Thanks for your time and effort to comment, Joseph.

Let me alleviate your concerns point-by-point.

First: “you do not adequately consider the reasons why many patients become disillusioned conventional medicine and turn to other sources for medical information.”

It was not my intention to address this point. I’m less concerned with the reasons why people choose alternative medicine (AM) over conventional, but far more concerned with the consequences such decisions may yield.

Take Steve Jobs as a case in point. When he was diagnosed in 2003 with pancreatic cancer (a chance discovery during a kidney scan), he chose AM instead of conventional medicine (CM). Pancreatic cancer is typically a death sentence and not a nice way of dying. He had been lucky enough to have a rare, operable form of pancreatic cancer. CM’s surgery procedure would, in all likelihood, have saved his life. He later came to regret his decision, although it was too late.

https://www.forbes.com/sites/alicegwalton/2011/10/24/steve-jobs-cancer-treatment-regrets/?sh=1fa66157d2e9

Jobs had made this decision against the advice of his doctors and his family and friends. You can read about his rationale in the above link and in Walter Isaacson’s Steve Jobs biography.

As an epidemiologist, I’m a numbers guy. I don’t judge people by their decisions, but I question the sensibility of decisions when the numbers are in favor of the option that they decide against.

Second: “Your figure comparing outcomes of conventional and alternative treatments for breast and colon cancer does not, as presented, provide evidence that conventional treatment is better than alternative treatment. Among other problems, you do not state how the two treatment groups were selected.”

If you follow my post’s link to the paper I referenced, you’ll discover that the data come from the National Cancer Database between 2004 and 2013.

Patients who underwent AM were identified as those coded as “other-unproven: cancer treatments administered by non- medical personnel” and who did not receive CM treatment (chemotherapy, radiotherapy, surgery, and/or hormone therapy). Patients with metastatic or stage IV disease, or in palliative care, or unknown treatment status were excluded.

You can’t get any closer to an unbiased comparison. There is no “selection of treatment groups” as you suggest. Which leads me to:

Third: "The data support your interpretation only if patients from the same population were randomly assigned to the two treatment groups”

That simply cannot happen. It would be unethical to randomly assign cancer patients into AM and CM groups, and see which ones die earlier. So you won’t find any data on such a study design anywhere.

Fourth: “At least some woman who seek alternative treatment for breast cancer likely do so precisely because conventional treatment did not work for them.”

That possibility has been excluded from the data, as I mentioned above. Patients who had received both types of treatment were excluded, so your hypothetical case does not play a role in the analysis.

Fifth: “a comparison between standard and highly aggressive conventional treatment would show the same pattern, because highly aggressive treatment is more likely to be used on sicker patients”

I’m unsure whether I understand that correctly: the more aggressive treatment arm would fare worse compared to the less aggressive arm? That might well be, but that was not the topic of my post.

I hope, I could alleviate your concerns about the lack of evidence for my data presentation and conclusions.