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Posted Friday, October 23, 2009 11:32 AM

BREAKING: Health Author Suzanne Somers Mostly Wrong About Science, Medicine

Patrice Wingert

It’s the book every medical writer in the country wants to ignore. Suzanne Somers’s latest “health” tome hit the bookstores this week, and this time she's offering her advice on how to cure and prevent cancer. As if people with cancer don’t have enough problems. When the review copy arrived, we decided to give it a once-over—so you don’t have to.

The gist of Somers’s argument is that conventional cancer treatments—surgery, radiation, chemotherapy—take a destructive approach and that chemo, in particular, is overused. Long an advocate of alternative therapies, Somers argues that it makes more sense to build up the body to fight cancer than it does to tear it down through radiation and chemicals. She is particularly enamored of nutritional “cures.”

Of course, Somers has had no formal medical or scientific training, but considers herself an authority—in part because she’s survived breast cancer after choosing not to have chemotherapy, and because she’s a regular on the alternative-medicine circuit.  This book, like her others, consists mainly of transcripts of her conversations with various alternative-medicine doctors, as well as lots of details about her own experiences and prevention regimen, which she has spelled out many times before, most notably on Oprah  earlier this year. It’s noteworthy that her promotion of the book began by publicly blaming Patrick Swayze’s recent death on chemotherapy, rather than his pancreatic cancer. (She has since apologized to his family.)      

Cancer is a highly emotional topic, particularly since the war on cancer isn’t going particularly well. As my colleague Sharon Begley recently put it, “Cancer is on track to kill 565,650 people in the United States this year—more than 1,500 a day, equivalent to three jumbo jets crashing and killing everyone aboard 365 days a year.”  The fact is that  modern medicine is far from understanding everything we need to know about cancer, and the most effective treatments available often come with nasty side effects. We all wish there were more effective and less toxic options, and we need to stay open-minded about new discoveries and alternatives. Maybe some of the doctors Somers interviewed in her book will eventually prove to be on to something.

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But there is a big difference between staying open-minded and tossing aside treatments that have been proven effective after rigorous testing in favor of new “natural” therapies that have undergone much flimsier scrutiny. If you’re someone who needs answers now, and want to make health decisions based on solid scientific findings rather than wishful thinking, there’s not much in Somers’s latest book to help you. The basic problem with the book, says Dr. Otis Brawley, the American Cancer Society’s chief medical officer, “is that it’s really inaccurate” when it describes the science behind current treatments  and lacks a basic understanding of the scientific method. Not all research findings are equally authoritative. Just because something sounds good doesn’t mean it works. “Some people confuse what they believe with what they know," Brawley said. 

Even if some patients are cancer-free after following a certain treatment plan, that doesn’t prove that it was the treatment that cured them, especially if no control group was used for comparison. “We’re finding that about 25 to 30 percent of some cancers stop growing at some point,” Brawley says. ”That can make some treatments look good that aren’t doing anything.” Until doctors figure out how to identify which patients have cancers that won’t progress, he said, the only option is to treat everyone.   

Somers relies heavily on patient testimonials, but any scientist knows that  talking only to those who benefited from a treatment can give less than objective results. A case in point: she lavishes praise on the research of Dr. Nicholas Gonzalez, who uses a combination of enzymes, massive amounts of nutritional supplements (130 to 175 a day—yes, you read that right), a strict diet, and daily coffee enemas, which he says can cure pancreatic cancer. However, just about two months before Somers’s book was published, the Journal of Clinical Oncology  published the results of a controlled observational trial of Gonzalez’s protocol vs. chemotherapy for patients with inoperable pancreatic cancer. The study was funded by the National Cancer Institute and enrolled 55 patients who met strict clinical criteria. A year into the study, 56 percent of those using chemotherapy were still alive, compared with only 16 percent of those who chose the enzyme therapy. In other words,  those who picked chemo over the alternative treatment lived three times as long. Interestingly, the study was concluded in 2005, yet Somers doesn’t mention this in the book.

Somers also shines the spotlight on  Dr. Stanislaw Burzynski of Houston, whose controversial cancer treatments have resulted in years of battles with the FDA and the courts. Over the past 30 years, despite government investment, he has failed to provide compelling data that his expensive treatments work. More recently he expanded his research efforts into anti-wrinkle creams. (Side note: it is more than a little ironic that Somers is touting the work of Burzynski, who synthesizes peptides from human urine to create what he says is a cancer cure. In the books she’s written about hormones, Somers has expressed nothing but disdain for FDA-approved hormones synthesized from horse urine.)

Another treatment that gets the sign of approval from Somers is mistletoe extract, which is a popular treatment in Germany, and which she credits with keeping her cancer-free for years. There are some intriguing studies, but good science requires looking at all the studies, not just the ones that support your opinion. When German scientists published a review of the data on mistletoe as a cancer treatment in 2008, they found that the evidence was “weak.” Other reviews have concluded that there were quality problems with many of the studies and that more research is necessary.

Not all the recommendations Somers makes in the book raise eyebrows. She says eating healthy and exercising, reducing stress, and getting a good night's sleep may reduce the risk of cancer. That's true, but it's not news. She’s right that not every woman with stage I breast cancer needs chemo. Few doctors would argue. In fact, they have the technology to calculate the size of the likely benefit, and agree that sometimes it’s quite small.  Most doctors offer it as a choice to women who want to do everything possible to prevent cancer’s return.

“And she’s right when she says that only some leukemias, lymphomas, and testicular cancers can be cured with chemotherapy,” Brawley says. “We admit that many conventional treatments are not as beneficial as we would like. But that doesn’t dismiss evidence that screenings have reduced the death rates of breast and colon cancer, or that the lives of other patients with cancer can be saved with early treatment or that chemo prolongs lives. Even in cases of stage IV breast cancer, or lung or prostate or colon cancer, when the cancer has spread throughout the body and particularly into the bone, we can’t cure people with chemotherapy, but we can prolong life and increase their quality of life. In her book, Somers completely rejects the idea that chemotherapy has any of these benefits.”

When I interviewed Somers earlier this year, she said that she gets irritated when the media identify her as the former ditsy blonde from the TV sitcom Three’s Company. She would rather be identified as an author; after all, she’s written 18 books, most on the topics of weight loss (even though she’s admitted to Larry King that she’s used liposuction) and hormones (she recommends treatments most hormone specialists and oncologists describe as potentially risky.)

For her next book, we’d like to suggest a topic she knows very well: media manipulation. You have to love the fact that the only blurb on the back of the book (“Ms. Somers writes with the passion of the prophet”—Wall Street Journal) comes from a review trashing an earlier book. Somers’s real specialty is understanding that when a celebrity writes a controversial book, it doesn’t matter how much mainstream doctors and serious researchers attack it, or whether people’s health is put at risk. Attacks bring publicity, and publicity sells books. Here’s hoping that this time the public proves her wrong.

Wingert is a NEWSWEEK correspondent and  the coauthor of  The Menopause Book.


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Member Comments

Posted By: MemeMime (January 2, 2010 at 5:53 PM)

To a large degree, her latest books (Breakthrough, and now Knockout) address a gap of ignorance- physician ignorance of data already available regarding treatment options, and ignorance of patients as a result of physicians failing to communicate options and other relevant pieces of information.  Providing “alternatives” to those who seek more options than the conventional “standard of care” addresses the gap in a way that laypeople can understand and take charge of their own health.  Anyone who 1) has been misdiagnosed, 2) was neglected treatment for an underlying medical disease (had signs, symptoms, and lab results indicative of disease, yet received neither the information of such disease state nor treatment for it), or 3) dealt with side effects from treating chronic conditions and wondered if there was an option with less sting can relate to this, as can cancer patients.  Patients need options and information in order to take better care of themselves, yet the current standard of care restricts options and downplays the effectiveness of treatments (sometimes nonconventional/nutritional, sometimes pharmaceutical).

A case in point: 2009 estimates show 192,280 would be diagnosed with prostate cancer, and about 27,360 would die from it.  Current standard of care involves radiation, chemotherapy, surgery, & hormone blockade (antiandrogens &/or gonadotrophs of various types), among other therapies.  With the exception of surgery, many of these contribute to anemia, which is frequent among cancer patients.  Left untreated, anemia itself reduces survival rate.  Of particular interest is the relationship multiple studies have noted between anemia and angiogenesis, the growth of new blood vessels.  Tumors often employ new blood vessels to spread and grow, and anemia provides conditions (low oxygen, increase VEGF [for angiogenesis]) for such growth.  Despite the wealth of studies documenting this relationship between anemia and worsened cancer prognosis, doctors are slow to address anemia in cancer patients (especially in older cancer patients, as anemia is almost expected).  Admittedly, 1) some of the treatment options for anemia (like EPO/Procrit) are expensive, and 2) carry their own risks of adverse effects, yet these are concerns that the patient deserves to weigh for himself.  Physicians’ ignorance confines men to acquiesce to suffering, thus worsening the overall outcome of the patient.

Medical ignorance of scientific studies is not confined to footnotes of certain types of cancers; it is extensive throughout other fields of medicine.  In the branch of endocrinology, doctors frequently do not understand, e.g., basics of testosterone replacement, including frequency and quantity of dosage, how larger doses tend to entail more side effects, and such side effects can be avoided or minimized with other methods of administration &/or dosing schedule.  Often, there is ignorance of clinical guidelines, including a) the American Association of Clinical Endocrinologists Guidelines for Hypogonadism, & b) the Endocrine Society’s guidelines.  Research continues at an alarming rate, yet if physicians cannot keep up to date with 5 year old recommendations in endocrinology, how will they keep pace with more recent developments in oncology?

Moreover, patients can access these guidelines via their respective websites, in addition to related studies via pubmed and other publicly accessible sites, so why don’t doctors know this info, too?

Despite this example and others which would chronicle physicians failing to translate studies to real world application, I doubt these problems arise from malice on the part of physicians.  Severe time restraints govern what a doctor can check (as the average time a doctor has with a patient is 15 min), as well as what a doctor can schedule to read in medical journals.  

Which brings me to my two points: 1) though a physician’s judgment is undoubtedly necessary for the individual patient, that judgment can be and often is greatly skewed by ignorance of studies in their relevant fields; and 2) there is a corpus of knowledge (studies) above the doctor which undergoes peer review.  Some studies explore innovative treatment that is not yet FDA approved, some studies explore the expansion of FDA treatments to conditions not yet approved, and some seek to verify prevailing ideas (and occasional myths) in medicine.  An informed patient should be allowed access to treatments beyond the usual standard of care when access to additional means offers some therapeutic usefulness, as documented by a large number of studies.  An informed patient should be permitted access by his doctor when he presents relevant studies to his doctor, with significant sections highlighted, indicated, and clearly cited.  Some patients have found this method effective in getting initially reluctant physicians to explore additional routes of treatment, whereas many (including myself) have not.  Unfortunately, knowledge is not enough to move the gatekeeper to unlock the potential therapy.

Studies are not infallible- thus, not every study merits being shown to one’s doctor to pursue a different therapy.  It is true that a) not all studies are well designed (both for nutritional therapies and pharmaceutical therapies), b) for every study there seems to be a counter study, and c) some “alternative therapies” have been shown to be ineffective and/or unsafe.  It is also true that some pharmaceuticals have been approved on the basis of iffy studies, a surprising lack of studies, or have bogus contributors, as recent exposes on medical ghostwriting have shown.  These are problems that affect both “conventional” and “alternative” medicine.  Approving therapies apart from scientific analysis is problematic, but this problem is not exclusive to alternative medicine.


Posted By: MemeMime (January 2, 2010 at 5:51 PM)

Suzanne Somers integrates her own experience, the anecdotes of others, the success of particular doctors in addressing specific diseases, and the collective knowledge available via published research.  Her last two books point to references that prove the claims she makes about particular therapies.  

Regarding chemo, Dr. Brawley makes broad brushed statements that have little usefulness.  “Extending life” by 10 months via chemo is not necessarily a noteworthy feat in certain cancers, especially slow progressing cancers that would allow a person to live longer independent of such treatment.  Depending on the circumstances of prostate cancer, “watchful waiting” may be more appropriate than medical intervention.  This could both extend the lifespan &/or the quality of life for the patient.

The quality of life issue requires definition, as chemo can improve sense of well-being if it reduces tumor size in the lungs, for example, *without* a cumulative worsening of patient health and functionality.  The patient needs to know options to compare against in order to evaluate the safest, most effective, and most appropriate option, whereby he or she can decide what constitutes “acceptable loss”.

*The author of this review misses the point of Somers’ opposition to Premarin, which is derived from horse urine.  On page 137 of Knockout, Suzanne stipulates her contention with Premarin, noting that it is not administered in a cyclical fashion (hence, “not mimicking nature”), and is not compatible/interchangeable with human female estrogen.  In her previous book, Breakthrough, she noted the cruelty involved in the process of extracting Premarin’s ingredients from mares, not the fact that the hormone originated from urine itself (as does pharmaceutical hCG).  Combining info from Breakthrough with that obtained from other sources, one can see that Premarin 1) contains estrogens not found in humans (equilin and equilenin), which raises issues of compatibility,potency, and duration of effects compared to human female estrogens, 2) lacks estradiol and estriol, which are major human estrogens (though estrone can convert to either of these estrogens), 3) may play a significant role in cancer development via estrone, which is another long-lived estrogen and quite potent, and 4) does not match the proportions of the 3 major estrogens found in human females.  

Somers’ repeats the mantra that “natural is better” with regard to replacing missing or deficient biochemical products with (bio)identical products, whether those are obtained through naturopaths or mainstream doctors.  Though perhaps limited in scope, the recommendation is useful, as depression does not indicate a “Prozac deficiency” or even a “Premarin deficiency”, but may in fact reveal an estradiol deficiency.  Sometimes, the deficient hormone or biological product itself is safer and works better than the synthetic alternative.

Space limits what can be said about these issues, but the author has demonstrated more of a condescending attitude than a fair and balanced review.  One must question how extensively she read the book she seeks to criticize.


Posted By: lovelife4ever (December 30, 2009 at 7:09 PM)

People that bash alternative medicine should spend a little time learning and researching before criticizing people that are better researched. Most cancers are caused by lack of oxygen to the cell.  Look up Nobel Peace Prize Dr. Otto Warburg...Most cancer cells die when given oxygen.  Most alternative cancer therapies are based on getting oxygen to the cells and helping your NK (Natural Killer) cells to identify and kill the cancer.  This isn't quackery...In my opinion quackery is continuing to prescribe chemo therapy to patients with pancreas cancer when there is no case of it ever curing anyone.  

Has anyone ever noticed that the people that usually beat cancer, aids and other life threatening illnesses are usually rich and or famous?  Perhaps Suzanne Somers is connected with those people more so than the lay person is and is giving us a gift.  If I understand her message it is to research all of the options before blindly taking conventional thinking.  Remember, conventional thinking only cures 2.5% of cancer cases.  Is there a grade you can give low enough to reflect 2.5% success?

Further, some of the doctors that have been quoted and interviewed were sued for their quackery and lost in federal courts.  They had to prove their science and still are considered quacks even though their science has been proven to work in many cases and are still practicing.  If they couldn't prove their science they would have lost their medical licenses.  Mocking what you don't understand isn't going to help rid the planet of this hideous disease.