Opinion: Cancer is Hard, But Let’s Not Turn to Woo.

Cancer. The word alone invokes deep emotions in many people. For some, fear, for others, anger. This is completely understandable. During my biomedical science degree I worked in nursing with a predominant focus on patients with various stages and types of cancer. Some made it and others were not so fortunate. I was even quite emotional seeing the plight of these patients, but maintained my resolve to give them the best care I possibly could. It wasn’t just me either; each patient had a large team of nurses, doctors and specialists who worked with them, investing their expertise to help every person they saw. However, the emotions of fear and anger were very real and very present. These emotions, for some, can lead to bad choices (often out of desperation). It is this that I want to focus on in this opinion piece.

Tonight I saw an article in the Sunshine Coast Daily talking about a woman who has been diagnosed with cancer and is turning her back on “conventional” (read evidence- and science-based) medicine, instead opting for so-called “alternative” treatment. What I will do is bring up some things that were said in the poorly written article and give my opinion on them. I will also try to identify some fallacies written into the story.

Firstly I will say that overall the story utilizes a strong appeal to emotion by talking about the woman, Corissa Macklin-Rice, and the relatively recent (2011) death of her mother from cancer followed by her own diagnosis (grade 3 ductal carcinoma with lymph node involvement) in 2013. This is the tone of the story, the wording of which lowers the sympathetic reader’s guard, making many forget that no where throughout the whole article is any real science addressed (in fact at the end of the article, woo is promoted). Ok, specifics,

“In the last week before Mum passed, she said to me, ‘Keep going with what you’re doing’ and ‘don’t ever have chemotherapy’, as it takes your quality of life,”

We should never let emotion trump reason. It was devastating that her mother had died from breast cancer yes, but remember, chemotherapy may not end up working for some, especially those with particularly aggressive cancers. An oncologist weighs up the pros and cons of a patient’s treatment knowing full well that most of the time the person will die if they receive no therapy. If you are the unfortunate person who is poorly responsive to a given therapy, that doesn’t mean others should not get that particular treatment. Also keep in mind that we no nothing about her mother’s breast cancer, which makes it hard to comment on.

“In my research to find something other than chemotherapy to help her, I later used some of these alternative therapies for me.”

This is often a big face-palm for me. As soon as people who are not doctors or scientists talk about “doing their own research”, a giant red flag gets raised. I have talked previously about the logical fallacies to avoid when doing your own research (and the cognitive biases here, here and here), and judging by her logic throughout the article, it is clear she has failed to avoid several. Most people think consulting Dr. Google or attending the University of Wikipedia is research. Wrong. Wrong to the power of 10 (wrong¹⁰). I am not saying you shouldn’t look for more information, in fact you should try to become as informed as possible if struck down with a condition like cancer. But the best place to start is by consulting your doctor and specialists involved (like oncologists and surgeons) and even getting second opinions from other physicians if not sure. Ask them for advice on where you can get more information so as not to lead yourself astray on the Internet where there is woo as far as the eye can see.

With her mum’s advice firmly in mind, Ms Macklin-Rice said she chose not to have chemo, radiation or any medication the oncologists suggested.

This is both sad and terribly foolish. Again, I understand that seeing ones family member suffer from the same type of disease you went on to develop is hard, and you will (fallaciously) relate their experience to yours. This should be avoided for the most part, as even the same type of cancer affects different people in different ways. Chemo may not work for one patient, but then be the best course of action for another. For example, her mother’s age could have played a role, just the same as when she got diagnosed and may other variables. A doctor will be aware of this, patients frequently are not (Corissa is case in point).

After the mother-of-three was diagnosed with a grade 3 ductal carcinoma with lymph node involvement, she tried an alternative treatment on it immediately and had underwent surgery in March.

Mentioning the children only serves as more emotion-baiting of the reader. Given her diagnosis, surgery is unlikely to be considered “alternative” if that is indeed what the writer is trying to convey. However they may be referring to-

Instead she decided to try alternative therapies such as veganism and yoga after looking into the success rates of treatment……”I have anywhere up to 13 juices and five coffee enemas per day. I only eat organic food, use no chemicals and gave up my hairdressing job due to the chemical exposure.”

Sigh. I don’t know if my head can handle another face palm. Look, yoga is great for relaxation, absolutely and I know doctors who would recommend it to their patients to help them relax. But they would also be working on treating the disease and its root cause. Yoga won’t cure cancer. There is absolutely no solid evidence that yoga or veganism will cure any cancer (though healthy eating is absolutely important). Juicing and coffee enemas are the same, no evidence whatsoever. Prof. Edzard Ernst talks about coffee enemas as a triumph of ignorance over science here. In fact coffee enemas can cause serious harm. Here too we see the naturalistic fallacy or appeal to nature by mentioning she only eats organic food. There is no benefit health-wise for eating organic food, and often it will only serve to lighten your wallet. Also she mentions that she “uses no chemicals”; this makes no sense, since you should remember that water is a chemical (dihydrogen oxide), so is the air you breath. Refer to Sense About Science and their discussion on “chemicals” here.

“I am happy with what path I have chosen,” Ms Macklin-Rice said.

So were the people in the Heaven’s Gate cult. You can be happy after making the wrong decision, especially if fallacious reasoning led you there.

“I personally believe that the body has the capability to heal from anything and everything naturally.”

Tell that to the people dying of Ebola in Sierra Leone. This is again another appeal to nature and an argument from ignorance. You know what else is natural? Death. Look, the body is an amazing machine, capable of recovering from a lot, but there is a limit as there is with anything. If you get cancer there is always a chance that no matter what you do, you will die unless you receive the appropriate therapy. Even “mild” cancers can lead to complications, such as those in Australia with multiple myeloma who have around a 1 in 3 chance of dying if they catch the flu (if you are down under right now, get vaccinated for the flu…you may just save a life other than your own). Healthy living won’t necessarily prevent death when disease comes knocking.

The rest of the article mentions people raising money for Corissa, but not obviously for real treatment involving evidence-based and science-based medicine. No, I am skeptical this money will go straight down the toilet, especially if it is going to her 5 a day coffee enema habit. She mentions that she will see later in the year how she is going. I hope she is still going as strong as she thinks she is going now, I really do. But will we really know if it is due to her surgery rather than the woo she has engulfed herself in? Not likely, and it will serve people well to remember that anecdotes are the lowest form of evidence.

At the start of this opinion piece I said that the word “cancer” brings out many emotions in people. Well for me personally it brings out hope. Hope that those who suffer can achieve some level of alleviation and hope that colleagues and others I know in medical research will continue making giant strides and breakthroughs for the many types of cancer out there. This requires time, money and expertise, so if you are a member of the public, consider making a donation to medical research rather than throwing money at hokey “cures”.

Note, the image atop the page is of prostate cancer cells dividing.