DANGERS, COSTS AND DISASTERS IN ALTERNATIVE MEDICINE

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DANGERS, COSTS AND DISASTERS IN ALTERNATIVE
MEDICINE
DR. LLOYD OPPEL CANADIANS FOR RATIONAL HEALTH
POLICY
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TOPICS TO BE COVERED

• THE DI BELLA AFFAIR
• WHAT IS ALTERNATIVE MEDICINE
• WHY IS IT ALTERNATIVE
• DIRECT HARM
• EXAMPLES OF FINANCIAL HARM

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...TOPICS TO BE COVERED

• OPPOSITION TO PUBLIC HEALTH MEASURES
• HOW ALTERNATIVE MEDICINE SAPS THE RESEARCH BUDGET
• DIVERSION FROM PROPER CARE
• PUBLIC AND PERSONAL CATASTROPHES
• WHAT CAN BE DONE

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THE DI BELLA AFFAIR

• 1997/88 ITALY
• THE CURE FOR THOUSANDS SOMATOSTATIN,MELATONIN,B
  ROMOCRIPTIN, VITAMINS, CYCLOPHOSPHAMIDE
• NEVER TESTED IN HUMANS OR ANIMALS
• COST UP TO 5000 / MONTH

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...THE DI BELLA AFFAIR

• PATIENTS SUE GOVERNMENT
• PRESS HAILS DI BELLA AS A HERO
• COURT ORDER PUBLIC PAYMENT FOR 2000 TREATMENTS
  AND 10 CLINICAL TRIALS

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...THE DI BELLA AFFAIR

• CLINICAL TRIALS SHOW NO EFFECT, BUT SIGNIFICANT
  SIDE EFFECTS

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...THE DI BELLA AFFAIR

• OVERALL DIRECT COSTS
• 20 MILLION

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...THE DI BELLA AFFAIR

• WHAT ABOUT THOSE WHO DELAYED TREATMENT WHILE
  EXPLORING THE OPTIONS?
• WHAT ABOUT THOSE WHO CHOSE THE CURE OVER PROVEN
  THERAPY?

INDIRECT COSTS INCALCULABLE
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HOW WERE PEOPLES OPINIONS FORMED?
...THE DI BELLA AFFAIR

• THERE IS OVERWHELMING EVIDENCE THAT THE MEDIA
  CONTRIBUTED MOST TO THE AFFAIR
• THIS SAD STORY HAS REVEALED HOW POORLY THE MASS
  MEDIAUNDERSTAND MEDICAL MATTERS

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HOW WERE PEOPLES OPINIONS FORMED?

• PASSALACQUA ET AL
• SURVEY OF CANCER PATIENTS DURING THE AFFAIR
• MOST PEOPLE GOT THEIR INFORMATION FROM
  TV/RADIO/PRESS

ONLY 1 FELT THE THERAPY WAS INEFFECTIVE
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HOW WERE PEOPLES OPINIONS FORMED?

• 63 OF THOSE SURVEYED STATED THEY WOULD TRY AN
  UNPROVEN THERAPY IF IT OFFERED A CHANCE OF CURE

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TAKE HOME LESSONS

• CAVEAT EMPTOR
• DESPERATE AND VULNERABLE PEOPLE WANT HOPE, NOT
  PROOF
• FREEDOM OF CHOICE IN THIS CONTEXT ALL TOO OFTEN
  MEANS FREEDOM TO EXPLOIT
• POOR UNDERSTANDING OF SCIENTIFIC ISSUES CAN LEAD
  TO SQUANDERED FUNDS
• THE MEDIA HAVE A RESPONSIBILITY

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WHAT IS ALTERNATIVE MEDICINE?
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DEFINITIONS

• UNPROVEN
• GENERALLY UNAVAILABLE IN HOSPITALS
• NOT USUALLY TAUGHT IN MEDICAL SCHOOLS

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MYTH

• NATURAL SAFE

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FACT

• MANY NATURAL SUBSTANCES ARE VERY POISONOUS,
  INCLUDING SOME HERBAL REMEDIES

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TOBACCO ARISTOLOCHIA CHAPARELLE GERMANDER EPHEDRA
JUST TO NAME A FEW
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MYTH

• MANY ALTERNATIVE REMEDIES HAVE ABUNDANT
  SCIENTIFIC PROOF BEHIND THEM

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FACT

• EVEN THE MOST STUDIED HERBAL REMEDIES SUCH AS
  ECHINACEA AND GINKO BILOBA HAVE ONLY VERY WEAK
  SUPPORTING STUDIES AND NO SYSTEMATIC LONG-TERM
  SAFETY DATA

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MYTH

• CONVENTIONAL MEDICINE KILLS MORE PEOPLE THAN
  ALTERNAIVE MEDICINE

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FACT

• WHILE MANY MEDICATIONS CAN HAVE SERIOUS SIDE
  EFFECTS THEY ARE USED ONLY WHEN THE POTENTIAL
  BENEFIT OUTWEIGHS THE RISKS (CHEMO, FOR EXAMPLE)

IF A TREATMENT HAS NO PROVEN BENEFIT, THEN NO
LEVEL OF RISK IS ACCEPTABLE
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MYTH

• THE CONVENTIONAL MEDICAL ESTABLISHMENT HAS
  IGNORED OR SUPPRESSED THE HIGH QUALITY EVIDENCE
  IN FAVOR OF ALTERNATIVE MEDICINE

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FACT

• ALL TREATMENTS PROVEN EFFECTIVE HAVE BEEN
  ACCEPTED BY CONVENTIONAL MEDICINE

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MYTH

• ALTERNATIVE MEDICINE IS GENTLE, NONINVASIVE AND
  PERFECTLY SAFE

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FACT

• COLON THERAPY - BOWEL PERFORATION ELECTROLYTE
  DISTURBANCE
• CHELATION-HEART FAILURE, ELECTROLYTE IMBALANCE
• CHIROPRACTIC - STROKES FROM NECK MANIPULATION
• ACUPUNCTURE - HEPATITIS TRANSMISSION,
  PNEUMOTHORAX
• ETC., ETC...

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WHY IS IT ALTERNATIVE?

• ALL TREATMENTS PROVEN EFFECTIVE HAVE BEEN
  ACCEPTED BY CONVENTIONAL MEDICINE

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WHY IS PROPER TESTING IMPORTANT?

• PROTECTION OF THE PUBLIC FROM FINANCIAL
  EXPLOITATION
• ASSURANCE OF EFFECTIVENESS
• NO DELAY IN PROPER CARE
• ASSURANCE OF MORE BENEFIT THAN HARM

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PERSONAL FINANCIAL HARM

• METABOLIC THERAPY FOR 17,000 EACH
• MAGNETIC CANCER CURE MANY THOUAND
• I HEAR ABOUT HOMES MORTGAGED AND SAVINGS CASHED
  IN TO PAY FOR TREATMENT.

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WHAT DOES IT COT?

• CANADA 1.8 BILLION - PROVIDERS
• CANADA 2.0 BILLION - REMEDIES

USA 27 BILLION
EQUALS OUT-OF-POCKET EXPENSES FOR ALL DOCTORS IN
THE USA
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WHERE DO ILL PEOPLE GO?
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HOW MANY VISITS ARE THERE?
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ANTI-PUBLIC-HEALTH ATTITUDES
OPPOSITION TO IMMUNIZATION

• CHIROPRACTORS
• NATUROPATHS
• HOMEOPATHS

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DIVERSION FROM PROPER CARE

• ANECDOTES
• PUBLISHED REPORTS
• SYSTEMATIC STUDY URGENTLY NEEDED

IS ALTERNATIVE MEDICINE GETTING A FREE RIDE?
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TYRELL DUECK

• 13 YO BOY WITH OSTEOGENIC SARCOMA.
• PARENTS DO RESEARCH AND CHOOSE ALT. MED.
• DELAY GETTING CHEMO
• REFUSE AMPUTATION WHILE CURE RATE STILL 65

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TYRELL DUECK

• COURT BATTLE DROPPED ON NEWS OF METASTASIS
• TO MEXICO FOR VITAMINS, SHARK CARTILAGE, HERBS,
  APRICOT SEEDS, GARLIC
• MEDIA PRESENTS BOTH SIDES AS EQUALLY REASONABLE

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TYRELL DUECK

• FAMILY SPENDS 65 000
• TYRELL DIES IN PALLIATIVE CARE WARD IN
  SASKATCHEWAN

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COMMENT FROM THE MEDIA

• Tyrell Dueck is dead, killed by cancer and . . .
  you pick.
• The refusal of the 13-year-old, who loved hunting
  and fishing, to let doctors amputate his diseased
  leg?
• His fundamentalist parents sincere, but
  mistaken, belief that prayer and alternative
  therapies could cure him?
• The irresponsibility of a Mexican clinic which
  duped a desperate,
  gullible family into believing its apricot
  seeds and shark-cartilage cures were more than
  bunkum?
• The failure of the Saskatchewan courts to
  immediately insist that Tyrell be treated -- a
  lapse which allowed his malignancy to become
  inoperable?

Toronto Globe and Mail
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WHAT CAN BE DONE?

• Link regulation of health professions to validity
  of the treatments
• Enforce laws against practicing medicine without
  a license
• Protect the public by preventing false or
  misleading health claims