Perception or Deception – Let’s Get It Right

Our bus pulled over by the roadside and let us down to a shop selling locally made chocolate. The shop is among many orange trees. This being the month of June, most of these trees remain lush with green leaves not bearing any fruit. However, there are two or three trees near the shop that are unique – they have nice oranges on them! And many of us – the tourists – are taking pictures with the trees as the backdrop. I too took a nice picture of this “wonder” tree. But it did not take long for me to figure out that these are “fake oranges.” In short, it was a “deception,” although our human eyes perceive it as real oranges!

This trip to Korea just taught me one lesson – many things in life are all about perception – just that, perception! For many issues if we have time enough to look deeper into it, we may discover it is more than what the eyes can see! Then we can ask, is it just our perception or is it a deception or even a manipulation?

John F Kennedy once said, The greatest enemy of the truth is very often not the lie – deliberate, contrived and dishonest, but the myth – persistent, persuasive and unrealistic.

After I got into the bus again, I recalled a book that I wrote some years ago – Getting it right. 

Actually I call this a book of quotations because it contained statements made by renowned medical experts as found published in established medical journals.  By doing this way, I want to ensure that I get it right and not wrong! Among the questions I asked and attempted to answer in this book are: Is modern medicine the only proven and scientific therapy? Is traditional and complementary / alternative medicine quackery? Are research data always reliable and proven when published in peer-reviewed journals? Are drugs perfectly safe after FDA approval?  Are “they” protecting public safety or safe-guarding self-interest? Can medicine cure cancer?

This orange tree was all forgotten after I came home. But after reading the book, The End of Illness, which my good friend S.Y. Yeong had sent me, “triggered” me to revisit this subject of perception again. Two sentences that Dr. David Agus wrote, awakened me – In the upcoming chapters, I’ll help you to answer that questions because many of these commonly held perceptions are just that – perceptions. I’m going to bust a few of these ideas and show you a different way of considering what’s good for you or not.

What is it that Dr. Agus wanted us to know? I suggest that you read his book for yourself, but let me share with you some of my thoughts.

First, I have high respect for this man. Dr. Agus  is professor of medicine and engineering at the University of Southern California Keck School of Medicine and the Viterbi School of Engineering. He obtained his undergraduate degree from Princeton University and his M.D. from University of Pennsylvania School of Medicine. Dr. Agus did his medical internship and residency at Johns Hopkins Hospital and his oncology fellowship training at Memorial Sloan-Kettering Cancer Centre. He is indeed well qualified to be saying what he is saying.

Second, it is not only his paper qualification that is just attractive, but the attitude of the man that I have the highest respect for.  Dr. Agus related a “trivial” event (for most people!) that changed him. This is what he wrote:

When I walked past my hospital’s gift shop and saw the cover of Fortune magazine proclaiming “Why We’re Losing the War on Cancer, “ … it seemed to be pointing a finger at me telling me how terribly I’d been doing my job. Cancer care has been much criticized over the last several decades, and clearly this article was trying to rip apart my field some more… It left a deep impression on me, for any cancer doctor who comes across such a blunt headline and well-thought-out essay is bound to feel disheartened and failing at his most essential job.

Clifton made remarkable points in the article, the most significant of which explained how we – as a society, but more specifically, within the medical community – have come to look at biology. For the last fifty years, we have focused on trying to understand the individual features of cancer in order to treat it rather than putting our efforts directly into controlling cancer. We have forgotten that curing cancer starts with preventing cancer.

When we reduce science down to the goal of finding the tiniest improvements in treatment rather than genuine breakthroughs, we lose sight of the bigger picture and find ourselves lost.

Is this why we’ve barely budged in our “war” against cancer in the last five decades?  … Gnawing questions like these began to bother me. I am, after all, an oncologist who cannot treat advanced cancer well. Medical science has made extraordinary progress over the past century, but in my field, the progress stalled out decades ago.

But, despite my initial reaction, I did and do believe that this kind of criticism is desperately needed, and I am inspired by the challenge to fix what’s broken.

To me, this is the measure of an honest, thinking man. This is what the wise and the educated should aspire to do. If there is a problem – say it out and more importantly, try to find a solution to it.

What are the problems that Dr. Agus see which do not seem to be right? He wrote:

Limitations of Medical Science

1.  The truth is that some doctors inflict a lot of harm today. The entire notion of “do no harm” has been corrupted; we’ve move into an extreme place in medicine that’s rarely data-driven and is horrendously overrun by false or unproven claims.

2.  A lot is going on in the body at any given moment. Yet we perform medicine in piecemeal – targeting one problem at a time. If you’re diagnosed with pneumonia, then you’ll receive a treatment specific for pneumonia and await your next health challenge. But what happens when you’ve got a system that’s broken down in a way that cannot be explained by any single invader …? Then you’ve got a real problem … because current methods of medicine don’t know what to do with you. The proposed treatment will probably mess with other areas in your system in ways that we may or may not know about. Your doctor will tell you that that treatment is “safe and effective,” but he’s only talking in relation to that one conditions, at that moment in time. He’s not considering everything else that encapsulates you – especially in the long run – because a lot of that knowledge remains to be understood.

3.  Rather than honouring the body as the exceedingly complex systems that it is, we keep looking for the individual gene that has gone awry or for the one “secret” that can improve our health. This kind of short-sightedness had led us far astray. 

The Medical Treatment for Cancer

1.  When Murray (Nobel laureate in physics) said to me point-blank, “Look at cancer as a system,” I really began to rethink everything – about cancer and our approach to treating it; about illness and our approach in medicine in general … I couldn’t help but ask myself: Is our way of looking at cancer keeping us from curing it? Moreover, does this faulty perspective preclude us from treating anything in medicine successfully?

2.   We’ve got a serious problem on our hands if all the intelligence and money currently going toward cancer are doing next to nothing in this so-called war. It’s time to change not only how we think about cancer … We need a radically different way of thinking…

3.   Cancer treatment is the place where we take the most risks in medicine because, frankly, there’s little hope for survival in many cases, and the cure is as evasive today as it ever was. I’m infuriated by the statistics, disappointed in the progress that the medical profession has made, and exasperated by the backward thinking that science continues to espouse, which no doubt cripples our hunt for the magic bullet.

4.  If you come to me for help in treating advanced cancer detected late in the game, your game is likely to be over soon. I don’t say this … to sound insensitive; I say it because it’s the truth … it’s a shame that the technology and innovation in medical research and treatment are so archaic, outdated, and, dare I say, in some cases barbaric.

5.  Despite chemotherapy’s being a widely used treatment for cancer, nobody has ever shown that most chemotherapy actually touches a cancer cell. It’s never been proven. Researchers can perform all this elegant work in tissue-culture dishes – if I expose a cell to this cancer drug, here’s what happens, and so on – but doses in those dishes are nowhere near the doses, nor the environment, that happens in the body.

6.  The death rate from cancer from 1950 to 2007 didn’t change much.  We are making enormous progress against other chronic diseases, but little against cancer. With the more common deadly cancers, including those that ravage the lung, colon, breast, prostate and brain we’ve had an embarrassingly small impact on death rates. The lack of change in the death rate from cancer is truly alarming. How can this be? What did we do wrong in our research?

7.   Doctors such as myself arrive at solutions through plain old trial and error, and therefore we can’t always explain how things work. I can’t always tell you why a certain drug works or how it works other than to say I have seen results proving that it does. I also can’t always give you’re a straight answer as to which course of therapy might work for you. In fact, doctors – myself included – don’t actually know why these drugs kill cancer cells at all! There’s a lot of trial and error in my business. We don’t have the technology yet to precisely predict what medicine you’ll respond to or which one will work best. 

8.   When cancer is exposed to chemotherapy, drug-resistant mutants can escape. In other words, just as resistant strains of bacteria can result from antibiotic use, anticancer drugs can produce resistant cancer cells. The number of mutations shoots up exponentially as a cancer patient is treated with drugs such as chemotherapy, which inherently causes more mutations.   When chemotherapy drugs bind to DNA, they can cause cancer just as radiation can cause cancer by mutating the genome. This helps explain why survivors of breast cancer, for instance, can suffer  from leukemia later in life due to the chemotherapy they received to cure their breast cancer.

9.   It’s human nature to want to find magic bullets in medicine, but they happen once in a blue moon, and we may already have had all of our blue-moon moments. We haven’t found many new pills lately that really cure diseases. This is why the pharmaceutical industry is somewhat broken right now; it has run out of … a magical chemical that cures a disease. I don’t think we’re likely to find a lot more of those; it seems like a waste of time, money, and resources to keep looking for these magic bullets. We need a different approach – a new model.

Many doctors and authors before this have been saying similar things about cancer treatment. Dr. David Agus – one of America’s outstanding oncologist – has decided to join in the chorus. Let the song plays on to full volume!


Related post:  Book Review: The End Of Illness By Dr David Agus, M.D. by  Yeong Sek Yee & Khadijah Shaari