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Ask the Skepdoc: Qivana diet supplement claims and hyperthermia for cancer

1/9/2015

 
The JREF is pleased to bring you Dr. Harriet Hall to answer your health-related questions about alternative treatments, questionable claims and science-based medical information. 

This edition: Qivana supplements and OncoTherm (heat) as cancer treatment

By Harriet Hall, MD

Question: I’m interested in the Qivana company’s products for weight loss and improving cardiovascular disease. Do they work?

Answer: Qivana appears to be just another in a long line of multilevel marketing companies that employ a pyramid scheme to sell untested diet supplements. They sell overpriced products with exaggerated claims. They enable a few early recruits to make a lot of money by recruiting lots of other distributors.  A portion of each distributor’s profits goes to the distributors who recruited them. The distributors lower down in the pyramid overwhelming lose money. 

I have evaluated the claims of so many of these companies that identifying their flaws has become a positively boring déjà vu exercise. The Qivana website is full of the usual red flags that raise suspicions about a website’s credibility. It emphasizes business opportunities, makes only the vaguest claims about what its products do, has a “gimmick” that promises a unique approach and sounds sciencey but is really pseudoscientific, features lots of customer testimonials, but can’t cite a single scientific study of its products. The website gives me no information that would make me think their products have any advantage over other weight loss approaches or over the “heart health” provided by the nutrition of a well-balanced diet. Their use of the word “detox” is enough by itself to brand the company as not to be trusted on medical topics.

Qivana offers a suite of products: a patented delivery system for a probiotic, a mixture of Asian herbs designed to help you reach your bioenergetic potential (whatever that’s supposed to mean), mushrooms that supposedly boost your immune system (a common pseudoscientific claim that is scientifically meaningless), a mixture of natural “detox” ingredients that supposedly remove metals and toxins, and a natural sleep remedy. They say the ingredients are scientifically proven to help with various things, but the research they refer to is preliminary and largely preclinical. The fact that a mushroom extract has some effect in a mouse or in a cell culture in the lab doesn’t necessarily mean it has any therapeutic effect in the human body. In her book Suckers: How Alternative Medicine Makes Fools of Us All, Rose Shapiro reminds us that you can kill cancer cells in a Petri dish with a flame thrower or bleach. Every webpage ends with the disclaimer that the products are not intended to diagnose, treat, cure, or prevent any disease. One is left wondering exactly what they are intended to do and why anyone would want to take them.

Do these products work? The way to find out if they work is to do controlled clinical studies, and no such studies have been done. Under the Diet Supplement and Health Education Act (DSHEA), these products can be sold without any of the kind of supporting evidence that the FDA requires before they approve marketing of a pharmaceutical drug. The double standard is obvious.

I’m not saying they don’t work. We can’t know that without testing. But considering the percentage of initially promising treatments that fail to survive the scientific testing process, we do know that the odds are not in their favor. I’m not a gambler; but if I were, I wouldn’t put my money on this kind of thing.

Is it a deliberate scam cynically designed only to separate victims from their hard-earned money? Probably not. I’m guessing most of the sellers truly believe they are improving the health of their customers. What they are really selling is hope. Caveat emptor.

Question: There is a Dr. Pyatt in Calgary whose website advertises that he uses an OncoTherm device to treat cancers. Is heat treatment effective for cancer?

Answer: Maybe; but if it is, it’s not very effective and it only has a limited role as an adjunct to other treatments; and what he’s offering is not likely to be effective at all. Pyatt is a naturopath, not an MD. He offers all kinds of other questionable treatments including craniosacral manipulation, chelation, intravenous vitamins, and homeopathy. The OncoTherm device is not approved by the FDA and cannot legally be sold in the US. If it were being used by an American doctor, the clinic could be raided by the government and the device confiscated. Hyperthermia has been used to treat cancer, but it is almost always used in conjunction with chemotherapy and radiation, treatments that naturopaths are not licensed to use. And of course using machines to heat the body can hardly be considered a “natural” treatment.

Hyperthermia is a treatment method that exposes body tissue to high temperatures (up to 113 degrees Farenheit) with the intent of damaging and killing cancer cells. There is a fact sheet from the National Cancer Institute that covers the subject pretty well here.

There are several approaches including local, regional and whole-body hyperthermia. It’s easy to kill cancer cells with heat in the lab (a blowtorch works nicely), but there is very little evidence that hyperthermia is an effective or safe way to treat cancer in live human bodies. Hyperthermia can make cells more susceptible to radiation when used within an hour of radiation treatments. It can also enhance the effect of some anti-cancer drugs. Some studies have shown a significant reduction in tumor size when hyperthermia is combined with other cancer treatments; but other studies have not, and not all of the studies showed increased survival. A number of side effects have been reported, including burns, blood clots, and vomiting. There are few if any rigorous well-designed randomized controlled studies. Research is ongoing. Hyperthermia is promising, but it is not yet ready for prime time; it hasn’t become a generally accepted part of the conventional cancer treatment armamentarium. It is still considered experimental and it would be best to give it only in the context of a controlled clinical trial. Any patient with cancer should be treated under the supervision of an oncologist who is an MD and has experience in providing conventional cancer treatments that have been proven effective. In my opinion, naturopaths (even so-called “naturopathic oncologists”) simply don’t have the necessary training and experience to be meddling with life-threatening diseases.

Dr. Pyatt says the device he is using has "proven benefits in both life expectancy and quality of life...” I think that statement is misleading: it goes way beyond the actual evidence. 

Harriet A. Hall is a retired family physician, former U.S. Air Force flight surgeon, and health advocate who writes about alternative medicine and quackery for Skeptic magazine, Skeptical Inquirer and Science-based Medicine.

Ask the Skepdoc: Pancreas miracle and Dispenza's thought healing

12/16/2014

 
The JREF is pleased to bring you Dr. Harriet Hall to answer your health-related questions about alternative treatments, questionable claims and science-based medical information. 

This edition: A seemingly miraculous healing of a pancreas injury and the self-healing claim of Joe Dispenza.

By Harriet Hall, MD

Question: My mother claims she experienced a miracle 25 years ago. Her pancreas was severely damaged in a car accident. Her clinical state was getting worse every day: she was getting high fevers and losing a lot of weight. All the doctors thought she was going to die, but then her pancreas miraculously recovered in 24 hours. Is there any logical explanation for what happened? Can the pancreas heal and reconstitute itself by some natural biological means?


Answer: As I explained in my article “On Miracles” in the recent issue of Skeptic magazine, this is typical of the great majority of medical “miracle” accounts. There is insufficient information to establish whether anything unusual or inexplicable actually happened. It amounts to a testimonial and is no more valid as evidence than a person’s report that he saw a ghost or a UFO.  If we had access to her medical records and results of tests, we might be able to get a clue; but without them, all I can do is speculate. 

Damage to the pancreas is not uncommon after car accidents, but it is usually characterized by pain and other symptoms, not just by weight loss and fever. It is difficult to diagnose, since blood tests are unreliable and imaging studies are difficult to interpret. And 25 years ago she wouldn’t have had the kind of imaging studies we would do today. Today, a CT scan is usually the study of choice, but it only picks up 40-68% of injuries. Death from pancreatic injury is usually due to hemorrhage, and rather than slowly “getting worse every day,” hemorrhage would have killed her quickly without surgical intervention. We can assume that if she had any internal bleeding, it must have been minor, and minor bleeding can sometimes stop on its own thanks to the body’s normal clotting response. If there was damage to pancreatic tissue rather than to blood vessels, there would be no reliable way to know if she had recovered completely in 24 hours. Low-grade injuries can sometimes heal spontaneously, and today it is acceptable to manage selected patients conservatively with watchful waiting as long as their vital signs are stable. Unstable or deteriorating patients are not told they are going to die; they are operated on to try to save their life.

So I think we can assume that either the diagnosis was inaccurate or she had a minor injury that healed through the body’s normal healing mechanisms. Why should anyone assume something supernatural had occurred? Even if her recovery was unexplained, that only means we haven’t yet been able to explain it; it doesn’t mean there is no natural explanation. And it certainly doesn’t mean the explanation is supernatural. It would have been appropriate for her doctors to write up a case history and submit it to a medical journal so other doctors could comment and learn from their experience. I’m guessing they didn’t do that.

Medical science is imperfect, and we can’t always explain everything. Sometimes we just have to live with uncertainty.  For example, I had shoulder pain for a year that severely limited my range of motion in one arm, and suddenly one day I realized the pain was gone. I can’t explain what caused it or why it wentaway, but that doesn’t mean there isn’t an explanation. I would rather not know the explanation than believe an explanation that was wrong.

Your mother will not change her mind, and without reliable documentation we can never know what really happened. She chooses to interpret her experience as a miracle. I do not, because skeptics don’t accept beliefs without sufficient evidence. Different world views. End of story.

Question:  Dr. Joe Dispenza recounts a truly remarkable experience on his website: He shattered 6 vertebrae in an accident, ignored his doctors’ advice, refused surgery, and instead healed the damage by thought alone. What happened to all the bone slivers and damaged tissue? Did they somehow dissolve or liquefy? Did the separated fragments of bone move together in order to heal? Can a thought move bone particles and lock them into position? What processes were triggered in the body?

I am aware of the astonishing results placebo surgery does achieve activating the self healing powers of the body.  But Dr. Dispenza’s case surpasses  anything I ever heard of. There have always been people around who stretched the limits of existing paradigms -  is Dr Dispenza one of them?


Answer:  No, “Dr.” Dispenza is not some lone genius who has made some new scientific breakthrough. He isn’t even a medical doctor, only a doctor of chiropractic, a discipline that is based on a mythical concept (the chiropractic subluxation) and a vitalistic belief in a kind of “energy medicine” that mysteriously heals the body when the spine is in proper alignment.

I can understand why an account like Dispenza’s might sound impressive to a layman, but there’s no mystery here. As a science-based medical doctor, I have no reason to think that the healing of his fractures had anything to do with his thoughts or his meditation practices. Fractures have always healed themselves. Immobilization and orthopedic surgery don’t heal, they only aim to facilitate the body’s healing processes and minimize complications. Before modern medicine, some people survived serious injuries, just as some people survived pneumonia before antibiotics were developed. 

The process of fracture healing is well understood. There is bleeding at the site of injury. A hematoma forms and is infiltrated by inflammatory cells. Granulation tissue forms, blood vessels grow into the area, and a soft callus develops, forming a ball of new tissue around the broken bone ends. Damaged bone is resorbed and new bone is laid down. Eventually the bone is remodeled, re-shaped to approximate its original form, although there are still residual signs on x-ray that allow a radiologist to diagnose an old healed fracture. Incidentally, this same process occurs in normal bone, which is a living tissue where cells called osteoclasts are constantly breaking down old bone and cells called osteoblasts are constantly depositing new bone. Osteoporosis occurs when the osteoclasts get ahead of the osteoblasts. 

Dispenza took a big risk when he refused surgery. His case might well have turned out differently. He was fortunate that even without surgical fixation, his fractures healed without complications. Without surgery, there is a danger of paralysis or permanent nerve damage from shifting bone fragments or nerve compression before healing can occur; he was one of the lucky ones. There is no reason to think that his injuries wouldn’t have resolved just as quickly without any thought control or meditation. 

Placebos are widely misunderstood. They don’t have any objective healing powers. Placebos have never been shown to change the course of any kind of illness; they have only been shown to temporarily improve subjective complaints like pain and nausea. You have a misconception about placebo surgery; no, it does nothing to activate the self-healing powers of the body. Placebo surgery is never used clinically for treatment. It has only been used as a placebo control in scientific studies, where it has been useful in demonstrating that a particular surgical procedure was ineffective and should be abandoned.

The idea of “mind over matter” is seductive. We would love to believe we can get control over the uncertainties in our lives. We would love to think we can alter reality with our thoughts alone, but we can’t. The mind can help us cope with reality, but it can’t change reality.

Incidentally, if you thought Dispenza was a credible witness, you might be surprised to learn that he is a New Age woo-monger, a gullible believer in an imaginary “Quantum Field” that supposedly responds to human thoughts and intentions. He was featured in the reprehensible movie “What the Bleep Do we Know.” He has no evidence to support his claims, only testimonials, fanciful hypotheses, and speculations.

More:
Ask the Skepdoc: Eye Health and Aspirin

Questions for Ask the Skepdoc can be sent to [email protected]

Harriet A. Hall is a retired family physician, former U.S. Air Force flight surgeon, and health advocate who writes about alternative medicine and quackery for Skeptic magazine, Skeptical Inquirer and Science-based Medicine.
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    SWIFT is named after Jonathan Swift, the author of Gulliver's Travels. In the book, Gulliver encounters among other things a floating island inhabited by spaced-out scientists and philosophers who hardly deal with reality. Swift was among the first to launch well-designed critiques against the flummery - political, philosophical, and scientific - of his time, a tradition that we hope to maintain at The James Randi Foundation.

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