell. Normally for most cancers this is not a major issue, but the brain is different. It is enclosed in a hard case of bone, the skull. If the brain and tumor become inflamed in response to radiation there is no room for the brain to swell in response to inflammation, which means inflammation can result in increased intracranial pressure. Given that the brain is sensitive to increased pressure, this can potentially be a very dangerous situation. Steroids, for all their adverse effects and undesirability in many situations, are unparalleled in stopping inflammation in its tracks. That’s why they’re given before radiation to the brain. By refusing steroids, this patient endangered her life, and McKinney was complicit in that.

And this is a guy who has written several books on “naturopathic oncology.” His story of how he became a naturopath involves traveling to Tijuana to visit the Hoxsey Bio-Medical Clinic

To be honest, I was surprised that it was only 13 out of 18 naturopaths who were willing to treat a patient like the one described. That’s only 72%. I would have expected more like 90%. Of course, maybe it was, given that only one out of eighteen naturopath offices said no. Neither is a good number, as no naturopath has any business treating cancer patients primarily. Come to think of it, no naturopath has any business treating any patients primarily, given that McKinney is so deluded that he claims that:

“We (also) sometimes shrink the tumours enough that the surgeon can get them out,” he says, echoing his assistant. “I had a case like this recently — sarcoma that was considered incurable, reduced to a point where it was curable.”

So which is it, I wonder? McKinney claims he doesn’t treat patients with cancer and urges them to stick with conventional therapy, but then he says that he can shrink tumors to the point where inoperable tumors become operable. In essence, he is claiming he can use naturopathy as what we call “neoadjuvant therapy.” Neoadjuvant therapy (usually chemotherapy) is used to shrink tumors so that inoperable tumors become operable or to make organ-sparing surgery possible where it would not have been possible before. For instance, we frequently use neoadjuvant chemotherapy to make it possible to remove breast cancers that would have required mastectomy using lumpectomy or to remove rectal cancers that would have required the resection of the anal sphincter without having to sew their anuses closed. If naturopathy can accomplish the same thing nontoxically, McKinney really needs to publish his results pronto!

He won’t, though, because he can’t. Indeed, one thing that irritated me about this article is its reference to Sylvia Rickard, who had surgery for colon cancer and decided to reject postoperative adjuvant chemotherapy in favor of high dose vitamin C. It was irresponsible not to mention that it was the surgery that kept this woman alive, not the quackery of high dose vitamin C.

We also get to meet naturopath Dugald Seely at the Ottawa Integrative Cancer Centre. He’s the guy who’s gotten a total of nearly $7 million in the form of two grants from an anonymous source to study the use of naturopathic oncology in cancer patients. That’s why I had a hearty chuckle when Seeley is is quoted as saying that it’s difficult to “raise money for rigorous clinical trials of natural treatments that have little profit potential for investors.” Certainly, he’s done quite well; I don’t know too many conventional medical researchers who have a $7 million war chest in the form of grants to study their treatments.

I’ve long suspected that a major part of the reason that so many physicians team up with naturopaths to treat patients is because they really have no clue what naturopathy really is. They don’t realize that there is virtually no form of quackery that naturopathy doesn’t embrace and minimal concern over whether any of it actually works. To paraphrase Harriet Hall, what is good about naturopathy is not unique to it, such as an emphasis on diet and exercise. Unfortunately, what is unique to naturopathy is not good. Moreover, the only argument in favor of letting naturopaths treat cancer patients supportively that reassures science-based oncologists, namely that naturopaths would never overstep their bounds and try to treat cancer themselves, is clearly a lie, as this survey shows. Naturopaths, quite simply, do not know their limitations.