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A major focus of my blogging for Science-Based Medicine ( SBM ) has been to leverage my understanding of cancer as a cancer clinician and scientist to deconstruct alternative cancer cure testimonials. Whichever quack is behind such testimonials, over the years I’ve made it one of my main goals to demonstrate how seemingly convincing stories are damned near close to never good evidence of an anticancer effect due to the intervention used in the testimonial. Indeed, I refer to these stories as “testimonials” rather than anecdotes or case reports. In medicine, the word “case report” has a specific meaning as an organized, detailed description of a case, something that testimonials almost always lack. In reality, these testimonials are marketing, either to sell a product to make a profit, to sell a story because the patient telling the story has become a true believer in the quackery chosen, or both. Unfortunately, as we learned from a survey released by the American Society of Clinical Oncology (ASCO) last week, belief in alternative cancer cures is prevalent in the US, with 39% of the population agreeing with a statement that alternative medicine “natural treatments” can cure cancer by themselves, without conventional surgery, chemotherapy, or radiation therapy, a percentage that approaches 50% among young adults.

From my perspective, a large part of the reason for the prevalence of beliefs like this is that alternative cancer cure testimonials are effective. They’re the reason that cancer quacks like Robert O. Young attracted people with cancer to Rancho del Sol, his 40-acre ranch located in Valley Center, California, for so many years before the law finally caught up with him, promising to cure them with his “pH Miracle Living” program, which involves “alkaline water” and a number of other treatments claiming to “alkalinize the body.” I’ve written about Young’s quackery rather extensively, particularly in this post and on my not-so-super-secret other blog; so I won’t go into a lot of detail, other than to point out a couple of things. First, this was what Young claimed about cancer:

The following is a summary of understanding cancerous tissues: Cancer is not a cell but a poisonous acidic liquid. A cancer cell, is a cell that has been spoiled or poisoned by metabolic or gastrointestinal acids. A tumor is the body’s protective mechanism to encapsulate spoiled or poisoned cells from excess acid that has not been properly eliminated through urination, perspiration, defecation or respiration. The tumor is the body’s solution to protect healthy cells and tissues. Cancer is a systemic acidic condition that settles at the weakest parts of the body – not a localized problem that metastases. Metastases is localized acids spoiling other cells much like a rotten apple spoiling a bushel of healthy apples. There is no such thing as a cancer cell. A cancer cell was once a healthy cell that has been spoiled by acid. The tumor is not the problem but the solution to protect healthy cells and tissues from being spoiled from other rotting cells and tissues. The only solution to the acidic liquids that poison body cells causing the effects that medical savants call cancer is to alkalize and energize the body. In conclusion, the human body is alkaline by design and acidic by function! If we desire a healthy body we must maintain that alkaline design.

This is wrong on so many levels, particularly the part about cancer cells being healthy cells “spoiled by acid” but also including his claims that “alkalinizing the body” will cure cancer. I also note that he claimed that viruses are “molecular acids” (he claimed his “pH Miracle Living” could cure HIV/AIDS as well) and that he is basically a germ theory denialist as well, having used the tragic death of a Brazilian model due to sepsis to claim that sepsis is not caused by bacterial infection, but rather by “acidic lifestyle choices, including acidic food, drink, and drugs – especially dextrose and/or antibiotic IV’s given at hospitals around the world.”

However, the case that made Robert O. Young most infamous was that of Kim Tinkham. Tinkham, you might recall, was a woman diagnosed with breast cancer who appeared on The Oprah Winfrey Show over 11 years ago. During the interview, Tinkham told Oprah that she was not going to undergo surgery, chemotherapy, or radiation but that, thanks to The Secret, she believed that the universe would bring her healing, which was why she chose to use alternative medicine to treat her cancer. (Often forgotten these days is that Oprah was a big proponent of The Secret back then, which preaches that if you want something badly enough, visualize something clearly enough, the universe will manifest it for you.) Who was the quack that Tinkham chose? You guessed it: Robert O. Young. As a result, Tinkham became a passionate advocate for Young’s quackery, even recording YouTube videos with him to tout his “pH Miracle Living.” Ultimately, Tinkham died of her disease, although it did take over three years to happen. No one knows how many other cancer patients who didn’t talk to Oprah Winfrey chose to trust Young, with the same results.

Oddly enough, none of them ever sued Young; that is, until now. Indeed, last week was a very bad week for Robert O. Young, because he was on the wrong end of a $105 million judgment of a lawsuit brought by one of his victims. First, however, let’s back up a couple of years to see what befell Young.

The further fall of Robert O. Young

As I alluded to above, the law finally did catch up with fake “doctor” Robert O. Young nearly three years ago, when he was arrested for practicing medicine without a license, as well as other charges, including fraud. He was convicted of multiple counts of practicing medicine without a license, but the jury deadlocked on other charges, including the fraud charges. The prosecutor planned to retry him for the charges over which the jury had deadlocked, but ultimately a plea deal was struck in which Young did spend time in prison, had to admit in open court that he was not a microbiologist, hematologist, a medical or naturopathic doctor, or a trained scientist, and could no longer offer any sort of medical treatments at his ranch. (Basically, Young claimed to be a naturopath, but he had actually gotten his degree from a diploma mill.)

Since he got out of prison, I haven’t heard much about Young, and that’s good. It means that he hasn’t been practicing his quackery. Oddly enough, though, I also never heard about the lawsuit brought against him in late 2015 by a former patient of his, Dawn Kali. (Oh, well, I guess I can’t catch everything.) The suit specifically charged Young with holding himself out as a licensed medical doctor, advising Kali (who had been diagnosed with breast cancer) not to have her tumor removed or to undergo chemotherapy, and treating her with his “pH injections” and other alternative medical therapies. Her further claim was that this was all done under the cover of a doctor named Ben Johnson who “did not have a physician-patient relationship with Plaintiff, but negligently allowed Defendants Young and pH Miracle Living to use his name and license as a cover for their negligent, unlicensed, conduct.”

Here’s a news story from a couple of weeks ago, when the case went to trial:

From the story:

He [Young] is now defending his controversial therapies in civil court, where former patient Dawn Kali is suing him for fraud and other wrongdoing. Kali told the jury she was diagnosed with breast cancer 10 years ago. She explained in detail how she rejected chemotherapy, radiation and other conventional Western cancer treatments and instead followed Young’s advice and alternative treatments. Kali said her cancer continued to spread, despite Young’s reassurances that his treatments, if followed strictly, would cure her disease. One of Kali’s attorneys, Bibi Fell, said her client now has stage four invasive breast cancer and has a life expectancy of about four years. Kali’s lawyers are asking the jury to award their client more than $10 million in general and punitive damages.

To be sure, a ten year course without treatment is considerably longer than average for breast cancer. As I’ve discussed many times before, we know from historical data from Middlesex Hospital in the UK that the median survival for untreated breast cancer in the pre-mammography era was 2.7 years. However, breast cancer is a very heterogeneous disease, and biologically it can behave very differently in many women, and we also know from the same study that there is a “long tail” to the survival curve, with 3.6% of women with untreated breast cancer being alive at ten years. These days, we would expect the number to be larger, given that so many breast cancers are diagnosed by mammography and are thus much earlier in their progression than cancers diagnosed during the period 85-203 years ago covered by the study to which I’m referring. None of this means that Young actually helped her or that any of his methods are effective against cancer. There’s no evidence that they could be or that they are. It just means that Kali likely has a more indolent form of breast cancer.

You might notice that the lawsuit only asked for $10 million (although another site implied that $50 million was being sought). The verdict, however, included an award to the plaintiff much, much larger than that:

I’m not a lawyer, but whenever a jury awards a plaintiff a lot more money in judgment than was being requested, it’s usually to send a message. This can be because the plaintiff was particularly sympathetic and/or the defendant was particularly unsympathetic or clearly lying and/or the offense was particularly egregious.

I only have part of the trial transcript, but it’s Young’s testimony (PDF1 and PDF2). Predictably, he testified that Kali knew he wasn’t a medical doctor and that she was free to seek conventional cancer care any time, but a lot of his other testimony was pretty damning. We learn from him that “retreats” at his ranch were a minimum of seven days and could run up to $2,000 a day. Of course, she likely heard disingenuous responses like this one, which came in response to a question about whether or not Young had ever done “blood analysis” on Kali’s blood:

Well, for the benefit of those who are listening to this testimony, the live blood test is a test where you take a finger prick and you take that one drop of blood and you put that on a slide. Then using a compound microscope you look at those cells. And there are specific ways that those particular cells should look. So it’s not a quantitative test. It doesn’t give you a number, it gives you a view. And since red blood cells are being changed at 5 million per second, that picture could evolve different ways over a period of 120 days, which is the life of a red blood cell. So I would take a drop of blood, not for diagnostic purposes, but I would take a drop of blood, I would put that on a slide and allow the client to see the quality of their blood. And based on millions of samples of blood that I have taken over 40 years, it is obvious to someone who has been trained in live and dry blood cell microscopy by one of the greatest scientists in the world – – Professor Murray Reicher from Essen, Germany — that when you are studying looking at blood, it’s not to diagnose any disease, but to allow that person to see the quality of the blood and to note changes in that blood if someone is doing lifestyle changes or diet changes. It’s been the nature of my research for 40 years.

“Live blood analysis” (as well as “dried blood analysis”) is utter quackery. It’s basically looking at blood and making things up about it. It’s not for nothing that Mark Crislip once referred to it as “the modern auguries.”

Now here’s the disingenuousness:

I looked at Dawn’s blood and what I said, I can’t remember. But I would have commented not quantitatively, but qualitatively. I would show her a picture of what a healthy red blood cell looks like — which is round and symmetrical, even in color, even in shape, even in size — and I would show her a picture of what unhealthy blood looks like, which is uneven in shape, uneven in its color, and its form.

After this he denied telling Kali whether he saw cancer cells in her blood, going on about how you can’t see cancer cells in blood analysis. He also claimed that he was just trying to help, that he never charged Kali anything, and that the pH Miracle Ranch paid for thermography, cancer marker tests, ultrasounds, and more. Then he kept being disingenuous during his questioning by the plaintiff’s attorney:

Q. Did you advise Dawn Kali not to get a biopsy of the lumps in her breast and armpit? A. That was her decision. I never told her not to get a biopsy. Never. Q. Did you ever recommend to her not to get a biopsy? A. Never. Q. Did you ever recommend to her not to get surgery? A. Never. That was her decision in 2007, 2009, 2012, even when she went to the doctor in 2013. This is all Dawn Kali. Q. Did you ever recommend to her not to get radiation? A. That subject never came up. I never heard that word, “radiation,” coming out of her mouth. Q. Did you ever recommend to her not to get chemotherapy? A. Absolutely not. We had clients that were receiving chemotherapy, and we supported any client and their medical doctors. Q. Did you ever recommend to any of your clients not to get a biopsy? A. That’s beyond my belief system. You know — yes, you know, Hippocrates says, you know, do no harm, but the bottom line is the patient is in control of their decisions. It’s their decision, not my decision. Absolutely would I — would I not tell somebody not to do something, especially if they are getting advice from their medical doctor. It’s just — I can’t — I can’t oversee that. And that just goes beyond — beyond my belief system.

I wouldn’t believe Young about any of this, given his long history of writing how the treatment for cancer is not chemotherapy, radiation, or surgery, but correcting the patient’s pH, and I’m guessing the jury didn’t believe him either, given that he was led through some of his past quack claims in one of his books by the plaintiff’s attorney and reconfirmed his belief in all of them. For example:

Q. (As read): “Cancer is not a cell but an acidic liquid that spoils ourselves, whatever acids are not properly eliminated through urination, perspiration, respiration or defecation.” Do you agree with that statement? A. Yes. Q. (As read): “Hence, all cancers are the expulsion of acids from the blood and then tissues at different points and are essentially of the same character and evolving from the one cause, namely, systematic acidosis.” Do you agree with that? A. Absolutely. Q. (As read): “Breast cancer is the leading cause of death in women, and these fatty tissues, parenthesis, breast areas, are being used by the body to bind or collect the acids in order to protect the organs that sustain life?” Do you agree with that statement? A. Yes. Q. (As read): “If you don’t want cancer, if you want to prevent it, you have to pee or eliminate your acid through urination or perspiration. And if you are a cancer sufferer, you have to pee your way to health because cancer is not a cell but a poisoning acidic liquid.” Do you agree with that? A. A poisoning acidic liquid of the cells, yes. Q. Of the cells? You mean in the cells? A. No. Can I explain? Q. You’ll have a chance when your lawyer — A. I’ll explain later. Okay. Q. (As read): “So cancer is a systematic acidic condition that settles in the weakest parts of the body, not a local problem that metastasizes. You see, metastases is localized acid that spoil other cells much like a rotten apple spoiling the bushel of other healthy apples.” Do you agree with that statement? A. I do. Q. (As read): “The cure, the prevention, the reversal for cancer is not found in the treatment of tissue but rather in maintaining the alkaline design of the human organism. And the most important test that you can do to determine whether you are in a state of over acidity is testing the pH of the fluids.” Do you agree? A. I agree. Q. (As read): “So are tumors bad or good? They are good because they are the expression of the body in preservation mode trying to prevent healthy tissue from spoiling.” Agree or disagree? A. I agree.

This goes on for several pages of the transcript, during which Young repeatedly confirms his belief in cancer as reaction to cells “spoiled by acid”, his belief that bacteria don’t cause infections, and a number of other pseudoscientific beliefs. Worst among these is victim blaming, in which he agreed with statements from his book stating that:

“All cancerous tissue is curable, not all patients are. I’ll say it one more time. All cancerous tissue is preventable, reversible, curable, but not all patients are because they are not willing to do what it takes to bring their body in balance.”

“Cancerous tissue by any name is nothing more than a consequence of choice.”

“Someone doesn’t get breast or brain cancer. You have to work on it every day.”

It kept getting worse and worse. Young claimed that over 300 patients had come to his ranch with cancer and left without it, that he had a high success rate with stage IV metastatic cancer.

He also compared himself to Jesus.

The verdict, and why more victims of quacks should sue

Assuming that the plaintiff’s attorney did her job well (and she appears to have), Young’s testimony had to be disastrous, as he blathered on about how cancer is the body’s reaction to cells “spoiled by acid,” how viruses are “molecular acids,” how cancer can be cured with diet and “alkalinization” alone, and tried to evade questions. We also learn that, since he got out of prison has been doing some lectures, although he denies that he’s done any retreats. On the other hand, he sounded as though he planned on doing a retreat in Italy in 2019. I got the impression from his testimony that Young was definitely planning on taking his quackery overseas as soon as he can. I can’t help but wonder if that’s another part of the reason that the jury ruled as it did, for a total of $105 million.

Young and his attorney Conrad Joyner also, predictably, blasted the verdict:

“It’s totally outrageous,” Young said of the verdict when reached by phone Friday afternoon. “It’s one-tenth of a billion.” He also said it was “appalling” that the jury awarded so much more than the plaintiff had sought.

And Joyner’s reaction:

Joyner said he sees the case as “ripe for appeal”:

“I have never heard of a jury case with that much damages where the jury comes back in about three hours,” Joyner said. “I wonder how much thought they really put into it.” Young said there was “a tremendous amount of evidence” he was not allowed to present to the jury. He said he would appeal.

Of course he will.

I’ve discussed before how ineffective state medical boards are in reining in even utter quacks. It’s problem that’s frustrated me ever since I started paying attention to cancer quackery and other alternative medicine. Not infrequently, I’ve wondered why victims of cancer quacks (or their families, given that the victims usually die of their cancers before a lawsuit can be concluded) don’t sue the quacks who victimized them more often. I suspect that part of the reason is embarrassment on the part of the patient and family that the patient has been taken advantage of and believed the quack. On the other hand, people who have been financially defrauded for other reasons don’t seem to have this same reluctance to sue.

Whatever the reason, if there’s one thing I can say about this case is that it couldn’t have happened to a more appropriate guy. Robert O. Young was one of the first cancer quacks I took notice of back when I was first discovering how deep the rabbit hole of alternative medicine is. He’s been one of the most egregious, preaching the most blatantly pseudoscientific nonsense and charging huge sums for it. So you’ll pardon me if I’m feeling more than a bit of schadenfreude to see him not only having had to serve time in prison, but to be facing a judgment and selling his ranch, for which he’s asking $3.2 million.

More please. I want to see more victims sue their quacks. Maybe if state medical boards can’t stop them, civil lawsuits can. A guy can dream, can’t he?