Tag Archives: lies

ALS Pseudoscience: What Quacks Won’t Tell You

I have yet to hear one argument against the ALS icebucket challenge that isn’t either fundamentally flawed, or simply petty when put next to the giant sum of money that has been raised to help sufferers of one of the most brutal and relentless diseases that can befall a human being. 

This post, however, is not about the absurdity (or hypocrisy) of criticising the challenge on the basis of clean water shortage in the third world, or the fact that the uncomfortable symptoms of “FB peer-pressure” tend to dissipate naturally over a short period of time, whereas ALS causes an inexorable disabling of all the body’s faculties until the sufferer can no longer breathe on their own, and results in death, always. No, this is about medical pseudoscience at its very, very worst. And I’ve seen it shared by some pretty sensible people, which has been disturbing. To those people: 

Please be aware that most articles posted on social media that talk about health, disease or science, are BULLSHIT. A good rule of thumb is to type the author’s name into Google followed by the word ‘skeptic’. Then do the same with the word ‘rational’, ‘quack’ (or ‘quackery’), ‘debunked’ and ‘pseudoscience’. Repeat this process for the name of the website, and key words from in the article.

I was ‘inspired’ to write on the subject of ALS charlatanism by this profoundly misleading article, authored by conspiracy-mongering pseudowhistleblower and all-round crank Anthony Gucciardi. The article is first and foremost a libellous denigration of the ALSA. He couples this with a few references to some cherry-picked studies he either hasn’t read or doesn’t understand, which he uses for the purposes of implying, strongly, that  ALS is a disease which can be easily prevented or reversed through diet. Hint: it isn’t. The most flabbergasting aspect of Gucciardi’s article is how outrageously, wantonly, and shamelessly lazy (or calculatedly deceitful?) a mere couple of clicks around the ALSA’s website reveals him to have been.

I’ll be focusing mostly on what Gucciardi has actually written, though I will broaden the discussion at times. I would also point out that numerous members of the ‘alternative’ crowd, such as Joseph Mercola, have posted articles or videos encouraging members of the public not to donate to the ALSA – the whole incestuous ‘alterweb’ is buzzing with them. Take your pick – they are mostly variations on one quack theme: don’t give money to ALS charities; buy our supplements instead. 

Disclaimer

What follows is a long article, and no doubt there will be sections that for some readers will represent a case of tl;dr. That’s fine. I just wanted to be as thorough as possible, because that’s what I think this topic deserves. So I’ve said everything I think needed to be said. I could have summed the whole thing up like this: “Gucciardi and his cronies are spreading misinformation about the charity they are publicly slamming, and if you want to verify that for yourself, all you need to do is to do is visit the ALS Association’s website. None of the studies he cites say what he thinks they say and, in any case, knowing a few risk factors for a complex disease doesn’t mean the disease is preventable or reversible. Furthermore, what is he doing citing scientific studies when they come from institutions that are just as (inevitably) tied up with the pharmaceutical industry as the ALS Association is? His article and the principles upon which it is based are a mess of double standards and illogic. He’s out of his depth and I think he knows it. Next!” But if I did that, I’d only end up having to write a patchwork version of my essay in the comments thread anyway. Instead, I will now be able to refer commenters to relevant sections, if they respond in disagreement, having not read them.

Who is Anthony Gucciardi?

To give you a better idea of the kind of person we’re talking about here — and I highly recommend following some of these links if you are new to medical pseudoscience — Gucciardi is a frequent guest on Infowars (a show hosted by Alex Jones, who is quite possibly the most deluded person in the world), a writer for Natural News (known to be the Internet’s #1 anti-science website), and a specialist in grossly misrepresenting scientific studies, often with the aid of outright lies. Here is a crystal-clear demonstration of him wilfully and grossly misrepresenting a fluoride study; here is a discussion about him and Mike Adams proudly exhibiting their failure to grasp basic scientific concepts (while ‘critiquing’ a scientific paper); here is documentation of him spreading falsehoods about vaccines; and here is a report of lies he’s told about five further topics. He is the founder of naturalsociety.com and storyleak.com, where he publishes re-cycled myths and long-debunked conspiracy theories dressed up as STUNNING NEW INFO.

Who is Sayer Ji?

In his article, Gucciardi references this almost identical blog post on the ALS icebucket challenge, by Sayer Ji, founder of GreenMedInfo, another hive of quackery. Just like Natural News, GMI deals in regurgitated anti-vaccine myths, dangerous misinformation about chronic diseases like diabetes, and all things anti-science and anti-medicine. In order to legitimise his career in cherry-picking, Sayer Ji labels objections to this abuse of the scientific literature as ‘scientism’. He buys into just about every conspiracy theory on the market, compiling and proudly presenting them as  “conspiracy factualities.” He denounces evidence-based medicine, calling it nothing more than a “coin’s flip of certainty”, something for which he was rightly ridiculed by science blogger and surgical oncologist David Gorski.

Though it includes much more extensive (professional-standard!) cherry-picking, Sayer Ji’s article doesn’t add anything qualitative to Gucciardi’s, so my focus will remain mostly on that. However, this is arbitrary, resulting from the fact that I discovered Gucciardi’s first. I will comment on Sayer Ji’s misinformation campaign at the end, because I think it will be doing more damage than Gucciardi’s, and is arguably a couple of orders of magnitude more disgraceful.

To any scientifically-literate person, especially anybody with an understanding of complex disease (on which more later), it is plain as day that Gucciardi’s and Ji’s take on ALS stems from ignorance and delusion. But I dread to think how many well-meaning people without the necessary background knowledge to see this will have been roped in by their sleazy impersonations of people who know what the hell they’re talking about.

Rebutting attacks against the ALS Association

The opening section of Gucciardi’s article revolves around a pie chart published by the ALSA on their website, displaying the various ways in which their finances were allocated, and in what proportions, over the financial year ending January 2014.

Gucciardi introduces his pseudo-exposé with the heading:

“$95 Million Later: Only 27% Of Donations Actually Help ‘Research The Cure’”

fye2014But of course the pie chart tells us nothing about how the ice bucket donations will be used. It tells us how the ALSA apportioned their funds last year, when they had about $25 million to work with. There is no reason to expect the slices of this pie to increase proportionately with respect to one another in the wake of a sudden influx of over $100 million. And besides, there is a button you can press when you make your donation, if you want 100% of it to go to research. The unctuous preface for the paragraph headed by this baseless claim reads, “But don’t just take my word for it”. Well, thanks, Anthony, we won’t.

Readers should be aware that the ALSA made a correction to this pie chart. The one shown here is correct.

Since ALS is currently incurable (and care for a patient can cost upwards of $200K per year), one of the single most important resources for patients and their families is access to support, which the ALSA calls patient and community services. In his piece, Gucciardi mentions twice that even more important than supporting local communities “the spread of information.” What, you mean, like, public and professional education, Anthony? You know, that thing represented by the largest slice of the pie you just shat all over?

Just so we’re really clear on this, there absolutely is no grand secret being revealed here. If he had bothered to look, Gucciardi would have seen that the official remit of the ALSA’s charitable work is three-pronged, entailing research, patient services, and education.

So, this leaves only two slices that don’t represent one of the ALS Association’s core activities, as declared in their manifesto. These core activities, incredibly, cost money. (I know, right?) There’s a name for the systematic gathering of money. It’s called fundraising. The more you publicise your cause, the more funds you’re likely to raise. Being a businessman, Anthony, presumably you are aware of the costs associated with publicity. One slice left.

Where Gucciardi really goes to town is with administration costs, particularly via his having copied and pasted the salary figures for the ALS Association’s executives, including — gasp! — the CEO’s salary of $339,475. He has this to say on the matter:

“And let’s be clear: I am a huge proponent of prosperity and business expansion. When it comes to private business and commerce, it benefits us all to see growing numbers among a company and its members. This, however, is not the case for a ‘non-profit’ organization that is based around the concept of ‘searching for the cure’ and ‘funding research’ as its primary goal. Especially when this organization is being funded with close to 100 million dollars through a viral social media campaign in which it appears no one truly took the time to investigate the very company they are shoveling their assets into.” [Emphasis his]

Congratulations, Anthony, on finding such a convenient way to cover your back: It’s perfectly virtuous to want to earn a large salary, but if you accept one and play an instrumental role in the running of an organisation that works directly to improve the lives of other people, then you become immoral. Duh!

Good logic right there.

I fail to see how it could be the case that “when it comes to private business and commerce, it benefits us all to see growing numbers among a company and its membersbut when it comes to the non-profit sector, it doesn’t. I’d say that the downstream effects of charity CEOs having substantial financial incentives are probably much more beneficial “to us all” than are the consequences of private business CEOs having them. Gucciardi seems to be expressing a feeling, apparently shared by many, that someone who heads a charitable organisation ought to have no desire to earn a good living – that there is something hypocritical about accepting a good wage if you’re receiving that wage from the non-profit sector. Personally, I’d say that someone who earns a six-figure salary heading a furniture (or supplement) company deserves fewer ethical brownie-points than someone earning the same amount of money via activities that directly help people with a crippling disease. As devil’s advocate, I’d turn the tables and say of those working in the profit sector that not only are they not working to improve the lives of others, but they’re also accepting a large wage! Shocking!

If you object to large salaries per se, given how many people in the world live in poverty, then I’d suggest that your campaigning efforts would be better directed towards people who have hundreds of billions of dollars squirreled away in vaults, doing nothing; you know, that 1% of people who control half of the world’s ‘wealth’, in the form of little bits of paper. If you’re coming at this from a Marxist perspective (which Gucciardi clearly isn’t, since he expressly doesn’t object to “growing numbers” in the profit sector) then forgive me but you seem to be forsaking one of your own core principles: what $300K a year can buy you under our current system is within what the world could theoretically provide for every person living in it. If you’re attacking this individual CEO, you’re doing it because the opportunity to do so has been served up for you on a plate; not because you’re an activist. Every minute you spend attacking this person is a minute you could have spent campaigning against real corporate juggernauts. It’s a simple case of lazy scapegoating.

Besides, the moral status of this one person is not the relevant issue. We have to think of this from the perspective of the ALSA, which has an official moral duty to perform as well as it can. To make a large-scale charity as innovative and successful as possible, you need a leader with maximum experience, business know-how, connections, and an intimate knowledge of the sector’s infrastructure and dynamics, working full-time. In other words, you need a CEO who can command a high salary. One could just as well argue that it would be immoral for the ALSA to scrimp on such an integral component of their organisation. The ALSA do not set salary standards  – it’s not their fault that high-level CEOs are in a high wage-bracket.

In a document addressing the various accusations levied against them by misguided characters from the ‘alternative’ crowd, the ALS Association writes:

The salaries of our executive staff are in line with the job markets where they are located—and in line with those of other national charities. Salary review is part of the accreditation process for the watch dogs mentioned above and is a requirement of the National Health Council (NHC), of which we are a member. In fact, The ALS Association is the only ALS charity that has qualified for membership. Read what this journalist has to say about The ALS Association’s executive salaries: “they are all well within the range of nonprofit salaries; the compensation for ALSA’s CEO compares favorably with that of his peers, including some who run low-performing nonprofits.” [Emphasis my own.]

As his final word on the way in which the ALS Association spends its funds, Gucciardi references Sayer Ji, who he says

“points out in his breakdown of the ice bucket phenomenon [that] even the smaller portions spent on ‘research’ for ALS are actually going towards pharmaceutical interventions and the pharmaceutical industry at large.” [Emphasis my own]

So, after all that fuss about not enough money going towards research, Gucciardi reveals that he doesn’t support research anyway. Sigh.

In any case, this statement is absolute bullshit. There is no evidence that the ALSA give money to “the pharmaceutical industry at large”, much less that the money they spend goes there rather than on research.

The ALSA’s research and its links to ‘big pharma’

One of the things the ALSA do is award grants to independent scientists who can demonstrate strong scientific merit and present promising research proposals, through their Investigator-Initiated Research Grant Program. I had a look through the grants that the ALSA have awarded to past and ongoing studies as part of this initiative. Gucciardi either didn’t bother, or is simply a liar – evidenced by the fact that:

Nearly all of them have been awarded to researchers looking at care protocol and equipment. Things like how to measure respiratory impairment and assist ventilation in the best way, how best to support patients nutritionally, keep their muscles moving, support their families, and generally maximise their quality of life. In other words, NOT pharmacological interventions. Of the eighteen grants awarded over the last several years, as far as I could tell, only two have been for pharmacological studies. One of these looked at whether the substance used in botox treatments could help prevent patients drooling, and the other (prepare yourself for some truly savage irony) was on…

*drumroll*

THC.

Amazing, isn’t it? The alternative crowd devote all that time to criticising “the medical industry” for not funding research on cannabinoids, because “pharma companies aren’t interested in something they can’t profit from it”. And then they’re so blinkered in their approach, so damned lazy, and so lacking in even the measliest morsel of integrity that they end up actively dissuading people from supporting one of the very few institutions that actually happens to have done so. One of Gucciardi’s other ‘articles’ is entitled Cannabis Treatment Threatens Deadly Painkiller Industry. The THC study that the ALSA funded through their grant scheme was on whether it could reduce painful cramps in ALS sufferers. This calls for a *facepalm*. Ouch, that one’s going to bruise.

The ALSA are also currently recruiting for a clinical trial they’ve funded to ascertain whether THC helps with spasticity. I found it using this search tool (via the ALSA’s website), which can pull up a list of all the clinical trials they’ve ever funded. Again, only a small fraction of these studies are on pharmacological interventions, because, unfortunately, our understanding of ALS is still not good enough for there to be lots of potential drugs discovered and ready to test. Part of the reason for this is that ALS is a rare disease, so it’s not an attractive research area for pharmaceutical companies. Which is precisely why charities like the ALSA end up contributing towards the cost of clinical trials on the very few drugs that are worth investigating.

It is true that if a new drug were shown to be effective in treating ALS, pharmaceutical companies would manufacture it, and benefit (though on a relatively small scale). It is also true that pharmaceutical companies certainly deserve the (intelligent) criticism they have received (though things really are improving). However, all too often, a vague, hand-waving mention of “big pharma” is used as an opportunity and justification to dismiss medicine all together, which is a terrible mistake.

The two main prongs of argument against pharmaceutical companies surround 1) transparency and 2) profiteering. Regarding transparency, pharma studies that have been part-funded by an independent organisation like ALSA should garner less, not more, suspicion than those which are purely industry-funded. And with respect to profiteering, if you don’t like the fact that medicine is tied up with this, then you need to be campaigning against our political system in the large – against the privatisation of medicine, and against capitalism, at least in its current form. Campaigning against pharmaceuticals per se, like the alt-med crowd do, is bad reasoning at best, and outright hypocrisy at worst, namely when it concludes — as it usually does — with “so, buy our health products instead!”

Drug discovery requires large numbers of scientists, doing difficult science, working full-time jobs. Pharma companies do have enormous incomes, but they also have enormous expenses. Getting a drug approved costs about a billion dollars. (Even if every penny of the icebucket challenge’s $100 million were handed over to big pharma, it would represent but a teeny drop in this ocean.)

Many of the arguments used by pro-alt-med bloggers and commenters break down when you consider countries that offer universal healthcare. But wherever you’re from, and whatever you feel about the privatisation of medicine, or capitalism in general, pharmaceutical companies are currently the only organisations that are able to properly test and manufacture drugs, and drugs are what ALS sufferers desperately need because unfortunately…

ALS Cannot be Cured ‘Naturally’

We should start this section with a brief consideration of complex diseases, which can be contrasted with ‘simple’ Mendelian disorders with clear inheritance patterns like Huntington’s disease, that result from a single mutation with powerful a effect whereby if you have the gene, you will get the disease.

Heart disease is an archetypal example of a complex disease. It is weakly associated with heaps of common genes, as well as various environmental risk factors that seem, statistically-speaking, to slightly increase a person’s risk of becoming a sufferer. Like other complex diseases (such as arthritis, most cancers, and ALS), it doesn’t usually have clear, straight-forward inheritance patterns, though it does often run in families.

However, as with cancer, where some rare genes confer a greatly increased — or even 100% — risk of developing disease, there are some rare genes which are very strongly associated with ALS and, like all genes, they are heritable. Inherited forms of ALS are called ‘familial ALS’, and account for about 10% of all ALS cases. Roughly half of these cases can be explained by around 17 known genes. (Some are discussed by the ALSA on their website, and a comprehensive database of all genes which have been found to be linked to ALS can be found here.)

To give an example, depending on which population you look at, between 20% and 40% of familial ALS cases are caused by inherited mutations (in this case, repetitions) of a gene called C9ORF72. (An inherited mutation is often just called ‘a gene’, which can be confusing.) This gene was discovered recently through studies conducted by two different research groups, independently of each other. Both were funded by the ALS Association.

Importantly, however, as this twin study, and this (free) paper on ALS as a genetic disease point out, the distinction between spontaneous and familial ALS is largely artificial. This starts to make sense if you think of ALS-causing genes as sitting on a continuum of effect-size, or ‘penetrance‘. At one end are genes with complete penetrance, which are certain to manifest in ALS, like the C9ORF72 repeat expansion discussed above. As you move along the spectrum, certainty becomes likeliness, which gradually peters out, with associations becoming ever weaker. (Also, de novo mutations — occurring spontaneously during the very early stages of development, rather than being inherited from a parent — can produce the same effects as inherited ones.)

The evidence we have points towards a ‘liability threshold’ model of ALS, under which disease manifests only once a critical tipping point has been reached. Everyone is born with a pre-determined genetic liability and, over time, this liability can be modulated by the environment. The fewer environmental risk factors you are exposed to, the less likely you are to reach the tipping point, provided your initial genetic liability, or ‘genetic load’ isn’t so high in the first place as to completely flood the effects of environmental influences.

There is an enormous variety of ways in which one might reach the threshold. The ‘easiest’ way is to carry a gene from right at the top end of the effect-size spectrum. But you could also do it by carrying lots of genes from somewhere in the second quartile of the continuum, and then exposing yourself to some environmental risk factors. Or you could do it by carrying a very, very large number of genes right from the low end of the spectrum.

And here’s the thing. It is much, much, much easier to identify genes that greatly increase disease liability, compared to genes that only increase it a little bit. These big bruisers ‘stand out’ when you compare large enough samples of cases (ALS patients) with samples of controls (people without the disease). But the potentially huge number of mutations that ever-so-slightly increase ALS risk sink into the background and are virtually impossible to distinguish from random ‘noise’, since they are each found almost just as often in healthy controls as they are in ALS cases – it is their collective presence in a person’s genome that causes disease. However, these low-penetrance genes are just as heritable as genes with high or complete penetrance.

Genetic material is shuffled and split in half during reproduction. In the case of one, fully penetrant gene that is sufficient to cause ALS without the ‘help’ of others, or of environmental factors, since a sperm or egg either ends up with this gene or not, the resulting person is either destined to develop the disease, or not, manifesting in a classic Mendelian inheritance pattern (autosomal dominant, for C9ORF72 mutations). When we’re talking about a large number of low-penetrance genes, however, a sperm or egg could, by chance, end up with anything from 0% to 100% of those genes (50% on average). This can explain the fact that we often see striking familial clustering of ALS cases, despite the fact that none of the 17 big genetic players are contained within their DNA – something that is enhanced by the fact that people from the same families tend to have more shared environmental influences than two people picked at random.

You could also inherit ‘sporadic’ ALS in the absence of any family history, if the combination of genes you inherit from your parents happens to place you at or beyond that threshold, even though neither of them were particularly close to it themselves.

To make things even more unpredictable and hard to shed light on, genes modulate other genes. And they often act differently depending on which other genes they end up with. Different versions of the same gene can also interact differently with the same environment and, conversely, a single gene variant can act differently in different environments. It is feasible that the same environmental factor could increase or decrease your risk of ALS, depending on what your genome looked like.

All this ferocious complexity is part of the reason why studies looking at environmental risk factors for ALS have been inconsistent in their results, with some finding associations, and others failing to reproduce these. It is also immensely difficult to tease out causation in a world teeming with correlation, or to eliminate the numerous forms of bias which can so easily creep into observational studies (as opposed to randomised, controlled trials). Finally, publication bias skews the picture too. Some associations that have been flagged up will turn out to be spurious; others will turn out to be explained by other, unseen variables. Others won’t be found, even though they really do exist. Please keep this in mind as you read the rest of this article.

Gucciardi’s cherry-picking trip

Starts with:

“Numerous studies available through the United States National Library of Medicine have demonstrated the natural preventative effects of key substances…

Vitamin E: Shown by research to exhibit a whopping 50-60% decreased risk of developing ALS when taken alongside powerful polyunsaturated fatty acids.”

The vitamin E research Gucciardi is referring to was headed by Jan H. Veldink, who is based at the University Medical Centre, Utrecht. The UMCU is one of the partners of Euro-MOTOR: European multidisciplinary ALS network identification to cure motor neurone degeneration. Also based there are Bryan J. Traynor, who headed the ALSA-funded Netherlands study that identified the role of C9ORF72 in familial ALS, and Leonard H. van den Berg, who was awarded a $25,000 research grant by the ALSA. After telling people to shun the ALSA because of its connections to the pharmaceutical industry, Gucciardi shows that he is nonetheless happy to cite studies that are connected to the ALSA (and, of course, to the pharmaceutical industry too, in similar ways to the ALSA), so long as he reckons they can slot nicely into his ideology.

Irrespective of the quality of the vitamin E/ALS research he cites, a reduced risk does not equate to a preventative, and in any case applies at a population level, though as we’ve seen, some individuals are born with a 100% risk of developing ALS, regardless of environment. What about them? Don’t they deserve access to the drugs that might be discovered through pharmacological research?

Critically evaluating individual studies was not what I set out to do here. I mentioned earlier that there are various inherent weaknesses of observational studies, and I would have left it at that, but since this study is being flaunted so widely (it features on GreenMedInfo too, and therefore on scores of other popular alternative/conspiracy websites), I couldn’t help but feel that a brief critique was warranted.

Not that the authors claim it is, but we should be clear that this study is not a randomised trial. The researchers didn’t give one group of people vitamin E and polyunsaturates and one group a placebo and then wait to see whether either group had higher rates of ALS. They sent questionnaires to patients in clinics, both ALS and healthy, asking them to “recall their dietary habits during the period 1 year before the onset of muscle weakness or bulbar signs”. Then, amongst 15 micronutrients, they looked for associations with ALS. The authors apparently did not apply a correction for multiple comparisons, which is a serious oversight, and it makes the study seem like something of a fishing expedition, since the more things you compare, the more likely you are to get a ‘significant’ result, just by chance. This is called a ‘false discovery’. One would expect the false discovery rate (FDR) to be pretty high with this many comparisons.

There is a later vitamin E study, cited by Sayer Ji but not by Gucciardi, that pools five datasets (including the one just discussed). However, it too appears to lack statistical rigour. The researchers found that, overall, vitamin E did not reduce risk of ALS (in fact, there appeared to be a slightly higher risk of ALS in vitamin E supplement users – though to be clear, this does not provide evidence that vitamin A actually increases risk of ALS). However, when they then looked at the (very small!) datasets that included information on the duration of use, they found a significant trend. But to get their significant results, it seems that the authors had to run various different analyses on their data, reorganising it for the purpose (and apparently without making FDR adjustments). For a discussion of the problems with re-arranging and re-analysing data, see chapter 4 of Ben Goldacre’s Bad Pharma, especially the sections called Dodgy subgroup analyses and Dodgy subgroups of trials rather than patients.

From that chapter: “If your drug didn’t win overall in your trial, you can chop up the data in lots of different ways, to try and see if it won in a subgroup: maybe it works brilliantly in Chinese men between fifty-six and seventy-one. This is as stupid as playing ‘Best of three … Best of five … ‘ And yet it is commonplace.”

The most recent study on vitamin E and ALS was a randomised clinical trial conducted in Finland, and the researchers did more than just measure ALS risk – they also measured subjects’ serum vitamin E levels (how much of it people had in their blood) at the beginning of the trial. Overall, they found that vitamin E supplementation did not significantly mitigate risk for ALS. However, when the data was split in half along the mid-point (median) to produce one group of subjects who, prior to the trial, had higher vitamin E serum levels and one group who started with lower levels, they found that in the lower group, supplementation did confer a reduction in risk. But the study doesn’t tell us about the finer-grained relative-risk distribution; the data was simply cut in half along the mid-point.

The interpretation of this study most likely to be correct is that ALS is associated with vitamin E deficiency and that only the people right at the bottom of the low-serum group (people who had levels far lower than the median) benefited from vitamin E supplementation. This seems most likely for two reasons:

  • This study looked at ~ 30,000 people. The fact that their overall results weren’t significant, despite such a large sample size, suggests that there were very few people within it for whom supplementation had any effect (which is parsimonious with the fact that vitamin deficiency in 1st world countries is rare), but that in those people, since there was very a real initial risk to begin with, vitamin E had a significant enough effect to be detectable even when diluted by the rest of the group.
  • Vitamin deficiencies are bad news for the human body. We already know that vitamin E deficiency can cause neurological issues, so this observation is not surprising.

In other words, the most rigorous study we have on vitamin E and ALS does not provide any evidence that the average person will reduce their risk of ALS by increasing their vitamin E intake, despite Sayer Ji having included it in the collection of cherry-picked articles he has put together and posted on his supplement-pushing website.

Gucciardi continues:

Vitamin B12: Demonstrated by scientific study to be highly beneficial in the aid and understanding of ALS. In fact, PubMed research specifically reveals the integral usage of vitamin B12 in ALS research:”

Now, perhaps this is petty of me but I can’t resist pointing out how silly referring to a study as “PubMed research” makes Gucciardi look. PubMed is a search engine. Not a research outfit. And if that’s what he thought it was, again, what was he doing citing its research? “PubMed research” is a wellspring of industry-funded studies.

This study did not demonstrate vitamin B12 to be “highly beneficial in the aid and understanding of ALS”. What does that even mean? The idea that the study “reveals the integral usage of vitamin B12 in ALS research” came from Gucciardi’s head (or arse, depending on how you look at it). This wasn’t a study about studying ALS and how useful vitamin B12 has been for that. It was a study with a very specific remit, looking at the effect of ultrahigh-dose vitamin B12 on compound muscle action potentials (CMAP) in ALS sufferers. To achieve significant results, the investigators had to give patients roughly 17,000 times the recommended daily allowance (RDA). There is little evidence that vit B12 is toxic even at this level, but it’s all by the by really, since the authors of the study are careful to point out that “CMAP improvement, as demonstrated in this study, needs to be interpreted with caution, because it may not reflect clinical muscle wasting or weakness. Moreover, this transient effect does not necessarily lead to retardation of the disease process.”

In other words, this study does NOT provide evidence that vitamin B12 helps to reduce the risk of getting ALS, nor does it provide evidence that vitamin B12 prolongs the lives of those who have ALS. And it certainly, absolutely, totally does not suggest that vitamin B12 can cure, or will ever be able to cure, this disease.

“And the list goes on”, says Gucciardi.

(What, you mean, the list of studies that don’t say what you think they say?)

It should be pointed out that even if a ‘natural’ substance were one day found to be useful in ALS treatment, this would not make it superior to, or even meaningfully different from, man-made treatments. As neurologist Steve Novella points out, herbs are drugs. Furthermore, about 50% of all pharmaceutical medicines on the market are derived from nature.

He continues: “But what’s even more important to consider is the lack of information regarding the actual cause of ALS, which may be even more valuable to many sufferers.” [Emphasis his.]

Notice “cause”, singular. A typo? Who knows.

Let’s have a quick glance at the ALS Association’s website. Oh look. A section devoted to possible environmental causes and another to the genetic causes of ALS. Hmmm. Now let’s type ‘ALS’ into Wikipedia. Oh look. A section all about the multifactorial causes of ALS, which references a systematic review of what we know about lifestyle and its links to ALS. Let’s see what happens when we type ’causes of ALS’ into Google. Funny, that. I seem to have found an enormous list of results.

He goes on: “Looking to the research we find an extensive list of culprits that can be identified and reduced, including:

1) Pesticides: Not mentioned by the ALS Association, a number of studies have drawn links between ALS and pesticide exposure.”

It’s really, really hard not to explode with swear-words at this point, as Gucciardi flaunts, yet again, his scandalously irresponsible failure perform a few clicks around the website of the organisation he is publicly denigrating. This really is an unambiguous case of

Libel.

Pesticides ARE mentioned by the ALS Association. You know what else? The ALSA have FUNDED RESEARCH ON PESTICIDES AND ALS. 

Signs of an association between pesticides and ALS are found amongst people who, because of their occupation, are directly exposed to pesticides. For instance, farmers. There is no evidence whatsoever that normal exposure (ie, from residues on fruit and vegetables) is harmful. In fact, there is even some evidence to suggest that low exposure might be good for us. Oh, and, by the way, organic pesticides are just as toxic as synthetic ones. They are also less effective, resulting in their being used in higher quantities.

The next item on his list reads:

2) Lead: Often contaminating the food supply and foreign products, 4 studies have demonstrated a relationship between lead and ALS at large.”

In 2009, a systematic review of the evidence surrounding lead as a risk factor for ALS was published. It looked at 50 studies on lead, mercury, aluminium, cadmium, manganese and selenium, and found no evidence of a causal relationship between any of these and ALS.

Since then, some other studies have supported a link between lead and ALS, but the researchers make it clear that this excess risk could by no means be enough to account for ALS, representing just one factor amidst a sea of genetic and possible environmental influences. Indeed, if lead were a particularly powerful causative agent in ALS, we would expect this to have shown up unambiguously the 2009 review. Furthermore, lead exposure in developed countries (like the ones in which readers of Natural Society and Storyleak reside) has been greatly reduced through public policy, especially during the last few decades, as a result of lead-reduction programmes.

Intriguingly, lead exposure actually holds some promise for therapy in ALS sufferers, since it seems to reduce motor neurone loss and slow the progression of the disease in mice. Life is complicated. Much more so than Gucciardi and his posse give it credit for.

And the final thing he claims ’causes’ ALS:

3) Statin Drugs: You may already be well aware of the dangers surrounding statin drugs, in which case this may not surprise you. ALS has been identified as a possible side effect of these drugs that aim to reduce cholesterol.”

This review of all the studies looking at statins and ALS points out fundamental problems with the available studies finding an association, including several very serious limitations of the study Gucciardi links to, which the authors themselves acknowledge, conceding that their research does not provide actual quantitative support for an association between statins and ALS. The paper most certainly does not make the claim that ALS is a “side-effect” of statins. Grrrrrrr!!!

The authors of the 2009 review point out that the only rigorous study on statins and ALS to date did not find an association, which is parsimonious with the observation that, since the 90s, statin use amongst 60-to 69-year-olds has gone up from 5% to 50% in men and 33% in females, and yet, when increased life-span is taken into account, there is no evidence that rates of ALS have risen since then.

Anthony wants us all to know, in no uncertain terms, just how thoroughly bloody wonderful he is.

He writes:

“Earlier this year, I found out about a Washington native named Ben Charles whose charity had been shut down by beauracratic [sic] government officials — even going as far as to threaten Ben with arrest for feeding the homeless on the streets of Olympia. Concerned about this issue, I further reached out to Ben back in early December of 2013, documenting the government crackdown on his initiatives and others.

Later that month, I gave another church that was targeted by the government for handing out turkeys on Thanksgiving a $1,000 donation in order to purchase additional food items (specifically turkey) and distribute it among those who needed it in the area — a proverbial middle finger to the bureaucratic park rangers and officers who sought to shut them down. This was also done as an initiative to drive others to do the same.

Now, amid yet another social media donation campaign that has led to almost 100 million going ‘towards the cure’, I am inspired (and want to inspire others) to give to a charity that really gives directly to the people it seeks to serve. That’s why I am giving $2,000 to Ben Charles and his grassroots ‘Crazy Faith’ food program in Olympia, Washington in order to help feed hundreds of homeless individuals on the streets with healthful food items.”

[Emphasis his!!!]

When I read this ingratiating report of how much money Gucciardi has personally given to charity (a report that Storyleak (ie. Gucciardi himself) has made into a headline that appeared as an enormous banner on the site for a couple of weeks), I wondered whether the whole article had been a pretext to lord his magnanimity over us.

I learnt in Gucciardi’s biography (see note at end of article) that one of his favourite bible verses is Psalm 94:16: “Who will rise up for me against the evildoers? or who will stand up for me against the workers of iniquity?” [sic]

I wonder what he feels about Matthew 6:1-4: “When you give to the needy, sound no trumpet before you, as the hypocrites do in the synagogues and in the streets, that they may be praised by others. Truly, I say to you, they have received their reward. But when you give to the needy, do not let your left hand know what your right hand is doing, so that your giving may be in secret.”

Gucciardi concludes:

Whether or not you have the funds available to support your local communities, what’s even more important is the spread of information. If everyone donating to the ALS Association actually took the time to share key articles such as those highlighting the dangers of ALS-linked toxic substances, or those discussing the power of natural alternatives to ALS treatment, millions would be helped within hours.” [Emphasis his]

I hope that this article has made it clear that what Gucciardi is doing, and encouraging others to do, is hurting people, rather than helping them, because what he is spreading isn’t information but misinformation.

GreenMedInfo – Competing with Natural News for #1 spot in the World’s Worst Anti-Science Websites Hall of Shame 

Sayer Ji, whose fast-growing website has an estimated net worth of $189,000, is getting around 90K page views per day, and making around 8K per month in advertising, is running a particularly appalling ALS misinformation campaign, apparently hand-in-hand with Joseph Mercola. In this article, the headline screams “60+ Natural ALS Cures the “Ice Washing” Campaign Isn’t Funding!” (Here’s another one — the one Gucciardi links to — where he makes most of the same nonsense claims.) To support his claim that ALS can be cured in 60 ways, he refers you to a “GreenMedInfo’s free ALS research PDF”, where he has listed all the scientific papers he’s cherry-picked that sport titles seeming, superficially, to support his view that ALS is something that can be prevented/reversed ‘naturally’. It’s hard to find the words to describe just how criminally unethical this is. The research written up in these papers has been conducted by scientists who understand that ALS is a complex disease. Not one of these papers contains the claim that ALS is curable, and there is no doubt that they would be horrified to see their work being exploited in this way. Compiling them, in a catalogue, under the banner of “ALS cures”, knowing full-well that none of his subscribers will read or be able to understand them, and almost certainly having not read them himself, is a heinous abuse of science, and of the trust of his readers. It’s enough to make you weep. Because of this document, and because of their so-called “cumulative knowledge database“, a scarily sophisticated-seeming system for disguising their woefully unscientific enterprise with apparent scientific credibility, I vote GreenMedInfo for most inhumane, despicable website on the net.

I wrote this article for various reasons, summed up here. But in particular, I wrote it because…

Neurodegeneration quackery harms patients

I spoke to neurologist Jonathan Howard about the damage that this kind of charlatanism does to actual patients suffering from ALS, whom I think for Gucciardi and Ji are more like an imaginary concept than real people. Here is what he said:

Many of my patients with chronic and untreatable neurological diseases (ALS, MS, and Parkinson’s disease to name a few) embrace unproven treatments.  I get it.  These are desperate people dealing with terrible diseases. These “treatments” are usually harmless.

However, there is a subset of patients who embrace only quackery for diseases such as MS, where there are effective treatments. (And of course, those same quacks are happy to take their money.) The same will undoubtedly be true of ALS, once effective treatments are available.  Some patients spend tens of thousands of dollars on unproven treatments, enriching unethical, modern-day snake oil salesmen.  These are the most obvious harms done by charlatans like Gucciardi and Ji.

But what is less appreciated is the terrible psychological price paid by patients who feel they ’caused’ their disease, or are to be blamed for its worsening.  Some of my patients feel responsible for every downturn and berate themselves endlessly for it.  Powerlessness in the face of an unrelenting disease is inherently difficult to come to terms with. However, being told and able to accept that they did not cause their disease — and have little control over its course — can be profoundly liberating. It can allow people to enjoy themselves as much as possible without shame or guilt.

Additionally, telling patients that ‘natural’ cures exist but are are being suppressed by Big Pharma serves to make some patients paranoid and bitter.  I suspect Gucciardi and Ji know this, and it is easy for them to exploit when they are not faced with the challenge of seeing these patients face-to-face on a daily basis.  In adding fear and guilt to their already profound physical suffering and poisoning the relationship between doctors and patients, they open the door to their highly remunerative quackery.


*If you do read Gucciardi’s biography, I would like to draw your attention to sceptical literature on ‘chronic lyme disease‘. I’d also point out that normal treatment for lyme disease does not include steroids. Steroids only become appropriate if the lyme disease has caused an auto-immune response like arthritis. In general, steroids would be a bad thing to give to someone suffering from a bacterial infection, since they suppress the immune system. Make of that what you will.

With special thanks to Joseph Bundy and Jonathan Howard, for being excellent sounding boards and offering helpful suggestions. It was extremely useful to be able to discuss vitamin E research with Joseph, and to have Jonathan’s first-hand account of how quackery harms patients with neurodegenerative diseases.

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Ty Bollinger’s Cancer(un)Truth, AKA: cancertruth.net

Over the past couple of months, we’ve been seeing some FB adverts for cancertruth.net, a crank-magnet hub of cancer misinformation run by fanatic Christian Ty Bollinger, an all-round quack who makes public examples of sceptics who question his claims and motives by calling them “lowly Pharma trolls” from the “medical Mafia”. This kind of name-calling is a well-documented trick of the trade, as anyone who has ever confronted a quack will know. For those of you who haven’t ever had the pleasure, this type of response is called an ad hominem argument.

Bollinger has written a book called “Cancer: step outside the box”, which you can buy for 20 quid or 30 bucks and which he says is the product of several years of “medical research”. In reality, it is the product of equating anything-goes conspiracy junk à la Mike Adams with credible medical literature, combined with years of religious indoctrination. (Indeed, for Ty, cancer is ultimately a result of sin, and your only real chance of being saved from it is by seeking redemption through Jesus Christ. But we’ll leave that aside.) As a sceptically-active adult who can usually smell bullshit before having read the first word on a webpage, it is very easy to get it into one’s head that only stupid idiots are fooled by people like Ty Bollinger and his unquestioning embrace of all and any pseudoscience the Internet has to offer. But this is a mistake. Harnessing the skill of detection takes practise and prior knowledge. It hurts me to imagine how many bright young minds, as we speak, are discovering Ty’s world of “InfoWars” and “What ‘They’ Don’t Want You to Hear”, and revelling in the false knowledge that they are fast-tracking themselves into enlightenment by fuelling their brains with the cutting-edge. Equally, it’s a tragedy to me that Ty Bollinger’s “thousands of hours” spent “researching” were in actual fact thousands of hours spent willingly applying his brain-power to the task of rooting around in humanity’s intellectual dustbin.

Ty-Bollinger2For a sense of how difficult it would be for any conscientious 16-yr-old biology student to debunk Ty’s homepage article on the question “What is Cancer?”, consider standing with a small, empty wicker basket in the heart of an untouched apple orchard in Devonshire, on an early-autumn afternoon of a particularly good year for apples. 

Of course, Ty could always say, HA! Text-book biology is just what ‘they’ want you to see anyway.

…And you might be stumped for a millisecond, but then you’d recall that his entire website revolves around scientifically-established, text-book concepts like pH, respiration, trans-fats, antioxidants, mutation, immune function, radiation, cholesterol, and so forth, and so forth. (He just doesn’t know what they actually mean.) If he doesn’t trust science, why on earth does he enjoin his readers to trust that these scientific concepts aren’t just deep layers of conspiracy construction, designed to function as a believable framework for all the lies ‘they’ tell us, and that he so diligently exposes? Perhaps it’s because in reality, they function as a convenient conceptual framework for readers to place his lies neatly into. It makes them easily remembered and spreadable. One thing’s for sure: when we see such selective inconsistency, we know the motivation is something other than truth.

I will go through his answer to the question “What is Cancer?”, bit by bit. The entirety of his original text is quoted, but feel free to observe it in context at his website, via donotlink, here.

Please note that I go into more depth on the kind of misinformation Bollinger spreads, and give an explanation of what cancer actually is (without assuming any prior knowledge), in this blog post. I’ll indicate if one of Ty’s claims is dealt with directly in it, and which paragraph to look at. Here is the first section of Ty’s piece on the question “What is Cancer?”

“Conventional medicine defines cancer as a colony of malignant cells, or a tumor. If you have a tumor, then the conventional oncologist will try to cut or slash it out via surgery. After they cut you, then they typically recommend chemo to try to kill any remaining cancer cells with toxic poisons. And they will finish off with radiation, to burn whatever cancer cells remain.”

Firstly, notice the use of loaded, repetitious language (“cut or slash”, “burn”, “toxic poisons”). What follows, this strongly suggests, is so reliant on unsubstantiated claims that he feels the need to poison the well by doubling-up on nasty words before he can let people read on, to inflame their emotions and make them less likely to go and do some fact-checking. The use of the snide expression, “they will finish off with radiation” is another, more subtle example of the same ploy – immediately planting in the mind the image of a gang of sadistic doctors toying with your body for their sport. Furthermore, look at the term “conventional oncologist”, which implies that some oncologists (the unconventional ones) think more like Ty than others. They don’t. To be an oncologist, you have to have studied cancer genetics and cell biology and passed some long, hard exams. Practising oncology means treating patients on the basis of what you learned for those exams. ‘Alternative oncologist’ is a meaningless term, used only to set up a double standard.

More importantly, Ty’s description of the transition from diagnosis to treatment is ridiculous. And it implicitly makes one of the most fundamental oncological oversights, as seen in cancer quackery across the board: failing to distinguish between a benign tumour and a malignant tumour. A malignant tumour is one that contains cells which have gained the ability to break away from the tissue that holds them together. Before a tumour has started shedding cells into the blood lymphatic system, or ‘metastasised’, tumours are ‘benign’, and can in many cases be removed (or “cut or slashed”) out via surgery without complication. When possible, it is preferable to use surgery as the only treatment, because of the side-effects that are associated with chemotherapy and radiotherapy. However, unless there is good evidence that the tumour has not yet started to shed cells, it is often recommended that surgery is combined with other treatments, to give maximum confidence that all the cancer has been killed. If a patient is diagnosed with metastatic cancer, treatment must be tailored to the particular kind of cancer they have. This will be the result of careful analysis of the particular genetic traits of the cancer. At this point, I should say: cancer is NOT a disease, it is an remarkably diverse CATEGORY of disease. No two cancers are the same. Different tumours in the same body can have very different genetic profiles. In fact, even within the same tumour, cells may be different in this way. Likewise, chemotherapy isn’t a drug, it’s drug category. The drugs that are recommended as part of a patient’s course of chemotherapy will reflect their individual case. Radiation therapy works locally, targeting a specific area of the body, whereas chemotherapy and oral medication (Ty doesn’t mention pills) work on the whole body. Broadly speaking, these differences, combined with the patient’s profile, determine the treatment approach.

“This is why I, and many others, refer to “the Big 3” protocol as “Slash, Poison, and Burn.” Alternative medicine sees cancer as a multidimensional, systemic total body disease. The cancer tumor is merely a symptom and the purpose of the alternative cancer treatment is to correct the root causes of cancer in the whole body.”

So, after reiterating his fondness for loaded language, he tells a lie. In reality, the opposite is true. A one-dimensional, dumbed-down view of cancer, and the ignorant portrayal of the [category of] disease as predictable that is what defines cancer quackery – not the ‘individualised’ approach they claim to take but actually are incapable of taking because of their lack of even the most basic understanding of cancer, DNA, and human physiology. Saying that the “root causes of cancer” are “in the whole body” is, again, meaningless. Massive oversight number 2 from Ty Bollinger: the difference between proximate and ultimate causes, which, when it comes to cancer, is crucial. Please see paragraph 1 of the section entitled “Miracle cure for cancer?” in the blog post I mentioned above, for more on this. The causes of cancer, both ultimate and proximate, are as diverse as cancer itself. The claim that “the cancer tumor is merely a symptom”, which is false, is discussed later.

“The fact is we develop cancer cells throughout our bodies throughout our lives.”

This is kind of true, but not really. Cells are called “cancer cells” when they’re part of a cancer. Cells do spontaneously mutate, and Ty is correct in saying that “normally”, our bodies “are able to find [these cells], identify them, and destroy them before they are able to grow uncontrollably” (ie, before they become cancer, and thus, before they come cancer cells).

“It is a normal occurrence, which is constantly taking place in a healthy body.  It is only when the healthy body becomes unable to mount its normal defenses and the cancer cells are allowed to reproduce at an uncontrollable rate that cancer becomes life threatening.  This is a failure or breakdown of our normal immune system. The immune systems breakdown, and its cause, needs to be treated in conjunction with the cancer, in order to assure the best possible outcome for the patient.  Any treatment that does not address underlying causes for the breakdown of the immune system will be palliative at best, and life threatening at their worst.”

It’s just not true that this mechanism (find, detect, destroy) will not fail if you are “healthy”. The word “healthy” is, in any case, spectacularly broad in meaning and impossible to define without including more and more words. Here we see Ty’s complete ignorance of the probabilistic nature of cancer, which arises from the fact that any copying system has an inherent error-rate. We see it in all copying systems, not just in DNA-replication. Cancer can occur in people who are in very good physical shape. This doesn’t mean that the immune system has no role in cancer. Far from it. But sometimes, even in a fully-functioning system, something slips through the net. Ty fails to mention hereditary cancer predispositions, some forms of which will result in a person getting cancer very early in life, and dying. Try Googling famililal adenomatous polyposis, or Li-Fraumeni syndrome, for example. Please see paragraph 3 of “Some background information” for more on this. Now, be prepared, this is where it all kicks off…

It’s important to remember the basic physiology of all cancer cells. Whether it be breast, prostate, renal or lung, there are many facets of their physiology that will remain constant.  Glucose is taken in as a primary food; lactic acid is excreted from the cancer cells into the blood.  The blood carries the lactic acid to the liver, where it is converted back into glucose to feed the cancer cells.  This occurs in all known cancer cells.  It has been well documented in many studies, that, many years ago serum glucose levels were used to monitor the progress of the disease.  It was well established that as the disease progressed, serum glucose levels would rise.

Yes, there are basic elements of physiology that all cancer cells share. They’re the ones that all non-cancer cells also share. There is a lot more *unshared* physiology going on in cancer cells than there is in normal cells. Glucose? Taken in as a primary food? Yes, by all cells, including the healthy ones! It’s testament to the mental tragedy I was talking about earlier on that after several years of what Ty thought was “medical research”, he’s managed to miss the fact that all cells require glucose for cellular respiration…..which, of course, renders the rest of that last paragraph moot. Oh, and the whole of the next paragraph.

“Knowing this, the wisdom of removing simple carbohydrates and sugars from the diet becomes obvious.  The ignorant use of glucose I.V.’s in cancer patients also becomes painfully obvious.   The object is to make it difficult for cancer cells to reproduce.  Why fuel them with a primary requirement?”

…Because you can’t stop fuelling them with a primary requirement without also cutting supply to healthy cells.

“They are unable to efficiently use protein or complex carbohydrates for food.”

Actually, proteins and complex carbohydrates can both be converted to glucose just fine by the liver and the pancreas.

“The healthy cells of our body and immune system are able to use these as fuel and for repair.”

And so are the cancer cells.

“Adapt the patient to a diet that includes protein and complex carbohydrates and eliminate the rest.  This is a simple change that can make a huge difference in the final outcome of the disease process.”

Forgetting for a moment that complex carbohydrates and proteins are both routinely converted into glucose by the body, where’s his evidence that eliminating everything but complex carbohydrates and protein “can make a huge difference in the final outcome of the disease process”? Even if his premise were correct, which it is not, this would still need to be supported by controlled studies.

“It’s also important to remember that a large number of cancer cell types have receptor sites for opiates.”

So do healthy cells. And just because a cell has opiate receptors doesn’t mean that opium helps keep them alive.

“In other words, opiates used to fight pain will actually increase the cancer cell’s growth rate.”

No, this does not follow.

“The quick shrinkage of tumors that is sometimes seen in chemotherapy or radiation therapy is not a sign of recovery from cancer.  It is a complete shutting down of the normal immune response.”

This is not true. Cancer is made of tumour mass. If the tumour shrinks, the patient has less cancer. Tumours aren’t “symptoms” of an underlying disease, they are the disease, and their growth into surrounding structures causes a host of symptoms (say, difficulty breathing if they grow in towards a patient’s wind-pipe). There is absolutely no basis for the claim that tumour shrinkage, when it occurs after chemotherapy or radiation (but presumably not if it were to occur in someone who eschewed “conventional” treatment for cancer), is the “complete shutting down of normal immune response”.

“This is as indisputable fact, yet the pharmaceutical companies are allowed to use it to get their chemotherapy approved.  Under optimal conditions, tumors will enlarge as they become engorged with CD-cells and macrophages.  These cells identify the cancer cells, kill them and then devour their remains.  This is an inflammatory response and results in the tumor growing slightly as it becomes engorged with these cells.  If the tumor shrinks quickly from chemotherapy or radiation therapy, the ideal healthy response of the body to controlling cancer does not have a chance to occur.”

Whoah, Nelly. Ty starts that paragraph by saying that something anyone who has ever studied cancer would dispute is undisputable. He then uses this as the basis for the idea that chemotherapy doesn’t work, but pharmaceutical companies are selling it anyway. (I invite you to read that first sentence again just in case you missed that he inadvertently implies that pharma companies are using *his* absurd interpretation of tumour shrinkage to sell their drugs. We are dealing with a seriously impaired thinker here, folks.) Let’s not forget that for this to be true would entail that every single oncological researcher, many of whom have come out of the best universities in the world, are willing to forfeit all semblance of scientific integrity for dirty pharma payouts. In principle, as someone who studied cancer as part of their degree, and who has friends in cancer research, I find this insulting. In practise, I had to get over that a long time ago when I realised that people like Ty are all over the place, and that taking offense doesn’t get you anywhere.

Let’s avoid the false dichotomy that says you have to be in love with pharmaceutical companies to confront pseudoscience. In the words of Ben Goldacre, one of pharmaceutical companies’ most vocal critics (from his book, Bad Pharma):

“Alternative therapists […] have no role to play in fixing these problems. These business people often like to pretend, with an affectation of outside swagger, that their trade somehow challenges the pharmaceutical industry. In reality, they are cut from the same cloth, and simply use cruder versions of the same tricks, as I have written many times elsewhere. Problems in medicine do not mean that homeopathic sugar pills work; just because there are problems with aircraft design, that doesn’t mean that magic carpets really fly.”

“Never confuse rapid tumor shrinkage with beating the cancer.  It is just the opposite.”

Yeah…no.

This is the last bit:

“CT scans and PET scan show inflammatory responses, not just cancer. Since the normal and healthy body response are CD-cells infiltration and consuming of cancer cells is also an inflammatory response, they are often confused by radiologists untrained in cancer fighting agents that work with the immune system to facilitate both increases in CD-cells and at the same time being cytotoxic (selectively killing cancer cells).”

Here’s a definition of “inflammatory response” from Wiki: “part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants.” As we might expect, on the basis of this definition, cancer certainly does cause inflammation. As tumours grow and displace surrounding tissue, cells are damaged. Tumours also secrete a variety of substances which could act as harmful stimuli or irritants. A trained oncologist would never confuse inflammation for a tumour, let alone to the point where the patient would be referred for a PET scan. The two things look completely different. If on the off-chance such a rare error of judgement were made one the first consultation (very unlikely), further consultations with other doctors (they don’t work alone) would expose the mistake. A biopsy, for example, would show unmistakably that the lump was not cancer. Inflammation is generalised fluid swelling, redness, and heat – not a mass of cells. In a PET scan, a radiologist is looking for areas where more energy is being expended – ie, where more glucose (from blood) is being demanded. PET scans are expensive, and usually aren’t used to diagnose cancer in the first place but to ascertain where the cancer has spread to, or whether treatment has been effective. No patient would ever be referred for a PET scan because of inflammation.

Bollinger throws around the term “CD-cells”. The fact he seems to think that “CD-cells infiltration” is what the “inflammatory response is” demonstrates as clear as day that he he is using the term because he thinks it makes him sounds clever. “CD” stands for “cluster of differentiation“, and is always followed by one or more numbers. That’s because there are a LOT of different types of CD cells. The CD number is the name given to a specific protein on the surface of a cell. Many CD cells (for example, CD4, CD8, CD20), are not involved in inflammation. It would have been good if Ty had read up on the topic he’s taken it upon himself to use as a basis for pushing his medical delusions on cancer sufferers.

So, what would a radiologist *not* “untrained in cancer fighting agents that work with the immune system to facilitate both increases in CD-cells and at the same time being cytotoxic” look like? Let’s see. Well, on paper at least, they’d have to look a bit like Ty Bollinger. Because they’d have to believe, like Ty, that glucose is the primary source of fuel for cancer cells but *not* the rest of the cells in the body. And they’d have to believe that increasing CD cell-numbers was the holy grail of cancer treatment. It’s not. The only thing CD cells necessarily share is that they are all involved the immune system. The immune system is mind-blowing in its degree of organisational complexity. Its many subsystems interact in an exquisitely specific manner and there is no reason to think that increasing all of a patient’s CD-cell levels should result in tumour-shrinkage. In fact, sending someone’s whole immune system into overdrive would probably be a very, very bad idea. Here’s an article on why “boosting” the immune system (which is what I think Ty is getting at) is (another) meaningless concept, and probably dangerous in the sense that Bollinger seems to be inadvertently endorsing through his ignorance. In other words, then, this kind of “radiologist” would actually have to be a quack who, like Bollinger, lacked any medical qualifications. If they were caught using this term to describe themselves, they’d be in serious trouble.

The selectivity problem (which, through an amazing feat of learned stupidity, Ty seems to think he has solved) is the central and most difficult problem in cancer treatment research. It is discussed briefly in paragraph 3 of the section called “Miracle cure for cancer?” of the note. There are promising avenues of research currently being pursued, which aim to overcome the problem of singling out cancer cells, but the majority of current cytotoxic (cancer-killing) drugs can affect the whole body, being fatal to rapidly-dividing cells like cancerous ones, those from the gastrointestinal tract, hair follicles and early blood cells in the bone marrow. Cancer treatment is not perfect, but it does save lives.

As a final word on this dense cacophony of ignorance: perhaps the most badly thought-out element of Bollinger’s piece was his singling out of “a radiologist” as the the crux of the problem. Radiologists diagnose or confirm diagnoses of disease (not just cancer). When the disease is cancer, science-based medicine requires a pathology specialist (for example, breast, lung, prostate or renal) to ascertain the invasiveness of the cells. Then a group of surgeons will work together to figure out the best way to achieve the best possible outcome, hopefully with complete removal of the tumour, causing the smallest amount of damage. Next, oncologists (plural) will use the data from the pathologists (data that describes the profile of genetic over- and under-expression of in the tumour cells) to decide which drug(s) will be most effective against the particular case of cancer the patient has. In short, medicine is a team effort.

Nothing in Bollinger’s statement stands up to the most basic medical science or current medical practice. He starts with the typical and tiresome premise of denigrating science, then fails to provide any scientific argument whatsoever, instead backing up his utterly unfounded and impressively stupid statements by impersonating science – its language and its terminology, its concepts and its techniques.

Science is not some collection of answers from which one can pick and choose what one likes. Science is a method of inquiry, and it is the method – the way in which we seek the answers – that makes something scientific, and not the terminology or the answers themselves. While science never demands our ultimate trust, it does demand that, if you want to disagree with it, you must disagree using more science. That means you must disagree with the method, rather than simply reject the answers. And to disagree with the methods used to determine scientific answers, you need to…ahem…understand the methods, and the answers, that you are disputing.

All this got me thinking about how formidable a beast the “alternative” healing/pseudoscience/conspiracy scene is. It can sometimes feel (if you’ll allow me to get into the spirit) like a giant conspiracy against reason and human emancipation from mental slavery.

People competing for recognition in the “alternative” world seek to obtain the things “they” MOST don’t want you to see. This compels to hunt the Internet for the most cracked out, far-fetched, hare-brained articles and “nuggets” (Ty’s preferred term for the misinformation he emits from his little cyberspot on the World Wide Web) that they can possibly find. It sort of reminds me of football or Pokémon cards. There are some that you find in every packet. And there are some that are really hard to track down and that only a few people have ever got hold of. THOSE are the ones people are after. “Alternative” suppliers stock the collectables – the articles and interviews and pictures with words under them, and the pressure is on to be the website or FB page that has the rarest, most STUNNING NEW INFO to provide its consumers with, to increase their page rankings so they can earn maximum dosh from advertising or selling their rubbish. But whereas football and Pokémon cards (or medicine) correspond to a finite number of characters (or available treatments), as a crank you don’t have this limitation. You can simply invent stuff. It doesn’t have to be stuff that’s true, or even stuff that people might be able to point out with irrefutable evidence is not true. It doesn’t have to make sense, or be good for people. There are no rules. And the more recognition you get, the more people you can hire to pluck bullshit from their arses and convert into (just) readable prose, and the crazier the people you can employ, so your posts are always on the forefront of Cutting-edge Crap. Oh, you like that effect? Check out the title of Ty Bolinger’s most recent book, “Monumental Myths of the Modern Medical Mafia and Mainstream Media and the Multitude of Lying Liars That Manufactured Them”, with a preface by Mike Adams. He’s got alliteration down to a tee. We can at least say that about Ty.

In Bollinger’s world, there is no reality-check. He just keeps going. His readers gotta catch ‘em all – all of those lies, all the conspiracy theories, all the cheap bunk that the human mind can produce when released from the onus of fact-checking. Writing this article reminded me of what I just found out is called “Rule 34” which, in the form I heard it, goes something like this: if you can think of a sex fetish, no matter how weird, someone has already thought of it. It’s been done.

See for yourself. Think up some pseudoscience – pick an object or concept and see whether some whacko out there on Google has spun some junk from it. In my experience, they usually have.

To conclude, all the evidence you need to ascertain that Ty Bollinger is a dangerous quack has been provided to you by his own words, and his astonishing ability to confuse broadcasting his ignorance with providing credible refutation of medical theories.