CANCER IS IN THE NEWS AGAIN
SEE WHAT THE EXPERTS HAVE TO SAY ABOUT THIS TERRIBLE DISEASE
Liz Szabo from the February 9, 2017 issue of USA Today (Dozens of New Cancer Drugs do Little to Improve Survival) talking about a study from JAMA Otolaryngol Head Neck Surgery (Unintended Consequences of Expensive Cancer Therapeutics — The Pursuit of Marginal Indications and a Me-Too Mentality That Stifles Innovation and Creativity)
A good friend of mine works in an oncology department somewhere (purposefully anonymous) here in the Midwest. He says that every single lunch is a veritable smorgasbord for everyone working in the facility; the catering paid for by one or another of the numerous drug reps that are a fixture in the clinic (HERE). It's the price of doing business. And no one will deny that CANCER is big business --- really big business. In light of this, it's always interesting to take a look and see what some of the latest Cancer research has to say. After all, aren't we supposed to be following a model based on "BEST EVIDENCE"?
It is becoming increasingly clear that equivocating EARLY DETECTION with PREVENTION is a huge myth (HERE). We are also seeing that the medical research community believes Cancer is, for the most part, a random event. Case in point, the study from yesterday's issue of Science (Stem Cell Divisions, Somatic Mutations, Cancer Etiology, and Cancer Prevention). The authors (from Johns Hopkins) started things off by saying, "Most textbooks attribute cancer-causing mutations to two major sources: inherited and environmental factors. A recent study highlighted the prominent role in cancer of replicative (R) mutations that arise from a third source: unavoidable errors associated with DNA replication." The authors concluded by using a variety of "STATISTICS" to show that nearly 7 out of 10 cases are totally random, i.e. there's not a durnned thing you can do about it. In other words, they are largely throwing the concept of EPIGENETICS out the door.
"Cancer is today the most common cause of death in the world. Primary prevention is the best way to reduce cancer deaths. Recognition of a third contributor to cancer—R mutations—does not diminish the importance of primary prevention but emphasizes that not all cancers can be prevented by avoiding environmental risk factors. Fortunately, primary prevention is not the only type of prevention that exists or can be improved in the future. Secondary prevention, i.e., early detection and intervention, can also be lifesaving."
What's interesting is that these authors end by propagating the myth that increasing numbers of experts in the field of Public Health are decrying --- that early detection, prevention, and intervention are lifesaving in the way we have been led to believe they are. For peer-reviewed proof that this is not the case, you can go back and click on the appropriate links at the beginning of the second paragraph above. Or you can read the piece I wrote on this very topic almost two years ago called "RANDOMNESS RUN AMOK". But what about those who have already been diagnosed with Cancer? While I'm not here to make suggestions one way or another, there is some highly interesting information coming to light that everyone should be aware of.
There is good reason that many, including myself, have described American Healthcare (no matter which political party is running the show) as "UNSUSTAINABLE". Cancer treatment is a microcosm of this fact. For instance, in January of last year, JAMA Oncology (The Use of Superlatives in Cancer Research) revealed that when it comes to describing new Cancer drugs, hype and propaganda rule the day. "The language used in oncology practice and research may elicit important connotations. Whereas most new cancer drugs afford modest benefits, approved drugs or those in development may be heralded as 'game changers,' 'miracle cures,' 'home runs,' 'revolutionary,' 'transformative,' 'marvel,' 'lifesaving,' 'groundbreaking,' 'marvel,' or 'breakthroughs' in the lay press. These news articles may be important sources of information to patients, the public, and investors—with a broader reach than medical journal articles. However, omission of medical context or use of inflated descriptors may lead to misunderstandings among readers." This, folks, is the art of the PRESS RELEASE (or HERE). BIG PHARMA is doing everything in it's power to lead you to the Koolaid. And just how effective is the Koolaid we've been collectively drinking? Let me show you by discussing something called "Surrogate Endpoints".
People want drugs to do big things --- give them their sex life back (HERE), cure their Diabetes (HERE), or reverse their COPD (HERE). Surrogate Endpoints are all of the little (measurable) things that drugs do on their way to doing their big thing. For instance, BLOOD PRESSURE DRUGS are supposed to lower high blood pressure --- that is a Surrogate Endpoint. The ultimate goal of these drugs is that the patients live longer and have fewer strokes and / or heart attacks. One of the dirty little secrets in the practice of medicine is that we have developed an entire industry around managing Surrogate Endpoints, while doing little or nothing for the patient as far as the big picture is concerned. We see this in both STATIN DRUGS (yes, they lower blood cholesterol) and DIABETES DRUGS (yes, they lower blood sugar) as well as any number of others --- including those used to treat Cancer. The question is not whether or not a drug is reaching Surrogate Endpoints, but whether the drug is accomplishing its "Big Thing".
Ed Silverman, writing for STAT's December 7, 2016 Pharmalot Column (Many Cancer Drugs Approved Using Surrogate Markers Don’t Improve Quality of Life) said, "More than a dozen cancer drugs that were approved based on so-called surrogate markers, such as the ability to shrink tumors, failed to improve the quality of life for patients. Yet most of the medicines, which previously were found not to extend lives, are also expensive, with many costing much more than $100,000 annually, and all but one remain on the market, according to a new analysis." The study itself, from the December issue of the British Medical Journal (BMJ) said, "Cancer drugs initially approved by the US Food and Drug Administration on the basis of surrogate endpoints often remain FDA approved even after postmarketing studies find that they neither prolong patients’ lives nor improve their quality of life." A study from last month's issue of JAMA Internal Medicine (Quality of Life, Overall Survival, and Costs of Cancer Drugs Approved Based on Surrogate Endpoints) echoed these results. "The lack of evidence of a clinically meaningful benefit for many cancer drugs approved by the US Food and Drug Administration (FDA) through expedited pathways raises questions about whether physicians and patients can make informed treatment decisions." There are any number of similar studies coming to identical conclusions.
For instance, last August, Meghana Keshavan wrote an article for STAT called Experimental Cancer Therapy Holds Great Promise — But at Great Cost. In it she discussed the newest and hottest trend in Cancer treatment, Immunotherapy. Immunotherapy is defined by Wikipedia as, "the "treatment of disease by inducing, enhancing, or suppressing an immune response." Sounds rather benign until you read what she wrote about one of the latest forms of Immunotherapy. "The treatment induces such sudden and severe side effects that it can take a small army of top specialists to keep patients alive while their newly engineered immune systems attack their cancer cells. The result: [these treatments] remain so risky, so complex, and so difficult to manage that experts warn it’ll be years before it’s available to most patients who would stand to benefit — even though two drug makers, startup Kite Pharma and pharmaceutical giant Novartis, are racing to get their versions of the therapy approved by the the Food and Drug Administration as early as next year." Believe me when I tell you that this was a freaky article. But that's my opinion; what are the experts saying about Immunotherapy?
Just days ago, Dr. Nathan Gay, an oncology fellow at Oregon Health and Science University, and Dr. Vinay Prasad, an assistant professor in Hematology Oncology at Oregon Health and Science University, teamed up to write an article for STAT (Few People Actually Benefit from ‘Breakthrough’ Cancer Immunotherapy) that showed that even though it was being touted in one of this year's Super Bowl ads, Immunotherapy is not all it's been touted to be. As are all the quotes in my posts, these are cherry-picked due to restraints on time and space.
"Today, though, only a tiny minority of patients expected to die from cancer will benefit from immunotherapy. As is often the case, hype sadly exceeds evidence. Using US national cancer statistics and FDA approvals, we estimated the percent of cancer patients who might actually benefit from immunotherapy. The result was surprising, given the way these drugs are described. The answer was just 8 percent. We also ran the numbers another way by setting a lower bar for success, and credited these drugs for any patient whose cancer did not grow substantially during follow-up. Even with that adjustment, the estimate was less than 10 percent. Who is to blame for the disconnect between reality and hype? Doctors, researchers, the pharmaceutical industry, reporters, patient advocates — all use sensational language to describe these drugs. To make matters worse, the United States is one of the only countries to permit direct-to-consumer advertising, resulting in an astonishing 80 drug ads airing every hour — some of which are misleading."
There were two comments to these doctor's article; the first by a person decrying the article as unfair because the treatment has so much promise. The second by one Steve Kohn, an individual who says he was "lured" into becoming part of a clinical trial in Immunotherapy because of the "hype" he'd been exposed to. Listen to what he says. "Little did I know how much suffering would come from finally being in remission. The Chemo-Induced Peripheral Neuropathy I suffered from when I began the trial has worsened to the point where I question whether the decision to participate in the trial was the right one. In my case the treatment destroyed the cancer cells so far, but also is in the process of destroying my sensory nerves making my pain at times unbearable." I truly feel for the millions of people like Steve, who end up making decisions because they are essentially between a rock and a hard place, with few places to turn, and advice that is often questionable at best, and at worst, meant to TAKE ADVANTAGE OF SUFFERING PEOPLE. Speaking of advice, what's the medical community saying that we can do to prevent Cancer as far as our diets are concerned?
Writing for the March 15 edition of the American Society of Clinical Oncology, Dr Amanda Narod (Georgetown University) put out an interesting article called, A Menu for Cancer Risk Reduction? Five Truths About the Role of Food and Diet in Cancer Prevention. Some of the article was very good. However, some of it made the same old mistakes that we've seen for decades. For one, she wrote about VEGETABLES & FRUITS. Click the link to see why, while fruits are not all bad, they are not synonymous with vegetables (she did talk about the benefits of CRUCIFEROUS VEGETABLES). She also touted the benefits of whole grains (to see why this is largely a mythical impossibility for most people in Westernized society, read my short post on GRAINS). She even went as far to tout SOY as one of her five "Cancer Prevention" tips. In some ways I feel like I just stepped into Dr. Emmet Brown's Lamborghini and went back to the 1980's.
Her last point, "fire up the grill with caution," was not terrible advice, but neither was it worthy of a spot on a "Top Five" list. She discussed the problems associated with "well done meats" as related to polycyclic aromatic hydrocarbons or PAH's, which have been associated with everything from Cancer to HEART DISEASE to developmental issues such as low IQ's. Also be aware that because these creatures have a benzene-like ring structure, they also happen to act as XENOESTROGENS (artificial sources of estrogen --- just like Soy). While it's true that people can get a degree of PAH exposure from their cooking habits, the real exposure is coming from (Wikipedia), "smoking rates, fuel types in cooking, pollution controls on power plants, industrial processes [there were a slew of them listed], and vehicles." It sort of reminded me of an article I wrote a while back about AGES (Advanced Glycation Endproducts). While it's true that charring your grilled food can produce AGES, they are largely the result of LIVING THE HIGH CARB LIFESTYLE. Which brings me to one last point --- arguably the biggest and most important point on her list ----a point that the good Dr. Narod completely failed to mention.
I'm not quite sure how one can legitimately talk about using diet to prevent cancer, and not at least mention the work of the venerable DR. OTTO WARBURG. Warburg (MD / Ph. D) won the 1931 Nobel Prize in Medicine by figuring out that Cancer is fed via the fermentation of sugar. That's right folks, sugar feeds cancer. If you really want to do something to prevent cancer, I suggest you click on the link above (the article is very short) and read it. As I showed you back in 2015, Cancer is not as "random" as an event as we are being led to believe. Face it; if it really is random, there is nothing --- not a blasted thing --- you or anyone else can do about it other than bend over and take whatever it gives you. I'm not into that, and you shouldn't be either (HERE).
For more information about fighting chronic illnesses of all sorts (not to mention chronic pain) take a moment to READ THIS POST. And in light of today's post, it's not surprising that the KETOGENIC DIET remains one of the most exciting things going in the diet-based treatment of Cancer.