Tuesday, June 14, 2005

Another Suzanne Somers in the making

Via Anne, I've learned that Kylie Minogue has turned to "alternative" therapies after surgery to treat her breast cancer:
The pop babe, who was diagnosed with the life-threatening illness last month, has began seeing a bio-energy healer to help her cope with the course of radiotherapy she is about to begin.
During the sessions, the healer will try to beam positive energy in to Kylie's body with one hand and remove negative energy with the other.

In a bid to beat the illness, the 'Slow' singer has also turned to colour therapy, insisting a room at the private hospital where she received her lumpectomy be painted pink in a bid to assist her recovery.

It is believed Kylie, 37, turned to alternative therapies after speaking with fellow breast cancer sufferer Olivia Newton-John who used Buddhist chanting to overcome the disease.
Ms. Minogue certainly has the right to choose any "therapy" she wishes, and it is to her credit that she has not abandoned conventional treatment in favor of this "bioenergy healing." Fortunately, I can't think of any way that this sort of thing is likely to harm her chances of a cure. Unfortunately, I can't think of any way it will help her chances either, other than serving as a very fancy (and probably very expensive) placebo. Indeed, even a 9-year-old-girl was able to show that these "energy healers" can't even detect the human "energy fields" they claim to be able to manipulate. She even managed to get her study published in the Journal of the American Medical Association! (Thanks to Skeptico and Nurse Kelly for the reference; a more detailed description is here and the article is here.) Of course, energy healing and therapeutic touch advocates jumped all over this study, claiming it was invalid because there was no eye contact or, even more amusing, because the experiment involved a "nonhealing" task and lacked the "intention of doing the greatest good for the person being treated." (Are they really trying to argue that a "healer's" ability to "detect" these human "energy fields" depends upon the intent of the healer to "do good"?) Worse, they even teach this stuff in nursing schools as a serious therapy, and, as Kelly points out, no mention of the JAMA study is made, even in newer textbooks. Fortunately, not all nurses buy into this. It may well be true that a good "therapeutic touch" or a good massage can relieve tension and make a patient feel better, but the salutory effect of such human contact almost certainly has nothing to do with "energy fields" or "redirecting these energies to bring the person back into energy balance," nor do you have to worry about using it on people "sensitive to energy repatterning" (mainly because there is no "energy repatterning"). I also can't help but wonder how these "healers" determined what points on the body are the proper targets of "therapeutic touch." Somehow I doubt there was any science involved.

But I digress, as I am wont to do sometimes and promised to try to stop doing.

Regardless of the specific "alternative medicine" therapeutic modality chosen, I dealt with the issue of people choosing alternative medicine for breast cancer treatment in detail veryearly on in this weblog's history; specifically, how patients who choose alternative therapy after having had conventional therapy will often become "testimonials" for that therapy and will attribute their good outcome more to the "alternative" therapy than the conventional therapy they had already undergone. (The converse is also true; they tend not to blame these alternative therapies when they relapse.) Unfortunately, celebrities seem particularly prone to this phenomenon. For example, Suzanne Somers decided to opt for injections of the mistletoe extract Iscador rather than chemotherapy after her surgery and later had glowing things to say about it. Olivia Newton-John turned Kylie on to therapeutic touch. Both have become a "testimonial" for alternative medicine, and it looks as though Kylie Minogue may be heading down that path.

What one needs to understand in evaluating these "alternative therapies" is that surgery alone or surgery plus radiation therapy cures most early stage breast cancers. The chemotherapy and/or hormonal therapy can reduce the rate of recurrence signficantly, but the bulk of the "cure" comes from the local therapy. In effect, chemotherapy is just "icing on the cake." What's going to "cure" Ms. Minogue will not be "energy healing," "color therapy," or Buddhist chanting, but rather the scientifically-proven (and much less glamorous) treatments of surgery, radiation therapy, chemotherapy, and possibly hormonal therapy, just as surgery cured Suzanne Somers. However, like many cancer patients who supplement their therapy with such means, it is possible (even likely) that, once her therapy is complete, assuming she does well she will attribute her cure to the "alternative" therapy more than than the conventional therapy that preceded and accompanied it. She will become a "testimonial" for these therapies.

Ah, you say, Kylie Minogue is continuing to pursue standard therapy; so maybe she is just using these therapies to help her deal with the potential side effects of radiation therapy, such as fatigue and skin rashes or perhaps she'll use it later to help with chemotherapy side effects. Possibly. The article does make it sound as though that is what she is using these unconventional methods for. Unfortunately, there is no evidence that "energy healing" does anything whatsoever to help these symptoms. Personally, I'd like to know how any "healer" can "beam positive energy" into Kylie (or anyone) with one hand and "remove negative energy" with the other. What is the frequency of this "energy"? How can we detect or measure it? How does the healer identify what "energy" is "positive" and what energy is "negative," much less control such energy flows? It's all religious or New Age hokum, nothing more than a very expensive and showy placebo.

What bothers me is not so much that a celebrity has chosen this sort of therapy. It's more the way the press tends to give credulous and positive coverage to such unproven and questionable therapies or, at the very least, to "balance" the skeptics with the testimonials of the advocates. Even in the CNN article describing the study debunking therapeutic touch, a note of credulity slipped in; the article recounted glowing testimonials of patients who had undergone therapeutic touch and even wrote:
Advocates are blasting the young science student's research, and even skeptics concede many patients benefit from the therapy.
Which skeptics concede this? They don't name or quote these skeptics who "concede" this. Inquiring minds want to know who these "skeptics" are!

In any case, Anne got it right when she pointed out:
In a few year uncritical reporters will be talking of Kylie (or Olivia Newton John) and how she used "bio-energy healing" to overcome her disease
Indeed they will, the same way they talk of Suzanne Somers as having used mistletoe extract to overcome her disease, even though it was her surgery that cured her. Actually, if you look at the original storyAnne cites, it looks as though credulous reporters have already begun to do just that. Notice the utter lack of questioning whether such methods have any efficacy. The writer seems to assume that these methods have value because the celebrity has chosen them. I usually have no objection to patients using such therapies in addition to the proven, as long as I know what they are so that I can know if they might interfere with her standard treatment. (For example, some vitamins will interfere with clotting at high doses, and we surgeons don't like anything to interfere with clotting.) Unfortunately, the "testimonials" that come out of such use often make it sound as though the alternative, rather than the standard, therapy is responsible for the patient's survival. Even if Kylie herself does not give undue credit to this therapy for her cure, you can bet the press will do glowing puff pieces on her and how she used "unconventional" means to "beat" breast cancer.

12 example(s) of insolence returned:


At 6/14/2005 8:01 AM, Anonymous Flex said...

"In effect, chemotherapy is just "icing on the cake." What's going to "cure" Ms. Minogue will not be "energy healing," "color therapy," or Buddhist chanting, but rather the scientifically-proven (and much less glamorous) treatments of surgery, radiation therapy, chemotherapy, and possibly hormonal therapy, just as surgery cured Suzanne Somers."

Actually, I take issue with the phrase describing scientifically-proven treatments as less glamorous. (Unless you are referring to the original meaning of glamour, which includes witchcraft and enchantment.)

Scientifically-proven treatments are far more alluring and fascinating than 'woo-woo' treatments. Where the alternative treatments have simplistic explainations, unable to be examined in depth. Scientifically-tested treatments can be explained at many levels, as deep as the patient wants to explore. And all the information given to the patient has been tested in numerous ways, by numerous researchers.

Ultimatly the patient is relying on the authority of the physicians. But contrast the two versions. In the alternative world, a single person gets an idea about what might be benefical and provides this as therapy. On the other hand, on the scientifically-proved side of medicine, there have been hundreds of thousands of people, collaborating over decades of time, testing, rejecting, and improving their knowledge in small increments to develop the technique used by by your physician today.

Which is more glamorous?

Maybe doctors should provide a pamphlet to patients listing some of the many people who helped develop the therapy they are going to use. It may be hard to create, but a list of say 5,000 names of the people who helped develop a therapy may help convince patients that the doctor's therapy is better than their friends alternative.

Cheers,

-Flex

 

At 6/14/2005 8:36 AM, Blogger OutEast said...

Oh, Orac! I'm surprised at you - don't you read through your own posts? You say 'I can't think of any way it will help her chances either, other than serving as a very fancy (and probably very expensive) placebo. In other words, you believe there is a good chance that Ms Minogue will experience some benefit from this therapy.

Then, only sentences later, you lay into that poor, innocent CNN reporter for suggesting that 'skeptics concede many patients benefit from the therapy' - when you yourself made that same point! Who are those skeptics? Why, you yourself are one one of them!

(Should I close with one of those '/irony' tags?)

 

At 6/14/2005 11:01 AM, Blogger Kelly said...

Well Outeast, as far as I can tell, in med-speak, placebo isn't the same as a "benefit." Using the term "benefit" would imply that the treatment surpasses the expectations of a placebo. Otherwise, every little white sugar pill would be "beneficial."

And Orac, feel free to carry on in a long discourse if it promoting something I wrote. I have no problem with that whatsoever .

 

At 6/14/2005 11:28 AM, Anonymous PaulP said...

I see she spoke to Olivia Newton-John, who hot the nickname "Olivia Neutron Bomb" a long time ago.
Did you know that her grandfather was Max Born (a famous physicist - see e.g. http://nobelprize.org/physics/laureates/1954/born-bio.html).
I think this is the most unlikely true thing I have ever heard.

 

At 6/14/2005 8:39 PM, Blogger Orac said...

Placebo effects are not entirely worthless, but only nearly so. However, I am unaware of any study that ever showed an objective antitumor response due to a placebo; she will not epxerience any anti-tumor response from this "therapy."

 

At 6/14/2005 10:36 PM, Blogger HaloJonesFan said...

I'd be quite happy to beam some positive energy into Kylie Minogue, if you know what I mean. (Not so sure about how I'd "remove negative energy" but I could probably work it out.)

 

At 6/15/2005 12:25 AM, Blogger Tim said...

Your point about how the alternate therapies often don't get blamed if a relapse occurs is very true. If (and I bloody well hope it doesn't) Kylie Minogue has a relapse I doubt we'll hear her blaming the "energy healer" for getting his hands mixed up and shooting negative energy out instead of positive energy, and sucking out positive energy instead of negative energy.

 

At 6/15/2005 7:02 AM, Blogger OutEast said...

I was, of course, being heavily ironic - the point being that this journo has brobably picked up on people making comments about the 'benefits' to be derived from any 'alternative' treatment due to the placebo effect.

 

At 6/15/2005 5:00 PM, Anonymous T. Bruce McNeely said...

I also find it interesting that there seems to be no consistency to these "therapies" - Kylie Minogue chooses bioenergy manipulation and colour therapy, Olivia Newton-John chooses Buddhist chanting and Suzanne Somers opts for mistletoe extract. How does anyone make this choice? By the way, I've seen the singer referred to as Malaria Neutron-Bomb - a small payback for her contribution to late 70's pop music.

 

At 6/16/2005 12:17 AM, Anonymous Anonymous said...

http://www.oliviaappeal.com/onjcc/default.asp

That's the Olivia Newton John Cancer Centre. I'm thinking I should ring them up (or visit: I'm also in Melbourne) and see if they'll go on the record saying that donations don't go towards "research" into the sort of altie rubbish that ONJ and Minogue's names are becoming so strongly associated with...

 

At 6/23/2005 10:29 AM, Anonymous David Edwards said...

I was amused to read this. Not least because there is actually a vaild interpretation of the terms 'positive energy' and 'negative energy' in the world of quantum physics, but somehow I have serious doubts that Kylie's "energy healer" is manipulating quantum fields for therapeutic purposes: rather, it sounds to me as if he's got himself a very plum job indeed putting his hands all over Kylie's body and getting her to pay for the privilege ... cynical, moi? Whatever gave you that idea? :)

However, to return to my tangential diversion, 'negative energy' (albeit defined in a highly precise manner that almost certainly has nothing to do with Kylie's "healer") has been experimentally observed - in soemthing called the Casimir Effect. However, before various people start whooping with delight over this, the facts surrounding this are a little more prosaic: it simply describes the conditions that occur between two uncharged metal plates as the separation between the plates decreases (and, to be more pedantic still, the quantity being measured was the energy density, which is a statistical measure of the amount of energy present within a specific volume of space).

"Negative energy" is therefore a highly respectable term in quantum physics,and occurs in various experiments in the discipline of quantum optics, for example. However, as a Scientific American article in January 2000 stated, the idea that we will be able to manipulate arbitrarily large magnitudes of negative energy is a complete non-starter, as this would seriously violate the Laws of Thermodynamics.

Now, not having toured this blog extensively, I do not know for certain as I'm writing this if Orac is a Star Trek fan, but if so, the Scientific American article cited above will prove highly amusing reading to anyone who is [1] a Star Trek fan, and [2] reasonably scientifically educated. I have more gems in this vein for Orac to dwell upon, but I'll save those for another time.

As for Ms Minogue, well, if having some weird individual running his hands all over her body gives her some pleasureable feelings, so be it, but I cannot help but muse that if I were to try and run my hands over Ms Minogue's body in a similar fashion, my reward would not be in the form of payment, but a prison sentence. :)

 

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