Flowers of the bloodroot plant, Sanguinaria canadensis. You’re welcome, I could have used a very different image (warning: gross bordering on horrifying).
I first wrote about escharotic treatment for cervical dysplasia in 2015. A caustic substance is applied to the cervix. This produces an uncontrolled chemical burn and the dead tissue sloughs off, hopefully taking the abnormal cells with it. The standard treatment for cervical dysplasia is excision by cone biopsy or LEEP (Loop Electrocautery Excision Procedure). Escharotic treatment has not been proven as effective as excision, and it has several drawbacks. It requires multiple visits, is not covered by insurance, and the biggest problem is that there is no tissue sample to send to pathology to see whether abnormal cells remain. It was easy to predict that eventually some patients would develop invasive disease that might have been prevented by conventional treatment. That prediction has proven correct.
I wrote about Nicholas LeRoy in 2016. A chiropractor, he offered escharotic treatments along with other dubious treatments. In an update a year later, I reported that his license had been revoked and that he had been practicing without a license, and had continued to offer escharotic treatments.
Patients report disastrous results and lies
A concerned correspondent who follows the Inspire message board passed on information posted by one of LeRoy’s patients. She first saw him after he had lost his license. After 12 escharotic treatments, she thought she was cured. But a month later, a biopsy and ECC (endocervical curettage) done elsewhere showed adenocarcinoma in situ. This should have been a wake-up call; but instead, she went back to LeRoy and had 8 more escharotic treatments. Another endocervical biopsy again showed cancer in the cervical canal. She then had a cone biopsy, but the margins were not clear. Her (real) doctors told her that the delay in treatment had allowed the cancer to spread to her uterus and she will require a radical hysterectomy. One can only hope that the hysterectomy will be curative; but if the cancer has spread beyond the uterus, she may not only lose her uterus but her life. This unfortunate outcome would almost certainly have been avoided if she had agreed to standard excisional treatment in the first place.
Others on the message board described how LeRoy had lied to them, for instance saying that if a cone biopsy didn’t show clear margins, conventional medicine would do nothing for six months! He told patients that no one had ever needed surgery after his treatments. He told them that if the cervix closed together after a LEEP or cone biopsy, a hysterectomy would be required; that is simply not true.
There are case reports of successful escharotic treatments, but no studies comparing outcomes to excisional treatments. LeRoy claims a 99% success rate, but I don’t believe it. His claim is not supported by any published studies. Escharotics are among the “natural” treatments used by naturopaths. I fail to see what is “natural” about burning the cervix with caustic chemicals.
Britt Hermes, the ex-naturopath who writes the Naturopathic Diaries, warns “Don’t let a naturopath near your vagina.” She characterizes escharotics as “unproven, dangerous, and very stupid.” She says the practitioners are delusional, the practice is barbaric, and she doesn’t hesitate to call it quackery.
LeRoy passes the baton to Michelle Brannick
LeRoy’s website continues to advertise escharotic treatments and has a link to make an appointment. I contacted his office asking if it was true that he had lost his license, and “Drnickfrontdesk” replied “That is correct–he has sold his practice to Dr. Michelle Brannick and is teaching her everything he knows about treating dysplasia. Dr. LeRoy is also consulting with her on all cases until she is fully trained and has increased her knowledge base.”
Michelle Brannick is even worse than LeRoy. Her website lists her as a licensed Naturopathic and Chiropractic Physician in Vermont and Illinois respectively. She was trained at Bastyr, the same school that mis-educated Britt Hermes. She offers a variety of questionable treatments. Her website makes it clear that she is anti-vaccine, linking to an anti-vaccine website. She demonizes conventional medicine, linking to Gary Null’s infamous article “Death by Medicine.” (I have already explained what is wrong with those “death by medicine” arguments.) She links to other ridiculous websites like Notmilk, which says Swiss cheese causes Alzheimer’s and milk protein is the cause of autism. It blames every known illness on milk, from cancer to the common cold. She even supports homeopathy, saying homeopathic arnica 30C should be available in every household.
Naturopaths are not licensed in Illinois, so she must be practicing under her chiropractic license. A proposed law in Illinois that would have licensed and regulated naturopathic physicians included the restriction in Section 65 (9) that licensed naturopaths may not treat any lesion suspicious of malignancy or requiring surgical removal. While I don’t support licensing, I do think that restriction would have been wise. And I don’t think chiropractors have any business treating lesions suspicious of malignancy either.
Conclusion: This tragedy was avoidable
LeRoy has once again found a way to get around the law, and patients are being harmed. I don’t blame that patient who is losing her uterus and possibly her life. She was misinformed; she thought he was a reliable doctor and did not know enough to question his advice. I blame the authorities for not stopping LeRoy. Regulators have a responsibility to protect patients from harm; and at the very least, to stop providers from practicing without a license.
Addendum
I have just learned some additional information. LeRoy has been telling his supporters he is “beginning a gradual transition from a clinical practice to a teaching and consulting practice.” When you lose your license, you are supposed to STOP clinical practice, not gradually transition away from it. I wonder how the authorities will interpret his involvement with Brannick on all her cases; couldn’t it be considered practicing by proxy?
He plans to publish “longitudinal data” to support the efficacy of escharotics. That would be a case series, which is only a little better than a collection of testimonials; and without a control group, it can’t establish efficacy. He doesn’t seem to understand what is really needed: a controlled study showing that escharotics are at least as efficacious and safe as LEEP, and that the absence of a tissue sample doesn’t lead to worse final outcomes.
I also learned that his patients are being asked to populate the internet with their testimonials and specifically to post comments on my SBM articles. The plural of anecdote is not data.
This article was originally published in the Science-Based Medicine Blog.
