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Jeff Witzeman released just released his newest film Flipping The Script: Parents Fight Back . I reviewed his last film Cancer Can Be Killed , which in retrospect, was a pretty tame film compared to this one. Flipping the Script argues that parents should have the right to refuse maintenance chemotherapy on behalf of their children while also expressing anti-vaccination views, promoting alternative medicine, and trying to sell you on ridiculous scientific and conspiracy theories. This film displays a critical lack of self-awareness and knowledge of science, medical ethics, literacy, and basic human decency.

The film opens with a recording of a phone call with a child’s oncologist who said that they will need to contact Child Protective Services if the parents do not take their child in for their maintenance chemotherapy treatments. Jeff Witzeman states that parents have called him asking “If cancer can be killed naturally, why is my child being forced into two to four years of chemotherapy when they’re already in remission?” My review of Cancer Can Be Killed covers Witzeman’s favorite “natural cancer treatments”, and how they’ve all been found to be ineffective. Flipping the Script , like Cancer Can Be Killed , relies entirely on testimonials of parents and experts with shady backgrounds.

All of the testimonials from parents follow the same format. First, their child is diagnosed with cancer, which was always leukemia or lymphoma, the most common and treatable types of cancer in children. Second, after undergoing the induction phase of chemotherapy, the child’s cancer was in remission but the child had terrible side effects. Then after learning that the cancer was no longer detectable on scans or tests, it came as a shock when their child’s oncologist wants their child to have maintenance chemotherapy treatments for more than a year. When they refused, the oncologists called CPS to report what they reasonably believed to be medical neglect. Without maintenance chemotherapy, the child would be at significant risk for having their cancer relapse. What follows varies and there’s no way to verify what actually happens with any of these stories. Some parents claim they were investigated by CPS and claim that nothing followed. Two parents fled to Mexico and lived there for years before returning to the US. Some parents claimed they walked into the hospital with a lawyer, said “no more chemo”, then took their child home.

Here’s the thing

Witzeman’s argument in the film is that parents should have the right to refuse chemotherapy on behalf of their children. The majority of the children featured in the film had acute lymphoblastic leukemia (ALL), which I will make the focus of the article to keep things simple. Acute lymphoblastic leukemia is the most common type of childhood cancer. When properly treated the average cure rate is somewhere around 90%. After being diagnosed, the first course of action is to begin the induction phase of chemotherapy, in which chemotherapy drugs are given in high doses intravenously or intrathecally for about a month, followed by a one week break. About 98% of children with ALL will go into remission (defined as having no leukemic cells in the blood, and less than 5% of leukemic cells in the bone marrow after) the induction phase. However, just because there are no cancer cells detectable on tests, doesn’t mean that they aren’t there. It just means that the tests are not precise enough to detect them. While it is possible to survive without relapsing, the chance of a relapse is much higher without maintenance therapy.

It’s very important that cancer relapses are prevented after the cancer is put into remission. Cancer cells are likely to be more resistant to chemotherapy if the relapse occurs shortly after initial remission. One study looked at the factors that influence survival after an ALL relapse; the numbers for early relapses aren’t pretty. If the relapse occurred less than 18 months after the initial diagnosis, the survival rates for the majority of relapse sites is below 15%. Relapses that occur later than 18 months, survival rates a bit more promising with the survival rates based on site of relapse being around 50% or higher – which is why oncologists are extremely concerned with preventing relapses in the first place

In order to prevent relapses after the initial induction phase, the consolidation phase is used to kill any remaining cancer cells that weren’t killed in the induction phase. The consolidation phase lasts for 1-2 months and consists of IV and intrathecal chemotherapy.

After the consolidation phase, the maintenance phase begins which is designed to prevent the cancer from relapsing. In this phase, lower doses of chemotherapy medications are given and the patient is monitored to ensure the cancer hasn’t relapsed. The recommended length of maintenance therapy for ALL is 2 years for girls, and 3 years for boys. When the maintenance phase beings, there are still no detectable cancerous cells in the blood or bone marrow. They may need to take daily chemotherapy drugs and receive IV or intrathecal chemotherapy every few weeks for years.

The research shows that it is very important that children receive these treatments to prevent their leukemia from relapsing. A study in 1997 measured the blood concentrations of methotrexate and mercaptopurine (common maintenance chemotherapy drugs) in cancer patients, and divided them into two groups. The group with blood concentrations of mE-MTX -6TGN greater than 818 mmol had a risk-free survival rate of 86%, people in the lower blood concentration group had a risk-free survival of 70%. One study published in the Journal of Clinical Oncology found that children with a medication compliance rate lower than 95%, had a 17% chance to relapse compared to only 5% with daily medication compliance of 95% or above. The study also concluded that 59% of all relapses could be attributed to medication non-adherence. So overall, maintenance chemotherapy is an important step in reducing the risk of a child’s cancer coming back. While it is possible to survive without a relapse after the induction and consolidation phases, the risk of a relapse is much higher and will be much more dangerous.

The consequences of chemotherapy refusal

If parents refuse maintenance or consolidation chemotherapy for their children, the results can be tragic. Friend of the blog Orac covered the case of Jeremy Fraser 10 years ago, Jeremy’s mother didn’t give him the daily oral chemotherapy prescribed by his doctors to prevent his cancer from relapsing. His cancer relapsed and he was given a 10% chance to live; he didn’t make it. Jeremy’s mother was convicted of reckless endangerment and spent 5 years in prison. Jeremy’s father had this to say to her in an interview: “If you ever get the chance to see that little boy again, pick him up. Just…. tell him you’re sorry”.

Cassandra Callender was forced into chemotherapy by the Connecticut Supreme Court, despite her, and her mother’s objections. Callender was diagnosed with Hodgkin’s Lymphoma and refused chemotherapy after running away from home. CPS petitioned the court and was granted temporary custody of Cassandra in addition to being authorized to make all medical decisions on her behalf. Unfortunately her cancer would relapse months later after she was able to make medical decisions for herself at which point she chose to pursue natural, alternative cancer treatments offered by the “Hope 4 Cancer Institute” including IV vitamin c, ozone therapy, laetrile (AKA vitamin B-17, which is basically cyanide), and hyperthermia. Unsurprisingly, the cancer progressed over the months she spent pursuing fake cancer treatments. She finally realized that the fake treatments weren’t working and decided to pursue chemotherapy, and fortunately the treatments were successful, resulting in a happy ending.

Parents are not allowed to neglect or abuse their children by law, which includes denying them necessary medical care. Children do not have the decision-making capacity to make medical decisions for themselves, therefore adults have to act in their best interest. The child’s best interest and parents’ wishes can conflict in some cases, and this film is a series of perfect examples. I think it is a reasonable assumption that it is in a child’s best interest to receive medical treatments that will significantly reduce the risk of their cancer relapsing. If parents refuse to consent to necessary medical care on behalf of their children and ensure that they receive that care, it is a healthcare provider’s ethical, and legal duty to contact the appropriate authorities. When CPS is contacted they have to investigate if there is any neglect going on and potentially remove children from their parents’ home, medically neglect can meet that criteria. In some cases, the state may take custody of parents’ children and force the child to receive chemotherapy, even if the child doesn’t want it. While that might sound bad, CPS is acting in the child’s best interest in these cases. Without treatment the child’s cancer has a significant chance of relapsing, which is life threatening. You don’t have the right to endanger your child’s life.

The bad science

Jen’s cancer theory

About midway through the film, one mother explains her theory of how leukemia works. There’s even this cute cartoon that plays like something you’d see on PBS:

After doing some research, Jen came up with this theory about leukemia. When a strong virus combined with toxins and stress hit the body, white blood cells rise up to meet it in order to fight off the onslaught. During this period if you were to measure the blast, or white blood cell count, you could call this extreme reaction leukemia. But as the virus, toxins and stress are removed; the white blood cell counts go back down. Now making it hard to even call it leukemia. This is the situation for many adults who just through nutrition and detox strategies are able to reverse their leukemia in just months.

The problems with this are:

No singular cause of leukemia has been identified. There are many risk factors for leukemia such as family history, blood disorders, and radiation. There is no evidence leukemia in any form is caused by any virus.

The blast count on a blood cell count panel does not measure the while blood cell count. We have a white blood cell count for that.

The blast cell count measures the presence of blast cells in the blood or bone marrow. Blast cells are not white blood cells; they are undifferentiated, primitive blood cells. In leukemia these mutated blast cells multiply in large numbers and will be present in high concentrations in the blood and bone marrow. There is no research I can find where adults of cured their leukemia using diet and “detox” strategies.

Nutrition and sugar

Nutrition is a rather large focus in Flipping the Script , many of the parents accuse doctors of having no nutrition training or claim that oncologists don’t care about their patient’s nutrition. All doctors receive at least some education on nutrition in medical school, and many will receive more training during their residency program after medical school. Many of the parents in the film firmly believe that sugar feeds cancer, and talk about how they forbid their child to eat food with sugar. While it is true that cancer cells get their fuel from sugar, so do all of the other cells in your body, not to mention many healthy foods including fruits and vegetables contain sugar, often in considerable amounts. There is no risk in eating sugar in normal amounts, however eating too much can lead to obesity.

Imposing a restrictive diet on your child while they’re receiving treatment for cancer can be dangerous. Research has shown that children who are underweight have a higher risk of relapse, and it is very important that people maintain a healthy body weight during and after treatment. Imposing a restrictive diet on a child that causes them to lose too much weight puts them at risk. One mother in the film talked about how frustrated she was when the hospital told her that the reason her child wasn’t gaining weight was because she fed her child an “all organic diet”. There’s no harm in feeding your kid an all “organic” diet (and no benefit). However, if the diet is so restrictive that the child is losing weight, then it would likely be a concern to the child’s doctors.

The Electrical Box of Doom

There are so many weird moments in Jeff Witzeman’s films. In Flipping the Script , Witzeman takes the time to explain what he thinks caused the child’s cancer. This explanation however just caught me totally off guard:

…and along with that had this electrical box sitting away from her bed every night. Unless you doubt that an electrical box could have an effect, the previous tenant in that same room became ill with TPP, which is also a blood disorder.

Thrombotic thrombocytopenic purpura is a very rare blood disorder, that is not like cancer in any way. It is incredibly rare, there are only about 4-5 cases per million people each year. There is no evidence that exposure to electromagnetic fields (EMF) causes TPP (or anything else). He backs up his claim that EMF exposure causes cancer with this page from the NIH. According to the NIH no consistent evidence has shown that exposure to EMFs cause cancer; Witzeman shows the NIH page that states exactly this on-screen. You can’t make this stuff up.

Vaccines and doctors in politics

Flipping the Script is also an anti-vaccine film. One of the parents says that a possible side effect listed on the vaccine information sheet was cancer. No vaccine I can find has cancer as a potential risk, and there is no evidence that vaccines cause cancer (not to mention the problems with relying on packaging inserts as if they were infallible). Some vaccines, such as the HPV vaccine, actually prevent diseases that can cause cancer.

Later in the film, Witzeman argues that parents’ rights have slowly been taken over by the government. To support this argument, he cites the passing of SB277 in California, which bans personal belief exemptions to vaccine requirements in schools. The bill was penned by Dr. Richard Pan, who is a practicing pediatrician and California State Senator. Witzeman then dropped this knowledge-bomb:

And yes, you heard me right. Doctors are now trying to get into politics with the express goal of taking away parents’ rights and enforcing millions of dollars in vaccines and forced treatments.

Doctors in politics, including Dr. Pan, did not get into politics did not get into politics with the express goal of taking away parents’ rights. They got into politics to serve their constituents; whether you agree with their policies is another topic entirely. Dr. Pan proposed SB277 in response to the “Mickey Mouse Measles” case in 2015, where measles – a disease declared to be largely eradicated in 2000 by the CDC – erupted in outbreak of 147 cases after a contagious person visited Disneyland in that year. This outbreak was due to vaccine refusals by parents with no legitimate reason to refuse the measles vaccine. The vaccine has been shown to be incredibly safe and effective at preventing measles, as well as mumps and rubella, with next to zero risks. These treatments aren’t even forced; children must receive the vaccine to enter primary or secondary school in California or must have a valid medical exemption. The option to homeschool your children is still available.

Witzeman tries to frame this as an issue of “adequate testing”‘. Vaccines have been proven to be safe and effective at preventing vaccine-preventable illnesses. Vaccines are tested extensively before they are brought to market. SB277 was necessary to help prevent the resurgence of one of the most contagious and deadly diseases in human history because parents wouldn’t vaccinate their children based on their irrational beliefs.

Conclusion: How dare you?

Flipping the Script is the vilest film on Amazon Prime, and gives unqualified, dangerous medical advice to parents. Maintenance chemotherapy is necessary for long periods of time to prevent the relapse of many cancers. If parents refuse they are putting their children at serious risk for a relapse and even death. Doctors are legally obligated to report medical neglect such as refusal of consent to lifesaving treatment on behalf of their children. This film blatantly accuses doctors of only using chemotherapy instead of some mythical “other” treatment because chemotherapy makes them a lot of money. Parents in the film laugh when asked “Do you ever think it’s all just about money?” One of the “experts” states “the overall survival rate for cancer has only improved 5% since the introduction of chemotherapy” – when in fact the death rates from cancer have been steadily falling for decades.

Witzeman has the audacity to conclude the film by stating that there is a “better way” to treat cancer and that cancer is “just a warning sign”. It’s not the pitiful “science”, or the despicable people held up as “experts” that frustrates me so much about this documentary; it’s the smugness and utter lack of self-awareness. I wanted to have fun with this review, it’s hard not to laugh at how ridiculous Jeff Witzeman’s films are. But there was a short segment in the film that broke me; it made me realize what this film stands for – what could happen if parents took this film’s advice. One mother had this to say in an interview:

It’s really interesting because you do see all the kids at St. Jude, but you don’t see the survivors. Where are they? Where are these people who have survived and lived on? You just don’t see them or hear much from them. Even Gunner commented when you go through St. Jude there’s this huge hall with all of the names of the kids who’ve died. They’re all over the walls, in the halls…. They have a few pictures, maybe six or eight pictures of survivors on one hall.

This quote has been on my mind for almost a week now, I have no idea why he chose to include it in the movie. I assume because in his warped worldview it somehow proves that children who get treated there don’t often survive. I imagine one reason they don’t put the names of survivors up in their halls is because fitting all the names would present a significant logistical issue when you have some of the best outcomes for pediatric cancer in the world. Patients treated at St. Jude for acute lymphoblastic leukemia have a 94% event-free survival rate. The other reason they don’t put the names of survivors in the halls is because the staff at St. Jude have the satisfaction of knowing those kids got to go home and live normal lives. You can find the stories of children who survived cancer because of the work of St. Jude everywhere. It’s easy. The staff at St. Jude put the names of children who died in their halls to pay their respects to the children they couldn’t save. They have integrity, humility, and tact; virtues Jeff Witzeman and his “experts” lack.

Jeff Witzman is so oblivious, ignorant, and uncouth that he states “in defense of St. Jude and every other children’s hospital, they’re just doing what they’ve been told to do. They’re just enforcing the protocol sent from on high”. Where does he think these treatment protocols come from? Unlike in naturopathy, doctors don’t just make up treatment protocols based on how trendy they sound, or how likely patients are to spend five figures on them. The doctors at St. Jude don’t have a jolly sit down with the Eli-Lilly C-suite every quarter to fill their bellies with caviar and fillet minion to get the latest “protocol from on high” that they will blindly use to treat children. They conduct and review research, and modify their practice to fit what the research shows is best. St. Jude plays a huge role in creating the “protocol from on high”, they had over 250 articles published in peer-reviewed, scientific journals last year.

In conclusion, I don’t think this film should be on Amazon Prime. It gives dangerous, unqualified medical advice to viewers who may be parents with children who have cancer. This film only exists to sell parents on medical fraud and magical thinking. It is completely devoid of critical thinking, scientific reasoning, and basic human decency. I couldn’t even recommend as a bad film; it’s just depressing. If any medical advice in the film were taken seriously, it would lead to tragedy.