Cancer screenings, overdiagnosis and an “epidemic of treatment”


In November – or as it is now more commonly being referred to “Movember” – millions of men commit to grow moustaches to raise awareness of men’s health issues, such as prostate cancer, testicular cancer and mental health problems. One of the most important conversations which should be had this month – and every other month – is the one about appropriate screening tests – which ones to get, and which NOT to get, etc.

Let’s discuss thyroid cancer first. An op-ed published today in the New York Times by Dr. H. Gilbert Welch, professor of medicine at Dartmouth Institute for Health Policy and Clinical Practice, discusses the “epidemic of diagnoses” of thyroid cancer occurring in South Korea. There is no biological explanation for this “epidemic.” There is no new infectious agent. The explanation for this epidemic is that the government initiated a screening program meant to detect such cancers earlier and reduce its toll. Since screening for thyroid cancer is so easily done — requiring merely an ultrasound of the neck – many hospitals and doctors began to do this screening routinely. And surprise – more thyroid cancers! But what happened to the “toll” of thyroid cancer subsequently? Well, that toll was vanishingly small to begin with. The fact of the matter is that many of those thyroid cancers diagnosed were small “papillary thyroid cancers,” which would not have been discovered during a person’s life. This results in needless stress and an “epidemic of treatment,” subjecting patients to lifelong thyroid replacement therapy, all for an irregularity that would not have affected the person’s health in the first place.

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What If You’re A Skinny Type 2 Diabetic?


As usual an excellent piece reprinted by Steve Milloy. Nothing to add.

JunkScience.com

It is estimated that 80 percent of type 2 diabetics are overweight. It’s not clear who came up with this figure, or–more importantly—how it was determined. Perhaps it is tied in with modern medicine’s love for cataloging risk factors, especially simplistic ones. Cynics might go even further, suggesting that risk factors do a much better job of selling drugs than preventing diseases, but we digress.

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Psychiatry Is Not Based On Science


This piece written by PHILIP HICKEY, PH.D. would have been what i would have written if i weren’t so lazy. It’s deadly sober accuracy describes the fallacies of psychiatry (and in my view, psychology also) perfectly. This post by Phil should be in all newspapers, journals and whatever so humanity can get some counterweight against the ‘everyone is crazy except us professionals’ meme that sweeps the world. Hardly a day goes by and one doesn’t see an event where a ‘psychological support team’ is present to caress the poor tender souls of the onlookers, or a new mental ‘disease’ gets focused on to scare people in taking their unruly children to a psychiatrist to get drugged.


by Phil on June 1, 2013

On May 27, David Brooks, a New York Times columnist, wrote a piece on psychiatry called Heroes of Uncertainty.

It’s an interesting and somewhat contradictory article. Here are some quotes:

“As the handbook’s [DSM-5] many critics have noted, psychiatrists use terms like ‘mental disorder’ and ‘normal behavior,’ but there is no agreement on what these concepts mean.”

“What psychiatrists call a disease is usually just a label for a group of symptoms.”

This is beginning to look like an anti-psychiatry article. But then:

“Psychiatrists are not heroes of science. They are heroes of uncertainty, using improvisation, knowledge and artistry to improve people’s lives.”

“They certainly are not inventing new diseases in order to medicalize the moderate ailments of the worried well.”

So what we’ve got is a kind of middle of the road article. Psychiatrists are basically good guys (heroes, actually), but their subject isn’t as scientific as they claim.

If I were a psychiatrist, I think I would have just left it alone. But the not-scientific jab had to be addressed, and psychiatrists Jeffrey Lieberman and Jack Drescher weighed in with comments.

Dr. Lieberman is president of the APA and a professor of psychiatry at Columbia University.

He opens his rebuttal with this paragraph:

“While I share David Brooks’s frustration over the slow progress in finding the biological causes of mental disorders, I am concerned about his opinions on the scientific basis of psychiatry and the clinical care that it provides to millions of people. The brain has proved to be infinitely more complex than any other organ in the human body, and the functions that mediate behavior are the most highly evolved in the animal kingdom.”

There’s a lot of spin in here. Firstly, David Brooks, in his article, never expressed any “frustration over the slow progress in finding the biological causes of mental disorders.” What he said was:

“Furthermore, psychiatric phenomena are notoriously protean in nature. Medicines seem to work but then stop. Because the mind is an irregular cosmos, psychiatry hasn’t been able to make the rapid progress that has become normal in physics and biology.”

What he’s saying here is that mental phenomena are inherently too complicated, irregular, and changing to ever yield the kind of scientific certainty that one finds in physics and biology. And that’s what Dr. Lieberman can’t let go of, because that is their Holy Grail – that “one day” we’ll know the underlying biological causes of “mental illnesses,” and psychiatrists will finally be real doctors.

Back to Dr. Lieberman’s quote:

“I am concerned about his opinions on the scientific basis of psychiatry and the clinical care that it provides to millions of people.”

This is the spin mechanism known as juxtaposition. The “scientific basis of psychiatry” is juxtaposed (irrelevantly) with “clinical care…to millions of people”. We’re good guys toiling in the trenches of human suffering; therefore our work must be scientifically based! It’s not real logic. It’s Madison Avenue logic, and psychiatrists are getting better at it every day. It’s the equivalent of politicians arranging to have themselves photographed kissing babies or shaking hands with soldiers in wartime.

“The brain has proved to be infinitely more complex than any other organ in the human body…”

Note the phrase “has proved to be” – like this is something that psychiatrists have just discovered. They went looking for their neurochemical causes of complex human behavior, and guess what – the brain is more complex than they had thought! For decades they and their psycho-pharma allies have been telling us that they had it all figured out. But now the beans are spilled. So will they come clean and say: “Guys, we’re a bunch of shysters who have been deceiving you for decades?” No. The brain was just more complex than they had thought. The scale of complexity of the brain has been known for at least 100 years. But perhaps they didn’t teach that in psychiatry school!

Here’s more spin from Dr. Lieberman:

DSM- 5 “… reflects the current state of our knowledge, limited as it may be. This does not negate its value in helping clinicians evaluate and treat patients, as well as the fact that it can and will continue to be improved as subsequent research enables us to better understand the biology of the brain and mental illness.”

There it is again: the “biology of the brain and mental illness.” Still the Holy Grail.

Jack Drescher, MD, is a psychiatrist, and served on one of the DSM-5 work groups. Here are two quotes:

“Like the rest of humanistic medicine, a science of the mind should never lose its heart.”

This sounds good, but says nothing.

“In comparing psychiatry with astronomy, however, Mr. Brooks should remember that in 2006, the International Astronomical Union voted on whether Pluto is a planet. Even astronomy, the hardest of sciences dealing with the most irrefutable of facts, is dependent on its human practitioners’ subjectivity and interpretation of data.”

This is very high order spin. The message that a casual reader would take from this paragraph is that psychiatry is just as scientific as astronomy – “the hardest of sciences.”

The International Astronomical Union voted to designate Pluto a dwarf planet instead of a planet, but no astronomer ever imagined that this had any significance other than administrative. NASA called the shuttle a “vehicle.” They could have called it a “spaceship.” It wouldn’t have made the slightest difference. A botanist can call a plant by its Latin name or its English name. It doesn’t affect anything in the world of botany. But when psychiatrists vote, for instance, to expand their “diagnosis” of depression to routinely include bereavement, this is an entirely different matter, and highlights that the entire taxonomic system is arbitrary and subjective.

A biological analogy of the DSM voting system would be if biologists voted that henceforth geese would be swans. They could vote all they liked, but that will not make geese swans. Biological classification is based on reality, whereas psychiatric classification is based on the subjective perceptions and votes of psychiatrists.

An analogy from astronomy would be if the astronomers had voted to make Pluto a star.

As we often find when we analyze the psychiatric spin, Dr. Drescher is either not too bright or very deceptive.

CONCLUSION

Psychiatry is under attack for its spurious concepts and its destructive, disempowering practices. It presents no defense based on logic or facts, because it has none. It’s a sandcastle, and the tide has turned.

Last updated by Phil at June 1, 2013.
Original Post by Original Writer

Exercise and Obesity


And yet again the obesity hype has scored another victim. The exercise dogma. We westerners get fat because we don’t move enough.
This latest study puts that one to rest:

Western lifestyles differ markedly from those of our hunter-gatherer ancestors, and these differences in diet and activity level are often implicated in the global obesity pandemic. However, few physiological data for hunter-gatherer populations are available to test these models of obesity. In this study, we used the doubly-labeled water method to measure total daily energy expenditure (kCal/day) in Hadza hunter-gatherers to test whether foragers expend more energy each day than their Western counterparts. As expected, physical activity level, PAL, was greater among Hadza foragers than among Westerners. Nonetheless, average daily energy expenditure of traditional Hadza foragers was no different than that of Westerners after controlling for body size. The metabolic cost of walking (kcal kg−1 m−1) and resting (kcal kg−1 s−1) were also similar among Hadza and Western groups. The similarity in metabolic rates across a broad range of cultures challenges current models of obesity suggesting that Western lifestyles lead to decreased energy expenditure. We hypothesize that human daily energy expenditure may be an evolved physiological trait largely independent of cultural differences.

That’ll make a lot of exercise guru’s very unhappy.Exercising

Hunter-Gatherer Energetics and Human Obesity

We shall prove it, regardless objectivity. FAT is bad. Cognitive Dissonance strikes again.


Plos published a nice article exemplifying how deep the cognitive dissonance of the medical world regarding FAT is BAD has become.

The article boldly claims to have added to the case of there being a causal link between BMI and IHD, in other words FAT is BAD. Climate alarmism is spreading as a ‘scientific method’.

See The disease FAT does not exist

What are the facts? BMI is a lousy way to measure body mass. It doesn’t differentiate between muscle mass and other mass, nor by type of other mass. As such is it is virtually meaningless. A calculation that gives the same value to a highly trained heavy weight boxer and a couch potato is definitively faulty.

So the basic assumption is already false, so the whole article is useless. However to add insult to injury the final conclusion heavily promotes the idea that FAT is BAD by suggesting (not proving by any scientific standard) that there is a mathematical calculated link between BMI
(i.e. FAT Oh NO, FAT!!!!)
and IHD and therefore causality is overwhelmingly likely but at the same time admitting that the real causality is NOT BMI but other factors.

It seems there is so much grantmoney floating around to fuel the obesity craze that any paper gets published nowadays in a frantic scramble for the big bucks.

A sad state of affairs indeed.

The offending article (PDF alert):
Proving cognitive dissonance is rampant

Update:

Who’d have thought:

Cholesterol of any kind doesn’t change CVD risk

Basic assumption that Cholesterol causes CVD is again proven wrong, but still they don’t get the message.

Update:

But statin vendors need not worry. A totally new even more scary reason has been discovered to take statins:

Cholesterol causes Alzheimer!!!!

Quick buy that stuff.