[jcims]

This may be true in your experience or elsewhere, but it's patently false in my experience. There's 'standard of care', very narrowly scoped clinical trials, and everything else is "fringe". Some treatment proven effective for cancer? OK, but it wasn't proven effective for this cancer. Oh, it was proven effective for this cancer? OK, but it hasn't been proven effective after partially effective cytoreductive surgery. Oh, it was proven effective there? Yes but it hasn't been proven to be effective after disease recurrence. Oh, it was proven effective after disease recurrence? Ah, but it was only proven effective in germline mutations. Oh it was proven effective on somatic as well? Sure but not after immunotherapy has been tried...

On and on and on and on. The decision tree is so deep and patient communities sliced into smaller and smaller subgroups that we don't have enough people on the planet to 'prove efficacy' for them all (as if such a task is even possible, the most we usually get is evidence of efficacy in similar cases).