Yes, you can have a chiropractor for a gynecologist, but it’s not a good idea.
Over a year ago I wrote about escharotic treatments for cervical dysplasia. It is offered not by MD gynecologists but by chiropractors and naturopaths, along with inconsistent and unproven diet recommendations and supplements. A corrosive agent similar to “black salve” is applied repeatedly to the cervix; it works by destroying tissue. There are no controlled studies evaluating it for safety and effectiveness. One major drawback is that there is no surgical specimen to submit to pathology to determine if there is invasive cancer. I urge you to read my first article for further details. Escharotic treatment is decidedly not a good idea.
In that article I focused on the treatment itself. I recently revisited the website of the chiropractor I mentioned in that article, Nick LeRoy, and I want to comment on some other issues raised by this individual who is offering the treatment.
Who is Nick LeRoy?
On one website he is listed as a Chicago holistic medicine physician and primary care physician for an HMO, Alternative Medicine Incorporated, which he says is underwritten by Blue Cross/Blue Shield. When I googled for Alternative Medicine Incorporated, I found a company in England, but none in America with that name. On his other website he claims to have “post-doctoral medical training in gynecology and internal medicine and to be a credentialed primary care physician (PCP) for Blue Cross of IL.” I phoned Blue Cross of Illinois, and they told me he was not listed as a provider in their records. They suggested I contact him directly to ask for clarification. I did, by email. He didn’t answer.
He has taken courses in acupuncture and Traditional Chinese Medicine, and got “private breast thermography training.” It’s not clear how much training he has in gynecology. On one page of his website he says his “integrative medicine training included gynecology, internal medicine, acupuncture, chiropractic, and nutrition.” In a video, he says he has been specializing in gastrointestinal disorders for twenty years, and he describes how he does unconventional food allergy testing for 154 different foods.
He lists himself as “DC, MS, AcT,” but he calls himself “doctor” and readers are likely to assume he is an MD. The testimonials all refer to “Dr. LeRoy.” He sells his books and supplements through his “doctor’s supplement store.”
His services
He offers breast cancer prevention and detection, and cervical cancer prevention and detection. For breast cancer prevention and detection, he offers breast thermography, blood work, guidance on a plant-based diet, and prescription of immunity boosting supplements. He claims these methods can prevent cancer and can also be used to treat cancer in conjunction with conventional cancer treatments of surgery and radiation. (Curiously, he doesn’t mention chemo.)
He says, “Breast thermography may be the most effective diagnostic tool for early breast cancer detection.” He is wrong. Our own breast cancer expert Dr. Gorski has explained why breast thermography is not an effective diagnostic tool.
For cervical cancer prevention and detection, he offers dietary advice, supplements, and escharotic treatments. He claims that the escharotic treatment destroys HPV-infected cells while leaving the healthy cells intact. I don’t think that could possibly be true, and he provides no supporting evidence for that claim. He says the escharotic discriminates between healthy and abnormal cells by “uncoupling the electrochemical gradient of abnormal cells.” That’s just sciencey-sounding malarkey.
He promotes “detoxification,” which is a red flag for quackery. I took his detox questionnaire and it said I needed a 10-day elimination diet and medical food for imbalanced detoxifiers. No thank you. In the first place, that questionnaire has not been validated and is about as meaningful as those quizzes in the women’s magazines that claim to predict if your marriage will last.
Costs
He lists his fees here:
- $200 for a general women’s health visit
- $250 for breast thermography (which typically costs $200 elsewhere)
- Initial visit for cervical dysplasia $215, $85 for follow-up visits. Typically, 10 treatments are required. Total would be $980.
The conventional treatments of cone biopsy or LEEP (loop electrosurgical excision procedure) cost more (typically $1,300 to $1,500), but they are proven effective and the costs are covered by insurance, which does not pay for escharotic treatments. Lower cost is not an advantage if the treatment is ineffective and risky.
Chiropractors as PCPs and specialists
Jann Bellamy and I have written about the efforts of chiropractors to re-classify themselves as primary care providers and the inadequacy of their education to prepare them for that role (the full list of posts can be found here).
Classroom education is not enough. MDs get hands-on experience treating seriously ill hospitalized patients and they get years of post-graduate training before they can call themselves specialists. There is nothing comparable in the world of chiropractic. Steven Novella has written about so called “chiropractic neurologists.” He says there is no reason to take their claims seriously. The same goes for “chiropractic gynecology.”
In some states, chiropractors are allowed to perform obstetrical exams, sign birth certificates, order thermography, perform a bi-manual pelvic exam, speculum exam, recto-vaginal exam, and Pap smears. In other states chiropractors are not even allowed to do pelvic exams. I couldn’t find the details of the scope of practice for chiropractors in Illinois, but I don’t think treatment of cervical cancer is included in the scope of practice in any state. I suspect the chiropractic board could order LeRoy to stop offering it; I also suspect that they won’t.
Misinformation about HPV
He says cervical dysplasia and cervical cancer are not caused by human papillomavirus (HPV). He “knows” this because 80-90% of women eliminate HPV infections without treatment. Elsewhere he contradicts himself by saying HPV is known to cause cancer. He claims that lifestyle factors determine who will develop cancer, and he says gynecologists are hiding the truth from their patients.
The most effective preventive measure we have is the HPV vaccine. Think about it: a vaccine that prevents cancer! He refuses to recommend it to his patients. He says that HPV vaccines have more risk than benefit. He says that HPV vaccines account for over 60% of all reported vaccine injuries. He says the Vaccine Adverse Event Reporting System (VAERS) reported over 26,000 adverse events, 92 deaths, 866 cases of permanent disability and over 9,000 injuries requiring emergency hospitalization. This is simply ignorant. He doesn’t understand what VAERS is. It lists anything and everything that has happened to a patient after getting the vaccine, and in the vast majority of cases the reports show no higher incidence than what would be expected in the normal population without the vaccine. VAERS is an uncontrolled data dump that does not establish causation. 90 million doses of HPV vaccine have been given, and no serious side effects have been detected. The deaths reported in VAERS have been investigated; there was no credible evidence that any of them were caused by the vaccine.
He cites Japan’s decision to withdraw the HPV vaccine. Japan was wrong. There has been a lot of irresponsible fear-mongering about the vaccine but in reality it is very safe and is even being recommended for boys. Steven Novella has written about how anti-vaccine activists have distorted reality to support their agenda.
Conclusion: LeRoy is misguided
Chiropractors are not qualified to act as gynecologists or PCPs. They are not qualified to treat cancer at all, much less with an untested, potentially harmful treatment. They should not be spreading misinformation about the HPV vaccine. (Incidentally, only about half of chiropractors support vaccination at all.) Freedom of speech allows LeRoy to say whatever he wants, but freedom of speech has limits: it does not allow people to start a panic by falsely crying “Fire!” in a crowded theater. Some might argue that medical fear-mongering and misinformation approach those limits.
I don’t think he is deliberately practicing quackery. I will give him the benefit of the doubt and assume that he believes in what he does. According to Hanlon’s Razor: “Never attribute to malice that which is adequately explained by stupidity.” He may not have a low IQ, but he is clearly not smart about the basic principles of science and evidence, and he is doing his patients a disservice.