Book Review


Malignant Medical Myths

Why medical treatment causes 200,000 deaths in the USA each year, and how to protect yourself

Joel M. Kauffman; West Conshohocken, PA: Infinity, 2006; ii + 326 pages.


In this eye-opening and meticulously documented book, Dr Joel Kauffman presents a damning critique of mainstream medicine in the United States. The US spends $2 trillion per year on healthcare, about $7000 per person, yet it buys almost the poorest care among developed countries, with at least 200,000 deaths per year from medical treatment. Based on a thorough review of the professional literature, Kauffman shows that official advice on screening tests, drugs, diet, exercise, alcohol, radiation, and water fluoridation is often wrong and commercially motivated, that clinical trials are often slanted, and that ‘sickness’ is created to sell treatments.

There is compelling evidence that treatment with some of the best-selling prescription drugs fails to prolong life or improve its quality in many of the people who take them. This includes anticholesterol drugs, blood pressure drugs, and most anticancer drugs used for chemotherapy. Over 90% of drugs only work in 30 to 50% of the people taking them. However, if medical providers fail to follow ‘official’ guidelines for diagnosis and treatment or if they use an ‘alternative’ treatment, they may be threatened with lawsuits for malpractice or suffer ostracism or even delicensing.

Schering-Plough, one of world’s biggest drug companies, is known to send doctors unsolicited cheques for $10,000; in return they are ‘invited’ to sign an attached ‘consulting’ agreement requiring them to prescribe the company’s medicines. Johnson & Johnson, Wyeth, and Bristol-Myers Squibb have made similar enticements. Giant pharmaceutical companies peddle biased information on drugs and tests, and pay academics to give papers at international conferences, reporting favourable results from drugs trials. Respected reporters and commentators often owe part of their salaries to corporations whose products they endorse.

As Kauffman demonstrates in great detail, articles in peer-reviewed medical journals can’t necessarily be trusted. It is usually only the information contained in the abstracts of such articles that receives publicity. But abstracts are often incomplete and misleading. For instance, many people taking part in drug trials tend to drop out because of side-effects, but this information rarely finds its way into the abstract. ‘You would be appalled to find how often only favorable results are cited in an abstract,’ says Kauffman (pp. 8-9). One of the favourite types of phoney evidence results from ‘selection bias’ – i.e. the inclusion of all studies that support one’s biases, and omission of some or all that do not. Reviewers of articles submitted for publication are supposed to be independent of the financial sources of the authors and their peers in expertise. Many are, says Kauffman, ‘but considerable trading of favors and behind-the-scenes pressures must occur to lead to the publication of so many poorly written, or well-written yet misleading papers’ (p. 5).

US government cholesterol guidelines, which promote more and more aggressive use of cholesterol-lowering drugs, were prepared by drug experts, many involved with drug manufacturers, without any government supervision or approval. During the advisory committee meetings held by the Food & Drug Administration (FDA) to discuss the safety and efficacy of two new drugs for diabetes, one-third of the committee’s nine members had financial ties with the drug manufacturers that submitted the new drug applications or with their competitors. Staff at the National Institutes of Health (NIH) are allowed to engage in lucrative private consulting deals with drugs companies. One university professor who reviewed two dozen treatments for psychiatric disorders favoured three of the treatments he stood to profit from based on his consultancy ties. University or medical school researchers cannot be trusted either, due to the influence of their commercial sponsors. Researchers who publish findings unfavourable to the sponsor have been threatened with loss of funding, lawsuits, blacklisting from future contracts, or loss of employment.

Drugs trials are often flawed. A favourite trick is to test drugs on healthy male adults, then use the result to prescribe for women, children, and the elderly as well. Trials of tests, devices, and drugs often fail to compare the results with earlier work, or with competitors’ drugs, and only the studies with the most favourable results are publicized. Companies routinely delay or prevent publications that show their drugs to be ineffective. A majority of studies on Zoloft, an antidepressant drug, showed it to be no better than placebo (i.e. sugar pills). In 1990, more than a decade after antiarrhythmic drugs had been introduced, it was estimated that they were killing more Americans every year than had died in action in the Vietnam War. The tendency of Big Pharma to publish only drug trial results which are positive is so pervasive and misleading that Spain has made it mandatory to publish the result of all clinical trials run in that country.

Randomized clinical trials (RCTs) are essential: this means that half the subjects receive the genuine drug, operation, or treatment and the other half a fake version (placebo), without being told which group they belong to. Positive results typically occur in 30 to 50% of subjects in the placebo group, and a significantly higher percentage of the subjects in the other group must show positive results if the treatment in question is to be considered genuinely beneficial. Clinical trials with no control or placebo groups are automatically suspect.

Many drugs have side-effects underplayed in the trial results presented to the FDA, which does not test drugs and devices itself but merely examines the test results the manufacturers choose to offer. Kauffman writes:

Many interventions are justified on conveniently measured parameters, such as bone density, cholesterol level, EKGs, and blood pressure. In all of these cases, examples exist in which the intervention improved the easily measured symptom, called the surrogate endpoint, such as lowering blood pressure, yet worsened the primary endpoint of heart attack, bone fracture, or death. One extreme example was the use of antiarrhythmic drugs. ‘Success’ was shown by altered EKGs (electrocardiograms), but the drugs caused sudden cardiac death. Conversely, the FDA has sometimes been a ferocious obstructor of effective and nontoxic alternative treatments ... (p. 4)

Treatments are often claimed to reduce the relative risk for some condition by a certain percentage. For instance: ‘Take this treatment and your chances of a heart attack will drop by 50%.’ Kauffman says that this is a major method used to perpetuate today’s medical myths on diet, blood pressure control, cholesterol control, annual mammograms, and many other subjects. This is because any reduction in the relative risk of some condition, however large, may pale into insignificance when the absolute risk is considered. For example, saying that taking a particular drug for 10 years cuts the relative risk of acquiring a sickness by 50% sounds impressive. But this could mean that your absolute risk of acquiring a sickness is reduced from 2 in a million to 1 in a million. Seen in these terms, the improvement is negligible, and if the treatment is highly expensive and has adverse side-effects, it would be advisable to avoid it.

The following is a typical example of unreliable medical advice: A 54-year-old English literature teacher at Oxford University was diagnosed with multiple myeloma and told to begin chemotherapy within a week otherwise he would be dead within a year. He was told that chemotherapy would enable him to live up to two or three years longer. After seeking other opinions on the value of chemotherapy, he refused it in favour of a combination of alternatives. Eight years later he was still alive and employed.

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A brief summary of the ‘malignant medical myths’ that Kauffman explodes is given below.

Myth 1: Taking an aspirin a day forever will make you live longer.

Careful review of the available literature shows that aspirin is neither a safe nor effective way of treating congestive heart failure. Occasional use of aspirin for headache and arthritis pain should not cause serious side-effects, but more than occasional use can hurt you. Studies have shown that four supplements – vitamin E, magnesium, certain omega-3 fatty acids, and coenzyme Q10 – each provide much greater long-term benefits than aspirin, and all have fewer side-effects. Yet mainstream physicians are far more likely to recommend aspirin, because it was introduced by a giant pharmaceutical company that is still around – Bayer – and is advertised more than all four supplements together.

Myth 2: Low-carbohydrate diets are unsafe and ineffective for losing weight.

The truth is that the advice from every government agency and most non-profit foundations to eat low-fat diets, especially low in saturated fat and cholesterol, is utterly baseless, and results in immense suffering and costs. ‘Much of the evidence for low-fat (high-carb) diets,’ Kauffman concludes, ‘is a result of poorly designed studies, misinterpretation, exaggeration, and outright fraud’ (p. 73). The safety of low-carb diets, on the other hand, is well established and there is indisputable evidence that they contribute to weight loss and help prevent the complications of diabetes. Evidence for the benefits of low-carb diets is even found in journal articles claiming to provide evidence of the opposite – once their actual data are studied and not just the misleading abstracts.

Myth 3: Using cholesterol-lowering drugs, especially the statins, would benefit nearly everyone.

Kauffman shows that the basis for using cholesterol-lowering drugs is pure mythology. Low cholesterol levels are dangerous; high ones usually are not. Clinical trials of statin drugs indicate no worthwhile overall benefit for primary prevention of heart attacks, but a high risk of debilitating side-effects; 75% of people stop taking them within two years. Any hype for alternative cholesterol-lowering treatments is fraudulent since there is usually no reason for lowering cholesterol levels. ‘The only thing we can be absolutely certain of,’ says Kauffman, ‘is that lowering everyone’s cholesterol produces the incredible profits realized by the pharmaceutical industry’ (p. 79).

Myth 4: Nearly everyone over 50 should take drugs for high blood pressure.

Blood pressure increases naturally with age, and is higher in women than in men of the same age. It is very low blood pressure that is dangerous. Using drugs to forcibly lower blood pressure by dilating arteries or veins, weakening the heart, or increasing urination rarely does anything of overall value. Only people with very high blood pressures (the top 10%) would obtain any benefit at all from antihypertensive drugs, and this would be minor as well as accompanied by severe side-effects. The side-effects are so bad that 20 to 60% of people stop taking the drugs within three years.

Medical textbooks are warring about the right blood-pressure levels, and new national standards come out every few years placing the target values ever lower. Kauffman asks: ‘Is good medical practice fueling this war or might it just be the multi-billion dollar pharmaceutical industry? For to lower the target value 5 points on the BP scale can mean $billions more in drug sales’ (p. 110).

Myth 5: A drink a day keeps the doctor away.

Kauffman writes: ‘There is no evidence that moderate drinking of any common alcoholic beverage has worthwhile health benefits overall. ... If you do not already enjoy beer, wine or spirits, there is no reason for you to begin drinking in a vain attempt to obtain longer life’ (p. 142). It is worth noting that when well-known researchers claim in national journals that we can reduce the probability of dying from a heart attack by 60% simply by drinking wine regularly, this wins the author of the article a life-long supply of wine from appreciative manufacturers!

Myth 6: Exercise! Run for your life! No pain, no gain!

Evidence shows that strenuous activities – e.g. fast dancing, running, jogging, handball, squash, tennis, long-distance cycling, and heavy weight lifting – can be dangerous and damaging. The first marathon was performed by Pheidippides in 490 BCE. He ran 42 km from Marathon to Athens to carry the news of the victory of the Greeks over the Persians. What is rarely mentioned is that after delivering his message, he dropped dead!

Strenuous exercise may indeed lead to arrhythmias that produce sudden death in some individuals. Instead of preventing cardiovascular disease and congestive heart failure extreme aerobics such as running and marathon cycling appears to cause them. Knee problems, stress fractures of bones, and joint problems affect a majority of those doing strenuous exercise for years. The mantra ‘No pain, no gain’ ought to be changed to ‘More pain, more risk’.

On the other hand, moderate exercise, such as walking, gardening, swimming, slow dancing, yoga, tai chi, light weight lifting, mild calisthenics, and the use of exercise machines will make those who enjoy the activity feel better and possibly even live a little longer. The important thing is to heed your body’s stress messages.

Myth 7: EDTA chelation therapy for atherosclerosis is ineffective, dangerous and a fraud.

This ‘alternative’ therapy involves administering EDTA (a weak, synthetic amino acid related to vinegar) into the veins. The truth is that this biochemically simple procedure retards or reverses atherosclerosis, prevents cancer, lowers blood pressure, and increases pain-free walking distance. Some 50 clinical trials have shown that it has an extraordinary 87% success rate, even though no one knows exactly how it works. Yet it is vigorously opposed and vilified by mainstream medicine and the pharmaceutical industry, which have resorted to rigged trials and deliberate manipulation of clinical data to support their views. There is simply far more money to be made from orthodox treatments such as coronary bypass surgery and angioplasties. As Kauffman says, ‘Discouraging sick people from undergoing an effective treatment such as EDTA chelation is despicable’ (p. 176).

Myth 8: All ionizing radiation is dangerous except when an oncologist delivers it.

Contrary to the popular dogma that any amount of ionizing radiation causes cancer, there is overwhelming evidence that small doses of radiation actually prevent cancer by stimulating the body’s natural defences. This is known as radiation hormesis, but it is ignored by the authorities. Not only is typical background radiation harmless, it is actually beneficial, and is usually less than the optimum amount. Kauffman concludes that small leaks from nuclear power plants or radioisotopes in transit, and small doses from radon in homes and from most medical imaging techniques are harmless and probably beneficial. People are now paying money to enter caves with radon-laced atmospheres for the purpose of helping their cancers and arthritis, and they are doing so because they find that it works ( Radon may well be one of mankind’s oldest therapies; in Europe, the use of hot springs with high radon content dates back some 6000 years.

Kauffman says that hysteria about low-dose ionizing radiation has been fed by overzealous environmentalism.

This has led to needless expense both in dwellings and workplaces, resistance to nuclear power plants, as well as avoidance of exposure to beneficial medical procedures utilizing low-dose radiation. ...
    The scare over low radon levels, combined with the lawfully mandated remediation cost is one of the most arrant frauds ever perpetrated on an innocent public in the radiation protection field by self-serving ‘health-scare professionals’. (p. 198)

Myth 9: Annual mammograms and follow-up treatment prolong life.

The hard facts about mammograms are these: In an average group of 1000 women aged 40-50, eight will have breast cancer. Seven of the positives will be found by mammograms, the other one will be missed. Of the 992 women who do not have breast cancer, 70 will be wrongly identified as ‘positive’ on the basis of mammograms. In other words, out of the total of 77 ‘positives’ discovered by the mammography programme, only seven (i.e. 9%) will be correct. The only reason that mammography has become so entrenched is because mass cancer screening with follow-up and treatment is big business. Kauffman writes:

The pain of mammograms is not accompanied by the gain of any lifespan. Undergoing annual mammography does not improve all-cause mortality after a diagnosis of breast cancer. The most careful examination of mammography trials does not even support a lower breast cancer mortality. If there is a lower breast cancer mortality, some of it may be attributed to the hormetic effect of the Xrays used in mammography. Another reasonable explanation is that aggressive treatment of the many false positives from mammography ... is replacing cancer deaths with deaths from treatment. (pp. 216-7)

Myth 10: Cancer treatments are better than ever, and have cure rates of 60%.

Cancer experts claim current treatments have a 60% ‘success’ rate, but this should not be confused with a true ‘cure’ rate. What they mean is that 60% of those treated will still be alive five years after diagnosis. But even this modest progress is the result of earlier and earlier diagnosis with very little improvement due to the benefit of mainstream treatments. The five-year survival rate has been called ‘the world’s most misleading number’. In clinical trials, a control patient dying of any cause is counted as a failure of nontreatment, whereas a patient who dies just before a treatment programme is completed is not counted as a failure of treatment, on the grounds that the patient had not completed the treatment programme!

Kauffman says that professional scaremongers, especially pseudo-environmentalists, have caused alarm with their claim that the total number of new cancer cases is at an all-time high in industrialized countries, and that most of the increase in cancer is caused by pesticides or other pollutants. When cancers due to smoking are removed, the age- and smoking-adjusted rate actually shows a 33% drop since 1950.

There is no epidemic of cancer at present except lung and malignant melanoma (skin cancer). The former is due to smoking and the latter, possibly, to too much UVA from sunlight, often caused by overexposure despite UVB ‘protection’ from sunblock, which makes things worse by preventing vitamin D formation in the skin.
    Since there is no epidemic of cancers of the gastrointestinal tract or other places where certain foods, pesticides or pollutants would be expected to manifest themselves, these factors can hardly be major causes of these types of cancers. (p. 254)

It is beyond dispute that mammography in women and the test for prostate cancer in men with no symptoms have no overall benefit. And since the treatments for lung and pancreatic cancer are so poor, there’s not much use being screened and finding out early that you have one of them.

The five-year survival rate was cleverly chosen to mask the delayed destructive effects of radiation and chemotherapy. Highly toxic chemotherapeutic drugs kill all rapidly dividing cells in the body, which means not only cancer cells, but also many kinds of healthy cells, including those of the immune system. Mainstream treatments often provide only a few weeks to months more of poor-quality life. Some alternative treatments work well enough to cause complete remisssions, but are not always available in the US.

Myth 11: Water fluidation prevents tooth decay in children and is perfectly safe.

In the US, sodium fluoride, which is still sold today as rat poison, began to be added to drinking water in 1945, supposedly to prevent tooth decay in children. This provided corporations and federal government agencies with a convenient way of disposing of fluoridated waste products. Fluoridation of drinking water continues in 60% of public water supplies in the US today. Much of Australia, Canada, Ireland, and New Zealand have fluoridated water, but most developed non-English-speaking countries have rejected this practice as nonbeneficial and probably harmful.

Studies reported in the past 15 years indicate only possible slight benefits from water fluoridation for the deciduous teeth of five-year-old children. There is no decay reduction in older children and adults – according to studies by researchers who are not supported by organizations that benefit financially from fluoridation. Kauffman writes:

Proponents of fluoridation have censored most mass media, ignored intelligent discussion of fluoridation, slandered most opponents of fluoridation, and overturned legal judgments against fluoridation in a manner that demonstrates their political power. Many published studies that had conclusions favoring fluoridation were later found unsupported by their raw data. ... Such studies are still quoted regardless.
    There is evidence that fluoridation increases the incidence of cancer, hip fractures, joint problems, and that it damages both teeth and bones by causing fluorosis. (p. 274)

Over a hundred other problems have been linked to fluoride exposure, one of the most serious being low thyroid gland function.

Kauffman says that opponents have weakened their case against fluoridation by condemning all organofluorine compounds, some of which are toxic, but many of which are beneficial, such as teflon.

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In his concluding chapter, Kauffman stresses that although the US has the most expensive medical care in the world, it certainly doesn’t have the healthiest and longest-lived population. In fact, it ranks only 15th among 25 industrialized nations in matters of health. Moreover, there are at least 225,000 premature deaths per year in the US from medical care (known as iatrogenic deaths), half of them from FDA-approved drugs used according to instructions. This makes mortality from treatment the third biggest cause of death in the US after cardiovascular disease and cancer! Other sources argue that the real figure for iatrogenic deaths could be as high as 786,000 – equivalent to six jumbo jets falling out of the sky every day.

Kauffman concludes there is too much surgery in the US, and too many screening tests are carried out; if there is no satisfactory treatment for a condition, as with most cancers, there is little point having a test done. Too many drugs are prescribed, including many of the best-sellers such as antinflammatory, anticholesterol, antihypertensive, and antidepressant drugs. A fifth of hospitalizations occur because of the adverse effects of drugs, and cost more than the drugs themselves. In addition, too many antibiotics are prescribed for non-bacterial infections.

No one is allowed to die a natural death free from the adverse effects of FDA-approved, yet unproven treatment:

The typical 70-year-old USA citizen takes about 7 prescription drugs daily, of which none are really a benefit in most cases, and 5 merely deal with the adverse effects of the other 2. ... [M]edical myths have made normal aging expensive, debilitating and depressing. (p. 280)

A disturbing development is that the UN’s Codex Alimentarius Commission, which has strong ties with the World Trade Organization and multinational corporations, is planning to ban all non-prescription sales of vitamins and supplements, even though many are of great value in preventing and treating some important conditions, as well as being low cost. Kaufmann calls this a ‘Codex-driven pharmaceutical takeover of the natural products industry’. In Canada, for example, possession of DHEA, a harmless and valuable supplement, is now a felony, carrying the same penalty as crack cocaine.

As Codex continues its march, herbs are increasingly classed as drugs with restricted access. ... This is designed to assist drug companies in their technology of PharmaPrinting, which produces versions of herbs that will be standardised and patented by drug companies and approved by government regulators as drugs. (p. 283)

There is a fortune to be made by multinational drug companies that obtain a monopoly over the manufacture and sale of life-sustaining natural products. It has been estimated that if the Codex Commission is allowed to obstruct the eradication of heart disease by restricting access to nutritional supplements, more than 12 million people worldwide will continue to die every year from premature heart attacks and strokes.

Kauffman criticizes the way powerful commercial interests and the government agencies they control routinely debunk all forms of alternative medicine. Although the promoters of alternative treatments are sometimes even less scientific than mainstream promoters, there are some valuable alternatives available.

An extensive list of recommended books and websites is given at the end of Kauffman’s engaging book.

by David Pratt. June 2006.

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