Archives of The Cheerful Oncologist, Volume 2

One of the frustrations of educating the public about new developments in cancer care is that most people get their information from the mainstream media, which in my opinion often fails to report these stories clearly and accurately. This leads folks to make broad assumptions about cancer and its treatment that can lead to disappointment and disillusion when they are eventually proven to be false.

Here is a case in point: this news story suggests that “doctors have found statistical evidence that alternative treatments such as special diets, herbal potions and faith healing can cure apparently terminal illness.”

This internet article is grossly misleading and incomplete. The abstract from the actual paper reveals the following:

1. The patients were all from Australia, which simply means that any conclusions made cannot necessarily be extrapolated to include Americans with lung cancer.

2. These 2337 selected patients were all given low dose radiation therapy, defined as less than 36 Gy (standard ‘curative’ RT would be at least 60 Gy). They were not given alternative treatments such as herbal potions.

3. Of the 2337 patients, 25 survived five years and 18 of those 25 patients were not only alive five years later, but still free from progression of their lung cancer. One percent of patients survived five years - this is a “cure”?

4. The five-year survivors “were less likely to have distant metastases (P=0.020).” Now there’s a shocker! Who knew that people with localized lung cancer have a better chance for long-term survival than those with widespread metastases?

5. The conclusion of the authors, in contrast to the conclusion of the news article, is that “approximately 1% of patients with proven NSCLC [non-small cell lung cancer] survived for > 5 years after palliative RT, and many of these patients appeared to have been cured by a treatment usually considered to be without curative potential.” In fact, one researcher is even quoted in the news story as stating that “it is important that the frequency of this phenomenon should be appreciated so that claims of apparent cure by novel treatment strategies or even by unconventional medicine or ‘faith healing’ can be seen in an appropriate context.”

Translation: If one percent of all patients with lung cancer are cured with low-dose radiation therapy, which is considered not to be a curative treatment, then perhaps one percent of all lung cancer patients survive for five years no matter what treatment they are given, or whether they are treated or not.

Oh, now I get it…I can peddle anything I want as a cancer cure as long as my customers can live with a proven success rate of 1% and weather the criticism from skeptics who say that my treatment t’weren’t even the reason they’s alive!

Or, to put it in the lingua franca of academia, one who assumes his alternative cancer therapy is the cause of his patient surviving is commiting the logical fallacy of “Post Hoc, Ergo Propter Hoc.”

Lord knows we oncologists have our work cut out for us when it comes to disseminating accurate information. That is why we thrive on counseling patients, for every day that we break through the wall of ignorance entrapping those patients or caregivers who are experiencing the agony of cancer is a day when we have earned the right to watch the setting sun canopy the sky with layers of pink and orange, and feel satisfied.