illness, but not if your medical problem is a hangnail.
Medical science is, in the main, a triumph of statistics over common sense. When bumping up against unpalatable truths in the study, medical scientists, who again always assume a medical treatment to be beneficial, are inclined to put the best face on the whole exercise, or cut and paste, refine and edit, to fit the premise or explain away an undesirable result.
Some years ago, a large study from the Netherlands Cancer Institute showed that all women taking the Pill, no matter what their age, had an increased risk of breast cancer. Most worryingly, 97 per cent of women under aged 36 who contracted breast cancer had taken the Pill, for any length of time.14 For more than 30 years, doctors have been touting the Pill as the safest drug ever developed. The Dutch study, now the fifth and possibly most damning to show a link between the Pill and cancer, was a colossal embarrassment to an entire industry devoted to contraception at all costs.
However, once they trumpeted the negative findings in the beginning of their article, the Dutch researchers began back-pedalling, by qualifying the overall implications of their findings. They emphasized that the increased risk mainly occurred among certain subgroups. Because the numbers supposedly showed no increased risk of breast cancer after long-term use among women in their latter thirties, their study was, in effect, good news: ‘Our findings accord with the mass of evidence that [oral contraceptive use] by women in the middle of their fertile years [25–39 years] has no adverse effect on breast cancer risk’ (my italics).
Doctors can often minimize the risks of drugs by magnifying the risk of not using them. Most studies have been able to justify that the Pill is safe by turning pregnancy into a dangerous disease. This risk-benefit equation only works if you believe it is better to risk breast cancer, cervical cancer, a stroke or thrombosis – all known risks associated with the Pill – than to have an unwanted baby or to use a condom instead.
A spokeswoman from the British Family Planning Association, which has probably handed out its fair share of Pills to teenagers, dismissed any breast cancer risk out of hand, arguing that this theoretical risk had to be weighed against the ‘evidence that the Pill protects against endometrial and ovarian cancer’.15 This is a typical example of medical reasoning. This drug is beneficial because it may ‘protect’ you against one kind of fatal cancer (a highly questionable conclusion, in any event), even though it may give you another potentially fatal cancer.
And because they live and breathe medicine by numbers, and believe in the infallibility of their tools, doctors are willing to hand out dangerous medication on the confident assumption that new tests will pick up any side-effects that they cause, and yet other drugs will be able to treat these new problems. Hence the reason why family planning enthusiasts will usually patiently explain that, even though the Pill may cause cervical cancer, cervical smears should pick up early changes, at which stage things are mainly treatable. Like many in medicine, they make the fatal error of requiring medicine to be infallible. This reasoning works if a test that can be wrong more than half the time picks up the cancer early, and if medicine can always cure cancer, which thus far it has singularly failed to do.
This kind of tortuous logic was once used to minimize evidence showing a link between vasectomy and the development of prostate cancer. The two studies, which examined over 74,000 men who had had vasectomies, showed that vasectomy increases the prostate cancer risk by 56 to 66 per cent.16 Those patients who’d had their operation done 20 years ago faced a whopping increase in risk of between 85 and 89 per cent. In other words, having a vasectomy 20 years ago nearly doubles your risk of getting cancer.
Pretty damning evidence, one would have thought. Nevertheless, after it was published, some professional magazines encouraged doctors to tell their patients that the risk of prostate cancer following a vasectomy was minimal. The article attempted to claim that, compared to other methods of birth control (the condom? natural family planning?), vasectomy is ‘still one of the safest’. A Family Planning Association spokesperson concurred: ‘These studies do not tell us that vasectomy causes prostate cancer’ (again, my italics).
A similar situation has occurred with HRT. Although two major studies were stopped when it was found that women on HRT are more likely to have heart attacks, cancer and stroke, the British medical establishment refused to recant or admit that this might not be the treatment of choice for women going through the menopause.
Doctors and medical researchers have been known to hype up the risks of a disease compared with the risks of the drug used to treat it. Dangerous drugs look good if you turn an ordinarily benign problem into a killer disease. In 1992, the UK Department of Health (DoH) announced the hasty withdrawal of two of the three brands of the combined measles, mumps and rubella (MMR) vaccines. The official line circulated to the press about why these drugs were withdrawn, after having been jabbed into millions of 15-month-olds, were allegedly the results of a study showing that the two withdrawn brands had a ‘negligible’ (1 in 11,000) risk of causing a ‘transient’ and ‘mild’ (all DoH words, these) case of meningitis. The third brand, made from a different strain of the mumps virus, supposedly did not pose this risk.
In 1989, when I first interviewed Dr Norman Begg of the UK’s Public Health Laboratory Service, which recommended the vaccine in Britain, he assured me that mumps on its own was a very mild illness in children. Mumps, he said, ‘very rarely’ leads to long-term permanent complications such as orchitis (where the disease hits the testicles of adult males, very occasionally causing sterility). The mumps component had only been added, he said, to give ‘extra value’ to the jab.17
By 1992, however, when the two versions of the MMR were withdrawn, the British government painted a very different picture, announcing that mumps leads to meningitis in 1 in 400 cases. Hence, even though the old vaccine was dangerous (and it must have been pretty dangerous to get hauled off the market virtually overnight), it was not as dangerous as catching mumps.
But of course, two-thirds of medical practices don’t have any proof at all. There is no such regulatory agency like the Food and Drug Administration or the Committee on Safety in Medicines to monitor surgery, screening or diagnostic tests – nothing but peer review through national medical associations. Run by doctors for doctors, these organizations tend to rule by consensus, and by a peculiarly circular logic: if a practice is universally employed, it must be safe, even when many studies point otherwise.
In the case of surgery, most treatments get the nod without any kind of clinical trial (partly because it is very difficult to have either a randomized or double-blind trial or to reverse an operation with an unfavourable result). Consequently, some new techniques get adopted with very little in the way of proof to show they are doing any good or at least not doing drastic harm.
Medicine as it is currently practised is a private conversation by doctors, for doctors. There’s no doubt that medicine maintains a double standard. Doctors often privately voice their doubts, disappointments and fears about particular treatments in their own literature, yet fail to disclose this in any discussion with patients or the press. For instance, some years ago an especially alarming piece of information came to light about vaccines. The US Centers for Disease Control and Prevention in Atlanta, Georgia, discovered that children receiving the triple jabs for diphtheria/tetanus/whooping cough or for measles/mumps/rubella were three times more likely to suffer seizures. Nevertheless, this information was only announced to nine scientists and was never otherwise publicized.
Another prime example of this double standard surrounded the issue of treatment for breast cancer. An editorial in The Lancet published a scathing attack on the failure of mammography as a technology to halt the rising breast cancer death
