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Cancer Decisions

THE MOSS REPORTS Newsletter (02/01/04)

 

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Ralph W. Moss, Ph.D. Weekly CancerDecisions.com

Newsletter #118 02/01/04

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ARE CLINICAL TRIALS FOR YOU?

 

 

There are currently over 2,300 clinical trials for

cancer in the US and abroad. The clinical trials

industry, powerfully connected, aggressively recruits

patients to join these studies. It often explicitly

promotes the idea that clinical trials will benefit

those who participate in them. However, a new study

shows that in reality cancer patients rarely benefit

from participation in such trials. Scientists from

Boston's Dana Farber Cancer Institute report that

" Despite widespread belief that enrolment in clinical

trials leads to improved outcomes in patients with

cancer, there are insufficient data to conclude that

such a trial effect exists. " Writing in this week's

Lancet, they explain that participating in a clinical

trial is mainly an altruistic act, something a cancer

patient does " for improving treatment of future

patients, " not for enhancing his or her own chances of

survival. I'm sure that this will come as a shock to

many patients who have been urged to take part in

clinical trials.

 

 

Personally, I believe that every cancer patient should

take his or her best shot at surviving, even when the

disease is very advanced. Can clinical trials

contribute to that goal? Rarely. But it is necessary to

take a balanced view of such trials. One should not

reject them entirely, since there are a few kernels of

value hidden amidst the dross. How can you distinguish

a trial that may be of therapeutic benefit to you from

the many that will not help you at all? What exactly

should you look for in a potential clinical trial? What

are the perils and pitfalls of entering the various

phases of a trial? Or should you be thinking instead of

going to a complementary and alternative (CAM) clinic

in the USA or abroad? What is the best way to approach

and evaluate the many options available today?

 

 

In our frequently updated Moss Reports, we have a full

discussion of these issues, as well as many other

topics of urgent importance to cancer patients. I have

spent three decades investigating the very complex

field of cancer treatment. This knowledge, carefully

organized and clearly presented in our reports, can

jump-start your own investigation and give you the

benefit of my years of work and insight. I also offer

phone consultations and research services. In other

words, I want to make available to you my experience

and study in this field so that you can make the most

effective treatment decisions possible.

 

 

The cost of a Moss Report is $297. Many clients have

told us that they not only saved money in the long run

by ordering a report but also saved something even more

precious - time. To order a report on almost any kind

of cancer please visit our website at

www.cancerdecisons.com or call Anne or Diane toll-free

at 800-980-1234. (Use 814-238-3367 when calling from

abroad.) Let us know how we can help you.

 

 

 

 

FRAUDS AND FAKES IN MEDICINE

 

 

(A continuation of last week's discussion of two

fascinating books on quackery)

 

 

Quackery remains a problem all over the world, but it

is unusual these days to find what might be called a

" classic quack " , i.e., a brazen fraud who claims to

have a medical degree that in reality he does not have.

Generally speaking, medical boards guard their

prerogatives quite well. A few years ago the BBC

identified a " fake doctor factory " calling itself the

Metropolitan Collegiate Institute, operating in the

heart of London. The BBC reporter visited the

Institute's " hospital " and found a " narrow door with

peeling paint sandwiched in between a hairdresser's and

a café…. " Yet this organization's " graduates " were

using their phony degrees to set up shop in poor

countries, giving substandard care to the hapless local

population. One of these so-called graduates operated

an offshore clinic catering to Americans.

 

 

While frightening in its implications, such a situation

is relatively rare; indeed, in this case it was the

very novelty of the problem that brought it to the

headlines. Nor is it correct to associate such

impostors with alternative medicine, as some

quackbusters are determined to do. Most phony doctors

of today practice perfectly orthodox medicine in order

to stay " below the radar " of legal scrutiny. They are

happy if they can pass as typical allopathic doctors.

 

 

So, what about unconventional practitioners who spout

strange theories and sport obscure degrees? There are

certainly some of those, and part of the reason for

their continued existence is that there is little or no

organized credentialing apparatus in place for many

kinds of complementary and alternative medicine. On the

one hand, there are genuine schools of naturopathy,

homeopathy, hypnosis, acupuncture, etc., which require

long, rigorous and expensive courses of study before

they will grant a well earned degree. These schools

turn out skilled practitioners who offer valuable

services to the community, usually at reasonable

prices. (An increasing number of such services are paid

for by health insurance.) At the other extreme, though,

there are the phony diploma mills, creating

" doctorates " as fast as their printers can spit them

out. Sometimes it is hard even for knowledgeable people

to tell the difference.

 

 

One problem is that in our society we make little

serious effort to control the use of honorific titles

other than that of medical doctor. Today, one can

purchase all sorts of phony degrees over the Internet.

Such degrees come complete with a crisp,

authentic-looking diploma and a transcript (of

non-existent courses) for a few hundred dollars. I pity

the inexperienced patient who is thrown into this snake

pit of so-called doctors, with their various arcane

titles and opaque credentials.

 

 

Just the other day I got an email from a woman who was

contemplating treatment at a cancer center near her

home. According to the center's website, one of its

directors was an " internationally renowned

researcher " who had developed " an exciting new approach

to Mind, Spirit, and Body wellness. " Describing this

man's education, the website stated quite frankly that

he had a doctorate from the American College of

Metaphysical Theology, a virtual college (in the most

literal sense) offering degrees for sale through its

website. A bachelor's degree could be bought for

$149.00, a master's for $209.00, and a doctorate

(Ph.D.) for just $249.00! (By contrast, a bona fide

Ph.D. generally requires residency at an accredited

university, a minimum of three years of study, arduous

oral examinations and a scholarly dissertation. The

financial cost of a genuine Ph.D. has been estimated

between $63,000 and $112,000.)

 

 

Lest anyone miss the potential value of their online

diploma, the " Metaphysical Theology " website points out

that their doctoral degree brings " [h]eightened

credibility in any practice of spiritual healing in

which you may become engaged. Psychologically, " the

website adds in confidential tones, " the title 'Doctor'

and the word 'healing' have a natural affinity in one's

mind. " In other words, there are still a few people out

there who might confuse a mail order " doctorate " in

Metaphysical Theology with a medical degree.

 

 

I think I succeeded in persuading the woman who wrote

to me that putting her health in the hands of a person

who had purchased a mail-order degree on the Internet

and had no valid medical training would be ill-advised,

to say the least. But what worries me most is the

disservice that this sort of diploma mill does to the

credibility of complementary and alternative medicine

as a whole. I repeat that a majority of practitioners

working in CAM today are well trained, dedicated, and

highly skilled. However, the unscrupulous exceptions

are a gift to the self-styled quackbusters who are

eager to discredit alternative medicine in its

entirety.

 

 

Unconventional Practices

 

 

These self-proclaimed quackbusters hold up as examples

the worst abuses perpetrated by the dishonest few on

the fringes, using them to attack the many valid and

well-intentioned practitioners in the field of CAM. In

their respective books, Profs. Roy Porter and Piero

Gambaccini have done a wonderful job of exposing the

unfairness of this kind of generalization (see

references below). Without moralizing over the behavior

of the quacks, Prof. Porter even questions the value

judgments implicit in the term 'quack'.

 

 

" I disclaim any absolute, Platonic meaning for my

application of the term, " he writes. " I shall take as

quacks the broad spectrum of those operators who were

typically pilloried as such. " Quack was often a

convenient term to attack one's ideological opponents.

The essence of the quack, however, was that he

" transgressed what those in the saddle defined as true,

orthodox, regular, 'good' medicine " (Porter, p. 11).

 

 

" Father of Scientific Surgery "

 

 

In addition, the distinction between quack and

qualified doctor was not always clear-cut. For

instance, there were some apparent quacks who did

indeed have university degrees. In 18th century London,

for example, Dr. John Pechey advertised cures via

handbills and offered medical services at cut-rate

prices. Yet he was a graduate of Oxford University and

after his medical apprenticeship he was licensed by the

Royal College of Physicians. On the other hand, Dr.

John Hunter (1728-1793) dropped out of grammar school

at the age of 13 and entered the field of medicine by

preparing cadavers for dissection! Yet he became an

extremely famous physician - indeed, " the father of

scientific surgery " - whose influence, according to

historian Michael Shimkin, MD, permeated all of

medicine (Contrary to Nature, p. 86).

 

 

Perhaps above all else, what distinguished quacks was

the fact that they advertised their wares and services.

In this, they could be viewed as innovators. They were

among the first merchants to give out printed

handbills, which most recipients first read carefully

and then used for less dignified purposes. In time, the

quacks learned to paste these bills on walls and later

still to have them printed in newspapers and magazines.

One could argue that this was the very beginning of the

advertising industry.

 

 

Indeed, a fascinating topic explored in Prof. Porter's

book is the intimate connection between quackery and

the media. These two " industries " grew up together, as

many newspapers profited from quack medicine

advertisements and often themselves became distributors

of the medicines. At this time, regular doctors were

forbidden to advertise, advertising being considered

unseemly and too closely associated with the

disreputable quacks. This ban continued until the

financial exigencies of the 1970s and 1980s led the

medical profession to reconsider its resolutely

anti-advertising position. (Today, of course, medical

practitioners advertise relentlessly. A ride on the

New York subway system, or even a glance through the

physician listings in the classified Yellow Pages, is a

graphic reminder of how far the pendulum has swung in

the opposite direction.)

 

 

Quacks typically sold secret proprietary remedies

(which later came to be known as 'patent medicines').

This secrecy not only discouraged competition, but also

added an aura of mystery to the product. Perhaps

realizing how lucrative such remedies had become, many

regular doctors also got into that same business. For

example, Dr. Edward Jenner, who today is revered as the

father of vaccination, was famous in his own day for

his patented indigestion lozenge. The celebrated

orthodox physician Dr. Richard Mead had his name

attached to a rabies powder, and Paul Chamberlain,

FRCP, marketed his own brand of teething necklaces for

babies.

 

 

Dr. Hans Sloane (1660-1753), physician to King George

I, had visited Jamaica, where he tasted a newfangled

substance called " cocoa, " which he found nauseating. By

adding milk he managed to make it more palatable and

thereby invented milk chocolate (centuries before

Monsieur Nestle). His recipe was later adopted by the

British firm, Cadbury Brothers, and achieved ubiquitous

popularity and acceptance, even though in essence milk

chocolate was originally a kind of quack remedy.

 

 

To view Cadbury's original milk chocolate label, click or

go to: http://www.cancerdecisions.com/images/choc.jpg

 

 

Even some of those who did not make nostrums themselves

had no qualms about promoting the remedies of others.

The aforementioned Dr. Hunter wrote enthusiastically to

Edward Jenner, " Dear Jenner, I am puffing of your tartar

as the tartar of all tartars, and have given it to several

physicians to make trial…. " (A tartar was a drug to make

people vomit…which, along with bleeding by lancet or leeches,

was one of the favorite treatment strategies of regular

doctors in the 18th and 19th centuries.)

 

 

(TO BE COMPLETED NEXT WEEK)

 

 

My first book, " The Cancer Industry, " discusses in some

detail the historical development of cancer treatment

and the role of some so-called " quack " remedies in that

process:

 

http://www.amazon.com/exec/obidos/ASIN/1881025098/cancerdecisio-20/103-4018872-4\

386244

 

 

To purchase a copy of Prof. Roy Porter's excellent book

Quackery: Fakers & Charlatans in English Medicine,

please click or go to:

 

http://www.amazon.com/exec/obidos/ASIN/0752417762/cancerdecisio-20/103-4018872-4\

386244

 

 

To purchase a copy of Piero Gambaccini's equally

fascinating history of Italian charlatanism:

 

http://www.amazon.com/exec/obidos/ASIN/0786416068/cancerdecisio-20/103-4018872-4\

386244

 

 

 

--Ralph W. Moss, PhD

 

 

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References

 

 

Peppercorn JM, Weeks JC, Cook EF, Joffe S. Comparison of

outcomes in cancer patients treated within and outside

clinical trials: conceptual framework and structured review.

Lancet 2004;363:263-70.

 

BBC News, 'Fake doctor factory' awards degrees, November 26,

2000. Accessed on Jan. 29, 2004 at:

http://news.bbc.co.uk/2/hi/uk_news/education/1039562.htm

 

On the cost of a doctorate: Hungary: Higher Education

Reform Project (1998):

http://www.worldbank.org/education/economicsed/project/projwork/good/New%2098/co\

st16536.html

 

 

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IMPORTANT DISCLAIMER

 

 

 

The news and other items in this newsletter are

intended for informational purposes only. Nothing in

this newsletter is intended to be a substitute for

professional medical advice.

 

 

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