Homeopathy and EBM

[andersenpa]

This is a continuation of the discussion which derailed the thread here:

http://www.physicianassistantforum.com/forums/showthread.php/36407-Shouldn-t-This-be-Manslaughter

 

I would like to address this post:

 

Please show me evidence and I am not comparing chemo as prevention, I said diet was prevention. Chemo doesn't treat cancer effectively, it mask it for a few months to years and then cancer comes back. Same way as surgery, your just cutting of the "tip of the ice berg" and cancer is else where in the body.

 

Realize that this is a broad, sweeping and categorically incorrect statement about surgical oncology. There are numerous cancers which are cured by surgery, with and without adjunctive medical onc.

 

From reading the posts on the last thread it seems you have an antipathy to some forms of western medicine, perhaps to such a degree that I wonder how you will reconcile it with your PA education (which is based in EBM/etc). I am the first to agree that diet and lifestyle are major contributors to health and illness, but we need to avoid going to far in the other direction to state that diet alone is the panacea (to the exclusion or proven drug therapy).

 

Pharmacology and surgery do NOT universally mask or temporarily suppress disease. This is a fundamental concept that you will need to embrace in order to get the most out of your PA training.

[andersenpa]

Chemo therapy has not worked in a statistical fashion over the last 40 years. The stats are very low on "curing" cancer and cancer rates have increased since 40 years ago. Look at the numbers and you need to watch the movie "Healing Cancer from the Inside Out." It will behoove to be educated on the cancer topic and the treads that cancer has been taking over the last 40 years. I will post more on cancer if need be, but again the flu vaccine fails over and over again in all the research articles everyone has given me...The efficacy maybe be high in a relative fashion, but when put in to a real number (absolute risk) it is very low and when comparing how many people actually get the flu <2% and how many people get the 3 specific strains that are covered by the vaccine the 1% is cut in half or even more. Then after that vaccine "might" protect against the virus then about 15% of those affected get a simple illness (low grade fever, cough, sore throat) so what is the benefit of risking allergies against the vaccine and/or injecting KNOW toxins in ones body to potentially protect against a cough or sore throat. In my research article above it was 0.33 people of 1 person/100 gets the flu then only 15.7% of that 0.33 person = 0.05181 people of the 0.33 people of that 1 person out of 100 will have symptoms. That 1% is the attack rate and not the people that have the 3 strains covered by the vaccine out of hundreds of different strains, plus in many articles it has been shown that 50-75% of the cases are not the 3 strains covered by the vaccine and a mere <2% (from the article above) actually are protected if they get those 3 strains and a mere 15.7% (article above) have simple symptoms (cough, sore throat, low grade fever). So, you are talking about a extremely low % of people that is counted in 0.000 numbers. This is from the WHO on the entire WORLD that died from H1N1 2,185/209,438 = 1.04% and they go on to state that "Given that countries are no longer required to test and report individual cases, the number of cases reported actually understates the real number of cases." So, the % would be even LOWER because the cases reported actually understates the real number of cases...http://www.who.int/csr/don/2009_08_28/en/index.html

 

I am not talking about flu vaccine or chemo.

I'm talking about surgery for cancer and general medical therapy for disease (essential hypertension, diabetes, COPD, etc).

I understand how fixated you are on the flu vaccine but that was not the point of my post.

[mdebord]

A few quick thoughts:

I have reviewed your preventcancer.com links and ask that you please try to cite references from this century. With the rate of advancement in cancer therapy, much of this is already out of date.

Also, please remember that it does not boil down to simple mortality rates. For instance, early detection through mammography associated with lumpectomy/XRT has allowed many women to keep their breasts. Sure, they may have survived at the same rates if it were discovered years later through a CBE - but at that point a mastectomy is often the only ticket.

[andersenpa]

I 100% agree with general medical therapy for diseases if the EBM shows significant numbers in helping with the condition. I have ZERO problems with that, they numbers are NOT there for the flu vaccine or chemo therapy. Truth be told, you cannot find articles with high significant value for either the flu vaccine or chemo therapy. If so please post them.

 

DUDE....if you post something and someone responds to it (kinda the reason people post on a forum...unless you're just here to hear yourself talk...), then RESPOND in kind, and don't just non sequitur your way back to some other topic. To repeat:

 

 

Please show me evidence and I am not comparing chemo as prevention, I said diet was prevention. Chemo doesn't treat cancer effectively, it mask it for a few months to years and then cancer comes back. Same way as surgery, your just cutting of the "tip of the ice berg" and cancer is else where in the body.

 

You seriously miscategorized surgical treatment of cancer. It's just wrong, it's not a debatable point.

Furthermore describing meds as toxic and stating modern western medicine is all about drugs and not about prevention is ALSO wrong.

 

I agree with you and think there is a balance also. There is a need to not push medications on people when there is a fix to a problem. Modern medicine is all about medication, medication, medication and not on prevention (life style changes). There needs to be more emphasis on diet diet diet because this is what is ultimately killing our patients.

 

Cardiac patients undergo dietary counseling from a nutritionist, cardiac rehab w/ physical therapy, smoking cessation programs, glucose management with a diabetic educator, and multimodal lipid management with specialists (docs, NPs, PAs). All that on top of "just drugs and surgery". This is the reality of what you're commenting on.

 

Western medicine gives a pill and it works within hours to days, but does NOT fix the problem, just mask it.

 

Excluding the obvious example of antimicrobials, there are multiple other drugs that target and treat/reverse inherent or genetic disease. Best case example is insulin for type I DM.

 

I appreciate that you are passionate about the topic and are doing your research, but you have to embrace the entirety of medical treatment in order to offer your patients the full spectrum of care. Being dogmatic will only end up failing someone.

[Craigk]

So 6 articles written by the same guy and over 10 years old is the basis for your argument?

rBHG in Milk: http://www.cancer.org/Cancer/CancerCauses/OtherCarcinogens/AtHome/recombinant-bovine-growth-hormone

Nuclear power plants: http://www.sciencedaily.com/releases/2011/07/110712093844.htm ( I understand this is discussing childhood cancers but I believe we can all agree that children are more sensitive to radiation effects)

Nuclear power cont: http://www.cancer.gov/cancertopics/factsheet/Risk/nuclear-facilities (older study that disproves overall cancer risk)

The Pill: Research has shown there is a slight increase in risk with oral contraceptive use but not as much risk as 1st degree relative history, early/late menarche, nulliparous and late 1st pregnancy >35yrs of age. All these put the pt at more risk than BC.

Mammogram risk: http://hps.org/publicinformation/ate/q4720.html ; http://www.mayoclinic.com/health/mammogram-guidelines/AN02052 cites study in Sweden of 1 million women who received mammogram screening was noticed 29% decrease in breast cancer related deaths. That's 290,000 women, pretty dang significant especially if one of those were your mom, wife, sister or daughter.

[Craigk]

You have just proven yourself to be completely blind to the advances in medicine and I sincerely fear the damage you may cause to your future patients. Much of your rhetoric suggest that you are not a current PA student due to the lack of understanding in the overall approach to patient care. Preventative medicine is discussed at great length in PA school, diet, exercise and decreasing at risk behaviors (ie. smoking ETOH abuse, drug abuse) is at the basis of everything we are taught. Your lack of knowledge of this suggest that you are not as you portray yourself and therefore lose all credibility in my opinion.

 

Oh, surgical intervention is curative for cancer when detected early, case in point, my mother diagnosed renal cell carcinoma, had nephrectomy, tumor was confined to the kidney and has been cancer free for 15 years. Seems curative to me, in her case.

[Contrarian]

Pine Nuts, Acai Berries, Seaweed from the northwest Japanese coast, pulverized into a fine powder no larger than 2 microns, then mixed... actually blended in a Tornado Ninja Blender, then dried into a paste and brought to exactly 147.3 degrees in a George Forman grill in Saran Brand wax paper... prevents West Nile Virus...

[GeneValgene]

don't feed the troll!

 

[EMEDPA]

Pine Nuts, Acai Berries, Seaweed from the northwest Japanese coast, pulverized into a fine powder no larger than 2 microns, then mixed... actually blended in a Tornado Ninja Blender, then dried into a paste and brought to exactly 147.3 degrees in a George Forman grill in Saran Brand wax paper... prevents West Nile Virus...

DAMN, i've been heating it to only 147 degrees and using generic wax paper....but it does prevent aligator bites prepared in this fashion. in my exhaustive n=1 trial I have never been bitten by an aligator while using this mixture.

[cinntsp]

C'mon guys...why bother with what is obviously a troll?

[Just Steve]

I really don't see what the infatuation with flu vaccines and curative treatments for cancer is all about. There are obviously soooo much more dangerous, deadly things in this world than just a little bit of evidence based medicine. Holy cow people, do some reading, do some research... I bet every last one of you has pushed this poison onto your patients.. ohhh the shame.

 

http://www.dhmo.org/facts.html

 

I leave you now to reflect on what you have been doing. Hopefully, someday you'll see how valid my warning is....

[Joelseff]

Steve u made me LOL....

 

Sent from my myTouch_4G_Slide using Tapatalk

[EMEDPA]

WHOA, I've been telling my patients to take their oral medicines with DHMO for years.....:)

[Contrarian]

Sleep Disturbance... Check

Perseveration... Check

Grandiosity... Check

Delusions... Check

 

Decompensating Mental Illness...????

Probably needs a Lithium or Neuroleptic adjustment.

[LT_Oneal_PAC]

http://m.theoncologist.alphamedpress.org/content/9/1/80.full.pdf

 

An article about alternative treatments, where they are helpful, and where they are basically outright lies.

 

http://www.nejm.org/doi/pdf/10.1056/nejm198903303201302

 

Article demonstrating effectiveness of chemo therapy and lumpectomy.

 

http://m.guardian.co.uk/world/2011/nov/22/increase-survival-rates-cancer-types?cat=world&type=article

 

Article stating the drastic increase in survival rates for several types of cancer in 40 years.

 

Now show me where homeopathy "cures" or even extends life with cancer, or where it completely 100% prevents it. Unless it 100% prevents it or has at least a modest relapse free 5 year rate, the surgical and medical oncology as we practice it is here to stay.

[mdebord]

I am not a troll, I am a real PA student. I am shocked at the amount of ignorance here and the lack of ability, time whatever in looking up/reading research articles correctly. NOT ONE person has disputed me against the FLU VACCINE and proved to me that I was incorrect in my calculations of relative vs. absolute numbers. Again, prove to me from my prior posting in the other discussion, that was closed, that flu vaccines work...

 

Look, you're talking to PAs and PA students here. We have already done our time researching these things. Personally, my thesis was on lumpectomy vs mastectomy. Do not interpret our unwillingness to post articles supporting what is widely-accepted EBM as a lack of research on our part. To be honest, it's a waste of our time. These days I spend my research time reading cutting edge information likely to benefit my patients rather than rehashing these subjects with someone like you who so clearly has an agenda.

 

Okay, one more thing and then I promise not to feed the troll anymore. I'm not sure what kind of medicine you plan to practice after graduation, but if it in any way involves Preventive Care, you will quickly become familiar with Quality Metrics. You will essentially be graded on how many of your patients are UTD on their mammos, how many with CKD are on an ACE-I, etc. Even if you don't believe in these, the rest of the medical bureaucracy does (with good reason of course.) So if you continue to stray so far from the pack, you may very well be unemployable because you would be a detriment to the bottom line of any practice willing to take you on. So the problem may fix itself - you may comply or be forced into homeopathic practice. Perhaps one day we'll be debating whether you should be charged with manslaughter because you continue to preach diet to a noncompliant pt instead of treating their HTN.

[LT_Oneal_PAC]

As for flu I have an article: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr59e0729a1.htm

 

Here are some excerpts, particularly notice the trial that provided 92-100% prevention of illness due to the TIV in healthy college students.:

 

The recommended composition of influenza vaccines changes in most seasons, with one or more vaccine strains replaced annually to provide better protection against wild-type viruses that are likely to circulate. However, evidence from clinical trials suggests that protection against viruses that are similar antigenically to those contained in the vaccine extends for at least 6--8 months. Three years after vaccination with the A/Hong Kong/68 vaccine, vaccine effectiveness was 67% for prevention of influenza caused by the A/Hong Kong/68 virus (145). In randomized trials conducted among healthy college students, immunization with TIV provided 92% and 100% efficacy against influenza H3N2 and H1N1 illnesses, respectively, during the first year, and a 68% reduction against H1N1 illness during the second year (when the predominant circulating virus was H1N1) without revaccination (146). In a similar study of young adults in 1986--1987, TIV reduced influenza A (H1N1) illness 75% in the first year, H3N2 illness 45% in the second year, and H1N1 illness 61% in the third year after immunization (146). Serum anti-influenza antibodies and nasal IgA elicited by vaccination remain detectable in children vaccinated with LAIV for more than 1 year (147). In one community-based nonrandomized open label trial, continued protection from MAARI during the 2000--01 influenza season was demonstrated in children who received only a single dose of LAIV during the 1999--2000 season (148).

 

Adults aged ≥65 years typically have a diminished immune response to influenza vaccination compared with young healthy adults, suggesting that immunity might be of shorter duration (although still extending through one influenza season) (149,150). However, a review of the published literature concluded that no clear evidence existed that immunity declined more rapidly in the elderly (151), and additional vaccine doses during the same season do not increase the antibody response. One study that measured the proportion of persons who retained seroprotective levels of anti-influenza antibody declined in all age groups, including those aged ≥65 years, within 1 year of vaccination. However, the proportion in each age group that retained seroprotective antibody levels remained above standards typically used for vaccine licensure for seasonal influenza A (H1N1) and influenza A (H3N2) in all age groups. In this study, anti-influenza B antibody levels declined more quickly, but remained elevated well above licensure threshold for at least 6 months in all age groups (152). The frequency of breakthrough infections is not known to be higher among those who were vaccinated early in the season. Infections among the vaccinated elderly might be more likely related to an age-related reduction in ability to respond to vaccination rather than reduced duration of immunity.

 

...

 

Estimates of vaccine efficacy or effectiveness among children aged ≥6 months have varied by season and study design. In a randomized trial conducted during five influenza seasons (1985--1990) in the United States among children aged 1--15 years, annual vaccination reduced laboratory-confirmed influenza A substantially (77%--91%) (139). A limited 1-year placebo-controlled study reported vaccine efficacy against laboratory-confirmed influenza illness of 56% among healthy children aged 3--9 years and 100% among healthy children and adolescents aged 10--18 years (171). A randomized, double-blind, placebo-controlled trial conducted during two influenza seasons among children aged 6--24 months indicated that efficacy was 66% against culture-confirmed influenza illness during the 1999--00 influenza season but did not reduce culture-confirmed influenza illness substantially during the 2000--01 influenza season (172).

 

A case-control study conducted during the 2003--04 season indicated vaccine effectiveness of 49% against laboratory-confirmed influenza (170). An observational study among children aged 6--59 months with laboratory-confirmed influenza compared with children who tested negative for influenza reported vaccine effectiveness of 44% in the 2003--04 influenza season and 57% during the 2004--05 season (173). Partial vaccination (only 1 dose for children being vaccinated for the first time) was not effective in either study. During an influenza season (2003--04) with a suboptimal vaccine match, a retrospective cohort study conducted among approximately 30,000 children aged 6 months--8 years indicated vaccine effectiveness of 51% against medically attended, clinically diagnosed pneumonia or influenza (i.e., no laboratory confirmation of influenza) among fully vaccinated children and 49% among approximately 5,000 children aged 6--23 months (169). Another retrospective cohort study of similar size conducted during the same influenza season in Denver but limited to healthy children aged 6--21 months estimated clinical effectiveness of 2 TIV doses to be 87% against pneumonia or influenza-related office visits (165). Among children, TIV effectiveness might increase with age (139,174). A systematic review of published studies estimated vaccine effectiveness at 59% for children aged >2 years but concluded that additional evidence was needed to demonstrate effectiveness among children aged 6 months--2 years (175).

[True Anomaly]

Tah- I'll save you the time of putting up a response to Oneal's post:

 

"Again you have not shown me evidence about the flu vaccine- using the CDC is wrong, they are wrong. Again, show me evidence, and I mean absolute numbers and not relative I will be back with more articles, articles which cannot be refuted, after I use the bathroom. BTW, if something is understated, that means its LESS than it is reported. I know, because I have flawless reading skills"

[Just Steve]

Fluoride is a KNOWN toxin and it is in our water supply. Studies show year after year that it does not decrease teeth decay nor does it help in anyway. If you are suppose to swallow fluoride at the dentist office, then why are we drinking it everyday...?

 

Not everyone gets flouride. I live in a town that does not put flouride in it's public water supply, in a state where only about 19% of the population gets it in their water.

 

You made a typo when you said you are supposed to swallow it at the dentist office. I understand that you meant to say NOT swallow it. Surely you must have some understanding that dilution and titration will specify the route of administration.

 

Here is a link that lets you know how your state measures up for flouride use. Overall only about 60some% of the US gets flouride on average. http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/WaterFluoridation/CommunityWaterFluoridationState.htm

 

A key component you seem to miss is that there is constantly a risk to benefit ratio being used. Yes, evidence based medicine can have untoward or adverse outcomes. However the risk of the adverse is outweighed by the benefit in most situations. This is where patient education and consent are important.

 

Water is a known toxin when used in an inappropriate manner...just like valerian root, willow bark, nightshade, mountain sorrel, tomatoes, carrots. So we fall back to the adage of "everything in moderation".

 

So what school selected you to bear their name on your diploma? I am curious to know which program has such an obvious preference for being outside of the box.

[LT_Oneal_PAC]

Tah- I'll save you the time of putting up a response to Oneal's post:

 

"Again you have not shown me evidence about the flu vaccine- using the CDC is wrong, they are wrong. Again, show me evidence, and I mean absolute numbers and not relative I will be back with more articles, articles which cannot be refuted, after I use the bathroom. BTW, if something is understated, that means its LESS than it is reported. I know, because I have flawless reading skills"

 

That reminds me, mine was also after a 5 minute google search. Okay, okay...I used google scholar for the chemo stuff.

[andersenpa]

Western medicine does practice prevention, don't understand why you are disputing that...

 

Um, YOU are the one disputing that. Do you read your own posts?

 

I agree with you and think there is a balance also. There is a need to not push medications on people when there is a fix to a problem. Modern medicine is all about medication, medication, medication and not on prevention (life style changes). There needs to be more emphasis on diet diet diet because this is what is ultimately killing our patients.

 

...what is surgical treatment of cancer if I am wrong with what I am saying...also can you show me any article that shows that Western medicine has worked for cancer in the past 40-50 years..?

 

I don't understand this sentence but surgery is definitive/curative treatment for several cancers...colon....breast....lung...prostate.....

It's beyond "articles" now, it's in the books.

[LT_Oneal_PAC]

Well the research articles handed to me state a relative benefit/risk, but when you calculate the real numbers "absolute benefit/risk" the numbers are flat out low and not significant...even breastcancer.org states "When you read about research on treatments or lifestyle choices that can reduce or increase breast cancer risk, it's important to know that in most cases the change in risk is for a specific time period that's noted in the study. Also, when you read that something caused an increase or decrease in breast cancer risk, this change in risk is usually relative risk unless it's otherwise noted." They also give examples using bleach in a washing machine...so the numbers are manipulated to make one think there is a significant difference when there really is a small difference...You need to read the articles better instead of the abstract and calculate the numbers yourself...Even though the relative risk decreases 20% if you use only powder detergent, the absolute riskdecreased by only 2% (8% vs. 10%). This is an example from the website...20% and 2% is much different and even the ACS states that anything less than 30% is non-significant and as good as a placebo (sugar pill), was what they state...not my words, their words...

 

Please post where they state this on ACS. You're making the statement, so it falls on you to prove it.

 

Also please reply to my previous posts.

[LT_Oneal_PAC]

Respond to my studies. Post REAL articles, not websites, that show cancer TREATMENT (wish I could bold on the app),i.e. surgical removal, is ineffective. Do it today or leave.

[LT_Oneal_PAC]

Western medicine gives medications like its candy, but never did I say they did not practice prevention. It is ALL about meds and not the time to sit and educate someone on diet, life style etc...give a pill and run...Just cause it is in books does not mean it is correct...I will show you article after article that cancer is the SAME as it was 50 years ago...how can you not understand that a tumor is a dummy proof way of saying, "Oh look, there is a tumor (i.e. a symptom) and there must be something wrong within the body." That is like the check engine light comes on and you unplug it or break the bulb so it "goes away" then 6 months down the road the engine stops working...who would have known...

 

In the first sentence you say they practice prevention, and literally in the next sentence you more than imply they don't.

 

You, my friend, have a disorder or are just plain stupid. I vote for both. Go find Jenny McCarthy and Jim Carrey and Tom Cruise so you can all cry together about how no one listens to you about vaccines and drugs despite you all having clear expertise.

[andersenpa]

Western medicine gives medications like its candy, but never did I say they did not practice prevention.

 

Reread:

 

 

I agree with you and think there is a balance also. There is a need to not push medications on people when there is a fix to a problem. Modern medicine is all about medication, medication, medication and not on prevention (life style changes). There needs to be more emphasis on diet diet diet because this is what is ultimately killing our patients.

 

 

I agree with you and think there is a balance also. There is a need to not push medications on people when there is a fix to a problem. Modern medicine is all about medication, medication, medication and not on prevention (life style changes). There needs to be more emphasis on diet diet diet because this is what is ultimately killing our patients.

 

 

I agree with you and think there is a balance also. There is a need to not push medications on people when there is a fix to a problem. Modern medicine is all about medication, medication, medication and not on prevention (life style changes). There needs to be more emphasis on diet diet diet because this is what is ultimately killing our patients.

 

 

I agree with you and think there is a balance also. There is a need to not push medications on people when there is a fix to a problem. Modern medicine is all about medication, medication, medication and not on prevention (life style changes). There needs to be more emphasis on diet diet diet because this is what is ultimately killing our patients.

 

in case you missed your own words:

 

 

I agree with you and think there is a balance also. There is a need to not push medications on people when there is a fix to a problem. Modern medicine is all about medication, medication, medication and not on prevention (life style changes). There needs to be more emphasis on diet diet diet because this is what is ultimately killing our patients.

 

so.....

 

Western medicine gives medications like its candy, but never did I say they did not practice prevention.

 

............................

 

I agree with you and think there is a balance also. There is a need to not push medications on people when there is a fix to a problem. Modern medicine is all about medication, medication, medication and not on prevention (life style changes). There needs to be more emphasis on diet diet diet because this is what is ultimately killing our patients.