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This place matters

Monday, June 20, 2016

Do not go gentle

Last week, Salon.com featured an interview with Chuck Klosterman, author of the book But What If We're Wrong. One of the things we're probably wrong about, he says, is chemotherapy: 
I would not be surprised if chemotherapy will seem like bleeding people with leeches. It will seem crazy that we poisoned people to make them better... We were just pumping poison into people because we had no other guess.
Lots of people share his opinion of chemo, and it's understandable. Chemotherapy is absolutely horrible. It is most definitely poison. However, unlike leaches, chemotherapy does actually do good, and it's way better than a guess.
It's that scotch tape on her face
that really gives it credibility
I know a lot of people who believe I'm dead wrong - a lot of really intelligent folks I know think that treatments like chemotherapy are part of a conspiracy to keep cancer patients sick so that big pharma can make more money from them. As conspiracy theories go, this one's particularly cogent. Pharmaceutical companies are pretty evil, and cancer treatment does make a lot of money for certain interests. But let's look at the facts.
First, let's talk a bit about cancer. Cancer is defined as a group of diseases characterized by abnormal cell growth. The fact that cancer is a group of diseases rather than one disease is significant. Some cancers involve tumors, some don't. Some are caused by environmental factors, some aren't. Some respond well to chemotherapy, radiation, or surgery, while others don't. People often talk about a cure for cancer that science already secretly knows about; that betrays a fundamental misunderstanding of cancer - there will never be one cure for all cancers. What makes treating all the various types of cancers especially tricky is that the patient's own body is creating the cancer cells, so killing the cancer without harming the healthy cells around it has proved incredibly difficult.
Even so, it seems possible that the industry is sitting on treatments that are more effective, but less profitable. However, if you look critically at the facts, you'll find that if doctors and researchers are trying to profit from our illness are doing a really bad job of it.
For one thing, they're constantly shoving the best weapons against cancer in our hands for free. If you're looking to get cancer, smoking's about the best way to do it. So why are doctors and other medical professionals constantly harping on you about smoking? Why does Big Pharma keep making new smoking cessation drugs when a full 22% of cancer cases can be linked to smoking? 
For that matter, why does my doctor remind me of my obesity every time I see him, as if I don't have mirrors at home to do the job? It's because another 10% of cancers are caused by obesity, inactivity, drinking, and other enjoyable pursuits. Why would doctors nag their patients about that stuff so much, if they just wanted them to get sick anyway?
When it comes to cancer prevention, some supposed members of the cancer conspiracy are putting a lot of effort into sabotaging themselves. The Cleveland Clinic, for example. Some years ago, they lost a lot of money breaking their contract with the McDonald's then set up in their food court. Now the cafeteria sells food that's a lot less profitable and a lot less likely to cause cancer and other deadly health problems. They replaced all the tasty foods in their vending machines with twigs and leaves, and they now randomly drug test their employees for tobacco. Now, I personally find these measures creepily invasive and paternalistic, but it seems weird that one of the fanciest hospital systems in the country would spend so much money trying to get people to adopt lifestyles that will keep them from getting cancer if what they really wanted was for people to get more cancer. 
But setting aside prevention, doctors also recommend less profitable cancer interventions all the time. Like leaving the cancer where it is. For instance, if a dude lives long enough, he will get prostate cancer - I think I read somewhere that like 80% of guys over 80 have it. But not all kinds of prostate cancer are fast-growing enough to ever be a problem, so doctors very commonly just leave the cancer alone. Doctors could easily get together and decide to always prescribe some kind of angiogenesis inhibitor for guys with prostate cancer, and they'd be able to boast that 98.9% of people who take angiogenesis inhibitors for prostate cancer live at least five years after their diagnosis. They wouldn't have to tell us that the number is true whether the drugs are used or not. Search for "prognosis for prostate cancer" on Google and you'll find that the American Cancer Society, Web MD, the Mayo Clinic, the UK's NIH, and Cancer.Gov all agree that 99% of all people diagnosed with prostate cancer won't die of it. If there were some conspiracy to give us all cancer drugs we don't need, wouldn't that number be way lower?
It certainly seems like the progress in cancer treatment is glacial, but the fact is that in 1990, only half of cancer patients lived five years after their diagnosis. Now two thirds do, thanks to conventional medicine. We know more about cancer than ever before, and personalized cancer treatment that attacks cancer on a cellular level is showing huge promise. We have made good progress and, may well be right on the cusp of a great leap forward.
Look - I can't even imagine how horrible chemo is, and I've got a pretty active imagination. The side effects are ungodly. The treatment is well and truly poisonous. And I believe people do have the right not to choose that route. But they also have the right to know that doing so comes with a vastly increased risk of death. When people post about the evils of traditional cancer treatment, mindlessly re-posting links and memes and articles on social media without even bothering to fact check, they're perpetuating a deadly lie. If a person wants to ignore the study after study demonstrates that people who choose alternative medicine over chemotherapy are far more likely to die, that's their business. What they don't have the right to do is regurgitate  pseudo-science encouraging others to risk their own lives. It's shameful and inexcusable.
And that's actually my whole problem with alternative medicine in a nutshell. The pseudo-science of it, and the simultaneous vilification of science based medicine. If a suffering person gets relief from unscientific remedies like reiki or vitamins or crystals, then screw the science and embrace the crystals. But don't claim there's science when there's not. It's perfectly accurate and acceptable to say "this vitamin makes some people feel better and it may make you feel better, but science doesn't know why." It's not acceptable to say "you should stop using that scientifically proven remedy and use this vitamin instead because all scientific studies are lies," because people have the right to make their own informed decision about their care.    
Stay tuned for the truth about the truth about cancer.

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