Dear Surly Amy,

I have a friend who was diagnosed with testicular cancer about a year ago. It was caught a bit late, but he still had a chance of fighting it. However, he decided to go an alt-med approach rather than using solid medical treatments. I have had him speak with an oncology nurse, who recommended that he speak with an oncologist and seek normal medical treatment, and I have tried to urge him to seek help from an oncologist. However, he seems bent on his “natural treatments”, and he seems to be getting worse. At this point, I’m wondering if there’s anything that I could try to do to convince him to seek better care. He is aware that his chosen method may not work for him, and I suspect that if I hammer on the point, he’s likely to simply stop listening. Any ideas?

~Mathew

Dear Mathew,

This is so tragic that I am almost at a loss for words. And I really want to open this up for the entire skeptical community to weigh in on.

We often need and hope to sway people before they get into this situation.

My simple advice is to try to be a good friend and to be understanding while at the same time continuing to enforce the absolute necessity of seeking legitimate care. Perhaps you can sway your friend to seek medical attention with the knowledge that they may be able to continue some of their alternative remedies while under the supervision and treatment of an actual MD. Tell him it is better to be safe than sorry and remind him that this is a life or death situation.

Ask him questions about the treatment he is using. How does it work exactly? What is the mechanism that heals? How do you objectively quantify the healing? Ask questions that may get him thinking on his own about treatments. Explain how actual science-based cancer treatments work. Science Based Medicine blog is an excellent resource if you are in need of trustworthy information to pass along. I have found in my experience that you often can not change a person’s mind about something on the spot or face to face, but if you can convince them to think about the fallacies associated with their idea you can often get them to change their minds later on their own. Sadly, in this case you are really running against the clock.

I would also direct your friend to the what’s the harm website and specifically the section on alternative medicine.

This is an extremely difficult situation to be in. It’s very true that, good intentions or not, if you push a person too hard they will simply shut you out.

If he does not follow your advice, I still recommend trying to be there for him as a friend. In situations such as these, sometimes that’s the best we can do.

If anyone else has dealt with this, or has any good ideas to help in a situation like this, please leave your thoughts in the comment section below.

Got a question you would like some Surly-Skepchick advice on? Send it in! We won’t publish your real name, unless you want us to and creative pseudonyms get bonus points! Just use the contact link on the top left of the page.

Amy Roth

Amy Roth

Amy Davis Roth (aka Surly Amy) is a multimedia artist who resides in Los Angeles, California. She makes Surly-Ramics and writes about vegan food. She is the founder and president of the Los Angeles Women's Atheist and Agnostic Group: LAWAAG. Follow her on twitter: @SurlyAmy or on Google+.

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19 Comments

  1. Profile photo of
    October 19, 2011 at 12:19 pm —

    One of the things that bugs me about the folks who avail themselves of “alternative” treatments, and others who rely on prayer to heal themselves, is the sort of implicit notion that these things have to be done to the exclusion of normal medicine.

    What I would do if I were this guy is to go straight to his buddy — look him in the eye – and say – “dude, I can respect the fact that you want to try anything to survive this cancer, and I would never discourage you from going to any treatment that you felt might give you even an extra boost or the slightest increase in your chances. But, why not see a doctor, too? Can’t you do both?”

    Try to get the friend to verbalize why he will go to an alternative medicine practitioner, but will not take a chance on a regular medicine practitioner. I suspect that the friend may never have thought of the idea of doing both.

    Like – if you’re sick, just because you take vitamins and homeopathic remedies doesn’t mean you can’t also take some antibiotics….

  2. Profile photo of LenaPhoenix
    October 19, 2011 at 1:13 pm —

    I am very sorry to hear about your friend. I live in a town where this kind of thing is disturbingly common, and I know how difficult it is to change someone’s mind when they are frightened and getting bad advice from many sides.

    If he won’t start with conventional medicine, would he consider using regular docs to monitor the size/growth of his tumor to see how well his treatment is working?

    That’s what ultimately saved the life of a man I know tried to treat a testicular cancer recurrence with the Gerson Method. During the three months he juiced, his one small tumor grew into 2 large ones. When it became clear the cancer was still growing, his doctors had the opportunity to explain that his window to use chemo was closing quickly, because once it spreads to certain places, it’s no longer treatable. Once he’d had a chance to try alt med methods and saw they weren’t working, he was able to change his mind. He did the chemo and is fine now.

    • Profile photo of dr. dr. professor
      October 19, 2011 at 3:23 pm —

      ….
      Ironically, I know someone named Alina Pheonix who’s a promoter for several alternative medicine “products”.

  3. Profile photo of James Fox
    October 19, 2011 at 1:17 pm —

    I had a similar situation with a sister in law in the UK who went to a Laetrile clinic in Mexico for breast cancer. Sadly their oncologist in the UK recommended Laetrile to them which would have likely resulted in the moron having his license suspended in the US. In the end my sister in law received medical treatment including appropriate surgery, radiation and chemo. However she persisted in injecting herself with Laetrile for a long time and I can only hope there has been no long term harm as a result. I emailed back and forth with Steve Novella about this at the time and he recommended I be as honest and up front as possible with them because their decisions could result in my sister in laws death; and what’s a lost relationship compared to that.

  4. Profile photo of icepick
    October 19, 2011 at 1:40 pm —

    I think this is a very common experience. In my case it was an inoperable stage IV Glioblastoma. Honestly, there was very little to be done but buy time. My friend pursued all kinds of alternative treatment in parallel with radiation and chemo.

    I know she was hoping that it would maybe just improve her quality of life or tolerance for the science-based treatments, which can be rather harsh. Unfortunately, I think the acupuncture, reiki, vitamins (lots and lots of vitamins), homeopathy, algae smoothies, chasing halfway across the country to the Block clinic (Block is a darling of the altmed community when it comes to cancer treatment), etc.. may have made the majority of her last year a lot more work for her.

    I echo Amy’s sentiment, however, your friendship, caring and support is the most important thing you can do. If you can softly, compassionately, introduce some skepticism while there is still time, you should do that as well.

    • Profile photo of SkepLit
      October 19, 2011 at 2:07 pm —

      My father also died of a glioblastoma a few years back. The day after they excised what they could of the tumors his nurses were trying to sell him magic juices. When your medical staff is no more capable (or willing) to distinguish medicine from woo, what chance do lay people have?
      The cancer was pretty far along when it was diagnosed and my dad wasn’t really mentally competent to direct his own care. Fortunately my mother was there to run interference against both the well-intentioned-but-naive friends and bloodsucking charlatans trying to push their miracle cure du jour.

  5. Profile photo of davew
    October 19, 2011 at 2:10 pm —

    This sucks. You’re a good friend if you can be around sustained absolute stupidity without smacking the guy. The problem with alt-med treatments for cancer is that they frequently involve mega-doses of vitamins with are probably worse than doing nothing.

  6. Profile photo of DeanFromBC
    October 19, 2011 at 3:34 pm —

    May I suggest that you point him at the plethora of recent stories about Steve Jobs? And how he started treating his cancer with non-science based methods and switched to a more conventional approach when it wasn’t working.

  7. Profile photo of Maleficent
    October 19, 2011 at 4:57 pm —

    Lance Armstrong’s biography does not pull any punches in describing his treatment for metastasized testicular cancer, which could possibly turn your friend further away from treatment. However, it certainly does illustrate how one can overcome that type of cancer with proper medical treatment, even at a late stage. It also STRONGLY STATES that the best thing to do with cancer is to harness the best medical talent available to you. It could inspire your friend to seek more appropriate treatment. I’d bet your local library has it. You could read it first, since you know best how your friend might respond to it.

    Bonus: No bible-banging.

  8. Profile photo of Bookitty
    October 19, 2011 at 4:58 pm —

    Might also want to find out what his health insurance options are. If he’s under insured or not insured, he may be trying all other options before putting himself into bankruptcy.

    If that’s the case, he may need help navigating his own insurance company or medicare. Both are a nightmare to deal with. Support and help with the gazillion necessary phone calls and forms might make him more willing to seek treatment.

  9. Profile photo of quantheory
    October 19, 2011 at 5:32 pm —

    I have an aunt with breast cancer, who seemed to be successfully managing it with tamoxifen (and some additional treatment of which I am not aware). I believe that this the second time; the cancer had been in remission, but a tumor popped up again years later. This new tumor was also responding to the treatment and shrinking, but my aunt said that the medication made her feel tired or fatigued. The vagueness of these symptoms, combined with the fact that she was deeply embedded in a New Age, pro-alt-med community that told her about the serious “toxicity” of chemotherapy, makes me suspect that either these symptoms were a nocebo effect, or that these symptoms were merely an excuse to switch to a “natural” alternative.

    I certainly do not believe for a moment that she would have stopped the treatment if she had not believed that the “alternative” treatments from a local homeopath would work just as well. She didn’t discuss this with any M.D.s or with family, but rather just switched treatments one day without telling anyone. She went through various procedures (I believe energy healing and herbal and homeopathic remedies) that were supposed to “purge” her body of bad stuff, and that she claimed she could feel working, but over the next few months the tumor tripled in size, and her prognosis changed to such a degree that, when she finally went back to her real oncologist, she had to recommend a much more aggressive treatment.

    That was a few months ago, and I haven’t gotten any major news since, which may be a good thing. Perhaps, and I dearly hope this is the case, she has dodged the bullet (though not the emotional or financial damage). Still, it was an incredibly pointless risk, and showed the stark contrast between her prognosis after using the science-based medicine that she thought was toxic, and her prognosis after using the alternative medicine that she felt was removing all the toxins from her body.

    I don’t know what you can say to someone that will stop them from making this mistake. I don’t think that there is a magic bullet, a simple slogan that will make people suddenly wake up. All I can say is that it’s worth some degree of persistence.

    It might be worth asking why this guy is so reluctant to switch to a mainstream scientific treatment, and addressing that first.

    If he’s committed to a particular treatment for ideological or community-based reasons, it might be better to try to focus his thoughts on what’s best for his health and his plans for the future, rather than some cultural affiliation.

    If he feels committed to his particular treatment because it’s all he’s used so far (a “sunk cost” bias), or because he’s afraid of being told that it’s too late, it might be worth pointing out that testicular cancer has a relatively good cure rate, even if treated late, and that an oncologist might be able to give him a really good chance.

    He might actually be worried about losing a testicle, which is, from what little I know, likely to happen at this point. Castration anxiety is a touchy subject, a visceral fear, and not something most guys would want to talk about. If that’s the problem, there might not be a good, non-awkward way to talk about it, but what he needs to know is that a) until he sees a doctor, he isn’t well-informed about what the treatment/surgery might be like, b) sperm can be frozen in a bank ahead of time in case of decreased fertility, c) even if he does lose a testicle, that will not cause a loss of testosterone, and d) even after losing both testicles (rare, but possible), hormone levels can be maintained and life can continue more-or-less as normal. And, if you’re worried about the aesthetics of the result, there are also prosthetic testicles. It sounds silly, but it really matters to a lot of people.

    But the really important thing is that none of that matters if you’re already dead. People who get cancer usually have to make some tough decisions, but you have to step up to the plate eventually. Denying that there’s a serious problem, or pretending that fake treatments will solve it, accomplishes nothing in the end.

    • Profile photo of quantheory
      October 19, 2011 at 5:36 pm —

      Oh, and if his problem is financial, you can see what his options are. Maybe he can find some way through it. But the financial situation only gets worse if he’s paying for “alternatives” or if his delay causes him to need more aggressive treatment when he finally gets around to seeing a real doctor. And again, since the alternative is probable death, finding himself in serious debt still seems like the better option.

    • Profile photo of anthroslug
      October 19, 2011 at 7:47 pm —

      Thank you for a very useful and thorough breakdown of the matter. All of the comments have been helpful, but they way you broke it down is getting me to think in a somewhat different way about how to communicate. I have already heeded some of your advice and sent an email asking him if he’d be willing to share some information with me.

  10. Profile photo of anthroslug
    October 19, 2011 at 7:44 pm —

    Thanks Amy, and thanks to everyone who wrote comments. You have given me some ideas for how to ask him about his treatments, as well as how to point him gently towards the appropriate resources. He was already at an advanced stage when he told us about the cancer, but things have continued to get worse, and I am grateful for any useful advice.

  11. Profile photo of Jack99
    October 19, 2011 at 11:23 pm —

    My wife was diagnosed with breast cancer a little over a year ago.

    She owes her life entirely to science based medicine, prompt follow up and surgery, chemo and the best doctors around. Result: apparently, 95% odds of no recurrence.

    Above all, Herceptin (monoclonal antibody) treatment is subsidised in Australia by an excellent public health care system. Sadly, I believe, available only to the rich in the USA.

    Once again, I will say, life is precious and make the most of every moment with friends and family.

  12. Profile photo of Orange
    October 20, 2011 at 1:32 am —

    My experience with people who pursue alternative medicine treatments is that these treatements fulfill some sort of an emotional need. (Usually there is a belief that the ills of the world are caused by modernisation and technology and consumption, etc. and that they are fighting this by going “natural”, whatever that term means.)

    Maybe simply asking questions as to find out what this really means to him, it’s not truly only about “seeking the best treatment” but something else…

  13. Profile photo of docj
    October 20, 2011 at 4:18 am —

    This is incredibly sad, especially since testicular cancer is one of the most treatable cancers out there. It is one of the few cancers that has a relatively high cure rate.

  14. Profile photo of Reality
    October 20, 2011 at 6:24 am —

    Don’t divorce your advice from your motivation for giving it. Make it clear that you are really scared for his life and that you really care. This will make it hard for him to shut you out, even if he isn’t receptive to the advice initially. Don’t hold back any genuinely-felt tears. Sometimes coupling an emotional appeal with a logical one can make all the difference, and in this case the emotional appeal is not a fallacy.

  15. Profile photo of gmccardle
    November 20, 2011 at 10:40 pm —

    This is really a sad story. Unfortunately, it is not that uncommon. When I hear stories like this, I sometimes wonder if the people truly want to be healed. Some people have been known to shun effective treatment because of depression.

    –Guy
    The Inconvenient Truth

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