'Placebo effect' may not require deception

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Steve n Dallas
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Date Joined Mar 2008
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   Posted 12/23/2010 6:15 AM (GMT -6)   
Not really PC related - but interesting none the less.
 A simple sugar pill may help treat a disease — even if patients know they're getting fake medicine.
Half the patients were given a bottle with the word "placebo" printed on it. The pills it held, they were told, were like sugar pills. The patients were told they didn't even need to believe in the placebo effect, but had to take the pills twice daily.
The other half were given no treatment at all.
At the end of the three-week trial, 59 percent of the patients taking the placebo said their symptoms had been adequately relieved, far outstripping the 35 percent in the nontreatment group.
** Mind over matter shocked

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Date Joined Jan 2010
Total Posts : 1011
   Posted 12/23/2010 7:50 AM (GMT -6)   
It is amazing what we will waste money on.
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%, nerves spared, no negitive side effects of surgery.
PSA's < .01, .01, .07, .28, .50. HT 5/10. IMRT 9/10.
PSA's post HT .01, < .01

Tim G
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Date Joined Jul 2006
Total Posts : 2361
   Posted 12/23/2010 12:42 PM (GMT -6)   
The placebo effect is powerful.   If P. T. Barnum, the 19th century American Circus Showman ('There's a sucker born every minute'), were alive today he would have skipped a circus career and worked in the diet industry, financial services or some variety of medical quackery.  
In order to move people along to make room for more customers at  circus sideshows, he placed signs with pointing arrows: "This way to the egress", using a technical term to make people think they were about to see an exotic creature rather than heading for the exit.
Same thing probably happens all too often in medicine with  the medicalese.  It may even happen here on occasion in forum posts.

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Date Joined Apr 2008
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   Posted 12/23/2010 5:45 PM (GMT -6)   
This is the reason that trials of new medicines have to be much more complex than we might expect -- to eliminate the placebo effect. Also it's a heads up for us too -- if we take some supplement and it makes us feel better, how do we know that it is not the placebo effect kicking in?

I'm tempted to make up my own placebo -- M&Ms (see the "Need Diet Advice" thread) in an impressive glass jar, suitably marked. When the grandchildren visit, will probably cure all sorts of minor ailments.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4/12 cores
Non-nerve-sparing RRP 7 March 2008 age 63
Organ confined, neg margins. Gleason downgrade 4+4=8
Fully continent
Bimix worked well; now using just VED
PSA undetectable at first but now 0.3, doubling time 7 months
No radiation but ADT coming unless I can slow down the rise...

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Date Joined Oct 2010
Total Posts : 54
   Posted 12/23/2010 5:58 PM (GMT -6)   
The placebo effect is real.

And it's an important support for the quacks.
Dx 2004 at 67 yoa: Extensive Gleason 9 + Gleason 8.

Uro wanted to do cryotherapy, which I would have declined had I known anything. It failed, except I was rendered totally impotent; the only thing that worked as advertised.

IMRT + Lupron.

Studied PCa extensively.

Fired rad onc, who refused to read Dr. Strum's evaluation of my case.

Hired med onc. Have been on IADT since 2006.

Regular Member

Date Joined May 2010
Total Posts : 84
   Posted 12/25/2010 7:58 PM (GMT -6)   
I'd like to share another perspective on these results from a post by someone on another forum. Hopefully the mods won't mind. I'm a mod on the forum from which this came. I know the author won't mind me borrowing his quote. To put some of his comments in perspective, this is from a forum for people with spinal cord injuries and he's discussing people who have neuropathic pain from their injury.
Every medical student, at least the ones I know, has been taught that almost any study of benefit in a ratio of 60:40 is suspect and probably doesn't prove much. The reason is the so called placebo effect.

This doesn't keep drug companies from promoting sales based on this sixty/forty ratio, but real drugs with real effectiveness tend to come in at a higher rate.

You don't get any better than Harvard and Deaconess. Yet, they recently reported a study of irritable bowel where pills labeled placebo, given to patients who were told it was a placebo, had "adequate symptom relief". Even the investigators found it hard to believe.

The piece was published in PloS One, a journal not in the first tier, but gaining some popularity. Significantly, it is published by the Harvard Center for Alternative Medicine. Politicians funded and instructed NIH to establish a center for Alternative Medicine. I am not knocking anything at NIH, but it traces its roots to political influence. I am not aware that NIH is in the habit of turning down money, but from what is reported, it seems the idea for such large funding came from politically minded individuals, presumably with a strong belief Alternative Medicine is being ignored.

So what do we make of this 60:40 study of irritable bowel? First of all, why irritiable bowel, which is a symptom based diagnosis? Excess serotonin has been theorized as a generative cause. Never confirmed. Traditionally, it is diagnosed by the lactulose hydrogen breath test, which suposedly showed small intestinal bacterial overgrowth, although Vanner's article at Gut. 2010 Nov 26 showed this fancy test doesn't diagnose bacterial overgrowth. So we have a nebulous entity to begin with. Why not use placebo in strep throat, psoriasis, male pattern baldness, or atrial fibrillation, where there is something we can measure? So, what is IBS and how is symptom relief measured.? What is a number which represents "adequate symptom relief" What symptoms, subjective or objective, is the study based on. Finally, where are the biopsy, or chemical studies to confirm the data.

Predictably, this study has given new impetus to the mind/body crew, who tend to see anything anyone else has as largely psychosomatic.

I only ask this. Why would a spinal cord injured victim, who is entitled to plenty of validation just because people can see they cannot walk, resort to some fantastic story of unendurable pain, which is almost never validated. Do SCI people have an aversion to validation. Not likely.

Why would any sane person who is paralyzed, claim his/her pain is much more disabling and much harder to endure than the lack of mobility. Anything they are going to get, they are going to get because they cannot get around.

Why is it possible to create an animal model for central pain merely by a little cord injury? Why do these animals attempt to chew off the affected limb to get rid of the pain.

Having spent hard time in a review of journal articles with a master statistician, it soon became obvious that nearly all articles are plagued by statistical weakness. The samples are not random. There were confounding factors. The sample was too small, etc. etc. There is no objective measure of severity nor is there an objective measure of relief in IBS.

In such illnesses, there is a certain tendency to ignore what the patient is saying. It is time for capsaicin injection again, to beat back those who fall for the mind/body idea in severe pain of central origin.

Central Pain patients need this like Custer needed more Indians. When will people learn that sixty/forty is just not good enough.
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