Bad medicine: Dr. Oz continues promoting dodgy "radical cures" and pseudoscience

Doctor Mehmet Oz has become a household name of sorts since Oprah helped him land his own show. In that relatively short period of time, Oz has become one of the worst TV doctors out there, propagating bad information about supposed natural cures for cancer and new age 'medicines' which are said to treat any number of maladies, when they infact, do not. A recent episode entitled, "Dr. Mercola's Radical Cures," is made up entirely of this sort of nonsense, and goes to show why he earned a Pigasus award from JREF for the past two years in a row:

The Media Pigasus Award goes to Dr. Mehmet Oz, who has done such a disservice to his TV viewers by promoting quack medical practices that he is now the first person to win a Pigasus two years in a row. Dr. Oz is a Harvard-educated cardiac physician who, through his syndicated TV show, has promoted faith healing, "energy medicine," and other quack theories that have no scientific basis. Oz has appeared on ABC News to give legitimacy to the claims of Brazilian faith healer “John of God,” who uses old carnival tricks to take money from the seriously ill. He's hosted Ayurvedic guru Yogi Cameron on his show to promote nonsense "tongue examination" as a way of diagnosing health problems. This year, he really went off the deep end. In March 2011, Dr. Oz endorsed "psychic" huckster and past Pigasus winner John Edward, who pretends to talk to dead people. Oz even suggested that bereaved families should visit psychic mediums to receive (faked) messages from their dead relatives as a form of grief counseling.

Well, it's 2012, and Dr. Oz just gets wackier, putting him in a unique position to probably win the prestigious Pigasus for a third year. Luckily, there are science-minded writers who have put time into sussing out the batshit from the not-as batshit things that Oz has steadfastly been promoting:

Even after Dr. Oz landed The Doctor Oz Show, for the first half of his first season it fairly straight and science-based as far as I can tell not being a regular watcher. However, two years ago the mask began to slip when Dr. Oz first aired a credulous feature about reiki under the title Dr. Oz’s Ultimate Alternative Medicine Secrets. Not long after that, Dr. Oz featured a man who is in my opinion arguably the foremost promoter of quackery on the Internet, Dr. Joe Mercola, along with the master of quantum quackery, Dr. Deepak Chopra. It was at that point that one could rightly say that Dr. Oz had “crossed the Woobicon.” Since then, it’s been one thing after another, beginning in earnest about a year ago. For instance, in January 2011, Dr. Oz featured Dr. Mercola again in a completely credulous portrait that painted him a “brave maverick doctor,” only without a hint of irony. A couple of weeks later, he featured a yogi who advocated “detoxing” and a faith healer from my old stomping grounds in Cleveland. Then, just when I thought Oz couldn’t go any lower, he featured psychic scammer John Edward.

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Mercola is nothing if not non-rationally inclined when it comes to medicine, as evidenced by his response to Dr. Oz’s asking him why he thinks these “cures” work. Basically, he says it’s because of anecdotes and evidence. Note how he mentions anecdotes first. That’s how Dr. Mercola rolls.

Eggplant: A “cure” for cancer

The first claim Mercola makes is that a skin cream made of eggplant extract can cure cancer. However, compared to what he said in the opening segment, his claim turns out to be a lot less impressive than it initially sounded. Basically, Mercola claims that this cream, known as Curaderm, can cure non-melanoma skin cancers, particularly basal cell cancers. This is a lot less impressive than saying that “eggplant can cure cancer.” For one thing, basal cell cancers are not particularly malignant. They can grow locally, sometimes reaching impressive sizes, but they are cured by complete excision and rarely metastasize. Squamous cell carcinomas of the skin are a little nastier, but not hugely. They are cured with complete excision as well and are rarely fatal if treated promptly. Indeed, for all comers, there are an estimated 700,000 cases of squamous cell carcinoma of the skin per year in the U.S. and only 2,500 deaths. It just isn’t a particularly lethal cancer. Now, if Curaderm were shown to be potentially curative for melanoma, then I’d sit up and take notice.

Let’s get one other thing straight. Certainly, it’s possible that an extract from eggplant might have therapeutic value. As I’ve said before many times, herbal or plant-based medicines are about the only kind of “alternative” medicine that has significant prior scientific plausibility based on what we know about science. That’s because plants often contain biologically active molecules; i.e., they often contain drugs. Of course, the problem with plant-based medicines is that they are, in essence, highly contaminated drugs, the predictability of whose responses is variable because the amount of active ingredient can vary widely. However, there’s a big problem when claims for a plant-based compound become grandiose. It immediately makes me suspicious, even when there might be some biological plausibility that some compound with derived from a plant might have anticancer properties, when I see claims of “cancer cures” or the extensive use of testimonial evidence, which is all that Mercola had. Mercola seems to have derived his claim from someone named Dr. Bill Elliot Cham, who basically claims that eggplants cure skin cancer. Naturally, I know it’s true because I saw it on the Internet, and I’ve even seen some credulous reporting on it:
This is how Dr. Cham’s book The Eggplant Cancer Cure is described in its foreword:

Perfection or near-perfection is rare in any area of medicine. Dr. Bill Cham has achieved it in the treatment of two common cancers, basal cell carcinoma and squamous cell carcinoma.

And:

Even better, for those who want to know “how does it work”, this book tells us exactly how. The explanation is simple, easy to understand, and yet scientifically elegant, a molecular ballet. Here’s the explanation in one line of simple English: Dr. Cham has found substances which can penetrate and kill skin cancer cells but can’t penetrate normal skin cells, so normal skin cells are untouched and unhurt while the skin cancer cells die!

Can this “eggplant cure” actually do what Dr. Cham claims it can? In the video, he claims his eggplant extract been tested in “randomized trials” in the U.K.; so I figured that I could find the results of those randomized trials by searching PubMed. Silly me. A search of “eggplant” and “skin cancer” revealed…two references, neither of which present particularly convincing evidence that an eggplant extract can cure cancer, while a search of “solasodine glycosides” and “skin cancer” revealed only three. Only one of these was any kine of proper randomized clinical trial. It’s somewhat interesting, but it’s rather hard to get too excited about it without some replication.
Somehow, though, Dr. Cham claims that he’s done Phase I, Phase II, Phase III, and even Phase IV (post-marketing) trials. Now, I wouldn’t necessarily expect phase IV trials to be published; postmarketing surveys often remain unpulished. However, I would expect to see the phase III trial supporting his “Curaderm” to have been published. Oddly enough, many of the studies listed on Dr. Cham’s website don’t appear to be even particularly relevant to the question of whether his cream cures skin cancer. Particularly suspicious are a couple of articles that could have come straight from Kevin Trudeau, The skin cancer cure so effective, it’s being kept secret and The skin cancer cure nobody wants you to know about.

Now we’re talking crankery!

The odd thing is that the compounds isolated by Dr. Cham appear promising. Basal cell carcinoma, for example, is a type of cancer that is rarely fatal and rarely metastasizes. However, it can grow to large sizes and become disfiguring if neglected. Currently, surgery is indeed the only treatment of basal cell carcinoma. Simple surgical excision is curative (as they say, nothing heals like surgical steel). Consequently, a topical agent that caused basal cell carcinoma to regress would be very useful to dermatologists and skin cancer surgeons. I’m less enthusiastic about using such compounds to treat squamous cell carcinoma, because these tumors can invade and metastasize. Their treatment can require lymph node dissection and radiation. Treating such tumors is often more than just a matter of simple surgical excision. At least Dr. Cham doesn’t claim that his Curaderm can treat melanoma. That would be truly irresponsible.

So how, if it works, does Curaderm supposedly work? That’s where I see more red flags going up. There’s a long and seemingly plausible explanation in his book. There’s a listing of clinical trials, but none of them appear to have been published, at least not by Dr. Cham. Then, of course, there’s the conspiracy-mongering by Dr. Cham himself:

These dermatologists put pressure on the government health regulators who then decided to put Curaderm BEC5 as a prescription only drug.  Because of this no public awareness of Curaderm BEC5 was allowed and of course these dermatologists did not support Curaderm BEC5.  Consequently, I attempted to reason with the Health Authorities that Curaderm BEC5 should be widely available to the public.  This fell on deaf ears. The health regulators reasoning was the glycoalkaloids BEC were toxic because they were extracted from the Devil’s Apple plant.

I then examined a whole host of solanum plant species and found that the exact replica of BEC was present in the eggplant.  Most importantly the amount of BEC in one tube of Curaderm BEC5 is the equivalent to approximately 5g of eggplant (approximately 1 table spoon).  So how can the BEC in Curaderm BEC5 be considered toxic, especially after we had done full toxicological studies with the BEC where it was shown that it was completely safe at the concentrations found in Curaderm BEC5.  With this new information in hand I again approached the Therapeutic Goods Administration (TGA) to have Curaderm BEC5 back as an OTC (over the counter) item.  The TGA said they would get back to me.  I have been waiting for over 8 years but they have not responded to my request. I finally gave up on them and sought and obtained registration of Curaderm BEC5 as an OTC in the Republic of Vanuatu.

He then says he would love it if the FDA would approve his drug, apparently clueless that the FDA doesn’t come looking for drugs to approve. The inventors have to submit their treatment to the FDA for approval. Indeed, Dr. Cham has flirted with, if not outright crossed, the border from being a physician-scientist into becoming a crank. After all, he claims to have done all these studies on the BEC compound in extensive clinical trials, but they do not appear to be published in the peer-reviewed medical literature. Rather, they’re only discussed in his books, which, of course, you have to buy. Oddly enough, a few years ago, another group did actually do a clinical trial using a related compound and reported some efficacy.

So what we have here is a salve that might have some efficacy but has not yet been adequately validated (or validated at all) in adequate clinical trials. One notes that Dr. Cham is also claiming efficacy for terminal “internal” cancers, but that he also hasn’t managed to publish anything. Good physicians and scientists would see this and say something like, “Hmmm. This is interesting. There might be something here.” Then they’d do the work to figure out once and for all if there is, in fact, anything there. They would not recommend it as a “cure” for a disease for which we already have a treatment that is more than 95% effective, instead opting for conspiracy mongering about why his cure isn’t yet accepted.

No wonder a quack like Dr. Mercola likes him.

Here we go again…

Next up, Dr. Mercola tells Dr. Oz that people are being “poisoned” by their amalgam fillings and that the mercury allegedly being released from such fillings is responsible for a whole host of chronic health issues and diseases, including psychological, neurological, and immunological problems. Basically, if you have a chronic health complaint and amalgam fillings, the alt-med world will frequently tell you that it must be due to the fillings. In any case, this is an alt-med myth so hoary that it probably crawled up out of the primordial ooze (apparently, along with mercury), which is why I don’t feel the need to discuss it in detail, particularly given that Harriet Hall has covered the issue before. I will, however, mention that in his article discussing his appearance with Dr. Oz, Mercola posts the infamous “smoking teeth” video that Harriet had so much fun mocking (and rightfully so, I might add; that’s one of the silliest videos I’ve ever seen).

Instead, I’ll look at Dr. Mercola’s “cure” for this nonexistent health problem. Basically, it’s an algae known as Chlorella, which, if you believe Mercola, is a lot like the Oil of Aphrodite and the Dust of the Grand Wazoo. (I know, I know, another Frank Zappa reference in a mere week. It fits, though.) In any case, back in the 1940s and 1950s, Chlorella was seen as a new and potentially promising food source that had the potential to provide large amounts of high-quality food at a low cost. For whatever reason (probably mainly the clearing of more arable land and huge increases in the efficiency of farming, this potential was never realized, but Chlorella maintains its cachet as a “superfood” and alt-med cure-all. If you Google Chlorella, you’ll find lots of sites selling Chlorella supplements, and near the top of the list is Joe Mercola’s Chlorella supplement.
But does it do what’s claimed for it?

Well, with respect to treating problems caused by mercury from amalgams, the answer is certainly no, because there’s no good evidence that mercury from amalgams cause any disease. As for Chlorella, searching PubMed leads me to a bunch of articles looking at this particular algae as a food source, as a a test for hazardous effluents management and adsorbing mercury using Chlorella immobilized on silica gels. Chlorella, apparently, can bind mercury and heavy metals. Of course, there’s a disconnect here. While it might be somewhat plausible that an algae like Chlorella could bind mercury and other metals in the GI tract, it’s not so plausible that it could do so in the blood and tissues, because that would require a chelation agent being absorbed that can chelate heavy metals and lead them to be excreted through the urine. Let’s also not forget that amalgams don’t lead to the absorption of harmful amounts of mercury anyway, so even if Chlorella did what Mercola claims it wouldn’t mean that it’s a useful therapy for “brain fog.”

One can’t help but note that Dr. Mercola has been selling Chlorella for quite some time now. In fact, the ever-reliable Quackwatch notes that in 2005 Mercola received a warning letter from the FDA telling him to cease and desist, in part, from claiming that Chlorella can fight cancer and normalize blood pressure. In 2006, he received another FDA warning letter telling him to stop claiming that one of his Chlorella supplements can “help to virtually eliminate your risk of developing cancer in the future.” Basically, what Mercola is doing here appears to be extrapolating from in vitro and animal studies that suggest that Chlorella extracts can bind heavy metals and using them to justify selling them for human use to treat–you guessed it–heavy metal poisoning as a “detoxification” method. Again, Mercola puts the cart before the horse and massively exaggerates the potential benefits.

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Read more of the article from Science Based Medicine here, which provides an in depth debunk of Dr. Oz's recent episode with Dr. Mercola.