Another preventable death thanks to alternative medicine [Respectful Insolence]

What is it about Florida and quacks? It’s as though it’s the Wild West there when it comes to regulating the practice of medicine. There, quacks can get away with almost anything, or so it would seem. After all, Brian Clement, who isn’t even a doctor and isn’t even really a naturopath either, has been practicing his quackery for decades, even going so far as to travel to Ontario to look for new marks among the indigenous peoples and to Europe and the UK, leading to at least one preventable death and to a young mother with incurable breast cancer to waste her precious remaining time and effort pursuing dubious treatments before dying. The sorts of treatments administered by Clement’s Hippocrates Health Institute include various detoxification schemes, juice fasting, wheatgrass enemas, “bioenergy” treatments, ozone pools, far infrared saunas, and much more. yet, for some reason, even though the State of Florida has tried to shut Clement down, it’s failed.

Clement, unfortunately, is not alone. I just learned of another quack in Florida. This time, the quack is a real doctor with a real MD, which makes it all the worse in my eyes, because real doctors are regulated by real state medical boards, who can take away their medical licenses. Of course, as I’ve discussed many times before, medical boards seem inexplicably reluctant to take that step, even for obvious quacks. I tend to think that the reason consists of a combination of fellow physicians’ “there for the grace of God go I” attitude towards other physicians and, more importantly, a lack of resources, particularly in states controlled by governments with a lot of anti-regulation legislators and governors. That latter problem contributes to medical boards prioritizing straightforward cases, such as docs impaired due to substance abuse or docs who diddle their patients, over shutting down quacks, which is harder to do because it’s harder to prove that something is quackery that is a danger to the public than it is to show that an impaired or sexually inappropriate doctor is. You almost can’t blame them in a way. Their charter is to protect the public, and they have to decide whether to put away several impaired doctors or to shut down one quack.

Here’s one they’re trying to shut down now in Florida, Dr. Kenneth Wollner, and what he is accused of doing:

Stephanie Sofronsky was just 23, close to graduation from Florida Atlantic University, when she learned she had lymphoma.

She didn’t want to believe it. So she sought a second opinion from Moffitt Cancer Center in Tampa and a third opinion from Mayo Clinic in Jacksonville, state records show. Moffitt double-checked with the National Cancer Institute.

All confirmed that Sofronsky had Hodgkin lymphoma, a cancer that attacks white blood cells. They said she had an 80 percent chance of beating it with chemotherapy.

Hodgkin’s lymphoma. Why is it always Hodgkin’s lymphoma? OK, it’s not always Hodgkin’s lymphoma, but it frequently is. What’s so frustrating about seeing young people with Hodgkin’s lymphoma choosing quackery instead of effective medicine is that Hodgkin’s lymphoma is so treatable for cure. Indeed, even stage IV Hodgkin’s lymphoma can be cured about 65% of the time. Sofronsky must have had stage III Hodgkin’s because the story says she had an estimated 80% chance of beating it with standard treatment. Remember, Hodgkin’s disease is usually treated with a combination of chemotherapy and radiation therapy.

Of course, the problem is the chemotherapy. Of all the treatments for cancer, chemotherapy tends to be what scares people the most. It’s understandable. Take breast cancer, for instance, which I treat surgically. Most women operated on for breast cancer undergo fairly small operations, but even for those who undergo mastectomy, the recovery is generally within a month and the pain not long lasting. Chemotherapy, on the other hand, goes on for months and can in some cases make the patient feel worse than any surgery. It also doesn’t help that there is a narrative that chemotherapy is so toxic that it kills people before the cancer can, and ineffective, to boot, a false narrative fed by online anti-medicine cranks like Mike Adams. When someone whose outlook has been influenced by such a narrative hears the pitch from someone like Dr. Kenneth Woliner, who bills himself as an “integrative medicine specialist” in Boca Raton.

The decision of Administrative Law Judge Mary Li Creasy, who held two days of hearings in February and issued her opinion in late April, is chilling reading. It turns out that Sofronsky was originally diagnosed with peripheral T cell lymphoma, but after a second opinion a diagnosis of Hodgkin’s lymphoma was settled on. She went for a third opinion from Dr. Vivek Roy, who confirmed the diagnosis of Hodgkins lymphoma and recommended standard chemotherapy. Initially, Sofronsky appeared as though she were going to pursue standard of care for her Hodgkin’s lymphoma (HL), but then:

40. A few days before S.S.’s appointment with Dr. Rothschild, M.S. asked Respondent if it were possible that a “toxic something” was causing all of S.S.’s symptoms, including her swollen lymph nodes.

41. Instead of telling M.S. that S.S.’s symptoms, including her swollen lymph nodes, were more likely caused by her untreated cancer, Respondent suggested that S.S.’s house be tested for mold.

42. On July 5, 2011, S.S. presented to Respondent for a “check-up” and to discuss the little bit of mold that was found in her home. During the appointment, S.S. mentioned to Respondent that she met with Dr. Rothschild to discuss chemotherapy for her HL.

43. Respondent reiterated to S.S. that cancer was “low on his list” of possible medical concerns. Respondent indicated that S.S.’s tests showing she had increased lymphocytes^9/ were not indicative of cancer, especially since he did not see any “Reed- Sternberg” cells.^10/ Respondent insinuated that oncologists often overreact to the presence of lymphocytes and recommend chemotherapy before making an actual diagnosis. Respondent further insinuated that Dr. Rothschild may not be a competent oncologist.

44. Respondent recommended S.S. pursue her “mold allergy” issues and referred her to Daniel Tucker, M.D., a local allergist.

45. Respondent also provided S.S. with a letter addressed to Dr. Rothschild wherein he emphasized that “mold could be causing all of [S.S.’s] symptoms and exam findings.”

So basically, Sofransky decided to abandon standard of care treatment that had a high probability of saving her life in favor of Wollner’s rejection of the diagnosis made by pathologists at an NCI-designated comprehensive cancer center (Moffitt) and subsequent claim that all her symptoms were caused by “allergies” and other issues—anything but the cancer.

The last nearly two years of the narrative are painful to read about. Sofronsky kept developing new symptoms, all of which were consistent with progressing lymphoma, including complaints of back pain, more lymph node swelling and pain (which Wollner treated with low dose Naltrexone), leg swelling, increasing abdominal pain and swelling (which Wollner attributed to an allergic reaction), and weakness. Finally, she collapsed and died three days after a visit to Wollner’s office for a complaint of “pain and severe swelling in her legs,” which was almost certainly caused by growing lymph nodes in her pelvis pressing on the veins draining blood from the legs.

Even after the autopsy conclusively showed that Sofransky had died of complications of Hodgkin’s lymphoma (to which Wollner responded that the patient had never been diagnosed with Hodgkin’s lymphoma), Wollner remained in denial:

84. Despite having reviewed S.S.’s radiographic, pathology, and oncology consultation reports indicating that S.S. had HL,15/ and having treated her symptoms indicative of progressed HL for nearly two years, Respondent refused to believe that S.S. had HL, choosing instead to believe that she presented “more like a [chronic fatigue] patient allergic to mold than a lymphoma patient.”

85. It was not until Respondent received the final autopsy report, several months after S.S. died, that Respondent was finally “satisfied” that S.S. had HL all along.

I took a look at Wollner’s website. He actually presents a rather interesting conundrum—not to me, mind you, but to promoters of the specialty of “integrative medicine,” or, as I like to call it, integrating quackery with medicine. His practice does not take insurance and bills itself as offering concierge medicine with:

• Second opinions for “Difficult-to-Treat” medical conditions
• Functional Medicine. Find and treat the cause of your condition not just cover up the symptoms
• Nutritional IV Therapy
• Bio-Identical Natural Hormone Replacement Therapy for Menopause
• Individualized Treatment of Thyroid Disorders using all medications including Armour Thyroid and Nature-throid
• Effective Weight Management for Men, Women and Children
• Medical and Nutritional Therapies for Chronic Fatigue, Insomnia, Hair Loss, Diabetes, High Cholesterol and other medical conditions
• Effective Pain Management for Fibromyalgia ,Arthritis, Back and Neck Pain using Trigger Point Myotheraphy
• Holistic Therapies for Osteoporosis using diet, exercise and vitamins

I guess that second opinion for Sofransky’s “difficult to treat” medical condition didn’t work out so well. Of course, Sofransky wasn’t that difficult to treat. She had Hodgkin’s lymphoma, and even if she had actually had a peripheral T cell lymphoma, both diseases have pretty straighforward treatment protocols. Be that as it may, the above doesn’t describe everything. Wollner treats candida infections, for instance, in a manner that naturopaths do when blaming a vast panoply of vague symptoms on “chronic candida infection.”

On his website, Wollner touts the following credentials:

• American Board of Family Medicine (ABMS) – July 2000, Re-certified August 2007 and 2013; valid through Dec 31, 2017
• Board Certified Integrative Medicine (ABPS) – Certified February 5, 2015, valid through December 31, 2023
• American Board of Integrative Holistic Medicine – Certified 1997; Recertified November 2013
• Institute for Functional Medicine Certification Program – Certified November 2013
• U.S. District Court for the Southern District of Florida – Qualified as an expert witness, October 11, 2013.

Well, that last one is good to know.

Remember how I discussed the board certification in integrative medicine, how it was Andrew Weil’s attempt, in collaboration with the American Board of Integrative Holistic Medicine, to bring respectability to the specialty? Here’s the problem. “Integrative” medicine “integrates” the very practices that Wollner used on Sofransky. Oh, sure, the academic integrative medicine specialists in their ivory towers of academia will deny that integrative medicine encompasses anything that isn’t evidence-based, and maybe in university academic medical centers integrative doctors can delude themselves into believing that’s true even as they recommend acupuncture, reiki, traditional Chinese medicine, functional medicine, naturopathy, and even high dose vitamin C for cancer. And maybe at academic medical centers, there is even a modicum of quality control. However, when you get out into the community, what you’re dealing with when it comes to integrative medicine are docs like Dr. Wollner.

Patients like Stephanie Sofransky pay the price.