BY DR AMIR FARID ISAHAK
Everyone agrees that we should do more to prevent cancer, but there is much disagreement on how to treat the cancers that still ravage us.
BEFORE the discovery of bacteria, it was quite common for women to die of “childbed fever” (puerperal sepsis), which was actually septicemia due to unhygienic practices of the doctors and nurses then.
In 1847, a Hungarian physician by the name of Dr Ignaz Semmelweis discovered that by simply washing his hands before assisting in childbirth, he could dramatically reduce the problem.
He observed the phenomenon over several years from three different clinics. He instituted a hand-washing policy in these clinics, and the incidence of childbed fever and puerperal deaths dropped by 90%. He presented this evidence to the medical community.
Yet, his contemporaries refused to accept his idea because it went against the then-accepted science of the day – which was that disease was caused by an “imbalance of the four humours”, and was treated by blood-letting and purging of the bowels.
He was ridiculed and ostracised by the medical community. He eventually died in an insane asylum, while doctors still refused to wash their hands before delivering babies.
It was only decades later, when Louis Pasteur’s germ theory of disease (also rejected at first) was widely accepted, that the truth behind his observations was acknowledged.
Imagine how many lives could have been saved if the doctors had paid attention to the evidence he presented, instead of hanging on to the prevailing “established protocols”.
I feel an eerie similarity between what happened to him and my attempts to convey the message that chemotherapy is not necessarily the best strategy to fight cancer.
In several previous articles, I quoted several major reviews on chemotherapy, reported in the top peer-reviewed journals, that concluded that chemotherapy only helped 2-7% of the cancer patients, at the cost of so much additional suffering, and enormous financial burden.
Oncologists and the medical community in general continue to believe that chemotherapy protocols should be continued despite the overwhelming scientific evidence to the contrary. They then convince cancer patients that chemotherapy is essential if they hope to prolong their lives or recover from the disease.
Yet, the scientific studies show that what is believed by the oncologists is not always the same as what is proven by the studies.
The most recent comprehensive review of the effectiveness of chemotherapy was published by three oncologists in 2004 in the top cancer journal Clinical Oncology (16:549-560), and the conclusion was that overall, chemotherapy contributes just over 2% to improved survival in all the cancer patients in Australia and the US. Reviews done up to 11 years earlier showed similar results.
In 2004, most of the other oncologists neither refuted nor changed their reliance on chemotherapy despite the conclusive evidence. Now eight years later, although no similar comprehensive review has shown any significant improvement, that review is said to be outdated by some oncologists.
While I welcome criticisms and differences in opinions, I wish to clarify certain points. I do keep abreast of the latest studies. What I pointed out was that the last comprehensive review on chemotherapy showed only 2% success rate. Like others, I also hope that the next comprehensive review will show better results. I had quoted journal reviews from 20 years ago to show that there has been little change since then.
There is no doubt that there has been significant progress in the treatment of certain cancers at certain stages, some of which were mentioned in their article (Clarifying chemotherapy, Fit4Life, Oct 14, 2012). The improvements are often the result of combined therapies. What I was writing about was the overall impact of chemotherapy only.
What I lament is the painfully slow progress in cancer therapy, such that many are not saved. The US is arguably the most advanced nation medically, yet for 2012, the American Cancer Society expects almost 600,000 deaths from all types of cancer (including 160,000 from lung cancer, 50,000 from colorectal cancer, and 40,000 from breast cancer). One in four deaths in the US is due to cancer. There will be about 1.6 million new cancer cases this year.
Those figures certainly show that we are far, far away from winning the war on cancer. However, there is good news as well. While we may have not won the war, some battles have been won.
Cancer incidence (new cases) has been declining in some countries. This can be attributed to better preventive strategies – reduction in smoking (reduces lung and several other cancers), Pap smears (which also detect pre-cancerous cervical disease), hepatitis B vaccination (prevents the main cause of liver cancer), antibiotic therapy for Helicobacter pylori (prevents stomach cancer), etc. The preventive role of mammograms is still controversial, and the impact of vaccination against human papilloma virus, which causes cervical cancer, will only be apparent in a decade or two.
Better education and awareness can help reduce the incidence by encouraging people to live healthy lifestyles, eat healthy diets, exercise sufficiently, take preventive measures, and quit unhealthy habits.
Have we won the war?
Many oncologists say we are winning the war on cancer. Cancer death rates have been declining at about 1-2% per year in the last two decades.
To quote Dr Michael Paul Link (professor of paediatric oncology at Stanford University School of Medicine): “… from 1990 to 2007, the death rate from all cancers combined declined by 22% for men and 14% for women; certain cancers that were uniformly fatal only 40 years ago have yielded significant ground; almost 80% of children with cancer can now be cured; and close to 90% of children with acute lymphoblastic leukaemia (the most common form of childhood cancer) become long-term survivors.
“Young men with testicular cancer have a realistic chance of cure (even those presenting with metastatic disease), and patients with Hodgkin disease and non-Hodgkin lymphoma are approached with curative intent.
“Additionally, significant progress has been made in the management of key solid tumours, promising prolonged survival and improved quality of life for many patients…”
So there seems to be significant progress over the years, but we must remember that it is now 41 years since US President Richard Nixon declared the “War on Cancer” funded by a US$10bil (RM30bil) war-chest. Since then, the amount spent is estimated to be US$110bil (RM330bil).
Or have we the lost war?
However, how we interpret the statistics may differ and give contrasting conclusions. Sceptics attribute the declining death rates mostly to the decline in smoking (in the US), detection at earlier stages, and better surgical management – not necessarily because of better drugs.
I strongly encourage readers to read War on Cancer – A Progress Report for Skeptics (Feb 2010) by Dr Reynold Spector, clinical professor of medicine at the Robert Wood Johnson Medical School, US (www.csicop.org/si/show/war_on_cancer_a_progress_report_for_skeptics/).
His conclusion: “… unlike the successes against heart disease and stroke, the war on cancer, after almost 40 years, must be deemed a failure with a few notable exceptions.”
So, I am not the only one who thinks that the war on cancer has failed. Everyone agrees that we should do more to prevent cancer, but there is much disagreement on how to treat the cancers that still ravage us.
While the oncologists continue to look for the latest chemo and smart drugs, it is my duty to highlight the fact that while the next promising drug will be amply funded to prove its effectiveness, the next promising nutritional therapy is likely to be abandoned because nobody wants to spend money on something that cannot be patented in order to recoup the costs, as well as make a handsome profit.
I agree that only a few out of hundreds of such candidate-drugs will be found suitable for human trials and finally get approved for use, and that the same will also happen for candidate nutrients. The problem is nobody is interested to proceed with the nutrients.
Why ignore promising nutritional therapies?
In a previous article, I wrote about how a head-on comparison between curcumin (from turmeric) and the drug diclofenac sodium showed that curcumin is superior in treating patients with rheumatoid arthritis.
Curcumin has been available for millions of years, and naturopaths and traditional health practitioners have been using it to treat many ailments, including joint problems.
Yet, it is only this year that we can make a scientific claim that it is more effective than the popular drug, which has been used for decades as first-line treatment.
If the research was done earlier, imagine how many millions would have been saved from the side effects of the drug. Yet even now, I doubt if many doctors have switched to curcumin, or are even aware of the goodness of curcumin (many other health benefits and no side effects).
I believe that more such positive results will ensue if the studies on promising nutrients can proceed with funding made available. And some of these will be for cancer therapy.
I would also like to clarify that although I do not think that chemotherapy is the best approach, I have never asked any cancer patient to abandon chemotherapy. And I also cannot claim that cancer nutritional therapy is proven as studies are lacking.
What I am saying is that after over 40 years of the “War on Cancer”, and with the overall unsatisfactory results, shouldn’t we change our paradigm and treat promising nutritional therapies the same way we look at drugs in the last 40 years?
If we do, why shouldn’t we expect some to be effective from the thousands of promising nutrients?
Yes, that the future of cancer treatment is in nutritional therapy is my statement of faith, and not of fact.
The future is only predictive, and cannot be factual.