This post is part of a series of guest posts on GPS by the undergraduate and graduate students in my Science vs. Pseudoscience course. As part of their work for the course, each student had to demonstrate mastery of the skill of “Educating the Public about Pseudoscience.” To that end, each student has to prepare two 1,000ish word posts on a particular pseudoscience topic, as well as run a booth on-campus to help reach people physically about the topic.
Acupuncture, Steve Jobs, & the Placebo Effect by Stephanie Menotti
The latest biography publication from Walter Isaacson, Steve Jobs, offers up new and relatively tragic details about the illness that hit Steve Jobs, long-time Apple guru. Jobs had a rare form of pancreatic cancer known as neuroendocrine cancer which was first diagnosed in the fall of 2003 and took his life in 2011. Although most forms of pancreatic cancer have an extremely low survival rate (< 3%) due to the fact that they are normally diagnosed after the disease has already spread, Jobs lived for a whopping eight years after diagnosis. This is not an uncommon occurrence: people with this form of the disease live for months or even years after the initial diagnosis. This is due largely to the fact that a pancreatic neuroendocrine tumor is slow growing and easier to treat when compared to the more aggressive forms of pancreatic cancer in existence. The tumor that affected Jobs could have arguably been treated with a positive prognosis through the utilization of scientific methods and tested medical procedures.
Many of the details that have surfaced through the publication of Jobs’ biography suggest that he intentionally resisted the modern scientific treatments (that many professionals believe could have saved his life) in favor of “alternative diets” and “mysticism”. In Isaacson’s own words:
To the horror of his friends and wife, Jobs decided not to have surgery to remove the tumor, which was the only accepted medical approach. ‘I really didn’t want to open up my body, so I tried to see if a few other things would work,’ he told me years later with a hint of regret. Specifically, he kept a strict vegan diet, with large quantities of fresh carrot and fruit juices. To that regimen he added acupuncture, a variety of herbal remedies, and occasionally a few other treatments he found on the internet or by consulting people around the country including a psychic. For a while he was under the sway of a doctor who operated a natural healing clinic in southern California that stressed the use of organic herbs, juice fasts, frequent bowel cleansings, hydrotherapy, and the expression of all things negative.
So why are such “alternative” practices in medicine a pervasive part of our modern, scientifically-rich society if they don’t have empirical evidence in line to provide support their claims? In fact, according to the not-really-verified-yet-looks-fantastically-legitimate National Center for Complementary and Alternative Medicine (NCCAM) nearly 40% of Americans use non-conventional approaches of medicine to treat specific conditions or overall well-being. The problem lies within the context of anecdotal evidence and a possible placebo-effect. When a person begins utilizing methods that are not necessarily endorsed by reason and logic (or verified by scientific testing), one of the most common ways of perpetuating such a belief is by falling prey to the all-powerful confirmation bias. For example, if I participate in acupuncture to relieve a recurring pain, I would have certain expectations in mind that I would like to see as potential outcomes. Mainly, some relief from the chronic pain. Due to this mindset and set of expectations, it is very likely that I would see or feel some improvement in my ailment (due to the placebo-effect and not necessarily due to the fact that acupuncture is legitimate) and then I will spread the word to all of my friends about how great I feel and how well acupuncture works.
According to this article about acupuncture found in the New England Journal of Medicine,
…the most recent well powered clinical trials of acupuncture for chronic low back pain showed that sham acupuncture was as effective as real acupuncture. The simplest explanation of such findings is that the specific therapeutic effects of acupuncture, if present, are small, whereas its clinically relevant benefits are mostly attributable to contextual and psychosocial factors, such as patients’ beliefs and expectations, attention from the acupuncturist, and highly focused, spatially directed attention on the part of the patient.
To the lay person, the conclusion found in this article directly implies that while it may not be the case that acupuncture is as effective as the sham acupuncture, the placebo-effect found in this treatment is just as effective and should therefore justify the continued utilization of such treatments.
There is an obvious controversy within the scientific community between those that support the justification of using alternative medicine for the sake of riding the wave of positive placebo-effects, and those that believe that using these forms of pseudo-scientific practices are unethical and stray too far from the creed of evidence-based practice. Although one could argue the fact that there are a few interspersed articles relating placebo-effect and acupuncture to positive therapeutic outcomes, the evidence still exposes the underlying truth: “there is no important placebo-effect”.
After researching acupuncture in relation to the placebo-effect, it is very apparent that much of the so-called “research” that has been put into investigating this alternative is being used solely and primarily as a form of propaganda to fuel the NCCAM and that agenda. Any reasonable individual would realize that asking a patient to come in for a specific treatment (such as acupuncture) with the full knowledge that the specific treatment doesn’t work except for maybe the possibility of experiencing the effects created by psychosocial factors outside of anyone’s control, is unethical and rather naïve. Why would I want to pay money to visit an individual that is no different than myself, to get a magical treatment of placebo-effect? Or better yet, why would I want to pay for a non-treatment? Society should be on guard, because improper use of such a practice could lead directly to spontaneous human combustion (but not really!).
Obviously, Steve Jobs was a very highly intelligent and charismatic individual, and he experienced a level of success that will be his legacy well into any foreseeable future. He was a grown man, able to rationally and soundly make his own decisions. Imagine, however, how much more he could have contributed to our technological innovations and the advancement of our society had he heeded the advice of his doctors and scientific professionals and agreed to the simple surgery that could have saved his life and mitigated the awful effects of his liver transplant. Personally, I find his brilliance to be wasted on such an obvious logical lapse in judgment, and I hold the propaganda perpetuated by CAM as the perpetrating source.