Talk:Virginia Livingston/Archive 1

Original research

The page is filled with original research that promotes the idea that Livingston's theories have merit. They do not, they are considered disproven. I plan on going through the article and removing all syntheses, unreliable sources (for instance, the use of personal communication is inappropriate as primary sources). The purpose of wikipedia is not to prove that Livingston's theories have merit. We do not seek the truth. We represent the mainstream opinion as represented in the appropriate scholarly literature. Livingston's research and theories are fringe theories considered disproven rather than prospective. I plan on culling with considerable prejudice. WLU (t) (c) Wikipedia's rules:^simple/_complex 21:57, 11 May 2010 (UTC)

I was under the impression that material is edited based on discussion and debate. Is it customary to simply remove material one user deems prejudicial without input from other users? I ask this not in a spirit of contentiousness, but more as a matter of curiosity. Thank youRonsword (talk) 19:20, 12 May 2010 (UTC)

Also: You have included the American Cancer Society's conclusion that Livingston's therapy was found ineffective, but excluded the study coordinator's own commentary (i.e. Cassileth also said, her study group "hypothesized that survival time would not differ between the two groups on the basis of the assumption that the unproved remedy would be no more effective with end-stage disease than conventional care, itself largely ineffective".(Cassileth, ibid.)

Doesn't this show selective parsing of the actual facts of the study, i.e. undue prejudice? Thank you againRonsword (talk) 19:30, 12 May 2010 (UTC)

There wasn't much to discuss - it was a huge dump of primary sources integrated to advance a conclusion. The mainstream conclusion is that Livingston's work lacked merit and was quackery - that's the neutral perspective the article should take. Pages are based on the policies and guidelines, and in this case the material was pretty clearly out of line. The ACS's statement as a major national body takes precedence over any one person's view, but I will try looking into Cassileth when I have the time. However, if two groups, one untreated and one treated using Livingston's methods did not differ in their outcomes (how I read your statement) then that shows that Livingston's intervention was essentially worthless. But I'll try looking into the reference and see what it says. I'll need more to go on than "Casselith, ibid" though - could you link to the specific paper?

One final comment - "selective parsing" implies that we get to decide which references and points we are to include - that's essentially not the case, we must represent the facts as they are illustrated in reliable sources. We don't get to examine, criticize or comment on the merits of the actual studies involved (though if these criticisms can be verified with reliable sources, that can be included). However, overall the page should reflect the mainstream opinion that Livingston's work wasn't considered worthwhile rather than give it a careful, nuanced review that it had merit but was unjustly rejected. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:03, 13 May 2010 (UTC)

Sources

• [1]
• [2]
• [3]
• [4]
• [5]
• [6]
• [7]
• [8]
• [9]
• [10]
• [11] (full text)
• [12] curious that this is so positive when most sources are so negative, but look at the subject and expertise of the book...

I included Michael Lerner's work because he is considered one of the most objective commentators on the issue of alternative/complementary therapies. FYI, Lerner served as a Special Consultant to the Office of Technology Assessment for its official study Unconventional Cancer Treatments.Ronsword (talk) 18:16, 15 May 2010 (UTC)

Well, the publisher is clearly reliable but the opinion is so in opposition to the statements of other reliable sources, I'm a bit reluctant to use it at length. The NCCAM is also seen by some as simply a politically-driven apologetic for CAM that wastes funds chasing down scientifically unlikely hypotheses and treatments, while failing to clearly and adequately test them to the point where it can be conclusively said they are disproven (the history of the NCCAM's funding is both interesting and disheartening, as are the statements made about its research - Harkin's statement that he is disappointed it failed to "prove" any CAM treatments is rather horrifying to anyone with a modicum of understanding about scientific research). So I can't strongly object to it being re-integrated, but I would suggest caution about giving the source due weight and I would also suggest clearly attributing the text to Lerner (i.e. "Michael Lerner has stated that the trials were flawed because..."). WLU (t) (c) Wikipedia's rules:^simple/_complex 01:35, 16 May 2010 (UTC)

Suggested revision

Please take a look at the following statement---I believe it needs some clarification:

"The ACS also challenged the efficacy of Livingston’s autogenous vaccine and concluded in its report that "despite diligent research to isolate a cancer-causing microorganism, none has been found" and thus the rationale for her "autologous (i.e. autogenous) vaccine" is without any basis..."

The statement 'despite diligent research' may have been correct at the time, but currently is not.

One might interpret the ACS's conclusion as referring to any microorganism and not, specifically P. cryptocides which it doesn't reference in this sentence. (My read of the full ACS article renders a more generalized sentiment ascribed to 'microorganism' and not specifically to P.cryptocides). If this is the case, the discovery of H.pylori as a causative cancer organism, and additional research involving M.fermentans and others (see Cancer Bacteria) renders the ACS's point somewhat moot and only accurate from its scientific perspective at the time of its conclusion. The reader might be led astray here to assume that the ACS currently holds the same position. I think, therefore, some type of clarification would be appropriate. For example, a follow-up sentence which stipulates that "since the ACS report was published, newer research has established a correlation between certain bacteria and some forms of cancer, though a specific organism as proposed by Livingston has not been discovered".Ronsword (talk) 18:54, 10 June 2010 (UTC)

The findings of H. pylori shouldn't be extended to a general statement. The statement could certainly be modified, but later work should not be portrayed as a vindication of Livingston unless the source itself makes the point. We certainly shouldn't link Livingston with the discovery of cancer bacteria unless the source itself does - and I'm guessing that in any case the treatment for the cancer is very much in line with conventional care (chemo, surgery and radiation) rather than Livingston's approach. It's not a good idea to portray early, early pioneers (or quacks who happened to hold similar theories) as necessarily being prescient of later findings, unless their work actually led to it. The issue is, of course, that many predictions can be made but aren't always right, and it's cherry picking to point out when they are without context. Particularly when the approach, science, findings and lab studies used by the "early pioneer"/brave maverick doctor aren't reliable enough to be replicated by other researchers and turned into real science. WLU (t) (c) Wikipedia's rules:^simple/_complex 23:05, 11 June 2010 (UTC)

I'm hardly proposing a vindication of Livingston here. The ACS's statement that a microorganism has 'never been found' is, in retrospect and in light of modern research, outdated. Let me repeat: clarification that bacteria have now been found associated with cancer would include the qualifier that '...however, a specific organism as proposed by Livingston has not been discovered.' To leave the ACS statement as it stands raises questions about its position. Ronsword (talk) 15:44, 12 June 2010 (UTC)

I agree - it should be portrayed that Livingston's bacterial theory (and specific organism P. cryptocides) wasn't found rather than "no bacterial cause of cancer has been found." I've made an edit to this effect. Also, the link between bacteria and cancer Livingston made - it was general and systemic, right? As in "all or a significant amount of cancer is caused by bacteria", correct? That's not the link made between cancer and bacteria at cancer bacteria which only specifically associates one bacteria with one kind of cancer, and suggests a possible relationship with others. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:06, 12 June 2010 (UTC)

Affirmative to your above questions/points. Livingston did, in fact, believe her organism was systemic and a universal cancer pathogen while cancer bacteria differentiates from this controversial claim. Ronsword (talk) 00:34, 13 June 2010 (UTC)

One additional suggestion. The sentence "Multiple investigators attempted, but failed, to replicate Livingston's efforts to isolate and identify P. cryptocides is not quite accurate. This sentence creates the impression that a cadre of investigators set out to disprove the existence of Livingston's germ, when in fact, Acevedo was the primary investigator/source quoted by the ACS in [13] (see references 17-21, that article). In fact, Acevedo never referenced P.cryptocides or Livingston in his article PMID 2415456, only to say that bacterial isolates derived from the urine of cancer patients showed variable degrees of hCG synthesis. He thus concluded: "The results demonstrated that the isolates from cancer patients were not unique bacteria, as has been postulated by others". This isn't the same as saying that a "specific mycobacterium has been disproven in the etiology of cancer".

I'd be more in favor of something along the lines: "An investigation of hCG-positive bacterial cultures derived from cancer patients did not show the presence of a unique bacterium as Livingston asserted; in several studies, multiple species were isolated and some tested positive for hCG. These studies did not show the presence of a unique mycobacterium as Livingston's alleged organism was claimed to be". Ronsword (talk) 16:57, 13 June 2010 (UTC)

I'll try looking into the article at some point; this particular statement is sourced to the ACS article so the important thing is that it is accurate to that article; we don't parse or reject sources on the basis of their use of sources unless it's particularly egregiously bad. WLU (t) (c) Wikipedia's rules:^simple/_complex 20:53, 13 June 2010 (UTC)

If we are deferring to the ACS article and not the study abstracts it references, then I understand your point. Though I'm still not comfortable with our text's 'multiple investigators attempted, but failed' lead in which sounds like a consensus of investigatos; the ACS references are primarily to Acevedo. I think something along the lines of "investigators, in several studies, failed to confirm the existence of Livingston's alleged microbe" would be more accurate and would correctly reflect exactly what the ACS was saying. Ronsword (talk) 22:43, 13 June 2010 (UTC)

Your changes look fine to me. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:51, 15 June 2010 (UTC)

Just to touch on an earlier point which I brought up on Cassileth's clinical trial; re-reading the full text of that trial's article in NEJM, I note some issues/considerations that I believe requires clarification in the "Clinical Testing" section of Virginia Livingston. For example, Cassileth states that "there are a number of methodologic flaws intrinsic to this investigation". Primarily, the study was not "randomized" and patients were "self selected". She adds that, because the study was "restricted" to late stage patients, the study "did not permit an evaluation of efficacy in patients with less extensive disease, in whom treatment has more opportunity to succeed". Cassileth also states that "the results (of study) cannot be generalized to patients with less advanced stages of disease...". She concludes in her 'methodologic flaws' paragraph that: "Finally, one of the outcomes---quality of life---was different at base line in the two groups (conventional vs. alternative)." As you'll note, better quality of life was an important distinction between both patients groups, favoring the conventionally treated.

I am not suggesting a major revision here, but for the historical record, think it prudent to include an accurate and balanced description of the Cassileth trial---its strengths and flaws---taken from the trial investigator's own words. Ronsword (talk) 22:46, 15 June 2010 (UTC) Here's one possible edit suggestion:

A non-randomized clinical trial compared survival and quality of life between late stage cancer patients receiving conventional treatment and those undergoing the Livingston-Wheeler therapy. The trial coordinator noted that the study "did not permit an evaluation of efficacy (for)....less extensive disease, in whom treatment has more opportunity to succeed". Based on this study, reported in The New England Journal of Medicine in 1991, no differences in survival among late stage cancer patients were documented, whether treated conventionally, or via Livingston's treatment. The NEJM report also stated that patients treated at the Livingston-Wheeler clinic “had significantly poorer quality of life”.[14] According to Cassileth, there were differences in quality of life at baseline. Ronsword (talk) 17:27, 16 June 2010 (UTC)

I made some adjustments, mostly including details with wikilinks. Good suggestions, what do you think? WLU (t) (c) Wikipedia's rules:^simple/_complex 20:26, 16 June 2010 (UTC)

They're reasonable. Tnx for clarification. Please also note a few clarifications in "History" of cancer bacteria as well as a suggestion for deletion Ronsword (talk) 03:56, 17 June 2010 (UTC)