There is quite a bit of art to the practice of medicine: knowing how to get and to give information to a patient, how to create a sense of worry without creating a feeling of panic, how to use the best available science to help them maintain or return to health.  Underlying all of the art is the science: what blood pressure is likely to be harmful in a particular patient?  What can I offer to mitigate this harm?  This science is developed over years by observation and systematic study.  We have a very good idea of what blood pressure levels are optimal to prevent heart attacks in various populations.  These data are hard-won.  It has taken decades and it continues.

If a researcher were to discover a promising, new blood pressure intervention, they would have a long way to go from bench to bedside.  They would have to prove as well as possible that it is safe and effective—and from a science-based medicine perspective, that it is even plausible.  If the discovery is a drug that relaxes blood vessels, or a type of exercise, we have good reason to believe it might work and can go on to figuring out if it does work.  If the intervention is wearing plaid every day, we have little reason to think this would be effective, and it probably isn’t worth the time and cost of looking into it.

The well-respected journal Cancer has just wasted space in the study of wearing plaid.  Well, not really; it’s worse than that.  The article is called, “Complementary medicine for fatigue and cortisol variability in breast cancer survivors: A Randomized Controlled Trial.”  There is nothing that isn’t wrong with this study, and if it weren’t published in a major journal, it might even be light comedy.

Tragedy wins the day, however, because cancer is a big deal, and I don’t like it when people mess around with cancer.

People with cancer suffer from a number of vague and specific discomforts related to the disease and its treatment.  Everything from life-threatening blood clots, to intractable pain and nausea, to depression threaten to kill or disable people with cancer.  One symptom common to many illnesses is fatigue, and during chemotherapy, fatigue can be debilitating.  This new “study” allegedly investigates an intervention to alleviate fatigue.

Fatigue is one of those symptoms whose study can be difficult and deceptive.  It rarely has a single cause, is subjective, and waxes and wanes naturally.  Because of this natural variability, it is easy to attribute changes in fatigue to an intervention when if fact we may be observing the natural course of the symptom.  My patients with colds often want antibiotics.  Without antibiotics, their cold will likely last a week or two; with them, 7-14 days.  If I give them antibiotics, they will certainly credit me with curing their cold, but were I to take credit I would be riding nature’s coattails.

In the current study, the authors have chosen to ride the coattails of nature but rather than cling to them with medicine, they have chosen “biofield therapy”.  My spell checker doesn’t recognize “biofield” and neither should you.  The authors at least acknowledge this in passing:

Biofield therapies are complementary and integrative medicine modalities often used by breast cancer patients,
and have been described as therapies that are intended to affect energy fields that purportedly surround and penetrate the human body for the purposes of healing. (Emphasis mine, PalMD)

I have a big problem with studies built around something that only purportedly exists. What’s next, a study of cancer rates in Sasquatch?

This paragraph effectively nullifies everything that follows, but what follows is so horrid and humorous that we can’t just stop here.

The “biofield healing” technique chosen for the study?  ”Energy Chelation”.  It’s almost as if they looked for a term that took all of quackery and combined it into two simple words.  Nowhere does it tell us what sort of “energy” is being “chelated”; so I looked it up.

According to the study, the technique was chosen by one of the authors, Reverend Rosalyn L. Bruyere.  Is she an oncologist?  A physicist?

Rosalyn L. Bruyere is an internationally acclaimed healer, clairvoyant and medicine woman.

You don’t need to be a capital-S Skeptic to translate that as “con-artist”, although that would simply be an opinion.  The real question isn’t whether or not she is a con-artist (she may in fact be very sincere despite a website that makes her look like a cult leader) but why in the world any real physician or scientist would take such a person seriously?

Still, I want to know what the hell “energy chelation” is. It’s not an easy question to answer, but various searches describe it as a hands-on energy healing technique that, analogous to chelation therapy, “chelate” and remove negative energies from the body.  In other words, it’s a fantasy spun out of happy thoughts and a juvenile imagination.

The “science-y” bit of the study isn’t any better, relying of famously inaccurate “saliva cortisol” measurements, and something called “cortisol variability”, which does not appear to be a validated marker of the symptom in question (fatigue).  From my reading, I’m unclear that it’s ever been validated to measure anything.

For all I know, the editors of Cancer are detoxifying themselves in a sweat lodge to rid themselves of the embarrassment of publishing such dreck.  I just hope they remember to drink lots of water—faith healers do not have a great track record for patient safety.
References

Jain S, Pavlik D, Distefan J, Bruyere RR, Acer J, Garcia R, Coulter I, Ives J, Roesch SC, Jonas W, & Mills PJ (2011). Complementary medicine for fatigue and cortisol variability in breast cancer survivors: A Randomized Controlled Trial. Cancer PMID: 21823103

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