Monday, January 21, 2019

Is that really a good alternative?

As regular readers of these posts or Prescription for Bankruptcy know, I am very concerned about the influence of the pharmaceutical industry on doctors’ choice of therapies. They push hard, through multiple channels, for us to use new expensive treatments that offer only modest if any improvement over older ones. Big Pharma, however look like choir boys when compared to the proponents of many “alternative” treatments. Before the FDA allows a drug on the market, the manufacturer must do studies to show that it works and is reasonably safe. There is nothing similar for a new surgical procedure, but proponents of a new technique will generally perform studies comparing it to “standard” surgeries. So-called “alternative” treatments rarely if ever do such testing and rely on enthusiasm instead.
Non-traditional treatments have a long history. Through much of human history, well into the 20th century, traditional medicine did not have much to offer most illnesses, so it was natural for sufferers to turn to anyone who offered hope. The “treatment” with the longest history was faith-based: prayers and offerings to God or the gods were at times followed by cures. 18th and 19th century America had travelling wagons purveying various nostrums for any ailment. Newspapers of the 19th century were filled with ads for such products as Lydia Pinkham’s herbal tonic (whose most active ingredient was alcohol).
One would have thought that as modern medicine became able to offer therapies that actually did improve or even cure illnesses, the “alternative” practitioners would have faded away, but they are still very much with us. Nowadays, purveyors of megavitamins, colonic cleansing and chelation therapy have the wonderful medium of the internet to spread their message. While it puzzled me for some time why these messages took root, I am beginning to understand. The most obvious reason is that even as we enter the promising new era of gene-based therapy, there remain diseases doctors cannot cure. If a physician tells you this, why not seek answers elsewhere? Most therapies that traditional physicians suggest have data behind them: studies showing that they work better than alternatives (or placebos). The same cannot be said for most “alternative” therapies. What you will see instead are testimonials and/or unsubstantiated claims, often by an attractive person in a white coat. Since placebos work – a certain number of sufferers will be made better by an attractively colored sugar pill – it is easy to find success stories for any therapy.
Alternative medicine is big business. A study I saw in the Toronto Globe and Mail estimated world-wide sales approaching nearly US$200 billion. Social media are widely used and misused by the unscrupulous. Russian trolls not only tried to influence elections in France, the U.S. and Eastern Europe, but they are prominently pushing “anti-vaccination” theories to receptive audiences. While people should be free to spend their money on unproven treatments if they wish to do so, it should be incumbent on agencies such as the FDA and FCC to forbid totally unsubstantiated claims and fine offenders. Studies have found that 40% of Americans believe that alternative therapies can cure cancer. The truth is that a 2018 study from Yale found just the opposite: that patients who used “alternative” therapies had 2.5 times the death rate of those who used conventional treatment.
If you still feel that “alternative” therapies are worth trying, work with your doctors and tell them what you are doing. Combining conventional treatment with prayer may well work better than the treatment alone. The same cannot be said for many other treatments, which may even be harmful, but at least do not keep it a secret, as some “natural” remedies may interfere with other medicines you are given.
The best advise to follow is a very old maxim: caveat emptor – let the buyer beware.

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