The whole point of the Internet is that anyone can use it. And anyone does. According to an article in this week's British Medical Journal, "Shopping Around the Internet Today and Tomorrow: Towards the Millennium of Cybermedicine", more than 100,000 medical websites exist "and their number is growing rapidly". The article quoted a survey indicating that 27 per cent of female Internet users and 15 per cent of male users access health information at least once a week.
The sublime, the criminal and the insane - it's all there on the Net. And according to the article in the BMJ, by Gunther Eysenbach, Eun Ryoung Sa and Thomas L Diepgen, the information and advice is extremely variable, "ranging from the useful to the dangerous".
Take this example, from a website advertising something called "Rife therapy". This involves directing electrical frequency beams at the body from a Rife machine, which costs about pounds 1,200. Its beams are supposed to be toxic to bacteria and viruses, including HIV. There is only one problem. It doesn't work - you might as well stand in front of your toaster. But is it harmless? The website states: "If the person is taking AZT (a key drug used to suppress the virus that causes Aids), they may have to decide whether to take drugs or take frequency sessions, as AZT will complicate and confuse the apparent results."
Dr Ali Zumla, an Aids expert at University College Hospital in London, says: "Suggesting that people who are taking anti-viral treatment for HIV should discontinue their medication is totally irresponsible and encourages drug resistance. Many of our patients take alternative treatments, but the point is that these are complementary rather than a substitute for conventional medicine. Treatments have to be properly assessed in clinical trials before you can make claims of a cure and then charge people for them."
You might think that such websites were rare. However, a search of the Net using the term "ozone enema" led to 383 separate pages. Ozone therapy is based on the incorrect assumption that cancer is caused by insufficient oxygen. It seeks to correct this by exposing cells to ozone - modified oxygen - at the site of disease. "This is nonsense. The correct treatment for colonic cancer is surgery, with or without chemotherapy and radiotherapy," says Dr Carmel Coulter, a cancer specialist at St Mary's Hospital in Paddington, London.
The Trepan Brain Clinic Webpage suggests some astonishing variations on the ancient practice of trephination (drilling a hole in a healthy skull to relieve pressure). They offer a made-to-measure service where you can have "as much or as little brain modification to best suit your lifestyle - from simple trephination, to lobotomy, to complete decephalisation". You won't even have to have your head shaved. They can use small tools inserted through a hole in your ear. It's your happiness, they say. Only your brain can stand in your way.
For $49.95 (pounds 31) a product called Cansema guarantees 100 per cent success in the removal of skin cancers, even melanomas - regardless of type or size. The makers say that it can discriminate between healthy and cancerous tissue and can therefore both diagnose and treat. That is simply not scientifically possible. Cansema is a so-called "escharotic", which poisons and kills any skin it touches, cancerous or otherwise. There are documented cases of patients losing large areas of their skin and face, including the whole nose, after using escharotics, and needing years of plastic surgery to correct the damage.
Many sites are just eccentric rather than truly dangerous or exploitative. Try the Urine Therapy homepage. Here, a self-styled health consultant and urine therapist, Coen van der Kroon, tells you more than you probably want to know about what you can do with your own waste products, including gargling, inhaling it and bathing in it.
Maya the dolphin is webmaster of a site where they want to sell you a book of health tips in case you are abducted by aliens. Elsewhere you can buy a five-gallon polyurethane gravity tank for your home enemas and a smaller one for your dog and cat. Should all else fail there are numerous sites offering cryonics - the so-called science of having your corpse frozen until doctors come up with a cure for fatal illness.
Dubious cancer treatments that were briefly fashionable are popping up afresh on the Web. Essiac, Laetrile, Entelev, powdered shark cartilage, Hoxsey Treatment, Greek Cancer Cure... the list is endless. All have either been tested and found wanting by conventional science, or been thought too improbable to deserve investigation. All have numerous Internet sites making wild and unproven claims that they can cure cancer or other illnesses (for money). Many contain the querulous accusation that the conventional medical profession is trying to suppress them.
"People should remember that doctors are very enthusiastic to cure patients," says Dr Coulter. "If any of these treatments really worked we would prescribe them. We are in the process of setting up a website of our own, with information sheets for all the major cancer treatments." The General Medical Council regulates medical practice in Britain. Its spokesman says: "If these treatments are not offered by registered medical practitioners in the UK then we have no jurisdiction. The regional director of public health may have some local responsibility, but, of course, the Internet is difficult to regulate."
Dr Paul Cundy, chairman of the Information Management and Technology Sub-Committee of the General Practitioners' Committee, says: "The reality of the Internet is that it is free for anyone to use, and it is therefore impossible to police."
According to Linda Cuthbertson, of the Royal College of Physicians: "Increasingly, patients are coming to their doctors with computer print-outs advertising alternative treatments. Doctors just don't have the time to sit down with patients to sift the good from the bad." She adds: "There are of course many legitimate medical websites, such as the Imperial Cancer Research Fund's"
In the end you have to make up your own mind whether to trust any health practitioner, whether in the surgery or on the Web. Before you sign up for any treatment, though, it may be worth checking it out first. The organisation called Quackwatch may be a good place to start.
SO, WHICH WEBSITES CAN YOU TRUST?
Dr Paul Cundy, a Wimbledon GP, suggests that you should:
l Never rely on just one site
l Check that information is verified in a scientific journal, where authors are identified and their credentials and sources listed
l Look for evidence that the site is regularly updated
l Watch out for advertising or links to commercial organisations, which could indicate a conflict of interest
l Avoid online consultations, which are potentially dangerous
l Be sceptical of any miracle cures
l Look for evidence of an editorial board, rather than sites devised by single issue mavericks
Reputable websites include:
Quackwatch - this site offers critiques of alternative therapies:
Imperial Cancer Research Fund's site, containing news, fact sheets, contacts and links:
Cancer Research Campaign's site, which offers advice on preventative
measures and treatments:
Medline Plus, devised by the National Library of Medicine in the United States:
Sites to browse through in your lunchtime (but only if there's nothing wrong with you):
Interested in trepanning?
Need health tips, in case you're
abducted by aliens?
Thinking of getting your body frozen after you're dead? Then you could sign up here:
Research: Eva Johansson