Are carbs really the key to preventing brain disease?

The Times recent promotion of a new book by neurologist, David Perlmutter, raises some interesting questions t regarding the evidence base behind the books claims.  David’s book is called ‘Grain Brain: The Surprising Truth About Wheat, Carbs and Sugar – Your Brain’s Silent Killer’ and asserts that gluten consumed through wheat and grains are responsible for triggering brain disorders such as depression, dementia, schizophrenia, epilepsy, ADHD and decreased libido.  Let’s take a look at The Times piece and see if there is any merit in the claims.

David is quoted as saying; “The origin of brain disease such as dementia is predominantly dietary, he says, and the result of us consuming too many carbohydrates (particularly wheat-based bread and pasta as well as sugar) and too few healthy fats”

Straight off I think the word dementia has been misused here as (according to Alzheimer’s Society) dementia is an umbrella term used to describe the symptoms that occur when the brain is affected by certain diseases or conditions.  So dementia is not a brain disease but a symptom of a brain disease – the most common one being Alzheimer’s.

Now while there is some evidence for diet as a contributing factor to lifetime risk of Alzheimer’s disease it has in no way ever been concluded as the predominant factor.  Alzheimer’s Research UK and the NHS both state that age, family history, genetics, smoking and other diseases including  diabetes and obesity all increase lifetime risk of Alzheimer’s.  The only mention of ‘carbohydrates’ comes from a recommendation that people with diabetes need to control their blood glucose.

David continues to point out that; “Researchers have known for some time that the cornerstone of brain disorders is inflammation, he says. Gluten — consumed through wheat and other grains — and a high carbohydrate diet are among the most prominent stimulators of inflammatory pathways that reach the brain”

It would be hard to dispute that there is a link between inflammation and brain disorders such as Alzheimer’s, but to state that high carb diets are ‘the cornerstone of brain disorders’ because of potentially eliciting an inflammatory response seems a little far-fetched.  In fact, most people would argue that the greatest risk factor for Alzheimer’s is age.  Whether gluten and a high carbohydrate diet constitute a ‘prominent stimulator of inflammatory pathways that reach the brain’ is something I am not aware of, or know particularly much about, but I have yet to read anything to convince me.

Permultter argues that people should move onto a low-carb, high-fat diet, in order to protect themselves from brain disease.  To suggest nutrition is that simple is irresponsible.  Nutritional demands to sustain a healthy lifestyle are individual and increasing foods such as fats (suggested from cheese, meat, butter and eggs) could put some people at increased risk of other diseases.

It has been pointed out that very low carb diets can be a therapeutic tool for treating some neurological disorders.  However, it has been noted that ‘recommending a low-carb diet as an intervention for sick people is very different from promoting it as a preventative measure for the entire population, which is what Dr. Perlmutter does in Grain Brain’.

The truth is that we don’t know a great deal about the risk factors for brain disease, nor do we understand how they interact with each other or the level of risk each poses.  It has been stated by others more knowledgeable of this field than me that ‘which also suggest an element of blame towards the person with the condition, are unhelpful and do not do justice to the complexity of these diseases’.

Thanks to @_josephinejones for the article info

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Reporting bias in breast cancer clinical trials

The systems that regulate how drugs come to market are failing the very people that they are supposed to be protecting.  Behaviour that has been challenged for decades without resolution has now been publicly exposed through the work of people like Ben Goldacre and the AllTrials campaign.  One important facet discussed by Goldacre in his book, Bad Pharma, is the reality of reporting bias and results spin perpetrating clinical trials.  Reporting bias, such as selectively revealing or supressing drug-patient interaction, can make a drug look more effective than it really is or disguises potentially harmful side-effects.  Essentially, report bias is under-reporting the undesirable results from a clinical trial so that the benefits are maximised and the desirable hypothesis is proven.  There is a fundamental problem with this in that it violates the standards set by the scientific method and thus, renders any information obtained from such trials as tainted.  A hypothesis should not be desirable but should be part of an idea to be proved or disproved.  Accepting that there would be a desirable outcome from testing the hypothesis automatically makes the experiment bias.

There’s so much to write about when it comes to skewed clinical trials and evidence reporting and I encourage you to read further.  However, what I really want to discuss is a new commentary released by NICE (National Institute for Health and Care Excellence), the guidance body that makes recommendations to the NHS on which drugs they should buy.  It’s important to note that NICE can only make recommendations on a particular drug based on the evidence available to them.  Sometimes this can be very little and what is available is often bias.  The commentary was released through NICE’s ‘Eyes on Evidence’ bulletins which aims to provide access to significant new evidence as it emerges.  One section of the November bulletin caught my eye as it was titled ‘Bias in reporting of randomised controlled clinical trials in breast cancer’.  If you would like to know more about randomised controlled clinical trials (RCT’s) please click here.

I think the bulletin does a good job of reporting the evidence from the source publication (£) but lacks some of the important conclusive remarks made by the authors.  The study in question is a literature review, meaning that the authors went to the effort of finding the result of every RCT published between 1995 and 2011, and analysing them for bias reporting.  It sounds like a large job, and it is.  One way to tackle the review is to take all the RCT publications and compare the findings against what the trial aimed to achieve when it was publically registered.  When a trial is being designed the researchers will select a primary end-point – the final measure that determines the success of a trial.  For a cancer drug this may be something like ‘overall survival’ (OS), ‘disease free survival’ (DFS) or ‘progression free survival’ (PFS).  What’s important here is that the primary end-point is registered so that when the study data is released it will be clear whether or not the conclusions have been reached according to the registered end-point.  All clinical trials are supposed to be publically registered before they start in databases such as clinicaltrials.gov but practice is not enforced and many trials remain unregistered.  This is clear in the current review where it was noted that from the 164 trials selected only 30 (18%) were registered at clinicaltrials.gov prior to their start.  However, we should be very careful when interpreting this finding because clinicaltrials.gov only started in 2000 and at conception only included trials registered in the US, with EU trials being asked to register later on.  This means that any RCT in breast cancer from 1995-2000 is unlikely to be in the database.

What I think is more shocking is that from these 30 trials only 7 reported the same primary end-point than was registered.  This represents a serious failure to be transparent and makes post-trial evaluation by independent reviewers nearly impossible.  How does one review the effectiveness of a drug if the primary aim of the treatment is unclear?  In my opinion, changing the primary end-point looks like admission of spin and bias in the trial.

Reporting bias as a result of unclear end-points was evident amongst the 164 trials reviewed.  A total of 54 trials reported positive results based on non-primary end-points despite not finding a statistically significant difference in the primary end-point.  Essentially, if the aim of a new drug was to reduce deaths by breast cancer and the trial failed to show that, a positive conclusion can still be reached based on surrogate outcomes.  Interestingly, if you look at only the trials reporting no statistical significance for the primary end-point, you find that the percentage reporting positive results on surrogate outcomes increases dramatically.  This is a very sneaky way to spin the data to fit your preferred conclusion.  Currently, there is nothing legally wrong with this but it is irresponsible, misleading and means that the real-life risks and benefits of the drug are disguised from doctors and patients.

Another issue raised by the authors was the tendency to use DFS or PFS rather than OS as a primary end-point.  OS is a much better way to assess the effectiveness of a life-saving drug because it reports deaths by any cause and not just the condition being treated.  On merit, this takes into account deaths caused by drug side-effects, as well as deaths resulting from disease relapse.  On the other hand DFS and PFS only take into account the time before relapse or when the disease gets worse.  The review discussed here found that only 27 of the 164 trials (16.5%) reported OS as the primary end-point.  For women with breast cancer, neither DFS nor PFS have been shown to be adequate alternatives for OS, yet over 80% of the trials reviewed used them as end-points.

It was also noted that doctors will often only read the abstract of concluding remarks of a new clinical trial due to time constraints.  It is therefore essential that primary end-points are clearly described in these sections of a publication so that doctors can review the evidence accurately.  Primary end-points were rarely reported in the abstract or conclusions of the trials reporting positive results despite a non-significant primary end-point.

It would be nice to believe that this reporting bias is abnormal, but in fact the statistics presented in the article are consistent with reviews conducted elsewhere and on separate medical conditions.  This review simply adds more evidence to the fact that this fraudulent and misleading behaviour is rife amongst clinical trial reporting.  If there was ever a need for all trials to be published transparently, made fully accessible and regulated with enforcement, then it is now.

Please join the All Trials campaign and help put healthcare back in the hands of doctors and patients.

In reply to Michael Fitzpatrick

In a recent article on Spiked, the author Dr Michael Fitzpatrick took to ‘slamming the campaign to ban a wacky health mag from shops’.  Fitzpatrick takes considerable dislike to my blog posts in his article, and although attempts to fairly discredit my view, fails to fully understand the context of what I wrote.

First off, Spiked editorial have made the mistake of throwing a sub-heading on the story claiming we are trying to ‘ban’ WDDTY.  This is simply not the case – what we are asking is for supermarkets to take responsibility for the content they choose to sell.  Yes, you could argue that there are much worse things on sale when it comes to damaging public health, such as tobacco and alcohol, but that isn’t the point.  This campaign calls upon supermarkets to be more vigilant over false and misleading health claims.  It is not a call to ban the magazine.

Fitzpatrick says that I have ‘accused the alternative-health magazine What Doctors Don’t Tell You of misusing scientific evidence and language and of providing ill-informed advice about breast cancer in a feature about the film star Angelina Jolie, who recently underwent a double mastectomy’.  I don’t think I have accused them of this, I have proven, through analysing their references that the claims they make are incorrect, ill-informed and dangerously misleading.  Fitzpatrick points out that WDDTY is not a scientific journal and by accusing them of being ‘unscientific is like accusing the Beano of lacking literary merit’.  From this statement I can assume that Fitzpatrick has not recently followed the WDDTY press releases where they repeatedly claim that (1) they report on scientific evidence and (2) they have researchers that check for accuracy and validity of their claims.  If this is the case then they would be more scientific then journalists and editors from other media outlets and thus, believe that they have scientific credibility to back up their articles.  It has been shown on many occasions that this is not the case.  It is commonplace for WDDTY to use references that don’t back up what they are claiming and misinterpret or misuse statistics.  I have also shown how they have just made up quotes from researchers without their knowledge.  This makes WDDTY more dangerous than a sensationalist health piece in a newspaper because they are attempting to appear scientific and be a trusted source on what they report.

Fitzpatrick has a point regarding the misuse of scientific evidence elsewhere and I agree wholeheartedly that more needs to be done across the board to change the way evidence is presented, disseminated and accessed.  But how does that mean that this campaign is worthless?  It’s not his business where I, or others, choose to focus our attention.  Some would say that the misuse of scientific evidence isn’t important at all but instead we should all focus our attention on world hunger and global warming.  Does that make standing up for evidence a waste of time?  I don’t think so.

His final remark is to say that I believe that ‘the general public and readers of supermarket magazines are mere passive dupes of propaganda who need the protection of an enlightened elite’.  This isn’t true at all.  The points I make always refer to the fact that WDDTY give their claims credibility by referencing scientific publications.  This is misleading to everyone because unless you take the time to check each reference you will assume that the author has been honest.  WDDTY are far from honest when it comes to references and so by me taking the time to present where the flaws are in their references means other don’t have to.  Anyone can do this (within limit due to paywalls etc.) and I have never suggested that questioning the evidence is beyond anyone.

I disagree with Fitzpatrick over the fact that asking supermarkets to stop stocking WDDTY is a bad idea.  Supermarkets are one of the most trusted retailers and as a result have a duty to protect their customers.  Selling magazines such as WDDTY actively promotes dangerous and misleading health advice and gives it undue credibility.  No one has asked WDDTY to stop selling their magazine.  If anything has been learned from this is that loyal followers of the magazine will always buy it and they would still be able to.

Belief in medicine with no evidence

The term ‘blind faith’ is usually attributed to someone who holds strong beliefs even when there is a significant body of evidence suggesting that they are wrong.  It is something I have struggled against when trying to engage alternative medicine supporters in the reliability of medical treatments that lack an evidence base.  Blind faith can make conversations extremely frustrating, when no matter how much evidence you present, you can’t even for a second bring that person to question their belief.  For a while I would stay engaged in conversation, mistaken that the other party would comment rationally on what I showed them, but it never happened.  However, I don’t consider these exchanges futile, because it has made me ponder on blind faith and why it’s rampant amongst the alt-med community.

I am not a psychologist and would not profess to know anything about the subject (therefore any comments on statements I make below would be appreciated for my own learning).  Luckily, the internet is vast and I found that The Tao of Reason blog provides a great introduction to the psychology of blind faith.  Essentially, any evidence that conflicts with your own beliefs, leads to discomfort (referred to as cognitive dissonance).  When these beliefs are strong, as with blind faith, the subject will dismiss this evidence by any means in order to justify their views.  This refusal to accept evidence or even rationalise in the face of it could explain the dismissive nature of the alt-med community.  The Tao of Reason goes on to suggest that when faced with compelling evidence, blind faith can cause people to not only discredit the evidence, but also strengthen their beliefs.  So perhaps these engagements are actually fuelling the belief that a certain alt-med is effective.  In a scenario where no matter how much evidence is presented will change someone’s way of thinking, is it worth debating?

This notion of defending ones belief by dismissing even the most compelling evidence is something I have seen a lot.  Someone may defend their view by making a sweeping positive statement.  You can show them that this statement is flawed and provide direct evidence to support it and in return you will usually get a second defending statement with no bearing on the first or any clear response to your rebuttal.  This is what can be frustrating and denies the conversation from ever reaching a rational debate.  In the case of homeopathy, there is compelling evidence that it is not biologically, physically or chemically plausible (Avogadro’s constant and beyond).  Yet the homeopathy industry continues to thrive on a culture of blind faith amongst supporters.  This is because elaborate dismissals of the evidence against homeopathy are constructed to defend the belief that it is plausible.  This is also not helped by the fact that misleading and bogus pseudo-evidence is allowed to accumulate in the academic press.

The fact that the belief system is so rigorously sustained in that person’s mind means that removing it would leave an incomprehensible void.  Perhaps it is this dissonant void that religious converts or people that lose faith in their religion experience.  If so, then at least we know that there is a possibility to alter a person’s belief about alt-med, no matter how steadfast they are.  What is important is that in the process of challenging medicine with no evidence we don’t lose sight of the rational and critical thinking that leads us to do so.  New evidence is presented all the time, and we must be willing to change our own views, if there is any hope of changing someone else’s.

Sick as a dog – another worthless advert in WDDTY

So I was just casually scanning over the most recent (November) issue of WDDTY – yes that issue with the atrocious homeopathy and cancer article – when my eyes glanced over an advert for:

‘Apocaps –The world’s first all-natural apoptogen formula’

Now I have to admit, when I see the prefix ‘apop’, I automatically think of apoptosis, the process of programmed cell death that plays such a vital role in many aspects of an organism’s development.  On closer inspection it’s clear that the product in question is selling something about apoptosis – something that got my interest having previously spent time in the lab researching that very mechanism.  So let’s see what kind of bullshit the team at ‘Functional Nutriments’ have concocted for this ‘world’s first’.

The product itself appears to be a pill made up of ‘natural’ chemicals for kick-starting apoptosis in dogs.  Now I don’t know about dogs, but as a human I would not be convinced by someone wanting to kick off apoptosis in my cells by feeding me a pill.  Sounds like a quick way to end up in the hospital.

The special ‘apoptosis formula’ (I have to keep putting these things in quotations because I just don’t understand what they mean) is a powerful nutraceutical supplement designed by Dr Demian Dressler.  A quick Google search on Dressler reveals that he once thought of himself as a conventional veterinarian but know considers himself a full spectrum veterinarian, combining the best of conventional medicine with nutraceuticals, supplements, diet and body-mind medicine.  He is co-founder of Functional Nutriments and the inventor of Apopcaps.

But what are Apopcaps? The advert doesn’t really give you any information as to what the product is or does – a common theme amongst adverts of quackery.  I had to log on to their wonderful website to find out more information.  I always find the ‘About’ section of these websites the best for finding bullshit.  Here’s what they have to say about Apopcaps:

‘Apocaps was created as dog lovers began asking for a simpler, easier way to give apoptogens to their dogs.’

Really?! What the fuck are apoptogens? I’ve never used the word before and a quick Google search reveals that apoptogen is only ever used in conjunction with Apocaps.  So without knowing what they are how does one know that they need a simpler and easier way to give them to their dogs?

‘The challenge was to find a combination of the most important – luteolin, apigenin, silymarin and curcumin and other key ingredients – in a formula that is absorbed by the body.’

Ahh..so here are four alleged apoptogens.  Two flavonoids (luteolin and apigenin), milk thistle extract (silymarin) and a curcuminoid (curcumin).  I know from experience that luteolin and apigenin have been shown to induce apoptosis in the lab.  But so have many other things.  So how much evidence is there that these chemicals could induce apoptosis in dogs?  I’ll answer that in due course, for now let’s continue with the spiel.

‘Because luteolin, apigenin, curcumin and silymarin are all natural substances, the body’s digestive and elimination systems could potentially use up or eliminate these apoptogens before they reach the bloodstream. We didn’t want that to happen.’

This statement hints at a complete misunderstanding of mammalian physiology.  I eat a lot of natural substances every day, if I spent all that energy digesting food only to shit and piss the best bits out, I’d be very unhappy.  Nutrient absorption in the gut is very effective.  It’s evolved that way over thousands of years so we can spend energy doing other things like riding bikes or blogging about stupid pseudoscience.

‘The patent-pending proprietary “Trojan Horse” formula used to create Apocaps “tricks” the body into circulating the apoptogens throughout the bloodstream.’

This sounds exciting but my sceptic radar detects bullshit.  I couldn’t find a shred of evidence for their ‘Trojan Horse’ formula or how it would work.

After looking at the entire website for Apocaps, I still could not find one statement that actually said what the product was for or for what conditions it should be given.  I mean do you go into Dr Dressler’s clinic with your dog and he says:

“Yes, it looks like your dog has low levels of natural apoptosis; let’s boost this back up with Apocaps.  Don’t worry the active ingredients easily get into your dog’s circulation where they can have an effect on the whole body”.

Even if Apocaps worked, how would increasing apoptosis across your dog’s body help with anything?! It sounds like the least targeted form of chemotherapy ever made.  So back to my earlier question – is there any evidence that the four key ingredients have any effect on apoptosis in dogs?

The answer is no.

PubMed search for ‘Luteolin’ AND ‘dog’ – 8 papers, none on apoptosis

PubMed search for ‘Apigenin’ AND ‘dog’ – 11 papers, none on apoptosis

PubMed search for ‘silymarin’ AND ‘dog’ – 39 papers, none on apoptosis

PubMed search for ‘curcumin’ and ‘dog’ – 23 papers, none on apoptosis

 

 

 

WDDTY – no evidence for their cancer claims

The last few weeks have been an eye-opener.  We have witnessed Lynne McTaggart slowly crumble under the weight of evidence brought against her by rational thinkers.  The self-proclaimed champion of free-speech has silenced debate on Facebook by deleting any comments that bring criticism to the toilet paper she calls a magazine.  The claim has always been that those banished from the spiritual realm of WDDTY – were so because of abusive behaviour.  Everyone knows that this is not the case, but in fact bans were dealt out for posting real evidence of fallacy in their claims.

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I was personally banned for explaining to WDDTY supporter, Julia Barac, that WDDTY are not justified in the way they present the evidence.  Julia commented at one point that she believes what WDDTY publish because they reference scientific journals to support their claims.  I very politely pointed out that you shouldn’t be fooled and until you examine the evidence provided you can’t be sure that anything they have written is true.  As you can see in the screenshot of our conversation, Julia asked me to provide a couple of examples.  So I did – and a few minutes later found myself banned from commenting and all my comments deleted.

It would seem that trying to bring a rational argument – one supported by evidence – to WDDTY supporters is a sin.  I really want to emphasise to people like Julia just how poorly the writers at WDDTY are at presenting the evidence.  It may be an impossible task but hopefully by collating a large number of examples someone reading might have that ‘moment of clarity’ and see beyond the propaganda presented by Lynne and WDDTY.  Below is a comprehensive review of WDDTY publications on cancer and the editorial mistakes made in presenting the evidence.

16th October 2013 – Resveratrol in red wine helps beat cancer

This news article cites the scientific paper Fang et al. J Surg Res. 2013.

“If you’re having radiation therapy for your cancer, drink a glass of red wine first. Apparently, it makes the treatment more effective…”

This is already a gross misrepresentation of not only what the reference shows but what the body of evidence on resveratrol also shows.  First off, there have been no clinical trials investigating the benefits of resveratrol to radiotherapy, so to jump straight to the idea that you should drink a glass of red wine before radiotherapy is absurd.  Secondly, the referenced paper is a pre-clinical laboratory study using cells in a dish, a good starting point for any medical research but not evidence of clinical efficacy.

“right now, the researchers say there isn’t enough evidence for people to ditch conventional therapy in favour of resveratrol, but perhaps that may change when more data is collected”.

They researchers don’t say this at all.  They never suggest that resveratrol could replace conventional therapy in the future but suggest that ‘resveratrol may have a potential role as a radiation sensitizer for melanoma treatment’.  There is a big difference here – a radiosensitiser is a synergistic treatment used to improve the efficacy of conventional radiotherapy – not replace it.  The WDDTY article is only 150 words, and in that brief chatter, they have managed to cock up explaining a very simple piece of basic research.

 30th September 2013 – Sunscreens can trigger skin cancer, scientists confirm

This news article cites the scientific paper Turci et al. Chem Res Toxicol. 2013

In this example, the headline itself is a complete fabrication.  (1) There is no evidence that sunscreen causes skin cancer. (2) The referenced paper does not ‘confirm’ that sunscreens can trigger skin cancer.

“Titanium dioxide (Ti02) triggers a series of toxic effects—including skin cancer—when it is exposed to ultraviolet light, which is in the sun’s rays”.

This isn’t true – there is no evidence linking titanium dioxide in sunscreen to skin cancer.

Furthermore, at no point in the cited article do the authors mention that sunscreen could cause skin cancer.  What their paper shows is how UV light reacts with titanium dioxide to generate free radicals and modify lipid bilayers of cells in the stratum corneum.  To jump from this to ‘sunscreens can trigger skin cancer’ is absurd.  To state that scientists have now confirmed this when they haven’t is absurd.

30th July 2013 – ‘Safe’ HPV vaccine kills up to 1,700 young girls

We all know WDDTY’s stance on vaccination but claims like this are not only wrong but could potentially put people at risk of cervical cancer.  In this article they reference the CDC Morbidity and Mortality Weekly Report on HPV vaccination in the US (July 26, 2013).

This figure of 1,70,0 is actually 1,674, and more importantly is not the number of girls killed by the HPV vaccine.  The VAERS collects all the data on vaccine safety and collates ‘serious adverse events’ into one group, which includes hospitalisation, permanent disability, life-threatening illness or death – none of which have to be attributable to the vaccine itself but rather have occurred post vaccination.  So 1,700 is already an exaggeration because (1) it isn’t the number of deaths and (2) the deaths are not evidence that the vaccine was responsible.

Interestingly, when you look at the VAERS statistical report on HPV vaccine safety, you find that out of 12,424 adverse event reports there were a total of 32 deaths.  Out of these 32 deaths – 14 occurred after HPV vaccination alone.  And out of the reported deaths that had significant coronary reports – 4 were unexplained, 2 caused by diabetic ketoacidosis, 1 caused by prescription drug abuse, 1 case of amyotropic lateral sclerosis, 1 case of meningoencephalitis, a case of viral sepsis, 3 cases of pulmonary embolism, 6 cardiac related deaths and 2 due to idiopathic seizure disorder.

“Astonishingly, US health regulators say there are “no serious safety concerns” over the HPV vaccine. Instead, their concerns focus on the low uptake of the vaccine”.

I think it is clear why US health regulators are saying this – and I wouldn’t say it was astonishing.  It is too early to know the effects of HPV vaccination on cervical cancer cases, but if it goes the way other vaccines have gone, then I’d consider it dangerous to promote anti-HPV vaccine views based on no evidence.

20th May 2013 – Did Angelina get the right medical advice?

This article is from a longer feature which I have previously dissected in full.  It’s riddled with errors.

13th March 2013 – Bitter melon juice stops cancer’s growth

“Bitter melon juice seems to interfere with the growth of pancreatic cancer, researchers have discovered after they tested it on hundreds of patients across Asia”.

This isn’t true – there has never been a clinical trial of bitter melon juice for pancreatic cancer.  The evidence suggests that it has therapeutic potential in laboratory and mice studies but no in-human trials have ever been conducted.

28th January 2013 – Chemotherapy helps cancer tumours grow, say researchers

“Chemotherapy isn’t only useless against cancer—it even encourages the tumour to grow, researchers have discovered”.

This is a classic WDDTY statement about the apparent ineffectiveness of chemotherapy.  It is of course absolute bullshit and anyone with a rational mind would know that chemotherapy is in some cases the best treatment available.  The next bit is good because it suggests that chemo ‘even encourages the tumour to grow’.  The study they reference is Sun et al. Nat Med 2012.  The paper deals with understanding the mechanisms behind acquired drug resistance in prostate cancer patients – a major problem in clinical treatment.  They show that cyclic administration increases expression of the protein WNT16B via DNA damage pathways, which promotes a resistant phenotype within the tumour environment.  This is not ‘encouraging the tumour to grow’ but is an effect driven by selection of resistant clones as they adapt to therapeutic intervention.  This does not make chemotherapy useless – it means that new drugs need to be developed or combination therapies designed that circumvent resistance.

“They (the researchers) say that chemotherapy is “completely worthless” and that cancer sufferers would do better by avoiding the drugs altogether”.

Do I need to say anything about this ‘quote’?  What they actually conclude is: ‘We conclude that approaches targeting constituents of the tumour microenvironment in conjunction with conventional cancer therapeutics may enhance treatment responses’.

While I was writing this one I realised that Sun et al. were probably unaware that they had been quoted saying these things so I sent the lead author an email to find out.  Here is the response I got:

 It is very, very unfortunate that these groups routinely misquote scientific studies. The paper says nothing of the sort. The objective of the study was to identify resistance mechanisms to cancer therapeutics and to target them to make standard therapies more effective.

 Our study has been misquoted and misinterpreted—I believe on purpose—by several of these groups. However, I have not wanted to expend a lot of effort trying to correct this, unless asked directly, as it only adds visibility to their claims.

 However, your group and others are certainly more than welcome to go on the offensive and I would be more than happy to provide you with a quote or statement.

March 2012 Much more than placebo: Homeopathy reverses cancer

This is a diabolical piece of journalism on the supposed efficacy of homeopathy for cancer treatment.  Rational thinkers are aware that there is no evidence to support the efficacy of homeopathy for any medical condition – especially for the treatment of cancer.  WDDTY do not hold back in this article either and in my opinion straddle the clauses of the Cancer Act 1939.

The opening paragraph states: “studies paid for by the US government are showing that homeopathy could be our best defence against cancer. Several homeopathic remedies are as effective as powerful chemotherapy, according to clinical trials, and thousands of cancer cases are being reversed by homeopathy alone.

No reference to what US government funded study they are suggesting but no one yet has published a study proving that homeopathy is effective against cancer.  They also claim (with no reference) that homeopathy has been shown to be as effective as chemotherapy according to clinical trials.  I couldn’t find any clinical trials to support this and it is not my responsibility to find evidence for such extraordinary claims.  Same applies to the ‘thousands of cancer cases reversed by homeopathy alone’ claim.

“in one review of the work at the Prasanta Banerji Homeopathic Research Foundation, 21,888 patients with malignant tumours were treated only with homeopathy—they had neither chemotherapy nor radiotherapy—between 1990 and 2005. Clinical reports reveal that the tumours completely regressed in 19 per cent—or 4158—of cases, and stabilized or improved in a further 21 per cent (4596) of patients”.

WDDTY don’t really reference very well here and I couldn’t find the review they were speaking of.  The only Banjeri paper from 2008 was this one – a case study evaluation of 4 patients.  So there doesn’t appear to be any evidence to back up any of this statement and this is without taking into account the bias introduced by a review carried out by the person running the homeopathic clinic.

“The foundation’s homeopathic therapy—the Banerji Protocol—has been independently tested under laboratory conditions, and two of the remedies used, Carcinosin and Phytolacca, were found to be as effective against breast cancer cells as the chemotherapy drug Taxol”.

The reference they supplied has not been independently tested under laboratory conditions.  Prasanta Banerji is last author on the paper yet no conflict of interest is declared.  I couldn’t find any other papers that verify these results from an independent lab.  The only other relevant paper in PubMed was from 2006 and contradicts the evidence from Banerji’s paper.

“Another clinic in Kolkata, the Advanced Homeopathic Healthcare Centre, claims similar levels of success with its cancer patients and, although well documented, they have not been subjected to the same level of scientific validation as the Prasanta Banerji Foundation”

 No reference to these other clinical studies.

“Two of the remedies—Carcinosin and Phytolacca—achieved up to an 80-per-cent response, indicating that they caused apoptosis, or cell death. By comparison, the placebo solvent achieved only a 30-per-cent reduction, suggesting that the effect was more than twice that of the placebo”

This was a description of the lab study conducted with Banerji that has not been independently verified.  Bias aside, I would be very concerned that the solvent control achieved a 30% reduction; a suitable control should really have no effect in a well-controlled lab study.  This also cannot be described as a placebo effect.  Cells in a dish are not affected by the placebo effect.

There’s a whole section under ‘the other clinic’ which contains no references and just a load of anecdotal evidence – not convincing.

This whole article leans on the view that homeopathy is not only effective against cancer, but that it is better than conventional treatments.  Yet they provide no evidence to back up these extraordinary claims.  Without any evidence why would anyone believe that homeopathy works?  More importantly – pushing homeopathy as an alternative to conventional cancer treatment is unethical and dangerous.  This is why the Cancer Act was created and I do believe that publishing material such as this breaches that act.

 

WDDTY – They say they have a ‘qualified researcher’; but do they really?

Discussions on WDDTY’s Facebook page are apparently meant to be a fair and open place for debate.  However I, as have others, have found ourselves banned from commenting because of debasing and abusive comments.  In my case this is simply not true.  My ban came in response to a claim made by WDDTY that they have a qualified researcher who checks all their references and statistics before they publish.  I posted on their Facebook that if they did indeed have a researcher, why was there so many things wrong in their Angelina Jolie piece – an article that I found to be riddled with referencing errors.  Their retort was to ban me and delete my comments – an action some people would take this as admission of guilt.

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In the midst of all the Facebook patter I noticed WDDTY made a statement about how ‘prescribed drugs are now one of the biggest killers in the west’.  I’d heard similar claims from WDDTY before and remembered an article that they had published recently claiming that medicine is one of the biggest killers in the US.  The article appeared in the September 2013 issue and is solely based on the National Vital Statistics Report (2012, vol. 61).  They quote some pretty incredulous numbers in the article – but as they have a ‘qualified researcher’ on board I thought “surely they must be right”.  I mean anyone publishing health information would want to make sure that they get their figures right – especially when they want to make claims like medicine kills more than smoking, wouldn’t they?

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WRONG.  In fact they have made such a mess of the NVS report I can’t believe for a second that anyone with half a brain even looked at it.  Let me begin:

The first point worth noting is that volume 61 of the NVS report contains 9 sections.  I am going to assume (because WDDTY don’t specify) that the one they got data from was number 6 – Deaths: Preliminary Data for 2011.  The reason for this is because they say:

“America’s DOH and Human Services classifies all deaths in the US every year: in 2011 – the most recent year available…”

This is true – great job ‘qualified researcher’.

Next they say there were a total of 2.53 million deaths in the US in 2011.  It’s actually 2.51 (to 2 d.p.) but I’ll cut them some slack.

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They say that the biggest killer was heart disease (596,339 deaths), followed by cancer (575,313 deaths).  Also true.  Wow this person is doing a great job so far…

This is where it gets good (or bad).  They say that:

“Adverse drug reactions account for 106,000 deaths”

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This number has been plucked straight out of the air.  Adverse (medical) drug reactions are classified under the NVS codes Y40-Y59.  Within the NVS report for 2011 these codes are grouped under ‘Complications of medical and surgical care’ along with codes Y60-84 and Y88.  Deaths under this category total 2,580 – not 106,000.  In fact, totalling all adverse drug reaction (Y40-59) from 1999-2006, only accounts for 2341 deaths in an 8 year period.

They also claim that 98,000 people are killed by doctors.  This is clearly wrong because these deaths also fit in the 2,580 accounted for under ‘complications of medical and surgical care’.

Their conclusion then is to add 106,000 and 98,000 to get a total of 204,000 deaths by adverse drug reaction or medical error – making it the third biggest killer in the US (around 8% of total deaths) after heart disease and cancer.  In fact they account for 2,580 deaths or 0.1% of total deaths.

So by making up numbers, the ‘researcher’ at WDDTY has over-stated the number of deaths by a (approx.) whopping 100 times.  Maybe WDDTY will be good enough to explain where these numbers have come from because as far as I can tell they have been manufactured to propagate the idea that medicine and pharma are out to get everyone.