In another few weeks it’ll be 27 years since my mother died of metastatic breast cancer. Not a nice way to go – but eased by a very caring family GP and the wonderful people at the local hospice, who helped her die with dignity at home.
I was reminded of this by reading David Gorski’s recent post on Science-Based Medicine: chemotherapy vs death from cancer. In the US at least (although I suspect here as well), ‘alternative practitioners’ offer a wide range of ‘therapies’ for people with cancer, claiming ‘natural cures’ & the option of ‘dying healthy’ if you must die at all. Unfortunately for those choosing this option, modern chemotherapy really is the best treatment option for many cancers (alongside radiotherapy & surgery, depending on how the disease manifests itself). If those alternative therapies worked they’d have become part of the mainstream pharmacopaeia by now. Dr Gorski agrees that yes, chemo can be quite brutal in its effects – but the cancers it is aimed at are at least as bad. (The reason chemo can have serious side effects is that it’s a fine line between killing the cancerous cells & killing normal tissues.)
Anyway, Dr Gorski’s article led me to think about the way that other proponents of ‘alternative therapies’ make special claims for their own products, and level all sorts of accusations against mainstream medicine. Over on SciBlogs, for example, a local anti-vaccination advocate was quoted in the comments thread for an article on vaccination that the sooner New Zealand drops all vaccinations, the better. In support of their views that vaccinations are Bad, Bad, Bad, the commenters on that thread trotted out all the usual claims: that vaccines cause autism (false – there are no data to support this claim); that vaccines contain ‘neurotoxic’ materials including formaldehyde (true, but our bodies make far more of this, during normal metabolic processes, than is contained in any dose of a vaccine); that vaccines contain ‘aborted foetal tissues’ & ‘monkey kidneys’ (serious scare tactics, these, & also false). These claims have been ably addressed elsewhere, both on SciBlogs & on overseas sites such as Science-Based Medicine & Orac’s Respectful Insolence.
But I wonder – do the people advocating a complete cessation of vaccination really seriously think about the consequences of this? My mother contracted polio as a teenager in the 1930s. She was lucky – the virus ‘only’ paralysed nerves in her hand and leg. She recovered, but for the rest of her life the muscles in those areas were smaller & weaker than on the unaffected side. She never had to spend time in an iron lung – and at the height of polio epidemics, some overseas hospitals had entire wards devoted to patients in these machines, which ‘breathed’ for people who could no longer breathe for themselves because the necessary muscles were paralysed. Mortality rates from polio – before the widespread availability of a reliable vaccine – were around 5%, with a further 35% of those infected suffering some level of paralysis.
Or what about diphtheria? The mortality rate for this bacterial disease is between 5 & 10%, & outbreaks still occur, even in industrialised nations. Diphtheria often has respiratory symptoms, due in part to severely swollen lymph nodes in the neck. But the bacterium (Clostridium diphtheriae) also produces metabolic by-products that can lead to damage to the heart & nerves, & it can sometimes cause serious secondary infections in the skin.
And there’s measles, whooping cough, rubella – while in the industrialised world, with its generally good provision of health care, most of those who contract these infections go on to recover, they are not trivial diseases. (I couldn’t believe one comment I read a few months ago, where the writer commented that whooping cough was a trivial illness; her child had ‘only’ had a serious cough for a week… & was unwell for several more.) All have a rate of serious complications, including death, that is several orders of magnitude higher than the unquestioned rate of complications due to vaccination.
And I wonder – are people so ready to advocate a return to a world where these diseases are common because they’ve never had first-hand experience of the effects? After all, the highest rates of illness occur in the ‘third world’, which is a long way from the experiences of most people in comfortably first-world New Zealand. And is part of it due to a failure on the part of scientists, doctors, the education system at large to help people understand things like relative risk, and how science-based medicine operates? And – a key part of this – how well do we communicate the idea that correlation does not equal causation: that because B happens soon after A, for example, this is not proof that A caused B?
I think we still have a long way to go on these things.
PS And those with a genuine interest on what <i>is</i> in vaccines (as opposed to the wilder claims being made over at Sciblogs) might like to read this post from ERV: – basically a group of researchers did DNA analysis on most of the main vaccines, looking for evidence of contamination from other sources (monkey tissue, foetal tissue, etc etc). The result: modern vaccines are clean.