Saul Green, PhD, reviews the background of Stanislau Burzynski, his claims, rationale and scientific evidence for his popular questionable cancer remedy known as "antineoplastons" (JAMA, 1992;267:2924-28). Green's review is very informative and well-written. It will be of interest to anyone desiring knowledge on this persistently promoted remedy. Addendum: The State of Texas has recently moved to stop the sale of Antineoplastons. Frank Wiewel's People Against Cancer group (originally the IAT Patients Association) is campaigning on Burzynski's behalf.
Biofeedback is a popular psychological treatment for a variety of medical problems. It has been around for sometime and is sometimes equated with behavioral medicine. Alan Roberts, PhD, a researcher who is experienced in the clinical use of biofeedback, wrote a critical review (published in the American Psychologist, 1985;40:938-41). He concluded then that there is little relationship between research findings and clinical practices in the area of biofeedback. Roberts stands by his criticisms of biofeedback today, and feels that the public needs to be made aware that the validity of biofeedback is in question. Roberts' article is very well written and raises questions about the attitude with which researchers and clinicians should approach not just biofeedback, but any behavioral clinical procedure. He describes a movement within clinical psychology "from the tough minded to the tender minded" which "has led to a kind of muddleheadedness, of uncriticalness that does not serve either our profession or our clients well." He says that if clinical psychology is not an applied science, it has little more to offer than other groups who simply make people feel better.
Comment: Roberts puts his finger on a growing problem in health care which is to aim at patient "satisfaction" rather than true effectiveness. There is no doubt that health care providers need to pay attention to satisfying the emotional needs of patients, but this cannot be done at the expense of scientific validity.
NCAHF has been notified by the Division of Information Medicine, Medical Research Institute, of Tokyo Medical and Dental University that its position paper on acupuncture was translated and published in IDO-NO-NIPPON (The Journal of Japanese Acupuncture & Moxibustion). The communication stated that the paper was "being received with heterogeneous reaction from surprise, anger to agreement and support" (5/12/92 letter from Kiichiro Tsutani, MD, PhD).
Linus Pauling is still a believer in the anti-cancer benefits of vitamin C despite the fact he has been diagnosed with prostatic cancer. He credits his high-C regimen with delaying the disease until his present age of 91. People knowledgeable about the risks of prostate cancer are unlikely to be convinced that Pauling is exceptional. On the contrary, he seems to be well within the range of what can be expected of a white male with a relatively low body weight.
The New York City Department of Consumer Affairs has filed legal charges against six manufacturers of nutritional supplements for deceptive advertising in body-building and fitness magazines. Mark Green, Commissioner, stated: "This $100 million-plus-a-year industry essentially promotes snake-oil for strongmen and misleads gullible teens who aspire to be the next Arnold Schwartzenegger." Green noted that the Federal Trade Commission has taken only one action against such companies in the past 7 years. The companies and products charged were:
The department's 33-page report, Magic Muscle Pills - Health and Fitness Quackery in Nutrition Supplements is available for $5 per copy. Address: 42 Broadway, NY, 10004. NCAHF's Task Force on Ergogenic Aids is credited in the report.
Victor Herbert, MD, JD, presents the medicolegal case against the over-the-counter marketing of free amino acid supplements in "L-Tryptophan" (Nutrition Today Mar-Apr, 1992). Most shocking is the revelation that both the FDA and Canada's Food & Drug Directorate declared all amino acids to be non-GRAS (ie, not Generally Recognized As Safe) in 1974. The FDA did not enforce its prohibition on the sale of amino acid supplements while Canada did. The result was that Canada did not experience the epidemic of eosinophilic-myalgia syndrome (EMS) that led to many deaths and chronic disease. Herbert presents a history of how L-tryptophan was clearly marketed as a drug--which provided a cause for action by itself for FDA if it had chosen to act. His analysis of deceptive tactics used by marketers is highly instructional for consumer health educators. Seven potential harms are elucidated which could result from free amino acid supplement use.
Mary E. Turk, 67, of Dallas, Texas, is suing evangelist Robert Tilton for $70 million for delaying her trip to the doctor until it was too late to successfully treat her colon cancer. Three other women have also sued the Tilton ministry and want it shut down. Turk says that she took Tilton at his word that he was a prophet of the Lord and could heal her. She now accuses him of defrauding her. (The Dallas Morning News, 4/7/92)
On May 8, a frantic plea by Alexander Schauss (see "Diet & behavior 'expert' fakes his credentials," NCAHF Newsletter, Jan-Feb, 1989) went through the communications network of organized "alternative" medicine. FDA agents and King County Sheriff's office personnel had raided the Kent, Washington, medical offices of Jonathan Wright, MD, on May 6. The FDA seized illegally imported drugs, unapproved medical devices, and other items at the clinic. Sheriff's officers broke down the door and entered with guns drawn when people inside refused to open the door, which is police policy since emotions can run high at such times and irrational behavior can be anticipated (Schauss claims that no attempt was made to knock on the door). Wright is a celebrity maverick. He is a member, and former chairman, of the Board of Governors of the National Health Federation the leading anti-consumer protection lobbying group in the country. Supporters were asked to FAX White House Chief of Staff, Sam Skinner on Wright's behalf who Schauss said had dedicated a special FAX line to receive details on this raid. [Note: NCAHF responded by faxing Skinner the message that the FDA has been criticized by Congress for lack of enforcement, and should not be interfered with now that it is doing its job. The case should stand on its own merit and not be politically fixed. Further, we pointed out that the influx of mail should be interpreted as an indication of just how large and well-organized quackery has become.] The "medical freedom" advocates have made an issue of the guns drawn aspect of the raid and have managed to attract some media attention. Paul Harvey covered the incident in a way sympathetic to Wright. [Harvey also wrote against FDA regulation of vitamins in his newspaper column, and advertises health food products (eg, Kyolic garlic), which reveals his biases. (FYI: the Paul Harvey listed on the NHF Board of Governors is not the radio commentator.)]
Comment: The Wright affair has called attention to the "alternative" medicine community in western Washington. On June 8, NCAHF President Dr. William Jarvis, was called to KING-TV in Seattle for a taped interview on the matter. Dr. Herbert provided input by satellite. A key part of Wright's practice employs a device called the Computron, a galvanic device much like the Dermatron, Interro, Vega, and others, which measure electrical resistance on the skin. Readings are greatly effected by the amount of pressure on the probe, skin moisture and how long they are held in place. A unique feature of the Computron is a metal plate set in line which functions like the "well" on a radionics device. Substances which correspond to extracts given as drops on the patients' tongues are placed on the plate to test electronically for "allergies" (actually, ill-defined maladies that appear to be neurotic disorders). Wright was back in business soon after and appeared to be enjoying the attention.
A panel convened by the National Institutes of Health to evaluate voluntary weight loss and control issued a sobering message for people and commercial entities involved in weight loss. Frances Berg, coordinator of NCAHF's Task Force on Unsound Weight Loss summarized 15 of the panel's findings in the May-June issue of Obesity and Health. These points form the basis of sound consumer health education on this important topic.
Comment: Given the amount of advertising by commercial diet programs that consumers are exposed to, weight loss looms as probably the most unfulfilled in terms of expectations and results.
Dixie Lee Ray, PhD, former governor of Washington, long known for her eloquent rationalism, puts the facts to the popular scare stories that drive environmental politics these days. Her article, "Are the global threats real? Scientific Facts vs. Environmental Myths" (Priorities, Spring, 1992) is a welcome relief from the hysteria that Americans are regularly treated to by the both the popular and elitist media (ie, public broadcasting). Ray deals with alleged global warming, carbon dioxide increase, and stratospheric ozone. In a nutshell, records taken over the past century show no increase in air or ocean temperatures. Atmospheric CO2 levels are only modestly effected by humans, and plants adjust by taking in more CO2 when it is available. The hole in the ozone layer is based upon observations too limited and recent to know if it is abnormal or part of a normal cycle. Further, it has not been proved that freons produce the chloride ions believed to deplete the ozone layer, nevertheless, the refrigeration industry is being required to phase freon out (freon is considered a boon to safety by refriger-ation people who once had to use dangerous gases such as ammonia). Politics, not science, is driving environmentalism. Every citizen should read Ray's article.
Comment: The doomsayers argue that the survival of the planet is too important to wait for the scientific evidence. They seem unaware that public health, economics and the standard of living that has meant record longevity for Americans is inextricably tied to the environment that technology has produced. All of us want to save the wild places and improve our environment by reducing pollution, but this can only be done effectively when we have the facts. Creating enviromental scapegoats and killing them off just to assuage our paranoia is useless at best and can be destructive. These issues are important to NCAHF because piggy-backing on environmental hysteria are organic farming, supplement promotions, health foods, anti-medical research animal rights, clinical ecology, and more from the wonderful world of quackery.
The Colorado Board of Nursing (CBN) mandates a minimum of 20 hours of continuing education (CE) credit every two years for RNs and LPNs. The purpose of CE presumably is to bring practitioners up-to-date with the rapidly developing science and technology of their fields. However, CE has become the vehicle through which nonscientific practices are proliferated. Topics approved for CE in Colorado include Reflexology, Applied Kinesiology, Life Energy Balancing, Healing Colors, Aromatherapy, firewalking, Acupressure, and Therapeutic Touch which is the most popular. Such courses are usually justified as part of the art of patient care (ie, meeting patients' emotional needs). Art is important, but must be differentiated from the scientific aspects of care. Any procedure aimed at preventing, alleviating or curing a disease should meet scientific standards of safety and effectiveness. With tongue-in-cheek humor, Linda Rojas, RN (Rocky Mt Skeptic, Mar-Apr, 1992), describes a heart attack victim in front of a nurses convention who is set upon by nurses plying the techniques they have learned in CE. Some wave their hands over the victim (Therapeutic Touch), another grabs your pinky finger and pushes on your tailbone (acupressure), another flashes angel and animal guide cards (shamanism), others use crystals and colored lights. She also describes nurses as tending to be religious and superstitious in their eagerness to help patients, as well as poorly trained in statistical analysis and the scientific method. The CBN uses only mundane criteria such as having written learning objectives, questions, and handout materials with no attention to scientific validity of course content. Further, there are no caveats issued to CE students that a buyer beware situation exists for nursing CE. Rojas points out that CE ultimately affects nursing care which makes quality control within CE a consumer issue.
Rojas presented a written statement before the CBN which pointed out the importance of quality nursing care and asked for a an explanation as to how quality control was being done to assure valid CE coursework, and how the CBN viewed its accountability in this matter. The CBN decided to review the appropriateness of TT. At its May 28-9 meeting, it voted to continue awarding CE credit to TT and to review other courses on a case-by-case basis (letter dated 6/8/92).
Florida workers' compensation officials are complaining bitterly about abuses by chiropractors, according to the cover story of Florida Trend ("The manipulators," June, '92). A spokesman for the American Insurance Association says that he thinks of workers comp as "the chiropractic full-employment act!" Although DC care accounts for only 6% of the $1.25 billion spent annually on Florida's workers comp, it is singled out as the most egregious example of abuse. Over utilization, over diagnosis, and sweetheart relationships with unscrupulous attorneys are the problems. It was even proposed that DCs be kicked out of the system, but was decided that this could not be done. The only hope seems to lie within the chiro guild itself.
Comment: Little wonder that DCs are so good at ripping off the system. NCAHF has obtained a success school manual that teaches DCs how to milk insurance companies. If it were not for the honest DCs who are doing insurance reviews there would be little hope for improvement. NCAHF's DC advisors say that most state licensing boards back their constituents in disputes against insurance companies even when the claims are poorly documented and unjustified. A curious aspect of this report is that DC propagandists have bragged about their performance in Florida in chiropractic advertising promotions.
Health-conscious people generally reject drugs as incompatible with a healthy lifestyle, but seekers of superhealth are being fooled by herbal drug pushers. A study of health practices and beliefs revealed that people do not differentiate between symptomatic relief and truly effective remedies. [National Analysts, Inc. A Study of Health Practices and Opinions. Springfield, VA: National Technical Information Service, 1972] Subjectively feeling good is the gauge many use to evaluate whether a practice is good or bad. Giving hidden mood-modifying substances to convince customers that they are experiencing superhealth is known as the "Dr. Feel Good" approach to quackery.
The Dr. Feel Good approach was well-known to patent medicine promoters during the golden age of quackery. These medicines merely masked the effects of disease without having a material effect upon the condition. Prior to the 1906 Pure Food & Drug Act people did not know that the "secret ingredients" they were ingesting could be opiates, cocaine, strychnine, arsenic or other drugs. The 1911 Harrison Narcotics Act controlled many of these substances.
History is being repeated in many of today's herbal promotions. The same study revealed that very large numbers of people mistakenly believe that it is possible to gain noticeable improvements in vigor and energy by improving one's diet or using supplements. In reality, eating properly will not give normal, healthy people a "high." The misbelief that nutrition can supply vigor and energy is where the herbal quacks find their openings. Stimulating drugs can pep people up and depressants can alter a person's mood and create the illusion of a health benefit.
Many popular herbal products contain potent stimulant drugs which are unrecognized by consumers because the products are sold as "foods." One popular herb, guarana (street marketed as Zoom -- a legal stimulant and cocaine substitute), contains a potent dose of caffeine. An even more powerful stimulant being used more and more by herbal drug pushers is ephedrine. To prevent drug merchants from converting the easy-to-obtain ephedrine to methamphetamine, Nevada placed ephedrine on its list of controlled substances in 1991. This caused an outcry by users, many of whom were late night casino workers who used the drug to stay alert. In 1988, the U.S. judo champion who had been using the Sunrider product, Vitalite, which depends upon ephedrine for its lift, was disqualified from the Olympic trials when traces of ephedrine were found in his urine. More recently, a line called Lite Rite (aka, Thinergy) herbs has contained ephedrine dubbed "epitonin." Consumers are being fooled into taking drugs by sanitizing them by calling them "herbs."
The Dr. Feel Good approach to quackery is also employed in giving coffee enemas. Caffeine is absorbed through the gut wall giving the patient a real high. The high is misinterpreted as an improvement in health and well-being. Rebound lows are (mis)interpreted as "the poisons coming out." Again, an important study found that people must rely upon others to interpret the feelings they experience from drugs, and the Dr. Feel Good approach provides quacks with the opportunity to do just that. The next time you hear someone extolling the zip they are getting from their favorite herbal product, don't presume that it is simply the placebo effect. Although the placebo effect is undoubtedly part of the picture (as is the enthusiasm of being a salesperson if one is confronting a multilevel distributor), but do not overlook the fact that herbs are potent sources of mood-modifying drugs that can be used as Dr. Feel Good schemes. Feel good herbs include: ginseng, broom, mate, lettuce opium, lobelia, valerian, and others.
Mr. Irwin Lerner, President and CEO May
340 Kingsland St.
Nutley, NJ 07110
Dear Mr. Lerner:
A quote in the latest issue of Nutrition Forum attributed to your Mr. Anthony Iannarone is, if accurate, the most appalling and cynical comment that I have ever encountered from anyone in the legitimate health care industry. He is quoted as saying in part " ...neither government agencies nor industry, including the supplement industry, should be protecting people from their own stupidity."
When the supplement industry, through its own attempts (mostly via advertisements) consciously and intentionally fosters and perpetuates that "stupidity" by undertaking to convince the public at large, most of whom have little or no knowledge of nutrition science, that they are in fact poorly nourished, and then has the audacity to call us stupid, there is a definite problem of ethics . . . An instance of this sort originating from an illegitimate source such as a "health food" company is bad enough, but when a supposedly ethical firm like Hoffman-La Roche is guilty of such cynicism, lack of tact and disdain for public at large is inexcusable. . . .
.If his statement is representative of corporate thought and policy, I believe it is time for you and your board of directors and company officers to consider some major changes in your policies and attitudes.
Highland Park, IL