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Highly Commended 2004Comment and Opinion

Cancer Monthly: The Source for Cancer Treatment Results
(I have not asked for permission to link to the Cancer Monthly site, and I won't be asking in the future. Sorry.)

This site was Highly Commended in the 2004 Millenium Awards. The citation read:

The 2000 Anus Maximus Award was given to people who were using a dying child to advertise for a cancer quack, in that case Dr Stan Burzynski. I mentioned at the time that another site had just missed out on the award. The one which came in second was a supposed memorial site to a boy who died of cancer but it was really an advertising site for Burzynski's quackery clinic. It might surprise normal, sane people that anyone would exploit the death of their own child in an advertising campaign for a client, but the father of the dead boy turned up next writing PR material for baby-killer Alan Yurko so we can be assured that he had neither a conscience nor any sense of morality.

The father has a new project, Cancer Monthly, which is going to provide a database of information about cancer and its various treatments and cures. You might say that this is a noble goal, but you can rest assured that no treatment for any form of cancer which is even remotely likely to work will be listed there except by accident or as the single exception to be produced whenever the site is criticised. This project is driven by a man who hates medicine so much that he was prepared to use his son's death to promote quackery. The site will accept advertising, but not from drug companies or hospitals specialising in cancer treatment, or, presumably anyone else who might know what they are talking about.

The site is not all bad, and there are at least two things on it which are actually funny. One is the User Agreement which visitors are supposed to agree to before using the site, and the other is a list of eight questions to ask your oncologist.


Here are the questions which patients are urged to ask their oncologist. I wonder if people seeing quacks like Burzynski or Clark are supposed to ask these questions, and if they are, what would be the acceptable responses for Questions 2 to 8 might be.

Questions For Your Oncologist

Here are eight questions to consider when you are discussing cancer treatment options with your doctors.

1. Is it alright if I tape this conversation?
When life and death decisions are at stake, conversations with oncologists and other physicians take on enormous importance. In addition, sometimes these conversations take place when the doctor is very busy. Given the subject, the hurried bedside manner of some physicians, and the emotional intensity for the patient and family, it can be very hard to listen, understand, and ask appropriate questions. Tape recording important conversations with your doctor(s) about treatment options is an excellent way to provide a record so that you can: 1) concentrate on listening; 2) do not have to worry about taking notes; 3) can focus on your questions; 4) can replay and review the conversation in a less stressful environment such as your own home to fully comprehend what the physician communicated.

An added benefit is that recording the conversation can facilitate more time with the doctor. When the oncologist knows the conversation is taped they may actually give you a few extra minutes. Furthermore, it provides an advantage to both you and your doctors if there is ever a question later about what was or was not promised.

Do not secretly tape record anyone. In many jurisdictions this is against the law. You should always obtain permission by telling your doctor(s) that you want a tape recording of the meeting/consultation so that you can review it later or you wish to share the conversation with a family member who could not be present at the meeting. In fact, it is always a good idea to use the first few seconds of the recording to have all the parties acknowledge that the meeting is being recorded with their permission.

2. Did you send my pathology (report and slides) to another hospital for a second opinion?
The pathology of your tumor cells tells pathologists whether you actually have cancer and what kind. Having a second look/opinion by another pathologist from another hospital helps ensure that you have been properly diagnosed. There have been unfortunate situations when patients have been treated inappropriately because the wrong kind of cancer was diagnosed. In many hospitals it is standard practice to "send the slides out" for a second opinion. You may want to check to ensure this step was taken in your case and find out who rendered the second opinion and what they concluded.

3. Do you have any financial or research interest in this treatment you are recommending?
For example, are you being paid by a drug company when you prescribe these drugs? Do you consult for the drug company that makes these drugs? Some oncologists have financial arrangements with various drug makers or other financial incentives that could be construed as a conflict of interest. You should find out whether your doctor(s) has any financial or research interest in recommending a certain treatment.

4. How many patients have you treated with my exact same cancer?
Same age and same cancer? Which treatments did you use? Are any of the patients still alive? Can I speak with them? You want to get a good idea of what the oncologist's experience is with the various treatments being recommended. You should find out how many patients (your age with the exact same cancer) they have treated with each therapy. Ask if you can speak to these other patients. Other patients (like you) who have been administered the same therapy by the same oncologist(s) can provide valuable insight into what to expect.

5. Did any patients have side-effects from the treatment?
What were they? What was the worse side-effect? Did anyone die from the treatment, not the cancer? Some patients do not die from their cancer, but die from the treatment. You should ask questions to learn how toxic the therapy is.

6. Are these drugs FDA approved for treating my cancer?
Many cancer drugs are not FDA-approved for the use for which they are prescribed. (This is called "off-label" use.) In fact, some drugs that are widely used for a particular cancer may never have been approved for safety or efficacy for that use by the FDA. It is valuable to know if any of the drugs the oncologist intends to prescribe would be used "off label" and if so, why the oncologist is comfortable with that use.

7. Can you show me where the survival information comes from?
Is it reported in the peer-reviewed published medical literature? Can you give me a copy of the article? Cancer Monthly provides survival information from the medical/scientific literature - journals your doctors should be familiar with. The oncologist should be able to support any survival/prognosis claim they may make with data or published studies that they can share with you. Be wary, if they can not support their claims of a potential cure with medical studies or with examples of other patients they have treated.

8. What is my prognosis with no treatment?
Comparisons are very seldom made between the results of a clinical trial and those patients who received no adjuvant treatment (i.e. no therapy beyond surgery). When survival and quality of life comparisons are made, they are usually made between two or more treatments, not between treatment and no treatment. It is very difficult, therefore, for an oncologist to objectively answer the question how long did the treated patients live and what was their quality of life compared to those who received no adjuvant therapy. Nonetheless, it may be of interest to ask your doctor for a reference/study that discusses this. Be advised that such studies may not be available.


And here is the User Agreement. You have to tick a box saying that you accept these conditions before you can read anything on the site. I am not making this up. The shouting capital letter stuff is in the original. The reason for using all caps is to make those passages hard to read. This is a quite deliberate ploy, so it is always useful to look at these paragraphs closely as that is where you will find the stuff that they don't want you to notice.

Introduction

Welcome to CancerMonthly.com (hereinafter, "Cancer Monthly" or the "Site"). Cancer Monthly provides you with access to the Site subject to the terms and conditions contained in this User Agreement (the "Agreement'). Please read this Agreement carefully. You may wish to print this page for reference.

By accessing or using this Site, you agree without restriction to be bound by this Agreement. If you do not agree to follow and be bound by this Agreement, you may not access, use, print, e-mail, search, download, or otherwise use materials from this Site.

The Site is administered by Cancer Monthly from Raleigh, North Carolina in the United States. This Site and its contents (the "Content") are designed to comply with United States laws and regulations and are intended for use by United States residents only. Access to the Site and the Content may not be legal by certain persons or in certain countries outside of the United States. If you access this Site from outside the United States, you do so at your own risk and are responsible for compliance with the laws of your jurisdiction.

1. Modification of this Agreement

Cancer Monthly reserves the right to update or modify this Agreement at any time without prior notice. Any modification is effective immediately upon posting to the Site. Your use of this Site following any such change constitutes your agreement to follow and be bound by this Agreement as revised. For this reason, we encourage you to review this Agreement each time you use this Site. Your only right with respect to any dissatisfaction with any modifications made pursuant to this provision, or any policies or practices of Cancer Monthly in providing the Site, including without limitation any change in the Content, is to terminate your use of the Site.

All provisions of this Agreement pertaining to indemnification, disclaimer or warranties, limitation of liability and proprietary rights shall survive the termination of this Agreement for any reason.

2. Your Rights

Cancer Monthly grants you a non-exclusive, non-transferable, limited right to access, display and print out pages from the Site and the materials provided hereon, provided that you comply fully with this Agreement. The contents of the Site are only for your personal, noncommercial use. You agree not to interrupt, or attempt to interrupt, the operation of the Site in any way. You may download Content from the Site for your own personal, non-commercial use only, provided the Content is not modified in any way and you keep intact all copyright and other proprietary notices. You may also e-mail individual treatments summaries ("Treatment Details") and drug information ("Drug Details") to others, provided the Content is not modified in any way and you keep intact all copyright and other proprietary notices.

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THE CONTENT OF THIS SITE IS PRESENTED IN SUMMARY FORM, IS GENERAL IN NATURE, AND IS PROVIDED FOR INFORMATIONAL PURPOSES ONLY. THE CONTENT OF THIS SITE IS NOT INTENDED, NOR RECOMMENDED AS A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE, TREATMENT ADVICE OR TREATMENT RECOMMENDATIONS. ALL INFORMATION PRESENTED IN CANCER MONTHLY IS STRICTLY INFORMATIONAL IN NATURE, AND IS NOT TO BE CONSTRUED AS A FORM OF COUNSELING, DIAGNOSIS, OR TREATMENT. YOU SHOULD NOT USE THE CONTENT OF THIS SITE FOR DIAGNOSING A HEALTH OR FITNESS PROBLEM, CANCER OR ANY OTHER DISEASE. YOU SHOULD NOT USE THIS SITE TO TREAT A HEALTH OR FITNESS PROBLEM, CANCER OR ANY OTHER DISEASE. UNDER NO CIRCUMSTANCES SHOULD ANY OF THE INFORMATION ON THIS SITE BE USED TO SELECT A CANCER TREATMENT, THERAPY, PROTOCOL, MODALITY OR DRUG WITHOUT CONSULTING WITH A LICENSED HEALTHCARE PROVIDER. CANCER DIAGNOSIS AND TREATMENT SELECTION SHOULD ONLY BE MADE WITH A MEDICAL PROFESSIONAL. THE INFORMATION PROVIDED ON THE SITE IS NOT TO BE USED TO REPLACE THE GUIDANCE OF A MEDICAL PROFESSIONAL. IF THE INFORMATION ON THIS SITE LEADS YOU TO A TREATMENT OF INTEREST, THAT INFORMATION SHOULD BE SHARED WITH YOUR PHYSICIAN OR OTHER LICENSED HEALTHCARE PROVIDER.

NEVER DISREGARD MEDICAL ADVICE OR DELAY IN SEEKING MEDICAL ADVICE BECAUSE OF SOMETHING YOU HAVE READ ON THIS SITE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH PROVIDER REGARDING ANY MEDICAL CONDITION OR TREATMENT.

4. Information Presented is Not Complete or Comprehensive

You acknowledge and agree that the information provided on the Site is not complete or comprehensive. The information on this Site constitutes summaries of information provided in some articles written in some journals about the results of some cancer treatments. Therefore, the information on this Site should not be relied upon as comprehensive, nor as a presentation of information on all available cancer treatments. Summaries of many cancer treatments are excluded from this Site.

For those treatments where summary information is provided, such information is not comprehensive or complete. Important aspects or information about a particular treatment may be excluded. For more complete information about a particular treatment you should ask your licensed healthcare provider.

The Site provides some information about various drugs. The information provided about a drug is for informational purposes only and is not a substitute for consultation with your health care professional. The information about a specific drug is in no way a recommendation as to the safety, efficacy or appropriateness of any particular drug, regimen, dosing schedule, nor is it in anyway to be considered medical advice. As with any printed reference, the information about a particular drug may become out-of-date over time. New information may have been published and become generally accepted after the information that appears on this Site. Patients should discuss the appropriateness of a particular drug with their physician.

The brand name that Cancer Monthly associates with a particular drug is based on FDA information, however, there may be other brand names associated with that drug that the Site does not mention.

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Cancer Monthly does not guarantee or warrant the accuracy, completeness or comprehensiveness, of any of the source materials used, summarized, presented or discussed in the Site. By accessing this Site, you acknowledge and agree that Cancer Monthly summarizes information presented in some scientific and medical journals and that Cancer Monthly is not responsible for any inaccuracies, omissions or errors in these articles. You also acknowledge and agree that no treatment decision should be based on any article or articles printed in one or more medical or scientific journal. Only a physician can prescribe a treatment and no article cited, sourced, or otherwise used by Cancer Monthly should ever be used to make treatment decisions without consulting with your doctor and other medical professionals.

Moreover, while Cancer Monthly makes every effort to ensure that its treatment summaries accurately reflect what has been written in professional medical and scientific journals, there will be occasions where the information summarized by Cancer Monthly is inaccurate or wrong. This is another reason why the information presented in Cancer Monthly should never be used to make a treatment decision and that treatment decisions should only be made in consultation with medical professionals.

You acknowledge that any reliance upon any advice, opinion, statement, or other information displayed or distributed through the Site is at your sole risk. Cancer Monthly reserves the right, in its sole discretion and without notice, to correct any errors or omissions in any portion of the Site, or to deny access to the Site to anyone at any time.

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None of the Site information may be used in advertising or for any other commercial purpose, including any use on the Internet. Cancer Monthly will exercise all rights to prevent commercial use of its materials or its name.

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