HONEST MEDICINE: My Dream for the Future

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.

National Breast Cancer Awareness Month -- Honest Medicine's Julia Schopick Responds to Sen. Joe Biden

As most of you know -- how can you miss it? -- October is National Breast Cancer Awareness Month. With it come lots of pink ribbons and pink products, and lots of publicity advocating early detection through mammograms.

Sen. Joe Biden is a staunch supporter of early detection. On his blog there is a video where he eloquently expresses his longstanding support of the cause. He calls this video "Sen. Joe Biden's Strategy for Combatting Breast Cancer." I hope you will watch it.

As you might suspect, I have a different view of this topic than the one Sen. Biden espouses. I expressed my views in a comment following the video on his blog.

As you probably know (if you have left comments on other people's blogs), it is very difficult -- usually, impossible -- to include hyperlinks in these comments. I am reprinting my response to Sen. Biden here, as an HonestMedicine.com posting, in order to include the hyperlinks to all of the many resources and references that I cited in my comment.

I hope that visitors to my site who read this posting/comment will want to visit some of the websites I link to; I also hope you will want to read the articles and books I link to.

Dear Sen. Biden:

I admire (and am grateful for) your dedication to helping to eradicate breast cancer. It is an awful disease, which has touched the lives of many women I am close to. I hope you will read my comment (I guess it is really more like a letter -- even a tome!), and that some of the things I say will resonate with you, and that you will help to disseminate at least part of my message where it will make a difference.

As you know, every October, for National Breast Cancer Awareness Month, there’s a huge, multi-organization publicity campaign encouraging women to either buy “pink products” or to get mammograms -- or both. So, for one month out of every year, women and men alike work hard to do our parts to eradicate breast cancer.

At least, that’s what we think we are doing. It’s what we WANT to be doing.

But, most people aren’t really fully aware of the POLITICS that surround the entire “Cancer Industry.” (This phrase was coined by Ralph Moss, PhD, with his book of the same name.) This, and many other books, give lots of examples that demonstrate that the cancer industry has political and financial ties with pharmaceutical and chemical companies -- the very companies that benefit most from the chemotherapy that is given to treat cancer. (Pharmaceutical companies benefit because they provide the cancer treatments. Chemical companies benefit because they may actually be causing the cancers, as several books point out -- including Samuel Epstein, MD’s “The Politics of Cancer" (1978, 1998); and two books published in 2007: “Cancer: 101 Solutions to a Preventable Epidemic,” by Liz Armstrong, Guy Dauncey, and Anne Wordsworth; and “The Secret History of the War on Cancer,” by Dr. Devra Lee Davis.)

The Breast Cancer Industry is fraught with such ties. For instance, did you know that the American Cancer Society receives many donations from big pharmaceutical companies -- for instance, AstraZeneca’s $10 million donation, earlier this year? (Both Arimidex and Tamoxifen were developed by -- and are distributed by -- AstraZeneca!)

There are also political connections. For instance, when you buy pink products, with part of the money going to the Susan G. Koman Foundation, are you aware that Nancy Brinker, the founder of the organization, has heavy ties to the Republican party, and was named by George W. Bush to a US Ambassadorship? (She was also on governmental panels during the three most recent Republican presidents. Of course, these facts may not bother everyone -- but they may bother some of us.)

Numerous articles have been written about the politics and financial ties surrounding many National Breast Cancer Awareness Month activities. Several articles have been collected and posted on the thinkbeforeyoupink.org website. (Think Before You Pink is a project of “Breast Cancer Action,” an organization that advocates concentrating our research dollars on prevention, rather than treatment, and states in its annual report that it does not accept any funds from “pharmaceutical, biotechnology, or chemical companies, or any other entities that profit from or contribute to the breast cancer epidemic.”) Another organization with a similar agenda is the National Breast Cancer Coalition.

There are also lots of articles about the Cancer Industry on my website, www.HonestMedicine.com.

These are the on-the-surface financial concerns -- the fact that these organizations have financial ties to the very entities that benefit from their work.

But more recently, another concern has been raised -- a concern that is NOT at all being addressed by these organizations:

IS EARLY DETECTION WITH MAMMOGRAMS REALLY THE BEST WAY TO SAVE LIVES?

Several recent articles say that no, early detection with mammograms is NOT the best approach to treating breast cancer.

One of the most vocal, and highest profile, journalists to write about this is Shannon Brownlee, author of the recent excellent, and controversial, book, “Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer.” Her point is that Americans are being over-scanned, over-surgeried, and just plain over-treated, by our medical system, and that, in many cases, this over-treatment results in worse outcomes. This, and a book called “Money Driven Medicine: The Real Reason Health Care Costs So Much,” by Maggie Mahar, are two very important books; I hope you will read both.

But, Ms. Brownlee addressed the mammogram issue YEARS BEFORE the publication of her book, in a 2002 “New Republic” cover story, “Search and Destroy: Why Mammograms Are Not the Answer.” Her main point in this excellent article -- and she uses numerous credible resources to back up her position  -- is that mammograms, in addition to being moneymakers for the institutions that provide them, are the first step toward a huge cash cow these hospitals will enjoy when their mammograms discover breast cancers: chemotherapy, radiation, surgery, etc.

But, as if this weren’t bad enough, it turns out that mammograms may be detecting more of the tiny (and less virulent) cancers, which might never have bothered women had they not been detected so early, and fewer of the aggressive cancers that kill. In other words, in some cases, mammograms may actually be doing more harm than good, by subjecting some women with potentially harmless tumors to potentially harmful treatments -- surgery, chemotherapy and radiation.

But the best part about Shannon Brownlee is that she doesn't just criticize. She has a solution, too, which is to concentrate our research dollars on finding ways to tell whether a cancer is -- or isn’t -- the kind that will eventually kill a woman later on, so that doctors will not operate on all women with the tiniest (and least cancerous) of growths, telling them, “Boy, are you lucky we caught this so early!” (Well, maybe yes, and maybe no.)

So, maybe it’s time that the “think pink” companies and organizations look to avenues other than recommending that women buy products and get mammograms.

I realize that I have included many resources in this comment. I plan to put links to each and every one on my website.

Thank you so much for listening.
Julia Schopick
www.HonestMedicine.com