David Servan-Schreiber, MD, PhD's Excellent New Book Panned By the New York Times for Citing “Anecdotal” Evidence

When I began reading Dr. Abigail Zuger’s New York Times review of Dr. David Servan-Schreiber’s latest book, Anti-Cancer: A New Way of Life,  I was at first amused when she compared it to “the finest in nighttime infomercials” that hawk (I’m really quoting her here!) kitchen gadgets and acne preparations. But my amusement soon wore off.

I was familiar with Dr. Zuger’s writings, and with Dr. Servan-Schreiber’s, so I immediately knew where she was going with this. This was, to quote Margo Channing ("All About Eve"), “going to be a bumpy ride.” If a bumpy ride was what I really wanted, I was not to be disappointed by Dr. Zuger’s stinging assessment of this very important book. But, truthfully, I would have preferred a fair and balanced review.

You see, Dr. Zuger has a well-documented bias against all treatments that don't have randomized double-blind clinical trials to back them up. In other words, all “anecdotal” treatments are, to her way of thinking, suspect. She publicly chided her own mother in the New York Times in February 2006 (“Impressive Science Meets Unimpressed Patient (Hi, Mom!)”) for not believing wholeheartedly in medical studies. And in her December 25, 2007 review of R. Barker Bausell’s book, Snake Oil Science: The Truth About Complementary and Alternative Medicine, she confidently proclaimed that those who use alternative treatments “share a single mantra: ‘I don’t care what the studies say; it works for me.’” And then she went on to say (incorrectly, I might add): “The studies — at least the good ones — say that none of these treatments work the miracles often claimed for them.” She called this book –- probably because she agrees with Bausell’s very dismissive point of view -- a “tour de force.”

So, I was not surprised that Dr. Zuger would be inclined to criticize Dr. Servan-Schreiber’s approach to treating cancer, which includes a blend of conventional and alternative treatments, including diet. Nor was I surprised that she would be suspicious of the validity of the studies he quotes in the book. (Though not double-blind randomized clinical trials, all were performed by extremely reputable researchers at respectable institutions.) But I had hoped that she would at least be open to the very measured and convincing way he presented his ideas. She wasn’t.

I find it especially surprising that Dr. Zuger wasn’t at all impressed by the fact that Dr. Servan-Schreiber is a respected medical researcher and writer. Both an MD and a PhD, as well as a clinical professor of psychiatry at the University of Pittsburgh School of Medicine, he has authored several books, including The Instinct to Heal: Curing Depression, Anxiety and Stress Without Drugs and Without Talk Therapy, and is also a regular contributor to Ode Magazine. But perhaps even more relevant here, Dr. Servan-Schreiber is also long-term brain tumor survivor -– approximately 14 years out, by my calculation -- who followed the standard route (surgery, chemo and radiation), only to have his cancer return. It was at this point that he began to study and use an integrative approach. And he credits his long-term survival in good part to the dietary changes he describes in his book.

Nor does Dr. Zuger seem to notice that, even after enduring surgeries, radiation and chemotherapy, Dr. Servan-Schreiber’s mind is still obviously sharp as a tack. That, I can tell you from personal experience (my husband was a 15-year brain tumor survivor), is a mighty achievement. (Of course, Dr. Zuger would probably consider my personal assessment to be inconsequential –- even “anecdotal” -- as well.)

Saying that Dr. Servan-Schreiber is “like all the best pitchmen,” who “offers his own story of redemption as testament (he once was lost but now is found, was blind but now he sees),” she goes on to insult him further, asserting that:

For each of the foods on his anticancer shopping list there is a shred of scientific evidence — usually from experiments done on cells in culture, sometimes from studies of mice with cancer, and occasionally from small studies on actual human beings. For none is there the kind of data that would support, say, the licensing of a new drug.

Oh, dear. It’s obvious that Dr. Zuger hasn’t been paying attention to the many books, and articles in the press, touting the value of certain anti-cancer foods, such as garlic, onions, cabbage, broccoli, green tea, raspberries and blueberries, to name just a few. These and others are the same foods the Dr. Servan-Schreiber recommends in his book. (Among the many books on the topic of using food to fight cancer are:  Patrick Quillen’s Beating Cancer with Nutrition, Dr. Bob Arnot’s The Breast Cancer Prevention Diet: The Powerful Foods, Supplements, and Drugs That Can Save Your Life, and Richard Beliveau’s  Foods to Fight Cancer: Essential Foods to Help Prevent Cancer -- to name a very few.

Nor does Dr. Zuger seem to be aware of the widely publicized deceptive practices that are often used by Big Pharma to obtain and promote the so-called “data” that is so often used to “support” the licensing of a new drug. She has probably not read even a few of the thirty-seven articles I cited in my posting, “Financial Ties Between Big Pharma and the Medical Establishment: 37 Selected Articles Published Between 2005 and 2008,” all of which which described Big Pharma’s various methods of fooling both doctors and the public. Many of these articles are from her own New York Times.

As I described in my posting, Big Pharma’s deceptive practices include:

• “Rigging” the so-called studies, which they themselves fund

• Hiding the results of the studies that actually prove their products don’t work, while – at the same time

• Heavily publicizing the studies that demonstrate their products’ successes

• Hiring the researchers to conduct the studies, making it very clear to them exactly what kinds of results they are expecting the studies to show

• Hiring writers to write the articles that appear in the medical journals the doctors read, and also

• Hiring big name doctors to affix their names to these studies, while doing very little, if any, of the writing.

But Dr. Zuger doesn't seem to be aware of the downside of medical “testing.” Just as relevant, she seems to be oblivious to the real facts about the medical testing of natural substances –- including the reasons why there are so few reliable studies.  As Dr. Servan-Schreiber points out in AntiCancer:  “it is not financially feasible to invest such sums in demonstrating the usefulness of broccoli, raspberries, or green tea, because they can’t be patented and their sale will never cover the cost of the original investment.”

But to insinuate that Dr. Servan-Schreiber doesn't cite reputable studies in AntiCancer is blatantly unfair, and insulting.  Even though, for the above reason, the studies he cites are not randomized, double-blind studies, they certainly are credible studies, performed by reputable researchers. Three examples:

(a) to back up his assertion that cancer cells feed on sugar, Dr. Servan-Schreiber points to a joint American-Canadian study carried out by Harvard researcher, Susan Hankinson, ScD. (p. 63)

(b) a study conducted at the Karolinska Institute of Stockholm backs up his assertion that green tea has anti-cancer properties with (p. 97)

(c) he cites the work of M.D. Anderson researcher, Professor Bharat Aggarwal, PhD, on the anti-cancer properties of curcumin (pp. 104-105). I would hardly agree that these studies contain only “a shred” of evidence.

Dr. Servan-Schreiber's statement that, although he would like to see public institutions and foundations finance human studies on the anticancer benefits of food, “still I am convinced there is no need to wait for such large-scale results before beginning to include anticancer food in one’s diet,” seems very sound to me (p. 115), as it most probably would to a large segment of the population.  After all, is eating a healthy diet really so controversial? Apparently so, according to Dr. Zuger.

I am reminded of a wonderful quote attributed to Dr. Servan-Schreiber, in an article about him, “Our natural instinct to heal” in the July/August 2006 issue of Ode Magazine:

You have to have a medical degree to be brainwashed enough to believe that food does not have a major impact on physical and emotional health. For most people, its importance goes completely without saying. Nonetheless, during my studies I only spent four days learning about nutrition: We learned that eating too much makes you fat, that too much salt gives you high blood pressure, that you should eat less sugar if you have diabetes and that if you have high cholesterol you need to cut down on fat. This is where the teachings on nutrition ended, despite the fact that the World Health Organization (WHO) now states that the No. 1 cause of death worldwide is chronic illness. And what is the main reason behind chronic illness? Poor nutrition.

Perhaps Dr. Zuger should heed these words, before she reviews any other books on subjects relating to “alternative” medicine or nutrition -- two areas she so obviously knows very little about.

I strongly recommend Dr. Servan-Schreiber’s book for anyone who has cancer now, has a friend or relative with cancer, or who might get cancer in his or her lifetime. In other words, I highly recommend this book to everyone who cares about health!

This time, the New York Times failed to publish "all the news that's fit to print."

Comments

[Lisa]

I've discovered a group that believes nutritional supplements can aid those fighting cancers. Check out the website: www.preferredmedicalsupplements.com

[Gregory D. Pawelski]

Evidence-based medicine is based on data from medical journal articles, epidemiology and economics, which relies on randomized clinical trials, which doesn't even require a medical education. Nonphysicians trained in social science, science or even public policy analysis, have judgement over medicine.

Where doctors defined the "standard of care," now payers and purchasers of medical services redefine the standards for appropriate medical care, encouraging doctors to act in ways to promote their financial interest when they make medical decisions. Evidence-based medicine has morphed into pharma-based medicine and HMO-based medicine.

The use of clinical trials to establish prescribing guidelines for evidence-based medicine is highly criticized because such trials have little relevance for the individual patient in the real world, the individuality and uniqueness of each patient.

The specialty medical societies protect the status of treatments which are only marginally and minimally and inconsistently effective. This prevents serendipitous and fortuitous discovery. I feel that truly effective treatments or tests don't need prospective randomized trials.

Large academic cancer institutions that are soulfully involved in clinical trials feel a subtle pull towards getting patients involved in those trials. Some researchers discourage patient empowerment so they can call the shots through these trials. They've even broaden their appeal by encompassing community hospital oncology practices.

Evidence-based medicine is a trial-and-error process of a clinical trial to see what might "appear" to be improving cancer survival. It is the mindset of rewarding academic achievement and publication over all else. There is this aurora that organizations, government agencies, scientists, researcher and even practitioners work together, sharing information for the benefit of patients.

Each group has its own priorities and its own agenda. Moreover, the image of cooperation between these different groups only gives the illusion that reform isn't needed. The present system exists to serve academic achievement and publication, but not to serve the best interests of people.

The demise of the "discoverer" type with its not so well organized risk-taking, in favor of the "investigator" culture, well organized, exhaustive analysis of trivial hypotheses, is a perfect example of thirty years of the "trial and error" mind-set that has occupied cancer research.

A dysfunctional culture that pushes tens of thousands of physicians and scientists toward the goal of finding the tiniest improvements in treatment rather than genuine breakthroughs, that rewards academic achievement and publication even though their proven activity has little to do with "curing" cancer.

I have questioned guideline messages on the basis of profit conflicts. The joint Michigan/Harvard study confirmed how medical oncologists chose cancer chemotherapy based on how much money the chemotherapy earns the medical oncologist.

This study added to the "smoking gun" survey "Patterns of Care" by Dr. Neil Love. While the Michigan/Harvard study showed results before the new Medicare reform, the Patterns of Care study showed results that the Medicare reforms are still not working.

The same can be said for whole brain radiation vs stereotatic (focalized) therapy. Looking at the number of palliative fractions of radiation given to patients with advanced lung cancer is a situation in which there is a lot of discretion on the part of the physicians: one fraction is as good as 10, but 10 will reimburse more.

There is an inherent conflict of interest when organizations that provide guidelines for treating a disease also receive funding from corporations that benefit financially from the recommended treatment. There is no proof beyond reasonable doubt for any approach to treating advanced cancer today. There is only the bias of clinical investigators as a group and as individuals.

[Hanne Roschke/Denmark]

I've just read 'Bad Science' by Dr. Ben Goldacre.
Fascinating tour of the trial practices of both alternative medicine and pharmaceutical companies. It also teaches us - as patients - how to see through the bogus trials/research.
Readable, amusing and scary.
Read more about him at: http://www.badscience.net/about-dr-ben-goldacre/

[Patricia Hendrick]

I have been translating for a Ukranian doctor a few times a year and I'm facinated by his work and would love to talk to David Servan-Schreiber about his work. I'm reading Anti cancer at the moment and there are a few other things that I would like to share with him

[L. Schwartz]

I just read the article in the AARP magazine about Dr.Schreiber and was greatful for his recognizing that what we put into our bodies plays a huge part of battling cancer, but beyond that, to build up our immune systems.
About a year ago, we came across some great information concerning glycobiology and glyconutrients and how that plays a huge part in the body and the cells communicating properly for optimal health.
Just one thing about trying to eat properly. It is almost impossible to get the proper nutrition simply through foods in our world today. According to the 1992 Earth Summit, the USA has thw worst soil in the world--85% depleted. This means the potency of our food supple is not able to sustain optimum health. the amount of toxins in our environment has reached a level where the FDA now has designated 'permissible levels of dioxin and other harmful chemicals in the environment. Today we have over 300 chemical toxins including dioxin in the tissues that were not found in any human befor 1940.
There are many other factors leading to poor health in our nation. But the discovery of Glyobiology has been a major breakthrough of how our cells communicate, that cells have a language, made up of 'letters' and 'words'. the 'words' are called glycoproteins mad up ov various sugar molecules know as saccharides attached in pearl like strands to protein stems. These words extend off the surface of every cell and can change th ousands of times in a second. Disease and dysfunction occurs when the components necessary for cell-to-cell communication are absent.

Dr. John Axford, MD, leading expert in theis field of glycobiology and President of Clinical Immunilogy, Toyal Academy of Medicine, stated at a health conference recenlty, 'Sugars are going to be the molecules of the next decade. Glycobiology is one of the last fronties of science to be conquered and it's going to be at the cutting edge of a large number of discoveries and therapies over the next decade.

There's a lot of research on the glyconutrients. We, ourselves have been taking them for over a year now, and the results are extremely positive.

Just wanted to share this.
Thank you.

[Nicholas Ilijic]

Having had my 3 brain operation in 13 years, I suffered from blood clots this last time.

The Cumidin I take to stop the clots is effected by most green veg plus others colours and green tea ginseng, wine, beer... it's a long list stopping me from your cancer diet.

As brain tumors get larger cloting is a common problem.

[Mae Benson]

Dr. Arthur Furst from Stanford University was a developer of oral chemotherapy -- he later went to work for GNLD International, his research with whole food nutrients such as carotenoid complex boosted the immune system 37% in just 20 days -- (New York Academy of Sciences) for more information www.gnld.com

[Panic Away]

Thanks alot for the information. Really appreciate it. I've Subscribed to your RSS feed for Further updated. Ive read this book, thanks for the review.

Best Regards,
Debra@Panic Away