It’s A Miracle!

February 16th, 2006 by Ben Goldacre in alternative medicine, bad science, independent | 47 Comments »

Here’s a funny thing. I wrote the post below, at the beginning of the year, about how Jeremy Laurance, the Health Editor of the Independent, had apparently conjured a “miracle cancer cure” story out of thin air, but I didn’t publish it onto the blog in the end, because:

a) I couldn’t be bothered to attack alternative therapy nonsense at the time (it was a phase I went through)

b) for all I knew Jeremy Laurance might have gone to the study’s authors and got some kind of personal on-the-phone quote that explained his bonkers riff into miracle cures.

But then, whilst idly following it up and throwing a few emails around the place, it was pointedly pointed out to me that I was right, and that the actual authors of the study that this story purports to be about have written in to the Independent to complain about the misrepresentation.

They performed a study on long term radiotherapy follow-up, and how occasionally people with cancer survive longer than predicted. Somehow, and I have no idea how, the Independent’s health editor turned this into Scientists Have Proved Miracle Cures Do Work. Note: subsequent events appearing below suggest it was not he who was responsible.

Anyway, here’s my original piece, and their letter at the bottom. The lesson is, trust your instincts kids…

{begins}

Ok, I don’t want to drag you away from the much more interesting stuff that’s happening over here where everybody’s having fun bashing postmodernist nonsense about science, but if you can spare the time, help me out, because I’m sure there must be something I’m missing.

Below, I’ve pasted a news article from today’s Independent, titled “‘Miracle’ cures shown to work”. It opens with the sentence “Doctors have found statistical evidence that alternative treatments such as special diets, herbal potions and faith healing can cure apparently terminal illness, but they remain unsure about the reasons.”

Then after that, I’ve given you the abstract for the academic journal article that this newspaper article is apparently about. It has nothing to say about miracle cures. Seriously, I’ve got an open mind on this one, I don’t think I can be bothered to write about it in the column, but just for my own interest, or my own sanity: there must be something I’m missing here? There must be an extra source, a press release, maybe an interview, or a thought, a twist of mind, a mental leap that draws the connection, something that was cut out by the subs, maybe, anything to connect this paper in the journal “Cancer” about 5 year survival in cancer patients treated with radiotherapy, to this Independent article, which suggests it is about the radiotherapy article, but seems to be about miracle cures. Anyone? I’m open to suggestions.

It’s just puzzling me.

news.independent.co.uk/uk/health_medical/article340393.ece

‘Miracle’ cures shown to work
By Jeremy Laurance, Health Editor
Published: 23 January 2006

Dcotors have found statistical evidence that alternative treatments such as special diets, herbal potions and faith healing can cure apparently terminal illness, but they remain unsure about the reasons.

A study of patients with incurable lung cancer who were given weeks to live and received only low-dose radiotherapy to make their final weeks more comfortable found a small number recovered completely.

Researchers who followed 2,337 patients whose disease was too advanced for curative treatment found that 25 had survived five years and 18 had achieved “an apparent cure”. They appeared to have been cured by treatment that “would not normally be considered to have any curative potential whatsoever”.

The researchers, led by Michael MacManus, a consultant radiation oncologist in Melbourne, say: “Our data indicate that a chance for prolonged survival and possibly even cure exists for approximately 1 per cent of patients with non small cell lung cancer who receive palliative radiotherapy.

“It is important that the frequency of this phenomenon should be appreciated so that claims of apparent cure by novel treatment strategies or even by unconventional medicine or ‘faith healing’ can be seen in an appropriate context.”

Unorthodox cancer cures have included vitamin C, laetrile extracted from apricot stones, and the Gershon diet of raw vegetables.

The discovery of a small group of patients who unexpectedly recovered could yield new insights into the disease, the researchers say.

The findings are published in the online edition of Cancer, the journal of the American Cancer Society.

Unexpected long-term survival after low-dose palliative radiotherapy for nonsmall cell lung cancer

Cancer
Published Online: 23 Jan 2006
Michael P. Mac Manus, M.D. 1 *, Jane P. Matthews, Ph.D. 2, Morikatsu Wada 4, Andrew Wirth 1, Valentina Worotniuk 3, David L. Ball, M.D. 1
*Correspondence to Michael P. Mac Manus, Consultant Radiation Oncologist, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett Street, Victoria 3000, Australia
Fax: (011) 613-9656-1424

Copyright © 2006 American Cancer Society

Keywords
nonsmall cell lung cancer • survival analysis • radiation therapy • cure

Abstract

BACKGROUND
Many experienced oncologists have encountered patients with proven nonsmall cell lung cancer (NCLC) who received modest doses of palliative radiotherapy (RT) and who unexpectedly survived for > 5 years; some were apparently cured. We used a very large prospective database to estimate the frequency of this phenomenon and to look for correlative prognostic factors.

METHODS
Patients with histologically or cytologically proven NSCLC, treated with palliative RT to a dose of 36 Gy, were identified from a prospective database containing details of 3035 new patients registered from 1984-1990.

RESULTS
An estimated 1.1% (95% confidence interval, 0.7-1.6%) of 2337 palliative RT patients survived for 5 or more years after commencement of RT, including 18 patients who survived progression-free for 5 years. Estimated median survival was 4.6 months. Five-year survivors had significantly better Eastern Cooperative Oncology Group performance status at presentation than non-5-year survivors (P = 0.024) and were less likely to have distant metastases (P = 0.020). RT dose did not appear to be a significant prognostic factor. Patients who survived 5 years without progression had an estimated 78% probability of remaining free from progression in the next 5years.

CONCLUSIONS
Approximately 1% of patients with proven NSCLC survived for > 5 years after palliative RT, and many of these patients appeared to have been cured by a treatment usually considered to be without curative potential. Because of the potential for long-term survival, doses to late-reacting normal tissues should be kept within tolerance when prescribing palliative RT in NSCLC.
Received: 31 May 2005; Revised: 31 August 2005; Accepted: 29 September 2005

Their Letter:

Sir,

On 23 January you published a piece entitled” ‘Miracle’ cures shown to work”. The article described the findings of a scientific paper published in the journal Cancer. I was the first author of that publication.

Your report stated that our paper showed that “Doctors have found statistical evidence that alternative treatments such as special diets, herbal potions and faith healing can cure apparently terminal illness, but they remain unsure about the reasons.” This is absolutely untrue and a gross misrepresentation of our findings.

We suggested that the patients might have tumours that were unusually sensitive to radiation but our paper contains nothing to suggest that any patients were cured by therapies such as “vitamin C, laetrile extracted from apricot stones, or the Gershon diet of raw vegetables”. The Independent article has been widely quoted to give support to such therapies when it contains nothing to support them.

MICHAEL MAC MANUS
ASSOCIATE PROFESSOR
PETER MACCALLAM
CANCER INSTITUTE
EAST MELBOURNE, VICTORIA,
AUSTRALIA


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47 Responses



  1. Ben Goldacre said,

    February 16, 2006 at 2:11 am

    Heh, I just checked the link to the Independent article, but it’s dead, they’ve wiped the article from history.

    I’d have thought a more appropriate correction would be to leave it there with the letter from MacManus attached, so that the people who are claiming this as evidence for miracle cures (let me know if you spot any) will at least know they were misled when they read it in the first place.

    Meanwhile, from the Science Museum’s pages on MMR and the Media:

    www.sciencemuseum.org.uk/antenna/mmr/cip1/122.asp

    Attention span

    It’s a journalist’s job to keep the viewer’s, listener’s or reader’s attention. One editor told us what makes a good story.

    ‘Health stories in the newspapers tend to focus on “miracle cures” or “deadly scares”. Editors are always looking for a sensational story. That’s what sells papers.’
    Jeremy Laurance, Health Editor, The Independent

    Sometimes I crack myself up.

  2. pv said,

    February 16, 2006 at 7:44 am

    “Editors are always looking for a sensational story. That’s what sells papers.”

    It’s a pity that truthfulness and accuracy aren’t requisites for a published story.

  3. RS said,

    February 16, 2006 at 8:20 am

    So he saw that the paper found some people were cured by therapy that wasn’t expected to work (palliative radiotherapy), and perhaps also saw that quote (if he didn’t make it up) about the frequency of this effect being useful in examining the claims of faith healers – and then just riffed on it to provide a lovely little alternative therapy fluff piece. Prat.

  4. Teek said,

    February 16, 2006 at 9:47 am

    laurance is guilty of a serious misrepresentation of the scientists’ publication, and as such could be sued.

    what a total pillock – 1% of patients with NCLC recover after a dose of radiotherapy that doesn’t normally cure. so, children, shall we conclude that these patients’ tumours are unduly sensitive to supposedly palliative treatment, and that they benefit from low-dose radiation whilse others don’t, or shall we conclude that vit C, Gershon or magic fairy dust cured these lucky individuals…?!

    grrrr, makes me mad that an experienced, well-respected journalist would write such a crock of crap in an internationally-read and trusted newspaper.

    prat indeed.

    *takes a deep breath, wipes brow, calms down and gets off soapbox*

  5. Squander Two said,

    February 16, 2006 at 10:57 am

    > perhaps also saw that quote (if he didn’t make it up) about the frequency of this effect being useful in examining the claims of faith healers

    Oh, he definitely saw that. Trouble is, he took it to mean the exact opposite of what it really meant. There’s probably a lesson to be learnt here. Scientists should learn to talk in a way that assumes that no-one listening understands the implications of what they say. Spell it out.

  6. C. Augusto Valdés said,

    February 16, 2006 at 11:55 am

    that’s so irresponsible, I can already listen to quacks quoting from that article in the labels of their snake oil jars, conveniently leaving the 1.1% figure out. Jeez, that’s why I don’t play lotto in the first place…

  7. Varda said,

    February 16, 2006 at 12:09 pm

    People seem to be suggesting there might be a quote or an aside elsewhere in the paper that somehow justifies Jeremy Laurance’s “Miracle Cures” article. I have read the entire paper (it’s my field) and there is not. Here is the whole paper, it takes up a lot of room, but I think it’s important that people can see there is nothing whatsoever to even suggest where The Independent got this crazy idea from. Scroll past if you don’t want to read it. You can search in your browser for words like “faith” or “herbal”. They do not feature.

    Original Article
    Unexpected long-term survival after low-dose palliative radiotherapy for nonsmall cell lung cancer
    Michael P. Mac Manus, M.D. 1 *, Jane P. Matthews, Ph.D. 2, Morikatsu Wada 4, Andrew Wirth 1, Valentina Worotniuk 3, David L. Ball, M.D. 1
    1Department of Radiation Oncology, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
    2Center for Biostatistics and Clinical Trials, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
    3Patient Record Information Department, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
    4Department of Radiation Oncology, Austin and Repatriation Medical Center, Melbourne, Victoria, Australia

    *Correspondence to Michael P. Mac Manus, Consultant Radiation Oncologist, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett Street, Victoria 3000, Australia
    Fax: (011) 613-9656-1424

    Keywords
    nonsmall cell lung cancer • survival analysis • radiation therapy • cure

    Abstract
    Abstract MATERIALS AND METHODS RESULTS DISCUSSION References

    BACKGROUND
    Many experienced oncologists have encountered patients with proven nonsmall cell lung cancer (NCLC) who received modest doses of palliative radiotherapy (RT) and who unexpectedly survived for > 5 years; some were apparently cured. We used a very large prospective database to estimate the frequency of this phenomenon and to look for correlative prognostic factors.

    METHODS
    Patients with histologically or cytologically proven NSCLC, treated with palliative RT to a dose of 36 Gy, were identified from a prospective database containing details of 3035 new patients registered from 1984-1990.

    RESULTS
    An estimated 1.1% (95% confidence interval, 0.7-1.6%) of 2337 palliative RT patients survived for 5 or more years after commencement of RT, including 18 patients who survived progression-free for 5 years. Estimated median survival was 4.6 months. Five-year survivors had significantly better Eastern Cooperative Oncology Group performance status at presentation than non-5-year survivors (P = 0.024) and were less likely to have distant metastases (P = 0.020). RT dose did not appear to be a significant prognostic factor. Patients who survived 5 years without progression had an estimated 78% probability of remaining free from progression in the next 5years.

    CONCLUSIONS
    Approximately 1% of patients with proven NSCLC survived for > 5 years after palliative RT, and many of these patients appeared to have been cured by a treatment usually considered to be without curative potential. Because of the potential for long-term survival, doses to late-reacting normal tissues should be kept within tolerance when prescribing palliative RT in NSCLC.
    Received: 31 May 2005; Revised: 31 August 2005; Accepted: 29 September 2005

    Article Text

    With the exception of the significant subgroup of patients with good performance status, minimal or absent weight loss, and disease suitable for inclusion within a high-dose radiation therapy (radiotherapy [RT]) target volume,[1] patients with unresectable nonsmall cell lung cancer (NSCLC) are usually considered to have incurable disease.[2] Patients with advanced NSCLC are candidates for a variety of management approaches, including initial chemotherapy[3][4] and/or RT,[5][6] or supportive care.[7] Despite the well known dismal prognosis for such advanced disease,[8] experienced radiation oncologists will have encountered patients treated with relatively low doses of RT, with purely palliative intent, who return to the clinic year after year without evidence of disease progression. A proportion of these patients appear to have been cured by treatment that would not normally be considered to have any curative potential whatsoever. There is very little information on this phenomenon in the literature, and it is, therefore, difficult to say with any certainty how frequently it occurs.

    In this study, we have used a very large prospective database to identify patients with NSCLC who were treated with RT with palliative intent to a dose 36 Gy. Our aims were to determine what proportion of palliatively treated patients experienced prolonged survival and, by investigating their survival beyond 5 years, to study the possibility that some of these patients had been cured. We analyzed the well known prognostic factors for survival in NSCLC and sought features that may predict unexpectedly long survival with low-dose RT. Characteristics of survivors were compared with those of nonsurvivors. We believe that these patients are important because an understanding of the mechanisms underlying their prolonged survival could be invaluable in the development of novel treatment strategies.

    MATERIALS AND METHODS
    Abstract MATERIALS AND METHODS RESULTS DISCUSSION References

    Lung Database

    A lung cancer database was established at the Peter MacCallum Cancer Center (Peter Mac) in 1984. Peter Mac is a large tertiary referral center, serving the state of Victoria. Information collected on all new patients with lung cancer included demographic data, details of symptoms at presentation, paraneoplastic syndromes, initial extent of disease, prognostic factors including weight loss and performance status, and a range of radiation treatment factors including radiation dose, fractionation, and overall treatment time. Between January 1984 and March 1990, data were collected on 3035 new patients with NSCLC.

    Because the international staging system was undergoing revision at the time the database was established and during the study period, detailed clinical TNM staging information was not initially collected on all patients, but disease was classified as locoregional or metastatic.

    Treatment Policy

    During the study period, almost all patients who had symptomatic unresectable NSCLC, and were unsuitable for radical high-dose RT, were offered treatment with palliative RT. Radical RT (50-60 Gy in 2 Gy fractions) was offered to patients with Stage I-IIIB disease with medically or surgically inoperable NSCLC who had loss of 36 Gy; however, planned doses were available for only a small (nonrandom) subset of patients (including the patients who were known to have survived 5 yrs). Instead, patients were considered eligible if they were recorded in the database as having completed RT with 36 Gy, or if they had not completed RT but had received 36 Gy with fraction sizes > 2.5 Gy. Patients who had been prescribed a radical RT dose ( 40 Gy) but who had failed to complete RT were included in our analysis of results of radical RT, which have been described in a separate report.[11]

    Data Collection and Analysis

    During the study period, detailed information on each new NSCLC patient seen at Peter Mac was collected prospectively, entered into the database, and updated frequently during a patient’s clinical course. After RT, patients were closely monitored in the clinic with regular physical examinations and chest radiographs. Inquiries were made to the family physicians of patients who had not been seen in clinic for more than 12 months to collect information on relapse and mortality. Further information was subsequently obtained from medical case notes of patients identified as 5-year survivors from the database, using a standardized data collection form. Results of staging investigations and pathology reports were used to retrospectively assign patients to clinical or pathologic stages according to the 1997 update of the international TNM classification.[12] The RT treatment record was consulted to record acute toxicities of RT.

    The data were analyzed with a close-out (study censor) date of November 29, 2003. Only 4 (0.2%) of the 2297 NSCLC patients were lost before this date, 3 patients in the first 6 months after RT and 1 patient 9.2 years after commencing RT. The estimated median duration of potential follow-up from the date of commencement of RT to the close-out date was 19.3 years.[13] Survival has been measured from the date of commencement of RT until the date of death, regardless of cause. Patients who were lost to follow-up before the close-out date had their survival data censored at the date of last contact. Patients who were alive at the close-out date had their survival data censored at that date. Time to progression has been measured from the date of commencement of RT until the date of progression. Patients who died without progression before the close-out date had their time to progression censored at their date of death. Patients who were lost to follow-up before the close-out date had their time to progression censored at the date of last contact if they were progression-free at the time. Patients who were alive and progression-free at the close-out date had their time to progression censored at that date. Two patients for whom the progression status was unknown at the time of death had their times to progression censored backward to the last date at which the patient was known to be progression-free. One patient with a missing history was excluded from the study of time to progression. Estimates of overall survival and freedom from progression were made using the Kaplan-Meier method.[14]

    To compare characteristics of 5-year survivors and nonsurvivors, each patient who was lost to follow-up before 5 years was classified as a 5-year survivor if, given their observed survival time, their conditional probability of surviving 5 years was greater than 0.5, that is if the patient was more likely to have been a 5-year survivor than not. Characteristics of 5-year survivors were compared with those of nonsurvivors using exact statistical tests: the Fisher exact test for binomial data (gender, weight loss, etc.), the Cochran-Armitage test for trend for ordinal data (performance status), the chi-square test for contingency tables for categorical data (histologic groups), and the Pitman permutation test for continuous data (age, RT dose).

    Given the absence of data on planned RT dose, it was not possible to look at the prognostic significance of this factor. There is a potential bias in studying the prognostic significance of the actual RT dose because patients who died before completing their RT could possibly have received smaller doses than those who survived long enough to complete their RT. All patients who completed RT did so within 68 days of commencing RT. Thus, to study the prognostic significance of the actual RT dose given, a landmark analysis was performed, restricting attention to the 1671 patients who survived at least 68 days after commencing RT.

    Ninety-five percent confidence intervals (95% CI) have been given for the main results. Statistical analyses were carried out using S-PLUS 2000 (MathSoft, Seattle, WA), StatXact 6.0 (CYTEL Software Corporation, Cambridge, MA), and SPSS 11.0.1 (SPSS Inc., Chicago, IL) software.

    RESULTS
    Abstract MATERIALS AND METHODS RESULTS DISCUSSION References

    Overall, 3035 (74%) of 4123 patients in the database were coded as NSCLC patients. Of these, 2337 (77% of 3035) received palliative RT after presentation at Peter Mac. The dose received was 36 Gy for 2308 (99%) of these 2337 patients. Of 2308 patients who received 36 Gy, 2172 (94% of 2308) were recorded as completing RT and were, thus, eligible for the study. Of 2308 patients who received 10%b
    No 1672 1.1 0.7-1.8
    Yes 549 0.9 0.4-2.2 0.81
    Performance statusc
    0 75 5.3 2.0-13
    1 905 1.2 0.7-2.2
    2 600 0.5 0.2-1.5
    3 299 1.0 0.3-3.1
    4 90 0.0 0.0-3.9 0.024
    Age, yrs
    10% weight loss.
    c Excludes 328 patients with unknown performance status.
    d Excludes 1 patient with missing SVCO status.

    Given the absence of data on planned RT dose, it was not possible to look at the prognostic significance of this factor. The prognostic significance of the RT dose given was studied in a landmark analysis, restricting attention to 1671 patients who survived at least 68 days after commencing RT. Five-year survivors received significantly higher doses than non-5-year survivors (P = 0.046). However, differences were not significant after adjusting for either performance status (P = 0.11, Pitman permutation test stratified by performance status) or for the presence of distant metastases (P = 0.11, Pitman permutation test stratified by the presence or absence of distant metastases).

    There was no evidence of excessive acute toxicity in the 5-year survivors; the only acute toxicities of > Grade 1 were 1 case of Radiation Therapy Oncology Group (RTOG) Grade 3 and 3 cases of RTOG Grade 2 esophageal toxicity (Table 2).

    Table 2. Characteristics of 5-Year Survivors
    Patient no. Site treated Dosage Stage Histology Basis
    1 Upper lobe 20 Gy 5 fx I SCC Bronchoscopy
    2 Upper Lobe 20 Gy 5 fx I SCC Bronchoscopy
    3 Lung 20 Gy 5 fx I Large cell Bronchoscopy
    4 Upper lobe 20 Gy 5 fx I SCC Sputum cytology
    5 Upper lobe 20 Gy 5 fx IIA SCC Bronchoscopy
    6 Lower lobe 20 Gy 5 fx IIIA SCC Bronchscopy
    7 Upper lobe scf 20 Gy 5 fx IIIB Large cell Needle biopsy
    8 Lower lobe 20 Gy 5 fx IIIB SCC Open biopsy
    9 Lower lobe 20 Gy 5 fx IIIB Adeno Open biopsy
    10 Lumbar spine 20 Gy 5 fx IV Large cell Rib excision + sputum
    11 Brain 24 Gy 6 fx IV Adeno Open biopsy
    12 Brain 24 Gy 6 fx IV Large cell Previous surgery
    13 Middle lobe 28 Gy 10 fx IIIA SCC Bonchoscopy
    14 Middle lobe 30 Gy 10 fx I Large cell Sputum cytology
    15 Lower lobe 30 Gy 10 fx II Adeno Washings & sputum
    16 Abdomen rp mass 30 Gy 10 fx IV Large cell Laparotomy biopsy
    17 Upper lobe 36 Gy 12 fx IIIA SCC Sputum cytology
    18 Upper lobe 36 Gy 12 fx pIIIA Adeno Mediastinal biopsy
    19 Upper lobe 36 Gy 12 fx IIIA SCC Needle biopsy
    20 Upper lobe 36 Gy 12 fx IIIA SCC Bronchoscopy
    21 Upper lobe 36 Gy 12 fx IIIA SCC Needle biopsy
    22 Lower lobe 36 Gy 12 fx IIIB SCC Bronchial washings
    23 Upper lobe 36 Gy 12 fx IIIA Adeno Open biopsy
    scf: supraclavicular fossa; fx: fractions; SCC: squamous carcinoma; adeno: adenocarcinoma; rp: retroperitoneal.

    Long-Term Survival and Freedom from Progression

    Of 24 known 5-year survivors, an estimated 32% (95% CI, 17-53%) survived another 5 years. One had no information available with respect to time to progression; 2 had experienced locoregional progression; and 3 had experienced systemic disease progression within 5 years of commencing RT. The 2 with locoregional progression died 1.3 and 5.8 years after progressing, and the 3 with systemic disease progression died 1.3, 4.8, and 6.9 years after progressing. Of the remaining 18 patients who were free from progression (FFP) at 5 years, only 3 patients were known to have experienced disease progression within the next 5 years, in all 3 cases because of locoregional disease. These patients all died within 1 year of progression. No further patients were known to have progressed before the study close-out date. For patients who had survived for 5 years without progression, the estimated probability of surviving for another 5 years was 43% (95% CI, 23-66%), and the estimated probability of remaining FFP for the next 5 years was 78% (95% CI, 48-93%) (Fig. 2).

    Figure 2. Long-term survival and freedom from disease progression.
    [Normal View 14K | Magnified View 34K]

    The only significant late toxicities recorded were 3 cases of Grade 2 pulmonary toxicity; 1 case of mitral regurgitation; 1 case with aortic stenosis, congestive cardiac failure, left anterior descending coronary artery stenosis, and aortic regurgitation; and 1 case with an abscess in the tumor site. All but 1 of these cases were treated to 30-36 Gy.

    DISCUSSION
    Abstract MATERIALS AND METHODS RESULTS DISCUSSION References

    Our data indicate that a chance for prolonged survival and possibly even cure exists for approximately 1% of patients with NSCLC who receive palliative RT. This is a very small proportion, but lung cancer is a very common malignancy. It is important that the frequency of this phenomenon should be appreciated, so that claims of apparent cure by novel treatment strategies or even by unconventional medicine or faith healing can be seen in an appropriate context. All patients in this study had histologic or cytologic diagnoses of NSCLC in an appropriate clinical context. It is possible that errors could have been made in diagnosis in a proportion of cases, but it is very unlikely that all of the cases were misdiagnoses. In many of these patients, biopsy specimens were generous, including some surgical cases. It is well known that conventional cytologic or histopathologic tumor morphology is, by itself, a poor predictor of treatment response in NSCLC. The phenomenon reported here is potentially an important one, in that a subset of patients with NSCLC appears to have disease that is curable with minimal therapy and that prospective identification of such patients could potentially profoundly influence treatment.

    There is one other large published series showing prolonged survival after palliative RT. Quddus and colleagues from Edinburgh[15] reported on a series of more than 4000 patients, 70% of whom had histologic or cytologic evidence of NSCLC. They reported that 5-year survival was 1.3% and suggested that 1% of patients might be cured. These results are strikingly similar to our own. When Satoh et al. reported that 3.5% of 195 patients with Stage IIIA-IV NSCLC treated with platinum-containing chemotherapy survived for at least 3 years and that 3 (1.5%) patients survived for at least 5 years, they suggested that a small proportion of such patients might be cured by appropriate therapy.[16] It is noteworthy that 10 of the 14 patients in that series who survived for at least 3 years had received additional local therapy with RT or surgery. These results are very similar to our own results with low-dose RT alone. The appropriate therapy for attaining this small proportion of 5-year survivors with the least toxicity may be palliative RT. In another study of long-term survival after platinum-based chemotherapy for NSCLC, Sculier et al. described the outcome for 1052 patients with advanced unresectable NSCLC treated with platinum-based chemotherapy in 7 clinical trials.[17] In that series, 1.8% survived for 5 years and, interestingly, all of the survivors had received complementary chest irradiation and/or surgery. It is possible that such long-term survival may require administration of an effective local treatment, as in the case of solitary brain metastasis[18] and may even be independent of chemotherapy.

    We have been unable to identify any common features among survivors in our patients that could account for their unusually long survival. Spontaneous regression is exceedingly rare in lung cancer.[19][20] We have no information on psychological status of these patients, but limited evidence in the literature suggests that pretreatment optimism or pessimism is unlikely to influence survival.[21] There is no evidence that our patients had abnormally high intrinsic radiosensitivity of normal tissues, which could be associated with enhanced tumor response.[22] Several patients experienced disease progression in the second 5 years after treatment and might have had slowly proliferating tumors. For such prolonged survival to occur in our patients, distant metastases either must not have been present, or they were oligometastases (extrathoracic metastases) that were contained within treatment fields. It is well known that a proportion of patients with NSCLC who have solitary metastasis to the brain[23] or adrenal glands[24][25] may be cured by resecting both the metastasis and primary tumor, and it is possible that this phenomenon could also occur with RT to both primary tumors and metastases if the disease is unusually radiosensitive.

    In this study, prolonged survival was associated with a treatment that was given to relieve symptoms, and we do not mean to suggest that lower doses of RT should be used when cure is the intention of treatment. There is randomized evidence of a benefit from higher RT doses in terms of local control.[26] Randomized studies show, however, that radical RT is associated with improved survival when enhanced by platinum-based chemotherapy[27] or given as continuous hyperfractionated RT (CHART).[28] Both the randomized British Medical Research Council study[5] and our own nonrandomized study[9] suggest that there may be a survival benefit associated with use of a higher rather than a lower dose of RT for palliatively treated patients.

    In conclusion, our data show that close to 1% of patients with NSCLC have prolonged survival with doses of palliative RT that would not normally be considered sufficient for long-term disease control. When prescribing hypofractionated palliative RT for NSCLC, radiation oncologists should be aware of the potential for long-term survival and keep doses to late-reacting normal tissues within tolerance. We do not have an explanation for this phenomenon but believe that these patients have tumors that are both unusually radiosensitive and have a low tendency to produce blood-borne metastasis. Further studies of the biology of these tumors may provide valuable information.

    References
    Abstract MATERIALS AND METHODS RESULTS DISCUSSION References
    1 Penland SK, Socinski MA. Management of unresectable stage III non-small cell lung cancer: the role of combined chemoradiation. Semin Radiat Oncol. 2004; 14: 326-334. Links
    2 Hoegler D. Radiotherapy for palliation of symptoms in incurable cancer. Curr Probl Cancer. 1997; 21: 129-183. Links
    3 Cullen MH, Billingham LJ, Woodroffe CM, et al. Mitomycin, ifosfamide, and cisplatin in unresectable non-small-cell lung cancer: effects on survival and quality of life. J. Clin Oncol. 1999; 17: 3188-3194. Links
    4 Shepherd FA. Chemotherapy for non-small cell lung cancer: have we reached a new plateau? Semin Oncol. 1999; 26(1 Suppl 4): 3-11. Links
    5 Macbeth FR, Bolger JJ, Hopwood P, et al. Randomized trial of palliative two-fraction versus more intensive 13-fraction radiotherapy for patients with inoperable non-small cell lung cancer and good performance status. Medical Research Council Lung Cancer Working Party. Clin Oncol (R Coll Radiol). 1996; 8: 167-175. Links
    6 Simpson JR, Francis ME, Perez-Tamayo R, Marks RD, Rao DV. Palliative radiotherapy for inoperable carcinoma of the lung: final report of a RTOG multiinstitutional trial. Int J Radiat Oncol Biol Phys. 1985; 11: 751-758. Links
    7 Helsing M, Bergman B, Thaning L, Hero U. Quality of life and survival in patients with advanced non-small cell lung cancer receiving supportive care plus chemotherapy with carboplatin and etoposide or supportive care only. A multicentre randomised phase III trial. Joint Lung Cancer Study Group. Eur J Cancer. 1998; 34: 1036-1044. Links
    8 Paesmans M, Sculier JP, Libert P, et al. Prognostic factors for survival in non-small-cell lung cancer: univariate and multivariate analyses including recursive partitioning and amalgamation algorithms in 1,052 patients. The European Lung Cancer Working Party. J Clin Oncol. 1995; 13: 1221-1230. Links
    9 Ball D, Matthews J, Worotnouk V, Crennan E. Longer survival with higher doses of thoracic radiotherapy in patients with limited non-small cell lung cancer. Int J Radiat Oncol Biol Phys. 1993; 25: 599-604. Links
    10 Fowler JR. Brief summary of radiobiological principles in fractionated radiotherapy. Semin Radiat Oncol. 1992; 2: 16-21. Links
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  8. David Smith said,

    February 16, 2006 at 12:46 pm

    Hello all,

    Um… Press Complaints Commission anyone? It seems to me that the writer of the story clearly could not have made any effort to follow even basic journalistic practice, like, y’know, communicating with the authors of the paper, for example. Essentially this story was MADE UP. And given it is about a health issue, I would think that demonstrating the potential for harm resulting from this story would not be too difficult. The fact that they have apparently self censored clearly indicates an attempt to try to make the problem go away. This is appalling.

  9. David Smith said,

    February 16, 2006 at 12:50 pm

    From the PCC site:

    Accuracy
    i) The Press must take care not to publish inaccurate, misleading or distorted information, including pictures.

    ii) A significant inaccuracy, mis-leading statement or distortion once recognised must be corrected, promptly and with due prominence, and – where appropriate – an apology published.

    iii) The Press, whilst free to be partisan, must distinguish clearly between comment, conjecture and fact.

    Ahem.

    You have to be directly involved to make a complaint.

  10. guthrie said,

    February 16, 2006 at 1:00 pm

    You mean involved like the papers author? I wonder if we could get him to put a complaint in?

  11. David Smith said,

    February 16, 2006 at 1:35 pm

    I guess… I presume this is to avoid the PCC being swamped by “disgusted of Tonbridge Wells” type complaints.

    I am surprised by the Independent to be honest – I would have thought that a paper such as they would have held up their hands and said “yeah we botched up good on that one. Sorry. Science and the accurate reporting thereof is important to us and we will make every effort to ensure that this does not happen again”.

    Authors – if you are out there -the PCC link is: www.pcc.org.uk
    There’s a form you can fill in. I’m sure the Badscience massive will be behind you!*

    * example marching slogan “What is safe?” “MMR!”

  12. guthrie said,

    February 16, 2006 at 10:59 pm

    Ach, well, I think everyone should be held up to high standards of honesty and openness. Its just I dont think many people would like said standards to apply to themselves.
    I’ve sent a letter to my local newspaper (The scotsman) about a small page filling article about an amazing new machine that could be used to detect explosives. They neglected to tell us what the machine was called, who made it, where it was made, and how it worked. I’ve said it smacks of tabloid journalism, hehehheeh.

  13. Natalie said,

    February 17, 2006 at 11:28 am

    Don’t you just love all these “miracle cure for cancer” stories. What really makes me mad is when patients attending the lung cancer clinic my mum runs in a large hospital turn up clutching these stories with their hopes raised of a cure for their cancer. Through this amazingly incompetent journalism (to say the least) thousands of people with cancer end up being misled and this can have a devastating impact on their lives.

    Infact in doesn’t just make me mad, it makes me furious that this paper has been so grossly twisted by a respected newspaper into a complete fallicy of a story. Things like this have a huge impact on peoples lives. Journalists should be far more accountable for their actions, I really hope the authors of this paper do complain to the PCC and action is taken.

    And so we wait for the next story…wonder how long it will be!!

  14. RS said,

    February 17, 2006 at 12:01 pm

    Whenever I’ve talked to science journalists, or heard them talk about these issues, their attitude is almost always (a) its the fault of the scientists, (b) you don’t understand how journalism works. i.e. they have no responsibility for anything.

  15. RS said,

    February 17, 2006 at 12:02 pm

    And I guess health journalists rank even lower on the evolutionary scale than science reporters.

  16. Ben Goldacre said,

    February 17, 2006 at 12:13 pm

    In my experience ther’s a massive divide between science journalists and health journalists, I don’t know Laurance, but in general health journalists are fine for politics/economics/humaninterest stories, but when it comes to science, the science journalists are much more likely to know their stuff, and know what it takes to get the information and convey it properly, etc.

    Although of course people from both camps also occasionally say things like “scientists need to be better at communicating with lay people” (ie make their well-paid job less intellectually taxing) in which case they must die.

  17. RS said,

    February 17, 2006 at 12:35 pm

    Are you implying health journalists aren’t adequate for health stories perchance?

  18. censored said,

    February 17, 2006 at 1:37 pm

    [i]many of these patients appeared to have been cured by a treatment usually considered to be without curative potential.[/i]

    If you didn’t read the whole thing properly and in context, you might think ‘a treatment’ in that sentence meant that patients were also trying quack therapies that shouldn’t work.

  19. Weefz said,

    February 17, 2006 at 3:42 pm

    BTW Ben, you’ve double-pasted the Independent article twice, from “Dcotors have found statistical evidence that alternative treatments such as special diets” to “The findings are published in the online edition of Cancer, the journal of the American Cancer Society.”

  20. Weefz said,

    February 17, 2006 at 4:02 pm

    Hmm… that should be just “double-pasted”. Or “twice”. Take your pick. (slow friday afternoon)

  21. tideliar said,

    February 17, 2006 at 7:59 pm

    …never let the truth get in the way of a good story…

  22. Roger Macy said,

    February 19, 2006 at 7:57 pm

    Yes, it IS a miracle.
    Nearly a month after the original ‘Miracle Cure’ article, but less than a day after Ben’s posting of this piece, a correction appeared in the printed version of the Independent – Friday 17th, page 10.
    However if you search the Indie website for Michael MacManus, you still draw a complete blank.
    Googling produced an interview by Professor MacManus of 30th January on ABC at
    www.abc.net.au/rn/talks/8.30/helthrpt/stories/s1558620.htm
    which at least partially redeemed the reputation of health journalists.

    Incidentally, only the day before, the Indie carried a piece
    ‘Natural’ cure found for attention deficit disorder (original apostrophes)
    The word “natural” does not appear in the piece. Although a reasonable interpretation of the report is that boys who go out and play can turn out more normal than those who don’t, the body of the text calls it “space-age technology normally reserved for testing astronauts returning from space”. Thank heavens it’s not used when they return from the heavens.

    The reporter in this instance was Jerome Taylor ???

  23. Roger Macy said,

    February 19, 2006 at 8:08 pm

    Further to previous posting, I see Wynford Dore’s space-age discovery isn’t very new. He’s been chasing publicity for years and runs ‘Dore achievement centres’.
    Call me a cynic but I immediately clicked on ‘How much does it cost?’ and got the reply :-

    Please contact the Dore Centres on 1300 55 77 11 for further information about our payment options.

    Yes. I know, I know. Amphetamines can’t be the answer to millions of kids whose parents ‘Can’t do anything with him.’ But this is attention-deficit journalism.

  24. Ben Goldacre said,

    February 19, 2006 at 8:11 pm

    that’s really interesting, does anyone have a copy of the text of the correction? i can’t believe it had anything to do with our activities on badscience.net, but the timing is very interesting, and the correction was more than a day after i published this, really, since i posted the piece very late at night on wednesday while i was up working (1:45am on thursday morning, to be strictly accurate).

    i also sent a polite email to jeremy laurance on thursday feb 16th asking if there was an explanation, and got the apparently automated “I will be out of the office starting 03/02/2006 and will not return until 21/02/2006″, which i received on friday feb 17th.

  25. Ben Goldacre said,

    February 19, 2006 at 8:15 pm

    space-age technology normally reserved for testing astronauts returning from space, doctors may be able to rebalance the brains of those suffering from such disorders.

    fantastic! the independent are really on a roll here. any more?

  26. Roger Macy said,

    February 21, 2006 at 8:46 am

    Here’s the correction as printed :-
    FRIDAY 17 FEBRUARY 2006 THE INDEPENDENT
    Professor Michael MacManus
    Due to a production error, an article on 23 January relating to a study of terminal cancer patients incorrectly reported its findings in the headline and introduction. As the rest of the article made clear, the study, conducted by Professor MacManus, did not show that “miracle” cures or alternative treatments worked on those suffering from terminal illnesses, but that a small number of cancer sufferers who received only palliative treatment recovered of their own accord. We apologise for the error.
    Ends.

  27. Roger Macy said,

    February 21, 2006 at 8:51 am

    Kremlinologists studying the very rare corrections from behind Marsh Wall may interpret ‘Due to a production error’ as over-spinning by a sub, and ‘As the rest of the article made clear’ as Jeremy Laurence seeking to redeem his reputation from within The Independent’s doctrine of infallibility.

  28. Ben Goldacre said,

    February 21, 2006 at 2:08 pm

    “As the rest of the article made clear”…

  29. Ben Goldacre said,

    February 21, 2006 at 4:11 pm

    v nice email from jeremy, i’m inclined to have pretty good faith in him, and when it comes to stories like this i do tend to feel these are usually systemic issues, rather than individuals at fault, with some very obvious and extreme exceptions.

    i would say however that the criticism still stands of the independent as a system and, to my mind, the mode of correction, ie deletion of the article from the site after the letter.

    Hi Ben
    Just back – and got yr msg. We published a correction on Fri 17 Feb to my
    report of the Macmanus study. Here it is below. Suffice to say I was
    apoplectic when I saw the version of my story that appeared in the paper.
    You can probably guess the rest.
    I am a fan of your column. Keep it up.
    All the best
    Jeremy

  30. Bob Bury said,

    February 22, 2006 at 8:57 am

    That’s probably what I would have said if i was Jeremy. However, I think it’s very clear that he skim-read the paper, clocked the reference to faith healing etc. and, as someone above said, drew absolutely the wrong conclusion.

    Still, we all make stupid mistakes. It’s just that if you are a journalist working to tight deadlines with space to fill, they occasionally come back to haunt you (just as they do if you’re a doctor!). Deep down, he’s probably a good person.

  31. Bob Bury said,

    February 22, 2006 at 9:00 am

    That’s probably what I would have said if i was Jeremy. However, I think it’s very clear that he skim-read the paper, clocked the reference to faith healing etc. and, as someone above said, drew absolutely the wrong conclusion.

    Still, we all make stupid mistakes. It’s just that if you are a journalist working to tight deadlines with space to fill, they occasionally come back to haunt you (just as they do if you’re a doctor!). Deep down, he’s probably a good person.

  32. Mick James said,

    February 23, 2006 at 5:07 pm

    I’m inclined to believe Jeremy–as a journalist I’ve seen subs reverse the meaning of copy with a single punctuation mark. What probably happened here was that the sub was looking to “punch up” the opening paragraph, glanced down the story and found what they thought was confirmation of the classic “alternative” therapy story . “Doctors said I waas incurable: but look at me now!”

    The paper suggests that the underlying mechanism of last ditch alternative therapies is that people sometimes just get better. I am sure a lot of people in the last stages of cancer try alternative therapies, and even if they actually kill you off faster than doing nothing there’ll still be a steady trickle of written-off “survivors” to talk to the media about their “miracle cures”. The worst bit: the more people go alternative the more “miracle cures” there’ll be, until you get to the stage where people with good chances of survival refuse conventional treatment. And die.

  33. Charles said,

    February 23, 2006 at 9:08 pm

    I was going to pitch in because I’m a former work colleague of Jeremy Laurance’s – I sat a desk away from him. He’s conscientious and rigorously ignores rubbish stories. If you’d like to know how far he’ll go for a real story, he went to Hong Kong to find out about SARS – at the time when SARS was rather dangerous and most people were heading in the opposite direction.

    I read the article at the top, before seeing the other comments, and – with my experience of what happens in newspapers – thought “Hmm, the intro completely isn’t supported by the rest of the story”. Which usually means that someone on the newsdesk or subs desk didn’t like the fact that the story was straightforward, and decided to jazz it up – but, say, got it mixed up with something else.

    So to all you commenters calling him a “prat” or worse – are you prepared to head into a SARS zone while not entirely sure how dangerous it is? Conversely, have you ever seen your work appear with your name yet known that it’s wrong through no fault of your own? That’s what life can be like for a journalist on a daily. It is, indeed, the production process.

    Ben, I’d have to say one thing: on posts like this, it is important to close the loop and pick up the phone or drop the email and ask the journalist if that’s what they meant, and not leap into print (or electrons) until you have. If they brush you off, OK, go for it. But you have to allow for the many cooks who make up the news broth, If you haven’t experienced it directly, you have no idea how frustrating it can be. But closing the loop – that is, putting the question to those you accuse – is a basic tenet of, oh, what’s it called – ah, yes, journalism.

  34. Roger Macy said,

    February 24, 2006 at 9:14 am

    Fair comment about the personal abuse.
    But the criticism from Ben (and from me) has been at the paper. Ben, after all, did contact them straight away. The authors of the paper wrote. But the correction did not appear then, or after Jeremy went ‘apoplectic’ but later – just after the Ben posted this piece. And the correction was far less prominent than the original headline. The PCC code mumbles about ‘due prominence’ but the PCC won’t intervene except for an aggrieved party, which excludes virtually all scientific or social research.
    So the PCC is there to save newspapers from costly libel actions and/or real regulation but has no interest in the truth.
    I have other examples where this newspaper (and others, of course) has refused corrections on scientific mis-statements.
    Keep them rolling, Ben, but as Charles says, posters shouldn’t judge individuals.

  35. David Smith said,

    February 24, 2006 at 2:09 pm

    “But you have to allow for the many cooks who make up the news broth”

    Erm no, sorry I don’t have to do any such thing! Y’see I pays money to read my newspaper of choice and I expect the Journalists and editors and the whole glorious panoply of workers who come together to produce said newspaper to, erm, do their job…

    Perhaps Jeremy is being unfairly lumped in with other journalists of a less reputable nature (it seems that way), but the fact is that these days, I as a consumer of news from the various branches of the media, find it increasingly difficult to distinguish cock-up from conspiracy (in terms of bad science). Add in a tendency to “Jazz it up” and you have a recipe for disaster.

    And these news stories affect people. Deeply.

    If you want an example other than MMR then look at the Recurrent Miscarriage boards out there and see how desperate folks are to believe in Natural Killer Cell treatments. There’s no scientific evidence for it but there are some doctors out there (and accompanying Sunday supplement articles) who are pushing it, and there are legions of desperate souls who are just hanging in there hoping for the next pregnancy to be successful.

    Articles like the one discussed in this thread probably are froth to the 99.9% of readers. But for the 0.1%, the article may have a real effect. And if you are the poor bugger who has to explain that “no the article [about whatever miracle solution] is wrong or grossly overstated”… I can assure you that it is not at all nice. I speak from experience.

    Exceptional Statements get exceptional responses, and require exceptional supporting evidence. Journalists and Sub-editors should remember that when dealing in hyperbole. It’s about personal responsibility. Requests to “close the loop” do not cut it.

  36. Charles said,

    February 28, 2006 at 11:01 am

    I work at The Guardian now. I think its corrections policy is an excellent one. I haven’t read the article you link to (got work to do) but do think that it’s better not to have an Orwellian correction system going on.

    My point was about the personal abuse that has been directed at Jeremy Laurance, who is conscientious, and sceptical in all the right ways about health claims. I was explaining the mechanics of how a wrong story (because we can agree that the intro – the first paragraph – doesn’t support the rest of the story, and vice-versa) gets into the paper.

    So my point about “closing the loop” was that it’s important in these situations to find out how the bad story appeared, before hurling abuse at the person whose name is at the top.

    As to prominence of correction – yeah, sure, it’s a constant pain that corrections get less prominence. Kind of hard to do though. Would you like the newspaper of July 8th last year to have given over a page to explaining how it got the details of a pub’s name wrong the previous month, or publishing a list of those known to be alive after the London bombings? News sets its own priorities, and while the examples aren’t always as clear-cut as that example I just gave, they’re more or less the same: finding out new stuff is more engaging.

    You might as well ask why results of experiments where the null hypothesis is upheld don’t get more prominence in scientific journals. (Yes, I know there is the Journal of ..Negative? Results. Whateveritis.) Could it be because they want to engage their readers with results that seem more important?

  37. RS said,

    February 28, 2006 at 12:40 pm

    “So to all you commenters calling him a “prat” or worse – are you prepared to head into a SARS zone while not entirely sure how dangerous it is?”

    This is not a question of how big his balls are. A story appeared under his name that was in error – the story committed a rather obvious and silly mistake. The person committing this error was obviously a prat. It turns out that someone else may have been responsible for said error, and thus warrants said epithet. But he didn’t do anything about this error appearing in his name, even when the authors complained, so I was quite justified in assuming he was the prat responsible. Otherwise we’ll have to give Melanie Phillips the benefit of the doubt until we can definitively prove that no one has altered her words before they go to print.

  38. David Smith said,

    March 1, 2006 at 11:46 am

    Kudos Charles for sticking your head above the parapet but…

    As a consumer I do not expect to have to find out the mechanics of how a bad story appeared before voicing my displeasure. In my job (which for full disclosure is in the STM publishing area) I sometimes have to deal with customers of our who are upset and looking for someone to yell at. They do not care whether it is my personal fault that their journals or whatever have never arrived, they are the customer, they have paid for a product and they expect to get it. Likewise when an editor rings up and is unhappy about some aspecty of the journal that s/he edits…

    RS above hits the nail on the head. And I will add to this.

    You Publish – You are responsible in the eyes of your consumers. End of story. Any time you as a publisher (and I talk organisationally here) chooses to ‘Jazz things up a bit’ then you can expect to have to deal with the fall out when it all goes horribly wrong. It’s the price you pay for deciding that a story isn’t inherently attractive enough to stand on its own merits and is in need of some extra oomph or whatever. Agreed it’s a hard line to walk – boring but accurate on the one hand, snappy but possibly misleading on the other. The best policy is to put your hands up when you get it wrong and just say sorry.

    And as you work for the Grauniad now, I’ll say this. Their policy on corrections is excellent and this reader at least, gives the paper as a whole much credit for their clearly stated policy. They take it seriously. It shows a responsible and humble acceptance that their readers are worthy of respect. It shows a desire to engage and to work to do better. It might all be PR, but if it is, it is good PR.

    For the Indy to pull the article – that is just arrogant to be honest and shows a complete lack of respect for the readers it purports to serve. Honestly, if the Government had pulled an online item as a result of a journalist saying “Oy that’s wrong!” we would be reading a whole variety of headline items with variations on the word COVERUP!!!!. The inside pages would be filled with op-ed pieces disecting the appalling lack of respect and the erosion of trust and yaddayaddayadda. Now read this thread again.

    Sometimes you dish it out, and sometimes you have to take it.

  39. Roger Macy said,

    March 3, 2006 at 11:38 am

    Charles says :-

    “it’s a constant pain that corrections get less prominence. Kind of hard to do though.”
    …and… “finding out new stuff is more engaging.”

    Firstly, readers and viewers are constantly engaged in seeing other’s errors. That’s why media sections of papers like to dish it out on their rivals, and, at a more crass level, people watch out-takes programmes and the media home in on the foibles of celebrities. Discovering that something ain’t so is ‘new stuff’. I suggest that the problem isn’t that the correction isn’t newsworthy. It’s that said publications don’t want the story given the treatment their error would be given by their rivals – exactly the opposite of Charles’ point.

    It’s worth pointing out that my expressed motive in nudging Ben with this story was that the witch-doctor industry would otherwise be able to claim that the ‘truth’ was being suppressed by a world conspiracy of the media. I expect there’s a stand-in sub posting somewhere that ‘I tried to give the story the prominence that it deserved but they’ve pulled the whole thing because of backroom pressure by the medico-scientific establishment.’
    And the disappearing trick is not arcane. If we believe the pundits in the Indie and elsewhere, there won’t be a printed version in a few years. Then where’s the corrections ???

  40. Charles said,

    March 4, 2006 at 11:36 pm

    “I suggest that the problem isn’t that the correction isn’t newsworthy. It’s that said publications don’t want the story given the treatment their error would be given by their rivals – exactly the opposite of Charles’ point.”

    I suggest you have no idea of how a newspaper or magazine works, and how news priorities are set. It’s not random. It’s evolved. Does this blog parade its errors – because this post is itself wrong in “for all I knew Jeremy Laurance might have gone to the study’s authors and got some kind of personal on-the-phone quote that explained his bonkers riff into miracle cures.”?

    Ben’s comment above in 29 shows that he knows that”s wrong. Yet he hasn’t updated the post or created a new post explaining his error. Gee, how does that work? Same as a newspaper – it’s more interesting and important to get the new stuff in.

    You’ve got a point that the witchdoctor industry, which we all hate, would claim suppression. But where there’s visible correction – which is done quite easily online with the strike tag – then the whole story unrolls itself clearly.

    For the Indie to pull the article shows perhaps that they thought it was just wrong. Or most likely that Jeremy Laurance persuaded them that it was wrong. The nice thing would be a re-edited version. But sometimes newspapers are just too proud to do that.

  41. Ben Goldacre said,

    March 4, 2006 at 11:45 pm

    “Ben’s comment above in 29 shows that he knows that’’s wrong. Yet he hasn’t updated the post or created a new post explaining his error.”

    that’s incorrect, i did amend the post above several days ago to show that new information had come to light: will you now admit that you didn’t bother to re-read the post to check, and parade your error and omission here? or is it more interesting and important to get the new stuff in? it was me who posted the new information about the authorship of the miracle cures article on the blog, myself, in the comment you refer to, and also roger macy in comment 22.

    without wishing to get drawn into a petty dispute, i don’t see what you suggest i was wrong about in the original post? there was an article in the independent that was immensely foolish, and i pointed that out. it subsequently transpired that their ludicrous miracle cures piece was the responsibility of somebody other than the person listed as the author – when the independent corrected it, although after i posted about the story and rang the paper and emailed jeremy – the story about what a shameful fantasy this independent story isn’t about the identity of the author, but in any case that new information appeared in the comments section immediately, with a reference to it subsequently added in the post.

  42. Roger Macy said,

    March 8, 2006 at 12:29 am

    The following correction appeared in the Guardian on Saturday :-
    Corrections and clarifications

    Monday March 6, 2006
    The Guardian

    In our Bad Science column, page 13, February 25, the writer drew attention to an item in the Independent newspaper headed Miracle cures shown to work, which had said incorrectly that doctors had found statistical evidence that some alternative treatments could cure apparently terminal illness. The Guardian story failed to acknowledge that the Independent had published a correction on February 17 which made it clear that the error was not the fault of the bylined author of the article. Apologies.
    Email: reader@guardian.co.uk

    That’s awfully generous of the Guardian. The correction is valid until the last clause. If you look back at the correction, at post 26, it certainly did not ‘make clear’ (unless you’re a kremlinologist) that the error was not the fault of the bylined author, although it did make clear that the error was not the fault of the author of original paper. That Jeremy Laurance’s story had been hijacked was clarified in this thread (and, as far as I know, nowhere else) at post 29 by Ben.
    So the Guardian corrections column (and contributors to this website, including Charles) have acted, in my opinion, to redeem Jeremy Laurance’s reputation, even though his own paper is too proud to do so.
    And, of course, the correction that the Guardian refers to does not exist if you look online.

  43. MsT said,

    March 8, 2006 at 2:18 am

    Has anyone ever written to Ben about bad science in the Guardian? He says he can’t write about it, and suggests you contact the readers editor.

    I have done that, many times, and they have never once corrected basic simple scientific errors they have made in their articles.

    Presumably this is because the corrections page is there for when their friends in the journalist community complain, rather than for actually correcting facts.

  44. DLaurie said,

    March 8, 2006 at 2:58 am

    “So the Guardian corrections column (and contributors to this website, including Charles) have acted, in my opinion, to redeem Jeremy Laurance’s reputation, even though his own paper is too proud to do so.”

    Looking at Charles’s blog… “From 1995 to December 2004 I was technology editor at ^^^The Independent^^^ writing about technology, science and the environment”. “As of November 25 2005, I’m the editor of the Technology supplement of The Guardian.”

    www.charlesarthur.com/cv.php

    So Charles Arthur was a close colleague of Jeremy Laurance. Perhaps that helped lubricate his comments here? And at the Guardian too? It was a very strange thing for Laurance to complain about. “I’d like to complain about, er, NOT being mentioned in the Bad Science Column…”

  45. Jack55 said,

    March 29, 2007 at 8:01 pm

    Hi

    I’ve just written a booklet totally attacking Laterile / laterile / ‘B17′ / amygdalin because I am so appalled with the fundamentalist quasi-religion which is Alternative Medicine / Complementary Medicine. Basically an in-law said I should believe and its laughable; but I just checked the science of it and wrote it up with massive end notes for the average reader. Yes, this is just a plug because do you know how difficult it is to get sensible scientific information on this issue? Very difficult due to the PR rubbish put out by the ACM snake doctor people.

    The booklet is called ‘ Laetrile / B 17 / Amygdalin is Rubbish’ and is available on

    stores.lulu.com/store.php?fAcctID=645367

    And yes, a shameless plug, but in the right cause…

    ThaNKS!

  46. Legal Advice WebLog » Blog Archive » Synopsis Research 2001-3 said,

    July 22, 2007 at 4:29 am

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