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Posted by on Oct 18, 2013 in Health, Medicine, Pseudoscience, Science, Teaching | 12 comments

Acupuncture, Steve Jobs, & the Placebo Effect

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.

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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.

Wasting over 1.6 billion taxpayer dollars since 1999!

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”.

She is way too happy about those needles getting stuck into her.

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.

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  • http://www.skepticink.com/incredulous Edward Clint

    Sad about Jobs’s choices. I understand he was phobic about invasive methods. This lead him to find “alternatives” more attractive than he might have otherwise. That’s the tragedy of pseudoscience bunk- it can persuade people to to avoid real treatment even if that person thinks there’s the slimmest hope it’ll work.
    Very nice write-up.

  • Evelyn Stratmoen

    I have a friend who suffers from RA, and adheres to strict diets, juice fasts, and other alternative medicines to relieve the pain from the inflammation. What’s interesting to me is that 1) her doctor says it’s ok for her to do these things and 2) she says they work. I don’t have the heart to tell her that I think it’s the placebo effect at work, because if her perceived pain is lowered, then it’s lowered — she feels better. But that’s different than a growing tumor inside the human body.

    • http://www.caleblack.com/ Caleb W. Lack

      There are certain dietary changes a person can make to help regulate and decrease inflammation, so that might be quite useful. I’m pretty sure it doesn’t include juice fasts or CAM, though :(

  • RankingEffects

    Jobs is a great example of how people’s fears feed the alternative medicine industry. He was afraid of invasive treatment, but alternative medicine provided a means of circumventing this. Helping someone sidestep a fear of surgery when there’s a malignant tumor that’s entirely operable in their abdomen borders on predatory. Even though this decision was made by Jobs, I would find it hard to believe that no one suggested this, or reinforced it somehow. I wonder, how much did Jobs spend on these noninvasive treatments?

  • Ryan Danger McCall

    Over 40% of Americans use non-conventual medicines! That is crazy. It makes me wonder what the world would be like if people actually used proven and effective forms of treatment. People are just ignorant to what they see. People will believe anything if they think it may help or heal them. Of course these medicines and remedies are encouraged by people like Dr. Oz while actual treatments go unnoticed to the general public. The information is out there, people just need to look past the label and the shiny colors.

  • jaymacg

    I was surprised to read the statistic that nearly 40% of Americans use some sort of non-conventional medicine. However, after I thought about it, it seems pretty believable considering how main stream it has become. I am sure that many of those using the non-conventional forms of medicine didn’t even realize that they were using an alternative medicine. However, I did hear some radio show hosts discussing Steve Jobs and how his decision to attempt to treat his condition using alternative medicine may have cost him his life, so perhaps there is still some hope that people will figure out that this is nonsense.

  • IvyBrown

    It isn’t all that surprising that Jobs didn’t seek conventional medical treatment to improve his health. After all, he didn’t use a conventional strategy to improve Apple’s products either. (Case in point: iPods, which made Apple into the giant it is today.) He used an aggressive ad campaign which worked, while Jobs was alive, because Jobs himself was a dedicated, ingenious spin doctor. “How customers view a product,” he must have thought, “changes the product.” And if we expect the same old product to be completely different because of a few slick ads and minor actual changes to the product itself, then for many people the product does seem to be completely different. The nature of marketing—and let’s face it: Jobs was a master marketer—persuades customers to believe, irrationally, that a product will fulfill a need in our lives, a need that doesn’t actually exist. He was prey to a similar logic he used on customers. I don’t think his decision was an isolated, short lapse in judgment. His professional life was irrational as well. (Admission: I love Apple, irrationally. But at least I’m aware that it’s irrational)

  • Alexa Riffe

    The placebo effect and alternative medicines like acupunture really leave me on the fence. On one hand I am completely intrigued by the placebo effect and its results given to people by expectation alone. However on the other side, I cannot understand how someone would rely on alternative medicines as such to treat a major illness such as cancer, with no scientific proof at all?

  • pdavis13

    I know a lady who swears by alternative medicines and has tried to get me roped into it a billion times. She even goes as far as to project it on her dogs. True story, I was pet sitting for her for 2 weeks once and she left a good amount of alternatives for me to give to all 6 of her dogs. I proceeded to only give them actual prescribed medicines given by their doctor (don’t worry, I worked for a vet for over 4 years, I knew what I was doing) and left the alternative ones alone. When she returned she just raved about how well the dogs were doing and how much better they seemed to feel…what do you know, I wasn’t feeding the dogs all that junk! Disclaimer: I am a good pet sitter who will give your dogs the proper prescribed medications they need, but alternative, homeopathic junk is ridiculous!

  • shanshan1314

    As how palmistry works, it due to the placebo effect. There are a lot of things are due to the placebo effect, like people believe that dream analysis could cure the insigts of a person, like people believe that hypnothesis could really help people remember what they forgot. All of these are pseudoscience, all of these are not true.

  • tinafriar

    I knew that Jobs lived for several years with his disease but I knew nothing of his course of treatment. Having undergone cancer treatment myself, I totally understand not wanting to be cut open. I wrestled with that decision, but in the end I knew it was the best possible option for me and I am certain I would not still be here had I not allowed it. It saddens and amazes me that someone so brilliant let his fear and being persuaded by quacks very likely end his life far sooner than it had to.

  • dandymandyl

    It is really sad to know that a person who had the potential to do a lot more great things got sucked into the world of alternative medicine.

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