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gorskon's profile
David Gorski, MD, PhD
David Gorski, MD, PhD
David Gorski, MD, PhD
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@gorskon

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David Gorski, MD, PhDVerified account

@gorskon

Surgeon/scientist promoting science in medicine and exposing quackery. Editor of Science-Based Medicine. My opinions do NOT represent those of my employers.

Michigan, USA
sciencebasedmedicine.org
Joined October 2009

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    1. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

      David Gorski, MD, PhD Retweeted CTV News

      There are multiple horrible fails on the part of @CTVNews reporting this story. My heart goes out to Amanda Gould and her family and hope she does well, but I'm getting a distinctly quacky vibe about the treatment she's choosing for several reasons. But first, WTF, CTV? 1/https://twitter.com/CTVNews/status/1068517286607290368 …

      David Gorski, MD, PhD added,

      CTV NewsVerified account @CTVNews
      Mother travelling to Germany for costly cancer treatment unavailable in Canada http://ctv.news/GpBCjdJ 
      4 replies 13 retweets 29 likes
      Show this thread
    2. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

      Here are @CTVNews two MASSIVE reporting failures on this story: 1. The name of the clinic to which Amanda Gould is going is not mentioned anywhere. 2. The names of the doctors are not mentioned. (This info is essential to evaluate reputation and techniques.) 2/

      1 reply 4 retweets 10 likes
      Show this thread
    3. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

      Also, Gould has lung metastases from her soft tissue sarcoma that was apparently successfully treated but recurred 8 years later. Are these lung metastases potentially resectable? If so, THAT's the first treatment. Sarcoma is one cancer where resecting metastases can cure. 3/

      1 reply 1 retweet 5 likes
      Show this thread
      David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

      I can find preliminary evidence that isolated lung perfusion with chemo MIGHT result in better outcomes in sarcoma, but only in resectable metastases. (The evidence is weak, BTW.) I can find no evidence for better outcomes in patients with unresectable lung metastases. 4/

      8:05 AM - 30 Nov 2018
      • 1 Retweet
      • 3 Likes
      • (((Wendy Orent))) Robin Miller, Computer Negotiator Anne JW Liz "The Mask Goes Over Your Nose AND Mouth" Ditz
      1 reply 1 retweet 3 likes
        1. New conversation
        2. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

          I finally got the @CTVNews clip to play, and apparently Gould's lung metastases are not resectable, meaning that it's incredibly unlikely that the risky procedure of isolated perfusion of her lungs will help her. 5/https://www.ctvnews.ca/health/mother-travelling-to-germany-for-costly-cancer-treatment-unavailable-in-canada-1.4199088#_gus&_gucid=&_gup=twitter&_gsc=GpBCjdJ …

          1 reply 1 retweet 3 likes
          Show this thread
        3. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

          Now here's the wrinkle to add to the story. It turns out that Gould has alveolar soft part sarcoma, which is a very, very rare subtype of sarcoma. 6/https://www.curesarcoma.org/patient-resources/sarcoma-subtypes/asps/ …

          1 reply 1 retweet 3 likes
          Show this thread
        4. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

          It also turns out that alveolar soft part sarcoma is a slow-growing tumor (recurrence eight years after seemingly successful treatment is very uncommon for most sarcomas). It is also poorly responsive to standard chemotherapy. 7/https://www.ncbi.nlm.nih.gov/pubmed/30347044 

          1 reply 1 retweet 4 likes
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        5. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

          Particularly telling is the part of the interview in which Gould says that the treatment is not offered in Canada because "Canada is evidence-based," which strongly implies that the treatment she is seeking is not. 8/

          2 replies 2 retweets 14 likes
          Show this thread
        6. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

          Another @CTVNews fail: Having Gould encourage others with incurable cancer to do the same sort of thing she's doing after "doing their research." 9/

          1 reply 2 retweets 7 likes
          Show this thread
        7. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

          Particularly annoying is the false dichotomy through which @CTVNews framed the story: Palliative care (give up and go home to die) versus the "brave" choice to go off and try something unproven. 10/

          1 reply 2 retweets 11 likes
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        8. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

          OK, they didn't use those terms explicitly, but that's definitely how the story was framed: Giving up versus fighting the cancer. 11/

          1 reply 1 retweet 7 likes
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        9. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

          That sort of framing tells patients with advanced cancer that, if they make the perfectly rational and reasonable decision to go with palliative care and try to maximize the quality of their remaining life, they are giving up or being somehow less than brave. 12/

          1 reply 1 retweet 22 likes
          Show this thread
        10. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

          However, the worst journalistic sin committed in this @CTVNews report is not to have required, as a condition of having Gould on, that she let them report the name of the clinic where she is going and the names of the doctors who will be treating her. 13/

          1 reply 4 retweets 12 likes
          Show this thread
        11. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

          I understand that stories like this are compelling human interest stories. Only the most hard-hearted among us could fail to be moved by Amanda Gould's plight, but I've seen her plight many times before. However, I've ALSO seen many times how patients like her are victimized. 14/

          1 reply 3 retweets 15 likes
          Show this thread
        12. David Gorski, MD, PhD‏Verified account @gorskon 30 Nov 2018

          By failing to identify the clinic and doctors and by framing Gould's story as a choice between "giving up" and "fighting," @CTVNews has done a great disservice to the patients and families facing the horror of metastatic cancer. 15/15

          0 replies 8 retweets 26 likes
          Show this thread
        13. End of conversation

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