Tuesday, October 30, 2012

Psychosomatic Model fails in Cancer – again and again

Good gracious:

The Cancer to Health (C2H) intervention package is based on the assumption that psychological variables have clinically significant effects on physical health via the immune system. Despite the lack of support for this idea with respect to cancer, the idea remains highly attractive and resistant to rejection because it lends prestige to psychosomatic and behavioral medicine. …

Subtitling his commentary “To Light a Candle,” Kaufmann conceded that my colleagues and I had raised valid criticisms about the design and interpretation of the C2H intervention trial. However, he took issue with our recommendation that clinical trials of this kind be suspended until putative mechanisms could be established by which psychological variables could influence survival. Quoting our statement that an adequately powered trial would require “huge investments of time, money, and professional and patient resources,” he nonetheless called for dropping a “preoccupation with mechanisms and secondary aims,” and instead putting the resources to increasing the sample size and quality of an intervention trial.
Learn from psych*somatic medicine, never let a lack of putative mechanisms stop you! Psych*somatic medicine and homeopathic medicine seem to be made from the same cloth, both say "Trusst me, it works, just because!"

This PNI bunch really tries hard to take the woo-cake.
… If we compare this overall pattern of results to what was stated in the abstract, we see a gross confirmatory bias in the suppression of negative results and highlighting of positive ones. …

… Reviewers must have been swayed by the consistent confirmatory bias in presentation of the results of C2H. …

… PNI cancer researchers remain a self-congratulatory group with a strong confirmatory bias in their mutual citations of the field’s claimed successes. Judging by citation patterns in the incestuous journal Brain, Behavior, and Immunity, one can readily get the impression that there are never any negative studies in the PNI cancer literature.

The articles reporting results for the C2H trial continue to be highly cited, with little apparent effect of our criticism. With a lack of other positive trials that can be cited, particular importance in the PNI literature has been attached to the claims that C2H extend survival of cancer patients. There is apparently little concern about conveying unrealistic expectations to patients concerning effects of psychosocial intervention on their immune system, and these claims fit with patents’ impressions and motivations for going to peer support groups and group therapy.

Cancer patients sometimes faced difficult choices about medical interventions to manage their disease. It is unfortunate if they are provided with misinformation that all they need to do is get stress management interventions to slow progression and extend their survival. Belief that these interventions are effective can discourage them from committing themselves to more effective, but painful, fatiguing, and disfiguring medical interventions.
I guess I have to add "psychoneuroimmunological (PNI) interventions" to my dictionary of woo.

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