“Complementary medicine” is not helping cancer patients

“…Belief is powerful, it disrupts, distorts, delays or stops the comprehension and acceptance of scientific evidence. Scientists call this phenomenon the ‘3Ds+S’ cognitive effects of illusory thinking. Now, the best tonic against its infectious sequels was discovered long ago; it consisted, still does, on proper healthcare education for all. And, in contrast to misleading and unwarranted ‘paramedicine,’ the side effects of widespread science education will always be cheaper, plus save, for sure, some lives…”

By Guillermo Paz-y-Miño-C

Cancer hides or thrives in our bodies. Someone we know, close or distant, is destined to die because of it. And although therapies continue to improve thanks to scientific advances, diverse cancers persist and it might take decades, if ever, to fully manage them.

In the United States, breast, prostate, lung and colorectal cancer are the most prevalent, and chemotherapy, radiotherapy, surgery, and/or hormone therapy the usual treatments. Yet, more than half of the patients with cancer opt for “complementary medicine” to improve, as they believe, their quality of life and survival.

But, do herbs and botanicals, vitamin and mineral supplements, probiotics, traditional medicines, homeopathy, naturopathy, acupuncture, chiropractic or osteopathic manipulation, massage, prayer, reflexology, energy medicine, or special diets have an actual impact on prolonging cancer patients’ lives? The short answer seems to be no.

Physicians from the Yale School of Medicine have just published the study “Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients with Curable Cancers” in the Journal of the American Medical Association (JAMA). From a data set of 1.9 million individuals, gathered between 2004 and 2013 and stored in the National Cancer Database, the researchers extracted a representative sample of cancer patients whom opted for complementary medicine (CM) versus those exposed to conventional cancer treatment (CCT).

The study was straightforward. It aimed at identifying and comparing survival rates between CM and CCT groups.

Patients exposed to complementary medicine had a greater risk of death than those under conventional cancer treatment. In fact, only 82 percent of the CM patients versus 87 percent of the CCT patients survived during a 5-year monitoring lapse since they were first diagnosed with the condition. The trend was noticeable in women suffering breast cancer, with only 85 percent of the CM patients versus 90 percent of the conventionally-treated patients surviving since diagnosis (also during a 5-year follow up).

According to Skyler Johnson, Henry Park and Cary Gross, authors of the study and fellows at the Department of Therapeutic Radiology, as well as the Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, the general risk of death associated with complementary medicine was primarily linked to the patients’ refusal to receive: surgery (7 versus 0.1 percent refusal between the CM versus CCT groups, respectively), chemotherapy (34 versus 3 percent), radiotherapy (53 versus 2 percent), and/or hormone therapy (34 versus 3 percent).

Quite interestingly, patients in the complementary medicine group were more likely to be young, women, have breast or colorectal cancer, belong to high socio-economic cohorts, have private medical insurance, high-school education, and reside in the Intermountain West or Pacific West of the United States (where alternative-medicine schools are common, protected by state legislation).

In essence, the Yale study concluded that if patients went for unconventional cures to fight cancer, rather than scientific medicine, they had higher risk to die and do it earlier. Complementary medicine did not help.

As David Gorski, member of the Department of Surgery at Wayne State University School of Medicine and the Department of Oncology at the Barbara Ann Karmanos Cancer Institute (both in Michigan), already alerted back in 2014 when compiling a comprehensive review for the journal Nature “the vast majority of ‘integrative’ [complementary oncology] treatments [were] supported by little, if any, scientific evidence.” He pointed out, with concern and irony, “therein lies a key problem with integrative oncology. The less ‘alternative’ the intervention, the more it resembles conventional oncology; the more ‘alternative’ the intervention, the more it resembles the quackery from which integrative oncologists rightly distance themselves.”

Why do patients opt for unscientific methods to battle cancer? There are multiple reasons, and only one of them has to do with “hope,” trust on a possibility (the “alternative cure”) beyond the “conventional scientific wisdom,” one that might work and, if not, at least, it won’t hurt. There is always a friend or a relative that recommend “holistic cures” to somebody they love. But the Yale study demonstrates that such paths can indeed be harmful: remember that they were associated with higher risk of dying and doing it earlier among patients choosing “complementary practices.”

Belief is powerful, as research on people’s attitudes toward science suggests, it disrupts, distorts, delays or stops the comprehension and acceptance of scientific evidence. Scientists call this phenomenon the “3Ds+S” cognitive effects of illusory thinking. Now, the best tonic against its infectious sequels was discovered long ago; it consisted, still does, on proper healthcare education for all. And, in contrast to misleading and unwarranted “paramedicine,” the side effects of widespread science education will always be cheaper, plus save, for sure, some lives. — EvoLiteracy © 2018.

This op-piece appeared in The Standard Times (South Coast Today), see HERE.

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Smarter Than Average? Majority of Americans Think So

“Just believing in self- or collective-greatness will not materialize into competitive performance… For us, it will be impractical and blindfolding to insist on national self-flattering. But, if there is anything we do better than anybody else is to blindfold ourselves.”

By Guillermo Paz-y-Miño-C.

Overconfident? Self enhanced? Smarter than average? Yes.

Such widespread public opinions about relative intelligence were first reported in the United States in 1965. Yet, as a team of researchers puts it in a replication study just published in the academic journal Public Library of Science (PLoS), “American’s self-flattering beliefs about intelligence are alive and well several decades after their discovery.”

When asked to assess the statement “I am more intelligent than the average person,” via phone or online polling, 65 percent of responders either agreed or strongly agreed with the premise.

The pollsters, Patrick Heck, Daniel Simons and Christopher Chabris, affiliated with the Autism & Developmental Medicine Institute in Pennsylvania, the Department of Psychology at the University of Illinois-Champaign, and the Institute for Advance Study in Toulouse-France, respectively, interviewed 2,800 adults in the 50 states of the country, and analyzed their responses as per sex, age, race/ethnicity, and educational attainment.

More men (about 70 percent) than women (about 60 percent) considered themselves smarter than average, a trend comparable to the adults younger than 44 years of age (also 70 percent were confident in their intellect) versus those older than 44 years (60 percent). In terms of race/ethnicity, about 65 percent of both “whites” and “non-whites” agreed with the notion “I am more intelligent than average,” with the peculiar feature that up to 71 percent of “non-whites,” who responded to the survey online (rather than by phone and were likely skillful computer users), mostly or strongly concurred with the statement.

Interestingly, responders with college or post-graduate degrees underestimated themselves, with 70+ percent thinking they were above average intelligence; note that the pollsters expected 80+ percent of the highly educated to think that way according to their usual cohort performance in IQ-tests. Those with “no college” or “some college” education, by contrast, surpassed the expected 47 percent confidence score on self-brain-ranking, with 55-62 percent of them believing (themselves) to be smarter than the mean.

“…both the naturally talented as much as the taught-to-reason-average-individual can perform better in ‘the real world’ if provided with educational tools to excel…”

Overconfidence is not necessarily bad. It can actually boost performance, encourage bold, creative thinking and help persist on innovative projects even though they might have been initially dismissed by others (for an evolutionary take see Nature). The “smarter than average effect,” as it is known among psychology scholars, is apparently ubiquitous across cultures (particularly in the West; but see an alternative perspective here), although the trends in the United States are not directly applicable elsewhere.

There is no doubt that education brings self confidence to people, but there is also innate differential talent among individuals, which can be developed even further with proper mentoring and schooling. Take youth math ability, for example, the most reliable predictor of later-in-life career success (go to scientific article): all significant aspects of modern societal development, which are bound to science and technology, depend on quantitative, rational thinking to solving problems and innovating progress. And both the naturally talented as much as the taught-to-reason-average-individual can perform better in “the real world” if provided with educational tools to excel. Thus, “above average performance” — in respect to the past — can be continuously built in anyone and, by doing so, raise the bar for all.

Paradoxically, at some point, perhaps at a crucial one in history (now!), just believing in self- or collective-greatness (as celebrities often claim “as long as you believe, anything is possible,” which is always followed by tens of thousands of “likes” and “shares” in social media) will not materialize into competitive performance; at least not when so many countries out there are committed to, via meaningful actions in elementary-, high-school- or higher-education, lead the future.

For us, it will be impractical and blindfolding to insist on national self-flattering. But, if there is anything we do better than anybody else is to blindfold ourselves. — EvoLiteracy © 2018.

This op-piece appeared in The Standard Times (South Coast Today), see HERE.

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Taming a Fox in the USSR

“More than a ‘tit for tat’ encounter between Lee and Lyudmila, I see the production of this volume as an act of academic altruism, an exemplar of the evolution of goodness and cooperation between humans, in which the story of Vulpes vulpes, Dmitri and Lyudmila has been rescued from the glacial night and eternalized in a book for the large, youthful crowds. How to Tame a Fox resembles the launching of Sputnik and Vostok, but rather than commissioning Laika or Yuri Gagarin to pioneering our presence in space, it seems to have sent the red foxes, Dmitri and Lyudmila in a journey to the stars, where they belong.”

by Guillermo Paz-y-Miño-C

Almost two decades ago, a graduate student in a lab in which both of us were associates, she as a second-year trainee and I as a postdoc, gave me an end-of-the-year card with a wolf sketched on the cover and a note inside: Don’t Let Them Tame You. I loved it. Darkness in the sky, a snowy cliff and a grayish Canis howling at the moon were softly printed on pale paper.

Over the years, I have realized that her intention was to warn me, at least symbolically, about the nasty working environment I had just joined, and which required ferocity to survive. We both did it, no taming in trade. — But the card’s message at that time simply got me thinking of Darwin’s The Origin of Species (1859), in which he discussed “Variation Under Domestication” (Chapter I) and the many examples of humans’ successes in taming —over centuries and millennia— all sorts of animals and plants. In fact, Darwin’s central inference that Nature played the role of a “beast master” in shaping not only behavior but entire species’ anatomies and functions came directly from the evidence of domestication. He later dedicated a whole book, The Variation of Animals and Plants under Domestication (1868), to expand on the ideas first presented in The Origin.

“…If anything, the book’s wedge is Taming a Fox in a Dystopian USSR…”

Photo credit The Institute of Cytology and Genetics, Novosibirsk (with permission – LAD).

When biologist Lee A. Dugatkin approached me in January 2017, via Facebook, to ask me to share one of his posts announcing the upcoming How to Tame a Fox (and Build a Dog), I volunteered to —instead— write a review of the book for EvoLiteracy. Before long, I received an electronic copy of the proofs, read them enthusiastically non-stop, and came up with a 600-word commentary. I gave the book three stars, but never posted the narrative. I found the story light and told Avelina Espinosa (my research collaborator and co-author in papers and books) that How to Tame a Fox will become a best seller and do well in the popular science market: my review will make no difference. Besides, I said, this book is hard to assess without turning too critical. Starting from the title, nobody tames a fox and builds a dog, but rather selects for a tamed fox, the actual product. To me, the heading was equivalent to stating “how to tame a Grévy’s zebra and build a horse;” or tame a white-lipped peccary and build a pig; or a lynx and build a cat. All misleading premises; all involving relatively close taxa: canids (foxes and dogs), equids (zebras and horses), tayassuids and suids (peccaries and pigs) or felids (lynxes and cats). Although, it is true that the foxes were tamed –for the most part– in the dog’s image, no fox was ever turned into “The perfect dog” (Prologue). This early analogy fogged reality and remained latent, subliminal in the chapters.

“…The book narrates the work, struggles and joys of Russian scientists Dmitri Belyaev and Lyudmila Trut, whom in the early 1950s started one of the most ambitious experiments in domestication: the turning of a wild red fox (Vulpes vulpes) into a pet-lookalike…”

Along its pages, How to Tame a Fox resembles the ornate prose of the Victorian Era (Dugatkin’s style, also evident in Mr. Jefferson and the Giant Moose, 2009). The book narrates the work, struggles and joys of Russian scientists Dmitri Belyaev (1917-1985) and Lyudmila Trut, whom in the early 1950s started (i.e. Belyaev) one of the most ambitious experiments in domestication: the turning of a wild red fox (Vulpes vulpes) into a pet-lookalike. The igniting motivation was commercial (for the fox fur industry) as much as inspired by scientific curiosity (an attempt to fast-domesticate a wild animal by means of intense selective breeding), although the outcomes remained little known outside the Soviet Union during the Cold War (but see American Scientist 1999, BioEssays 2009). Sixty years later, Lee has teamed up with Lyudmila to host the late Dmitri’s journey together with his companion foxes. An arrangement of convenience, I suppose, to achieve harmony between writing and factuality in telling the story.

Back in April 2017, I put aside my commentary on How to Tame a Fox, continued working on my own writing, and waited for the public’s reaction to the book (not that it would change my views). While in Prague, in July-August 2017, I asked Miklós Müller, a knowledgeable critic of the villainous Trofim Lysenko‘s work in the former Soviet Union (see Volumes I and II) and his influence on distorting science for ideological reasons in the USSR and Eastern Europe during the 1940s-50s (times that coincided with the starting of the first Belyaev fox investigations, toward the late 50s), if he —Miklós— was aware of the foxes book. Indeed, we both had read a blurb in The New York Times drafted by Marlene Zuk in May 2017: How Do You Make a Fox Your Friend? Fast-Forward Evolution. — Miklós and I had a passionate conversation about Lysenko; we put the foxes on hold, and then were interrupted by the beginning of a scientific talk about unicellular eukaryotes (protists), the purpose of our overlapping presence in the Czech Republic (for related article see A visit to Prague and Kutná Hora).

“…the red fox trials are analogous to the long-term evolution experiments in Escherichia coli, in which, in only a few years… new geno-phenotypes emerged relatively quickly under persistent directional selection…”

Excerpts of How to Tame a Fox have been reproduced in numerous venues (e.g. American Scientist, Evolution Institute, for endorsements go here). However, there are two academic reviews of relevance that I recommend. A generous one by Dan Blumstein, published in The Quarterly Review of Biology, and a more critical by Adam Miklosi, which came out in Current Biology. Adam states “…this experiment [i.e. the foxes’ breeding for tameness] should have been referred to as an animal model of domestication in which foxes were selected for ‘tame’ behaviour. So just to be clear, nobody has domesticated these foxes. These are not domesticated animals, they are the result of a scientific experiment — no more, no less…” So far, so good, Adam is right. But he also highlights that “…scientists working in this field [animal domestication] agree that domestication is an evolutionary process taking place on a 1000–10000 (or longer) year time scale and it involves complex interaction between people and a specific set of animal species (e.g. dogs, pigs, bees etc)…” Here Adam misses the point. The Belyaev and Trut experiments demonstrate that, under controlled conditions of directional —and relentless— selection with a clear intention in mind (to tame the foxes), the “domestication-like-outcome” (i.e. significantly reduced aggression in the foxes toward humans or each other) was comparable to what has been accomplished over thousands or tens of thousands of years with dogs, pigs or bees. Of course not in all possible traits correlated with domestication, like some features of dog cognition that seem to have evolved in parallel with tameness, but at least in one specific dimension: reduced aggression and, therefore, increased amicable behaviors toward humans and conspecifics. In this respect, the red fox trials are analogous to the long-term evolution experiments with Escherichia coli (late 1980s – present), in which, in only a few years and thousands of generations (nothing unusual for bacterial populations that replicate every couple of hours), new geno-phenotypes emerged relatively quickly under persistent directional selection [(i.e. the emergence of aerobic metabolism based on an organic-acid nutrient called citrate, rather than on ordinary sugars, which E. coli “prefers;” but again, nobody domesticated or tamed the bacteria to build another microbe; the cells were selected to tolerate citrate and their descendants expressed geno-phenotypes that allowed them to feed on the citric acid –for an encyclopedic summary see E. coli LTEE)].

“… How to Tame a Fox does little to challenge the reader and engage him/her into inferring time or space connections via literary devices, even though the vast historical setting and wealth of the Russian literature were accessible to the authors; after all, Lyudmila was a contributor…”

My discontent with the book was not the buoyancy of the science, its redundant passages, the sticky narrative or emphasis on people (Lee, as narrator of historicity, Dmitri and Lyudmila as heroic characters struggling to doing science in a “communist regime”) rather than on the foxes, which are elements cleverly assembled into the text to precisely appeal to a broad readership prone to loving cute pets and being empathic with non-human animals; a multitude shallowly aware of the advent of the Soviet Union and the Cold War, and predominantly uninformed about the monumental cultural ancestry of the Russian people. How to Tame a Fox feeds on the stereotypic views the West has about life in the USSR; it swiftly examines the geopolitical past with Western values of the present, a no-no approach among academic historians. [(And this observation is not, by default, an endorsement of Stalin’s brutality, which still roams the mental architecture of Moscow’s modern politicians, nor a denial that the USSR imploded due to self-inflicted wounds plus its unsustainable clashes with the gluttonous capitalists, whom today form West-and-East alliances of their own to extort the world)]. If anything, the book’s wedge is Taming a Fox in a Dystopian USSR. As Miklós Müller justified it when we spoke in Prague: well, it is because an American author wrote the book.

How to Tame a Fox does little to challenge the reader and engage him/her into inferring time or space connections via literary devices, even though the vast historical setting and wealth of the Russian literature were accessible to the authors; after all, Lyudmila was a contributor. This only required creativity. — By contrast, the book secures an intellectual safe space; the discomfort is in others (Dmitri, Lyudmila, the foxes, the Soviets, the communists, the totalitarians, the thugs, the cronies, them), the comfort is in the self (the flawless bookworm). Yet, it is fun to explore its passages and envision its events in a video-clip fashion. And more than once I pictured the foxes jumping and playing adorably with their caregivers, unaware that their ancestors had been tamed —selectively— by scientists. Sometimes, I even envisioned their DNA changing as the experiments progressed: I felt The Commotion in the Genes as referred to in Chapter 10.

Early this year, the American Association for the Advancement of Science awarded How to Tame a Fox one of the 2018 AAAS/Subaru Children’s Science Book Prizes, in the category Young Adult Science Book. The work is currently —as I predicted a year ago— a best seller, and it is being translated into other languages (Arabic, Chinese, German, Italian and Korean –not Russian, yet). But the fortune of this tale might travel farther than that, and it is not wild to imagine a Hollywood animation about gentle versus vicious foxes; good battling evil in the cold, endless winters of Siberia; with oppressors wearing ushanka hats and mismatching Cossack attires; with Lysenko- and Stalin-like characters plotting malice against scientists and the creatures of the snow. A mirage of the imprinted allegories about the past.

“Freethinkers are those who are willing to use their minds without prejudice and without fearing to understand things that clash with their own customs, privileges, or beliefs.” — Leo Tolstoy

More than a “tit for tat” encounter between Lee and Lyudmila, I see the production of this volume as an act of academic altruism, an exemplar of the evolution of goodness and cooperation between humans, in which the story of Vulpes vulpes, Dmitri and Lyudmila has been rescued from the glacial night and eternalized in a book for the large, youthful crowds. How to Tame a Fox resembles the launching of Sputnik and Vostok, but rather than commissioning Laika or Yuri Gagarin to pioneering our presence in space, it seems to have sent the red foxes, Dmitri and Lyudmila in a journey to the stars, where they belong.

I do recommend this enchanting book to all audiences, just don’t let it tame you.

— EvoLiteracy © 2018.

You can contact Guillermo Paz-y-Miño-C via email at guillermo.pazyminoc@gmail.com — Follow us on Twitter @gpazymino and Facebook.