Wikipedia:Mediation Cabal/Cases/2006-01-29 Cancer evidence

I seek mediation on the issue of editing of sections on Cancer. I sought to add a new sub-section in Section 3. Causes and pathophysiology called “Psychological/emotional causes” providing the latest evidence that emotions and emotional trauma can play a part in the onset of cancer. I provided evidence from 8 randomised controlled trials.

Jfdwolff is an administrator who has blocked any editing by me on the subject of cancer. As soon as I had added this new sub-section he deleted it.

There are two distinct issues here:

1.	Wikipedia claims on its homepage that anyone an edit Wikipedia. This is clearly not true, as my experience clearly shows. Whilever anyone can delete every word a person adds as soon as it appears, the claim that anyone can edit Wikipedia is not true.

2.	Wikipedia claims to have rules under which users edit. These include respecting others’ points of view; and providing a balanced presentation of information – not a one-sided view.

The above experience shows that these rules and principles are not being adhered to. Jfdwolff describes himself as an “unrepentant deletionist”. He deleted everything I added and later commented that it contained “nothing useful”.

Unfortunately this dispute does not lend itself to the process of informal mediation because Jfdwolff is clearly not only not prepared to abide by the rules of Wikipedia. He is also not prepared to abide by the rules of the scientific method or scientific debate.

This second problem cannot be described in a few sentences because it represents a world-wide problem. In order to describe the situation so that it can be resolved fairly requires a brief description of my understanding of the scientific process as it applies to medicine in general and cancer in particular. I have been an experimental scientist for 37 years. Although I have not provided references to support my claims in this forum for reasons of brevity, these are available if required.

Evidence based medicine and the scientific method

Evidence based medicine is a new disciple that has arisen since 1991 because of the realisation of many medical and other scientists and statisticians that a majority of medical interventions is not based on solid evidence. This is leading to a general disillusionment with the medical profession among those who thought that the medical profession was based on the scientific method.

According to the Cochrane Collaboration, an international group of medical scientists who specialise in evidence based medicine, there is a particular hierarchy of levels of evidence that decides the quality of evidence. Level 1 evidence is based on results from a properly run randomised controlled trial. Such results can be used to state that a particular medical intervention has been proven to be effective. With lower levels of evidence the particular medical intervention can only be considered possibly useful and requires a randomised trial to confirm its efficacy. There are several lower levels, the lowest being anecdotal evidence, or that based on several personal or clinical observations that appear to show something to be true. Medical interventions based on lower levels of evidence are considered experimental. Using these criteria the Cochran Group believes that only about 15 % of medical interventions are based on good solid evidence such as properly run randomised trials. I have calculated that the figure for cancer is of the order of 6%, with much of this being due to the use of chemotherapy.

I am one of a growing group of scientists, who support the Cochrane Collaboration’s principles of evidence based medicine and, in the light of little progress being made with cancer survivla or mortality over the past fifty years, question the current paradigm about what cancer is and how it should be treated. We believe the rate of progress in cancer control is unacceptable and that this is probably because many current treatments are based on several unproven assumptions. We therefore question these assumptions about the efficacy of cancer treatments using the latest evidence from randomised trials with a view to developing a more accurate paradigm about what cancer is.

Editing Wikipedia

My recent attempt to edit the section on cancer was done in this context. I questioned the assumption that surgery (and radiotherapy) had been proven effective in providing any significant survival benefits in any properly run randomised trials. I also provided evidence from eight different properly run randomised trials that suggested that another particular therapy produced a much greater survival and a much more reduced mortality than any of the current orthodox therapies. This suggested that an alternative paradigm for cancer was probably more valid. I described what that paradigm is and one example of the mechanism by which some researchers believe emotions might cause cancer.

In my editing of the section on cancer I only added words to provide a more balanced understanding of the cancer process; I did not delete any words.

In contrast with this Jfdwolff deleted the whole section that I had added, thus acting in breach of Wikipedia’s rules and principles.

In justifying his argument for complete deletion he states that there was ‘nothing useful’ in the additions. He has his own set of rules about what the scientific method involves; and what is acceptable in describing what cancer is, how it is caused and how it should be treated; and his rules differ from those of the more open-minded sections of the medical and scientific community who rely on what is known as scientific evidence or evidence based medicine as described above.

In contrast with the scientific method, jfdwolff starts from the premise that most orthodox interventions for cancer are proven to be effective and don’t need a randomised trial to confirm their efficacy because he and a majority of his colleagues that he describes as “the medical community” know they are effective. Any of these interventions, such as cancer surgery or radiotherapy are known to be effective, mainly because they know that they can remove or shrink tumours (anecdotal evidence). Because this is an accepted observation and tumours are accepted as being the disease of cancer, these interventions are accepted as being effective. This has become dogma among cancer scientists in the same way that earlier scientists accepted that the world was flat, or the sun rotated around the earth. In their opinion it did not need to be proven. It was self-evident.

For jfdwolff science must be turned on its head to conform with his view of the world. Instead of him being required to justify his statements using acceptable scientific principles, and cite properly run randomised trials to show that therapies he supports are effective, he says that I am required to run a randomised trial to prove that his accepted but scientifically unproven therapy (surgery) doesn’t work.

The eight randomised trials that I cited that suggest that another therapy might be more effective because it produces greatly increased survival or reduced mortality are dismissed as ‘nothing useful’. No constructive scientific debate is offered about the subject. There is no questioning of the quality of the scientific references, which should be the staring point of the debate. They are just dismissed.

Rather than respect other points of view, anyone such as myself who questions this dogma is ridiculed. Any views we hold are described as “fringe medicine”. I am described as a “fluffhead” by other contributors. We are responded to with emotional and dogmatic assertions, not constructive criticism. Jfdwollf adds a section on the Discussion Page under the title Bizarre Additions to discusss my deleted additions. The word bizarre is itself derogatory of the information I presented (again in breach of Wikipdeia principles)

The principle of editing that I believe underlies Wikipedia is that someone adds something to what is already there to provide a more accurate or balanced description of the situation. The editor does not remove large amounts of material immediately it is added because he or she disagrees with it; rather they add or change words to make them a more accurate representation and remove bias. I deleted nothing. I only added new material to more accurately reflect the current scientific medical situation. I added scientific references to support my claims.

I therefore seek a decision about whether jfdwolff is entitled to delete all the material I add to Wikipedia because he disagrees with it. If this situation remains, the cancer section of Wikipedia will remain his personal plaything and the propaganda arm of the cancer industry.

Political Censorship About half of those who get diagnosed with cancer use one or more of the alternative cancer therapies. If this issue is not resolved these people will be denied accurate information about 1.the serious limitations of the orthodox approach to treating cancer; and 2.the good evidence behind some of the alternative approaches to treating cancer.

Essentially this issue is about censorship, suppression of important information and elimination of competition to the $500 billion a year cancer industry world-wide ($120 billion a year in the US alone). The cancer industry has successfully censored most of the media on this subject for the past fifty odd years so that most people only ever hear one side of the debate. In the late 1980s the US National Cancer Institute was exposed by a US Congressional Inquiry in its attempts to suppress alternative cancer therapies by having a clinic in the Bahamas close down. (This clinic used a therapy based on an alternative cancer paradigm.) Following this Inquiry the US Congress set up an organisation that has now become the National Center for Complementary and Alternative Medicine in competition with the National Cancer Institute to provide some balance to these strong commercial pressures. I also ordered the NCI to remove the biased propaganda from its web page.

The cancer industry, described in books by Ralph Moss and Samuel Epstein, now seeks to exercise the same censorship and suppression on the Internet. Wikipedia represents a media outlet that could get outside the cancer industry’s control and embarrass the medical profession. Very strong influences will be therefore be brought to bear to ensure that this doesn’t happen. Jfdwolff and others who seek to suppress this information, unwittingly represents those interests. I represent those who believe there should be an ongoing debate about one of the world’s greatest killers: what it is and how it should be treated. I believe that this debate should be based on scientific principles so that vested interests cannot be assumed to have a monopoly on the truth.

My credentials: As a scientist I have published two papers: One in 1993 questioning the efficacy of cancer surgery; and one in 1996 questioning the claim that mammograms reduce overall mortality. The conclusion from my 1996 paper in Medical Hypotheses was confirmed in 2001 by the Nordic Cochrane Group that specialises in evidence based medicine.

For the past 25 years I have been Convenor of a Sydney-based charity called the Cancer Information & Support Society that provides people with cancer with objective information about the benefits and harm from cancer therapies and emotional support to those who choose to use them. We evaluate the efficacy of both orthodox and alternative cancer therapies.

The medical skeptics Leading medical scientists and researchers who question the current paradigm to some degree or other, and whom I quote in my articles, include the following:

Ulrich Abel, epidemiologist and biostatistician at the Heidelberg Tumor Centre, Germany. Author of “Chemotherapy of Advanced Epithelial Cancer: a critical review”.

John Bailar, former US presidential adviser on cancer, former chair of the Department of Health Studies, University of Chicago, former editor of the Journal of the National Cancer Institute (JNCI), former professor of epidemiology and biostatistics at McGill University in Montreal, Chair of the Department of Health Studies at the University of Chicago. Author of “Cancer Undefeated” in the New England Journal of Medicine.

Michael Baum, Emeritus Professor of Surgery at University College, London, former pioneer and advocate of mammography screening in the UK. Author of “False premises, false promises and false positives--the case against mammographic screening for breast cancer” in the International Journal of Epidemiology.

William Black, Department of Radiology, Dartmouth–Hitchcock Medical Center, Lebanon, NH, and Center for the Evaluative Clinical Sciences, Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH. Author of “Overdiagnosis: An Underrecognized Cause of Confusion and Harm in Cancer Screening” in JNCI.

Barry W. Brown, Chief, Section of Computer Science, University of California at Berkeley; Larry and Pat McNeil Professor of Biomathematics, specialising in the mathematical modeling of cancer processes. Author of “Non-cancer deaths in White Adult Cancer Patients” in JNCI.

David M. Eddy, Senior Advisor for Health Policy and Management, Kaiser Permanente Medical Care Program, Pasadena, California. Former Professor at Stanford University, former J. Alexander McMahon Professor of health policy and management at Duke University. Author of “The Use of Evidence and Cost Effectiveness by the Courts: How Can It Help Improve Health Care?”

Ralph Moss, author of “The Cancer Industry”, “Cancer Therapy” and Questioning Chemotherapy”.

Candace Pert, microbiologist, discoverer of receptors on the brain for endorphins. Author of “Molecules of Emotion”.

Gilbert Welch, Professor of Medicine and Community and Family Medicine, Dartmouth Medical School; Co-Director of the VA Outcomes Group. Author of “Should I Be Tested for Cancer?” and “Dangers in Early Detection".

Mediator Response
I'm going to have a hack at this. Will try to work with the requester. --Wgfinley 04:28, 8 February 2006 (UTC)