whether Ernst is incapable of distinguishing having homoeopathic treatment
from having no treatment. He and many of his fellow aspiring skeptics have
made that mistake in the past, and evidently it's on this basis that Ernst
is now prepared to state that anybody who, in his totally uninformed
opinion, has delayed treatment by the methods he supports has had
homoeopathic treatment—and therefore has delayed because of homoeopathy.
Using as it does the exact standard of evidence that supports the
conclusion that vaccinations wiped out anything you care to name—that is,
proof by unsupported anecdotal generalisation—it's an unbeatable argument!
:-)
But let's be even more charitable than Shannon suggests, and assume that
Ernst has factual inside knowledge that Steve Jobs, after his nine-month
delay in doing anything insignificant, obtained homoeopathic treatment.
What does Jobs's survival for seven years [1] say in those circumstances?
According to <
http://cancer.emedtv.com/pancreatic-cancer/pancreatic-cancer-survival-rates-p2.html>,
the five-year relative rate [2] of surviving pancreatic cancer discovered
before spreading even to lymph nodes is just 16.4 per cent, and the
five-year relative rate of surviving it if it's discovered after it
has metastasised (as it had definitely by nine months after diagnosis and
most likely even before diagnosis [3]) is just 1.8 per cent [4].
If those survival rates are correct and relevant, then we can draw two
conclusions.
(1) On the basis of the more likely scenario—that the tumour had
metastasised to the liver by the time of his diagnosis—Jobs's prognosis,
statistically speaking, was a 98.2% chance of dying by early 2009 of the
cancer. Yet he outlived that five years by a further two and a half
years. It's not possible to conclude on the basis of such evidence that
Jobs would "probably" have lived longer had he been operated on sooner.
The available evidence suggests that the vast majority of people—who do not
take the unusual measures Jobs initially did of avoiding surgery and using
lifestyle changes to support his overall health—do not survive for five
years. Eighty percent do not even survive one year [5]. Therefore if
Jobs's choice to delay surgery and to adopt the lifestyle changes that
Ernst ignorantly calls "homoeopathy" in fact had any effect on his
survival, they would seem to have extended it by more than six and a half
years.
(2) On the basis of the less likely scenario—that the tumour had not
metastasised by the time of diagnosis—Jobs's statistical prognosis was a
16.4% chance of surviving to early 2009 [4]. That is, 83.6% of people
diagnosed before metastasis to the liver do not survive that long. Jobs
survived two and a half years longer. Again, even if there were some way
of knowing that diagnosis preceded metastasis, it would not be possible to
conclude that Jobs would "probably" have lived longer.
Clearly Ernst's studied ignorance of the difference between refusing or
delaying surgery and having homoeopathic treatment is compounded by a
woeful ignorance of pancreatic cancer survival rates under the best
allopathic treatment, even if he does enjoy unique access, unavailable to
all other investigators, to knowledge of Steve Jobs's exact selections of
lifestyle and alternative treatment in the first nine months following
diagnosis.
John
[1] David Gorski calculates eight years. Presumably the diagnosis was made
in early 2004 and Jobs lived closer to eight than to seven years further.
[2] This is higher than the (absolute) five-year survival rate for
pancreatic cancer because it takes into account that the five-year survival
rate of those without cancer is not 100%.
[3] Even the anti-alternative David Gorski honestly admits that, in a
slow-moving illness such as this, the very presence, at the time of his
pancreatic operation, of visible liver metastases indicates a high
probability that small metastases were already present nine months earlier.
"on the other hand, chances are very good that those liver metastases were
there nine months before. Insulinomas tend not to grow so fast that they
can progress from micrometastases to metastases visible to the surgeons in
that short a period of time. So, while on the surface this revelation
would seem to the average lay person to indicate that Jobs' delay very well
might have killed him, in reality, thanks to lead time
bias<http://www.sciencebasedmedicine.org/index.php/the-early-detection-of-cancer-and-improved-survival-more-complicated-than-most-people-think/>,
it probably means that his fate was sealed by the time he was diagnosed…
"Just yesterday, a pediatrician named Michele
Berman<http://www.celebritydiagnosis.com/'>speculating How
alternative medicine may have killed
Jobs<http://www.kevinmd.com/blog/2011/10/alternative-medicine-killed-steve-jobs.html>.
The article basically consists of many of the same oncologically
unsophisticated arguments that I complained about right after Jobs' death,
some of which are included in another blog post on Celebrity
Diagnosis<http://www.celebritydiagnosis.com/2011/10/steve-jobs-cancer-timeline-and-eating-disorder-an-infographic/>.
Clearly, an education in lead time
bias<http://www.sciencebasedmedicine.org/index.php/the-early-detection-of-cancer-and-improved-survival-more-complicated-than-most-people-think/>is
required… chances are that surgery right after his diagnosis probably
wouldn't have saved Jobs…
"Although it's no doubt counterintuitive to most readers (and obviously to
Dr. Berman as well), finding liver metastases at the time of Jobs' first
operation strongly suggests this conclusion because it indicates that those
metastases were almost certainly present nine months before… At the time
of his diagnosis and during the nine months afterward during which he tried
woo instead of medicine, it was entirely reasonable to be concerned that
the delay was endangering his life, because it might have been. It was
impossible to know until later—and, quite frankly, not even then—whether
Jobs' [*sic*] delaying surgery contributed to his death."
<http://www.sciencebasedmedicine.org/index.php/one-more-thing/>
[4] <
http://cancer.emedtv.com/pancreatic-cancer/pancreatic-cancer-survival-rates-p2.html
>
[5] According to the American Cancer Society, for all stages of pancreatic
cancer combined, the one-year relative survival rate is 20%, and the
five-year rate is 4%. <
http://www.pancreatic.org/site/c.htJYJ8MPIwE/b.891917/k.5123/Prognosis_of_Pancreatic_Cancer.htm
>
On 17 December 2011 01:42, Shannon Nelson <shannonnelson@tds.net> wrote:
> Interesting--and wow, you have done your research!
>
> Vendetta seems like a very plausible possibility--but would he
> deliberately lie to achieve it? (Well, I guess people do that...)
> Another possibility is that he's among the fundamentally clueless, to
> whom everything non-mainstream is part of "homeopathy," even the
> "diet, spiritualists and macrobiotics — "roots and vegetables". I
> guess that would be the more charitable conclusion. How sad!
>
>
>
> On Dec 16, 2011, at 5:32 AM, healthyinfo6@aol.com wrote:
>
> >
> > Edzard Ernst, considered the "first professor of complementary
> > medicine", is claiming,
> >
> > Steve Jobs was likely a victim of homeopathy, expert tells
> > Australian conference
> >
> http://www.nypost.com/p/news/international/steve_jobs_was_likely_victim_conference_UsflbUtE2MZpFr9py0rJXP#ixzz1ggVZEewU
> > My first thought was this is odd since the full details of Jobs
> > alternative medical treatment haven't been disclosed.
> >
> > It has been reported that Jobs delayed possible life saving surgery
> > for nine months to pursue alternative treatments and there has been
> > much discussion whether the delay would have made any difference in
> > outcome. Some reports say his cancer, a neuroendocrine tumor, that
> > affects the cells that make hormones like insulin. was found very
> > early due to an unrelated CAT scan and would have been curable if he
> > didn't wait to operate. Other reports say that cancer already has
> > spread. Jobs didn't want to be "opened up". Jobs spent $100,000 to
> > have his DNA sequenced to seek specific treatments that might have
> > been genetically beneficial for his type of pancreatic cancer and
> > subsequent liver metastases. Jobs had access to the best
> > alternative medical advice. It is also has been discussed whether
> > his celebrity status got him an early liver transplant bypassing
> > normal wait times. It would be highly unlikely that Jobs solely, if
> > actually, used homeopathy and if so, from a classical homeopath.
> >
> > No other mainstream, alternative, complementary source specifically
> > implicated homeopathy with Jobs' death.
> >
> > Andrew Weil doesn't mention homeopathy
> http://www.cnn.com/2011/10/27/opinion/weil-steve-jobs/index.html
> >
> > David Gorski, surgical oncologist, researched Jobs' treatment
> > doesn't mention homeopathy and he checked through the post-death
> > release of Jobs' biography. Jobs had a famous personal biographer,
> > Walter Isaacson, follow him to ensure his life story was properly
> > and honestly told.
> >
> > http://www.sciencebasedmedicine.org/index.php/one-more-thing/
> >
> > No mention of homeopathy by Walter Isaacson on a 60 Minutes TV
> > interview recently http://www.cbsnews.com/video/watch/?id=7385688n
> >
> > Another, no mention of homeopathy
> http://gawker.com/5851835/steve-jobs-regretted-wasting-time-on-alternative-medicine
> >
> > Scientific American, no mention of homeopathy
> http://www.scientificamerican.com/article.cfm?id=alternative-medicine-extend-abbreviate-steve-jobs-life
> >
> > NY Times, again no mention of homeopathy
> http://www.nytimes.com/2011/11/01/health/hindsight-is-kind-to-steve-jobss-decision-to-delay-surgery.html?_r=1
> >
> > Again, no mention of homeopathy but other treatments Jobs used.
> http://www.ajc.com/opinion/smart-people-dumb-choices-1249315.html
> >
> > Instead, according to Isaacson, Jobs opted for a combination of
> > diet, spiritualists and macrobiotics — "roots and vegetables" — and
> > waited nine months to begin treatment in earnest. By then, Isaacson
> > said, the cancer had spread from Jobs' pancreas to the surrounding
> > tissue. Jobs explained, "I didn't want my body to be opened. ... I
> > didn't want to be violated in that way." Isaacson concludes with the
> > question: "How could such a smart man do such a stupid thing?"
> >
> >
> > Not familiar with Edzard Ernst, my Googling shows he founded the
> > Complementary Medicine Dep't of at University of Exeter England and
> > after being accused of breaching a confidence by negatively
> > commenting on a British CAM report before it was officially
> > released, commissioned by Prince Charles, was then found innocent,
> > he feels he was treated as persona non grata, funding for his dep't
> > ceased and he took early retirement in 2011. The Lancet editor wrote,
> >
> > "Professor Ernst seems to have broken every professional code of
> > scientific behaviour by disclosing correspondence referring to a
> > document that is in the process of being reviewed and revised prior
> > to publication. This breach of confidence is to be deplored."
> >
> > Ernst wrote "Should We Maintain an Open Mind about Homeopathy?"
> > highly critical of it.
> >
> > Is it possible Edzard Ernst has a vendetta against homeopathy?
> >
> > Jobs is considered a god-like visionary figure behind Apple and
> > having homeopathy associated with his death, if not actualy true,
> > should not be allowed to go unchallenged.
> >
> > The sound bite-like publicity alone is damaging to homeopathy as the
> > public reads these headlines propagated through many news services.
> >
> > Even if this were true, one would have to look at who gave him
> > homeopathic remedies, what their background is, whether
> > professionally trained/certified, lay or claiming to be a homeopath
> > or using homeopathy as part of other alternative treatments.
> >
> > Susan
> >
> >
> >
> >
> > Steve Jobs was likely a victim of homeopathy, expert tells
> > Australian conference
> >
> http://www.nypost.com/p/news/international/steve_jobs_was_likely_victim_conference_UsflbUtE2MZpFr9py0rJXP#ixzz1ggVZEewU
> > My first thought was this is odd since the full details of Jobs
> > alternative medical treatment haven't been disclosed.
> >
> > It has been reported that Jobs delayed possible life saving surgery
> > for nine months to pursue alternative treatments and there has been
> > much discussion whether the delay would have made any difference in
> > outcome. Some reports say his cancer, a neuroendocrine tumor, that
> > affects the cells that make hormones like insulin. was found very
> > early due to an unrelated CAT scan and would have been curable if he
> > didn't wait to operate. Other reports say that cancer already has
> > spread. Jobs didn't want to be "opened up". Jobs spent $100,000 to
> > have his DNA sequenced to seek specific treatments that might have
> > been genetically beneficial for his type of pancreatic cancer and
> > subsequent liver metastases. Jobs had access to the best
> > alternative medical advice. It is also has been discussed whether
> > his celebrity status got him an early liver transplant bypassing
> > normal wait times. It would be highly unlikely that Jobs solely, if
> > actually, used homeopathy and if so, from a classical homeopath.
> >
> > No other mainstream, alternative, complementary source specifically
> > implicated homeopathy with Jobs' death.
> >
> > Andrew Weil doesn't mention homeopathy
> http://www.cnn.com/2011/10/27/opinion/weil-steve-jobs/index.html
> >
> > David Gorski, surgical oncologist, researched Jobs' treatment
> > doesn't mention homeopathy and he checked through the post-death
> > release of Jobs' biography. Jobs had a famous personal biographer,
> > Walter Isaacson, follow him to ensure his life story was properly
> > and honestly told.
> >
> > http://www.sciencebasedmedicine.org/index.php/one-more-thing/
> >
> > No mention of homeopathy by Walter Isaacson on a 60 Minutes TV
> > interview recently http://www.cbsnews.com/video/watch/?id=7385688n
> >
> > Another, no mention of homeopathy
> http://gawker.com/5851835/steve-jobs-regretted-wasting-time-on-alternative-medicine
> >
> > Scientific American, no mention of homeopathy
> http://www.scientificamerican.com/article.cfm?id=alternative-medicine-extend-abbreviate-steve-jobs-life
> >
> > NY Times, again no mention of homeopathy
> http://www.nytimes.com/2011/11/01/health/hindsight-is-kind-to-steve-jobss-decision-to-delay-surgery.html?_r=1
> >
> > Again, no mention of homeopathy but other treatments Jobs used.
> http://www.ajc.com/opinion/smart-people-dumb-choices-1249315.html
> >
> > Instead, according to Isaacson, Jobs opted for a combination of
> > diet, spiritualists and macrobiotics — "roots and vegetables" — and
> > waited nine months to begin treatment in earnest. By then, Isaacson
> > said, the cancer had spread from Jobs' pancreas to the surrounding
> > tissue. Jobs explained, "I didn't want my body to be opened. ... I
> > didn't want to be violated in that way." Isaacson concludes with the
> > question: "How could such a smart man do such a stupid thing?"
> >
> >
> > Not familiar with Edzard Ernst, my Googling shows he founded the
> > Complementary Medicine Dep't of at University of Exeter England and
> > after being accused of breaching a confidence by negatively
> > commenting on a British CAM report before it was officially
> > released, commissioned by Prince Charles, was then found innocent,
> > he feels he was treated as persona non grata, funding for his dep't
> > ceased and he took early retirement in 2011. The Lancet editor wrote,
> >
> > "Professor Ernst seems to have broken every professional code of
> > scientific behaviour by disclosing correspondence referring to a
> > document that is in the process of being reviewed and revised prior
> > to publication. This breach of confidence is to be deplored."
> >
> > Ernst wrote "Should We Maintain an Open Mind about Homeopathy?"
> > highly critical of it.
> >
> > Is it possible Edzard Ernst has a vendetta against homeopathy?
> >
> > Jobs is considered a god-like visionary figure behind Apple and
> > having homeopathy associated with his death, if not actualy true,
> > should not be allowed to go unchallenged.
> >
> > The sound bite-like publicity alone is damaging to homeopathy as the
> > public reads these headlines propagated through many news services.
> >
> > Even if this were true, one would have to look at who gave him
> > homeopathic remedies, what their background is, whether
> > professionally trained/certified, lay or claiming to be a homeopath
> > or using homeopathy as part of other alternative treatments.
> >
> > Susan
> >
> > _______________________________________________
> > Homeopathy Mailing List
> > homeopathy@homeolist.com
> > http://lists.homeolist.com/mailman/listinfo/homeopathy
>
> _______________________________________________
> Homeopathy Mailing List
> homeopathy@homeolist.com
> http://lists.homeolist.com/mailman/listinfo/homeopathy
>
--
"And if care became the ethical basis of citizenship? Our parliaments,
guided by such ideas, would be very different places."
—Paul Ginsborg, *Democracy: Crisis and Renewal*, London: Profile, 2008.
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