THE SHORTCOMINGS OF MODERN MEDICINE AND THE NEED FOR DISEASE PREVENTION

 THE SHORTCOMINGS OF MODERN MEDICINE AND THE NEED FOR DISEASE PREVENTION

Following are a few articles pointing out the shortcomings of modern and supporting the need for disease prevention.

'The Obesity Epidemic may bump Colon Cancer statistics 50%!'

BBC News - September 13, 2010

Colon cancer is directly correlated to obesity and lack of physical exercise.  A recent study undertaken in the U.K. predicts a rise of 50% in colon cancer over the next 30 years due to obesity.  The best prevention against obesity is a healthy diet, a balanced exercise program and a peaceful and cheerful approach to daily life.  For more, read below.

The UK is heading for a 50% increase in the number of new colon cancer cases over the next 30 years, says an international team of scientists. The forecast, in the European Journal of Cancer, is for 35,000 new cases a year by 2040, compared with 23,000 now.

Rising obesity is one reason - and if the UK reached US levels that could add another 2,000 to the total, they say. "We can safely say increasing physical activity across Europe to the level already achieved in The Netherlands, where everybody cycles, would be of substantial benefit”,  says Professor Jan-Willem Coebergh, of Erasmus University. The study used cancer data from seven countries to predict how cancer rates might change with an ageing population. Each year there are 38,000 cases of bowel cancer, which can split into those in the colon and those lower down in the rectum. This latest study looked just at those in the colon itself. Two of the biggest risk factors for colon cancer are physical inactivity and being overweight or obese.  Dr Andrew Renehan, from the University of Manchester, and one of the authors of the research, said that the computer models allowed researchers to predict what would happen to cancer rates in a variety of scenarios. If UK trends in obesity and activity stayed as they are now, the predicted figure of approximately 35,000 cases a year is reached by 2040. If obesity gets worse, following trends set in the US, where the problem has spiralled in recent years, then the annual figure is close to 37,000. But if that does not happen, and there is a modest increase in activity, then that rise turns into a similar-sized fall. And if the UK managed to match levels of physical exercise in The Netherlands - the best among the countries studied, that would prevent approximately 2,000 cases. Dr Renehan said: "The predictive modelling is beginning to tease out the independent relevance of each of these factors in the prevention of colon cancer. "We know that large numbers of colon cancer cases could be avoided by reducing exposure to risk factors." Another researcher, Professor Jan-Willem Coebergh, from Erasmus University in The Netherlands, said: "We can safely say increasing physical activity across Europe to the level already achieved in The Netherlands, where everybody cycles, would be of substantial benefit." And a second study published at the same time appeared to show a small additional risk not just for obese people, but anyone carrying excess fat around their middle - even if their overall weight appears near-normal. In the group studied, every additional inch of waistline from the slimmest to the biggest waisted meant an extra 2% risk of bowel cancer, even when the BMI of the person was accounted for in the calculations. The research, carried out by Imperial College London for the World Cancer Research Fund, combined the results of previous studies into the issue to produce more reliable evidence of the link.

"Vatican Radio transmitters 'pose cancer risk'"

BBC News - July 15, 2010

Dangerous sources of radiation are a counterpart of modernism and advanced technology. While we benefit from these technologies, it is often at the high cost of our own health and well-being, and while we can't always control what we cannot see, we can nonetheless exercise as much judgment and caution as possible when deciding where to live and what to surround ourselves with when it comes to energy.  Following is an article that clearly identifies the threat caused by large radio transmitters to the health of exposed populations in surrounding neighborhood, especially young children whose 'constitution' is even more easily affected by such technology. For more, read below.

From its studios in Vatican City, Vatican Radio broadcasts around the world. 'There is a "coherent and significant connection" between radiation from Vatican Radio aerials and childhood cancer', researchers have said. The Italian experts looked at high numbers of tumours and leukaemia in children who live close to Vatican Radio transmitters. The 60 antennas stand in villages and towns near Rome. The Vatican said it was astonished and would present contrary views to a court in Rome. Italian courts have been investigating for 10 years whether of an abnormally high number of deaths from cancer among families living near the aerials just north of the Italian capital can be attributed to electromagnetic radiation. The 300-page report, ordered by the courts and carried out by Italy's most prestigious cancer research hospital, now concludes that there is a connection between radiation and the cancer incidents. Some 60 huge steel aerials were erected on farmland owned by the Vatican during the last century. They transmit Vatican Radio programmes around the world on medium and short wave. However, the technology is now largely obsolete, as Catholic radio stations in many countries rebroadcast Vatican Radio shows after picking them up on the Internet. In one court case against the Vatican the statute of limitations ran out, but another case is still pending. The Vatican says it intends to defend its position and claims there is no threat to public health through its transmissions. People living near the aerials say the radio waves affect TV reception and interfere with many

household electronic appliances.

'Providing Tools for patients to evaluate Cancer treatments' 

New York Times - October 6, 2010 

Environmental and genetic factors sometimes come in the way of your health regardless of the best efforts you may be putting to maintain a healthy lifestyle.  However a Cancer diagnosis does not have to be a death sentence, it can actually be an opportunity to identify where a change needs to occur and if heeded can lead to a transformational and enlightening experience. Because Cancer is still a recent 'disease' and the treatments currently available remain mainly experimental in nature, this leaves a lot of open questions as to which options are available and which treatments to choose based on their success rate and the consequences on the patients' quality of life.  For more, read below.

Wiry, fair-haired and in his 60s, the patient had received a prostate cancer diagnosis a year earlier. When his doctors told him that surgery and radiation therapy were equally effective and that it was up to him to decide, he chose radiation with little hesitation. But one afternoon a month after completing his treatment, the patient was shocked to see red urine collecting in the urinal. After his doctors performed a series of tests and bladder irrigations through a pencil-size catheter, he learned that the bleeding was a complication of the radiation treatment. He recalled briefly hearing about this side effect three months earlier, but none of the reports he had been given or collected mentioned it, and once he had recovered from the angst of the emergency room and the doctor’s office visits and the discomfort of the clinical work-up, he didn’t give it more thought — until a few weeks later, when he started bleeding again. By the time I met him, he was in the middle of his third visit to the hospital. “I feel like I’m tied to this place,” he said. He showed me a plastic jug partly filled with urine the color of fruit punch, and he described a post-treatment life marked by fear of going to the bathroom and discovering blood. “If I had known that my life would be like this after radiation,” he sighed, “I would have chosen the surgery.” Whether conducted at a laboratory bench or in clinical trials, medical research has long been driven by a single overriding goal — the need to find a cure. Usually referred to more modestly as a search for “the most effective treatment,” this standard has served as both a barometer of success and a major criterion for funding. Most published studies are marked by a preponderance of data documenting even minor blips in laboratory values or changes in the size of a spot of cancer or area of heart muscle damage on specialized X-rays. Some studies bolster the apparent success of their results with additional data on societal effects like treatment costs or numbers of workdays missed. Few studies, however, focus on the patient experience. The result of all this emphasis on cure has been a nearly embarrassing richness of choice for patients with diabetes, heart disease, H.I.V. infections and even some cancers. The increasingly sophisticated treatment regimens that now make up medicine’s armamentarium have transformed once life threatening diseases into chronic ones, but in the process have given rise to a group of individuals who are caught in the unenviable position of living with an illness that never quite goes away. No longer forced to make once-in-a-lifetime life-or-death treatment

decisions, they instead struggle each day with the side effects of the very treatments that keep them alive. For many of these patients, the most important question becomes not “What treatment will allow me to live the longest?” but rather “Which treatment can I live with?” Now, according to a paper published last month in the policy journal Health Affairs, the Patient-Centered Outcomes Research Institute, a new initiative mandated by the federal health care overhaul, may offer a chance to alter the prevailing winds of medical research so the needs of this growing segment of the patient population are addressed. With a 21-member board made up of individuals from both the public and private sectors, the institute has a mandate to set the agenda for research comparing treatments for common diseases and to finance the most important studies. But according to the paper’s authors, the potential of such an enterprise will be fully realized only if the institute supports initiatives and strategies that place the patient experience not only front and center in research but also smack in the middle of the medical mainstream. “To some extent, we’ve conquered death,” said Dr. Albert W. Wu, lead author and a general internist and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health in Baltimore. “Now we have people living with chronic illnesses, and how they experience quality of life every day has become an important part of how they are doing and whether the treatments are worthwhile.” To effectively capture the patient perspective, Dr. Wu and his co-authors propose making patient-reported outcomes a more routine part of clinical studies and practice and administrative data collection, in some cases requiring the information for reimbursement. For several months now, they have been incorporating data about patient experiences into routine medical practice at Johns Hopkins. Using a dedicated portal called PatientViewpoint.org, patients can, at the suggestion of their physicians, fill out surveys about their energy levels, social functioning,

mental health, nausea and pain. The information is then handled like more traditional clinical testing; access is reserved for the patients themselves and their doctors. Currently, the site is open only to patients diagnosed with breast or prostate cancer, but Dr. Wu

and his colleagues hope that eventually all doctors will be able to order patient surveys that measure experiences like levels of pain, physical functioning or depression, proactively identifying results that are high or low, then reviewing those results with patients. And despite initial concerns that patients might feel overburdened by the questionnaires, most have been enthusiastic. “Patients want to have more conversations with their physicians and other providers about these kinds of issues,” Dr. Wu said. “Sometimes it’s difficult to cover all this information during the medical encounter, and these surveys may be another opportunity to do that.” Not all clinicians or researchers, however, are eager to embrace patient-reported outcomes. Many have never received training in the research methods involved and are skeptical about the value of a discipline or drill that is unfamiliar. “This is considered to be squishy, soft stuff,” Dr. Wu said. “It’s still not something you can order on a laboratory slip.” Nonetheless, Dr. Wu is hopeful that the new Patient-Centered Outcomes Research Institute will provide more direction to all researchers, while establishing new and more comprehensive standards that require patient-reported and quality-of-life outcomes. “I think we have a real opportunity right now, and this institute has great potential to be a positive force in understanding how treatments work and what’s effective and for whom,” he said. But he also cautioned: “We have to remember to include the patients. We have to include their perspective if we want to come up with evidence that they can really use to make better decisions for themselves about treatment and care.”

'Breast Cancer False Positives'

New York Times - Tuesday, July 20, 2010

Modern technology and the subjectivity of the human factor involved in the diagnosis process leaves room for disastrous errors and mis-diagnosis of cancer cases.  While this part of any process where personal reasoning and judgment is involved, it raises questions over the validity and adequacy of a sole diagnostic as opposed to multiple or cross-checked ones.  Because the consequences of misdiagnosis can be devastating, especially in the case of life-threatening diseases such as cancer, the process needs to be seriously rethought so that such errors can be avoided. For more, read below.   

Nearly a year earlier, in 2007, a pathologist at a small hospital in Cheboygan, Mich., had found the earliest stage of breast cancer from a biopsy. Extensive surgery followed, leaving Ms. Long’s right breast missing a golf-ball-size chunk. Now she was being told the pathologist had made a mistake. Her new doctor was certain she never had the disease, called ductal carcinoma in situ, or D.C.I.S. It had all been unnecessary — the surgery, the radiation, the drugs and, worst of all, the fear. “Psychologically, it’s horrible,” Ms. Long said. “I never should have had to go through what I did.” Like most women, Ms. Long had regarded the breast biopsy as the gold standard, an infallible way to identify cancer. “I thought it was pretty cut and dried,” said Ms. Long, who is a registered nurse. As it turns out, diagnosing the earliest stage of breast cancer can be surprisingly difficult, prone to both outright error and case-by-case disagreement over whether a cluster of cells is benign or malignant, according to an examination of breast cancer cases by The New York Times. Advances in mammography and other imaging technology over the past 30 years have meant that pathologists must render opinions on ever smaller breast lesions, some the size of a few grains of salt. Discerning the difference between some benign lesions and early stage breast cancer is a particularly challenging area of pathology, according to medical records and interviews with doctors and patients. Diagnosing D.C.I.S. “is a 30-year history of confusion, differences of opinion and under- and over-treatment,” said Dr. Shahla Masood, the head of pathology at the University of Florida College of Medicine in Jacksonville. “There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin.” There is an increasing recognition of the problems, and the federal government is now financing a nationwide study of variations in breast pathology, based on concerns that 17 percent of D.C.I.S. cases identified by a commonly used needle biopsy may be misdiagnosed. Despite this, there are no mandated diagnostic standards or requirements that pathologists performing the work have any specialized expertise, meaning that the chances of getting an accurate diagnosis vary from hospital to hospital. Dr. Linh Vi, the pathologist at Cheboygan Memorial Hospital who diagnosed D.C.I.S. in Ms. Long, was not board certified and has said he reads about 50 breast biopsies a year, far short of the experience that leading pathologists say is needed in dealing with the nuances of difficult breast cancer cases. In responding to a lawsuit brought by Ms. Long, Dr. Vi maintains that she had cancer and that two board-certified pathologists at a neighboring hospital concurred with his diagnosis. Yet several leading experts who reviewed Ms. Long’s case disagreed, with one saying flatly

that her local pathologists “blew the diagnosis.” The questions that often surround D.C.I.S. diagnoses take on added significance when combined with criticism that it is both overdiagnosed and overtreated in the United States —concerns that helped fuel the recent controversy over the routine use of mammograms for women in their 40s. The United States Preventive Services Task Force, an independent panel that issues guidelines on cancer screening, found last November that the downside of routine annual mammograms

for younger women might offset the benefits of early detection. The panel specifically referred to overdiagnosis of D.C.I.S., as well as benign but atypical breast lesions that left undetected would never cause problems. D.C.I.S., which is also called Stage 0 or noninvasive cancer, was a rare diagnosis before mammograms began to be widely used in the 1980s. Until then, breast pathology typically involved reading tissue from palpable lumps. The diagnoses — usually invasive cancer, a benign fibroid tumor or a cyst — were often obvious.

'F.D.A. Panel Opposes Plan to Tighten Use of Painkillers'

New York Times - July 23, 2010

The overuse of highly toxic and addictive painkillers in our society has reached an epidemic magnitude and is increasingly leading to fatal overdoses, yet the F.D.A. is unwilling to step in and regulate these drugs. Therefore. the responsibility falls upon us as  individuals to protect ourselves and the future generations, not to over medicate ourselves and to be willing to go to the roots of the dis-eases and illnesses that plague our society and treat them at that level. For more, read below.

An advisory committee for the Food and Drug Administration voted overwhelmingly on Friday to reject a plan proposed by the agency to reduce the misuse and abuse of long-acting painkillers like the drug OxyContin. Members of the panel, which included doctors, pain experts and others, voted 25 to 10 against the F.D.A. plan, saying they did not think it was strong enough to control the use of such prescription narcotics. The F.D.A. usually abides by the advice of its advisory committees. Most panel members voted against the proposal because it did not contain a requirement that doctors undergo training in the appropriate use of such drugs, F.D.A. officials said. While long-acting narcotics are critical to pain treatment, drugs like OxyContin, fentanyl and methadone have been associated in recent years with a national epidemic of prescription drug abuse and addiction, as well as thousands of overdose-related deaths. There are also growing concerns that their misuse by physicians poses risks to patients. Two years ago, the F.D.A. and the drug industry began working on a plan to try to reduce the misuse and abuse of these medications. The agency held subsequent public meetings at which interest groups like physician groups and patient advocacy organizations expressed their views about what the plan should look like. Initially, F.D.A. officials had indicated that they might require mandatory training as a condition for prescribing drugs like OxyContin. However, when the F.D.A. announced its plan last month, it contained a provision urging doctors to undergo voluntary training that would be organized by the drug industry. Even before the vote on Friday, the F.D.A. proposal had come under criticism by some pain-management experts as being weak. And after two days of hearings this week, F.D.A. officials received that same feedback from its advisory panel. “They were concerned about the voluntary nature of the training requirements,” said Dr. John K. Jenkins, the director of the office of new drugs at the F.D.A.’s Center for Drug Evaluation and Research.

Dr. Jenkins said the F.D.A. only had the authority to direct drug makers to provide mandatory training, adding that such a step would involve a cumbersome and complicated process. In addition, he said the agency was concerned that some doctors, faced with the requirement to undergo training, would simply decide not to prescribe the drugs and thus limit their availability to patients who needed them. At the moment, a doctor must only register with the Drug Enforcement Administration to prescribe narcotic painkillers. It would be less cumbersome to make training mandatory as a condition of such registration, but that would require legislative action by Congress.

'Doctors call for NHS to stop funding Homeopathy'

BBC News - July 5, 2010

Homeopathy is a medical science that follows the principle of vibrational medicine.  By identifying and prescribing an homeopathic remedy that is ingested in inoffensive doses and which will cause the same reactions as what the patient's symptoms, homeopathy stimulates the patient's self-healing mechanism and enables the patient to get better.  In some ways, it follows the principles of vaccination.  Unlike what the NHS is trying to achieve, it seems very logical that stimulating the immune system and the defense mechanism of patients would be extremely successful in healing disease. It's a shame that limited knowledge and narrow-pointedness on part of medical authorities could lead to very valid and useful alternative types of treatment losing funding. For more, read below.

'Homeopathic remedies often contain few or no active ingredients. The NHS should stop funding homeopathy and it should no longer be marketed as a medicine in pharmacies', doctors say. Medics voted on the issue at the British Medical Association's annual conference in Brighton. They dismissed the highly-diluted remedies as "nonsense" and potentially harmful to patients as it can lead them to shunning conventional medicines. The Department of Health homeopathy said treatment was under review. Homeopathy is a 200-year-old system of treatment that uses highly diluted substances. In some cases none of the original product is left. It is given orally in the belief that it will stimulate the body's self-healing mechanism. The NHS is thought to spend about £4m a year on the treatment, helping to fund four dedicated homeopathic hospitals and numerous prescriptions. Dr Mary McCarthy, a GP from Shropshire, said there was no evidence from hundreds of trials that homeopathy worked beyond the placebo effect - in which a patient gets better but only because they believe the treatment will work and their symptoms clear up because of the psychological boost. She added: "It can do harm by diverting patients from conventional medical treatments." She was supported in the debate by a number of other doctors dubious about the 'watery science', despite dozens of supporters of the treatment gathering outside the conference centre urging them not to. Dr Tom Dolphin, a member of the BMA's junior doctors committee, dismissed it as "nonsense on stilts". 

But what exactly is Homeopathy?  Homeopathy involves giving people very dilute amounts of a substance that in larger amounts might produce symptoms similar to the condition being treated. For example, one remedy which might be used in a person suffering from insomnia would be made from coffee.  Supporters believe homeopathy helps relieve a range of minor ailments from bruising to insomnia but critics say it is no better than sugar pills and people only get better because they believe the treatment will work - the so-called placebo effect. Opposers to what they view as 'bogus' medicine say, "We risk as a society slipping back into a state of magical thinking when made-up science passes for rational discourse."