Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
The time when I lose patience with quacks is when they make unjustified claims about serious diseases. Giving false hope to the desperate (often at a high price) is plain wicked. If the patient stops more effective treatment, it’s homicide. Homeopaths have been jailed for that. Sometimes it’s a result of wishful thinking. Sometimes it’s to make money. The latter is morally more despicable. Both are culpable.
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One example was the Totnes (aka Narnia) to “offer real alternatives to the conventional approach to cancer health care“. Another case, the Dove Clinic, was investigated in the Sunday Times, by Jon Ungoed-Thomas and Justin Stoneman: Clinics mislead patients over cancer ‘cure‘. |
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There is yet another cancer conference, Back2Health, coming up in April (remember that "integrative", in this context, is a euphemism for quackery).
The speakers are listed on the left, as they were when I first noticed the conference in December 2012. On the right are the speakers as of February 2013,
Spot the difference
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18 December 2012
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28 February 2013
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Yes, the one respectable oncologist on the programme, Robert Thomas, has withdrawn from the meeting.
I came across Robert Thomas because it was pointed out to me that he spoke at a meeting of YesToLife, an organisation that advocates all sorts of treatments that are unsupported by evidence. That seemed like an odd thing for a respectable oncologist to be doing, so I wrote to him, to point out some of the bizarre beliefs of his fellow speakers. Most are familiar names in made-up medicine, but probably not widely known among real oncologists.
Professor Thomas seemed unaware of this because he told me
"Thank you for your email and pointing out the vitamin C issues which of course, as you say has no scientific basis and should be outlawed along with many other practices."
Nevertheless he thought it was too late to pull out of the YesToLife meeting, so went ahead.
After this Robert Thomas wrote to me again (18 December 2012) to ask for advice about another conference he’d been invited to speak at, the Back2health event. Again he seemed unaware of the reputations of his fellow speakers, just about all of whom have a track record of advocating treatments for which there is no good evidence. Many of them are purveyors of false hope, often at a high price. I’ll deal with only three of them.
Dr Rosy Daniel is there. She’s featured several times on this blog. I met her, with Karol Sikora,here. Her course in quackery was ditched by the University of Buckingham after a year..
Chris Woollams of CancerActive is also there. As readers of this blog will know, I accept he is an honest man and I do feel a great deal of sympathy for him having lost his daughter. This doesn’t mean I am any closer to accepting his views on cancer treatment.
Next to Thomas’s picture is Barbara Wren. She was secretly filmed by the BBC claiming "to have cured thyroid cancer by applying external compresses, half an hour with castor oil and half an hour with your own urine". You can’t get much barmier than that.
Then there is a nurse, Patricia Peat, who runs a private "integrative" cancer consultancy, Cancer Options. She’s a prominent supporter of YesToLife which, since at least February 8th 2013, has been promoting a video, "Cancer is Curable Now", which makes totally irresponsible claims (and is illegal in the UK under the Cancer Act, 1939). Among other baseless treatments she has advocated high dose Vitamin C.
“The first of these people is the proprietor of Cancer Options. Cancer Options is a private consultancy offering advice to cancer patients. It is run by Patricia Peat who is a qualified nurse. My dad went to see her and she told him the good news, if he followed her advice he could be tumour free in 3 to 4 years. She advised him to have intravenous vitamin C, to have oxygen therapy, heat therapy and to take a myriad of supplements.”
I have heard that the cost of these useless recommendations over a three months would have been £4,640, plus the considerable cost of moving to Brighton, to the Vision of Hope hospital. That includes, for example, a telephone consultation (£175), supplement pills (£400) and intravenous vitamin C (£3000). There is no good evidence that any of these would help the patient. Not only would this have destituted his family and taken the patient away from them: it would also have made his last days an unnecessary misery. For Christmas he would have been condemned to a vegan diet, no wheat, sugar or alcohol, and to live on five glasses of raw juice and two jars of sprouts a day (see "Would you kick a dying man" for a real life experience).
Patricia Peat appears prominently on another web site too, Self Help Cancer. There she’s partnered by Dr Chris Etheridge (an ex biochemist, turned herbalist, with no medical qualifications). On that site you’ll find every kind of barminess endorsed. It even takes seriously the notorious Burzynski clinic about which so much has been written, both here and in the USA.
Recommending a bit of foot massage or reiki as a way to relax distraught patients is harmless enough if you like that sort of thing. Recommending you to ignore real doctors is quite another. Patricia Peat is on record as saying (my emphasis).
"Also detoxification is as important as what goes in – the rapid removal of toxins from the body would be massively beneficial in reducing the side effects. If someone is on chemotherapy, its very important to get any herbal preparations checked out by a qualified practitioner, to make sure there are no interactions, with the chemotherapy. A lot of nutritional and herbal supplements are very strong, and it is dangerous to suppose that because they are natural, they can do no harm. Probably the worst person to ask about this is your oncologist "
There is, of course, no reason to think that "detoxification" is anything other than a figment of the imagination. There is no reason to think that (never-named) toxins are important, and no reason to think that the procedures get rid of anything.
If you want sound advice about diet, go to somewhere like the American Cancer Society. There you will find that most of the things that quack nutritionists love to sell you just don’t work. The ACS asks "Will a vitamin a day keep cancer away?". Their answer is
"Can popping vitamin pills prevent cancer? The simple answer is no, based on what we know so far. In fact, some vitamin supplements have even shown harm."
The journalist, John Diamond, described movingly the way that the alternative industry moved in on him when it became known that he had cancer. His book, Snake Oil and Other Preoccupations was never finished before he died. These extracts from the foreword to the book, by Richard Dawkins, sum it up.
"When the pathologist has read the runes; when the oracles of X-ray, CT scan and biopsy have spoken and hope is guttering low; when the surgeon enters the room accompanied by ‘a tallish man … looking embarrassed … in hood and gown with a scythe over his shoulder’, it is then that the ‘alternative’ or ‘complementary’ vultures start circling. This is their moment. This is where they come into their own, for there’s money in hope: the more desperate the hope, the richer the pickings. And. to be fair, many pushers of dishonest remedies are motivated by an honest desire to help. Their persistent importunings of the gravely ill, their intrusively urgent offers of pills and potions, have a sincerity that rises above the financial greed of the quacks they promote. "
"They are targets that deserve to be hit hard, targets whose neutralisation would leave the world a better place: cynical charlatans (or honest foolish dreamers) who prey on gullible unfortunates. And the best part is that although this gallant man is dead, his guns are not silenced"
Shortly before he died, John Diamond said something that I think is one of the most perceptive comments that I’ve ever read. Some of the blame for the rise of the profitable alternative industry lies with the hype of real medicine. It’s worth quoting at length.
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"But we expected more. Hell, we’d been promised more. Just as we’d learned, rightly, to expect that the political system could be arranged to provide a roof over the head and food in the stomach of all of us, so, we believed, could the medical system be arranged to give us all health and happiness. It was our right, dammit. And the medical establishment, flattered by all those pieces in the popular press describing the latest miracle cure which was just about —always just about — to arrive at the local surgery, joined in with the celebrations and connived with the scam. Indeed, if the boom in alternative medicine is anybody’s fault it’s that of orthodox medicine. It was the orthodoxy -helped by the media and our own vanity – which allowed us to believe that we could all be healthy and happy, that there was a pill for every problem and that if we died too early or too painfully it was an act of some agency other than capricious old God. The orthodoxy allowed us to expect And the elsewhere we looked to was the alternative practitioners. They were only too willing to take our custom . . ." |
I have no way of knowing whether the people at this conference are "cynical charlatans" or "honest foolish dreamers". I impute no motives. But I can say that their treatments are very expensive and for the most part they don’t work.
There is an interesting question about the extent to which charities like YesToLife function as charities, and the extent to which they act as agencies that channel desperate patients into the hands of private hucksters. I don’t pretend to know tha answer. I’d like to.
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“It is difficult to get a man to understand something, when his salary depends upon his not understanding it.” |
Follow-up
1 April 2013. The Times contacted me shortly after this came out, about some of the (illegal) nonsense to be found on sale at Amazon. One of their journalists, Kat Lay, did a good write-up, and they contacted the MHRA and stirred it into action. [download pdf].
5 April 2013. I quoted some of Patricia Peat’s views on diet from a page on Woollams’ blog. I notice that the copyright conditions on that page changed
" This content may be copied, in full or in part", has been changed to " No content may be reproduced, in whole or in part".
It’s curious that there should be an attempt to ban the reproduction of content, of which he authors are presumably proud, and which appears on a public web site. Of course it is also baseless in law, because copyright law has always allowed reproduction of parts of any document for the purposes of fair comment or in the public interest.
20 May 2012
In the USA, the first amendment allows the most outrageous claims to be made. But when they do decide the law has been broken, they do something about it. Their law enforcement is not as pathetically impotent as in the UK.
A Dr Christine Donald treated patients with cancer with an expensive herbal concoction, from her Wellness Clinic in San Fernando Valley. She promised 60 – 80% success rate. she was trusted because she was also a Pentecostal minister.
She was convicted of four counts of mail and wire fraud, six counts of tax evasion and one count of witness tampering she was found guilty of in September 2011
She was sentenced to 14 years in jail and a fine of $1.2 million.
One wonders why that never happens in the UK
26 May 2013 I noticed another incredible assertion by Patricia Peat.
“One could be forgiven for thinking how does anyone manage to die from cancer when the answers to curing it are actually so simplistic and one dimensional.”
So that’s solved, then.
10 June 2013.
I have just come across a good source of information about all sorts of alternative cancer treatments. "CAM-Cancer" was originally funded by the European Commission (EC) within the Framework 5 Programme, it is now hosted by the National Information Center for Complementary and Alternative Medicine (NIFAB) at the University of Tromsø, Norway.
16 Responses to The exploitation of cancer patients is wicked. Carrot juice for lunch, then die destitute
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“If the patient stops more effective treatment, it’s homicide.”
No, it’s not homicide. If someone tells you that (in Britain) that it’s perfectly fine for you to drive on the right-hand side of the road,and that, despite the evidence of your eyes, that you do that and die in a head-on collision, then it’s not murder, it’s your own silly fault.
Individuals have a responsibility to look out for themselves, and ultimately, to make decisions for themselves, however stupid. As you rightly say, with your last quotation from John Diamond, the real fault lies in the “nanny-state” idea that some greater authority, some Big-Daddy has the capacity to make all your troubles go away: all you have to do is to hand, with total trust, your power over to them.
@Avoided Cranium
Whether it is homicide or not is a matter for the courts. In Australia, two homeopaths were convicted of manslaughter and jailed, after their own baby died because of their insistence on homeopathic treatment (i.e. no treatment). I suspect that this should happen more often.
I don’t think that John Diamond was saying what you suggest. It seems perfectly reasonable to have laws to prevent deceptive advertising. It’s hard to believe that big companies genuinely believe that sugar pills can prevent malaria or meningitis but they sell them anyway. I don’t imagine that you think that laws against theft and murder are signs of a nanny state. Do you really think that the Cancer Act (1939) is unreasonable or nannying?
*If parents refuse to seek medical treatment for their child’s life-threatening illness, then it could be considered manslaughter.
The point in law – what makes it manslaughter – is that they are legally responsible for someone in their care, not that they practised homeopathy. Their underlying belief in homeopathy, or Jehovah or woo is irrelevant.
Surely a sane adult person is perfectly free to refuse life-saving medical treatment for themselves if they wish?
I would agree with you about fraudulent advertising. But then again, ultimately people are responsible for making their own decisions. As with all things on sale, the watchwords are Caveat Emptor.
Regarding the 1939 Cancer Act – it makes no assumptions about the nature of the treatment. I’ve never understood why it singles out cancer, but has no mention of all the other terminal diseases.
*@Avoided Cranium
While it is true that patients are perfectly within their rights to refuse treatment and not be viewed as lacking capacity to make decisions regarding their care even if their decisions appear irrational, I think there is still a moral problem here. Purveyors of alternative treatments for which there is no evidence prey on sick and often desperate and vulnerable people.
Whilst convincing someone to stop evidence based treatment in favour of alternatives, especially expensive alternatives lacking evidentiary support may not be homicide. It is morally reprehensible.
I think the only way to prevent vulnerable people from such “charities” is probably to attack their claims on the basis of false advertising. Surely, if this can be done for mascara, then it can be done for alternative medicine.
The case of the young child and homeopathy in Australia was slightly different as you correctly note. Here, the issue was that the parents were considered to have a duty to put the best interests of the child first. Since in UK law adults with capacity are considered to be the authority on what constitutes their best interests, the case does not serve as a very good comparison.
Comments by Guy Chapman and Josephine Jones have been removed, because of legal threats from Chris Woollams and Patricia Peat.
[…] by me and Josephine Jones have been removed from David Colquhoun’s blog after more legal posturing by Chris […]
Legal threats to you? Because of the comments themselves? Or, as they’re not your comments, is it because you host the blog wherein those comments were made? Specifically who was being threatened with libel here?
@Lee Turnpenny
Yes threats against me, by both of them. They didn’t agree with what was said in the comments. I invited them to respond with their own comments so that we could all benefit from the public discussion. But they declined the invitation.
The problem for me is that, under the old defamation law, I have to bear some responsibility for comments made on my blog. because I’m regarded as a publisher. despite the fact that I’ve had nothing to do with writing the comments.
That will all change when the Defamation Act (2013) takes effect. Although the Act was passed in April 2013, it is not yet on force (don’t ask me why). Once it is in effect, it would not surprise me if similar comments appeared again.
For obvious reasons, I will not (yet) reiterate the point I made in my previous comment, but I think it’s strange that if Woollams has a problem with it, that he has not mentioned it to me. I made the same point on my own blog (as part of my review of one of his books).
I don’t think what I wrote was untruthful or misleading but if there has been some kind of misunderstanding or possibility for misinterpretation that I’ve somehow missed, I would be happy to correct or to clarify.
Thanks, David – yes. That ‘they declined the invitation’ to comment and resorted to threat speaks volumes, in my opinion, and smacks of a motivation to keep the topic from your site… perhaps on the basis that, if you were to be effectively silenced, then others would be ‘warned off’ also. The comment thread following Josephine’s book review ought to suggest to him/them that that ain’t gonna happen. Quite the opposite.
But David, they have the UK’s Number 1 cancer researcher presenting! Oh, wait, I checked for any evidence that he had actually published any research whatsoever and found none.
The back page of the book Everything You Need To Know To Help You Beat Cancer by Chris Woollams gives their aims of CANCERactive, as agreed with the Charity Commission. Notably, the word ‘research’ is in quotes.
It says:
Its aims, as agreed with the Charity Commission, are to ‘inform and support’ cancer patients and to provide ‘research’ into treatments.
The last sentence of their Mission explains what they mean by ‘research’:
We will fulfill our mission in the ‘research’ area by providing information on other people’s research.
They don’t even do that, but instead seem to cherry pick studies to suit their stance. Woollams mentions a lot of studies in his book but gives no references, or indeed any details of these,
making it impossible to learn anything from his ‘research’.
You are very charitable to Chris Woollams. I do not accept that he is an honest man.
He represents himself as the UK’s No.1 cancer researcher. That is dishonest: he has made, as far as I can tell, precisely zero contribution to the cancer literature. No papers I can find on PubMed reference him as an author or authority, not even the quack journals that are inexplicably included.
He has also written that laetrile is being suppressed because a half million pound charity (which sounds to me like CRUK) would be wiped out if it became known that a simple cure for cancer exists. That is dishonest and also grossly offensive to the many hardworking and dedicated professionals associated with CRUK, and indeed other charities supporting cancer research.
He describes his charity as the UK’s No.1 holistic cancer charity. That is dishonest, as it relies on the SCAM definition of holistic (i.e. including unevidenced treatments) rather than the plain English definition. Under a plain English definition many much larger and much better charities are holistic, especially Macmillan and CRUK, both of whom pay close attention to the social and daily living support of cancer patients.
He also displays a profound lack of intellectual honesty, representing the claims of quacks and charlatans as being on a par with the findings of science. He is a true believer in alternatives to medicine, and seems not to think that science only rejects these miracles because scientists are venal.
[…] interesting that the meeting was in Dartington. That’s near Totnes ("twinned with Narnia") and it’s a centre for the bizarre educational cult promoted by the mystic and racist, […]
Your Doctor can prescribe what they like, with little come back. Why can they and not be noticed when is it certainly does not work for the person with a unfathomable condition/problem
@ohsomiso
Please point us to the evidence that carrot juice or hyparbaric oxygen have the slightest effect on the progress of cancer. The fact that there has been little progress in the treatment of some forms of cancer (e.g. pancreatic) does not give a licence to sell phony made-up cures to desperate people, and to make money from their desperation. That is plain wicked.