07.27What Your Doctor Won’t Tell You
by Steven Novella, MD
How many times have you heard the rumor that “They have a cure for cancer?” Have you ever wondered who “they” are, or how anyone could be so callous as to suppress a treatment for such a deadly disease, or how vast such a conspiracy of silence would have to be in order to be successful? I hope so!
Conspiracy theories abound in many contexts; they are now a part of American culture. Americans, it seems, have an easy time believing that “the powers that be” are eager and willing to deceive them on a massive scale for a political, military, social, or monetary agenda. After all, some conspiracies are real – Watergate, Iran-Contra, and Abscam – and no one really believes that Clinton had a purely platonic relationship with that 21 year old intern. It is no wonder that some Americans can believe in a Roswell UFO cover-up, that OJ was framed, and that there is a secret cure for cancer.
Quacks, cranks, and cons of all kinds flourish by exploiting human nature, by knowing what people want and giving it to them. The truth is often harsh and unpleasant, so why not replace it with an appealing deception? Proponents of Alternative Medicine have been quick to portray themselves as the victims of a malignant “Medical Establishment,” their term for the “Big Brother” of medicine who is trying to protect its monopoly by keeping out all the little guys. They play upon people’s natural fear of large powerful organizations, they confuse professionalism with elitism, and then wrap it all up in a compelling conspiracy theory.
Patients, especially those with a disease which is not curable by conventional medicine, are eager to believe such conspiracy theories because they offer hope. It is far better to believe that there is a cure out there for you, with a small but dedicated band of rebels who will defy the establishment to bring it to you (for a fee, of course), than to believe that no cure exists anywhere. No where is this phenomenon more prevalent than with cancer.
In the 1970’s a new drug, Laetrile (called amygdalin in the research literature), was the latest promising treatment for cancer. Clinical trials, however, showed that the drug was not effective, and it was abandoned, like so many dead ends in medicine.2,3 In 1984 one cancer researcher wrote “The controversy over Laetrile is nearly at an end, the worthlessness of the drug having been demonstrated beyond reasonable doubt.”4 But that was only the beginning of the story for Laetrile. Once abandoned by scientific, evidence-based medicine, it was picked up by quacks. The Committee for Freedom-of-Choice in Cancer Therapy was formed, and since then they have been holding meetings in church basements where cancer survivors give their testimonials about how they were saved by Laetrile. Of course, those patients who died on Laetrile are not there to give their testimony. Desperate patients, convinced by these testimonials, can then be flown to Mexico where they will receive this miracle cure while their bank accounts are emptied.
Recently Laetrile proponents have been pushing their propaganda very hard. They have published a book, called “World Without Cancer,” which outlines their philosophy. One would assume that such a book, which purports to demonstrate that Laetrile is an effective cure for cancer, would be full of studies and evidence to support this claim. Such evidence is not to be found, however. What can be found is dismissal of negative studies as a conspiracy and in their place anecdotal testimonials are preferred. There is chapter after chapter attempting to make the case for a widespread conspiracy to suppress this new treatment. Their basic premise is that greedy doctors and pharmaceutical companies, who are making billions of dollars on treating cancer, are suppressing any treatments which are too effective so that they can go on making billions of dollars.
Let us now examine what would be necessary for such a conspiracy to exist, and let us start by looking at the alleged perpetrators of such a conspiracy. In other words, who is, or could be, “they.”
The primary flaw in any theory requiring a conspiracy of the medical establishment is the fact that the medical establishment really is not one cohesive entity. The health industry consists of physicians, nurses, and other health professionals, insurance companies, private consumer organizations, universities, government agencies (such as the FDA), hospitals, HMO’s and other managed care organizations, professional organizations (such as the AMA) and pharmaceutical companies and other private industry corporations. Most of these entities are independent and, in fact, are at cross purposes with other facets of the health care industry. Government agencies regulate physicians who are trained at universities, are members of professional organizations, and work for hospitals along side independently trained nurses, for example. Meanwhile, consumer organizations, such as the National Cancer Society, the MS society, and others, keep an eye on the whole process and advocate for patients with specific diseases.
Physicians also fill many different roles. Physicians in private practice do make money directly from seeing patients, but there are many physicians who do not. Many work for HMO’s or other managed care organizations and are therefore salaried. Many physicians also decide to follow an academic career and are either salaried by a university and/or make their money from grants for research. For these salaried physicians more patients means only more work, not more money.
Other physicians dedicate their careers to public health, and do not see patients at all. They work either for the government, for private industry, or for professional or consumer organizations. Their primary task is to review public health care policy, as well as other policies which may impact public health. They also review and monitor medical practices and conduct epidemiological research into disease incidence, looking for possible contributing or causative factors.
Of these various medical professionals, the ones who would be the first to know about a new cancer cure would be those in academic medicine and research. New treatments are first discovered by basic scientists, those who do laboratory research and attempt to discover the underlying mechanisms of disease. The knowledge they discover then suggests possible treatment strategies for those diseases. Drug companies or research institutes, such as the National Institutes of Health (NIH) or the National Cancer Institute (NCI), will then fund clinical research into the potential new treatment to see if it does indeed work, first on animals and then on humans.
The final arbiter of such new treatments is the Food and Drug Administration (FDA). The FDA will review all the clinical research involving one particular treatment for one specific disease and decide if the evidence supports the conclusion that the treatment is safe and effective for that indication.
The private practitioners and the hospitals – the ones who have a theoretical monetary stake in treating patients, are completely outside of the loop. They are the last to know about new treatments.
What about the scientists who make the discovery? If they have data demonstrating a new effective cure for cancer, then by publishing their data they will achieve fame and fortune, literally. Making a major breakthrough like that will make their careers, ensure future grants, get them promoted at the university, probably get them their own lab, and put them in contention for the noble prize for medicine. They will be showered with professional honors and fame, career opportunities, and more money. Even assuming purely selfish and greedy motives for a research scientist who discovers a cure for cancer, they have everything to gain and nothing to lose by going public with the information.
What about the evil drug companies, though? Won’t they simply abandon a new drug that threatens their existing drugs? This argument also does not hold water. Drug companies are always looking for new drugs, because existing drugs have limited patents that run out. Also, any company that patents a new drug which is a cure, or even an effective treatment, for cancer will make billions, even if they lose the sale of existing drugs.
Even if a short-sighted drug company executive decided to suppress a new drug because it was too effective, the scientists involved could still go public with the information, for the general good if for no other reason. Someone of the dozens of people who must be involved is likely to have a conscience. Also, they could eliminate the need for drug company support by applying for a grant to the NIH or NCI. If their new treatment has potential they should get it. Since so much is at stake for their careers, they would be highly motivated to do so.
One must also remember that physicians, scientists, and even pharmaceutical company executives are people, with family and loved-ones of their own. Cancer is the number two killer in the United States, second only to heart disease. The people involved in any theoretical conspiracy to suppress a cure for cancer are likely themselves to get cancer one day. Certainly, statistics indicate that someone close to them will be a victim of cancer at some time in their lives. It is difficult to imagine anyone so short-sighted, greedy, and evil as to condemn their loved ones, and even potentially themselves, to a premature death from cancer, no matter what the possible gain.
It seems unlikely in the extreme, therefore, that there is a hidden cure for cancer. Such a conspiracy would involve too many individuals; no one would clearly benefit from such a conspiracy; those who are in a position to allegedly benefit are not the ones who would have knowledge of such a cure; and it seems unlikely that anyone would be psychotic enough to believe that suppressing a cure for cancer would be a good idea. Added to this is the absolute lack of any evidence for a hidden cure or a conspiracy to suppress it. Laetrile specifically is a failed treatment that is kept alive only by con-artists, quacks, and misguided crusaders.
Despite its untenability, it is likely that the hidden cancer cure myth will survive in popular culture. People have proven too resistant to giving up a good story for something as dry as logic and facts.
1) Griffin G.E. “World Without Cancer,” American Media, 1997
2) Unproven Methods of Cancer Management, Laetrile; CA: A Cancer Journal for Clinicians. 41(3): 187-92,1991
3) Chitais MP, Adwankar MK, Amonker AJ. Studies on high-dose chemotherapy of amygdalin in murine P388 lymphocytic leukemia and P815 mast cell leukemia; Journal of Cancer Research and Clinical Oncology. 109(3): 208-9, 1985
4) Nightingale SL. Laetrile: the regulating challenge of an unproven remedy; Public Health Reports. 99(4):333-8, 1984