I'm largely with him on chemotherapy issue. I suspect it's usually a waste of time and money washed down with a healthy dose of nausea, lies and misery.
Some people do prefer to spend their remaining time on planet Earth in hospital appointments and feeling nauseated. I think they refer to it as hope.
This seems to be an
Australian paper from 2004 which looked at Australian and US cancer studies.
It does summarise a number of trials (meta-analysis) but there may be other meta-analyses, which might contradict this report. However, the trial might well be pretty plausible. Hell, it might even be true (not that 'true' is a word we use in medicine).
I've always found the plausibility (Man on the Clapham omnibus) test with chemotherapy to be challenging. Can such a blunt tool really target someone's specific cancer well? And why does nobody know the right recipe to use? It doesn't really make much sense.
So if the survival benefit is 2%-3%, I don't think that would even cover the time travelling to hospital appointments.
Of course, if you felt good during the chemotherapy, it would add quality to life, and might be worth it on that regard alone. But it frequently makes you feel pretty lousy in your remaining time.
That's not to say that the argument for one particular cancer might be a lot stronger in favour of chemo, but this study bundles everything in together.
Treatment largely depends on which personality we see. If you see an oncologist who says "Yes, I've had great results with X. This will be great for you", you will probably do what he says and not hold him to any level of accountability. What you should actually do of course is ask him to show you the published research that proves what he just said. He won't be able to. And in Britain were terribly polite. Even when we're dying. At that point chemotherapy is just a football team that he supports. All his patients die in the end. Pretty crappy results if you ask me.
The way we make decisions in medicine, which is to leave the patient to make the choice means there is no comeback to the doctor. It is actually a very appealing branch of medicine to go into - no chance of litigation.
It is utterly shocking that Americans doctors take a financial kickback from this and he's right that that should be illegal. That is news to me. There are only just growing up to the sort of accountability that we have had for years in the UK so in the coming years, that may change. It may not.
Of course, this clown bundles absolutely everything in together. He even dismisses surgery (which the paper he quotes did not look at) at a single stroke.
True, surgery can have the same problems, but plenty of survival benefits have been proven at certain (preferably early) stages of certain cancers and are not in question. Unless your surgeon is a half-wit of course.
'Late stage' operations however (or the wrong surgery such as the breast operations performed in Northallerton, courtesy of at least one clueless egomaniac) are likely to have the same results as the chemo paper.
That said, this guy is a self-promoting nutter.
Judging from
his twitter, there pretty much isn't a dodgy therapy that he won't be happy to promote. He even mentions homoeopathy in the video. Save me!
And selenium is the answer to all our ills? Really? I don't think any credible meta-analysis has ever shown selenium to have any effect whatsoever. Or any other single nutritional ingredient either.
But that will get people subscribing to his advice. Money will no doubt change hands at some point.
He is still profiting, but just from a different set of lies.
He calls himself a naturopathic physician. What is that? A medical school dropout? If that really means he's medically qualified, his mantra of FireYourMD.com would probably have him investigated by the GMC in this country.
In America, it just makes you rich.
The occasional person will appear to benefit from chemotherapy, of course. It's not inconceivable that somebody's life expectancy could be extended from one year to 4 years, and yet still not appear as an improvement in the 5 year mortality statistics, and therefore escape analysis by this paper.
But in that case, we need proof. We need 3-year stats. Or 2-year stats. (That said, five year stats are accepted as a pretty standard way of assessing whether or not a difference has been made).
These occasional "Hearts of Gold" tales then become the poster campaign for how great the treatment is e.g. stories appearing in papers, documentaries, followed by a lobby group (outside GMC guidelines of advertising and promotion and therefore frequently, possibly secretly, sponsored) telling everybody to have the same treatment. These anecdotes never refer to stories of the many people who died during therapy. There's nothing more offensive to an evidence-based physician than the concept of anecdote. It's just another football team.
It's hard to fight a Mexican wave.
