Pseudoscience: Because I see a lot of... - Advanced Prostate...

Advanced Prostate Cancer

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Pseudoscience

Tall_Allen profile image

Because I see a lot of pseudoscience purveyed on this site, I adapted a document about pseudoscience characteristics posted by a doctor on twitter. I doubt that it is comprehensive, and am willing to further adapt if someone has some good suggestions.

Some Characteristics of Pseudoscience

1.Is UNFALSIFIABLE (can’t be proven wrong); makes vague or unfalsifiable claims.

2.Relies heavily on ANECDOTES, personal experiences, testimonials, “professional” opinions, and bench (test tube or animal) studies. IGNORES “LEVELS OF EVIDENCE,” and GRADE given by professional consensus.

Levels of evidence: cebm.ox.ac.uk/resources/lev...

GRADE: ncbi.nlm.nih.gov/pmc/articl...

3.CHERRY PICKS confirming evidence while ignoring/minimizing disconfirming (especially higher level) evidence.

4.Uses TECHNOBABBLE: Words that sound scientific but don’t make sense.

5.Lacks PLAUSIBLE MECHANISM: No way to explain it based on existing knowledge, or deficient evidence for proposed mechanism

6.Is UNCHANGING: doesn’t self-correct or progress

7.Makes EXTRAORDINARY/EXAGGERATED CLAIMS with insufficient clinical evidence

8.Professes CERTAINTY; talks of “proof” with great confidence. Ignores statistical confidence intervals and power.

9.Commits LOGICAL FALLACIES: Arguments contain errors in reasoning.

10.Lacks PEER REVIEW: Goes directly to the public (e.g. YOUTUBE videos, blogs, direct-to-patient presentations only), avoiding scientific scrutiny.

11.Claims there is a CONSPIRACY (e.g., Big Pharma/FDA conspiracy) to suppress their ideas.

12.OVERSIMPLIFIES biochemistry (e.g. alkaline water, reducing sugar intake, antioxidants or anti-inflammatories will slow cancer)

13.Ignores INTERACTIONS with other substances, bioavailability, biochemical feedback effects, microbiome, substance purity or adulteration

14.Claims “causation” when only “ASSOCIATION” has been demonstrated.

15.LACK OF DISCUSSION of potential biases, missing confounding variables, effects that may have changed over time and/or with improved technology.

16. INAPPROPRIATE ENDPOINT OR SUBSET CONCLUSIONS given pre-announced endpoint and subsets, power to detect it within sample size and timeframe, poor choice of surrogate endpoint or subsets, "p hacking."

17. Failure to disclose CONFLICTS OF INTEREST or sponsors.

PS I added this article to provide some extra links, address questions/comments I saw here, and to make it easier to search for (the search engine on HU sucks).

prostatecancer.news/2021/07...

128 Replies

Amen

I am, unfortunately, fairly well tuned in to PC news and I'm amazed at the crackpot "cures" often promulgated on various media sources.

17. Can result in or hasten death if followed.

Tall_Allen profile image
Tall_Allen in reply to gregg57

AGREE! That is certainly the bottom line risk of following pseudoscience.

gregg57 profile image
gregg57 in reply to Tall_Allen

And there's also this idea that you have to somehow "integrate" this pseudoscience along with the real science-based treatments. This is an attempt to gain legitimacy. Mixing in pseudosecience with science-based, proven treatments also makes it easier to claim these non-treatments are working. When challenged, the fall back position is always, "You need both" but you don't need both. You only need treatments based on science.

Tall_Allen profile image
Tall_Allen in reply to gregg57

I think it's important to recognize that some decisions are based on belief, some on science. Trying to justify belief with science ("scientism") is as inappropriate as trying to justify science with belief.

Unfortunately, when a patient gets diagnosed, he feels lost and as we all know, will start to listen to all of the junk we see everywhere. I tried and tried all these quacks and NONE worked for me. Great post, TA. Thanks for compiling it

Tall_Allen profile image
Tall_Allen in reply to Ahk1

You raise a good point - am I preaching to the choir? Especially those who have cloaked their pseudoscience with conspiracy theories will write it off as "he's been paid off or co-opted."

spencoid2 profile image
spencoid2 in reply to Tall_Allen

but you have to admit that there is a significant amount of bogus research for many reasons. and many cases of insignificant results being used to allow the use of a drug. I don't trust big pharma much at all. Moritz's discussion of this is probably the good part of the book. He seems like a good (listening to audio book so can't check references) researcher but I believe his conclusions are bogus.

Tall_Allen profile image
Tall_Allen in reply to spencoid2

Sadly, not all researchers are not immune to the lure of pseudoscience. If you don't trust Big Pharma, perhaps you trust the FDA that audits their findings.

Hi TA,

This reminds of a post I wanted to make: When initially diagnosed with PCa, why physicians do not explain what will happen to the male's sexual organs after prolonged ADT treatment.

That's a totally different topic about full disclosure, which I very much agree with.

WSOPeddie profile image
WSOPeddie in reply to DarkEnergy

This is my pet peeve. Doctors treat the disease and not the man. Gynecomastia or penile atrophy? Not his problem.

My urologist and surgeon, (before it was determined I wasn't a surgical candidate), certainly kept reinforcing the ability to have sex with injections or prosthesis, but failed to begin my ADT early or refer me to an oncologist. I kept telling them, I'd prefer to live than worry about sex right now, but they kept informing me, instead of treating me.

No balance to listening to what I was saying, just keeping on script.

Nice.

But logic fails before emotion.

I just had someone in another thread attempt to blame two leftwing consumerist senators for abusive US Pharma pricing practices.

If someone has an emotional need to believe something, neither logic nor self interest will get in their way.

Just look at the vaccination behavior in certain parts of the country.

Tall_Allen profile image
Tall_Allen in reply to cesces

Agreed. In fact, one of my favorite philosophers, David Hume, in the 18th century, wrote:“Reason is, and ought only to be the slave of the passions, and can never pretend to any other office than to serve and obey them." This was more recently neurologically substantiated by Antonio Damasio. Most recently, Jonathan Haidt has shown that what we call reason is usually just a justification for what we already believe, based on emotion. The metaphor he uses is a man (reason) sitting on top of an elephant (beliefs) thinking he is in charge of steering the elephant.

cesces profile image
cesces in reply to Tall_Allen

Yes.

That may yet doom human kind.

Reminds me of two quotes.

1: "Logic is just another way of going wrong with confidence."

2: "Rationalization is not just a river in Egypt."

Confirmation bias.

If a human believes in a lie long enough, the lie becomes the truth.

Good article. We are fighting misinformation and misinterpretation every day, Allen; in all healthcare arenas. Not just here.

cesces profile image
cesces in reply to diamondrn

Lol

I wouldn't limit it healthcare.

Just listen the evening news from any major mainstream news outlet.

diamondrn profile image
diamondrn in reply to cesces

I agree 100%, Cesces. I haven't watched network TV in many years. I cancelled my subscription to a mainstream newspaper (corporate-owned) a long time ago also.

I see 3 and 8 a lot. Not only pseudo-scientists are guilty of this but conventional SOC doctors are also guilty (Only a few years ago I was told by 4 doctors that it was a "fact" that increasing estrogen would not decrease testosterone).

Confirmation bias abounds and also blanket statements of "fact" when the fact is that science (including medicine) changes constantly. Remember when nicotine was considered healthy? I'm sure that there existing people who stated that it was a "fact" that nicotine is good for you. Even Bob Dole insisted it wasn't bad. And that was in 1996!

A smart man questions, investigates confirming and non-confirming data, experiments, and then arrives at his OWN conclusion.

Well said!!!

To those of us not familiar with the methods and language of science, it all sounds the same. When one is grasping for good news, the rigor needed to sort it out gets lost in the need for hope. For those of us who are scientifically oriented, all we can do is continue presenting the state of the art and science, knowing that they change. Using the COVID-19 experience, the difference between Dr Fauci, and the snake oil purveyors, is that when the state of knowledge changed, he acknowledged it and moved on. We should do the same.

When I began, I followed the standard of care treatment. Since then it has changed a couple of times. I had missed those opportunities that had not been developed yet. I have to keep reminding myself that the state of knowledge changes, to look forward, and not lament the past.

Shooter1 profile image
Shooter1 in reply to john205

Wow has the SOC ever changed.. my new MO says he wouldn't have done things that he sees in my records.. Agree, but SOC did keep me alive long enough to see what was done, if not wrongly, not a well as current treatments and orders. Live and learn... Life is Good.

RSH1 profile image
RSH1 in reply to john205

So true. When I used estrogen patches for ADT I was told by many that it wasn't ADT and wouldn't work (including a self-proclaimed "expert" on this site). Fast forward a couple of years and the PATCH trial among others is displaying that estrogen can indeed be used for ADT (androgen deprivation therapy for the "experts" out there).

I don't feel that I have the luxury of waiting around for SOC to catch up with government research.

Great list, thanks for posting that Allen

There are many guides to logical fallacies available online, but two that I like for quick reference are:

thevisualcommunicationguy.c...

reddit.com/r/coolguides/com...

Yes, Tall Allen, I’m buying what you’re presenting. BUT…..just for a moment believe it is not only pure science (I agree most of it is). Oncology seems more like an Art Form. Everyone presents differently. Everyone progresses or heals differently. We clearly do not understand the power of the mind. Faith. We clearly do not understand food chemistry. One week its great, the next week its terrible. Yes, it seems a combination of Science and Art is something we experience everyday. I admire you greatly. You are clearly very smart, very well read, a man of science, and a God send to all of us on HU. This is NOT me arguing with you….I know better. This is me saying “it all works, but nothing works well”. This is so complex, no one really knows how to cure. Just the unknown of laughter, or a good attitude can extend life. Why? It cannot be only Science.

Tall_Allen profile image
Tall_Allen in reply to Spyder54

I very much agree that it's not all about science. I'm only taking aim at those who present pseudoscience pretending it is science. I'm actually very holistic, meaning I think the body, mind, and spirit are all important. Some make up their own definition of "holistic" to include such pseudoscientific beliefs as homeopathy or naturopathy.

spencoid2 profile image
spencoid2 in reply to Tall_Allen

I think homeopathy sounds like total bullshit but I still will not deny the possibility. I forget what it was but I had a long standing medical annoyance of some type, might have been pain or who knows what I just don't remember. I don't remember if I went to a doctor or not but a friend suggested some homeopatic remedy. I took a few sugar pills with a littl very dilluted water or whatever? It worked almost immediately. I wish I could remember what the problem was. I took the pills exactly as prescribed fully expecting nothing to happen, but it worked? I am more likely to believe scientific explanations than "pseudo" science but if something works I don't care if it looks like bullshit. Placebo and expectations are very important and I believe that what Moritz says about this is important and overlooked in many studies. He does have some very good explanations and probably some good research. It is unfortunate that he reaches such questionable conclusions.

I trust the FDA more than big pharma but not completely.

Tall_Allen profile image
Tall_Allen in reply to spencoid2

The Placebo and the nocebo effects are real. That's why medicines are always evaluated via randomized controlled trials. The treatment has to work better than a placebo.

spencoid2 profile image
spencoid2 in reply to Tall_Allen

I am not thinking clearly right now, having a good day physically but not mentally. So I can not explain right now Moritz's description as to how the placebo effect is not properly accounted for in many studies. I would have to listen again to hear what he had to say. There is documented misuse of statistics in many studies. Researchers are highly motivated to create studies that support the interests of the sponsor. There is a lot of bullshit in many official studies. I will probably get the book and check out references if they are there. If they are not, the book can be considered total bullshit.

There are all sorts of tricks to make studies say what you want and I am sure this is rampant. My sister has a PHD in psychology and has studied and understood a lot more about statistics than I. She has pointed out abuse of statistics that really require a formal understanding of statistics.

Thank you Tall Allen for putting this out there. You will no doubt get some bad feed back but you said what needs to be said, and I appreciate that very much. Psychologist/economist and Nobel prize winner Daniel Khaneman has demonstrated how the human mind works hard to leave logic behind. We suffer from this in many ways beyond our own search for the best pc treatment. Read Thinking Fast and Slow and Dust by Daniel K. To learn how it works.

Tall_Allen profile image
Tall_Allen in reply to EchoII

One of my favorite books!

spencoid2 profile image
spencoid2 in reply to Tall_Allen

ordered

Totally agree!!!!...A word to the wise in general be your own advocate... question all....fragmented medicine today can lead to major problems!!!

#1 is a BIGGY! Good list.

Thanks T.A. There is so much truth in your post.

I knew of a man who had this condition, he progressively became more ill. Someone told him about the amazing healing effects of apricot kernels. He began consuming them, great amounts of them, he became seriously ill and died in hospital. Apricot kernels contain arsenic, he was in terrible pain when he died and just wanted to leave this life, he and his wife didn't tell the doctors about his efforts to self heal.

Another miracle, that doesn't exist.

Phil

LearnAll profile image
LearnAll in reply to Lettuce231

Lettuce231. I am not saying anything about whether Apricot seeds are helpful or not. I am only pointing out a factual error in what you wrote. Apricot seeds Do Not Contain any Arsenic. Check your source, please. Apricot seeds (Apple Seeds, Plum Seeds, Peach seeds) etc. Contain a substance called as AMYGDALIN...which get converted to a form of Cyanide after entering a cancer cell.

This is the proposed mechanism of their action. Again, there is no Arsenic in Apricot

seeds.

Here is my source of information...........

pubmed.ncbi.nlm.nih.gov/293...

Lettuce231 profile image
Lettuce231 in reply to LearnAll

My apologies LearnAll, you are correct, am I allowed to blame it on early morning brain fog ? My fault, not a great comment when dealing with facts, was it ?

Unfortunately the result was the same.

Phil

dentaltwin profile image
dentaltwin in reply to LearnAll

Yeah, but my brother is gradually ruining my life by telling me all the foods I eat that DO contain arsenic. Won't name them--easy enough to look up.

Stevecavill profile image
Stevecavill in reply to LearnAll

To clarify, apricot kernels contain amygdalin, which is converted to cyanide after eating, NOT when entering a cancel cell. The idea that amygdalin is somehow a cancer cure is a very good example of pseudoscience en.m.wikipedia.org/wiki/Amy...

Love this! I have seen advice or personal stories of alternative treatments, diets etc. here. It's perfectly okay that people use pseudoscientific therapies alongside there scientific treatment for themselves, but I have been a bit worried that people can be influenced and carried away to rely on alternative medicine more or less alone. As Tim Minchin said "Do you know what they call alternative medicine that's been proved to work? .... Medicine".

Tall Allen,

While I completely agree with your sentiments about belief in unfounded theories, I consider that you are making the picture much too black and white – wheras in the natural world there are an infinite variation of colours and grey shades. I am a geologist who has spent my whole working life in understanding and predicting the history and geology of the subsurface. In your definition very little of this is proven – but it does not have to be pseudoscience – although I have seen many gross examples of the latter. With increasing data we are able to predict an unknown outcome lying 3km below the surface with over 90% accuracy (success rate).

In the question of evolution vs Creation that you Americans seem to be engrossed in I consider the case for Evolution 99% proven – but it will fail your test criteria.

When working beyond the walls of proven science we need to venture into the realm of probability we need to be more circumspect. If a particular medicine/foodstuff is consistently shown to be effective in vitro, and in mice/rats, and has an acceptable theoretical background in biochemistry, but cannot be verified due to the difficulty of effective control of phase 3 clinical trials, then we can imagine that the probability that it will also be effective in humans is at the very least more than 50% - for example 60/40%. This is not pseudoscience – even though there may be some as yet unknown factors which cause it not to be effective in humans (the 40%).

So it there are good reasons for example to include turmeric in your daily diet, and you know that it is safe – then by all means do it – but don’t expect it to be a miracle cure.

LearnAll profile image
LearnAll in reply to Stoneartist

Stoneartist, Your above post is one of the best post I have read on this forum in a long time. I could not have explained it better. People take extreme positions ..pro SOC ..anti SOC...like you said ..Black and White thinking ,,,and that creates conflict and useless arguments.

Salesmen for big pharma and clinical trial commission agents can be excused because they are just trying to earn a living. But ..under the veil of being patient advocate ....restricting people's choices and stopping them to consider other possible helpful interventions is plain misleading.

Sometimes, SOC dictators find this sadistic pleasure in making people very afraid by showing them worst case scenario...Instilling Fear is a salesman's most powerful weapon. Lets keep our minds open to all possiblities and do not allow any salesman to cage our choices about our treatments.

Tall_Allen profile image
Tall_Allen in reply to LearnAll

Perfect example of #11 - conspiracy theories. Sadly, those who engage in such theories build a wall around their pseudoscience: if they can't make a case using science, they attack the motives of those who do.

LearnAll profile image
LearnAll in reply to Tall_Allen

Its an age old tactics to start calling people "conspiracy theorists" when they start figuring out the sales man's game and the plans of masters' he serves.If dietary interventions, supplements and exercise are not effective...why these fellows are feeling so threatened by people talking about complementary interventions. Go and keep rejoicing in your "Only SOC and Nothing But SOC" . Why this urge to attack and stop people from thinking something more than SOC ?

Tall_Allen profile image
Tall_Allen in reply to LearnAll

I haven't even mentioned SOC - that is entirely in your imagination. I don't feel threatened, I just want to make sure that patients are protected from predators who espouse conspiracy theories.

LearnAll profile image
LearnAll in reply to Tall_Allen

Do you not realize that members on this forum come from various professional backgrounds....are educated,,have a record of successful careers, decades of life experience... and above all..they are all adult. Why you have this need to treat them as if they are little kids ..who you need to protect. They are capable of protecting themselves and sorting out what is in their best interest. You seem to be grossly under estimating the intelligence, maturity and wisdom of this esteemed group. Take it easy..Man.

Tall_Allen profile image
Tall_Allen in reply to LearnAll

Yet - except for you -most members liked this post. Response was overwhelmingly positive. Just because someone is intelligent doesn't mean he is not susceptible to imagining conspiracies. In fact, paranoid delusions are more common in more intelligent people.

bean1008 profile image
bean1008 in reply to Tall_Allen

That's so true. One of the most intelligent people I know is completely off his rocker. It's been sad to watch his self-destructive behavior and not be able to do anything about it.

Hey Stoneartist!

I manufactured specialty chemicals for 14 years. I then embalmed bodies for 6 years. I returned to manufacturing in pharmaceuticals for 14 years. I have run the dangerous batches, pilot plant batches, handled the most toxic chemicals--things were different in the old days--and run manufacturing crews--I am proud to say that my crew in pharma had the highest production with the fewest incidents. When the new, 117 million dollar manufacturing building was being designed and built I was one of the team that met daily to discuss equipment lines, brands of equipment, piping and so on. Experimental batches--yes. I was also part of the "brain trust" that would discuss design and engineer safety into a new line of equipment for a new product--as well as inspect and do testing on it. One really has to be observant, almost intuitive when running equipment lines that have never been run before. Complicated saves to simple saves such as noticing a blue color between the piping and relief valve for the upper jacket of a 2,000 gallon S/S reactor. The contractor had left the plastic shield in the relief valve orifice! There was a discussion about this with the site foreman. I have run batches in maybe, 5 gallon, glass vessels in R&D. Seeing what happens under the hood on a small scale when possible is advisable. On "the side" I served as captain of the Confined Space Rescue Team and was then elected to two terms as chief of The Emergency Response Team, (~80 members), dealing with Haz-Mat Response. A wrong decision resulting in harm to some of the responders or even those who were deconning, decontaminating entrants, could lead to a jail term and a personal fine. I was a busy guy!

We were all well compensated earning well above the average income in our area as well as benefits that were very generous. The R&D facility employed about 20 including those who were scientists--new products keep a company viable! New products often require a new line of equipment if existing equipment lines can't be adapted. The new equipment needs to be thoroughly tested. A dry run is done. Raw materials, some quite expensive, some Schedule 2 drugs, some deadly in other ways, if batch records are not followed and reactions in the manufacturing process could occur be deadly. The FDA gives a company a 5 batch run to prove they can make a safe product that does what it is supposed to do. Three batches in a row have to meet the requirements. A license to manufacture that product is then up for review. If a batch fails it could well cost as much to destroy it as the profit from it would have been. I have held in my hands, after the very last addition of a material to the container of a batch that took a month to go through the equipment line, that was worth at that point, more than a million dollars. When encapsulated for use the value would increase perhaps 10 fold. That is just one example--just one.

Pharma companies compensate those who produce well. Company cars are supplied to all department directors and management. I believe I have the number correct. One of the company's vice presidents told me that in about 125 new drug trials, one succeeds in being considered for a new product. He was lured in with dollars, many $$! Talented in overseeing product development with many connections in the industry.

We never manufactured any capsules containing broccoli, green tea, garlic, blueberries --things like that. Selling broccoli sprouts isn't going to produce enough income so that most have a 6 figure salary--and the other benefits and perks!

I believe in a blend of conventional treatments as well as diet changes, lifestyle changes and some alternative treatments. One of my doctors --once--told me that the menu at McDonalds would supply all the nutrients needed for a healthy life. Done with him!

Funny how my onco, who is the head of the genitourinary department at the hospital --after a couple years began smiling again and told me not to change anything I am doing. I don't think he expected me to be stable.

I guarantee there are charlatans out there. That is an easy one to guarantee. I also guarantee this--no big pharma company will ever do studies on something like combinations of broccoli, green tea and so on. The money would dry up! The Davinci isn't cheap either. There is a massive amount of money in health care.

I find that "tunnel vision" is common among uros. Whatever they do is the best. Be it radiation, the 'robot' --whatever. They are working on percentages. As Dirty Harry said--"Do you feel lucky?"

Currumpaw

dentaltwin profile image
dentaltwin in reply to Currumpaw

You make a valuable point--the bar for approval of a pharmaceutical is very high--too high for approval of a nutrient or "orphan drug" that will not generate big money. Likewise, people working in fields we consider "real" science are subject to bias and not infrequently outright corruption (one reason I read "retraction watch". Neither is the drug approval process so pure, as the recent adventures with Aduhelm and the FDA have demonstrated.

Daveofnj profile image
Daveofnj in reply to Currumpaw

Yes, it's a bit of a Catch 22. Amongst the current treatments considered pseudoscience there could be highly effective treatments, but without full testing we will never know. Yet, the industry in large part controls what gets tested.

Daveofnj profile image
Daveofnj in reply to Stoneartist

Yes, a probability calculation comes into play not only in evaluating "alternative" treatments but also in considering the likelihood and acceptability of SOC outcomes. Everyone's calculus is a bit different. Some patients put all of their faith in SOC regardless of the likely outcome. Others may view the SOC path as offering an unacceptable array of probable outcomes and in that case, the most logical behavior is to search for alternatives.

You are confusing two different things:(1) the answers - which may often be undecidable

(2) the process for getting the answers - which is the subject of the post

Science is the process we've all agreed upon since the Scientific Revolution in the 16th century for getting to the answers. In your "evolution" example, it would violate scientific principles to claim certainty (#8). Experiments in evolution continue in accordance with #1. Probability is key! I have no idea what you see in the science of evolution that violates any of those. Perhaps you can point it out?

But medical science is not geology or evolution. In geology, you have relatively little opportunity to conduct randomized controlled experiments, whereas in medical science, almost all progress is from randomized controlled experiments.

You wrote: "If a particular medicine/foodstuff is consistently shown to be effective in vitro, and in mice/rats, and has an acceptable theoretical background in biochemistry, but cannot be verified due to the difficulty of effective control of phase 3 clinical trials, then we can imagine that the probability that it will also be effective in humans is at the very least more than 50% - for example 60/40%. This is not pseudoscience."

I beg to differ. That is exactly what pseudoscience is. Your first clue that you have ventured into the black hole of pseudoscience is your language - "we can imagine that it will also be effective in humans. " In fact, 95% of substances found effective in mice are not at all effective in humans. Mice are bred for such experiments because they react readily. Such experiments are only used to rule substances OUT, never to rule them IN. I suggest you read the link on "levels of evidence." You may find it enlightening.

TA, I highly value your science-based writing and advice. I have personally been helped much both by your posts and by the generous replies you have given on a number of questions I have posted.

And you are right in pointing to the strong limitations of animal-only studies. The literature abounds with cases of promising animal studies that didn't work in humans.

But perhaps it is not quite as bleak as a 95% failure rate in replicating positive results from mice studies to humans? I tried searching for a study on this and the one percentage I found gave a 37 % success rate in replicating animal studies in human randomised trials. I didn't find the original study only a reference:

From "Of mice and men: why animal trial results don’t always translate to humans" in conversation. com:

"A 2006 review looked at studies where medical interventions were tested on animals and whether the results were replicated in human trials.

It showed that of the most-cited animal studies in prestigious scientific journals, such as Nature and Cell, only 37% were replicated in subsequent human randomised trials and 18% were contradicted in human trials. It is safe to assume that less-cited animal studies in lesser journals would have an even lower strike rate.

Another review found the treatment effect (benefit or harm) from six medical interventions carried out in humans and animals was similar for only half the interventions. That is, the results of animal and human trials disagreed half the time"

If something in the range of say one third of positive mice studies indeed are replicable in humans, perhaps one should be open to trying the substance if the animal-only results appear highly interesting and side effects probably are limited, particularly if there are some other confirming indications, at the same time understanding that it is by no means proven and one is taking a chance? There may be many promising substances that will not attract funding for expensive human trials e.g. because they are not patentable.

You are way overestimating the success of mouse drugs that work in humans.

You may enjoy this review from Harvard:

sitn.hms.harvard.edu/flash/...

Or this:

"A retrospective analysis for 39 compounds where both extensive xenograft testing and Phase II clinical data were available, performed by the National Cancer Institute (NCI), has shown that 15/33 agents (45%) with activity in more than one-third of xenografts showed clinical activity (P=0.04). However, with the exception of non-small cell lung cancer, activity within a particular histological type of the xenograft generally did not predict for clinical activity in the same tumour. Today, the question (largely unanswered) is how useful is the xenograft model (particularly the traditional s.c. model) in contemporary cancer drug discovery?"

pubmed.ncbi.nlm.nih.gov/151...

or this:

"Of the large number of promising anticancer agents entering into clinical testing, only a disappointingly small number ultimately assume a place in the armamentarium of the practicing oncologist as clinically useful therapies. Thus, despite the obligatory requirement for showing promising activity in preclinical models, only a select few new drugs will successfully traverse the hurdles necessary to demonstrate both clinical safety and efficacy that are required for approval by regulatory agencies. This stark reality is the fundamental challenge of clinical cancer drug development."

clincancerres.aacrjournals....

or this:

"It is not uncommon for new anti-cancer drugs or therapies to show highly effective, and sometimes even spectacular anti-cancer treatment results using transplantable tumors in mice. These models frequently involve human tumor xenografts grown subcutaneously in immune deficient hosts such as athymic (nude) or severe combined immune deficient (SCID) mice. Unfortunately, such preclinical results are often followed by failure of the drug/therapy in clinical trials, or, if the drug is successful, it usually has only modest efficacy results, by comparison. Not surprisingly, this has provoked considerable skepticism about the value of using such preclinical models for early stage in vivo preclinical drug testing."

pubmed.ncbi.nlm.nih.gov/145...

Keep in mind, that this only reflects compounds that make it to clinical trials. "Less than 5% of drugs that reach Phase I gain a marketing authorisation (MA) . Even more, it has been reported that only 1 in 10,000 pre-clinical compounds ever reach the market ."

tandfonline.com/doi/full/10...

In this report, for every 10,000 substances screened, 250 (2.5%) make it through mouse studies. And of the 250 that make it into clinical trials, all but 5 (2%) are screened out. And of those 5, 1 gets FDA authorization.

proquest.com/openview/a25ed...

Thank you TA, this is indeed food for thought. The links you provided show that animal-only studies should be interpreted with great caution.

The discrepancy between theose studies and the one I referred to which showed a 37% replicability of mouse studies in humans, should be because the latter has an inherent bias for replicability, given that it was limited to the most cited animal studies in prestigious scientific journals. There may be a subset of animal studies that hold greater promise than the average.

Currumpaw profile image
Currumpaw in reply to Tall_Allen

Hey T_A--

Beagles were the first test subjects for an experimental cancer drug I worked on. Why not humans? I am not going to answer that.

Hypothesis, theory, (both of which require imagination!), compilation of empirical data --through testing first on other species--the days when Edward Jenner practiced are long gone! Ahh! the missing answer in the first paragraph! --finally studies with humans--then acceptance for human use or as a law.

Currumpaw

TA. You need to be careful that you dont sit high in your Level A castle and consider everything outside the walls as the enemy. The whole process of science starts by somebody imagining a new path beyond the frontier of your phase 3 randomised doubleblind clinical trials. Out there there are thousands of possibilities which thousands of diligent scientists are working on - imagining, building hypotheses, testing the same. And in this rather fluid world, with a great many non successful paths, will be some paths of research which in 10 or twenty years will be taken into your castle of proof. You can wait til that happens, or you can follow what is happening and see if there is anything that you wand to use.

This is the frontier process of science.

Pseudoscience is something very different. It would be like trashing the evolution theory in favour of creation just because it is written in a book. As long as and hypothesis is based on scientific results and remembers the difference between theory and proven it is part of the scientific process. Pseudo science does not have these links and is not part of the scientific process - it is not founded on solid ground - but it sure does prosper in our western scoieties - in the US it seems to be illustrated at present by the 35% of the country who believe that the election was stolen - completely without evidence. Or the vast numbers who are afraid of socialism without really knowing the first thing about what it is. We live, unfortunately, in a world of advertising (read propaganda) where we all need to evaluate and select the info we can trust - which is why so many of us are happy to be on this site, and are happy that you continue with your excellent contributions.

Why the warning?"You need to be careful that you don't sit high in your Level A castle and consider everything outside the walls as the enemy. " There are "levels of evidence," if that is what you are referring to, which it is certainly pseudoscientific to ignore.

No No - levels of evidence are important markers - and I am 100% behind you there. My point arises because I fear that your input, aided by a good many of the support comments appears to me to divide the subject into rock solid proven -- and the rest who are crackpots and will believe anything in their panic to find a miracle cure (OK - I am exaggerating a wee bit :-) .). My point is that there is a vast area of "in progress science which involves considerable uncertainty until it can achieve the levels of evidence that you seek.

I am on only one med - Zoladex (goserelin) which I believe was patented in 1976 and approved for medical use in 1987 - so it is 45 years old - and tried and tested - so I am playing safe. But in the area of nutrition there has been a lot of recent research and exploration. I use the word exploration to signify that nothing is known for sure, so we should not expect miracle cures. But many foods have been extensively studied for their possible effects in fighting cancer, and there is much incidental evidence. So I support guys who adjust their diet to include such things which "have been been shown" to have a beneficial effect in the fight. You may ridicule this as non scientific - and if you do then I disagree, but to me it is part of the ongoing exploration of the causes and mechanisms of cancer. I believe research on many approved drugs started with plant studies, so this is also the scientific way.

That being said I do not think it is a good idea to tank up with supplements - I do not use any, but get much benefit for natural food sources. For example I grow radishes - no longer for the root fruit - but for the leaves which I munch every time I pass the herb garden. Dont know if it helps - but it certainly doesnt hurt - and my PCa progression looks to be on a very good path.

So once again TA I would appeal for more appreciation of the grey colours which appear in the exploration phase between the proven and the ridiculous.

I don't blame anyone for taking supplements. But to claim that there is science behind that choice of most of them is just plain wrong in most cases. This does indeed go back to "levels of evidence." The Levels of Evidence are not arbitrary. They exist the way they are because, from painstaking research, it's been found that higher levels of evidence have more reproducible results than lower levels of evidence.

So when you state : "So I support guys who adjust their diet to include such things which "have been been shown" to have a beneficial effect in the fight." There are a couple of things that make that an unscientific statement. First, if one guy believes some intervention worked for him, maybe it did, maybe it didn' t(it violates #1, #2, and probably #3)). Even if it did, medical science is not physics. So working for one guy does not apply to any other guy. Only predictions across populations are valid in medical science. The other unscientific thing in your statement is the certainty in the word "shown." It violates #7 (extraordinary claims) and #8 (certainty). It is you, not I, who is being black and white instead of gray. There is always doubt in medical science, so skepticism is important. When you accept such claims as being "shown," you are leaving skepticism behind and you are being unscientific. That is not to say you are wrong to make that choice (that isn't for me to decide), just that it is not a scientific choice you are making.

Yes sceptisism is important, and even the gold standard stuff is not a precise tool against PCa - its more like a blunt sledgehammer than a precision tool - so there is considerable room for improvement, - all of which tells us to examine these things as variables and not black/white.

"So I support guys who adjust their diet to include such things which "have been been shown" to have a beneficial effect in the fight." is in your book an unscientific statement. But there is masses of research to show many things may be beneficial - unscientific for you maybe - but relevant for many. At present we dont know - but as I always say - we have to eat something - so why not load up on the foodstuffs which have anti cancer potential (Illustrated in research and published in peer reviewed journals), and cut down on foodstuffs which may be harmful. - It is this area of exploration where things have yet to be proven to your satisfaction , that gives much succour to many on this forum. And yes when dealing with probabilities we have to use terms like shall and may and for me they are quite correct - even though you want to label them unscientific. As I said - you may ridicule this statement - and you did, but it remains a high probability that diet and nutrition have an important effect on the progression of PCa - even though we do not as yet have proof, and the effects are too complex to be able to manufacture a master pill to cure all.

Life is about living - science is a tool - and always evolving. Therefore I am not at all concerned if you want to stick a label of scientific or non scientific on it. What matters is that we have good well founded reasons to do what we do and enough evidence to assess the probabilities involved. So we have to deal with things at all levels of evidence, and not just the gold standard. If folks have a valid reason for doing something based on scientific research - however incomplete, and they understand the questions of dosage and toxicology, and the risks, then I support them in their trial of one. They will never know if the path they have taken is better - or worse because everybody presents with different PCa, - but they will be engaged in the fight.

I never said any treatment is black or white. That was a strawman you created. In fact, I said exactly the opposite - that certainty is elusive (#8)..I said that a therapy can be judged as scientific or pseudoscientific or even non-scientific (if no pretense is made toward science).

I have given you a tool to judge a claim by - it is a checklist you can use - or not. If your claim fails to measure up, you are not practicing science - but no one says you have to.

Once again (and you keep ignoring that I wrote this) I am not telling you what to put in your mouth, and I am not telling you that it has no value. I'm only telling you that you are being influenced by pseudoscience. My mother told me to eat chicken soup for my health. I never pretended it was scientific, but I happily did so anyway.

As for your claims:

When you say "masses of data" - are you cherry-picking (#3)? are you using non-scientific tools to measure their worth (#2)? I have seen much more data than you have and would never make such a claim, given all the conflicting (and lower level) evidence.

" it remains a high probability that diet and nutrition have an important effect on the progression of PCa - even though we do not as yet have proof" How do you know that? Did you include the one study with the highest level of evidence in that statement? Or did you cherry pick to exclude it? The best data we have is a trial where men on active surveillance were randomized to increase their vegetable intake. It made no difference in their rate of progression.

jamanetwork.com/journals/ja...

I'm not telling you what to eat. I have much more humility on that subject than you have.I know that no proof of an effect (like my conflicting data on most dietary practices) is not the same as proof of no effect (like the MEAL trial.) I'm just saying that you are not following science when you religiously adhere to such behaviors.

I certainly support the right of everyone to only follow current SOC and do nothing on the alternative side. And I haven't seen that many who use alternative methods totally ignore the various forms of SOC.

I'd add that many doctors spread across the USA, whether GP, urologist, MO or RO, do not always follow current SOC for one reason or another. Perhaps the good doc can concentrate some of his fire in that direction.

There are scams all around. One must stay on guard.

Well said!

Thanks T/A for always being there for all of us. I also have total confidence in my Medical team to keep me alive and informed. Leo

Allen - I really appreciate your engagement and consistency on this forum. It’s easy to get spun up with fear staring down this dragon and it can make a person grasp at straws looking for the magic snake oil that will get the dragon back in the cave. Your advice has helped me in times like that. Of course I vet everything with my doctors now. That said, I think some of the ideas not yet proven and fully studied scientifically can serve as potential areas for new science to explore. I remain in awe at those scientists who are developing these therapies., true heroes!

Tall_Allen profile image
Tall_Allen in reply to Chugach

I agree. Part of science is hypothesis generation. The pseudoscience problem occurs when someone mistakes a hypothesis-generating experiment for a proven theorem.

One of my favorite quotes:

Plato-reason drives the chariot of the soul.

And so reason stays late constructing tenuous arguments, while taste goes home to watch “King of Queens.”

An integrative and holistic approach to healing is certainly the only rational way. A person didn't get sick because they were deficient in pharmaceuticals. Tap into modern medicine but also focus on complementary therapies and healing. A balanced approach is key. This black and white mindset does nobody any good. Besides, there's always a point when conventional won't help you anymore, and the doctors will give up on you.

gregg57 profile image
gregg57 in reply to to23456

"An integrative and holistic approach to healing is certainly the only rational way. A person didn't get sick because they were deficient in pharmaceuticals."

Lots of people die because they are "deficient" in proven treatments. I knew one of them. Subsituting unproven "sounds good" nonsense for effective treatments is a good way to die. No one dies because they are deficient in holistic non-cures. It's not necesaary to have a "balanced approach" that includes things that have no basis in science.

Lots of those who promote this pseudoscience are preying on the vulnerabilties and fears of those with life-threatening disease while in most cases they themselves are in a low-risk situation or don't even have cancer at all.

to23456 profile image
to23456 in reply to gregg57

I think it's safe to say that everyone has an agenda. Good day.

dentaltwin profile image
dentaltwin in reply to to23456

Quoting Tall_Allen, 14 minutes ago: "Sadly, those who engage in such theories build a wall around their pseudoscience: if they can't make a case using science, they attack the motives of those who do."

to23456 profile image
to23456 in reply to dentaltwin

Good thing I can make a case using science because science has already proven how important healthy sleep, diet and mindset is. In other words, a holistic approach.

dentaltwin profile image
dentaltwin in reply to to23456

I have no problem with that--so long as a specific claim is made such as: "If you do this, then you will have this result". Once you make a specific claim, I'd ask that you show your work--in other words, I'd ask for evidence--the same kind of evidence that you would expect to have for a pharmaceutical or other intervention.

This is a line that is fooled around with all the time. For instance, Prevagen gave all those nice people their memory back. At the same time, in microscopic print there is the disclaimer "This product is not intended to diagnose, treat, cure, or prevent any disease.", these statements have not been evaluated by the FDA, etc. Well, it certainly SOUNDS as if they are marketing to people who suspect they may have a disease--in fact a pretty specific medical condition.

As I said elsewhere, I've had plenty of problems with the FDA's approval process (and its results); I certainly don't think the pharmaceutical industry's hands are clean here either.

The FDA announced a plan to get stricter about claims made for supplements like Prevagen marketed for Alzheimer's (sort of):

fda.gov/news-events/press-a...

At the same time, their approval of Aduhelm for Alzheimer's raised a lot of eyebrows:

fda.gov/drugs/news-events-h...

Now, the FDA is investigating itself through the Inspector General:

cnbc.com/2021/07/09/biogen-...

It's such a fraught topic. I guess the transparency is refreshing.

Stoneartist profile image
Stoneartist in reply to to23456

Nicely written!!

Always love your posts. You always leave me with something to think about.

🧡

Most universities offer a 4 year degree in political science. Maybe that degree should be re named “Political Pseudoscience”. You could even become a Doctor of Political Psuedoscience (Phd?) and weigh in on mandatory vaccinations and masks for schoolchildren under 12.Just this month the National Geographic magazine has printed the latest “possible cure” for cancer. Stay tuned to see the reaction to that from all corners of the health sciences.

I prefer to think of some things as "beyond science" rather than "pseudoscience". "Pseudo" implies "false" which is "not true", when in fact it is simply "unproven" or "controversial due to lack of evidence". Is everything unproven false? Do we know everything and not know nothing? No. The more we know, the more we know we don't know.

Pseudoscience means that it is "sciency" (i.e., it "looks" like science) but is not science. Science is a process for deciding the veracity of empirically decidable claims. It has nothing to do with whether the claims are true or false. The process is indifferent to the outcome.

that is a great list thanks. Moritz's book certainly contains some of these . i have only read three chapters and I tried to make that clear as well as the fact that I was not endorsing the book. so far the worst problem is when he discusses metastasis. He says that there is no such thing that sites other than the primary are actually new independent tumor. So why does a metastatic site contain cancer cell of the same type. Prostate metastasis are prostate cells not bone cells or lymph node cells. This is when I decided I would listen for useful information but dismiss the main premise. I have seen logical errors in otherwise excellent writing but rarely something this obvious.

I am not an advocate of Pseudoscience or Quakery especially since I am a scientist myself. However, there are always two sides to stories and experiences and each cancer patient reacts different.Let us keep open minds to alternative treatments. After all the trials that some of you participate in are not based on yet proven science either.

You seem very knowledgable and it seems you helped a lot of people on this site. However, I believe that the Covid added another dimension to the treatment choices. In addition, some people are looking for quality of life rather than quantity.

But maybe this is easier to say after the experience with my husband recently.

He had prostrate surgery 10 year ago. He was fine all 10 years. On March 2020 he had COVID and he had PCS - Post Covid Syndrome - he got relapses and Covid symptoms for over a year.

On end of Feb 2021 he was diagnosed with metastatic cancer - T11 vertebra - 3 small spots. From Feb 25 to April 4 2021 - he had one 6 months Lupron shot - two XGEVA shots, was put on Xtandi and had 10 targeted radiation session. He ended up in the Hospital almost dead from side effects. In the hospital he was pumped full of medication again until they admitted they did not know what to do and he went home totally without medication and he is recuperating besides the side effects from the Lupron which is still good for 2 more months.

My husband made the decision that he wants no more treatment for a cancer that seemed to grow so slow for 10 years. It is for everyone a personal decision.

I wish every one on this site the best and hope you find the right balance between treatment and quality of life and happiness.

I need to find a site where we get encouragement for good nutrition and possible some alternative treatment options.

Thank you for all your insights and love that is so genuine.

Tall_Allen profile image
Tall_Allen in reply to Enail

"Let us keep open minds to alternative treatments. After all the trials that some of you participate in are not based on yet proven science either." This post has to do with PROCESS not OUTCOMES. Science is a process for testing hypotheses. Those who claim that some outcome is true without going through the scientific process, are practicing pseudoscience. The trials are part of the process.

I like the formulation re: "open mind"--attributed to Walter Kotschnig--"Keep an open mind--just not so open that your brains fall out."

LOL

Excellent list--to which I would add "failure to disclose conflicts of interest", which of course can also occur in what we'd otherwise recognize as "legitimate" science.

Good one! I'll add it!

Well, after reading this I am throwing away all my supplements. Not! I reject black and white, everything must pass a clinical trial before use, thinking.

Tall_Allen profile image
Tall_Allen in reply to WSOPeddie

Belief is fine - it's just not science.

WSOPeddie profile image
WSOPeddie in reply to Tall_Allen

Who gets to be the arbiter of 'science'?

I'm trying hard not to mention Dr Fauci.

Tall_Allen profile image
Tall_Allen in reply to WSOPeddie

Since the beginning, science has been done by peer-review and consensus. The strength of the process is that equally well-educated observers will arrive at similar conclusions.

Anomalous profile image
Anomalous in reply to Tall_Allen

It is possible, though, that peer review groups become inclusive and intolerant, which is a human trait of course .

Tall_Allen profile image
Tall_Allen in reply to Anomalous

Doctors often complain that peer-reviewers are too strict and add to their workload without much to show for it, if that's what you mean by intolerant. But I'd rather they erred on the side of wanting more data. I'm not sure what you mean by "inclusive," since they and authors are anonymous.

Anomalous profile image
Anomalous in reply to Tall_Allen

I meant insular. Changed the whole meaning

Tall_Allen profile image
Tall_Allen in reply to Anomalous

Peer reviewers are anonymous from each other and from the author.

dentaltwin profile image
dentaltwin in reply to WSOPeddie

This goes to levels of evidence. Not everything can be tested in a double-blinded controlled clinical trial. How do you prove that global warming is caused by human activity? It's done by modeling--just as the public health people have done predicting the course of the COVID pandemic.

But getting high-level evidence for a single intervention in disease is easier, though not always fast enough. It was totally understandable (for example) that once it was in the ether that hydroxychloroquine was a good treatment for COVID that it became part of some people's belief system, though evidence emerged that it was of little or no help. The same thing now with ivermectin, which is generating SOME real evidence of utility, though not of the highest quality--yet.

But you have to go where the evidence leads you, and if you don't actively look for evidence, you won't get it, and then we're talking about articles of faith, not science.

Thanks for your observations!

Good post. I do think there is a lack of good evidence around diet / foodstuffs. They are very under studied, particularly to the gold standard of double blind randomised trials. No real incentive for pharma companies, and very hard to organise, plus so many variables that could be studied. The NHS did a small study of the pomi-t supplement of turmeric/pomegranate/green tea/broccoli, which seemed positive. I also read of a mushroom trial with positive results, but less so. One intriguing stat I recall reading quite some time ago - stage 1 PCa men actually showing a longer overall life expectancy than those without PCa. If correct it would not surprise me, as lifestyle including diet is bound to improve on average after a diagnosis. I do what I can to eat a very varied mainly plant based diet, main weakness I have to combat is for added sugar and to a lesser extent alcohol, I've convinced myself that red wine good in moderation :) The positive mental upside of doing what you can, which is worth a lot.

Excellent

Scientific thinking is not something we do naturally but something we must learn. In that perspective, it is perhaps not so strange that unscientific thinking, ie pseudoscience, appears on the site. Thank you TA for your teaching.

Tall_Allen profile image
Tall_Allen in reply to Gemlin_

I agree - the scientific revolution didn't start until the 16th century in Europe. Magical thinking goes back to pre-history.

Hi TA

Lists of characteristics of "pseudo science" have been written innumerable times since the term "science" came to be. None of them are complete. Many are mutually inconsistent and historians can regularly find exceptions where yesterday's pseudo science became rock solid science (and vice versa). But most of us "know" pseudo science when we see it. We apply commonsense with a dash of scepticism. That said, I have a big issue with you. It is contained in the first phrase of your post and it is utterly false.

"Because I see a lot of pseudo science purveyed on this site,..."

I do not see that. There is very little and what arises is quickly and calmly corrected and there the matter ends. We are an uncommonly commonsense group.

How could you have come to such a counter factual conclusion?

It is a case of confirmation bias. let me be clear: the kinds of "facts" emerging from large, well conducted trials are very important but they are not by any means the major part of our decision making processes here among the advanced PCa. We are each a case of one and we must decide in conditions of great uncertainty our own treatment path. This is not "scientific method(s)". It is learning from experience and the best advice we can obtain for us. That is a different kind of logic. It has a technical name: Bayesian logic (after the rev Tomas Bayes 1702-1761). It concerns how we modify our knowledge and approach in the light of new data and evidence. (eg Yikes! I am now castrate resistant (new data) What do I do now? As contributors to this site can attest there is no a one size fits all answer).

To be sure, your "scientific facts" are part of the background to our decision making (I call it our wallpaper).

Your item 9, Logical fallacies is an important one and one can, if sufficiently anally retentive, find them in most posts, including mine and yours. However they are just as prevalent in science itself.

Tall_Allen profile image
Tall_Allen in reply to kaptank

I've been here a LOT longer than you and seen many more posts using pseudoscience. If you stick around long enough, you'll see them too. I didn't say anyone is free from logical fallacies. Usually, the peer-review process corrects them.

I'm very familiar with Bayesian statistics, but that has more to do with subsequent trials and little to do with pseudoscience.

Statistical studies predict only for the group and never for the individual. But I've only seem problems arise from thinking that "I" am going to be the exception to the group mean. That is just a subjective belief and has nothing to do with science.

kaptank profile image
kaptank in reply to Tall_Allen

Strictly statistically speaking, the longer you and I have been around the closer we are to dementia.

Tall_Allen profile image
Tall_Allen in reply to kaptank

Umm - speak for yourself.

kaptank profile image
kaptank in reply to Tall_Allen

Touche sir!

I never said Bayesian stats have anything at all to do with pseudo science. And while it has some application to subsequent trials (and a lot of science itself), it has more to do with our "case of one" learning and decision making on this site. To show just how tricky this pseudo science versus science caper is, I cite a relevant example of a rock solid bit of past science becoming pseudo science with not a bit of solid evidence for it and much against. It is the fallacious and false proposition that Testosterone is fuel for PCa. For 80 years it has been the basis of both treatments and research. If you believe it there is no point in researching more sophisticated views of the relation between T and PCa. And anything to do with v high T is downright dangerous. You do still believe it (or say you do) but I think you say this by just redefining what "fuel" is to maintain your belief. This trick, of redefining away problems is very common in science (and elsewhere, including pseudo science). The fact is, T does not act like a fuel at all. At some low concentrations it limits PCa, at slightly higher concentrations it promotes it and at very high concentrations it inhibits it again. That is not a fuel by anybodys' dictionary but yours. We have known by accumulating anecdotal evidence from the 1980s and before, and by exemplary scientific work since about 2000 that the evidence for the hypothesis was weak (it was not even tested, it was assumed that v. low T is good therefore v. high T is bad. A good example of a logical fallacy). This was not picked up in peer review for 60+ years and it is still found in some text books and lecture halls. I repeat "T is fuel for cancer" is now pseudo science. It is a well and truly busted flush.

As a member of our site I have not come down in the last shower and have a fair few years of experience, both as a member and much more as a PCa dogface. I dispute very strongly your fancy that pseudo science is rampant in our discussions. It is not. Good, rational questions are asked and answered as best our lot of commonsense writers can. We are a diverse bunch united in the common cause of learning as much as we can about our disease and treatment options. Commonsense prevails and rare occurrences of pseudo science are typically gently but firmly rebutted. Mostly we are exploring hypotheses and treatment options in very reasonable fashion.

Of course "I am going to be the exception" is a statistical fallacy. That is just bleeding obvious.

Tall_Allen profile image
Tall_Allen in reply to kaptank

Like many, you are confusing outcomes and process. Science is a process whereby hypotheses are tested. So the "saturation hypothesis" is a scientifically testable proposition. It is not pseudoscience. Nor is the "any T adds fuel to the fire" hypothesis pseudoscience. It is testable, and therefore scientific. Neither hypothesis is pseudoscience, they are both scientific. One so far seems to be wrong, the other so far seems to be correct, but they are both scientific hypotheses. Conclusions are provisional until large-scale RCTs are done, which may be never.

I'm glad you think this is a pseudoscience-free zone. I have a different POV based on my experience here. I see many posts that make unverified claims, while claiming they are verified. I see lots of posts making claims based on low levels of evidence. I see many cherry-picked research studies proffered as evidence. I see MUCH faulty biochemistry. I see many posts that claim conspiracy theories. Many confuse association with causation. Many show poor analysis of available research.

Thank you T_A for giving so good a base for a welcome discussion.

I’d like to add some thoughts, mainly about context.

Of course charlatans abuse people despaired by their health condition, and for that, they use pseudo-science arguments.

What T_A give us, is mainly a negative description of what science should be; for instance science HAS TO BE FALSIFIABLE etc …

To T_A’s very well done description of what science should be, I’d add that science should be PUBLIC and REPRODUCIBLE.

Now, the context. SCIENCE is not what guide important individual choices. When someone marries, he has no proof that he chose the good person for living with for the next 50 years. Furthermore medicine is not at all a science, because experiments are not possible. RCT can’t act as, for many reasons, one being the lack of publicly available data.

Moreover Science doesn’t exist (disclaimer, I’m a former scientist) , it’s just a word used for its prestige to add authority to somebody’s speech (e.g. government). What do exist are scientists, scientific institutions, and scientifically proven facts. And scientists are humans, some good, some bad, some honest, some dishonest, some seeking truth, some seeking their own carrier development.

You can’t insulate scientific progress from the main forces of the societies where it develops, it used to be religions, now it is economic interests, and for health system, these interests are so huge that nothing can resist.

Why some well educated man with PCa could be interested in not proven therapies? Because it’s sure that all health system is, by construction –RCT for instance --, oriented exclusively towards more and more expansive cures. So there is no doubt that possible cheap cures will always be unproven. And there is little doubt that such cures do exist: PCa incidence as for many other illnesses, is very dependent on civilization, e.g. western (date I say, American) way of live being one of the worst.

As far as PCa is concerned, there is one more important fact. It’s scientifically, i.e. statiscally, proven than treatments add only little to lifespan but much trouble to QOL. But as individuals, we all hope to be one of the anecdotal exceptions this forum is full of. Hope often drives much than science.

Philosophical digression: as a Mathematician, I often ask me if Maths is a science because reality and experiment play absolutely no role in Maths which is only theory, while they are so fundamental in all other sciences. But yes, Maths is also a science if we adopt this definition: science is what everybody (with a little or huge work) can verify. And medicine doesn't fulfill this definition at all.

Tall_Allen profile image
Tall_Allen in reply to GabF

I certainly disagree with much of what you say, but you gave it some thought, and it merits a reply.• Medical science is certainly a science. As I keep saying, science isn't a thing, it is a process. The process involves hypothesis testing with experiments, repetition, verification, thesis, and consensus. Scientists are people who engage in the process of science.

• The whole idea behind levels of evidence is reproducibility. That's why a large, well done RCT that is verified by another large-well-done RCT is given Level 1a status (e.g., STAMPEDE and LATITUDE).

• But medicine is based on biology, not physics. Medical experiments must be conducted among large samples of the relevant population to form conclusions that apply to the population, not individuals. In physics, a single instance can prove a thesis. (btw, I doubt that math is a science because the process is totally different, but I am on a fence).

• All data on peer-reviewed published RCTs are certainly public - in fact, they are published for all to see. What do you suppose The Lancet does? De-identified data from RCTs are made available to other researchers.

• Researchers have screened hundreds of thousands of substances for anticancer activity. That is the purpose of mouse studies (and more recently , in silicio studies). They are almost always screened OUT. The very few that are screened in move on to small clinical trials. I just posted an estimate that for every 10,000 substances screened, only 250 makes it to clinical trials, 5 make it to Phase 3 RCT, and only 1 gets FDA approval (nb, science is a process). This is expensive. It is paid for by our tax dollars (e.g., NHS, NIH/NCI, DoD-sponsored trials), by charitable contributions (e.g.,Prostate Cancer Foundation), by large teaching hospitals (e.g. MSKCC, MD Anderson, Johns Hopkins), and by the high prices we pay for pharmaceuticals. There are organizations of doctors, like NRG Oncology, SWOG, and UNICANCER that design and conduct trials of many substances (often with no patent protection) and combinations. The Romantic days of a single heroic doctor finding a cure for syphilis in his moldy cheese are long gone. Just as with technology, "breakthroughs" are found with increasing sophistication, not the "cheap cures" you unscientifically believe in.

TA, I want to continue our discussion of above as it is at base an important issue: how we assess evidence and risks and how we learn as we go. But first I must tell you about myself, as arguments from authority are sometimes employed even in our collegial discussions. My first career was as a scientist (chemistry, photochemistry of amino acids, chemical metrology). My subsequent careers were as academic in fields like the history, philosophy and methodology of science, technological and social change, logic and a brief dabble in linguistics. I have been a full time direct advisor to governments at a high level on finance, energy, education and weights and measures. I was a founding editor of a significant global scientific journal for many years. So I know a bit about the peer review process. I have done it many times but mostly I mediated disputes between reviewers and authors. Let me tell you about your rose coloured fantasy of the peer review process as rigorously rooting out error and fallacy. It is fallible and many mistakes get through. And they are often big ones pertaining to basic assumptions. People get bitchy. There is a tangle of egos. Mostly the I’s are dotted and the T’s crossed and the big problems just smoothed over. It is in real need of reform. But it is the best we have.

My point in all this self-aggrandisement is that science (process and product) is not the critter you claim it to be. It is much, much more nuanced and ragged. Take falsification. We have known for about 2 ½ thousand years the modus tollens argument That “if a then b” and “not b” is the case, then “a” must be false or not the case (“a” is falsified). Certain. Everywhere, everytime. It has always been part of the everyday toolbox of science. In the 1930s it was elevated to the distinguishing level of arbiter of science and pseudo-science by a certain Karl Popper in a much discussed work called The Logic of Scientific Discovery. Science was falsifiable, pseudoscience was unfalsifiable. Unfortunately on hearing this, historians suddenly started finding unfalsifiability everywhere at the very heart of science. There are many ways to explain away apparent anomalies so they never falsify. Let me give one example of many: “the speed of light is constant”. This is a good, scientific looking fact. We can measure it to confirm or falsify it. That is not true. ALL our calibrations of measuring instruments are tied to the speed of light (the meter is the distance travelled by light in a particular time interval). The speed of light cannot be measured. Any attempt to do so must have only one result and none other. It is unfalsifiable. This is at the heart of physics.

There are many other examples but let us get straight to the “T is fuel for cancer” case. In the 1940s Charles Huggins showed that lowering T to castrate levels lengthened survival time for PCa patients. It was big news because it was the first useable treatment for PCa. He got a Nobel for it. Textbooks and medicos for the next 60 years believed that low T is good, high T is bad for PCa patients – T is fuel for cancer. It was a fundamental tenet. Any paper finding otherwise could not get through the peer review process. Research funds were denied anybody trying to test the “T is fuel” thesis. It was futile and pointless as we knew the answer. Peer reviewers agreed all. It was the basis of all treatments (still is, it works). By the early 2000s papers started appearing casting doubt and anecdotal evidence had also been building. (consistent anecdotal evidence by the way is very useful on the principle of : “if there’s smoke there’s probably fire”) Anyway, for that 60 or so years, “T is fuel” was indeed unfalsifiable. It ceased being unfalsifiable only when thinking changed (a “new paradigm”) and it started becoming apparent that there were much more complicated things in the relations of T and other hormones with PCa. Before that “T is not fuel” was literally unthinkable. I had such an oncologist up to about 2015. Old paradigms linger.

I am sorry to go on so, but it is important to know that science is necessarily fallible and context dependent. So is medicine and so are our decisions on treatment. We all do the best we can in the circumstances. It is clear we have very differing ideas of science and pseudo-science (and why don’t we call it non science, conspiracy science etc). You have a narrow reductionist idea that once used to be held up as an ideal but reality is messier than that.

Anyhow, to the real point of all this. Having discussions about, say, supplements is perfectly rational and goes back to Asclepius and the growth of medical thought. You cannot say supplements don't work. We just don't know. Questions are asked, opinions given, new ideas brought forward and in the process we inch to better understanding. It can be a messy process, in science and in this forum. There are over 12000 people on this forum with great knowledge and experience. Even an account of a single case treatment is very useful from what can be learned. We have TA to keep us honest with the stats but we have many others who also discuss and draw attention to, recent advances in the science and in the treatments and generally contribute with reports on their own cases of one. We have retired oncologists. We can even learn from naturopaths (who as I have observed often have superior diagnostic and background practical medical knowledge than most docs).

We are the world’s largest trial. Have a scroll through the search engine for posts and you realise what a body of knowledge it represents. I repeat, the forum does not much frolic with pseudo-science. There is a self-correcting wisdom in a crowd like us. I would hope for tolerance, respect and collegiality in our back and forth. Throwing down the gauntlet that we wallow in pseudo-science is neither helpful nor true.

Tall_Allen profile image
Tall_Allen in reply to kaptank

• I agree that peer-review can get nasty - but isn't that actually a good thing? If it were gloves-on, it wouldn't ferret out problems.

• biology/medicine is not physics. All medical propositions are falsifiable. "T is fuel" was NEVER unfalsifiable. It was unexplored and therefore unfalsified, but it was always a falsifiable proposition.

• Again, you are confusing results with process. The results may be wrong, but the process of science has stood the test of time. Some results are unexplored. Some inadequately explored. If you actually look at the checklist, it is a checklist for evaluating claims as coming from science vs pseudoscience (meaning sciency-sounding, but not science). The checklist argues against certainty (#8), which is a hallmark of science. All findings are provisional.

• Whether a supplement works or not can be determined scientifically. We do know, for example, that Vitamin E promotes prostate cancer. That was proven in a large randomized clinical trial. But most remain unproven. No evidence of benefit is not the same as evidence of no benefit. Benefits and safety are testable (falsifiable). What I see on this site are many instances of #2 (anecdotes), #3 (cherry picking studies), #7 (exaggerated claims), and #8 (certainty). You must have blinders on to filter out all the pseudoscientific claims on this site. Again, I take no issue with those who make no claims to science, only with those who pretend.

• I agree that this forum often is a valuable resource. That's why I'm here. I also believe that not all truths are discoverable by science. The purpose of this post is to help others sort out scientific claims from pseudoscientific claims. If you want to eat apricot pits, who's stopping you? But claims that science has shown it works and is safe are just plain wrong.

kaptank profile image
kaptank in reply to Tall_Allen

Anybody thinking of eating apricot pits we should try to stop, they must never just go through to the keeper. They need to be told straight but respectfully that it contains cyanide. That has in fact be done quite a few times in this forum whenever the topic arises.

By the way, there is no "the process of science". There are processes and they change, as do their products.

But the main problem is your insistence on a rigid falsifiability/unfalsifiability distinction and there is none. This sort of talk, of science v pseudoscience, originates from bitter debates in the 1920s between "rationalists" and "occultists". Good folk wanted a defining characteristic to distinguish the 2. As I explained above, Popper obliged and was promptly shot down in flames by the reality of science. Both science and occultism have moved on a bit from those times so the whole dispute seems quaint and old fashioned now. I object to the term "pseudoscience". It is a useful as phlogiston. This is the age of conspiracy theories (a very small proportion of which unfortunately turn out to be more or less correct). They are the danger and so is bad science. Whether or not it is falsifiable the "T is fuel" episode is an example of very bad science with very bad consequences. For 60 years nobody had the curiosity to enquire whether high T could also be part of the PCa management equation. Nothing in the literature, despite Huggins himself suggesting high T may limit the growth of PCa. Nothing, nada, nil. We are splitting hairs by arguing about falsifiability here. For any scientist or medico of the times thinking outside the box it would certainly have seemed like "T is fuel" was unfalsifiable. It is certainly not-science and a shameful episode - it was unscientific. Evidence was not consulted and no questions were asked. And this is an entire possible treatment modality that is only now getting any (but still small) attention.

It is perfectly rational for this forum to ask questions, gather information, consult journals etc about (eg) supplements among many other topics. Hey, we are all adults and all in the same boat. We can make up our own minds, evaluate evidence and most importantly, assess risks. None of us came down in the last shower, we can do all that. We are in the fight of our lives. It is worth our paying attention.

Tall_Allen profile image
Tall_Allen in reply to kaptank

Glad that you now recognize the problem of this site. There is no "wisdom of the crowd." There are a lot of people with conspiracy theories who will not be convinced, no matter what you or I say. The best we can do is provide tools, like the checklist to help others.

Science is a process.

All medical scientific propositions are falsifiable. Formerly, science thought that it's propositions are provable. Popper showed that is not the case (He was not "shot down" - all modern statistics are based on him). Any science built on inductive reasoning can't be proved (as was known since David Hume), it can only be falsified. In other words, statististics can only be used to determine whether a null hypothesis (e.g., taking Vitamin E pills does not cause PC) is to be rejected. As you see (below) that's exactly what they did - the null hypothesis was falsified with over 99% confidence. By convention, we accept it as true that Vitamin E contributes to causing PC.

jamanetwork.com/journals/ja...

In fact, I defy you to come up with even one medical proposition that is not potentially falsifiable. "T is fuel" certainly is a falsifiable proposition. You seem to only be interested in setting up strawmen. Have doctors drawn erroneous conclusions? Of course, they are human. But that doesn't mean that they cannot be proved wrong using science (as, for example, Morgentaler did in 2008, at least provisionally). Anyone who insists that he has a treatment that cannot be proven to not work (unfalsifiable) has abandoned science. It appears you have (which is OK, as long as you don't claim to be scientific.)

You and I differ. Your attitude is to let all information, regardless of its truth, be put forward as truth. After all, you argue, "we can make up our own minds, evaluate evidence and most importantly, assess risks." So you evidently believe that the news should report "the election was stolen" without comment? I do not. I believe that responsible journalists should insist on evidence, and show the evidence that is there. The burden of proof is on the ones making the claim. The more extraordinary the claim, the more extraordinary the proof required, as Carl Sagan said.

kaptank profile image
kaptank in reply to Tall_Allen

You are badly misrepresenting me (and indeed, the contributors to this forum -I see no tendencies toward conspiracy theories, nor "pseudoscience" ) and the processes of scientific enquiry. I do not reckon "let all information regardless of truth, be put forward as truth".

That is abundantly clear from my own words and actions.

Yours is just a spurious insult.

Belligerent assertion is not proof.

There is no merit in continuing this conversation. Make of that what you will.

Tall_Allen profile image
Tall_Allen in reply to kaptank

I quoted your own words - there are quotation marks surrounding your own words - anyone can find them in your posts. I can provide quotes too from the conspiracy theorists, but I reckon you've already seen them.

"America has a science problem. We don’t understand the basic concepts of scientific methodology, the importance of admitting the limitations of models and experiments, or how to interpret results. These shortcomings are combined with our predisposed natural tendencies to seek patterns and cling to certainty over skepticism . . ." blairbellecurve.com/unknown...

kaptank profile image
kaptank in reply to cigafred

Amen to that!

Beautiful. A friend of mine with metastatic CRPCa told me that eating chicken causes prostate cancer. He chose no modern medical treatments and is now undergoing 40 days of radiation treatment (too late I'm afraid). He has lost a lot of weight. I believe he refuses all scans. Crazy. Yes, this is an anecdote... :)

Tall_Allen profile image
Tall_Allen in reply to tallguy2

Tragic!

Thank you👍