When Placebo Was More Powerful Than Brain Surgery

The placebo effect was the term first coined by anaesthesiologist H.K. Beecher back in 1955. He used this phrase to describe the phenomenon that he had observed in about one-third of the 20 or so patients’ case histories he was reviewing: they had healed from ‘nothing’. Since Beecher’s original study there have been many others, and often the response rate was even higher – up to 75% - than Beecher’s one-third.

Nowadays, the word placebo is used to describe any form of treatment where the patient is led to believe that they are receiving something beneficial when in reality they are receiving something with no known (medical) healing properties. The placebo can be something as simple as a sugar pill or common salt solution, or it can be more complex such as actual surgery when nothing is actually done. While the person may have agreed to participate in a medical study they do not know precisely what their role in it will be. They may undergo all the experiences of surgery including anaesthesia, being cut into, and having stitches, but nothing is in reality added, taken away or changed.

Let’s look at some of the ‘placebo effects’ that have been reported:

* 1994 Surgeon Dr. Bruce Moseley had scheduled 10 American Military veterans for knee surgery to help relieve pain in their arthritic knees. The procedure involved scraping and rinsing the knee joint. Unbeknown to them only 2 were actually operated on, 3 would receive the rinsing, and 5 would undergo no real surgery at all.  Six months later all the patients reported much less pain.

* In the 1960s, Seattle cardiologist Leonard Cobb carried out a groundbreaking  trial of a procedure then commonly used for angina. During this surgery, (called internal mammary ligation) small incisions in the chest were made and knots were tied in two arteries to try to increase blood flow to the heart. This technique was extremely popular and ‘effective’ at the time - 90 percent of patients reported that it helped. However, when Cobb performed the placebo surgery in which he made incisions but did not tie off the arteries, these operations proved just as successful! The internal mammary ligation surgery was abandoned soon after his findings.

* In 1999, the share price of a British biotech company called Peptide Therapeutics dropped 33 percent after it revealed that its new allergy vaccine was only as effective as a placebo. During the trials on food-allergy patients, a company spokesman had reported delightedly, 75 percent had improved to the point where they could tolerate foods they'd never been able to before. But when the control group data came in, so - embarrassment, embarrassment -  had 75 percent of the subjects taking inert tablets.

* 10 years ago pharmaceutical company Merck announced that it was halting development of MK-869, a new antidepressant it had been promoting for months as a blockbuster drug on the scale of Prozac. Apparently, the dummy pills worked just as well.

* A genetically engineered heart drug VEGF had been announced with much fanfare by its manufacturer, Genentech…. but the placebo actually performed better. Two months after their treatments, patients who had gotten low doses of VEGF could walk 26 seconds longer on a treadmill, those who had gotten high doses could walk 32 seconds longer and those who had gotten a placebo could walk …… 42 seconds longer!

* The placebo effect is not limited to the subjective sensations of patients; some studies show actual physiological change as a result of placebo treatments. Doctors in one study successfully eliminated warts by painting them with a brightly coloured, inert dye and promising patients the warts would be gone when the colour wore off. In a study of asthmatics, researchers found that they could produce dilation of the airways by simply telling people they were inhaling a bronchiodilator, even when they weren't. Patients suffering pain after wisdom-tooth extraction got just as much relief from a fake application of ultrasound as from a real one, so long as both patient and therapist thought the machine was on. Fifty-two percent of the colitis patients treated with placebo in 11 different trials reported feeling better - and 50 percent of the inflamed intestines actually looked better when assessed with a sigmoidoscope.

And, saving the best until last, here is my very favourite…..

Fabrizio Benedetti from the University of Turin published in 2004 some phenomenal results with Parkinson’s patients. He started off by giving the patients drugs that mimicked dopamine. It is the lack of dopamine in Parkinson’s that results in abnormal firing of the neurons in the brain and leads to the tremors & rigidity commonly seen in this illness.  24 hours after having given the patients this dopamine ‘look-alike’ they underwent a surgical procedure (fully conscious) in which they were told that they would receive a substance to restore their brain chemistry. During this procedure the only substance that was introduced was a simple salt solution which should have had no effect whatsoever on their condition. However…. their brain cells responded as if they had been given the original dopamine look-alike that had eased their symptoms. (And for those of you with very inquiring minds who are really on the ball – no, there weren’t any remnants of that substance since it has a short life span in the body and is metabolized after just 1 hour). This took findings from a Canadian group, led by Jon Stoessl, in 2001 a step further – they had observed that placebos could actually raise the brain levels of dopamine. The patients had managed to change their own brain chemistry and structure to improve their condition!

So what does this all show?

The power of our body, mind & spirit connection!

Scientists are now investigating the ‘biochemical pathway’ of the placebo effect …. watch this space for future updates :=)


References:

H.K. Beecher ‘The Powerful Placebo’, Journal of the American Medical Association, 1955, volume 159, number 17,pages 1602-1606.

Margaret Talbot, “The Placebo Prescription”, New York Times 9th Jan 2000. Full on-line article available at:
http://www.newamerica.net/publications/articles/2000/the_placebo_prescription

F. Benedetti et al. “Placebo-responsive Parkinson patients show decreased activity in single neurons of subthalamic nucleus” Nature Neuroscience, 2004, volume  7,  pages 587 – 588.

R. de la Fuente-Fernández, A. Jon Stoessl et al. “Dopamine release in human ventral striatum and expectation of reward” Behavioural Brain Research, 2002, volume 136, pages 359-363.
Andy Coghlan “Placebos effect revealed in clamed brain cells” New Scientist 16th May2004. Article available on line at: http://www.newscientist.com/article/dn4996.html

Gregg Braden “The Spontaneous Healing of Belief: shattering the Paradigm of False Limits” 2008,  Hay House, pages 42-44.