Thursday, January 13, 2011

Urine Therapy for Follicular Lymphoma?

And I thought I'd heard (almost) everything. John Bettens says that he has kept his follicular lymphoma at bay for going on three years now, by drinking one cup of his own urine every day. Maybe. I honestly do hope that Bettens's tumours continue to shrink, and disappear, and stay that way. But I also have to say that I genuinely can't see how that would be related to urine.

The statistical record shows that around one in four or five lymphoma patients experiences meaningful regression (shrinking) of tumours, and most of the rest of follicular lymphoma patients still have a very slow disease course. This makes it a very ripe field for misleading anecdotal evidence.

According to Bettens, after he was diagnosed with follicular lymphoma, his family doctor told him that,
she was aware of anecdotal evidence to suggest that this type of lymphoma but not for any other type of cancer, and that she had no explanation... [I]t may have something to do with improving the immune system's ability to recognize the cancer and therefor [sic] be able to do the job it was intended to do. So the explanation may be that the urine eliminates the ability of the lymphoma cancer cells to disguise themselves, making them vulnerable to an immune response.
On this theory, Bettens started drinking one cup of urine a day. Over the next year, he says that 3 cm tumor in his stomach, chest, and neck shrank or even disappeared. By early last year, after two years of urine "treatment," only one small node was still visible on a CT scan. I'm genuinely glad for him in that respect.

Not being an immunologist, I couldn't say for sure that urine had no beneficial content in it, but as a skeptic, it immediately struck me that something was off about this. Urine is removed from the body because it's a waste product -- i.e. not beneficial. If there was something beneficial that the body is accidentally flushing away, then it ought to have been in the bloodstream originally (where it would have an effect). The skeptical medicine blog Respectful Insolence has consistently berated urine therapists in the past, but then, Orac is a particularly ornery individual.

That said, someone is going to have to point out an active ingredient in urine that has a meaningful positive effect on the immune system before I'll agree that this seems like a useful therapy. My quick search turned up only one article on the subject, a paper published in Medical Hypotheses in the 1990s. The author, J. Eldor, suggested that antigens released by malignant cells are sometimes removed from the body via urine, so if the urine is reintroduced back into the body (i.e. you drink it), this might help provide a target for the immune system to focus on.

There are several problems with this. First, Medical Hypotheses is just one short step above bunk as far as scholarly credibility goes. Despite being published by Elsevier, it was not (at the time) a peer-reviewed journal. It just went peer-reviewed, and the editor resigned in protest, which is a very bad sign. Its call for submissions proudly advises that it is open to new "radical, speculative, and non-mainstream" hypotheses, without extensive trial or empirical data. In fact, it explicitly discourages submissions that contain large amounts of empirical data.

This is sort of the opposite of where you'd want a reliable journal to be, especially in an important medical field. And in the past it's resulted in the sort of articles you might expect from such an approach. In 2006, an article explored the relationship between sun cycles and the immune system. Some of the articles look more serious, but let's just say that as a scientific researcher you tend not to want the results from your important, large-scale clinical trial appearing next to an analysis of how the solar cycle stimulates the immune system.

As for the urine therapy article in question, it's written by J. Eldor of the Theoretical Medicine Institute in Jerusalem. I have no idea what institute this is, or who they're affiliated with, but it's evidently not a particularly important medical organization because almost all I can find of them online traces back to this single article. I can't imagine drinking your own pee will accomplish anything more than forcing your kidneys to do double-duty, filtering it back out of your bloodstream again and sending it back to the bladder. But if you want to drink your own urine, I guess that's your right.

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