A response to the "Herbinator"
But don't confuse "polite" with going easy on him. Here goes:
I see you've found my humble blog. Your sarcastic little comment about how you've supposedly discovered a "blog dedicated to the celebration of conformity" amused me, but unfortunately that is an incorrect characterization. In fact, Respectful Insolence is a blog dedicated mainly to science, evidence-based medicine, and skepticism (none of which alties like yourself appear to understand or embrace)--plus whatever else the inimitable Orac feels like blogging about at any given time. In actuality, I leave the conformity to alties, too many of whom will defend even quacks like Hulda Clark rather than admit that they might have a problem with quacks among their ranks. They're much better at lockstep conformity and adherence rigid dogma than I. Oh, and before you go accusing me of the same sort of "circle the wagon no matter what" behavior with regard to conventional medicine, I suggest you read this, in which I go after conventional doctors for selling unnecessarily and potentially harmful "screening" MRIs for breast cancer. I am an advocate of evidence-based medicine, and I try to apply the same standards consistently to so-called "alternative" treatments and conventional medical treatments.
Your sarcasm notwithstanding, however, I'm still glad that someone like you discovered my blog. In fact, I even hope you'll stick around. You might actually learn something. You'll also likely find that I'm far more receptive to honest criticism than most alties are. Perhaps, if I have time later, I'll go back to your blog and politely politely on some of the stuff I encountered the first time I visited. Then, we'll find out what your tolerance for honest debate really is.
In fact, let's find out a little right now. How about a little taste of Orac's own special brand of respectful insolence? I'm afraid you're just plain wrong when you assert on your blog that little or no progress has been made against cancer in 50 years. One example: Childhood cancers that were death sentences in 1955 are now, thanks to chemotherapy, anywhere from 75-90% curable. Another example: leukemias and lymphomas that were also death sentences 50 years ago are now treatable, and, depending upon the specific disease, anywhere from 30-80% curable. It is true that we haven't made much progress for certain tumors over the last 30 years or so, but admitting that is a very different thing than saying (as you did) that we've made "little progress or no progress against" cancer in 50 years. Let me put it this way: If you were diagnosed with cancer, would you rather be treated with the methods we have now or the methods that were the standard of care in 1955? I realize it's likely that you would simply say you'd prefer "natural" methods. If so, I wish you good luck and hope you never get cancer, even more so than I hope the same thing for anyone--because if you do get a treatable cancer and opt for the "natural" treatments that you advocate on your blog over conventional therapy, you'll be screwed. And I don't wish death from cancer on anyone. Putting that aside, however, I know what my answer to the question would be (not to mention, I daresay, the answer of anyone capable of critical thinking).
But how about another little taste? In another post, you say, "Cancer treatment is probably no more effective today than it was in the 1930's." Oh really? Can you back up that assertion with, oh, say, some actual facts? Do you have some survival statistics? Have you considered not just mortality, but morbidity as well? For example, if you were a woman with an early stage breast cancer, would you want a radical mastectomy (the standard of care for even small breast cancers in the 1930's) or a lumpectomy with sentinel lymph node biopsy (the standard of care for most early stage cancers today) as your surgical therapy? And, if you were unfortunate enough to have a tumor large enough to require a mastectomy, why bother with breast reconstruction (nonexistent in the 1930's) when you can have a deformed chest? Would you want to increase your odds of long-term survival with chemotherapy or take the lower chance that surgery alone would do the trick? How about hormonal therapy? The standard means of hormonal therapy before Tamoxifen and the newer aromatase inhibitors was to do an oophorectomy to stop the body's natural production of estrogen. Now we have drugs that will do the same thing. The same is true for prostate cancer. Castration used to be the first treatment of choice for metastatic prostate cancer, even as recently as my early residency days in the late 1980's. Now, we have drugs that accomplish the same thing. The list goes on and on.
After that, how can you not want just one last taste? Correct me if I'm interpreting incorrectly, but here, you seem to be implying strongly, if not saying outright, that a "nature-cure approach is at least as effective as Standard medical treatments." You wouldn't happen to have, oh, say, some actual scientific or clinical trial evidence showing that this is so. Any disease will do, but, since I'm primarily a cancer surgeon, I'd be most interested in evidence showing such a result for a cancer, any cancer, for which there is presently effective "conventional treatment." Failing that, how about any disease for which there is presently an effective conventional treatment? Or even diseases for which present treatments leave much to be desired? No testimonials, please, because they do not show any generalizable effect, and are impossible to evaluate to see if the presentation of the case is accurate, nor do they tell us actual success rates. I'm talking hard data from well-designed, controlled clinical trials that show your therapies are as "effective as Standard medical treatments." And, if you don't think your therapies should be subjected to such testing, I would then have to ask: Why not? Why should your therapies be exempt from the same testing that mine are subject to? How do you know that your treatments work? Again, as I explained extensively before, anecdotes don't constitute adequate evidence. I will give you this, however. You said, "In the end, you either believe or you don't." The problem is, nature doesn't work on "belief." You can "believe" anything you want, but that doesn't make it so.
That ought to do it for now. I hope you don't think I was too hard on you. However, if you show up and leave sarcastic comments on my blog, don't expect me to take it lying down (although I do always reserve the right to ignore them). I've dealt with alties for a long time now on Usenet in misc.health.alternative; I highly doubt you can show me anything new, but feel free to give it your best shot, should you be so inclined. I'm always interested in honest discussions with advocates of alternative medicine who might be able to show me that I am wrong. I just haven't found one yet. Be advised, as well, that no one but Orac drives the agenda of this blog and certainly not you; so I will not allow myself to become drawn into prolonged exchanges. Orac, and Orac alone, decides when he will and will not respond. I'm sure you run your own blog the same way, which I may find out if I start leaving some comments.
Finally, don't forget Orac's favorite saying: "A statement of fact cannot be insolent!"
P.S. Have a nice Easter weekend.