If you don't already know about this, I think you'll be interested. The founders of evidence-based medicine also did research on personalized medicine.
For many of us at the end of our undergraduate and the beginning of professional life, much of the investment required to enter medical school has already been made. I stand at the precipice now, though your writing gives me pause. I am not sure how to proceed at this point, but I wonder about the options available to me.
In laboring to become concise, we become obscure; If you had to point to one location to begin reevaluating one's direction, what book/who/where would that be?
On another note, in your opinion, is the DO track equally compromised, or is it more complicated?
Thank you Dr. Smith. I have completed 6 taxol/ carbo infusions. I had a CT scan yesterday that showed no evidence of disease. Doctor is now suggesting two to three years of parp inhibitors to prevent recurrence. I don’t have BRAC genetic mutation but he says there’s good rct’s to prove benefit over risk. So hard to find the best path. I fasted before, during and after infusions and have little to know issues other than scalp hair loss. No nausea, etc. Thanks for your suggestions. Very much appreciated for those of us who have eaten whole foods, worked out through adulthood yet now find ourselves in the cancer wilderness.
In defence of those who value and apply Evidence Based Medicine: You have made some interesting points, but the crux of medicine is that the individual practitioner is always the interpreter of what they know from prior evidence (not necessarily all faceless data) and their own interaction with their patient. Some doctors - those that put in the time and effort - will use EBM as one tool in their kit. Of course, GIGO - there is the problem that many studies are flawed and the reviewers have to be clever enough to call those studies into doubt, thereby reducing their value as evidence.
What a good - refreshing - post this is. Thank you for all the references you have included.
One of the things I love about Substack is that it brings so many different viewpoints to the table. I’m naturally drawn to pieces that challenge the norm or explore unconventional angles, because curiosity is one of the most important traits we can cultivate in medicine. If we only ever read what we already know from mainstream sources, we risk missing opportunities to learn and grow.
That said, one of the things that struck me about your article was your confidence in presenting a conclusion that, to me, is still very much open to interpretation. The idea that melanoma is not caused by sunlight just doesn’t align with what I see in my clinic. I treat hundreds of melanoma patients every year, and their stories share a common thread. Almost without exception, it’s a fair-skinned person with a history of brief, intense UV exposures — the vacation sunburns in childhood or adolescence, or the tanning bed use in their teens or twenties. Chronic sun exposure is not usually the culprit, which is why we don’t tend to see melanoma on the most sun-exposed areas.
When we sequence melanomas in my practice, the mutational signature is highly consistent with UV damage. In fact, skin melanoma often carries one of the highest tumor mutation burdens of any cancer. We know these patterns can easily reproduced in animal models with controlled UV radiation exposure. These patterns are absent in acral and mucosal melanomas.
I’m genuinely open to ideas that challenge the standard narrative, but your piece left me wondering: in your research, how much did you engage with people who study melanoma and what questions did you ask them along the way? Are you still curious 👀?
I don't buy the argument that one distant event to sunlight that was severe enough to cause a sunburn is the root cause of melanoma decades down the line.
Just like I don't buy the argument that exposure to a viral particle decades ago is the cause of a tumor.
The causality is full of holes, and in my opinion without merit.
The alternative hypothesis, to me, is far more plausible.
Here's my anecdote on the body's ability to heal. Around twelve years ago my sense of smell went majorly sideways. Weird smells, terrible smells so bad they'd trigger crushing headache, strong phantom smells that would jolt me out of sound sleep. Then tapering off to no smell at all. Along the way I saw neuros and ents. Did have sinus surgery to remove an ossifying fungal mass in the maxillary. That helped in other ways, but the smell thing went on and on. CT scans. MRI. Nothing evident anywhere. Then this past year, out of the blue, I can smell again. And it's lasted. The one major change over these years? I entered menopause a few months before my smell returned. All the doctors told me protracted smell loss is permanent and almost always indicated something worse coming down the line. The only explanation I can think of is God decided to give me a miracle, because it certainly wasn't anything I did!
You walked into a medical school which is not medical, it is an allopathic prison where what you are taught is controlled by pharma. MD’s are not taught about what our bodies need, but what is beneficial to pharma and then FDA/AMA police force enforce the standard of care. Become a Dr of Naturopathy.
Much of what you say aligns with natural healing, however, your statement below flies in the face of a self-healing body. How exactly does medical training become smarter or more intuitive than the body’s innate intelligence that has sustained our species. “For example, if the body is too hot (by fever), you can facilitate its healing process by cooling it to the extent that the heat doesn’t overwhelm the body.” Wondering how you determine this?
I believe it was Robert Mendelsohn or perhaps a similar physician who stated that it was the rapidity of the fever rise rather than the absolute temperature of the fever which triggered seizures. He advocated for letting the inherent wisdom of the body dictate fever, and healing, rather than the presumption of Dr knows best which I think we can agree is arrogance.
For instance, one can get hot enough to induce a seizure amongst other manifestations that people would want to avoid.
What you want to avoid is personal preference, and probably some physiologic limit as to what is appropriate. People fear being too hot, as certainly there is such a thing as too hot.
Whether or not you get too hot as a result of artificial impositions on the body is another question. Can a fever induced by natural means ever get too hot? I dont know.
But, a fever brought on by artificial means probably can get too hot.
You have this knack of very succinctly packing in so much into such a short piece that is easy to read and absorb. Less is more; and I'm also reminded that "The highest ideal of cure is rapid, gentle and permanent restoration of the health, or removal and annihilation of the disease in its whole extent, in the shortest, most reliable, and most harmless way, on easily comprehensible principles." (Samuel Hahnemann)
Barbara McClintock, geneticist, wrote a book about "having a feeling for the organism." As a research scientist and someone who has been successful in curing myself and helping others, I believe that I know what she means. I do have an advantage, perhaps, that most of my friends and neighbors do not: I've taught cadaver anatomy, histology as well as human physiology. I also have a good handle on chemistry and physics as well as botany and microbiology. My research has involved pharmacological methods.
The COVIDian scam taught me to take my own care of myself much more seriously. My physician (I finally found one) cooperates with me and complements what I am unaware of, he gives me direction for my own research and brings years of case experience that I do not have. I make use of some pharmaceuticals (the much maligned "Rockefeller drugs" when necessary, but only when necessary, and only the basics until I can do better)
Thank you for you informative, creative approach to medicine and helping to educate us as we grope for better ways.
If you don't already know about this, I think you'll be interested. The founders of evidence-based medicine also did research on personalized medicine.
https://x.com/ChrisMasterjohn/status/1963411537378312682?t=kvnF9TXgonFOCtJy7-FQ2w&s=19
And yet you don’t share with us how you managed do “cure” it.
You mean the whole article I wrote explaining how I cured my IBD that's been on my publication for over a year?
For many of us at the end of our undergraduate and the beginning of professional life, much of the investment required to enter medical school has already been made. I stand at the precipice now, though your writing gives me pause. I am not sure how to proceed at this point, but I wonder about the options available to me.
Pursue the real medical arts, if you wish to practices medicine.
Pursue MD if you plan on selling your soul.
In laboring to become concise, we become obscure; If you had to point to one location to begin reevaluating one's direction, what book/who/where would that be?
On another note, in your opinion, is the DO track equally compromised, or is it more complicated?
If you plan on practicing osteopathy in its true form, it's an option. Unfortunately, most who go to DO school practice modernallopathty.
Naturopathy, homeopathy, Unani medicine, Tibetan medicine, traditional Chinese are all viable options for the real art.
I love when I read something that flips my view of things. You did that here. Thank you
my pleasure.
Thank you Dr. Smith. I have completed 6 taxol/ carbo infusions. I had a CT scan yesterday that showed no evidence of disease. Doctor is now suggesting two to three years of parp inhibitors to prevent recurrence. I don’t have BRAC genetic mutation but he says there’s good rct’s to prove benefit over risk. So hard to find the best path. I fasted before, during and after infusions and have little to know issues other than scalp hair loss. No nausea, etc. Thanks for your suggestions. Very much appreciated for those of us who have eaten whole foods, worked out through adulthood yet now find ourselves in the cancer wilderness.
In defence of those who value and apply Evidence Based Medicine: You have made some interesting points, but the crux of medicine is that the individual practitioner is always the interpreter of what they know from prior evidence (not necessarily all faceless data) and their own interaction with their patient. Some doctors - those that put in the time and effort - will use EBM as one tool in their kit. Of course, GIGO - there is the problem that many studies are flawed and the reviewers have to be clever enough to call those studies into doubt, thereby reducing their value as evidence.
What a good - refreshing - post this is. Thank you for all the references you have included.
One of the things I love about Substack is that it brings so many different viewpoints to the table. I’m naturally drawn to pieces that challenge the norm or explore unconventional angles, because curiosity is one of the most important traits we can cultivate in medicine. If we only ever read what we already know from mainstream sources, we risk missing opportunities to learn and grow.
That said, one of the things that struck me about your article was your confidence in presenting a conclusion that, to me, is still very much open to interpretation. The idea that melanoma is not caused by sunlight just doesn’t align with what I see in my clinic. I treat hundreds of melanoma patients every year, and their stories share a common thread. Almost without exception, it’s a fair-skinned person with a history of brief, intense UV exposures — the vacation sunburns in childhood or adolescence, or the tanning bed use in their teens or twenties. Chronic sun exposure is not usually the culprit, which is why we don’t tend to see melanoma on the most sun-exposed areas.
When we sequence melanomas in my practice, the mutational signature is highly consistent with UV damage. In fact, skin melanoma often carries one of the highest tumor mutation burdens of any cancer. We know these patterns can easily reproduced in animal models with controlled UV radiation exposure. These patterns are absent in acral and mucosal melanomas.
I’m genuinely open to ideas that challenge the standard narrative, but your piece left me wondering: in your research, how much did you engage with people who study melanoma and what questions did you ask them along the way? Are you still curious 👀?
I don't buy the argument that one distant event to sunlight that was severe enough to cause a sunburn is the root cause of melanoma decades down the line.
Just like I don't buy the argument that exposure to a viral particle decades ago is the cause of a tumor.
The causality is full of holes, and in my opinion without merit.
The alternative hypothesis, to me, is far more plausible.
Not sure you really addressed my question, but I respect your opinion.
Here's my anecdote on the body's ability to heal. Around twelve years ago my sense of smell went majorly sideways. Weird smells, terrible smells so bad they'd trigger crushing headache, strong phantom smells that would jolt me out of sound sleep. Then tapering off to no smell at all. Along the way I saw neuros and ents. Did have sinus surgery to remove an ossifying fungal mass in the maxillary. That helped in other ways, but the smell thing went on and on. CT scans. MRI. Nothing evident anywhere. Then this past year, out of the blue, I can smell again. And it's lasted. The one major change over these years? I entered menopause a few months before my smell returned. All the doctors told me protracted smell loss is permanent and almost always indicated something worse coming down the line. The only explanation I can think of is God decided to give me a miracle, because it certainly wasn't anything I did!
You walked into a medical school which is not medical, it is an allopathic prison where what you are taught is controlled by pharma. MD’s are not taught about what our bodies need, but what is beneficial to pharma and then FDA/AMA police force enforce the standard of care. Become a Dr of Naturopathy.
Something about being baked in the sun with petrochemicals (sunscreen) doesn't sound right.
Sun damage I assume. 20yrs in OZ. 10 in Nz. I have read that the highest incidence of melanoma is in Oz...I wonder why...
Very high usage of sunscreen.
I can hardly see past the white-paste on everyone’s face.
I never used much...but there was a big campaign. What do you think about freezing?
Very astute observation on melanoma I work in oncology and melenoma is not diagnosed in areas exposed to the sun.
How would you suggest treating keratosis on the forehead. Persistent. Dermatologist will freeze it. I've had 2 cut out of nose. 30 stitches....
Starting with understanding why you have keratosis.
Much of what you say aligns with natural healing, however, your statement below flies in the face of a self-healing body. How exactly does medical training become smarter or more intuitive than the body’s innate intelligence that has sustained our species. “For example, if the body is too hot (by fever), you can facilitate its healing process by cooling it to the extent that the heat doesn’t overwhelm the body.” Wondering how you determine this?
I believe it was Robert Mendelsohn or perhaps a similar physician who stated that it was the rapidity of the fever rise rather than the absolute temperature of the fever which triggered seizures. He advocated for letting the inherent wisdom of the body dictate fever, and healing, rather than the presumption of Dr knows best which I think we can agree is arrogance.
For instance, one can get hot enough to induce a seizure amongst other manifestations that people would want to avoid.
What you want to avoid is personal preference, and probably some physiologic limit as to what is appropriate. People fear being too hot, as certainly there is such a thing as too hot.
Whether or not you get too hot as a result of artificial impositions on the body is another question. Can a fever induced by natural means ever get too hot? I dont know.
But, a fever brought on by artificial means probably can get too hot.
You have this knack of very succinctly packing in so much into such a short piece that is easy to read and absorb. Less is more; and I'm also reminded that "The highest ideal of cure is rapid, gentle and permanent restoration of the health, or removal and annihilation of the disease in its whole extent, in the shortest, most reliable, and most harmless way, on easily comprehensible principles." (Samuel Hahnemann)
Barbara McClintock, geneticist, wrote a book about "having a feeling for the organism." As a research scientist and someone who has been successful in curing myself and helping others, I believe that I know what she means. I do have an advantage, perhaps, that most of my friends and neighbors do not: I've taught cadaver anatomy, histology as well as human physiology. I also have a good handle on chemistry and physics as well as botany and microbiology. My research has involved pharmacological methods.
The COVIDian scam taught me to take my own care of myself much more seriously. My physician (I finally found one) cooperates with me and complements what I am unaware of, he gives me direction for my own research and brings years of case experience that I do not have. I make use of some pharmaceuticals (the much maligned "Rockefeller drugs" when necessary, but only when necessary, and only the basics until I can do better)
Thank you for you informative, creative approach to medicine and helping to educate us as we grope for better ways.