SCIENCE
Notebook
Monday, January 22, 2007; Page A08

http://www.washingtonpost.com/wp-dyn...012101145.html

Medical Breakthrough? The Laurels Go to Sewers
--------------------------------------------------------------------------------
What was the most important medical breakthrough of the last 167 years?
The structure of DNA? Nope. The invention of vaccines? Nope.
Antibiotics? Sorry.

According to a poll by the British Medical Journal, the answer is:
Sewers.

To mark a redesign of the prestigious medical journal, the editors
decided to poll readers about what they considered the greatest medical
milestone since 1840, the year the forerunner of the journal started
publishing.

More than 11,000 readers responded, and sanitation won with 1,795
votes. London was one of the first modern cities to improve public
sanitation after John Snow showed that cholera was spread by water, and
Edwin Chadwick came up with the idea of sewage disposal and piping
water into homes.

Antibiotics was a close second with 1,642 votes. Anesthesia came in
third with 1,574 votes, followed by vaccines and the discovery of the
structure of DNA.

"The general lesson which still holds is that passive protection
against health hazards is often the best way to improve population
health," said Johan Mackenbach of Erasmus University Medical Center in
the Netherlands, who nominated sanitation.

The journal noted that inadequate sanitation is still a major problem
in the developing world. In 2001, unsafe water, sanitation and hygiene
accounted for more than 1.5 million deaths from diarrheal diseases.

-- Rob Stein
© Copyright 1996-2007 The Washington Post Company

On Jan 24, 3:59 pm, "Peter Moran" <pmo...@bordernet.com.au> wrote:
I'm not making it up. Your defense of chemotherapy was to cite the
evidence on metabolic cancer diets. Your statement that *some* cancers
are not responsive to chemotherapy is meaningless because no RCT
studies exist to correlate the effects of chemotherapy to survival
outcomes in the first place. So-called palliative chemotherapy is
attributed to the benefits of a reduction in tumor size (when it
occurs, which isn't often), but again, such a view is unproven because
the concomitant use of palliative nutrition confounds the claim.
Mainstream oncology is co-opting the effects of therapeutic nutrition
while disparaging such factors outside of standard treatment. In light
of your refusal to provide chemotherapy data, I located something of
interest from the University of Wisconsin. See the chart at
http://www.eperc.mcw.edu/fastFact/ff_099.htm. There are several
interesting things about this table. The most obvious is that it shows
how broadly ineffective chemotherapy is in terms of improving survival
times in cancer patients. Note that "Median Survival" figures
represent survival times for BOTH "responders" and "non-responders"
(ie., those who experience a tumor reduction while undergoing
chemotherapy, and those who do not.) No effort was made, however, to
statistically separate the effects of chemotherapy in either group.
Again, this is not a comparison between non-treated and treated
patients, but a comparison *among* treated patients. Footnoted is the
authors' comment that "patients who respond to chemotherapy typically
live longer than those who do not." How do they know this? If tumor
reduction is meaningfully correlated with improved survival times, why
are these effects not precisely measured and reported? What is
"typical?" Do we not get beneficial outcomes from the use of placebo,
making those effects "typical?"

Furthermore, the "Response Rate" (tumor reduction) column shows breast
cancer to be the most associated with (but not corrrelated to) a
chemotherapy response, somewhere around 40% for the average treated
patient. This is *associated* with a range of survival from 24 months
to 36 months. Again, no RCT data exists to show that a definitive
correlation exists -- even empirically-derived percentages are not
provided except in aggregate. In other words, we have no way to know
what percentage of "responders" are found in the longer-surviving
group, or what percentage of "non responders" can be found in the
low-end group. I would refer to that as a conspicuous omission. Let's
do a little meta study ourselves using the data we do have. Compiling
the average percentage of "responders," we get 24.44% of patients who
experience tumor reduction during (but not necessarily resulting from)
treatment. This amounts to about 1 in 4. If we compile the average
number of months representing low-end and high-end survival times (we
have no choice because the data is blended that way) we get a figure of
about 4.3 months, or 17 weeks of additional survival *associated* with
a reduction in tumor size. What can we derive from these numbers?
Not much. All we can say for sure is that one in every four patients
treated for these particular cancers will experience a tumor reduction
(some of which *may* be associated with chemotherapy.) Since tumor
regressions can occur without treatment, we cannot conclude that such
shrinkage is solely attributable to administration of chemotherapy. We
cannot even say that survival time will average 4.3 months of
additional life for that fourth person because the survival data for
both "responders" and "non responders" has been aggregated. We are
only told that survival times will be "typically" greater for those
whose tumors shrink. Due to the absence of data, I would venture a
guess that one in 50 such cases might actually be *associated* with the
use of chemotherapy, but even that is being generous. Put simply, the
evidence that chemotherapy is beneficial in the vast majority of
cancers is very, very poor. Note also the statement that "response
rate data that is generally quoted to patients comes from clinical
trials using GOOD PERFORMANCE STATUS [emphasis mine] who are closely
monitored patients; the response rates for patients outside of clinical
trials can be expected TO BE LOWER [emphasis mine]." [ref.
http://www.eperc.mcw.edu/fastFact/ff_014.htm.]

If I ever develop cancer, and I pray that I don't, here is what I would
personally do. 1. Seek a naturopath familiar with intravenous vitamin
C and laetrile therapy and begin treatment immediately. 2. Take 2g
daily Lysine, as this amino acid interferes with cancer's ability to
spread. 3. Take 2g N-acetylcystein daily, to boost overall immunity.
4. Abstain from food entirely every other day, or at least 12 hours on
the second day to reduce unnecessary metabolic activity. 5. Visualize
the elimination of cancer cells several times while lying down with the
eyes closed. If nothing else, biofeedback techniques have been proven
to reduce stress, and that will support immunity.

PeterB

Correction: Near the end of the second paragrah above, the word
"associated" is used when the word "linked" was intended. It should
have read: "Due to the absence of data, I would venture a guess that
one in 50 such cases might actually be *linked* with the use of
chemotherapy, but even that is being generous."

In misc.health.alternative PeterB <pkm@mytrashmail.com> wrote:

: Your statement that *some* cancers
: are not responsive to chemotherapy is meaningless because no RCT
: studies exist to correlate the effects of chemotherapy to survival
: outcomes in the first place.

: If I ever develop cancer, and I pray that I don't, here is what I would
: personally do. 1. Seek a naturopath familiar with intravenous vitamin
: C and laetrile therapy and begin treatment immediately. 2. Take 2g
: daily Lysine, as this amino acid interferes with cancer's ability to
: spread. 3. Take 2g N-acetylcystein daily, to boost overall immunity.
: 4. Abstain from food entirely every other day, or at least 12 hours on
: the second day to reduce unnecessary metabolic activity. 5. Visualize
: the elimination of cancer cells several times while lying down with the
: eyes closed. If nothing else, biofeedback techniques have been proven
: to reduce stress, and that will support immunity.

Have any RCT studies been done to correlate the effects of the above
therapy to survival outcomes?


-----
Richard Schultz schultr@mail.biu.ac.il
Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel
Opinions expressed are mine alone, and not those of Bar-Ilan University
-----
". . . for while he was not dumber than an ox, he was not any smarter."
-- James Thurber, _My Life and Hard Times_

Richard Schultz wrote:
Your sponsors have managed to criminalize our study of laetrile, or had
you forgotten? The data we do have persuades me that laetrile is a
better choice than chemotherapy. Pauling and Cameron demonstrated
substantial improvements in survival times for cancer patients using
intravenous vitamin C, whereas large population studies have shown
substantial lifespan gains for those in the highest quartile of
*supplemental* vitamin C intake. Later vitamin C studies were frought
with charges of fraud, an echo of earlier press leaks regarding
positive laetrile data coming out of Sloan-Kettering. NAC is in
professional use already, though not typically for its ability to raise
white blood cell count. The infection-limiting affects of NAC are well
documented, however. Reduction in metabolic activity through caloric
restriction has an excellent chance of slowing cancer, as studies have
shown dramatic lifespan gains in animals. Human volunteers in caloric
reduction are demonstrating equivalent improvements in biomarkers for
aging, suggesting they will derive a similar effect. For several
reasons, the use of RCT data in managed healthcare is not relevant to
the use of natural medicine approaches. First, the high cost of
chemotherapy drugs should be compensated for by results, in terms of
both efficacy and safety. As only a small fraction of cancer patients
appear to benefit from the use of chemotherapy, use of these in the
majority of cancer patients constitutes fraud. Second, natural
medicine approaches using nutrients that are food-derived and the
product of biosynthesis are not held to the same threshold of evidence
as regulated drugs, because those nutrients drive homeostatis in the
first place. It thought you were a scientist. Notice the question was
purely rhetorical.

PeterB

"PeterB" <pkm@mytrashmail.com> wrote in message
news:1169749273.338538.34270@v33g2000cwv.googlegro ups.com...
But you will surely also have the cancer cut out, if that were possible?
There is no good evidence that any of the above methods work, whereas
surgery probably accounts for 90% of the 50-60% of cancers that are cured by
present methods.

A simple lumpectomy will many breast cancers, for example..

Peter Moran

Peter Moran wrote:
pine box cure.

"PeterB" <pkm@mytrashmail.com> wrote in message
news:1169749273.338538.34270@v33g2000cwv.googlegro ups.com...
Bullshit. Show me where I did this.

Bugger! I hate being pushed into a defence of chemotherapy, because I am no
great fan of it myself, outside of a few areas where it has great benefits
and actually cures people of their cancers and every time I do so I am
accused of being paid by someone!

But for God's sake let us have truthful information!

Actually there is a LOT of data showing a correlation between chemotherapy
response rates and length of survival, even in the cancers with the very
poorest results with chemotherapy such as colon cancer and NSCLC. I will
put one such at the end of this.

There are also numerous studies comparing chemotherapy with "best supportive
care" (BSC), as you would find out if you put these terms into Medline. It
is thus not true that chemotherapy has never been shown to have benefits
over no chemotherapy in controlled trials (although in some specific
instances there were no worthwhile beneifts and those methods would not now
be ever used for those purposes). I will put an illustrative example below.

But you are making two other wrong assumptions in this long spiel of your
(if it is yours, which I doubt). When used in a palliative role
chemotherapy is used mainly in patients who already have *symptoms* of their
cancer or who are very likely to soon have symptoms. Often the only way of
obtaining relief from cancer symptoms is to induce remission. Even if
survival was not significantly prolonged in some patients those responding
to the chemotherapy may still derive substantial benefits for this reason.
The quality of their remaining life may thus be improved. Most modern
studies on chemotherapy also look at quality of life indicators. .

The other thing you fail to realise is that a median duration of response of
a mere few months obscures some far longer responses for some patients.
Responses are in truth very variable and chemotherapists cannot be blamed if
a few excellent, prolonged, complete responses play a part in their minds
whenever they are facing a patient for whom they have nothing else to
offer. WHere they may mainly go wrong is if they persist with chemotherapy
if there is no obvious response within a couple of cycles.

Coll Antropol. 2005 Dec;29(2):583-8. Links
Gemcitabine in the first and second-line chemotherapy of advanced non-small
cell lung cancer.
a.. Cucevic B,
b.. Samarzija M,
c.. Baricevic D,
d.. Jakopovic M,
e.. Redzepi G,
f.. Samija M.
University Hospital for Lung Diseases "Jordanovac", Zagreb, Croatia.
branka.cucevic@zg.htnet.hr

Aim of this study was to estimate efficacy of gemcitabine in first and the
second-line chemotherapy for patients with advanced non-small cell lung
cancer (stage III and IV). In first-line chemotherapy, 120 patients were
treated with different chemotherapy regimens. Fifty-nine patients were
treated with gemcitabine / cisplatin (PG), 41 with cisplatin / etoposide
(PE) and 20 with mitomycin / ifosfamide / cisplatin (MIC). Forty patients,
unsuccessfully treated with PE and MIC in first-line therapy were treated
with PG (24 pts) and with best supportive care (BSC) (16 pts). In first-line
therapy PG was superior to PE and MIC protocol (mean survival (MS) 10 vs. 7
vs. 8.5 months). Response rate (RR) for PG in first-line therapy was 46% and
21% in second-line. We showed also significantly better survival in patients
treated with PG in second-line chemotherapy comparing to best supportive
care (MS 9 vs. 5.5 months). Toxic side effects for combination PG was
acceptable. This study confirmed that PG combination is safe and effective
as first and second-line chemotherapy for patients with advanced non-small
cell lung cancer.

PMID: 16417165 [PubMed - indexed for MEDLINE]


1: Lancet. 2000 Jul 29;356(9227):373-8. Links

Comment in:
Lancet. 2000 Jul 29;356(9227):353-4.
Lancet. 2000 Nov 18;356(9243):1771.
Relation between tumour response to first-line chemotherapy and survival in
advanced colorectal cancer: a meta-analysis. Meta-Analysis Group in Cancer.
a.. Buyse M,
b.. Thirion P,
c.. Carlson RW,
d.. Burzykowski T,
e.. Molenberghs G,
f.. Piedbois P.
International Institute for Drug Development, Brussels, Belgium.
mbuyse@id2.be

BACKGROUND: Treatment of advanced colorectal cancer has progressed
substantially. However, improvements in response rates have not always
translated into significant survival benefits. Doubts have therefore been
raised about the usefulness of tumour response as a clinical endpoint.
METHODS: This meta-analysis was done on individual data from 3791 patients
enrolled in 25 randomised trials of first-line treatment with standard bolus
intravenous fluoropyrimidines versus experimental treatments (fluorouracil
plus leucovorin, fluorouracil plus methotrexate, fluorouracil continuous
infusion, or hepatic-arterial infusion of floxuridine). Analyses were by
intention to treat. FINDINGS: Compared with bolus fluoropyrimidines,
experimental fluoropyrimidines led to significantly higher tumour response
rates (454 responses among 2031 patients vs 209 among 1760; odds ratio 0.48
[95% CI 0.40-0.57], p<0.0001) and better survival (1808 deaths among 2031 vs
1580 among 1760; hazard ratio 0.90 [0.84-0.97], p=0.003). The survival
benefits could be explained by the higher tumour response rates. However, a
treatment that lowered the odds of failure to respond by 50% would be
expected to decrease the odds of death by only 6%. In addition, less than
half of the variability of the survival benefits in the 25 trials could be
explained by the variability of the response benefits in these trials.
INTERPRETATION: These analyses confirm that an increase in tumour response
rate translates into an increase in overall survival for patients with
advanced colorectal cancer. However, in the context of individual trials,
knowledge that a treatment has benefits on tumour response does not allow
accurate prediction of the ultimate benefit on survival.

PMID: 10972369 [PubMed - indexed

Peter Moran

www.cancerwatcher.com

"Mark Probert" <markprobert@lumbercartel.com> wrote in message
news:Wkwuh.19$li4.2@trndny08...
Yep, cut it off.
Is that what they did for your brain cancer?

"Peter Moran" <pmoran@bordernet.com.au> wrote in message
news:45ba9717$0$16552$afc38c87@news.optusnet.com.a u...


There are many very aggressive methods that seem, statistically to work. I
have seen little evidence that one works much better than the other. I put
PeterB therapy in the same category.

Assuming that no one in this thread HAS cancer, the primary point should be
prevention or getting it in its very infancy.

What is absolutely sickening is the refusal by all with their pet theories
to recognize cancer for what it is and not have major efforts at prevention
or constant , aggressive resistance.

Absolutely sickening and unconscionable.

"Mark Probert" <markprobert@lumbercartel.com> wrote in message
news:Wkwuh.19$li4.2@trndny08...
PeteyB

vernon wrote:
Projecting again? Try to use something other than a refrigerator bulb.
That is not very bright.

"Mark Probert" <markprobert@lumbercartel.com> wrote in message
news:n5Quh.78$li4.62@trndny08...
"CURE" cancer --- cut it off.
"Cure" a stomach ache --- remove it.
"Cure" short sighted --- remove the eyes
"Cure" cataracts ---- remove the cornea.

"Cure" breast cancer --- remove the breast and a half dozen lymph nodes.
"Cure" Testicular cancer --- Castrate

In misc.health.alternative PeterB <pkm@mytrashmail.com> wrote:
: Richard Schultz wrote:
:> In misc.health.alternative PeterB <pkm@mytrashmail.com> wrote:

:> : Your statement that *some* cancers
:> : are not responsive to chemotherapy is meaningless because no RCT
:> : studies exist to correlate the effects of chemotherapy to survival
:> : outcomes in the first place.

:> : If I ever develop cancer, and I pray that I don't, here is what I would
:> : personally do.

:> Have any RCT studies been done to correlate the effects of the above
:> therapy to survival outcomes?

: Your sponsors have managed to criminalize our study of laetrile, or had
: you forgotten?

Stop weaseling and answer the question.

[example of Mr. B taking a paragraph to avoid providing the correct answer
to my question -- i.e. "no" -- deleted]

-----
Richard Schultz schultr@mail.biu.ac.il
Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel
Opinions expressed are mine alone, and not those of Bar-Ilan University
-----
"I love people. But I don't suffer fools gladly."
-- Deborah Lipstadt

Peter Moran wrote:
The post at http://groups.google.com/group/misc.health.alternative/
browse_frm/thread/e054990e03082cc4/9921d0cc524a9db7?lnk=gst&q=Gerson
+PeterB&rnum=1&hl=en#9921d0cc524a9db7 refers to your earlier rebuttal
using a discussion of metabolic diets, a response not relevant to the
discussion of chemotherapy. Although I couldn't find your original
comments, my rebuke in the earlier post condemns your website for
skating around the facts exactly as you do on mha.

Of course you are being paid, otherwise you wouldn't be doing it.

Oh, let's.

With the volume of data you claim is available, offering one little
study seems awfully selfish of you.

I do not regard BSC studies as meaningful, for several reasons.
First, the heterogeneity of BSC terms means that comparing
chemotherapy to such effects is no more clear than using aggregated
data for chemo "responders" and "non-responders." More importantly,
the methods and protocols used to assess outcomes in patients in whom
chemotherapy is deemed inappropriate suggests their prognosis is poor
to begin with. A study is only as good as its design.

I can create a study that "proves" cigarettes are safer than chewing
on ice, especially in those who do both. Your sponsors are notorious
for funding studies like this.

I write everything you see attributed to me. I seriously doubt that
is equally true of you.

You make your premise and your conclusion the same thing, without
supporting either. You provide no evidence for the palliative effects
of chemotherapy, nor do you provide data that chemotherapy "induces
remission." It's all in your head.

But the average patient represents what is typical, and exceptions are
not proof of causation. Here's an illustration. Let's say that 1% of
traffic accident fatalities occur after one full year of
hospitalization, whereas the other 99% of fatalities occur within 3
days after the accident. Does this mean that 99% of victims are more
responsive to treatment, or does it mean they are simply less injured
to begin with? For most, it means they are less seriously injured.
Likewise, cancer is highly variable in terms of illness severity,
whereas chemotherapy remains poorly correleated to remission. You
cannot give treatment credit simply because it was applied.

Let's rewrite this to make the same point about people wearing green
shirts. Here goes:

Responses are in truth very variable and clothes salespeople cannot be
blamed if a few lucky, lottery winning, people with green shirts play
a part in their minds whenever they are faced with a customer for whom
they have nothing else to sell. So, let's persaude them to buy green
shirts because they, too, could be a lucky winner.

That's all you said.

The false premise continues.

This study is observational, compares two drug regimens, evalutes very
narrow disparities in survival, and might easily have contributed to
the table of aggregated "responders" and "non responders" in the
citation I provided earlier. In other words, it's quite meaningless.

No one should find this to be persuasive evidence for the
effectiveness of chemotherapy. Like the other observational study,
this one compares two drug regimens. The survival benefit is razor
thin, so it's remarkable to read the study author comment that "the
survival benefits could be explained by the higher tumour response
rates." Just read the interpretation to see that all this study shows
is that drugs can induce tumor shrinking. Unfortunately, this effect
is meaningless. Like most disease, cancer is not confined to a
localized event -- it's systemic. Shrinking a tumor is sort of like to
shaking a rattler off your arm after he bites. Where's the poison?

PeterB

Peter Moran wrote:
The post at http://groups.google.com/group/misc.health.alternative/
browse_frm/thread/e054990e03082cc4/9921d0cc524a9db7?lnk=gst&q=Gerson
+PeterB&rnum=1&hl=en#9921d0cc524a9db7 refers to your earlier rebuttal
using a discussion of metabolic diets, a response not relevant to the
discussion of chemotherapy. Although I couldn't find your original
comments, my rebuke in the earlier post condemns your website for
skating around the facts exactly as you do on mha.

Of course you are being paid, otherwise you wouldn't be doing it.

Oh, let's.

With the volume of data you claim is available, offering one little
study seems awfully selfish of you.

I do not regard BSC studies as meaningful, for several reasons.
First, the heterogeneity of BSC terms means that comparing
chemotherapy to such effects is no more clear than using aggregated
data for chemo "responders" and "non-responders." More importantly,
the methods and protocols used to assess outcomes in patients in whom
chemotherapy is deemed inappropriate suggests their prognosis is poor
to begin with. A study is only as good as its design.

I can create a study that "proves" cigarettes are safer than chewing
on ice, especially in those who do both. Your sponsors are notorious
for funding studies like this.

I write everything you see attributed to me. I seriously doubt that
is equally true of you.

You make your premise and your conclusion the same thing, without
supporting either. You provide no evidence for the palliative effects
of chemotherapy, nor do you provide data that chemotherapy "induces
remission." It's all in your head.

But the average patient represents what is typical, and exceptions are
not proof of causation. Here's an illustration. Let's say that 1% of
traffic accident fatalities occur after one full year of
hospitalization, whereas the other 99% of fatalities occur within 3
days after the accident. Does this mean that 99% of victims are more
responsive to treatment, or does it mean they are simply less injured
to begin with? For most, it means they are less seriously injured.
Likewise, cancer is highly variable in terms of illness severity,
whereas chemotherapy remains poorly correleated to remission. You
cannot give treatment credit simply because it was applied.

Let's rewrite this to make the same point about people wearing green
shirts. Here goes:

Responses are in truth very variable and clothes salespeople cannot be
blamed if a few lucky, lottery winning, people with green shirts play
a part in their minds whenever they are faced with a customer for whom
they have nothing else to sell. So, let's persaude them to buy green
shirts because they, too, could be a lucky winner.

That's all you said.

The false premise continues.

This study is observational, compares two drug regimens, evalutes very
narrow disparities in survival, and might easily have contributed to
the table of aggregated "responders" and "non responders" in the
citation I provided earlier. In other words, it's quite meaningless.

No one should find this to be persuasive evidence for the
effectiveness of chemotherapy. Like the other observational study,
this one compares two drug regimens. The survival benefit is razor
thin, so it's remarkable to read the study author comment that "the
survival benefits could be explained by the higher tumour response
rates." Just read the interpretation to see that all this study shows
is that drugs can induce tumor shrinking. Unfortunately, this effect
is meaningless. Like most disease, cancer is not confined to a
localized event -- it's systemic. Shrinking a tumor is sort of like
shaking a rattler off your arm after he bites. Where's the poison?

PeterB

PeterB wrote:
Petey the asshole cannot prove it. He is intellectually bankrupt.

Dr. Moran was wrong to expect it from you.

One study proving his point puts the ball in your court. Of course, you
cannot handle that.

Most important reason is that they show you are wrong. Thus, they must
be dismissed.

Another moronic statement.

If I were you, I would not brag about what you write.

On 29 Jan 2007 13:30:43 -0800, "PeterB" <pkm@mytrashmail.com> wrote:


Rubbish. There are many cancers that can be totally localised (breast,
testicular, prostate, just to mention a few). These are totally cured
if this encapsulated tumour is excised.

jack

On Sat, 27 Jan 2007 17:32:40 -0700, "vernon" <stillhere@anhere> wrote:

Where possible, absolutely!

Don't be idiotic!

Again, more childish stupidity!

Absolutely. replace with perpex (lucite) or similar lens.

Absolutely. My wife has just had both breasts and 21 lymph nodes
removed. She now has NO cancer. She and I would have it no other way,
idiot!

Well, it is invariably a 100% cure in cases where it is caught early
without metastases. What would you do, idiot?

Get cancer? Stop eating coal. SNARFFFF!!!!


jack

vernon wrote:

Hey, Vernon, based on this, you must never get a headache.

BWHAHAHAHAHAHA!