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Total Bollocks |
What is it about the word ‘alternative’ that lends undue
respectability to the words that follow? For example we have ‘Alternative
Energy’, ‘Alternative Lifestyle’ and of course, ‘Alternative Medicine’. The
word ‘alternative’ confers a patina of respectability to concepts that are
often found wanting if only we are prepared to probe a bit deeper.
Many of us are critical of modern medicine and rightly
so. Medicine is an evolving science and has yet to find cures and effective
treatments for many common and often fatal diseases. And this is where
‘Alternative Medicine’ enters the fray. In fact the term ‘Alternative Medicine’
covers a whole host of so called ‘therapies’ from the down right bizarre and
silly (yes homoeopathy, I’m talking about you) through to treatments which have
acquired a certain degree of prestige, such as acupuncture; even conventional
medical practitioners have become seduced. And let us not forget the
financial incentives. Alternative medicine is a big and largely unregulated
business. It is estimated that in the US alone consumers spend 34 billion
dollars annually on alternative therapies. Unscrupulous individuals are making
a lot of money as ‘practitioners’. Undoubtedly there are those who are sincere
and believe in the effectiveness of their therapies. Equally, there are those
who are utter charlatans whose main concern is the fleecing of the gullible and
desperate.
Adherents of alternative therapies often claim
astonishing results for their respective treatments. Beware of ‘cure all’
therapies. Panaceas for all our ills do not exist; this applies to both
conventional medicine and the alternative variety. Modern medicine is founded
on sound scientific principles and is subject to the rigours and self righting
mechanism of the scientific experimental method. This of course reflects the
world of perfection, which has never existed, but at least medicine is well
intentioned, and although progress is sometimes faltering, it is inexorably
forward. This is not the case with alternative therapies. Indeed they often
revel in their unconventional non-scientific approach. Or if they attempt to
explain their mechanisms they invoke non conventional ‘science’ or weird
esoteric principles beyond the reach of scientific scrutiny. And really, this
is the important point: Modern medicine is based on the double blind clinical
trial. To judge a treatment effective, or not as the case may be, it needs to
evaluated in a medical trial with a suitably selected control group. The
results are then published in a scientifically respected and peer reviewed
journal. The process is not fast but is designed to weed out effective from the
non-effective drugs, procedures and treatments. In contrast, most practitioners
of the alternative usually have little time for rigorous procedure. When they
claim ‘data’ supporting the effectiveness of their nostrums it is mostly in the
form of personal testimony (not worth the paper it is not printed on). In other
words, patients report that the treatment is effective. Here is the problem:
How are we to judge a treatments true effectiveness? Sometimes disorders get
better regardless of intervention; people exaggerate with respect to their
illness and possible cure. Others are not really ill at all; people lie. The
placebo effect is a real phenomenon. If we think a treatment is going to be
effective then that may well be the case, irrespective of medical worth. The
only way to distinguish between these possibilities and uncover a treatments
true value is by well established medical and scientific principles.
But surely I hear you say: ‘Not all the so called
alternative therapies should be judged together. Granted there some that are
plain daft, but others such as acupuncture, are actually very effective for
certain conditions’. A fair point. Of all the so called alternative therapies,
acupuncture has received more than its fair share of scientific evaluation. It
has some of the hallmarks of an effective treatment. It is an ancient practice
(must be worthy then?) and a degree of physical intervention is involved;
needles are inserted and stimulated, either manually or by electric current. It
also has its own ‘pseudo-scientific’ principles. I don’t want to go into too
much detail about the proposed rationale for its effectiveness, so I’ll briefly
summarise: Practitioners believe that by inserting needles at specific node
points (define please), the needles influence the body’s natural energy
channels (Chi- nice word, but what does it actually mean?). Whilst this is the
basis for a hypothesis it has not been borne up by scientific evidence. Of
course, this doesn’t mean that the treatment is ineffective. It could simply
mean that the proposed mechanism of action is wrong. So what do the studies
show? As far as I’m aware, and I am more than happy to be contradicted, the
only sound scientific evidence for the efficacy of acupuncture, for anything,
has been for the management of pain; that’s it. Moreover, it is no more
effective than conventional analgesic drugs. I don’t know about you, but I’d
rather take morphine or even Panadol. Other claims for acupuncture, as a
treatment, are anecdotal and therefore completely worthless as evidence. To
convince me otherwise I will require a reference to an article outlining a well
designed and executed trial published in an established and respected
scientific or medical journal.
I suppose we all want and yearn for quick fixes in life.
This applies to many things from our money woes through to our health, and yes,
it pays to be questioning and prudent in all things (this person does not
exist). In some ways bad decisions in many of life’s activities have no long
acting effects on our ultimate well being. Bad decisions with regard to our
medical conditions can, and do, have catastrophic consequences. Steve Jobs, the
highly talented and mega rich co- founder of Apple died in 2011 of pancreatic
cancer. No surprise there. Pancreatic cancer is associated with a particularly
poor prognosis. It is an aggressive disease and usually diagnosed when
advanced. Once the disease has spread to other sites (metastasised) an early
death is inevitable. Consequently, less than 1% of sufferers survive 5yrs post
diagnosis. Not even the wealthy can circumvent medical reality. However, this
is not quite true in Job’s case. Most pancreatic cancers are nasty
adenocarcinomas. Jobs had a rare form of pancreatic cancer (islet cell
neuroendocrine tumour) which is associated with a favourable prognosis and is
very amenable to early treatment. It is estimated that between 80 to 90 percent
of patients will still be around after 10 years-if treated. Jobs decided to
eschew conventional medical treatment and opt for a treatment regime based on
diet, herbs, acupuncture and spiritual consultation (God help us all!). After 9
months of ineffective ‘treatments’ he elected for surgery. By this time his
tumour had spread and extensive surgery was therefore necessary.
Steve Jobs was an intelligent, demanding, egomaniacal
perfectionist who also happened to be a Buddhist. He placed his faith in
unconventional treatments of dubious provenance when he should have been
undergoing effective, conventional, medical treatments which would have saved
his life. The irony of course, is that the character traits which served him so
well in his creative and business life failed him at the last, much to the
exasperation of his family and doctors. I suspect, towards the end, Steve Jobs
realised his folly, but by then no amount of chanting or chemotherapy could
have saved his life.
There is no such thing as alternative medicine, just
medicine.
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