CAM for Cancer: Preying on Desperate People?

By Hall, Harriet | Skeptic (Altadena, CA), Summer 2012 | Go to article overview

CAM for Cancer: Preying on Desperate People?


Hall, Harriet, Skeptic (Altadena, CA)


CANCER PATIENTS ARE A UNIQUELY VULNERABLE group. When patients are diagnosed with pneumonia or appendicitis, they expect to recover and they readily accept conventional treatment with antibiotics or surgery. They are not particularly vulnerable to false claims for other treatments. But when patients are diagnosed with cancer, they fear dying; and they fear it will be a slow, painful death. They fear that the treatment itself will add to their suffering--the so-called "cutting, burning and poisoning" of surgery, radiation, and chemotherapy. They often rebel against their fate in various ways, and may reject conventional treatment and seek a kinder, gentler, and more hopeful option elsewhere. When people are desperate, they will grasp at any straw. Even the most rational people will do irrational things when frightened by a life-threatening disease. Emotion rules, and critical thinking flies out the window. It is only natural that desperate people become susceptible to the deceptions of quacks and snake oil frauds. It is even more natural for them to turn to complementary and alternative medicine (CAM) because it is popular and is even endorsed by a subset of medical professionals.

CAM has much to offer cancer patients. But then, quackery has much to offer them too. Quackery offers them hope (albeit false), comforting beliefs, symptom relief (through the placebo phenomenon), the promise of "cures," and a more palatable (but unfortunately ineffective) substitute for effective but unpleasant conventional treatments. No ethical physician would knowingly promote quack medical treatments for cancer patients; but in promoting CAM, some providers may be inadvertently doing what is not in their patients' best interests.

Deceptive Terminology

What is CAM? It essentially comprises treatments that have not earned a place in conventional medicine. Complementary medicine is intended to be used along with conventional medicine; alternative medicine is intended to be used in place of conventional medicine. The field of CAM is vast: it includes methods that may work but have not been tested and methods that have been tested but have not generated sufficient evidence to have become part of conventional medicine. It also includes methods that have been tested and proven ineffective but that promoters still believe in because of personal experience, anecdotal evidence, rejection of scientific research, or misguided thinking.

As Marcia Angell and Jerome Kassirer famously said in The New England Journal of Medicine:

   There cannot be two kinds of medicine--conventional
   and alternative. There is only medicine that
   has been adequately tested and medicine that has
   not, medicine that works and medicine that may or
   may not work. (1)

When CAM methods are proven to work, they become conventional. The separation between CAM and conventional medicine is a false one. According to the Yale neurologist Steven Novella:

   CAM is a political/ideological entity, not a scientific
   one. It is an artificial category created for the purpose
   of promoting a diverse set of dubious, untested,
   or fraudulent health practices. (2)

Another ill-conceived concept is "integrative medicine." It claims to combine the best of CAM with conventional medicine and to treat the whole patient. Since the majority of unproven treatments do not pan out when tested, integrating unproven treatments with proven ones is likely to do more harm than good. Good clinicians have always treated the whole patient and employed all reasonable means to improve patient outcomes and relieve suffering. Integrative medicine tries to co-opt things such as exercise and nutrition that are not its unique province but are really part of conventional medicine.

And then there's naturopathy. The six basic tenets of naturopathy are:

* first do no harm;

* physician as teacher;

* treat the whole person;

* prevention;

* healing power of nature;

* treat the cause. …

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