Dangerous MISINFORMATION about Cancer YOU OUGHT TO KNOW !!

VIDEO: Exclusive video of Suzanne Somers: Birth Control Pills May Have Caused My Breast Cancer.

Be it from imbibing the atmosphere within the bubble of woo-friendly southern California or taking a crash course at the University of Google and, through the arrogance of ignorance, concluding that they know more than scientists who have devoted their lives to studying a problem, celebrities believing in and credulously promoting pseudoscience present a special problem because of the oversized soapboxes they command. Examples abound.

There’s Bill Maher promoting anti-vaccine pseudoscience, germ theory denialism, and cancer quackery on his show Real Time with Bill Maher and getting the Richard Dawkins Award from the Atheist Alliance International in spite of his antiscience stances on vaccines and what he sneeringly calls “Western medicine.” Then there are, of course, the current public faces of the anti-vaccine movement, Jenny McCarthy and her boyfriend Jim Carrey, the former of whom thinks it’s just hunky dory (or at least doesn’t appear to be the least bit troubled) that her efforts are contributing to the return of vaccine-preventable infectious diseases because she apparently thinks that’s what it will take to make the pharmaceutical companies change their “shit” product (her words), and the latter of whom spreads conspiracy theories about vaccines and contempt on people suffering from restless leg syndrome.

Finally, there’s the grand macher of celebrity woo promotion, Oprah Winfrey, who routinely promotes all manner of medical pseudoscience, be it “bioidentical” hormones, the myth that vaccines cause autism (even hiring Jenny McCarthy to do a blog and develop a talk show for her company Harpo Productions), or other nonsense, such as Christiane Northrup urging Oprah viewers to focus their qi to their vaginas for better sex.

Unfortunately, last week the latest celebrity know-nothing to promote health misinformation released a brand new book and has been all over the airwaves, including The Today Show, Larry King Live, and elsewhere promoting it. Yes, I’m talking about Suzanne Somers, formerly known for her testimonial of having “rejected chemotherapy and tamoxifen” for her breast cancer, as well as her promotion of “bioidentical hormones,” various exercise devices such as the Thighmaster and all manner of supplements. Her book is entitled Knockout: Interviews with Doctors Who Are Curing Cancer–And How to Prevent Getting It in the First Place. It is described on the Random House website thusly:

In Knockout, Suzanne Somers interviews doctors who are successfully using the most innovative cancer treatments–treatments that build up the body rather than tear it down. Somers herself has stared cancer in the face, and a decade later she has conquered her fear and has emerged confident with the path she’s chosen.
Now she shares her personal choices and outlines an array of options from doctors across the country:
EFFECTIVE ALTERNATIVE TREATMENTS
without chemotherapy
without radiation
sometimes, even without surgery
INTEGRATIVE PROTOCOLS
combining standard treatments with therapies that build up the immune system
METHODS FOR MANAGING CANCER
outlining ways to truly live with the diease
Since prevention is the best course, Somers’ experts provide nutrition, lifestyle, and dietary supplementation options to help protect you from getting the disease in the first place. Whichever path you choose, Knockout is a must-have resource to navigate the life-and-death world of cancer and increase your odds of survival. After reading stunning testimonials from inspirational survivors using alternative treatments, you’ll be left with a feeling of empowerment and something every person who is touched by this disease needs…HOPE.

I first found out about Somers’ book about a month and a half ago and was fortunate enough (I think) that one of my readers who had a review copy of the book sent me a chapter list. The reason I wanted a chapter list was because I was really curious just who these doctors were whom Somers had interviewed. In particular, back then I predicted (and hoped) that one of the doctors would be one whom we’ve met before. It was. Can you guess which one? Think about it. What major study did I blog about in the middle of September? What form of cancer quackery has been covered so ably by Kimball Atwood since the very beginning of this blog? No, no, you don’t have to go back to the archives and search. I’ll tell you:

Dr. Nicholas Gonzalez. He’s the second featured doctor who is “curing cancer,” right there in Somers’ book in Chapter 6!
That’s right, one of these doctors who are “curing cancer” is a quack (in my opinion, of course) whose “protocol,” which includes 150 supplement pills a day topped off by a couple of coffee enemas per day, was recently shown to be worse than useless for pancreatic cancer and, indeed, based on a recent study, far worse than conventional treatment.

From my perspective, it was incredibly bad timing and bad luck on Somers’s part to have one of the subjects she lionized in your book to have his protocol shown to be not just worthless, but likely actively harmful, a mere two months before the release of her book. In case there are any journalists who might be interviewing Somers and are interested in more than a puff piece that lets her promote her book, I list all the posts on Science-Based Medicine that have discussed the rank pseudoscience that is the Gonzalez protocol because, as many of you have figured out, I’m never satisfied with a hammer to smack down a form of woo when going nuclear is so much more fun:
“Gonzalez Regimen” for Cancer of the Pancreas: Even Worse than We Thought (Part I: Results)
“Gonzalez Regimen” for Cancer of the Pancreas: Even Worse than We Thought (Part II: Loose Ends)
Tom Harkin, NCCAM, health care reform, and a cancer treatment that is worse than useless
Cancer Quackery is Dangerous – The Gonzalez Treatment

The Ethics of “CAM” Trials: Gonzo (Part VI)The “Gonzalez Trial” for Pancreatic Cancer: Outcome Revealed
Sadly, this bad timing appears to have had no effect whatsoever on the publicity blitz of an actress who every day tries to live down to the character she played on Three’s Company back in the 1970s or on the questions asked of her by interviewers. Somers has been all over the media this week, and I’ve seen nary a challenging question stronger than pointing out that some of the doctors featured in Somers’ book have gotten in trouble with their state medical boards, much less a much deserved question about Nicholas Gonzalez. Instead we’ve thus far been treated to cliched, credulous headlines like Suzanne Somers questions chemo in new book, Somers’ New Target: Conventional Cancer Treatment, or Suzanne Somers works to ‘Knockout’ cancer. The article circulating about her book on the AP wire begins:
Less than a year after the former sitcom actress frustrated mainstream doctors (and cheered some fans) by touting bioidentical hormones on “The Oprah Winfrey Show,” she’s back with a new book. This one’s on an even more emotional topic: Cancer treatment. Specifically, she argues against what she sees as the vast and often pointless use of chemotherapy.

Somers, who has rejected chemo herself, seems to relish the fight.
Let’s get one thing straight here. It is most definitely not, as implied by various articles about Somers, in any way amazing that Somers is still alive after having “rejected chemotherapy.” As I explained at the dawn of this blog, Somers had a stage I tumor with a favorable prognosis. If Somers is going to play the gambit of repeating, “I rejected chemotherapy and tamoxifen and I’m still alive” and attributing her survival to the alternative medicine woo she chose instead, perhaps now is the time to go into more detail than I’ve ever gone into before about her case. Well, not quite. I did go into quite a bit of detail in my talk at the Science-Based Medicine Conference at TAM7 in July. After all, I did the research; so I might as well get some more use out of it and spread it beyond the 150 or so people who heard my talk.

Prelude by flashback: Suzanne Somers’ breast cancer

In preparation for my talk at TAM7, I searched for all the information I could find that was publicly available about Suzanne Somers’ diagnosis of breast cancer back in 2000. For your edification, I’ve also uploaded the slides from my presentation relevant to Suzanne Somers’ breast cancer diagnosis as a PDF file. Suffice it to say, there is a great deal of misunderstanding of breast cancer in Somers’ testimonial. In this case, I don’t actually blame Somers all that much for her misunderstanding, because it is a very common misunderstanding that clearly derives from a misunderstanding of the difference between using chemotherapy for primary treatment of cancer versus adjuvant treatment of cancer. In early stage breast cancer, which can be surgically removed for cure, chemotherapy and radiation therapy are in general used as additional therapies that decrease the risk of recurrence of the cancer after surgery. That’s what adjuvant therapy is, extra therapy that improves a patient’s odds of surviving after a primary treatment. In the case of early stage breast cancer, the primary treatment is surgery.

From what I can find from publicly available information on the Internet (I’ve never read one of Suzanne Somers’ books), at age 54 Somers was diagnosed with a breast cancer that was treated by lumpectomy (excision of the “lump” or tumor) and a sentinel lymph node (SLN) biopsy, the latter of which was negative for tumor cells in the SLN, plus radiation therapy. For those not familiar with the SLN procedure, it is a procedure that developed in the 1990s to determine whether a woman’s breast cancer has spread to the axillary lymph nodes (the lymph nodes under the arm) without actually removing all of the axillary lymph nodes. Before the advent of SLN biopsy, the standard of care was to do an axillary dissection (removal of all the lymph nodes under the arm) on the side of the tumor in order to determine if and how many of the lymph nodes are positive for cancer. This is critical information, because the single most powerful prognostic indicator for potentially curable breast cancer (i.e., breast cancer that has not spread beyond the axillary lymph nodes to the rest of the body, such as bone, liver, or lung) is the presence of metastases in the axillary lymph nodes and, if they are present, how many. Unfortunately, as less invasive means of treating breast cancer were developed, such as lumpectomy, the part of the operation that carried the most morbidity was the axillary dissection. Consequently, as science-based physicians are wont to do, during the 1990s surgeons tried to find a way to get the same information (are the lymph nodes positive or negative) with a less morbid procedure and thus reserve axillary dissection only for patients who do have lymph nodes with breast cancer metastases in them.

Why do I mention this? Because I want readers to understand that Somers underwent, as far as I can tell, standard surgery for a favorable, estrogen receptor-positive stage I cancer. She also underwent radiation, although she has stated in the past and now states in Knockout that, if she had it all to do over again, she would not have opted for radiation. Be that as it may, she has been trumpeting proudly for a number of years that she rejected chemotherapy and tamoxifen and has done quite well. This claim, although true, says nothing about whether he decision to eschew those adjuvant therapies was a good one and even less about whether the woo she pursued after that had anything to do with her survival. As I described so long ago, however, surgical excision is curative for most small breast cancers. Radiation therapy reduces the risk of local recurrences (recurrences in the breast), and chemotherapy and antiestrogen therapy (like Tamoxifen) reduce the risk of systemic recurrences (recurrences elsewhere in the body). In other words, chemotherapy and radiation are “icing on the cake” after surgery. Indeed, there is a website known as AdjuvantOnline.com that allows physicians to calculate the estimated risk of recurrence and the estimated benefit of chemotherapy and, if appropriate, antiestrogen therapy. Given when Somers had her cancer diagnosed (2000) and because I know that she had a stage I tumor, i entered data for her assuming a tumor between 1-2 cm in size, mainly because most tumors under 1 cm would not warrant adjuvant chemotherapy. Here is a blowup of the key slide from my talk where I showed the results I got when I entered the known information about Suzanne Somers’ tumor into AdjuvantOnline:

As I said before, Somers’ misunderstanding of the role of adjuvant therapy in breast cancer is somewhat understandable. It is a concept that can be difficult to communicate this to patients under the best of circumstances, and the absolute benefit of chemotherapy in treating a stage I ER(+) cancer is relatively small. Moreover, treatment paradigms change with new scientific evidence. Most women these days with a stage I ER(+) tumor would undergo Oncotype DX® testing, and the results of that testing would guide the decision of whether chemotherapy is recommended or not. Oncotype DX did not exist in 2000, and adjuvant chemotherapy was recommended for the vast majority of women with a stage I breast cancer with a tumor greater than 1 cm in diameter.
Somers’ second testimonial, however, is not as forgivable as the first, which is actually only somewhat forgivable, given how aggressively Somers has used her own testimonial to promote “alternative” medical treatments such as mistletoe extract (which may have some anti-tumor activity but the evidence is very weak–more on that perhaps in a future installment). It reveals such a profound ignorance of what she herself is recommending to women for their “health” that, as a breast cancer surgeon dedicated to providing only the best science-based surgical and medical care to my patients, I must call her out for it.

Knockout: Suzanne Somers’ “whole body cancer” scare
I do not yet have my promotional copy of Knockout, although, I’m assured, it’s on the way. I had debated whether to wait until I had read it to write about the book, but then last week I saw this interview with Ann Curry:
Visit msnbc.com for Breaking News, World News, and News about the Economy
It was also pointed out to me that Chapter 1 of Knockout is available online at the Random House website. It’s entitled A Cancer Story–Mine. I read it and was appalled at the degree of misinformation being discussed right there in the very first chapter of the book, so much so that I started to doubt whether it was such a good idea of me to get a copy of the whole book and do a review on it. Still, I’m made of fairly stern stuff, and Somers is out there promoting the hell out of this book; so I feel that it’s my duty to look critically at the story she begins her book with. Suffice it to say, after I read Chapter 1, I was left shaking my head that anyone would listen to Suzanne Somers about cancer or any other health issue, so deep is the ignorance and so strong the distrust of “Western medicine.” Somers starts out her book by describing a cancer scare. Specifically, she describes an incident in which she was brought to the hospital with what sounds like an anaphylactic reaction of some sort and was misdiagnosed with what she calls “full body cancer.”

Now, on to Chapter 1:
I wake up. I can’t breathe. I am choking, being strangled to death; it feels like there are two hands around my neck squeezing tighter and tighter. My body is covered head to toe with welts and a horrible rash: the itching and burning is unbearable.
The rash is in my ears, in my nose, in my vagina, on the bottoms of my feet, everywhere — under my arms, my scalp, the back of my neck. Every single inch of my body is covered with welts except my face. I don’t know why. I struggle to the telephone and call one of the doctors I trust. I start to tell him what is happening, and he stops me: “You are in danger. Go to the hospital right now.” I knew it. I could feel that my breath was running out.

Right off the bat, to me Somers’ symptoms sound like an allergic reaction to something or an anaphylactic reaction. It could be something else (more later), but the first thing that comes to mind is an allergic reaction. Indeed, upon hearing this story, I couldn’t help but wonder if one of the many supplements that Somers takes on a routine basis was the cause. Did she start any new supplements recently? Certainly I’d wonder about that.
So what was it?
I’ll admit that my first guess, sarcoidosis, was dead wrong. Given the symptoms of skin lesions, shortness of breath, and, apparently, “tumors around the heart” (which could indicate either pericardial involvement, or, more likely enlargement of the paratracheal nodes), I didn’t think it too unreasonable a first guess. (Besides, in the cases in House, MD, sarcoidosis almost always appears on the differential diagnosis list.) However, never having lived in the southwest, having forgotten my medical school learning about common fungal infections, and being what I self-deprecatingly like to call a dumb surgeon, I didn’t consider what turned out to be the real diagnosis right away, namely valley fever, or, as it’s known by its official name, coccidioidomycosis. Indeed, the description of the most severe disseminated form of coccidioidomycosis matches Somers’ presentation quite well:

Day 5. Dr. Oncologist comes into my room. Now, you would think he’d say, “Well, sometimes it’s good to be wrong.” Or “Isn’t it great that you don’t have cancer?” But no. He walks in, doesn’t sit down, just looks at me and says angrily, “Well, you should have told me you were on steroids.”

I am flabbergasted. I don’t know what to say to him; I am so stunned by his lack of compassion that I just stare at him. I am not on steroids. I would never take steroids. But because he is stuck in old thinking and so out of touch with new medicine, he has no clue and doesn’t understand cortisol replacement as part of the menopausal experience.

I don’t know where to begin with him. He’s too arrogant to listen to a “stupid actress,” anyway. So much of his attitude with me has been the unsaid but definite “So you think all your ‘alternatives’ are going to help you now, missy?”

Why steroids would have anything to do with being misdiagnosed with full-body cancer, I can’t guess. But we still don’t know what has gone wrong in my body. We still have to find out what caused me to end up in the ER.

A guy can hope, can’t he?
In the meantime, here’s a chapter list, which will give you an idea of what you have to look forward to when I get around to reading the book:
Most names I actually don’t know, but some names stand out, such as Dr. Burzynski, whom we haven’t yet discussed much on this blog but should (reviewing this book will give me just that opportunity), and Dr. Blaylock, who is best known for videos like this about H1N1:
I’ll spare you parts 2 and 3 of Dr Blaylock’s video. You get the idea, and if you are masochistic enough top want to view them, you can easily find them on YouTube. Suffice it to say, showing up on Alex Jones’ Prison Planet TV is not exactly a way to burnish one’s scientific credentials. Jones’ websites, Infowars and Prison Planet, are repositories of conspiracy craziness on par with David Icke’s lizard people, including 9/11 Truthers, “New World Order” conspiracy theorists (including, of course, the Illuminati and the Rothschilds), and a heaping helping of anti-vaccine and alt-med conspiracy mongering. In fact, Dr. Blaylock isn’t too far from David Icke’s rant about how the swine flu vaccine is a plot by the Illuminati.

Such are Suzanne Somers’ “doctors who are curing cancer.”

The bottom line is that, whatever her intentions, whether they be to help people or make money or both, Somers is unwittingly promoting dangerous cancer “cures” that are anything but cures. They are treatments that are anything but science-based, as well. Just as Jenny McCarthy, Jim Carrey, and Bill Maher are promoting anti-vaccine pseudoscience to the nation and Oprah Winfrey is providing an unmatchable soapbox for all manner of promoters of woo, Somers is taking advantage of her position to bash conventional medicine and promote non-science-based medicine, most likely raking in the cash hand over fist.

Posted in: Book & movie reviews, Cancer, Science and the Media13 Comments

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