Endorsing "alternative" cancer treatments is a danger to public health
Endorsing "alternative" cancer treatments is a danger to public health
Elle MacPherson's lies about her cancer treatment will harm others. People who reject evidence-based care have worse prognoses and die at much higher rates.
I’ve been wanting to start to dig into cancer pseudoscience for a long time, and in my other pieces, I’ve really only scratched the surface. But with the rampant headlines about Elle MacPherson, now is the perfect time to really start to get into it.
As an immunologist who works in immunotherapy, including cancer, misinformation and pseudoscience about cancer is not only frustrating on a professional level, but it is EXTREMELY dangerous.
If you missed it, Elle did a serious of interviews recently where she claimed that she ignored evidence-based guidance on cancer treatment and instead used “intuitive and holistic methods” including naturopathy and chiropractic when she was diagnosed with breast cancer in 2017, and credits that to why she is doing well 7 years later.
She said, verbatim:
Saying no to standard medical solutions was the hardest thing I’ve ever done in my life. But saying no to my own inner sense would have been even harder.
But this is a lie. Elle did not say no to standard medical solutions.
Conveniently, Elle MacPherson left out the standard medical solution, a lumpectomy, from her tall tale about “alternative” cancer treatments saving her life.
A lumpectomy, also called breast conserving surgery, is a surgical procedure that is done to remove a cancerous tumor within the breast while sparing as much healthy breast tissue as possible. Usually, healthy tissue is removed around the tumor to ensure clean margins.
Elle finally disclosed she was diagnosed with Ductal Carcinoma in situ (DCIS).
We now know that Elle had HER2-positive and estrogen-receptor positive DCIS. Ductal carcinoma in situ (DCIS) is sometimes termed stage 0 cancer; it’s non-invasive breast cancer that originates in epithelial cells in milk ducts, and is considered the earliest stage of breast cancer. It means the cancerous cells are fully contained within the milk duct and have not left the duct and invaded neighboring breast tissue.
The standard treatment for DCIS? You guessed it: lumpectomy.
In the US, oncologists may recommend radiation and/or hormonal immunotherapy to reduce the risk of recurrence after lumpectomy (in the chance residual cancer cells have taken residence in other areas of the breast). Radiation is recommended in other countries like UK and Australia, but particularly if the tumor was small, it is not automatically part of standard treatment. In other countries, including many European countries, Japan, and elsewhere, radiation is advised only under certain circumstances, for example, if DCIS was large (3-5 cm) or diffuse.
The universal recommendation following DCIS lumpectomy is regular mammograms and imaging, which allows for detection of recurrence (discussed here).
In most DCIS cases (and even some other breast cancers), lumpectomy as a standalone intervention may be curative.
Lumpectomy is often curative in the case of DCIS, accounting for about 20-25% of breast cancer diagnoses since the advent of mammography (read here).
Lumpectomy can be curative in some early stage invasive breast cancers, such as invasive ductal carcinoma (IDC), particularly when the tumor is small (less than 5 cm), located in one region of the breast, has not invaded the lymph nodes (or has only been detected in a few local lymph nodes), and surgery can allow for clean margins. These criteria are often met with stage 1 and stage 2 IDC cases. (IDC accounts for 70-80% of breast cancer diagnoses). Lumpectomy may also be curative in some instances of early stage invasive lobular cancer (ILC).
While radiation is often recommended after lumpectomy, this is a risk mitigation measure. Lumpectomy in combination with radiation has similar prognoses to mastectomy (removal of the entire breast plus surrounding lymph nodes and tissue). In some cases, particularly with hormone receptor-positive cancers, lumpectomy/radiation leads to improved outcomes compared to mastectomy.
Lumpectomy alone is quite effective in these instances. 15 years after diagnosis with DCIS, lumpectomy-only patients had 97.3% survival rate, compared to 98% survival with adjuvant radiation.
As a immunologist and biomedical scientist in cancer immunotherapy, I’m going to go out on a limb and say that the lumpectomy, not her “natural treatments” is what cured her cancer.
Why did Elle leave this critical detail out?
She’s a wellness influencer with a lucrative company hawking snake oil and false promises. Conceding that she used actual science to manage her illness would impact her business model and the perceived legitimacy of the products she hawks.
Elle owns WelleCo and she sells a myriad of unproven supplements. She’s got “greens powders” ($85 a bag), skin and nail supplements, women’s hormone supplements, hair growth supplements, sleep supplements, and even supplements targeting children.
Dietary supplements are unregulated, untested, and lack safety oversight. They also lack evidence to support their use and many can be harmful. The supplement industry is a predatory for-profit conglomerate that undermines science-based medicine.
The wellness industry has a direct connection to medical conspiracism.
A 2014 JAMA study found that as belief in medical conspiracies increased, so did “wellness industry” behaviors like buying and consuming herbal supplements and organic foods.
Another finding? Those individuals also participated less in evidence-based measures for health: wearing sunscreen, going to the dentist, getting an annual physical, and getting their flu shots. You know, the things that actually improve health outcomes.
The number one conspiracy that respondents believed is that the government is hiding “natural cures for cancer.”
Perhaps it needs to be more widely known that supplement companies selling “natural cures” are also drug companies, they just don’t have to answer to safety regulators? And the dietary supplement industry is valued at $177.5 billion dollars?
But this underscores the biggest issue of the Elle MacPherson story:
Belief in “alternative” cancer treatments is linked with anti-science beliefs and actions.
Elle is a former supermodel, not a scientific expert. She shouldn’t be perceived as any sort of authority on anything science or health-related. But her celebrity, visibility, and media attention she gets amplifies her dangerous rhetoric and the products she sells that have zero evidence to support their use.
Coincidentally, around the time she was diagnosed with breast cancer in 2017, she started dating the OG of the anti-vaccine movement, Andrew Wakefield (read more here). She endorsed his anti-science rhetoric, which he outright fabricated for personal gain. She has a long history of undermining science, the consequences of which harm individual and collective health.
Why should we all care about this? Why does it matter what Elle MacPherson chose to do or say?
Amplifying and legitimizing cancer misinformation leads to fatal consequences.
The most harmful claims in the cancer pseudoscience sphere relate to unproven and ineffective treatments. If people forgo evidence-based interventions in favor of alternative treatments, they have worse outcomes, increased risk of death, and poorer prognoses.
Celebrities like Elle have global platforms with massive reach. This reach is augmented when media outlets pick up these stories and circulate them further (see Bella Hadid and Lyme misinformation). The fact that Elle deliberately omitted the conventional procedure that actually played a role in her cancer survival while touting the “alternatives” that did not is reckless, dangerous, and irresponsible.
Who’s to say people won’t see her story and think these ineffective methods are sufficient to treat THEIR cancer?
This is why I care about misinformation. This is why I care about celebrities being amplified when spewing lies. Because it costs people their health and their lives.
Refusing science-based cancer treatments causes people to die unnecessarily.
Cancers are complex and multifactorial diseases, and every cancer is treated differently. Today, there are many different evidence-based treatments including surgery, radiation, traditional chemotherapeutics, immunotherapies, and cell therapies such as CAR T (shameless plug to one of my recent publications in that space).
No matter the cancer type, prompt intervention after detection is critical to improve survival. The longer a cancer can progress without intervention, the higher the chances are that cancer grows or spreads in a way that makes treatments less effective.
People who forgo conventional treatments for alternatives have worse prognoses and are less likely to survive.
When assessing 4 types of cancers, lung, breast, colorectal, and prostate, patients who relied on unproven therapies had a 2.5-fold greater risk of death within five years compared to those who opted for standard treatments.
Breast cancer patients had a 5.7-fold increased risk of death when using alternative treatments as opposed to conventional cancer treatments. 5-year survival plummeted to 58.1% compared to 86.6% for conventional treatments.
Colorectal cancer patients had a 4.5-fold increased risk of death when opting for alternative treatments. 5-years survival dropped to 32.7% compared to 79.4% for conventional treatments.
Lung cancer patients had a 2.2-fold increased risk of death. 5-year survival dropped to 19.9% compared to 41.3% when using conventional therapies.
Patients who opt for alternatives are less likely to consider conventional cancer treatments.
Yes, it needs to be said plainly: forgoing science-based treatments for serious illnesses causes people to die unnecessarily.
These beliefs exploit the appeal to nature fallacy and medical conspiracism. Patients who opt for alternative treatments are less likely to use conventional treatments in conjunction, worsening health outcomes. They delay proven treatments until cancers progress to more severe disease, reducing treatment options. 34% of the alternative medicine group refused any sort of chemotherapeutic, compared to 3% of those receiving conventional treatments.
People who opt for alternative cancer treatments tend to be younger, white, female, more affluent, and are moderately educated (but not highly educated).
Sounds like the target demographic for the growing wellness industry, right? This $5.6 trillion market is not actually concerned with wellness. If they were, they wouldn’t be touting unproven and untested interventions that cause people to die.
Alternative treatments have no evidence and can be harmful.
Elle summed it up in her interview when she rattled off all the “providers” she was seeing, but wellness products advertised to treat cancer are the same as those hawked to improve immunity, longevity, hormones, metabolism, and more. These include:
Alkaline diets, dietary supplements (including intravenous vitamin C, herbal remedies, megadose vitamins, “detox” blends), homeopathy, chiropractic, ozone therapy, coffee enemas, rigid dietary interventions, and more. Not only do these have no have evidence, many can pose serious risks to cancer patients (and the general population).
Elevating celebrities who spout pseudoscience harms everyone.
I’m sure it doesn’t surprise you that Elle MacPherson is getting ready to sell a memoir, which will be filled with accurate statements (sarcasm, if you couldn’t tell). Unfortunately, celebrities frequently use completely unqualified and uncredentialed “practitioners” as care providers, giving the appearance that people like chiropractors, naturopaths, and homeopaths are legitimate clinicians.
But media outlets play a role in this too. When they give global platforms to celebrities, many of whom are idolized by the public, it draws further attention to these harmful statements and behaviors.
I’m sure some reporters reading this will say “well it is expected that we cover celebrity news,” which I don’t disagree with! But do it in a responsible way. Don’t legitimize the lies - report the lies WHILE fact-checking them. Underscore why celebrities are not experts. Reinforce scientific evidence. The amplification and virality of pseudoscience means it reaches more people every time someone with a large platform speaks on it.
Cancer misinformation is a threat to public health.
It’s long past the time for “politeness” on these topics. Health misinformation is a tangible danger to society. That’s incredibly evident in the cancer space, a category of diseases that are already poorly understood and incredibly difficult to treat. Endorsing, elevating, and legitimizing falsehoods is harmful. Collective effort is needed to combat it. In the case of cancer, truth is a matter of life and death.
Thank you for supporting evidence-based science communication. With outbreaks of preventable diseases, refusal of evidence-based medical interventions, propagation of pseudoscience by prominent public “personalities”, it’s needed now more than ever.
Stay skeptical,
Andrea
“ImmunoLogic” is written by Dr. Andrea Love, PhD - immunologist and microbiologist. She works full-time in life sciences biotech and has had a lifelong passion for closing the science literacy gap and combating pseudoscience and health misinformation as far back as her childhood. This newsletter and her science communication organization are born from that passion. Follow on Instagram, Threads, Twitter, and Facebook, or support the newsletter by subscribing below:
well-presented thank you. It is also perhaps worthy to the note the extreme amount of privilege involved here in taking all these alternatives - there are not cheap in addition to not being effective. That will potentially cause someone who has less means to feel shamed for being able to take care of themselves or a loved one well. Alternatively, they might be persuaded to use limited resources to add these "drugs"/supplements to the more proven treatment and thus losing money that would be better spent on healthy food and other means of support.
Thank you for speaking to a critically important issue: our society’s belief that being a celebrity somehow makes you knowledgeable about anything and everything. We believe what we wish to believe, but that doesn’t make it a fact. I’m tired of the endless anecdotal stories of people with cancer who did something wild (e.g., eating only green vegetables for months) and were miraculously cured. I’m grateful to my PCP who sticks to evidence-based science. The first thing he did when I became his patient was recommend I stop taking all my supplements (except Viactiv for osteopenia), pointing out that they aren’t regulated, there’s insufficient data to support taking them, and many can be hard on the GI system. I have a bundle of degrees, but none of them are in medicine or science, so I will humbly follow the advice of people who ARE experts in this area.