BLOGGERS: MARK SCHOLZ, MD & RALPH H. BLUM

The co-authors of Invasion of the Prostate Snatchers, blog alternate posts weekly. We invite you to post your comments.

Tuesday, September 4, 2012

Three Cheers for the Humble Placebo

BY RALPH BLUM

“If we look ahead far enough we can see that placebos may be the best medicine of all.” So wrote Deepak Chopra, in his book Creative Health.

We have all heard of the “placebo effect,” the beneficial results that a substance, like a sugar pill, can produce if the patient is assured by his doctor that it will bring relief or healing. The pill might be nothing but sugar, but with the suggestion of healing and the patient’s belief in a positive outcome, there are often amazing positive results.

Norman Shealy, M.D., Ph.D., has said there is no drug as good as the placebo. According to Shealy, the “average” placebo effect is 35%. To be as good as the placebo, a drug would need to be 70% effective, and this is seldom the case. To give an example, Viibryd, a drug being promoted for Major Depressive Disorder, proved to be only 8% better than a placebo. And furthermore, sugar pills produce none of the complications and side affects associated with most drugs.

In his book The Biology of Belief, cellular biologist Bruce Lipton, Ph.D., writes that our cells respond to our perceptions, and that it is not our genes but our beliefs that control our lives. It is hard, however, for most people living in the 21st century to accept that what we believe and think and feel is manifested in our bodies. And despite the fact that real physiological effects can often be measured, by and large the medical community essentially ignores the significance of the placebo effect.

 One possible reason the placebo effect has not been studied more is because it cannot be manufactured or marketed. Yet when you consider the trillions of dollars spent on health care in this country, and the billions more spent in remedies to treat drug side effects, I would think it is time to look more closely at placebo responses.
 
Over the past three decades, I have met and talked with many men who had been diagnosed with prostate cancer. Some of them were told to “go home and set your affairs in order,” because their days were numbered. Setting your affairs in order is never inappropriate, especially if you are of advanced age. But the threatening manner of the suggestion is unfortunate, if not to say, malevolent.  Many men—among them, even the newly diagnosed—were told they had a fixed time to live. 18 months seems to be a popular time frame. When I hear that kind of threat, I tend to ask the doctor if he could show me his license for making predictions.

When you are diagnosed with cancer, the manner in which your doctor delivers the diagnosis actually has the power to influence the course of the disease.  Most of our generation was taught as children to believe in the infallibility of doctors. So if your doctor’s words are positive, they can plant within you, at a very deep level, the positive expectation that you can beat the cancer. As Dr. Bernie Siegel has said, it is the expectations aroused in the patient that ultimately determine the outcome.  So be sure to put the placebo effect to work by choosing a doctor you trust, and one who gives you large doses of confidence and hope. One who, with appropriate humility, understands the “placebo” effect he transmits to his patients through his demeanor and attitude.  

The physician as placebo. Now there’s a thought. A life-encouraging doctor should be the embodiment of an effective placebo in human form. 

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