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From the Townsend Letter for Doctors & Patients
June 2002
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briefed by Jule Klotter
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 Breast Examinations
In a 2001 article for the International Journal of Health Services (Vol. 31, No. 3; pp 605-615), Samuel S. Epstein, Rosalie Bertell, and Barbara Seaman advocate annual clinical breast examination (CBE) by a trained health professional and monthly breast self-examination in place of mammography screening. Using palpation to screen for breast cancer is "safe, at least as effective, and low in cost,” the authors say, while mammography screening has several risks. The American Cancer Society, which has strong ties to the mammography industry, admitted in 1985, that "at least 90% of the women who develop breast carcinoma discover the tumors themselves.” (Ross, WS. Crusade: The Official History of the American Cancer Society, p. 96. Arbor House, New York, 1987).

The 13-year results of the Canadian National Breast Screening Study [J. Natl. Cancer Inst. 92(18): 1490-1499, 2000] found that mammography screening had no impact on breast cancer mortality. The randomized controlled trial followed 40,000 women, initially aged 50 to 59, for 9 to 13 years. All of the women performed monthly breast self-exams after receiving instruction by trained nurses as well as receiving annual CBEs, performed by trained professionals. Half of the group also received yearly mammograms. While mortality in the two groups did not differ significantly, the mammography group "had a three-fold increase in the number of false positives compared with the [other] group, resulting in unnecessary biopsies.” Dr. Epstein and colleagues emphasize that the effectiveness of breast self-examination "critically depends on careful training by skilled professionals.” Such training, which is reinforced by yearly professional exams, encourages frequency of self-examination and confidence, resulting in a higher number of small tumors being found.

The authors say that mammography has several negative features: inaccuracy, carcinogenic effect of radiation, over-diagnosis and over-treatment of ductal carcinoma-in-situ (DCIS), and high cost. Pre-menopausal women and some post-menopausal women who are on estrogen replacement therapy tend to have dense breast tissue that make their mammograms hard to read. The result is missed tumors as well as a high number of false positives, "resulting in needless anxiety, more mammograms, and unnecessary biopsies.” The sensitivity of breast tissue to radiation has been known for decades. American women with the A-T (ataxia-telangiectasia) gene are especially sensitive to radiation's carcinogenic effect. Among women with this gene, routine mammography screening (which usually includes 2 or more films of each breast per year) "by some estimates …accounts for up to 20% of all breast cancers annually in the United States,” according to the article's authors.

Widespread mammography screening finds a higher number of a pre-invasive cancer, ductal carcinoma-in-situ (DCIS) than palpation. Breast cancer mortality from DCIS – whether the woman is diagnosed and treated early or not – is about 1 percent. In about 80% of the cases, DCIS never turns invasive. While many women are aware that false positive results can occur with mammography, few know that mammography can identify a type of cancer that usually does not progress. The authors says that this ‘over-diagnosis' often leads to over-treatment with surgery, radiation, and/or chemotherapy. Even without the need for further medical intervention, mammography screening is expensive, especially when compared to the cost of a clinical breast examination: "Medicare and insurance average costs are $70 and $125, respectively.” Costs threaten to rise significantly if current film machines that cost about $100,000 are replaced with $400,000 high-tech digital machines. In addition, the new technology will probably identify even more cases of DCIS.

Epstein, Samuel S.; Bertell, Rosalie; Seaman, Barbara. Dangers and Unreliability of Mammography: Breast Examination Is a Safe, Effective, and Practical Alternative.

International Journal of Health Services 2001; Vol. 31, No. 3: pp 605-615.

Pain Care
Fears of federal prosecution and lack of medical training in the area of pain relief have made many physicians reluctant to prescribe potentially addictive painkillers. As a result, studies show that many patients suffer unnecessarily. In one case, family survivors of a man who died from lung cancer sued the hospital and internist who treated him in the last days of his life. The patient, William Bergman, repeatedly rated his pain between 7 to 10 (on a scale of 1 to 10), according to his hospital records. Yet, the doctor had prescribed only one-quarter of the standard dose of Demerol to alleviate the pain. When he was discharged so that he could die at home, Mr. Bergman said his pain level was 10. His only pain medication was a mild oral analgesic. When the state medical board ignored the family's complaint against the doctor, Compassion in Dying, a nonprofit organization, helped the family file a suit against the doctor and the hospital under California's Elder Abuse and Dependent Adult Civil Protection Act. The hospital settled out of court. A jury deemed the doctor's treatment to be elder abuse and awarded the family 1.5 million dollars.

Robb M. Miller, executive director of Compassion in Dying, wrote in the organization's Fall/Winter 2001 newsletter that the AMA started offering continuing-education packets for doctors on pain management in 1997. Hospitals are now required to implement pain-management plans in order to be accredited. Compassion has a free Pain Care Checklist to help patients assess their pain level accurately. The checklist can be obtained by calling 206-256-1636 or toll-free at 877-222-2816.

Landmark Court Victory for Pain Care. Compassion in Dying of Washington 2001 Fall/Winter; 16:p 1.

Miller, Robb M. "The Robb Report” Compassion in Dying of Washington 2001 Fall/Winter; 16: p 2.

The Kelley Metabolic Cancer Cure
The handbook Cancer Cure summarizes the metabolic therapy protocol developed by William D. Kelley, DDS, MS. The authors of the 2002 edition are listed as Carol Morrison-Kelley, MD, FACC , Kathy P. Fairbanks, PhD, & William D. Kelley, DDS, MS. The program includes a diet of raw foods, supplements, coffee enemas, liver-flushes, and pancreatic enzymes.

The effect of pancreatic enzymes on tumors was first explained in The Enzyme Treatment of Cancer and Its Scientific Basis by Scottish professor John Beard, D.Sc in 1911. Cancerous tumors grow by producing an enzyme called malignin that digests left-handed, living protein such as human tissue. As tumors grow, malignin production increases, which promotes more cancer growth. Malignin is the mirror image of the pancreatic enzyme trypsin. Trypsin breaks down right-handed living tissue, including tumor mass. According to Dr. Kelley, "Large quantities of Trypsin in the bloodstream stop Malignin's acceleration of tumor growth. Also, the non-growing tumor can now be recognized by the human body's defensive warriors, white blood cells and antibodies. These defensive warriors engulf the liquefied, dead non-growing tumor debris from the digestive activity of the enzyme Trypsin.” He says that other enzymes are needed to break down the starch capsule that surrounds a tumor and the intermediate proteins that are created as trypsin liquifies the mass. Dr. Kelley says that the combination of pancreatic enzymes in the Kelley Metabolic Program "destroy and strip away about 97% of such starch capsules, thereby enabling tumors to be recognized, digested, liquefied and removed from persons' bodies via their bloodstreams.”

Over 93% of the cancer patients who strictly adhere to the Kelley Metabolic Program for at least 6 months have seen their malignancies disappear, according to Dr. Kelley's records. For some patients, it takes 18 months or longer before they are free of cancer. Dr. Kelley emphasizes that the diet change and pancreatic support must be continued even after the cancer has disappeared if the person wants to remain healthy.

When patients start the therapeutic program, their cancer markers rise temporarily because the markers held in tumors are released into the bloodstream as the tumors break down. The number of white blood cells also increases, and tumors may swell as the immune system attacks them. As the debris from the tumor(s) is released into the bloodstream, patients often have flu-like symptoms that include headaches, nausea, irritability, elevated temperature, and achiness. Dr. Kelley recommends that patients follow a cycle of taking the enzymes and metabolic nutrients for 25 days (or less if the patient feels too toxic), then stopping the supplements for 5 days so that the body has time to eliminate the debris. This cycling continues until the malignancies are gone.

The handbook Cancer Cure as well as Dr. Kelley's book Cancer – Curing the Incurable (2001) are available from New Century Promotions at 800-768-8484 or fax 619-479-3829. In Canada, the books are available from www.healthyodysseys.com.

 Laetrile
When Helen M. Curran was diagnosed with melanoma that had spread to her liver in 1978, her doctor expected her to die within a few months. Twenty-five years later, her book Apricot Power: How Laetrile Cured My Cancer (ISBN 0-9642185-0-X) is in its third printing, and Mrs. Curran is still an active participant of the Cancer Control Society. Her book reveals the events, fears, vulnerabilities, and self-examinations that she experienced during her diagnosis and eventual recovery from cancer.

Until she realized that conventional medicine had no treatment for her, Mrs. Curran had adamantly refused to consider anything alternative. In fact, she had a history, she said, of submitting to authority. But when she learned that her doctors had been concealing the severity of her condition and offered no hope, she turned to alternative medicine in the form of a clinic in Tijuana, Mexico, that a friend of hers was attending for her own cancer. A homeopathic doctor with a PhD in nutrition headed the clinic. He used metabolic therapy and laetrile/amygdalin, made from apricot pits.

During a two-week stay at the clinic, Mrs. Curran began a new regimen that included a meat-free diet that emphasized fresh fruit and vegetables, supplements and enzymes, daily exercise, and coffee enemas to help eliminate toxins. Each day she received an IV drip containing 100 grams of Vitamin C, some Vitamin B, and 25 grams of amygdalin. She also learned to slow her life's tempo, taking time to enjoy simple pleasures instead of being busy all the time; and she took her doctor's advice to think cheerful thoughts and avoid TV news. At the end of the two weeks, she was sent home to continue the same regimen, but instead of the IV drip, she received daily injections of amygdalin (3 grams) until the cancer went into remission. She visited the clinic's doctor at his California office once a month, then every six weeks, and finally every two months as she recovered. Mrs. Curran reports: "After a year and a half the liver scans and blood test showed that the tumors on my liver were gone.” She still adheres to the lifestyle changes that she made to regain her health.

Mrs. Curran's experience with laetrile made me curious, so I looked it up on the internet. According to the National Cancer Institute & National Center for Complementary and Alternative Medicine Cancer Facts (http://cis.nci.nih.gov/fact/9_3.htm), "Laetrile® patented in the United States …is a semi-synthetic form of amygdalin, while laetrile/amygdalin manufactured in Mexico is made from crushed apricot pits.” According to the Cancer Facts site, only two clinical trials, both sponsored by National Cancer Institute, have been published. The first, a small phase I trial with 6 cancer patients, looked at safety and dosage of amygdalin. Finding "minimal side effects,” researchers proceeded to a phase II study in 1982 with 175 cancer patients. The patients were placed on a metabolic therapy program that included vitamins, pancreatic enzymes, and diet changes for 10 weeks. They were also given injections of amygdalin for three weeks, followed by oral maintenance therapy. Although one stomach cancer patient's tumor decreased in size while receiving the 10-week course of amygdalin therapy, cancer continued to progress in 54% of the patients. Patients reported an improvement in their symptoms and in their ability to work, but the improvements eventually disappeared after treatment ended. Seven months after the 10-week treatment period, cancer had progressed in all the patients. "On the basis of this study, NCI concluded that no further investigation of laetrile was necessary.”

The summary of this trial did not give details about the metabolic therapy, information about patient selection, nor whether the patients discontinued the diet, supplements, etc. at the end of treatment. Helen Curran clearly stated that she was to receive amygdalin until the signs of cancer disappeared, and that she had to retain the diet and lifestyle changes used in her recovery in order to remain well. Also, amygdalin, in her case, was injected, not given orally.

In a transcript from the Laura Lee radio show in 1994 (www.whale.to/c/moss.html), Ralph Moss said: "Twenty years ago I was hired at Memorial Sloane Kettering cancer centre in New York as the science writer, later promoted to assistant director of public affairs [sic]. Shortly after I went to work there I went to visit an elderly Japanese scientist, Kanematsu Sugiura, who astonished me when he told me he was working on Laetrile (B17), at the time it was the most controversial thing in cancer….We in public affairs were giving out statements that Laetrile was worthless, it was quackery, and people should not abandon proven therapies….He took down lab books and showed me that in fact, Laetrile is dramatically effective in stopping the spread of cancer. The animals were genetically programmed to get breast cancer and about 80-90% of them normally get spread of the cancer from the breast to the lungs which is a common route in humans also, for how people die of breast cancer, and instead when they gave the animals Laetrile by injection only 10-20% of them got lung metasteses. And these facts were verified by many people, including the pathology department. Three years later, Dr. Moss held a press conference to publicize the results of these suppressed Laetrile studies. He was fired the next day.

Helen Curran's book can be obtained by writing the author at 56 B Calle Cadiz, Laguna Hills, California 92653. It is also distributed to health food stores by New Leaf.

Federal Crackdown on Medicinal Marijuana
In May 2001, the US Supreme Court ruled unanimously that medical necessity does not exempt marijuana users and distributors from federal prosecution under the Controlled Substance Act – even in states that permit medical use of marijuana. The Court focused solely on ‘medical necessity' and ignored the question of a state's right to pass laws on health care as it sees fit. Five months after this ruling, on October 3, 2001, federal drug enforcement agents raided the California Medical Research Center and the home of the center's directors, Dale Schafer and Mollie Fry, MD, a breast cancer patient herself. The agents seized 6,000 patient files and 32 marijuana plants. 

Six days later, the U.S. Drug Enforcement Administration (www.dea.gov) published rules that forbid the sale of any ingestible products that contain any amount of THC, the primary psychoactive compound in marijuana. Foods and drinks that contain hemp seed can no longer be sold or manufactured in the U.S. Hemp seeds contain protein, vitamin E, 2 essential fatty acids, and only a trace amount of THC. Cloth made from hemp fiber and personal care products (e.g., lotions, soap, shampoo) that contain oil from hemp seed are still permitted. The DEA cited the 1970 Controlled Substances Act, which defined "any material, compound, mixture, preparation which contains any quantity of THC” as being a controlled substance as the reason for their new rules. Poppy seeds, which contain trace amount of opiates (another controlled substance), can be sold because "Congress specifically exempted them from substance-abuse laws,” according to a Washington Post article.

The ban was scheduled to begin in February 2002. The Hemp Industries Association, representing product manufacturers and Canadian exporters of hemp seed, has petitioned the US Court of Appeals to overturn the DEA's order. Canada's Kenex Ltd., which provides most of the hemp seed to the US, seeks compensation of $20 million or more, under the North American Free Trade Agreement, if the DEA ban goes into effect.

Supreme Court Upholds Medical Marijuana Ban.
(http://usgovinfo.about.com/library/weekly/aa051501a.htm): 5/14/01.

Medical Marijuana: The Government vs. The People. Options (The Newsletter of People Against Cancer). 2001 December; 7: 1-2

DEA Clarifies Status of Hemp in the Federal Register. 2001 October 9. www.usdoj.gov/dea/advisories/pa100901.html
Note: Page has been relocated http://www.usdoj.gov/dea/pubs/pressrel/pr100901.html

Mayer Caroline E. Hemp-Food Firms Fight U.S. Ban, Deny Marijuana Link. The Washington Post. 2002 January 13; A01

High Incidence of Mastectomy
Diana Zuckerman, PhD, author of "The Need for Improved Informed Consent for Breast Cancer Patients” (Journal of the American Medical Women's Association, Fall 2000, 55: 285-289), reports that far too many American women with early stage breast cancer undergo mastectomies rather than the equally effective and less disfiguring lumpectomy: "… approximately one out of every two American women who have a breast removed as treatment for cancer do not need such radical surgery.” She points to several factors that contribute to this high incidence of mastectomy. "In many facilities, it's actually cheaper to remove a breast than it is to perform a lumpectomy and provide the necessary follow-up radiation therapy.” Doctors' bias also plays a large role. "In a study of 157 hospitals, patients treated by doctors trained before 1981 were less likely to have lumpectomies or other breast-saving surgery than women who had younger doctors.” "A study of 175 surgeons found that even doctors who know that lumpectomy is as safe as mastectomy may persuade their patients to get mastectomies by making subtly biased recommendations.” Women who end up with lumpectomies tend to seek a second opinion.  

In addition to the lack of information about their surgical choices, Dr. Zuckerman says that breast cancer patients are not being informed about the risks of reconstructive surgeries that "use synthetic breast implants or tissue transfers from other parts of the body.” She says that there is a lack of published epidemiological studies that have looked at the long-term risks, failure rates, and complications of these procedures. Similarly, few studies have shown that the practice of ‘prophylactic mastectomy' among healthy women with strong family histories of breast cancer is actually effective. Dr. Zuckerman states: "If objective information is not available on some aspects of breast cancer treatment because of lack of research, then the patient should be told that there is no research, or that existing research is inconclusive.”

Zuckerman, Diana, PhD. Unnecessary Mastectomies. www.cpr4womenandfamilies.org
(Link dead as of June 2005.)

Mammography
In The Atlantic Monthly (June 1996), David Plotkin, MD questions the value of routine mammography screening in his article "Good News and Bad News About Breast Cancer.” He explains at some length the factors that may skew results in mammography studies. For example, women who have routine mammograms may be diagnosed with cancer two or three years sooner than women in a matched control group who do not receive mammography, but actual survival time may not be affected at all. The women simply have knowledge of their condition for a longer period. "Statisticians call this effect ‘lead-time bias,'” Dr. Plotkin explains. "Although nothing has actually changed, a woman who would have died, say, three years after treatment now dies five to six years after treatment – manufacturing an apparent victory for medicine.”  

A second concern is ‘length bias.' While mammography can find small tumors that would not be identified through palpation, these small tumors are often less dangerous. Dr. Plotkin writes that "the tumors discovered by mammography tend to be those that grow relatively slowly and thus take longer to kill patients." He points out that the tumors found in the months between routine mammograms (usually by palpation) tend to be fast-growing and aggressive. Consequently, survival rates of women whose tumors are identified through routine mammography (and tend to be less aggressive) will compare favorably to the survival rates of women with fast-growing tumors identified through palpation. Unintentional selection bias is also a problem since medical experiments often take place in teaching hospitals, which attract affluent patients and others who seek expert care.

Dr. Plotkin says that eight large prospective randomized clinical trials on mammography, comparing a test group to a control group, had been completed by June 1996. A summary of the trials in Cancer (April 1995) reports that six of them show "no significant decreases in breast-cancer mortality as a result of mammography,” according to Dr. Plotkin. Only two trials indicate a significant (not caused by chance) decrease in breast-cancer mortality. One of them, the Health Insurance Plan of Greater New York study involving 60,696 women, had a serious methodological flaw. At the onset, the research team, headed by Sam Shapiro and Philip Strax, asked women assigned to the test group if they were either pregnant or if they had already been diagnosed with cancer. The women who answered yes to either question, a total of 434, were removed from the study. Since age range of the women in this study was 40 to sixty-four, most of the women who were excluded probably had cancer. Unfortunately, the researchers did not ask the women in the control group the same two questions. As the study progressed, the researchers were forced to go through old hospital records and rely on the memories of patients and family members to determine when cancer first appeared. Using this less reliable method, the researchers weeded out women in the control group who had been diagnosed with cancer before the study began. The researchers found that 147 of the women receiving mammography died of breast cancer within ten years compared to 193 in the control group – a significant difference. Dr. Plotkin explains that "…if it turned out that Shapiro and Strax had ascribed a mistakenly late date of diagnosis to as few as 25 women in the control group, the failure to exclude them, too, would have changed the study's conclusions. Correcting for it would cause the benefit of mammography to lose statistical significance….” Although the researchers concluded that mammography was beneficial, Dr. Plotkin notes that Shapiro and Strax attributed "the ‘higher proportion' of the benefit, at least in the first five years, to clinical breast examination – that is, palpation.”

The Swedish Kopparberg study, which began in 1977, also found a significant reduction (40%) in breast-cancer mortality among women who had routine mammograms. The study included 38,562 women in the test group (receiving mammography) and 18,478 women in the control group (receiving ordinary medical care). The researchers noted, however, that the overall mortality rate between the two groups was virtually the same; "the gain was offset by deaths from other causes, such as heart attack,” Dr. Plotkin explains.

Meta-analysis of data (in which each trial is compared to a ‘null' hypothesis, e.g., "mammography has no impact whatever on mortality from breast cancer”) indicates that routine mammography is linked to a reduction in breast-cancer mortality. A University of California-San Francisco team, led by Karla Kerlikowse, did a meta-analysis of the eight major trials. The team reported in the Journal of the American Medical Association (January 1995) that "mammography reduces the seven-to-nine-year mortality from breast cancer in women aged fifty to 74 by about 23%, but it has no impact on women in their forties,” according to Dr. Plotkin. A meta-analysis published in Cancer (April 1995) by Charles R. Smart included more follow-up data from the same eight studies and concluded that mammography reduced breast-cancer mortality in women in their forties by about 16%. These percentages refer to relative risk deduction. As Dr. Plotkin explains in his article, "…the figure from the meta-analysis is the answer to the question ‘Given that I have breast cancer, how much will I have cut my risk of dying if the tumor was detected mammographically?' It is not the answer to the question ‘If I am a typical woman, how much will I cut my risk of dying from breast cancer by having an annual mammogram?'”

Dr. Plotkin writes: "When my patients come in for their mammograms, I do not try to dissuade them. But I tell them that the most optimistic interpretation of the available evidence suggest that routine mammography has only a marginal effect on a woman's chances of surviving breast cancer – and that it may have no effect at all.”

Plotkin, David, MD. Good News and Bad News About Breast Cancer. The Atlantic Monthly 1996 June; 53-82

Cancer & Radiation
According to a three-part series in Rachel's Environment & Health Weekly [www.rachel.org; #691-693; April 2000], radiation from unnecessary diagnostic X-rays and nuclear waste/fallout is the major factor in the development of cancer. Researchers and medical doctors have been aware of the harmful effects of radiation since shortly after the discovery of X-rays in 1896. Within months of successfully operating the first nuclear reactor at a University of Chicago laboratory in December 1942, Dr. Arthur Compton, leader of the Manhattan Project, and his colleagues insisted that safety standards be set up for people working with radiation.  

One of the original five ‘health physicists' to set radiation safety standards was Karl Z. Morgan. Dr. Morgan served on the International Commission on Radiological Protection (ICRP), which set up most radiation standards. He also directed the Health Physics Division at Oak Ridge from 1944 until his retirement in 1972. In recent years, Dr. Morgan has publicly criticized the ICRP for failing to protect human health. In a 1994 article for the American Journal of Industrial Medicine, Dr. Morgan wrote: "The period of atmospheric testing of nuclear weapons by the United States, the United Kingdom, France and the USSR is a sad page in the history of civilized man. Without question, it was the cause of hundreds of thousands of cancer deaths. Yet there was complete silence on the part of the ICRP. During these years (1960-1965), most members of the ICRP either worked directly with the nuclear weapons industry or indirectly received most of their funding for their research from this industry.”

The ICRP's alliance with the nuclear industry includes ties to the International Congress of Radiology. In his 1999 autobiography, The Angry Genie: One Man's Walk Through the Nuclear Age (ISBN 0-8061-3122-5), Dr. Morgan related his concern about the ICRP's refusal to address the danger of excessive X-ray exposure during diagnostic procedures and dentistry. Until the passage of the Radiation Control for Health and Safety Act of 1968, some X-ray equipment used in the 1950s and 1960s delivered 2 to 3 rem per X-ray. X-ray doses as low as 1.6 rem increase a woman's chance of developing cancer, according to a 1974 study by Baruch Modan [Lancet (Feb. 23,1974), pp 277-279]. The Act did not address the cumulative effect of multiple, routine, and often unnecessary X-rays.

Karl Morgan is not the only scientist to point to medical radiation (X-rays, including fluoroscopy and CT scans) as a cause of cancer. John Gofman, a scientist with degrees in chemistry and medicine, has published studies on the hazards of low-level radiation for over 20 years. He co-discovered uranium-233 and was the first to isolate plutonium. In his 1999 book Radiation from Medical Procedures in the Pathogenesis of Cancer and Ischemic Heart Disease (ISBN 0-932682-98-7), Dr. Gofman presents support for his hypothesis: "Medical radiation is a highly important cause (probably the principal cause) of cancer mortality in the United States during the 20th Century.” Writer and editor Peter Montague explains in the Rachel's Environment series, "…when Gofman says X-rays are responsible for a large proportion of all cancers in the US, he is not saying that X-rays are the only cause of those cancers. However, he is saying that most of those cancers would not occur in the absence of X-rays.” Like Dr. Morgan, Dr. Gofman objects to excessive and unnecessary X-rays. He claims that the number of X-rays in the US could be halved without decreasing medical information.

The Major Cause of Cancer – Part 2. Rachel's Environment & Health Weekly (www.rachel.org) 2000 April 13; 692.

"The Major Cause of Cancer – Part 3” Rachel's Environment & Health Weekly (www.rachel.org) 2000 April 20: 693.

Cancer Treatment Affects Sexual Activity
In an article for Breast Cancer Action's newsletter, Lauren John points out that breast cancer patients are rarely counseled about the effect that surgery, radiation, and chemotherapy can have on their enjoyment of sex. Part of the problem lies in the lack of information about safe ways to deal with chemo-induced menopause. Although older women are often advised to take estrogen therapy to relieve vaginal dryness, the link between estrogen and breast cancer has made doctors reluctant to prescribe hormone therapy for breast cancer survivors with the same problem. The number of young women who have been thrown into menopause early by chemotherapy has pushed some physicians into suggesting that they use estrogen-based topical creams, but no research supports this recommendation. Herbal remedies may be another option, but, like hormone therapy, no studies have been done on their effectiveness or safety for women with chemo-induced menopause. More research is needed. 

Lauren John suggests that patients seek out a sex therapist, gynecologist, or endocrinologist who is knowledgeable about breast cancer. She also hopes that cancer centers will become more active by offering women health information packets with articles, medical referrals, and even vaginal lubricant samples. One small study by M. C. Wilmoth [Cancer Nursing, August 24, 2001: pp.278-86] found that "women who sought information about the sexual side effects of cancer treatment and who had strong intimate relationships appeared to experience a more successful adjustment.”

John, Lauren. Sex After Breast Cancer – Can We Talk? Breast Cancer Action Newsletter 2002 January/February; 69: 1.

Sugar & Cancer
An article posted on The Alternative Research Foundation website (http://cat007.com) says that high blood sugar levels promote tumor growth. The article refers to the work of the 1931 German Nobel laureate Otto Warburg, PhD. Dr. Warburg discovered that "malignant tumors frequently exhibit an increase in anaerobic glycolysis – a process whereby glucose is used as a fuel by cancer cells with lactic acid as an anaerobic byproduct – compared to normal tissues.” The buildup of lactic acid results in a lower, more acidic pH in cancerous tissues and in overall physical fatigue. In addition to lactic acid buildup, anaerobic glycolysis releases only about 5% of the energy in food and stored calories, which also contributes to fatigue. Eventually, the patient becomes malnourished and may begin to waste away.  

The article suggests controlling blood glucose sugar levels in order to "help starve the cancer and bolster the immune system.” It also suggests that mannoheptulose, a purified avocado extract, may help. Researchers at Britain's Oxford University Department of Biochemistry found that mannoheptulose inhibits tumor cell glucose uptake and also inhibits glucokinase, the enzyme used in glycolysis. In laboratory tests, mannoheptulose inhibited growth in cultured tumor cells as well as reducing tumor size in animal subjects.

The Alternative Research Foundation. Sugar and Cancer. http://cat007.com

Double-Blind Clinical Trials
Since the 1954 Cornell conference on "How to evaluate a new drug,” randomized double-blind studies (in which neither the experimenters nor the subjects know who receives the test drug and who receives a placebo) have been extolled as the way to neutralize the placebo effect and provide an accurate accessment of a drug's effect. At that conference, Harry Gold, the conference organizer, presented a double-blind study that showed that the drug khellin had no more effect on relieving anginal complaints than a placebo. His finding contradicted a single-blind study, performed by another doctor, that was also presented at the conference. Gold did not perform his own single-blind study of the drug as a control so that he could compare the two methods. Yet, Gold's double-blind study has been cited as proof of this method's superiority.  

An insightful critique written by Helmut Kiene, Dr med, points out that ensuing studies of the double-blind method have not proved it to be more accurate than the single-blind method. In 1957, P. Martini compared the results of nine Khellin studies: "two single-blind studies, one partially controlled single-blind study, and six double-blind studies.” One single-blind study and one double-blind study found that khellin had a moderate effect. The second single-blind study and the one with a partial control both found that khellin had a good effect. Two of the double-blind studies also found that khellin had a good effect. The remaining two double-blind studies showed no effect. "It thus emerges,” he wrote, "that the double-blind trial is in itself no guarantee of absolute reliability and uniformity of results.”

In 1966, A. W. von Eiff performed a study in which an investigator used the same placebo-controlled conditions in a single-blind test and a double-blind test to evaluate a stimulant's effect, a sedative's effect, and a muscle-relaxant's effect on healthy subjects. All three drugs were found to be more effective than the placebo. "However, none of the 30 measured physiological parameters showed a significant influence of the study method (single- or double-blind),” writes Dr. Kiene. "Hence the double-blind method was not superior to the single-blind method.”

Another experiment by von Eiff in 1971 found that the double-blind method did not necessarily prevent investigators from influencing the results. In this experiment, von Eiff chose two male investigators who had the "same age, similar appearance, same training background, and same audiogram.” Each investigator ran placebo-controlled, single-blind and double-blind investigations of the same drug. Although all outcome variables showed that the drug was more effective than the placebo, von Eiff also found that the spread of the results, irrespective of the method used, differed between the two investigators.

In addition to the possibility that a researcher can somehow affect the subjects' response, Kiene explains several other patient-related factors that can cause "biased results”. Patient expectation, whether positive or negative, can influence his/her response to the treatment. In addition, subjective responses by test subjects may be colored by a person's desire to report the effect that (s)he believes that the researchers expect. Subjects may also want to express gratitude for the doctors' attempts to help them and may exaggerate the benefits of the treatment. Patients may be concerned about giving inaccurate or "wrong” responses and try to avoid that risk by giving non-committal answers instead. G. Clauser wrote: "Trial results should not be accepted uncritically, only because they are based on the double-blind method. There is no ultimate way to exclude the physician's or patient's psychological reactions. Double-blind trials are valuable only in the hands of psychologically trained trialists.”

Even in cases in which subjective responses from the subjects are not involved, double-blind studies face other challenges that can skew results. Kiene explains that many double-blind studies allow test subjects and control subjects to have contact with one another, which can result in group assimilation. In group assimilation, people take on the behavior or characteristics of one another. Thus, the average differences between the treated group and the placebo group can lessen. Another factor that is often ignored in studies is that subjects, especially those who see no effect from the treatment they're receiving, may make unreported changes in their diet, stress level, or lifestyle, which affect outcome.

"A Critique of the Double-Blind Clinical Trial, Part 1" by Helmut Kiene, Dr med., Alternative Therapies, January 1996, pp. 74-80.

U.S. Mad Cow Risks
A Wall Street Journal article by Steve Stecklow discusses practices that may make the U.S. susceptible to outbreaks of mad cow disease. So far, 18 countries have reported cases of mad cow disease (bovine spongiform encephalopathy) in domestic cattle herds. Animal feed that contains ground-up meat and bone meal from infected animals is believed to be the means of transmission. Britain prohibited the feeding of meat-and-bone-meal to cows in 1988 and to other farm animals sometime later. The incidence of mad cow disease in Britain has been decreasing since 1993.  

The U.S. permitted meat-and-bone meal in cattle feed until 1997. Animal protein is still allowed in other animal feed, which can get mixed into cattle feed on the farm. Although the USDA banned the importation of rendered animal proteins from 31 suspect countries in December 2000, the FDA found that 30 shipments of animal byproducts entered the U.S. in the months following the ban. Federal inspection of 2,653 animal-feed mills found that over 20% were not taking sufficient care to prevent meat-and-bone meal from entering cattle feed products. In addition, the USDA, unlike European counterparts, does not test apparently healthy animals for signs of the disease: "The agency says 88% of US cattle are slaughtered at less than 20 months of age, and no BSE has ever been detected in an animal that young.” The USDA is focusing, instead, on downer cows that have difficulty standing, a symptom of mad cow disease. Out of an estimated 130,000 downer animals in the U.S. each year, the agency examined at least 4,400 in 2001.

Stecklow S. Despite Assurances, U.S Could Be at Risk For Mad-Cow Disease. The Wall Street Journal. 2001 Nov. 28; A1 & A6

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