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Ranjana Srivastava: When cancer patients want quackery

Regular readers will have noticed that I haven’t been blogging nearly as much as usual. All I can say is that a combination of personal and professional issues and obligations have gotten in the way. Also, I have been a bit under the weather, as hard as it is to believe that a Tarial cell-driven ultimate computer can be. Fortunately, however, things seem to be looking up, and I think that I’ll be able to get back into the swing of things next week. In the meantime, I saw a great article by oncologist Ranjana Srivastava, who notes that My patient swapped chemotherapy for essential oils. Arguing is a fool’s errand. It’s about a topic that I’ve written about a lot: What do you do when faced with a patient who is seeking alternative medicine to treat her cancer and is not interested in effective, science-based treatments.

Dr. Srivastava begins with an anecdote, one similar to what pretty much every oncologist has probably encountered at one time or another:

“Tell me why I should have your chemotherapy when I can be healed naturally!”

His face is set, his arms defensively squared. His friend carries a pamphlet that features a suspiciously healthy woman with glamorous hair and a glowing complexion. This is the urgent appointment of the day, for whom other patients were hastily shuffled to make room.

I know I shouldn’t take the bait but, like an addict, I have the urge to say:

Go ahead then, be healed. And I will almost certainly see you again, emaciated, ruined, lamenting the fact that it’s too late.

Thankfully, the code of conduct glides in. I imagine his dread. I remember my position. And I say: “Tell me more.”

I fully empathize. I don’t see such patients that often, likely not as often as Dr. Srivastava sees them, but I do see them. For a breast cancer surgeon, there are generally two kinds of such patients. One kind is the woman with early stage breast cancer who wants to treat her cancer “naturally,” without surgery, radiation, or chemotherapy. Such patients are, of course, usually in good shape. Often they are asymptomatic, their cancer having been discovered by mammography, or they have relatively small, palpable lumps in one of their breasts, the only symptom that their cancer has just yet produced. It’s understandable that such patients would be frightened at the prospect of surgery, followed in some cases by radiation therapy and chemotherapy, both of whose unpleasant side effects and complications are generally well known among the lay public. Without a knowledge of the biology of breast cancer, it’s not unreasonable to ask why such drastic treatments are needed to treat an asymptomatic disease or a little lump. On the other hand, the specter of cancer in the popular imagination is such that it terrifies people.

The second kind of patient I see like this is a woman who has neglected her breast cancer, treating it either “naturally” or not at all, so that it was allowed to grow unchecked, unremoved. This results in something known as en cuirasse disease, or, as I describe it, an ulcerating, fungating, bleeding, stinking tumor mass that can’t be resected without resecting a large portion of the chest wall. En cuirasse carcinoma is a horrible, painful, and nasty manifestation of breast cancer in which the cancer grows from the breast into overlying skin and spreads along the chest wall and back in nodules that eventually coalesce into large contiguous tumor masses. When breast cancer progresses to this point, the en cuirasse tumor often bleeds and becomes necrotic, leaving the unfortunate woman with a chest wall covered with bloody, partially dying tumor that smells like rotting meat–mainly because it is in essence rotting meat, with living tumor in and around it.

It’s a horrible fate, particularly when the cancer hasn’t spread beyond the chest wall and is the only site of disease. When that happens, there’s no acute danger of the patient dying from metastases in the short term, but the horrible local tumor can cause intense pain. (I wrote about this very phenomenon in the context of story of Michaela Jakubczyk-Eckert over 12 years ago.) Fortunately, en cuirasse disease is not always unsalvageable if it is not too extensive. Chemotherapy can often shrink the tumor masses markedly, and, if they’re confined to the breast, a mastectomy can clear the local disease. I’ve seen some pretty dramatic recoveries, as long as the chest wall disease is not so extensive as not to be resectable after chemotherapy.

But let’s get back to Dr. Srivastava’s story:

He asks: “What’s the guarantee of your chemo, anyway?”

I have perfected my retort during sleepless nights.

In life there are no guarantees but you have a curable cancer. Yes, there will be side effects but we can manage them. No, I can’t guarantee a cure, but I’d recommend evidence-based treatment any day over the magnet that purportedly draws out cancer cells. And while we are there, it’s not my chemotherapy. Your taxes fund my job but I don’t profit from giving you chemo.

But how many times have I heard that if oncologists hectored a little less and listened a little more, we might win more hearts?

So I bite my tongue again, thinking of the alarmed nurse who begged me to change his mind. As I talk him through his various options from least to most intensive, I remember the patient who swapped chemotherapy for essential oils, the one who chose to “burn” the tumour out and the one who suggested I become a sales representative for a life-saving juice.

“You don’t convince me.”

“You have the facts, you get to decide,” I reply.

I used to think that these second opinions were illuminating for patients and nudged them towards change. But what I have learnt in the last few years is that cancer patients in search of alternative cures are more deeply entrenched than ever in their beliefs.

I also note that I don’t profit by operating. I’m an academic surgeon. My pay is the same whether I do 100 or 400 cases in a year.

Be that as it may, Dr. Srivastava is correct. Arguing with such patients is pointless. Even though that is the case, that doesn’t mean that there’s nothing that can be done. I’ll admit that my perspective is limited because I am extremely specialized. I’m a surgeon, not a medical or radiation oncologist, and I generally treat only one kind of cancer, breast cancer. My goal with these patients is to persuade them at least to let me operate on them. Surgery alone can cure breast cancer, as I’ve described more times than I can remember. Surgery alone, of course, is not the ideal treatment. There’s a reason we add adjuvant therapies to surgery. Chemotherapy, radiation, and endocrine therapy can decrease the chance of recurrence, sometimes markedly. In some cases, chemotherapy alone can cure breast cancer. Still, it is surgery that is the primary modality used to treat surgery and most other solid tumors, like colon cancer.

So what to do when faced with a patient like this, someone who doesn’t want conventional treatment that can save her life?

My thought process with these patients seeking alternative cancer cures is actually simple. It has to be, and it’s this: If I can get them to agree to surgery, at least they have a fighting chance to survive, even if their chance is not as good as it could be if they were willing to accept the full gamut of science-based multimodality treatment for their cancers. I don’t care that much if such patients do what do many of them who accept surgery but refuse chemo/radiation/endocrine therapy do, which is to credit their survival to the quackery they chose and not to the surgery that actually cured them. Yes, it’s frustrating as hell to see patients like Suzanne Somers or Chris Wark undergo surgery for their cancers and then attribute their survival to whatever quackery they decide to undergo.

At least they lived.

In other words, I value saving the patient’s life with what I CAN do (surgery) if I can, or at least giving her the best chance that *I* can give her and get her to accept.If she wants to attribute her survival to the quackery that she chose in addition to surgery I persuaded her to accept, so be it. Such is life. At least she’s alive to do that.

Unfortunately, even though I’ve had some success persuading patients at least to undergo surgery, I can’t argue with Dr. Srivastava’s conclusion:

It has been received wisdom that oncologists can see off quackery through good communication but I’m afraid that isn’t so.

Oncologists have been properly entangled in a web of fake news. Their authority has been undermined and their expertise ridiculed by a determined, global and hard-to-track battalion of quacks and their acolytes. Greater vigilance, stronger regulation and improved health literacy might help, but the pull of alternative cures is strong.

Make no mistake. With so much misinformation fuelling the use of increasingly bizarre alternative therapies, patients will be ultimately robbed and disappointed, and their doctors will be relegated to the sidelines. To paraphrase an old joke, oncologists will no longer be giving chemotherapy until the grave, but the quacks will be laughing all the way to the bank.

Of course, I can’t help but note that none of this is new. I’ve been combatting quackery online for nearly 20 years now, the last 14+ years blogging and the last 9 years on Twitter. There’s nothing Dr. Srivastava describes that I haven’t been dealing with a very long time. Indeed, one thing that I (and other skeptics in medicine) often find frustrating is how many doctors act as though fake news, propaganda for quackery, and the resistance of believers in unscientific treatments to reason and science are something different now than they were in the early days of the Internet. Don’t get me wrong. I’m happy to have new doctors realize the threat of quackery, fake news about medicine, and medical pseudoscience. We need a lot more to join us. I just hope they understand the history of those who have gone before fighting this battle long before they realized the problem existed.

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]

180 replies on “Ranjana Srivastava: When cancer patients want quackery”

I suppose that is the problem with fighting quackery. The quack promisses a natural cure, with no side-effects and guarantees an absolute cure, while the true specialists can’t promiss any of this. Not because their treatments don’t work, but because they know they cannot guarantee things. It’s fighting propaganda with the truth.

Also by the time their mark is out of money and are not doing so well medically there are few with the strength and resolve to try and call these shysters to account for the lie they sold.

They sell hope to the hopeless more often than not and are the scum of earth, but there is never a refund.

You’re completely right. That’s why I hate cancer quacks more than any other quack. As soon as a quack specialises on potential deadly diseases they are really the scum of the earth. Sometimes a story about a dead patient makes the news and with a bit of luck, the quack will be prosecuted, but mostly nothing happens. I know 2 cases in The Netherlands, where this was the case, one was a known actress with a well-known quack advising her. The other one was the former wife of a Dutch politician, who wrote about her case. https://skepsis.nl/macrobiotics/

Sad story, but I enjoyed this bit

A radiant Wieke Nelissen, Adelbert’s wife, offered me a glass of kuzu juice. I declined. We sat in a circle, and my spouse had also joined us, ashen-faced. ‘My co-workers here are my best forces’, Adelbert said, with a broad arm gesture. ‘We all agree that a more vigorous approach is called for’.

Yes, I said, that means that she should now go nonstop to the hospital to have herself examined by a gynaecologist.

‘That’s what you think, but that isn’t necessary yet. What’s really necessary is that she sticks firmly to her diet, that you start cooking macrobiotically and that you won’t eat any cheese sandwiches anymore. That’s the reason why our efforts didn’t succeed’.

‘Are you out of your mind, arrogant bastard!’ I shouted. I walked over to him and smashed him in the face.

I cannot remember having ever done such a thing. I still feel deeply satisfied.

And then the sad conclusion after visiting his now divorced wife in her final days:

In the front room I saw in a polished wooden bookcase the books on macrobiotics. They were at eye level. They seemed to be evidence for the cause of death. Silently I promised myself that next time I won’t wait for three years before I hit someone.

So sad. I remember a fairly young woman with a college age daughter who had nothing left on her chest but a necrotic crater. It was our job to get the ER/PR/her2 done. There was nothing else that we could contribute.

No matter how successful we are in battling quackery, there’s nothing we can do to battle denial.

I had a hospice patient like that. Elderly African American female. However, she didn’t go for quackery. She simply couldn’t afford health care and resisted seeing a doctor until it was way too late. Doing her daily dressing change was heart breaking.

I guess a part of the problem is that the patient doesn’t want to head what their is telling them.
The quack promises the patient a dream: A cure without side effects and risks, and completely natural too! We know it is a lie, but it sounds wonderful, doesn’t it?
And then there is the doctor, (hopefully) offering what science based medicine has to offer. A regimen of surgery, chemotherapy and radiation. And they hear: There will be scars, and side effects. They will feel miserable. And while it might give them good chances, the doctor won’t lie to them and promise them they will live.
Ad I guess for some patients like fantasy more than reality.

I apologize, somehow the autocorrecting completely scrambled my comment. I seriously wish I could edit it and I hope you will understand the gist of it anyway.

The article is about her anti-vaccine rants, but ends with the accusation that she has posted racist tweets. Unfortunately, they produce two quotes which are not actually inherently racist (which is no to say that this wasn’t her intent)

Trump administration and Mediaite called attention to several of her racist tweets.

“Just singing to one of my jams ‘Golddigger’ by Kanye West when I realized If I sing along to the verse ‘Broke Nigger’ I might be a racist,” she tweeted in July 2015.

A month later, she tweeted, “If white chicks can’t perm their hair – black chicks can’t go blonde.”

Ogden Nash had a reply for people who get their health info from popular sources:
“the only cure for the relative who has read an article
is a hatpin to the left ventricle of their hearticle”
from a poem about the frustrations of dealing with self-educated experts accompanying the patient to the appointment.

A few years ago ( 7 or 8?) a woman I visit once a year revealed that just after the previous year’s visit, she had to have surgery for “stage 2 or 3” ( the most I could get out of her) colon cancer; she was advised to get chemotherapy and radiation both of WHICH SHE REFUSED because she didn’t want to be “weakened and disabled” by the treatments. AFAIK, she’s been alright. It hasn’t been mentioned so I don’t ask. I know her through another person so it isn’t as though we are close.

I sometimes wonder if a topic mentioned here- and exploited by the likes of Suzanne Somers, alties et al- is that she didn’t want to lose her hair. A commercial for CTCA shows a patient who “didn’t need chemo” and has hair like a shampoo model. This may be a factor in alties’ appeal. I hear this frequently at PRN/ NN. ( liars!)

In addition:
arguing may work further down the line if the patient gets feedback from other people or thinks about it more. When you counsel people with unrealistic beliefs, therapists are not educated to “go along” with the fantasy because even people with serious delusional disorders ( as they report later) say that ” a little part of them” was still somewhat realistic and “sided” with the therapist.

PLUS:
it’s great when new doctors come aboard the good ship HMS Sceptical but Orac was there long ago.

I’ve worked in Palliative care for the last 12 years and these is nothing sadder than seeing someone who had/has a cancer with a high 5 year survival rate who has fallen victim to one of the many cancer quackeries, from potato water to apricot kernels, I’ve lost count tbh of the ones out there, but to see them and their families suffering so un-necessarily makes my blood boil at times.

The worst ones are those who tried a bit of both, because invariably its the SBM and never the CAM that is to blame for their untimely end.

It shouldn’t be up to oncologists to try to ““Tell them why they should have chemotherapy when they can be healed naturally!” MDs aren’t trained for that. Medical centers should have some sort of professional interpersonal; communication specialists on staff to deal with this sort of issue.

Why waste that much effort on people who are hostile to you and your profession? Let them understand the gravity of the situation, then let them make their own choice.

“Go ahead then, be healed. And I will almost certainly see you again, emaciated, ruined, lamenting the fact that it’s too late.”

Sounds fine to me. It is factual and direct. Hearing this, a few will go 100% to the quack in order to somehow spite the MD. Most, however, will be surprised, remember those words, and consider again their rash choice. If they come back, use a softer dialog, but do not humor their delusions.

I’d go further; if a person refuses real medicine for 9 months and comes back with a condition that requires $50K worth of surgery + hospitalization rather than a $7K outpatient procedure, tell them “nope, not with insurance, we refuse to bill them for the excess. We will be happy to do your procedure for cash, less the smaller amount it would have taken to operate 9 months ago, but only if there are no cases with non self-inflicted conditions waiting.” Because that’s hours of surgery, the time of a dozen hospital staff directly and indirectly, Those resources are then not available to someone who will make good use of them.

You are rather harsh on people who have been exploited by charlatans.

The charlatans are a different story, even when they are self-deluded, because they have no business offering treatments for cancer when they have no expertise in oncology; and because I care more about the harm they do than excusing them because of their self-delusion.

Steve Jobs is perhaps the most high profile “victim” of cancer quackery. He had one of the most survivable types of pancreatic cancer – Neuroendocrine, yet we are told that Jobs took 9 months following his cancer diagnosis to try acupuncture and juicing before returning to EBM. Yes he survived 7 years but in thoes years he had a Whipples procedure, experimental radiotherapy and a liver transplant.

When Jobs died the alternative medicine gurus blamed the EBM not the 9 month delay.

One thing that annoys me is that oncologists dont blame the patient if their treatment doesn’t work, but the alternative medicine guys always do – the patient didn’t follow their regimen properly, they ate sugar / refined food / non organic, or worst of all they at some point sought treatment from EBM.

Like the AIDS deniers who never die of AIDS, nobody who goes to these quacks ever dies because the snake oil they got sold was useless, no they could have been saved except you know things.

Or patients have a Naturopath heart or counselor tell them that they don’t really want to live… Contemptible!!

I wonder if doctors could try something like this:

“What these people are promising sounds wonderful. I cannot promise you what they are promising you. And the reason for that is, as a doctor, I am bound by law and the Hippocratic Oath to tell you the truth, even if that truth is unpleasant or unpalatable. These people are not bound by any laws. They can tell you anything they want, whether it is true or not, because sadly in our country there is no law against non-doctors giving people incorrect and dangerous health advice. Please go away and think about what I have said. Research the laws about “alternative treatments” and see for yourself whether they are well regulated. Then come and see me again before you make any decisions. Please consider that if something sounds too good to be true, then it might not be.”

Oh, also mention the consequences:

“If I told a patient something that was incorrect, I could face disciplinary action from the medical association and the government body. I could lose my registration, be sued or even be put in jail. If these people lie to you, they face no consequences at all. You probably won’t even be able to ask for your money back.”

With the aim being to awake some kind of critical impulse in them via consumer advocacy. (I think many come to skepticism via consumer issues, which can be a good avenue to open people’s eyes.)

36berkeley yes I think this is good. Also additional background on how the profession has arrived at the standard treatment through trials etc. All explained with the utmost compassion, as this may be the most terrifying experience that patient has ever faced. Like you say the alternative practitioners are not bound by laws so everything can be hyped, and it’s important for the patient to understand that

the thing is; smart people, the readers of this blog, and the Science Based Medicine blog too, generally aren’t impressed with flimsy arguments (made by people you call quacks). The people who are easily impressed with flimsy arguments generally aren’t up to reading blogs like this (I would have thought). As such, what I have found from reading a lot of posts’ comments is an echo chamber generally speaking. Not a problem just an observation.

Now I regard myself as a smart lay person. I highly respect science based medicine. It has its place. A big place if not the ultimate, eternal ‘word of “god”‘ so to speak.

I do suffer from a serious condition. I do totally rely upon my treatments being rigorously science based. I will only work with doctors who exemplify, who are at the top of their game with respect to this.

I do not rule out evidence based medicine though. I selectively explore some of the more ‘interesting’ (to me) evidence based “things”, for example, some ‘natural’ supplements, herbs, etc. …

One slight criticism: There are most definitely many who deserve the term quack because they practice true quackery. The entire troupe at Truth About Cancer’ comes to mind. I do feel though that the term is a bit over-used here in the sense that I get the impression that only those who practice science based medicine are not quacks. Would you agree with that?

In my mind a quack is knowingly selling ‘a bill of goods’ in its most negative meaning – perhaps like those selling a cure for all cancers, you know what I mean. They are a kind of criminal even, if only indictable in the moral or ethical sense.

Then there are for example Chinese Medicine/Acupuncturists who are, generally speaking, entirely well meaning. Those here may disagree with the foundations of these ancient systems, they are indeed not science based, but their practitioners, shouldn’t in general, be identified with the darker side of potentially criminal quackery.

Quack must know, after certain number of patients, that his “therapy” does not work. A honest person would stop at this point.

Let’s do a rough and ready thought experiment. If you lived in a faraway (mythical) country where the entire population ate like uneducated Westerners, 90% junk food, lots of animal products etc, and your presumed quack came along and advised to his/her “patients” – go 100% vegan and apply that mode of eating for the rest of their life.

How does the “quack” test for their own honesty?

@Ian Goldsmid: Well, you can start unpacking the problem in the following way. First of all, there’s a misidentification of the claim made by the quack: we’re not so sure what he’s exactly claiming. Is he claiming that (1) such a diet would be a preferable one, its effects taken as a whole on a country’s whole population, or (2) such a diet would be the best one, its effects taken as a whole on a country’s whole population, or (3) such a diet would be a better one, for every individual involved, or (4) such a diet would cure such or such disease. The more you claim, the more you’re a quack, mechanically,…

So let’s assume the quack is only claiming (1), this assumption being a very generous one. Then kicks in the other important consideration, rationality, which can be summarized as follows: the way you think is more important than what you think. In other words, what combination of evidence and sound reasoning do you have to support your claim. 90% of the time, the quack will point out to “common sense” (i.e. magical thinking) and cherry-picked evidence, which simply doesn’t cut it.

In other words: if I had to bet a buck that vegan diet is better than junk food on the scale of a whole population, I’m willing to cope with a loss, but not willing, nevertheless, to change my diet on a guru’s whim. If I had to bet my hand that vegan diet would cure my own putative personal disease, I wouldn’t go for it.

Simple. Firstly clarify what the claim really is. Secondly, ask for all the evidence. Failure to provide on any of these two conditions is how a quack should test his own honesty.

Still waiting for you, Orac AKA David Gorski, to man up and refute VaccinePapers as you claimed you would do. We’re all still waiting though, it’s been crickets for years now ever since you made that remark. I’m just going to assume it is because you lack the ability to dispute with those who are actually educated on the matter. All this talk from you for years and yet when push comes to shove and someone actually challenges you then you run away. What a coward.

Dustin Briltz says, “What a coward.”

MJD says, “Orac is the most “respectfully insolent” science-based medical blogger on the planet, Dustin. The “Orac” has dominated for ~14 years and has only written three (3) disastrous posts. In my opinion, it takes a lot of courage to continue on with that number of said posts.”

Vaccine Papers is just the same old garbage (AKA PRAT) that has been refuted over and over again here and elsewhere. Why bother?

I went back for a second look and Dan is basically flogging the aluminum causes autism claim without any epidemiological evidence to support it. This is his way of ignoring the huge amounts of research that have been done in the last 20 years since concerns about autism took off in the 1990’s.

If you go back to the autism omnibus hearings in the VICP, there were two main theories about how vaccines might cause autism. The popular one in the U.S. was that thimerosol, which gets metabolized to ethyl mercury and is quickly excreted from the body, somehow causes mercury poisoning which causes autism. This had a very superficial plausibility due to a partial overlap of symptoms and led to the removal of thimerosol from all childhood vaccines except for multidose flu shots, which can be hard to find even for adults. However, autism or ASD diagnoses continued to rise with no discernible effect from this change. And studies showed no difference in incidence for children who received more thimerosol containing vaccines or a greater amount of thimerosol compared with those who received none.

The popular theory in the U.K. based on Wakefield’s paper was that the MMR, which didn’t contain thimerosol, somehow causes ASD. But research showed no difference in incidence for children who received one or two doses of MMR compared to those who received none.

Both theories were rejected in the autism omnibus hearings.

And these researches were directed to specific hypotheses (thimerosol/MMR) and were careful not to make claims about vaccines in general and autism. However they provided the basis for Taylor’s meta-analysis which had enough completely non-vaccinated subjects to get a reliable estimate of the autism rate in the non-vaccinated population. This showed no difference in the rate for vaccinated vs. non-vaccinated.

So, people like Dan want to switch the speculation to say maybe aluminum in vaccines causes autism while ignoring all the aluminum in the food we eat and the air we breath. But, we are not starting from square zero now. We have 20 years of research to base our thinking on. So, if you think aluminum might cause autism, the onus is now on you (or Dan) to show a real epidemiological connection ASD diagnoses and aluminum-containing vaccines like the TDaP, HiB, Hep-A and Hep-B. And they have to explain the general negative association that was Taylor’s result.

Just saying “oh look, I found aluminum, maybe aluminum causes ASD” doesn’t cut the mustard.

However, since you are eager to learn more about the subject, I recommend this article.

https://www.skepticalraptor.com/skepticalraptorblog.php/aluminum-adjuvant-vaccines-cherry-picking/

Also, when I tell Dan about real autism research, like the huge genetic research program SPARK for Autism by the Simon’s Foundation, he keeps saying that it is just “twin studies.” It not any sort of “twin study.” In fact, it has discovered almost a hundred genetic causes of over half of the types of autism along the spectrum: https://sparkforautism.org/portal/page/autism-research/

For more reasons why Orac will not debate clueless cranks like Vapor Genie Dan: https://respectfulinsolence.com/2018/09/28/the-one-conversation-public-debate-discussion-devolves-into-an-antivaccine-crankiest/

You assume genetics being causative (as opposed to correlated/associated). Can you point to conclusive science based proof that genetics are the cause rather than an association?

You really don’t have clue. Here is an idea, click on the first link I posted… and then go from there. You should be able to find the several papers written about the research being done at the Simons Foundation.

Ian: “what I have found from reading a lot of posts’ comments is an echo chamber generally speaking.”

Well, major props to Ian for being a maverick who’s not confined to the box of sound science and critical thinking, like the rest of us lockstep echo chamberists. 🙂

As for “good intentions” being decisive: first of all, it’s very difficult to tell just how much quackery promoters sincerely believe, as opposed to pretending belief in order to sell their nostrums. It doesn’t matter much in the end, since quackery is useless and potentially dangerous sludge no matter the intentions of those selling it. And as we know from long experience, quackery’s failures are ignored by its practitioners with the usual variety of excuses – the user “did it wrong”, ruined things by using evidence-based medicine as well, documentation of quackery failures is a plot by Evil Pharma and its shills, etc. ad nauseam. Very seldom do quackery promoters concede that what they offer has failed and needs to be eliminated from their roster of “cures”.

Acupuncturists and homeopaths, for instance, have been confronted for many years by excellent evidence that their theories are bunk and their effectiveness minimal to nonexistent (and explainable by placebo effect). Nevertheless they blithely carry on their quack practices, no doubt sincerely in the majority of cases.

@Ian Goldsmid: It’s telling that you choose not to engage with Dangerous Bacon’s points, instead deciding to be offended over a gentle criticism of your opinion of posters here.

If you feel you have a serious point to make, would you like to try again?

If you really think D.B. is being ‘wastefully obnoxious’ here, then you really are a snowflake. Can I wipe your tears for you?

Compare the aggressiveness with which the legal system prosecutes financial fraud versus the rarity of prosecutions and convictions against cancer quacks. A cynical view would be that with financial fraud, the losses amount to real money, whereas with cancer fraud, it’s merely people’s lives.

This kind of quackery is even more not-new than we generally think.
My grandmother had breast cancer in the 1920s. She refused surgery and radiation, not entirely irrationally, given the relatively primitive nature of those methods then. Even so, cobalt therapy and Halstead radical mastectomies did save or prolong the lives of a not negligible portion of the treated, and held out some hope. Instead, her brother was going to cure her with his herbs.
She died. My father was 4 and his brother was 7,

People criticize Halstead’s radical mastectomy because of how invasive and disfiguring an operation it was. However, in the context of the late 1800s and early 1900s it made sense. There was no adjuvant chemotherapy, radiation, or endocrine therapy to decrease the risk of recurrence. If a woman with breast cancer was going to be cured, it would have to be surgery alone that did it, and Halstead’s survival results were far better than any achieved before, which is why the radical mastectomy was so quickly adopted. Where surgery went wrong was in sticking with that operation 80 or 90 years, drcades past the time when less invasive options were producing equivalent results.

Indeed. Why waste time with a long exchange when you can get to the storming-off-in-high-dudgeon stage immediately?

@Ian Pictures of breast carcinoma en cuirasse here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760938
If a quack do not stop after this, he is a plain criminal
Twin studies compare identical and non identical twins. This difference starts early. Not many possible associations here. What one you have in your mind ?
And hundreds of genes are linked to autism. Perhaps you should supply hundreds of associations.

@Arno – yes absolutely, couldn’t agree more. But that that’s not the point I was making (trying to make).

OT but- you’ll be glad to hear it!

“As measles outbreak flares, vaccination rates soar…” NYT, Kirk Johnson / MSN last night
even on-the-fencers have come out to vaccinate kids. the overall rate of vaccination is 93% but there are pockets where 10-20% of children are not vaccinated.
AND… this is PORTLAND!

Our receptionist at the clinic this morning has been inundated with calls for Public Health asking about MMR shots and boosts, the outbreak in Vancouver has been all over the news over the weekend and its clearly pushing people to take vaccination seriously.

@chris – people are mistaking this responder for a sentient being. Its surely an AI prototype for an autistic person speaking their truth …

I am always stunned when I read this site and others similarly, that pour huge scepticism on “quackery” ruling it all as completely ineffectual due to that fact that it has not been tested in a medically-controlled environment and almost that, people who believe it are of a lesser intelligence. I agree that anti-vaxxers are ill-informed and frankly dangerous. However, having had cancer, and survived now 5 years, and now watching my wife get dosed with AC aka “red devil” as I write this, I have found that there is very little supporting factual evidence to support cancer treatments. I went through chemo and radiation, and thankfully it has worked, for that I am grateful, but ask the medical fraternity or search this site for clear statistical evidence that essentially proves current medicine both works and is making substantial improvements, is incredibly difficult. The response I find is that cancer treatment, “has come a long way”, “not what they used to be” etc. I can find the following statistics from an article on this site.

“For all sites, adjusted by case mix, five year survival has increased from 50.3% to 66.4%.
For more advanced disease, it’s not surprising that increases in survival have been less impressive but real. For instance, for metastatic breast cancer, five year survival has increased from 18.7% in 1977 to 33.6% in 2012, which is nearly a doubling in survival.”

The statistics are frankly not great, almost 1% p.a., really? That is fairly average, certainly not compared to the advances in say emergency medicine etc. Yes, I agree some clown selling a potion or elixir behind his horse-drawn wagon (or website) is just rubbish, when untested, but perhaps science needs to post its results and accolades more clearly than simply saying quackery is rubbish. In short, you cannot shoot down the opposition when you can’t prove up your own “science-based” results.

Happy to be proven wrong and I would be thrilled to be pointed to websites that clearly show substantial improvements in cancer treatment but to date I have not. I don’t believe green juice is a cancer killer, but I do believe completely writing-off health, diet, exercise etc (all things that are here put under the “quackery label”) is mind-blowing stupid. I know that if I eat well, I will perform better on the running track, gym, pool or general health area. Eat rubbish and the reverse happens. Does it not make sense to explore some of these “quackery’ areas rather than write them off. Perhaps it should be given time for medically-based review?

“However, having had cancer, and survived now 5 years, and now watching my wife get dosed with AC aka “red devil” as I write this, I have found that there is very little supporting factual evidence to support cancer treatments.”

Wow. Where do you do your research?

Some additional articles:
https://respectfulinsolence.com/2017/07/24/does-chemotherapy-work-chemotherapy-and-spreading-cancer/

https://respectfulinsolence.com/2013/10/30/so-chemotherapy-does-work-after-all-revisited/

I would also suggest reading The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee

Chris, I want current cancer treatments to work probably more so than most, but I also want to know a clear set of universally accepted statistics exist that prove convincingly current cancer treatment regimes are effective. When sitting there having this stuff pumped into you, it is a whole lot easier to adopt when you know that it quite clearly works. I want it to work, but I should be able to find clear evidence to support that. No? What I often find is that when confronted on the issue, a clear set of statistics is not available. That is frightening. When pushed I get comments back, like the one you posted, that suggest I am some pro-quack. Rubbish. Just give me the clear facts that would include trends along the lines of:

• Cancer treatment has significantly advanced since its broad inception with an across cancer reduction in direct cancer-related deaths of x % since (say) 1930;
• Due to advancements in treatment regimes and based on statistical advancement of treatments, cancer-related deaths are projected to be close to nil within the next x years;
• Significant studies have shown that combatting the negative side effects of cancer treatments have advanced to such an extent that virtually none of the previous side effects experienced are now evidenced.

Show me links to that. The links you sent are from this website. You get your knowledge from this site that promotes cancer treatments through evidence basis? Wow. How about you go a bit wider than that.

Link 1 (from this website):
“the use of adjuvant chemotherapy for breast cancer since the 1980s, among other factors, has contributed to a decline in breast cancer mortality of around 30% since 1990”. – that is a brilliant statistic, I hope it is correct, he has linked the stats to a PubMed reference, but that link does not reference either breast cancer or that statistic. I’m not sure it would hold up if it were in a court room scenario.

Link 2 (from this website):
“new protocols for Hodgkin’s lymphoma increased the complete remission rate from near zero to 80%, with 60% of patients with advanced Hodgkin’s disease who attained a complete remission never relapsing. Follow-up is now well-beyond 40 years. By 1970, Hodgkin’s disease went from a death sentence to being viewed as largely curable with drugs, the first adult malignancy cured by chemotherapy.” – that is also a brilliant statistic, and would be even better if it were referenced to some study as opposed to a mere statement. It is the sort of statistic I am looking to find however. I want to believe it, I would be surer if it was evidence based.

In reference to this link from within the article, (EBCTCG) Clinical Trial Service Unit at the University of Oxford – “In these confounded taxane trials, little follow-up beyond 5 years is yet available, but on average their 5-year findings again show small but significant reductions in recurrence, breast cancer mortality, and overall mortality” …. ok good news over a small field.

Orac writes, “Those who wonder why we haven’t cured “cancer” yet should read earlier posts I’ve written on the topic. Cancer is hard. Real hard. It is also hundreds of diseases, not some monolithic disease, just as chemotherapy is dozens of drugs and hundreds of drug combinations, not some monolithic mythical “chemotherapy.” – this is a fair comment, I imagine it is a very difficult thing to treat and fair play to Orac for putting that forward.

The link to the American Cancer Society 2013 does not appear to work, however this link to 2018 does work, https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2018/cancer-facts-and-figures-2018.pdf. A quote from there is supportive which states:

“The overall age-adjusted cancer death rate rose during most of the 20th century mainly because of the tobacco epidemic, peaking in 1991 at 215 cancer deaths per 100,000 people. As of 2015, the rate had dropped to 159 per 100,000 (a decline of 26%) because of reductions in smoking, as well as improvements in early detection and treatment. This decline translates into more than 2.3 million fewer cancer deaths from 1991 to 2015, progress that has been driven by rapid declines in death rates for the four most common cancer types – lung, colorectal, breast, and prostate” – a 26% decline is incredible until you scroll down though, the referenced Figure (graph) 1 is disturbing and conflicting. Colon cancer deaths in US males per 100,000 in 1930 was approx. 21, in 2015 that rate was approx. 18. Prostate Cancer in Figure 1 was approx.18 cancer deaths in US males per 100,000 in 1930 that rate was approx. 19, in 2015. Stomach cancer has a much happier trend. Correct me if I am wrong, but those stats are not great, are they?

Link 3 – The Emperor of All Maladies – thank you for that link, a Pulitzer Prize is not a small thing, I look forward to reading it. Does it provide statistical evidence of successful advances in cancer treatment?

The crux of this site perhaps correctly pushes back on quackery because it is not evidence-based. What you have provided, nor a lot of what I can find provides evidence-based support that cancer treatments work. I want that, please point me to it.

So you have been cured of cancer by science based medicine and STILL you complain about science based medicine and STILL you give alternative medicine a free pass. I find this attitude particularly hard to fathom.

Billy Joe every day I fear a metastatic recurrence. Now my wife has cancer and we have a young daughter. The fact that I have survived is due to conventional treatments no question in my mind, can you confirm that I will be cancer clear for the foreseeable future? You should be able to from evidence-based science. We have been at it a long long time.

I am not giving alternative medicine a free pass, I just find it odd that there is significant push-back on being able to provide evidence basis for common cancer treatments, but quite a willingness to crush alternative medicine because it is not evidence based. Point me to a clear website for say colon cancer that clearly shows in layman’s terms the advancement of cancer treatment over the last say 50 years, something that would make you quite clear that current cancer treatments are the way to go given you were faced with that treatment prospect.

Cancer treatments really really hurt, you may know from experience. I want to know they work, scientifically. You show me.

Don’t know if this is what you were thinking of but childhood cancers have shown an astounding increase in survival rates – from a cure rate of 10% 50 years ago to a cure rate now of 85%. If that’s not SBM doing good, then I don’t know what is. The article examining this is linked below.

Also remember that there are hundreds if not thousands of types of cancers and then within each type of cancer a huge amount of confounding factors. So each type of cancer needs it’s own research and treatment regimen.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702720/

Hi Shelly, this statistic about childhood cancers drives parents crazy. Statistics are complicated aalthough the stat that you mentioned is not exactly wrong. Yes, childhood cancer survoval rates are much highwe then they used to be. Part of that is because Acute lymphocytic leukemia accounts for the majority of childhood cancers. It also has a high survival rate. @ 85-90%. Before the 1950’s it was almost certainly a death sentence. The number of ALL cases makes the childhood cancer survival rate look rosey. As for the other childhood cancers neuroblastoma, osteosarcoma, acute myeloid leukemia, etc. Those cancers have not seen much improvement and still have crappy survival rates. Childhood cancers also have late term side effects like treatment related cancers, heart problems, infertility, and so on.

As for the gentleman who suggested that alternative treatments haven’t been adequately studied, they have, and scientists tend not to study treatments for which there is no prospect of efficacy. That is just how science works. One of the problems with cancer is that a lot of the efficacious treatments are harsh.I don’t think most people would argue with that. As for evidence based medicine, these treatments give a person with cancer the best chance of survival. I think people want cancer to have an easier answer for treatment. Cancer is complicated and still very much mysterious. We tend not to be comfortable with no clear answer especially with high stakes.

Shelly, thank you that is exactly what I want to see. “Outcome in Acute Lymphoblastic Leukemia (ALL) has gone from a six month median survival to an 85% overall cure rate.” That is astounding and from a substantiated source, thanks.

Perhaps you should check Google Scholar first ? “A vitamin cancer”, “C vitamin cancer” and “D vitamin cancer” returned over 2 million hits.

@scottie you are banging your head on a brick wall here. The “authorities” here are terrifically knowledgeable about the technique of science based (medicine). However they will never admit to its limitations outside of its (admittedly very important) scope of practical utility. Hence they disrespectfully insult and dismiss everyone and everything falling outside of their argumentative control as quacks/quackery.

I don’t think it matters that much as it’s essentially an echo chamber in here with a small few detractors like you and me who they keep trotting out the same canned responses to.

I really do appreciate their essays, but they need to stop being so painfully scientifically materialistic.

“I really do appreciate their essays, but they need to stop being so painfully scientifically materialistic.”

That’s mere name-calling, and therefore wastefully obnoxious. Can you spell out what you mean by ‘scientifically materialistic’, and then explain clearly what is wrong with it? I think you are performing empty and childish complaining. Maybe I’m wrong. Show me.

I’m not sure you understand what open-mindedness really is.

Where did you read that science based medicine has declared good diet and exercise detrimental to your well being as a cancer patient?????

I didn’t read it, my oncologist said to me, quote “don’t take vitamins they don’t do anything, save your money and give the money to your kid as a present.” Vitamins and diet are interchangeable based on the conversation we had. Interestingly he did say that exercise is positive.

You’re missing the point, I didn’t make the argument you are pushing, I asked the smart people on this site to show me evidence-based support for positive cancer treatment, not the reverse.

@F68.10 the weirdly named anonymous person, what is that about? Should I have added a few more question marks? Lol.

I have no idea what your question about my mentioning nutrition/exercise really is, or is it merely a rhetorical attempt at insult?

@Ian: it wasn’t an attempt at insult. It just means that in no way does science based medicine claim exercise or good diet is a bad thing. It just claims that it is more than unwise to believe that it can manage cancer…

@F68.10 “It just claims that it is more than unwise to believe that it can manage cancer…” .. I think that’s generally tue, though it seems that some Brain Cancer cases can respond well to a Ketogenic program. Blocking Cancers’ metabolic pathways are def an emerging factor though, as documented here: https://www.amazon.co.uk/dp/B07B2XMLT9/ – and which approach is being ‘professionalised’ at the Care Oncology Clinics … http://careoncologyclinic.com/

@Ian: Before believing this book, you should perhaps look at whether peer-reviewed articles support this view. To me, that’s playing with fire.

@Narad – advances in cancer are achieved through business as usual huh?, I guess Thomas Kuhn was an idiot then

I guess Thomas Kuhn was an idiot then

I think that invoking Kuhn when one is behind is all too common in venues such as this, that you haven’t read the book, and that this isn’t science in the first place, mooting the whole thing.

@F68.10, thanks for that. Does look to be compelling reading. So much to learn, or rather smart people to learn humility from, so little time.

You are right, I don’t know about the effect it might have on the overall treatment of cancer, I will look at your links thanks, but I do know that I have seen people using cannabis oil to treat the effects of chemo and it is hugely beneficial, as in massively. I had always thought “medical cannabis” was just a way to buy weed without getting into trouble but from what I have witnessed that is not right.

@Scottie: Cannabis may very well relieve the symptoms of chemo. Which as entirely different claim than “cannabis cures cancer” (which you did not make, mind you). However, THC and CBD act on the immune system in rather noncontrollable ways, so it may relieve the symptoms of chemo while simultaneously adding unknown parameters to what chemo is doing.

@Scottie/Ian

Re: “Now I regard myself as a smart lay person.”
and [Orac and the rest us think that] “people who believe it are of a lesser intelligence”

Strawman argument. Also, see Dunning-Kruger.
Orac and the regulars here perfectly know that a little knowledge could be a dangerous thing, and that physicians, scientists and other such “higher-intelligence” guys are as likely, if not more, to fall for pseudoscience. There are more than enough of them in the anti-vax bandwagon.
Actually, yes, the more you are sure of being smart, the easier a mark you are.
Orac even coined the term “Nobel Prize disease” to refer to, well, Nobel Prize recipients who suddenly took a wrong turn. Luc Montagnier, who suddenly started saying that viruses like HIV can be cured with radiofrequencies, is a prime example.
There is an amusing anecdote about young, unknown Richard Feynman meeting famous nuclear physicist and Nobel laureate Niels Bohr, during the Manhattan project. During a first meeting, Bohr noted that Feynman was not caught in full-idolization mode like the rest of the scientists in the room. He then recruited Feynman as his sounding board before revealing his ideas to the other scientists, as Feynman was competent enough to recognize if Bohr’s ideas veered into stupid territory, and wouldn’t hesitate to tell him he has gone senile.
The world would be a better place if ‘smart’ people and other ‘geniuses’ all had the reflex of hiring a Feynman at their side.

We may accuse antivaxers and quacks followers of being ignorant. That’s not the same as being stupid. As a scientist, I cannot fault people from coming to wrong conclusions when fed false information. I’m not impervious to it myself.
OTOH, quacks and anti-X leaders tend to be willfully ignorant, rejecting any fact that don’t please their narrative. To describe them, “evil” comes to mind. “Con-men” is definitively appropriate.

@athaic. You do make very good points here without resorting to disrespectful insolence, much appreciated. It’s not that i’m super sensitive/emotionally frail, far from it. Insolence has its place, but some people here I think use it as default rather than with discrimination.

One of the sticking points for me here and at the sister SBM blog, has been the 100% write off of Chinese Medicine (including but not restricted to acupuncture).

To explain why as briefly as possible:

To practice acupuncture and Chinese medicine (CM) effectively requires decades of learning, experience. I wonder whether science based trials that have looked into CM have taken this into account.

I don’t believe CM treatments are reliably scalable. What works for one person at some time, with a particular ‘’complaint’” treated by a particular practitioner will not reliably produce similar results in a presumed cohort. In some sense there is only a cohort of one.

Because I have a meditation practice, and have spent decades reading accounts of various yogis who talk about energy/consciousness experiences that are not common in the rest of humanity, I believe there are dimensions of energy and consciousness that are not detectable with ordinary human perceptual mechanisms, and as well there appear to be no instruments that exist to measure these energies,. I know this will sound totally woo woo to most. And I also know that 99% of those who espouse this woo woo are what you would call quacks. But a relative few are not.

As I said before, science based medicine is essential and I am in awe of those who can practice that rigorously. I also totally squirm when some chiropractic ‘doctor’ makes ridiculous and potentially dangerous claims.

I simply would prefer that science based medicine practitioners acknowledge there is some small delta of unscientific based medicine that might in the future be a member of the SBM set of treatments. In other words there are a ton of quacks out there that need to be called to task. But there are a few that I would say are the canaries in the coal mine of 99% unscientific medicine who may be the progenitors of some profound discovery in the future.

Practicing meditation can be argued to produce insights into the nature of the mind. Sam Harris makes a rather convincing argument for this claim on rational grounds. On the other hand, other people like Deepak Choprah go well beyond rational arguments and entirely devolve into quackery.

Practicing meditation does not condemn you to being delusional. That’s my main point. On the other hand, it does push others into delusions.

Choose your side.

“But there are a few that I would say are the canaries in the coal mine of 99% unscientific medicine who may be the progenitors of some profound discovery in the future.”

Make an argument then. I disagree with you. Why am I wrong? If you are all about respect, you might want to explain why you think that the people here are en masse unable to understand something simple. You think you have a point about civility; you are at the same time calling people here stupid.

I doubt very much that any of these ‘alternative’ modalities are better than random interventions, but I acknowledge the bare possibility that I’m wrong.

You think you’re criticizing scientific skepticism, but you are actually ‘criticizing’ caricatures, stereotypes of skeptics. You seem to be sincere, so I’ll just tell you you’re acting like a condescending jerk and perhaps should stop doing that.

I believe there are dimensions of energy and consciousness that are not detectable with ordinary human perceptual mechanisms, and as well there appear to be no instruments that exist to measure these energies

Please define ‘energy’.

“I simply would prefer that science based medicine practitioners acknowledge there is some small delta of unscientific based medicine that might in the future be a member of the SBM set of treatments.”

I can’t acknowledge this because I don’t think it is true. I could be wrong. Show me. If you show that this is true instead of saying it you will find that people very quickly agree with you. Have you considered the possibility that you simply are mistaken?

Traditional Chinese medicine uses the body parts of endangered animals. When you support the use of TCM you are supporting the extinction of several species of animals. What did a pangolin ever do to you?

Of course the committed anti vaccine pundits would not accept any evidence that doesn’t fit their worldview. They remind me of their cousins the creationists.

Stephen J Gould used to talk about his struggles with creationists. Gould would tell how they would demand fossil evidence of an intermediary animal between two species (if that’s the right term) knowing that one had not been found, but if a “missing link” happened to be discovered they would then immediately demand the scientists produce the intermediary between this new fossil and the next animal down the line. Like being caught between two mirrors the reflections can go on forever.

It’s the same with the committed anti vaccine pundits, no matter how much evidence is provided they will always want more. You can’t win.

Of course you can win. It’s just that they are unwilling or unable to admit it. That’s why Orac’s occasional allusion to the Black Knight is so appropriate: “It’s only a flesh wound!”

I could add Pauli once said about Einstein’s paper, that is was not entirely stupid. Einstein was amused. But more to point here is his assesment that something is not even wong.

@Ian Goldsmid: then your choice of language does not entirely reflect this. Sam Harris would definitely reject the concept of “energy” with respect to meditation.

@F68.10. That wouldn’t surprise me, as anything to do with energy gets misinterpreted by meditators. He wouldn’t go there even if he could talk about in some ‘circles’ do you know of any specific referees Sam.makes to “illusory” energy?

@Ian Goldsmid: no, I do not keep track of such things. I believe I understand what “misinterpretation” you’re referring to, but I wish to draw your attention on the impact of such wording and “misinterpretations”: they lead to people making unfounded health claims. We’re not in medieval India any more, and language and terminology should be adapted to the targeted audience.

Here is a simple version: tell us what kinetic and potential energies are, and how they are related.

Prove to us that you are not a Russian bot.

I had to look it up. Much too clever, and as a structures engineer I could stay within standard Newtonian physics. I asked a basic college freshman physics question, which I have done often. These guys who claim special “energy” are never able to answer it.

I did in the university the classical exercise: prove conservation of energy from uniformity of space.

@narad “please define energy:

if the normal definition of energy is:
.
Well, it’s hard to argue with a hanging colon.

No, we are just asking you to demonstrate that you know what you are talking about and not just tossing out facile explanations you have read somewhere.

Several of us have real training in physics and have spent time detecting and measuring energy in various forms and using it to achieve different effects. So it irritates us to see it tossed out as a hand-waving explanation for whatever you want to claim it can do.

There may well be more useful pharmaceuticals to be discovered in the array of herbs used in TCM, but they won’t be discovered by the methods of TCM, because they refuse to apply the methods of science to their system of medicine and don’t accept the results when they get them. Also, I don’t like torturing bears and killing rhinos while I wait for them to demonstrate the difference between the five elements and the four humors.

Where is David Chalmers when we need him? Yours is a purely speculative theory intended to explain consciousness by appeal to QM, which is not itself entirely well understood.

Sorry, Ian, first show you know Physics 101, still in the space and time realm where Newton’s basic laws still work. Just explain the difference between kinetic and potential energy, and how they are related.

One way to figure if you are just hand waving about “energy” is to ask you something that every physicist and most engineers learned their freshman year of college (or even in high school). It goes hand in hand with learning calculus and differential equations.

@Aarno wouldn’t it be more accurate to say that energy can be subtyped as rest energy or kinetic energy (and maybe other subtypes?), not as entirely different things. Surely they are different in the sense of what the different subtypes imply, but not in nature, not in fundamentally what they are?

You can shoehorn it together (in a way Einstein apparently didn’t like), but I don’t expect this manifestation of ELIZA to be able to explain it in a coherent way. I think normally there is little point in this mathematical exercise anyway.

wouldn’t it be more accurate to say that energy can be subtyped as rest energy or kinetic energy (and maybe other subtypes?)

No. Field energy (e.g., the uncertainty principle) simply is not like bowling balls.

This is apropos far too often.

F68.10. Emily Schaffer, Ah, so you would be dismissive with Roger Penrose if here showed up here too? Lol

Emily, in my opinion, David Chalmers has spent his lifetime looking (completely unsuccessfully, apart from gaining popularity for some good reasons) for an explanation of consciousness within the wrong frame of reference, probably akin to using science based medicine to explain chinese medicine. Hence the ridicule of Chinese medicine here (or at least the acupuncture Qigong aspects).

Chalmers does not believe that the problem of consciousness is a purely scientific problem. That is the whole point of the New Mysterian view of consciousness. It is a bad analogy.

Thank you Emily. I need to update myself on this, the new mysterian view. The name certainly appeals to my ‘sensibilities’. Can you recommend some good reading material?

Neurosurgeons would use induced coma during certain operations. So conciouness is hardly a philosophical problem. And problems of TCM are hardly related to definition of conciousness.

I think you maybe mistaking universal consciousness with its manifestion in the individual.

The Earth Coincidence Control Office cornered that market decades ago. You’re out of your depth.

Ian, you can start with the consciousness entry in The Stanford Encyclopedia of Philosophy. It is free and online.

@chris. Ok, I’m not a physics guy, I did do well with it at school, although naturally much better at chemistry. Re kinetic vs optional: “Kinetic energy relies on two factors which are the speed and mass of the object, but potential energy is based on the position and condition of the object.” Ok I looked it up, but I do understand more about this than probably most acupuncturists, lol.

So where are you (obviously leading me by the nose) with this? 🙂 I’m ok with that, I want to learn without having to live an impossible whole other lifetime to do so to catchup with some of you here on deep science.

“So where are you (obviously leading me by the nose) with this?”

As squirrelelite said, those of us who have had to use the laws of physics in regards to energy as part of our employment are annoyed by those who make stuff up about it. My question is to determine your actual physics education by asking about something that is learned early on and crucial to understanding much of physics. It has nothing to do with the speed of light or itsy bitsy bits of molecule behavior.

It is a reminder that some who are educated in basic physics do not even understand the non-Newtonian realm very well (myself*), but those who do not even understand the Newtonian realm should be ignored when bringing anything “quantum” up. Essentially for someone who does not know the basics, you are actually saying “magic exists.”

By the way, what you looked up is not adequate. Though props to you for actually trying, which is more than anyone else has done. You did not explain how those two forms of energy are related, which is a key part of creating mathematical models of dynamic mechanical systems. This understanding is required to design, analyze and construct every vehicle you have ever used to travel on, and every other machine you have used, like your chest freezer and automatic garage door.

Yes, I admitted I don’t know everything about physics. That is because my career did not require anything close to the speed of light (vehicular speeds are just a teeny tiny fraction… I can’t imagine how much rubber will burn on a tire at that speed!). Though one of my college friends was a nuclear engineer. He went from being a submarine nuclear safety officer to working for the state’s Dept. of Health “Radiation Hazards” department (he knows where all the radon hazards are… hint: don’t sleep on your granite counter tops). After his retirement he gave a presentation to a meetup group I am involved in… his periodic table was epic and resembled nothing I ever saw in a chemistry class. Let’s just say it took a quantum leap in complexity. So, really don’t invoke science you do not understand.

@chris, from the position you are coming from, I totally understand how irritating it must be, as you said … I won’t repeat your clear account of it, that I completely agree with and feel humbled by.

I think it will be difficult even unwise for me to do other than read this blog and hold off on the comments (mostly, perhaps except for asking some questions). Although I feel equal in intelligence to physicians and PhD researchers I most certainly don’t have even their basic qualifations.

For decades I’ve had more than a keen interest in the “Waking Up” dimension as Sam Harris calls it. Along the way I have encountered very advanced “Waking Up” practitioners who have convincingly written about ‘energy’ in a mode that is different from the way it is understood in Newtonian and Quantum physics. I now more clearly realise that this is most likely is not energy in the way it is conceived in current physics, and most likely needs a new label, and an as yet to emerge science. Interestingly, the Tibetan Buddhists got closest to a science of “Waking Up”. There are long gone practitioners like Nagarjuna whose writings are incredibly precise in describing states of awareness and whose “science” has been tested and replicated by serious meditators since.

One of the key things I have hoped to achieve in reading this blog and Science Based Medicine, apart from my general interest in the field, is to sharpen up my capacity to discriminate BS from plausible. Because medicine is not my job, I like to remain open to what’s plausible, and not just rigorously science based. So my personal challenge is shifting through the range of plausibility in subjects I’m linterested in like nutrition, herbs that support healing, and so forth. There are indeed legions of so called quacks.out there in these fields where the science is either non existent or at best nascent. And it is in these grey areas I hope to learn better critical thinking skills.

Here is a novel idea: sign up for beginning physics and chemistry classes at a community college. Then see if you can pass a thermodynamics class.

Plus also stop throwing around the term “energy” until you understand what it means. Because you and the others you “reference” are using it wrong.

You seem not to realize that you are coming in here new and telling people what to do, say, and think. To boot, you don’t know the science. Here’s an idea: learn some science and then see if your opinions change or stay the same. You may find after learning some science that those meanie-ol’ skeptics are actually the open-minded ones. Are you open to the possibility that people here reject some of your ideas because they are genuinely bad

I now more clearly realise that this is most likely is not energy in the way it is conceived in current physics, and most likely needs a new label

“Psychic Happy Goo”?

@chris – hhmmm back to the science based private club echo chamber, our point of view is what counts, bla bla bla. To reciprocate I you take a basic course in Chinese Medicine, yeah right …

No. You are more than welcome to learn about science, you just don’t get to re-define the words. I do not need to take a course in fantasy to understand how nature works. Especially since I abhor the slaughter of animals for useless nostrums.

My father was a linguist who could speak at least four non-English languages. We were yelled at in many of them… and we learned one very important thing: never use a word unless you can define it. That is what you are doing, using words without understanding them.

So has my dad.

Was Eric Hamp a professor of yours? My youngest also has a degree in linguistics, which required familiarity of three languages in two different language families. Which for them was Japanese, French and Swedish.

Was Eric Hamp a professor of yours?

Yah, and I remained familiar with one of his sons. I don’t even know where to begin — one time I was the only person who showed for the three-hour Old Irish class, and he did the whole thing. One time he just spent an hour on the discovery of felt.

a lot of you here are bunch of arrogant %&!?s. There’s a near global catastrophic epidemic or obesity, diabetes, heart disease and cancer so closely associated with mass market junk food, pesticides, dead farms …. with you poor meat heads trying to mop up the mess with science based medicine. You must be joking.

You are playing the worst possible role in a cosmic joke. And you’re arrogant and imperious about it. How foolish is that?

It would be side splittingly funny if it wasn’t such a pointless tragedy.

Ian, I often hear what you advocate from natural health aficionados:
( paraphrase)
people are unhealthy and make poor choices AND medicine does NOTHING!

Well, think about it:
1. adults choose unhealthy foods, drink, smoke, never exercise-
so what can medicine do? Force them?

SBM advises patients- based on research- to follow certain guidelines for diet, exercise, weight control etc
They can’t make anyone do anything. Patients are adults. They live independently of the doctor.
Even if a child is concerned, it doesn’t mean that parents or the child will follow the SB guidelines.

How can you be so sure that “junk foods, pesticides, dead farms” cause poor health? They may be a factor of course.
Is a vegan “healthy” because of all of those fabulous phyto-nutrients or merely because it’s hard for them to consume a huge amount of calories and thus, they’re thinner than average and less subject to several life-threatening diseases?
Perhaps alt med proselytisers get followers to obey their rules because they over-emphasise the importance of nutrition over many other variables in determining health outcomes.Nutrition is easier to control than genetics and other environmental issues.

And what’s a “dead farm”? Where zombies grow?

Glyphosate zombie crops. Ignorance. AG Pharma madness. Monsanto escaped to Bayer. And even smart people like you have little discrimination left. Spouting nonsense about plant based nutrition. Study Professor/Dr Joel Khan, then come back and explain how he’s got it all wrong.

“a lot of you here are bunch of arrogant %&!?s” Excuse me?

It is you who are advancing claims and getting angry when it is pointed out they are incoherent. It is you making assumptions about people you don’t know. It is you dismissing people you don’t agree with en masse. A lot of projection there. It is you who have been arrogant and condescending from the start.

Why exactly is it OK in your mind to verbally abuse those who disagree with you? It belies your claims to open-minded common sense, which you have not given me any reason to accept. Ar you open to the possibility that people here actually are willing to listen to open-minded argument that you simply have refused to advance?

If you think this blog is an echo chamber, you should have no difficulty in producing a convincing argument to this effect. And, if you really do represent the open-mindedness you claim, you will advance such an argument – or withdraw your statement since you’re a nice guy and all. In fact – can you give me any reason to think any of your interlocutors treated you with arrogance above? I see one particular writing behaving with arrogance, and then using ‘arrogant’ as a mere epitaph against others.

Medicine is not Big Ag. Or Big Food. They are completely separate groups with completely separate goals.
If you want to talk Big Ag and health, go read Marion Nestle’s (no relation) blog. Or any of her dozens of books.

I spend all day making cancer treatments. There is literally nothing I can do professionally to make “Mega Stuff” Oreos not exist.

This is like yelling at a geologist that it is raining. No relationship.

I appreciate that clarification, my rant was overly disrespectful, apologies to you for the kind of work that you do that is crucial to me and countless others … life-saving cancer treatments that I am fortunate to get for my condition, multiple myeloma

a lot of you here are bunch of arrogant %&!?s.

Well, we (tinw) better than you — more coherent and patient, more clever, better at insults, and better looking, just for starters.

I think Ian is having a wee bit of a hissy fit. Fortunately, since I lack a Y-chromosome, I do not have to defend my non-existing masculinity. 😉

condescending clever dick. the reply thingambob doesn’t display on a lot of the pre-existing replies here on my Chrome browser. On this one it self evidently did.

I repeat, learn how to use the fucking “reply” thingamabob. Jesus, you’re at Gerg level when it comes to posting comments yet expect to be treated as some sort of towering intellect on multiple fronts.

Narad, you ain’t no vedic sage mate

Although this remark on your part is apropos of exactly nothing, I’ll note that I sure the fuck am not, and I’m happy not to be a “sage” in this metaphysical dumpster.

@Ian: “Narad, you ain’t no vedic sage mate”

Schopenhauer was a “vedic sage”, and he was thoroughly pro science. He knew how to make an argument.

@Ian: no, but philosophy is at the root of science. Cannot do science with epistemology, and although Schopenhauer had other obsessions than science, wishing to extend and correct Kant, he always advocated a scientific mindset. His PhD was more concerned with rationality per se, but it has to be understood in the context of the 19th century.

@JustaTech

“Traditional Chinese medicine uses the body parts of endangered animals” ….

Certainly I do now see sme reporting about that. That is shocking.

So now justify the exemplary controls across the entirety of western medicine else you are merely displaying a feat of confirmation bias. Not to mention the propagandic technique of trashing an entire movement due to the disgusting behaviour of a rogue element.

Trump and his most awful cronies, Pence, Roger Stone et al are a disgrace therefore all Republications are too. Or going back a couple of years, the Clintons are war mongering money grabbing personal empire builders therefore all Democrats are bad people too.

1) The use of endangered animal parts is not a “rogue element” of TCM, but goes back to its roots (the 1950’s) and beyond (the many pre-scientific medicine systems of the many kingdoms of China).

2) There are no parts of scientific medicine that use endangered animals.

3) Your repeated use of “Chinese” and “Western” medicine is imprecise and racist. There are many, many doctors practicing scientific medicine in China. And Japan, And Korea. And India and Vietnam and Thailand and Zambia and Madagascar and all over the world. Scientific medicine knows no national boundaries.

I have no idea what you mean by “So now justify the exemplary controls across the entirety of western medicine else you are merely displaying a feat of confirmation bias.” Controls on what? Controls of what?

“Confirmation bias” of what?
I said I didn’t understand what you meant about controls and confirmation bias. Rather than explain you just keep repeating it.

“Confirmation bias” that there are outstanding researchers in China?

Ian, what are you talking about? I can’t answer questions that I don’t understand.

Say it, and say it again – scientific skepticism and rationality are not Western – they belong to everyone.

Not impressed.

Well, perhaps you should try to take a lesson from the fact that nobody here seems to be impressed in the slightest by you.

Make an argument that this blog unfairly singles out a ‘rogue’ element. Make an argument instead of asserting. I’m now pretty sure you don’t understand what open-mindedness really is.

If you aren’t familiar with it, you should look up the poem, Calling the Doctor by John Wesley Holloway, published in The Book of American Negro Poetry,1922. You can find it on the internet. It starts out like this:

AH’M sick, doctor-man, Ah’m sick!
Gi’ me some’n’ to he’p me quick,
Don’t,—Ah’ll die!

Tried mighty hard fo’ to cure mahse’f;
Tried all dem t’ings on de pantry she’f;
Couldn’ fin’ not’in’ a-tall would do,
An’ so Ah sent fo’ you.

“Wha’d Ah take?” Well, le’ me see:
Firs’,—horhound drops an’ catnip tea;
Den rock candy soaked in rum,
An’ a good sized chunk o’ camphor gum…

“Glyphosate zombie crops”

I had to walk out of “Night Of The Living Soybeans” – too upsetting. 🙁

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