Unproven treatments give false hope, can prove to be harmful

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It is unfortunate the news media and the general public are so vulnerable to sensational claims made by charlatans and undisciplined purveyors of unproven medical practices. I was recently reminded of this by a CBS "60 Minutes" program.

The story was recounted on the CBS News Web site under the heading "Homemade Cancer Machine Shows Promise." The subtitle read, "Created In A Patient's Garage, This Radio Wave Machine May One Day Offer Side-Effect Free Treatment."

In this news item a leukemia cancer patient claimed to have invented in his garage a radio wave machine that he believed would someday cure cancer. John Kanzius had no background in science or medicine. He had been a radio executive. The news story touted the determination and hope of the patient, but offered no relevant credentials.

He hoped his machine "...would zap cancer cells without the horrible side effects of chemotherapy or radiation."

The bulk of my work over the past 30 years in radiation therapy has focused on delivering effective doses of radiation to solid cancers while minimizing the side effects.

Huge technological strides have been made to this end. The interaction of radiation with cells and tissues is well understood and documented. That knowledge is used to optimize treatments for tumor control while minimizing side effects.

While not wanting to diminish the side effects that do occur, many patients go through their treatments without experiencing anything like "horrible side effects."

I know our chemotherapy colleagues have similarly made significant advances in mitigating the side effects of their therapies.

There is no doubt some cancers require more aggressive treatments than others. Those treatments can have more severe side effects. But, for a large number of patients, modern cancer treatments add years of quality life. Moreover, they are spared the horrible effects of dying from their untreated cancer.

Favorable outcomes are routinely compromised when patients delay treatment because they have been sidetracked with unproven therapies. For many cancers early detection and initiation of treatment are critical.

Delays caused by exploring and trying unproven treatments can result in disease progression. The opportunity for cure or control afforded by prompt treatment can be lost.

To those who argue there is no harm in trying unproven methods, it is easy to give examples of countless patients who delayed treatment. In doing so, those patient's diseases often advance from curable to incurable. Unproven methods are truly the horror visited on patients by advice which is misguided.

Mr. Kanzius offered no mechanism by which his device killed cancer cells. Neither did he suggest how the device discriminated cancer cells from normal cells.

The report states that Mr. Kanzius was "collaborating" with a liver cancer surgeon at MD Anderson Cancer Center. The research being conducted by this physician focused on "injecting" gold nano-particles into cancer cells. The radio waves would then heat up the gold and kill the cancer.

It is relatively easy to imagine treatments that might effectively kill cancer cells. The trick is to get the therapeutic agent to act only in the cancer cells and not in healthy cells. Many a proposed treatment has failed to achieve this discrimination; hence there is collateral damage to normal cells.

Application of heat to kill cancer cells is not new. It has been used for decades to enhance the therapeutic effect of radiation. Hyperthermia is one weapon used in special situations, and is far from a panacea.

The article further claims Mr. Kanzius subjected himself to treatments (without the gold nano-particles) with his machine. Though this patient has since died of his disease, he claimed to have had some remission before his demise. His energy level and blood counts were said to have improved.

However, CT scans showed continued disease in abdominal lymph nodes. Importantly, for his claim of a response to radio waves, there were a number of things occurring in his treatment that were more likely to account for these changes.

During the time Mr. Kanzius was self administering his radio wave treatments (without gold nano-particles) he was also receiving conventional chemotherapy.

There was no quantification of the "dose" of radio waves. He simply got into the machine for some arbitrary number of minutes. If there was a response, there would be no way of saying it was the radio waves or the chemo. Neither was there any data to indicate the effective "dose."

A number of observations about the reporting of this unproven therapy are important.

There was never a rationale given for how radio waves might differentially kill cancer cells (except in conjunction with gold nano-particles). The inventor simply asserted, "... somehow leukemia cells had a special, intrinsic property that would attract radio waves."

We are given no reason to think this method might be effective because we are never told how it acted on any cells, let alone cancer cells. This totally negates any claim for eliminating "horrible side effects" from collateral damage to normal tissue.

No meaningful response to the treatments was ever documented. The supposed response that was offered (improved energy levels and blood counts) could easily have been caused by changes in his conventional treatment regimen.

All proposed new treatment must undergo controlled trials. In such trials other potential contributing factors are accounted for. Only in this way can the response be unambiguously attributed to the therapy.

To judge the credibility of such claims one must ask a few questions:

I dislike being the naysayer. I never want to dampen one's hope. But, misguided decision making kills patients. The death and suffering of patients who might have had better outcomes is the real horror.

One must always remain hopeful without abandoning healthy skepticism. It should always be remembered that unusual or exceptional claims must be backed by exceptional data. This is no less true in matters of life and death than in more mundane matters.

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