I’ve been wanting to start to dig into cancer pseudoscience for a long time, and in my other pieces, I’ve really only scratched the surface. But with the rampant headlines about Elle MacPherson, now is the perfect time to really start to get into it.
As an immunologist who works in immunotherapy, including cancer, misinformation and pseudoscience about cancer is not only frustrating on a professional level, but it is EXTREMELY dangerous.
If you missed it, Elle did a serious of interviews recently where she claimed that she ignored evidence-based guidance on cancer treatment and instead used “intuitive and holistic methods” including naturopathy and chiropractic when she was diagnosed with breast cancer in 2017, and credits that to why she is doing well 7 years later.
She said, verbatim:
Saying no to standard medical solutions was the hardest thing I’ve ever done in my life. But saying no to my own inner sense would have been even harder.
Conveniently, Elle MacPherson left out the standard medical solution, a lumpectomy, from her tall tale about “alternative” cancer treatments saving her life.
A lumpectomy, also called breast conserving surgery, is a surgical procedure that is done to remove a cancerous tumor within the breast while sparing as much healthy breast tissue as possible. Usually, healthy tissue is removed around the tumor to ensure clean margins.
We now know that Elle had HER2-positive and estrogen-receptor positive DCIS. Ductal carcinoma in situ (DCIS) is sometimes termed stage 0 cancer; it’s non-invasive breast cancer that originates in epithelial cells in milk ducts, and is considered the earliest stage of breast cancer. It means the cancerous cells are fully contained within the milk duct and have not left the duct and invaded neighboring breast tissue.
In the US, oncologists may recommend radiation and/or hormonal immunotherapy to reduce the risk of recurrence after lumpectomy (in the chance residual cancer cells have taken residence in other areas of the breast). Radiation is recommended in other countries like UK and Australia, but particularly if the tumor was small, it is not automatically part of standard treatment. In other countries, including many European countries, Japan, and elsewhere, radiation is advised only under certain circumstances, for example, if DCIS was large (3-5 cm) or diffuse.
The universal recommendation following DCIS lumpectomy is regular mammograms and imaging, which allows for detection of recurrence (discussed here).
Lumpectomy is often curative in the case of DCIS, accounting for about 20-25% of breast cancer diagnoses since the advent of mammography (read here).
Lumpectomy can be curative in some early stage invasive breast cancers, such as invasive ductal carcinoma (IDC), particularly when the tumor is small (less than 5 cm), located in one region of the breast, has not invaded the lymph nodes (or has only been detected in a few local lymph nodes), and surgery can allow for clean margins. These criteria are often met with stage 1 and stage 2 IDC cases. (IDC accounts for 70-80% of breast cancer diagnoses). Lumpectomy may also be curative in some instances of early stage invasive lobular cancer (ILC).
While radiation is often recommended after lumpectomy, this is a risk mitigation measure. Lumpectomy in combination with radiation has similar prognoses to mastectomy (removal of the entire breast plus surrounding lymph nodes and tissue). In some cases, particularly with hormone receptor-positive cancers, lumpectomy/radiation leads to improved outcomes compared to mastectomy.
Lumpectomy alone is quite effective in these instances. 15 years after diagnosis with DCIS, lumpectomy-only patients had 97.3% survival rate, compared to 98% survival with adjuvant radiation.
Dietary supplements are unregulated, untested, and lack safety oversight. They also lack evidence to support their use and many can be harmful. The supplement industry is a predatory for-profit conglomerate that undermines science-based medicine.
But this underscores the biggest issue of the Elle MacPherson story:
Coincidentally, around the time she was diagnosed with breast cancer in 2017, she started dating the OG of the anti-vaccine movement, Andrew Wakefield (read more here). She endorsed his anti-science rhetoric, which he outright fabricated for personal gain. She has a long history of undermining science, the consequences of which harm individual and collective health.
Why should we all care about this? Why does it matter what Elle MacPherson chose to do or say?
Amplifying and legitimizing cancer misinformation leads to fatal consequences.
The most harmful claims in the cancer pseudoscience sphere relate to unproven and ineffective treatments. If people forgo evidence-based interventions in favor of alternative treatments, they have worse outcomes, increased risk of death, and poorer prognoses.
Celebrities like Elle have global platforms with massive reach. This reach is augmented when media outlets pick up these stories and circulate them further (see Bella Hadid and Lyme misinformation). The fact that Elle deliberately omitted the conventional procedure that actually played a role in her cancer survival while touting the “alternatives” that did not is reckless, dangerous, and irresponsible.
Who’s to say people won’t see her story and think these ineffective methods are sufficient to treat THEIR cancer?
This is why I care about misinformation. This is why I care about celebrities being amplified when spewing lies. Because it costs people their health and their lives.
No matter the cancer type, prompt intervention after detection is critical to improve survival. The longer a cancer can progress without intervention, the higher the chances are that cancer grows or spreads in a way that makes treatments less effective.
When assessing 4 types of cancers, lung, breast, colorectal, and prostate, patients who relied on unproven therapies had a 2.5-fold greater risk of death within five years compared to those who opted for standard treatments.
Breast cancer patients had a 5.7-fold increased risk of death when using alternative treatments as opposed to conventional cancer treatments. 5-year survival plummeted to 58.1% compared to 86.6% for conventional treatments.
Colorectal cancer patients had a 4.5-fold increased risk of death when opting for alternative treatments. 5-years survival dropped to 32.7% compared to 79.4% for conventional treatments.
Lung cancer patients had a 2.2-fold increased risk of death. 5-year survival dropped to 19.9% compared to 41.3% when using conventional therapies.
Yes, it needs to be said plainly: forgoing science-based treatments for serious illnesses causes people to die unnecessarily.
These beliefs exploit the appeal to nature fallacy and medical conspiracism. Patients who opt for alternative treatments are less likely to use conventional treatments in conjunction, worsening health outcomes. They delay proven treatments until cancers progress to more severe disease, reducing treatment options. 34% of the alternative medicine group refused any sort of chemotherapeutic, compared to 3% of those receiving conventional treatments.
Alkaline diets, dietary supplements (including intravenous vitamin C, herbal remedies, megadose vitamins, “detox” blends), homeopathy, chiropractic, ozone therapy, coffee enemas, rigid dietary interventions, and more. Not only do these have no have evidence, many can pose serious risks to cancer patients (and the general population).
Elevating celebrities who spout pseudoscience harms everyone.
I’m sure it doesn’t surprise you that Elle MacPherson is getting ready to sell a memoir, which will be filled with accurate statements (sarcasm, if you couldn’t tell). Unfortunately, celebrities frequently use completely unqualified and uncredentialed “practitioners” as care providers, giving the appearance that people like chiropractors, naturopaths, and homeopaths are legitimate clinicians.
Dr. Andrea Love, a microbiologist and immunologist, provides the facts (and the data!) on science and health topics. Follow Andrea on Twitter @dr_andrealove
A version of this article was originally posted at Immunologic and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article.
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