Critique of an article published in a medical journal, which was widely reported in the press in August 2004.
The article was entitled “Assessing
websites on complementary and alternative medicine for cancer” by K Schmidt
& E. Ernst
This was a study of websites
from December 2002 to January 2003, but not published until 2004.
(The article itself is
obtainable from Katja.Schmidt@pms.ac.uk)
Proportion of cancer patients
using the internet
The article starts by looking
at studies on the proportion of cancer patients who use the internet for
information. It cites one US study (16%
of 139 lung cancer patients used the internet) – the reference is a report in
2003. Another study was in
Using US and Canadian studies
to extrapolate to the
It would have been interesting
if original research could have been carried out on the proportion of
“At least one fatality”
indicated
The article states “Many cancer
patients desperately seek knowledge about their condition and thus can be very
vulnerable to misleading information”.
However, if orthodox treatment worked, then cancer patients would not be
desperately seeking elsewhere. “CAM
(complementary and alternative medicines) products can easily be purchased on
the Internet without prescription. This
has previously led to at least one known fatality of a cancer patient.” It would be logical if similar standards
regarding fatalities should be demanded of orthodox therapies. A recent independent report (August 2004)
indicated that one in ten patients admitted to NHS hospitals will fall victim
to medical errors, which have now become Britain’s fourth–biggest killer. Medical accidents and errors contribute to
the deaths of 72,000 people a year, and they are directly blamed for
40,000. These figures do not even
include errors occurring in primary care, such as in GP’s surgeries, and are
likely to be significantly less that the actual rate as they are only based on
reported errors. Research around the
world has indicated that most hospitals have an error rate of 10%, and that
about half these incidents could have been prevented. (Reported in ‘The Times’ 13.8.04)
Aim of the study
This article presented a study
which had two aims: to assess the quality of popular websites on
Criteria of the study
1.
Sandvik score (i.e. is information provided on:
ownership and authorship, references, able to contact the author, dated,
navigability, balanced information) They
used a set of scores to evaluate the quality of the website on the above eight
criteria. All 32 websites scored medium
to excellent on the Sandvik score.
2.
Did it have the HON code of approval? (Only two did) What or who this was, was not explained in
the article. On investigation it seems it
is a Swiss based organisation with a large committee including medical
professions, academics, WHO officials and others. But none were indicated who had any
expertise in ‘alternative’ therapies. So
this criteria seemed irrelevant to the websites being researched in this study.
3.
Ability to harm?
On four criteria (“does the site discourage use of conventional
medicine, or adhering to clinician’s advice; does it provide opinions and
experiences or factual details; and lastly does it provide commercial details? Only one site scored 4 (the highest risk),
two scored 3, six scored 2, twenty scored 1 and three scored 0. The article admitted this was “somewhat
reassuring”.
4.
Type of CAM advocated, distinguishing between
curative (118), preventative (88) and palliative
(59).
General discussion of results
The article says that “The
results of our survey are somewhat reassuring as they suggest that the majority
of the evaluated websites provide valuable and reliable information. This was the case, especially for the
prevention of cancer.” (We wonder if there were scientific trials to support
the authors’ opinions? – none were mentioned.)
However, they go on to say “Generally speaking, the ‘cancer cures’
discussed on these websites are not supported by good scientific
evidence”.
It is a generally known fact
that clinical trials cost many millions of pounds and that because natural
remedies are not ‘owned’ by companies and therefore vast amounts of money are
not being made from them, there are not the finances available to produce
double blind clinical trials demanded by the scientific community. Indeed this particular way of working may be
suitable for ‘wonder drugs’ but is not suitable for many natural therapies which
work synergistically with each other.
Indeed clinical trials can be questionable in their reliability. Many drugs have been approved and licensed
after trials, only to be withdrawn later when problems appear in patients’
actual health experience.1
The next comment in the article
is “Other sites were downright dangerous as they advise patients against using
conventional therapies.” They quote
some of the comments on the websites, but offer no argument to refute the
observations, no evidence of the efficacy of conventional therapies. As can be seen elsewhere on
anticancerinfo.co.uk, there is much statistical evidence that many conventional
therapies don’t work, and indeed can make matters worse. For an in depth view on orthodox and
alternative treatments by independent cancer specialist Lothar Hirneise see www.krebstherapie.de. He has researched over 100 therapies in over
30 countries and founded Menschen gegen Krebs (People against cancer) in 1997,
an independent organisation which publishes information, holds workshops and
offers advice by telephone or email (mgk@krebstherapien.de). The website is mainly in German so wouldn’t
have been covered in this study. There
is an article in English which is worth reading before starting any treatment.
Now reprinted on this website 'Chemotherapy
cures cancer - and the earth is flat'.
‘How Scientific are Orthodox
Cancer Treatments?’. This is the
title of an article by Walter Last, which can be accessed on www.campaignfortruth.com/Eclub
(click on July 22nd 2004).
First published in Nexus, Volume 11, Number 4, June-July 2004. This is well documented, citing various
studies on breast cancer, on chemotherapy used for various types of cancer,
giving the scientific basis for drug approval.
Worth reading before proceeding with orthodox treatment and attempting
to assess the risk factor for conventional medicine or treatment. Another interesting article on the same
website (click on February 23rd
2004) is entitled ‘Chemo (Toxico) Therapy’.
The study looks in detail at
the top five suggestions in each category (curative, preventative and
palliative)
We looked at the
authors’ comments on laetrile. These are misleading. They state that it contains the toxic
compound amygdalin. However,
amygdalin’s non-toxicity has been a well-known, fully accepted and
non-controversial fact for over one hundred years. Otto Jacobsen in his book ‘Die Glucoside’ in
1887 stated “Amygdalin is not toxic” and gave 99 references from studies made
within the 20 years prior to his publication.
For over 100 years pharmacology reference books have described this
substance as non-toxic. The only way
hydrogen cyanide can be formed (it isn’t present in amygdalin) is when
amygdalin comes into contact with an enzyme beta-glucosidase which is found in
cancer cells, but not in healthy cells.
For a full description see ‘Cancer prevention – a change in our diet (on
www.anticancerinfo.co.uk). See further
on the controversy about laetrile and cyanide in the book by Philip E. Binzel, Jr., M.D. ‘Alive and
Well’ (American Media, California 1994).
The study has also
been very selective in saying “Clinical trials and animal studies have found no
relevant benefit for cancer patients”, using two references. However, there are plenty of trials that
have shown the efficacy of laetrile killing off cancer cells. See ‘Vitamin B17
therapy – does it work?’ which includes references. We wonder if the authors have actually
researched for clinical trials, or have just quoted from previous inaccurate
articles. The scientific community tend
to quote each other to prove a point.2
We haven’t followed
up the article’s comments on other alternative treatments. But all of the comments relate to there
being no conclusive randomized controlled trials to prove that these cures
work. See our comments above on trials.
Another flaw in this
study is that it is unlikely that anyone is going to put in the parameters used
in this study into the search engine.
Patients would be likely to put their own type of cancer into the
equation.
The authors suggest
that websites should be monitored or given a seal of approval. This
might be good if there were an alternative therapy accrediting organisation or
a federation of such bodies, but to ask academics or orthodox professionals to
adjudicate on a subject in which they have no training or expertise in
administering, would defy logic and seem to be unethical.
……………………………………………………………………………………………………………………………………
After writing this
critique I have come across two comments about ‘scientific evidence’:
1 An article by Chris
Woollams in the ICON magazine of September/October 2004 comments on an article
in the BMJ by Professor Michael Baum slating the Gerson Therapy, Prince Charles
for mentioning it, and any CAM that has not passed the rigorous tests of
orthodox medicine. After questioning who
is going to pay for these trials which everyone agrees are so needed, Woollams
says “And the ‘scientific evidence’, of which there is none to support
Gerson? Does a person walking around
alive eight years after they were supposed to have passed on (like Michael
Gearin-Tosh) count for nothing? No, it’s
anecdotal, you see. Baum calls it ‘an
urban myth’. Scientific proof is the
clinical trial, which can use as few as 50 or so people taking a drug for just
one year, showing some improvement over previous drugs, and then be prescribed
for ever as ‘proven scientifically’.
(ICON published by CANCERactive)
2 I came across an
article in ‘Proof’ (a What Doctors Don’t Tell You publication) in which the
authors find it strange that Ernst, (the same author of the article on the
study of CAM websites we are looking at) in a paper on Arnica, claims “there is
little scientific evidence of its efficacy”.
In their reply McTaggert and Hubbard say “That’s surprising, because
Arnica has been well researched, and has been the subject of a number of proper
scientific studies – indeed, Ernst himself quotes six as positive
examples. So who says there is “little
scientific evidence”? Why, it’s a
certain E. Ernst who said so in a paper published in 1998. So could it be the one and the same? Surely not – because to quote yourself to
support your supposition is circular and, well, unscientific." (Proof
February 2003, WDDDTY)
August 2004
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