Nearer My God To Thee

Book Review: Bad Pharma—How Drug Companies Mislead Doctors And Harm Patients

Reviewed by: Yeong Sek Yee & Khadijah Shaari

Dr Ben Michael Goldacre, the author, graduated in 1995 with a first-class honors degree in medicine from Magdalen College, Oxford. He obtained an MA in philosophy from Kings College London, and undertook clinical training at UCL Medical School, qualifying as a medical doctor in 2000 and as a psychiatrist in 2005. As of 2012 he is Wellcome research fellow in epidemiology at the London School of Hygiene and Tropical Medicine.

We have heard about “Big Pharma.” Little did we know that it is also known as “Bad Pharma” and this book certainly enlightened us. According to Dr Goldacre, the whole edifice of medicine is broken, because the evidence that we (the doctors) use to make decisions is hopelessly and systematically distorted. We (doctors) like to imagine that:

ü Medicine is based on evidence, and the results of fair tests. In reality, those tests are often profoundly flawed.

ü Doctors are familiar with the research literature, when in reality much of it is hidden from them by drug companies.

ü Doctors are well-educated, when in reality much of their education is funded by industry.

ü Regulators only let effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients.

The essence of the whole book is distilled and summarized in the introductory pages of the book. The following paragraphs meticulously defends every assertion made by Dr Goldacre:

Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques which are flawed by design, in such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies don’t like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug’s true effects.

Regulators see most of the trial data, but only from early on in its life, and even then they don’t give this data to doctors or patients, or even to other parts of government. This distorted evidence is then communicated and applied in a distorted fashion.

In their forty years of practice after leaving medical school, doctors hear about what works through ad hoc oral traditions, from sales reps, colleagues or journals. But those colleagues can be in the pay of drug companies – often undisclosed – and the journals are too. And so are the patient groups.

And finally, academic papers, which everyone thinks of as objective, are often covertly planned and written by people who work directly for the companies, without disclosure. Sometimes whole academic journals are even owned outright by one drug company.

Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it’s not in anyone’s financial interest to conduct any trials at all. These are ongoing problems, and although people have claimed to fix many of them, for the most part, they have failed; so all these problems persist, but worse than ever, because now people can pretend that everything is fine after all.

Watch Dr Ben Goldacre’s speech on TEDTALK…What doctors don’t know about the drugs they prescribe…LINK:

http://www.ted.com/talks/ben_goldacre_what_doctors_don_t_know_about_the_drugs_they_prescribe.html

From the above, it is very clear that from Dr Goldacre’s perspective, medicine’s evidence base has been undermined by an unscrupulous alliance of the pharmaceutical industry and regulators, which leads to the routine suppression of negative studies revealing many drugs to be either ineffective or less effective than those they seek to replace.

This suppression has been willful and many academics (the industry’s “key opinion leaders”) have acted as willing partners in the enterprise, putting their names to ghostwritten articles reporting positive trials, while failing to publish negative trials.

Since there’s so much missing data, we (doctors) can’t really say whether the therapies we use work or not. Doctors generally want to do the best for their patients, but they can’t know what that is if half of the data on clinical trials of drugs is missing and some of the rest is distorted. Thus, according to Goldacre, medicine’s evidence base is irredeemably corrupted and needs reconstruction.

This book (448 pages) is divided into six chapters, which cover different aspects of the pharmaceutical industry:

Chapter 1 is entitled ‘Missing data’, and Dr Goldacre described at considerable length the important problem of publication bias. The take home message from this chapter is that we cannot assess the evidence for a particular drug if all the trials on it are not published, and worse still, those that are not published tend to be different from the ones that are.

Chapter 2 ‘Where Do New Drugs come from?’ is a brief description of the drug development process. Risky ‘first-in-man drug tests are conducted on homeless people, full clinical trials are globalised which raises serious ethical problems…also trial participants in developing countries are often unlikely to benefit from expensive new drugs…thus it also raises new problems for trusting the data.

Chapter 3 ‘Bad Regulators’, does what it says on the tin, and explains the many ways in which Goldacre believes that drug regulation isn’t working. The bar is very low: that drugs must only prove that they are better than nothing, even when there are highly effective treatments on the market already….this means that real patients are given dummy placebo pills for no good reason.

Chapter 4 ‘Bad Trials’ talks about the design of individual clinical studies and how they can be flawed. Several tricks have been introduced…one allows researchers to overstate and exaggerate the benefits of the treatments they are testing.

Chapter 5 ‘Bigger, Simpler Trials’ describes how pragmatic randomised trials could be (but very rarely are) incorporated into routine clinical practice.

Chapter 6 ’Marketing’ In this chapter, Dr. Goldacre addresses the abuses and excesses of the pharmaceutical industry marketing machine, which exists entirely to increase the revenue generated by the industry’s products and yet which masquerades as a system for disseminating useful information to doctors, patients, and politicians.

When you have read all the 6 chapters (as we did during the Ramadan), you will realize why Dr Goldacre decided to title the book as Bad Pharma. For the still unconvinced, we recommend that you peruse the following articles with the links as attached:

1) List of largest pharmaceutical settlements

Link: http://en.wikipedia.org/wiki/List_of_largest_pharmaceutical_settlements

2) List of off-label promotion pharmaceutical settlements

Link: http://en.wikipedia.org/wiki/List_of_off-label_promotion_pharmaceutical_settlements

3) Pharmaceutical frauds

Link: http://en.wikipedia.org/wiki/Pharmaceutical_fraud

4) GlaxoSmithKline controversies

Link: http://en.wikipedia.org/wiki/GlaxoSmithKline#Controversies

5) Ethics in pharmaceutical sales

Link: http://en.wikipedia.org/wiki/Ethics_in_pharmaceutical_sales

6) Pharmaceutical marketing

Link: http://en.wikipedia.org/wiki/Pharmaceutical_marketing

7) Why doctors don’t know what they’re prescribing

Link: http://www.abc.net.au/unleashed/4323556.html

NB: In the list of pharmaceutical settlements, most of the fines runs into hundreds of millions (USD) and mainly for offences like off-label promotions, false marketing, kickbacks, medicare fraud, etc. Recently a drug company was fined US 3 billion for various offences (see link below). To Dr Goldacre, these fines/settlements are just small change to Big Pharma.

Link: http://www.justice.gov/opa/pr/2012/July/12-civ-842.html

In addition to the above, you may want to read the following books (there are many, many more such type of books):

1) Big Pharma: How the World’s Biggest Drug Companies Control Illness is a 2006 book by British journalist Jacky Law. The book examines how major pharmaceutical companies determine which health care problems are publicised and researched.

2) Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial is a nonfiction book by investigative journalist Alison Bass, which tells the true story of a court case and the personal drama that surrounded the making of a bestselling drug. It chronicles the lives of two women – a prosecutor and a whistleblower – who exposed deception in the research and marketing of Paxil, an antidepressant prescribed to millions of children and adults. The book shows the connections between pharmaceutical giant GlaxoSmithKline (the maker of Paxil), a top Ivy League research institution, and the government agency designed to protect the public – conflicted relationships that arguably compromised the health and safety of vulnerable children.

3) The Emperor’s New Drugs: Exploding the Antidepressant Myth by Irving Kirsch demonstrated that in trials, SSRIs (a common class of antidepressants known as selective serotonin re-uptake inhibitors) performed no better than placebos, a fact that would have been known had some clinical trial data not been suppressed by pharmaceutical companies. Regulators happily licensed these new drugs in full possession of this knowledge.

4) The Truth About the Drug Companies…How they Deceive us and What to do about it by Dr Marcia Angell, MD…..read how the drug companies promote diseases to match their drugs and have enormous influence over what doctors are taught about drugs and what they prescribe. Drug companies have substantial control over clinical trials of their drugs…as a result the research results are biased.

5) What the Drug Companies Won’t Tell you and Your Doctor Doesn’t Know by Michael Murray, N.D.…the alternative treatments that may change your life –and the prescriptions that could harm you.

6) Rethinking The Ethics of Clinical Research….Widening The Lens by Dr Alan Wertheimer, MD……Clinical research requires that some people be used and possibly harmed for the benefit of others. What justifies such use of people? This book provides an in-depth philosophical analysis of several crucial issues raised by that question.

7) Money Driven Medicine by Dr David K. Cundiff, MD….Read the details of dozens of prescription drugs which extensive research has proven to be ineffective or dangerous for continued use.

After reading the whole book and the various links, we are really amazed how Big Pharma has the courage to market their drugs as “scientifically tested, evidence-based,” etc, etc (and everything else is not scientifically tested and not evidence-based). How can Big Pharma’s drugs be “scientifically tested and evidence-based” when clinical trials designs are flawed, negative data are missing/not revealed, and regulators, doctors and politicians are bribed or silenced, etc, etc. As Dr Goldacre mentioned, medicine’s evidence is irredeemably corrupted and needs serious re-construction. But, will it ever happen when there is so much at stake?

Perhaps, Dr Goldacre should have named the book as BIG, BAD PHARMA. What do you think?

Stage 4 Stomach Cancer: She Came, She Believed And She Got to Keep Her Stomach Intact

The file of YM laid buried among the pile of papers on my desk – almost forgotten. But about two months back (mid-2013), a medical doctor came to seek our help. When asked who sent him here, he replied it was his neighbour, YM. I asked the doctor how YM is doing. He replied, Very well. This episode make me go back to my old files and I started to track YM’s case. This is her story.

YM was diagnosed with stomach cancer in July 2007. A biopsy confirmed a poorly differentiated adenocarcinoma of the stomach. She underwent 6 cycles of chemotherapy. She took Xeloda for two weeks and stopped. Apparently the doctor suggested that her stomach be removed. YM was in a dilemma, not knowing whether to go for the operation or not. I recalled it was at this point in time that YM called me and we spoke on the phone. YM had just started taking our herbs. On 30 December 2007, YM and her family came to our centre in Penang.

This is the recording of our meeting that day.

The following are e-mails that give more details about YM’s cancer experience.

4 January 2008: Dr Chris,
I have come to see you last Sunday. My file number is T-711. I am a lecturer at Universiti Tunku Abdul Rahman. I have decided to hold on to my surgery and take your herbs for a long-term basis. I hope your herbs will prevent the need to do a surgery. I am taking capsule A, C-tea, Stomach 1 and 2. I am trying my best to adhere to your advice on the diet but I still have the following questions and hope you can answer them for me:

1. Does it matter when I take the stomach tea? Should I take it on empty stomach? Is it ok if I take it after juice or right after my dinner?

2. Can I take C-tea with Capsule A together or any other supplements like multi-vitamin. calcium, vitamin c, and plant oil?

3. I know that I should take stomach tea and C-tea at separate time. What is the minimum time interval between the 2 teas?

4. I read from your website that capsule A is for detox purpose. But C-tea is also for detox purpose (as told by you). Why am I asked to take 2 things with the same function?

5. Is capsule A made from the plant called “rodent tuber”?

6. May I use other organic sauce or seasoning for taste, besides sea salt and liquid aminos that you are selling at your center?

7. May I consume soup that boiled with chicken (kampung chicken or organic chicken) or pork but without taking the meat? I know I am not supposed to take meat but I need to know whether drinking meat soup is as bad as well.

8. How about soup with “ikan bilis”?

9. Is it ok to take the following food: “nangka” or jackfruit, peanuts, and small dried prawns? Even if in small amount?

Please do not get upset in answering the questions especially the questions about food. You may have answered them thousands of times but we, the patients, need to hear from you for sure.

Hope to hear from you soon.

Reply to her questions:

1. Better to take after food. Timing? When convenient.

2. Not a good idea. Take Capsule A on empty stomach if no gastric pain. Later take whatever.

3. Okay.

4. Same function but many ways of healing. Attack from all angles not enough.

5. Yes, but with 10 other herbs to balance it.

6. I don’t know what other organic sauce is. Sure it is good stuff? I don’t know.

7. No, no. no. Nothing from things that move with their legs.

8. Yes, but don’t overdo. One tea spoonful of bilis powder maximum.

9. Aya, very bad and my answer is NO.

10. The stomach regurgitates or reflux. Try to take herbs after food and see what happens.

13 February 2008: Dr Chris, I did have intravenous chemotherapy — that was why I was in hospital for a day for each treatment. So the cost includes the intravenous chemo done in the hospital plus 2-3 weeks supply of Xeloda and vitamins. There were 6 treatments like this for the whole course. It cost about RM33,000 in total.

Below is the breakdown of a typical bill:

Room                 RM128 (I wanted to be hospitalized)
Office                RM45
Lab                        RM200.90
Pharmacy            RM4,523.88
Sterile Supplies   RM132.79
Consultation         RM90
Insertion of Intravenous RM477.47 (insertion of needle into my vein)

I have been taking C-tea, capsule A, stomach 1 and 2 since 1 January 2008, only for one-and-a-half months. I am doing fine so far. Although I do not feel significantly different from before the herbs, I feel well and normal, and I got some good comments like I look better from my face. I believe in the herbs and the natural way of healing, so I will continue taking the herbs and other nutrients and watching my diet. Of course, I will consult doctor and monitor my condition from time to time.

In fact mine is a cancerous ulcer in the stomach. It is not a tumor. It has spread to nearby lymph nodes, therefore, classified as stage 4. It is under controlled after the chemotherapy. Now I wish to keep it under control as long as I can with the herbs and diet. I will take whatever you think is good for me especially it is targeted to cancerous ulcer. I strongly believe that, in my case, it was caused by the Pylori bacteria, which was preventable. I wish I have known much earlier the danger of being infected by this type of bacteria.

20 August 2008: Dear Dr Chris,
How are you doing? I know that you are a very busy man and I try not to disturb you too much.

If you may recall, I went to see Mr Lee and you end of last year, December 2007. I started to take your herbs 1 January 2008. You asked me to do a blood test at that time I saw you and I did. That was the beginning of the consumption of your herbs.

Seven months after consuming the herbs–Stomach 1 and 2, C-tea, and capsule A–I went to do a scope in my stomach and a full blood test at Subang Jaya Medical Center on July 23, 2008. I asked back the same doctor who did the scope and biopsy on me about a year ago. He was the one who delivered the bad news that I had stomach cancer stage 4. I remember very clearly he said that I had a very big ulcer in my stomach. And a year later he delivered the good news to me. He saw a perfect stomach with no ulcer–it was healed!

My blood test results looked ok too–all tumor markers were within the range except CA19.9, it was 36 (the upper range was 35 based on the report.) My white blood counts was a bit low with a rating of 2.9. I think the lower range was about 4. Anyway, the doctor said that the CA19.9 of 36 was not alarming and I may need to see a blood specialist for the low white blood cells. He declared me cancer-free for now. I just need to monitor closely from now on.

I am aware that I have a low white blood count since I started my chemo treatment last year, August 2007. If I am not wrong, there is not much I could do about it. It may affect my immune system and so far I am ok without getting sick.

I will continue my diet and herbs regime and will do a check up within half a year or so. I have cut out meat completely and for white sugar and salt, I cut them down as much as I can. I can’t be avoided completely if I eat out, hence I will not eat out unless I go traveling or for special occasions.

Anyway, Dr Chris, I believe in your herbs and I intend to continue taking it as long as I could. I understand that I am cancer free now but this does not guarantee anything. I will not be shocked if it comes back. I just try my best to prevent it from coming back. If it does come back, I will just deal with it accordingly. Of course, I hope that it will not come back with my diet regime and herbs therapy plus the supplements (OMX, plant oil, vitamin C, and complex enzyme) that I am taking.

So much about my updates. Thank you.

22 August 2008 Many thanks for your prompt reply. I am trying to close the gaps in my understanding of the story. If you don’t mind, can you clarify:

Question: What happened before July 2007. Were you suffering from something?

Answer: Prolonged bloating and a very uncomfortable stomach, no appetite, felt like vomiting.

When did this doctor say it was stage 4. After the biopsy result in July 2007? And it was stage 4?

Yes.

You had a big stomach ulcer — your stomach must be bleeding? Lost a lot of blood? He did not treat you for ulcer? Surprisingly I had no bleeding in the stomach based on what I know–if my stomach bleeds, my stool would be black in color. But my stool was not black but normal color to me. I did bleed but it was red, fresh blood, because I have piles. The doctor who did the biopsy did give me some pills for the ulcer but I went for chemo right away. I still finished the pills anyway.

What did he say about being alive — or his prognosis?

He did not say anything about that because he is not an oncologist. He referred me to an oncologist right after the biopsy results. The referred oncologist (a lady) came to see me and based on the conversation with her, I knew I was very serious and I needed treatment fast. So I decided to go for the chemo treatment within 2 days of the biopsy results.

Did you ask him if there was a cure?

I did not ask him since he is not an oncologist. But my oncologist mentioned to me that I just had to try the drug Xelox first. I might end up in the good basket and I might not be. (Note: XELOX regimen consisted of taking oral Xeloda plus injection of oxaliplatin.)

Did he ask you to go for surgery? Or chemo?

The oncologist asked me to go for chemo first and when I got response she advised me to go for surgery. The oncologist suggested chemo treatment and it was done within the next 2 days after the biopsy.

You said you have 6 cycles of chemo — Was it from August 2007 onwards? And when did it end? What drugs did they use?

The chemo started 2 August 2007 and ended 23 November 2007 with 6 cycles at 3-week interval. That is, one cycle every 3 weeks. Xelox was the regimen (Xeloda plus injection of oxaliplatin.)

Then you had 2 weeks of Xeloda and stopped the Xeloda — was this after you had completed your i/v chemo?

I was given 2 weeks supply of Xeloda for every cycle of chemo treatment.

After the chemo and Xeloda — were you okay?

Of course there were side effects like numbness in my hands, slight blurred vision, poor appetite, dropping more hair, and low white blood count. Other than that, I was feeling ok generally.

In December 2007 CT scan indicated everything fine. What did the doctor say about this report.

The oncologist was pleased with the results and suggested that I go for surgery to remove part or whole of the stomach so as to remove the source of the cancer within a month after the last chemo treatment, before the drug worn out.

Since response of the treatment was so good, why did you come to see us and want to take the herbs?

I came to see you because I read the book entitled “Cancer Cured Naturally” by Betty Khoo-Kingsley. I believed in it and based on the contact information at the end of the book, I located CACARE. I was reluctant to go for the surgery. I was told by the surgeon (I went to consult a surgeon) about the side effects of having the stomach removed and I would be made very weak. I went to see you to get your opinion as well, and you were very upset by what the oncologist told me. You said that surgery might not be necessary especially if the cancer had spread. You asked me to give myself 3 months to take the herbs and to do blood test and PET scan within that 3 months. I took the herbs and did blood test but I did not and still have not done any scan yet.

Now that it is healed. Did the doctor tell you why your cancer had disappeared?
The doctor who did the scope for me did not explain anything. He knew that I have gone through the chemo treatment. And I did not go back to see my oncologist since my last treatment in December 2007.

Did he ask you if you took anything else besides chemo and Xeloda?
As I mentioned above, this doctor did not ask anything and I have not seen any oncologist since December last year.

Your health conditions — before you took the herbs and after you took the herbs — were there any difference? I am trying to find out if the herbs helped you in any way?
Before I took the herbs I was still suffering from the chemo side effects and of course my health condition was not as good. After the chemo and taking the herbs, I feel fine, not lethargic, good appetite, sweat or perspire easily. The only thing is I have lost about 8 kgs or 17 lbs since the treatment and no-meat diet. But I feel healthy.

But I think that what is more important is to see whether the herbs help prevent the cancer spreads further (if is still there) or help prevent the cancer comes back (if I was “cancer-free” after the chemo treatment). I have consulted other oncologists for second opinion and they said the same thing. I should and should have done the surgery before the chemo drug wore out, which should be within a month or two after the last chemo treatment. If the herbs can prolong a relapse or keep cancer away then the herbs is considered effective. Also, if I, the patient, believe in the herbs and help keep my spirit and hope high, definitely the herbs is considered beneficial. Dr Chris, once we believe that cancer can be cured naturally, then taking herbs therapy is inevitable.

If you were NOT on the herbs — or you have NOT found us — would you have followed the oncologist’s advice and go ahead to have your stomach removed?
Yes. I would have gone for the surgery if the cancerous ulcer was still there. I had already talked to a surgeon before I went to see you.

Even after you have found us, why did you not follow the oncologist’s advice? What made you want to opt for our herbs — knowing that your problem was serious at that time — or you did not consider your situation serious at all?
Although I responded very well to the chemo treatment, I would not think that I was “cured”. I expected my cancerous ulcer was still there and I was facing two options — one is going for the operation, and the other one is taking an alternative treatment. After talking to you, I decided to give it a try on the herbs.

Latest update 19 August 2013: Yes, YM turns up occasionally to collect Cap A, or she sends someone on her behalf. She has put on some weight and looks very well. We saw her a few weeks ago when she brought a friend who has breast cancer.

A Point to Ponder

What do you think YM’s life is like if she was to follow the doctor’s advice and have her stomach removed?

BLOOD BOOSTING INJECTIONs (ESAs) WHILE ON CHEMO ENCOURAGE TUMOUR TO GROW!

Not many MDs, least of all an oncologist, would dare to break ranks from the rules of the medical establishment and especially from the clutches of Big Pharma in the present day cancer industry. One exception is Dr Otis Webb Brawley, MD, and oncologist and the Chief Medical and Scientific Officer and Executive Vice President of the American Cancer Society.

As we were reading the 2011 best seller in America “HOW WE DO HARM” by Dr Brawley, we were shocked to read in Chapters 6 and 7 that Erythropoiesis-Stimulating Agents (ESAs) causes tumour promotion i.e. the anemia-building drugs seemed to be encouraging tumors to grow.

What Are ESAs?

Erythropoiesis-stimulating agents are one of the most common drugs used to treat anemia i.e. these are medication that increase the production of red blood cells. For a brief introduction, go to: http://www.anemia.org/patients/feature-articles/content.php?contentid=000379

The doctor would give you ESA or a blood boosting injection if you do not enough blood after a chemo treatment. They use “the red juice” to fight anemia by stimulating red blood cell production and “the white juice” to fight neutropenia, a deficiency of white blood cells.

If these ESAs or “hemoglobin-building” drugs are supposed to perform a useful function in overall cancer treatment, why then is Dr Brawley so vociferous against these drugs? He even mentioned that “these drugs stimulate cancer growth”

Let us examine some of the reasons:

The FDA approved the drugs for the treatment of anemia in cancer patients in 1993 based on data pooled from only 6 small studies that altogether enrolled a total of only 131 patients (page 76).
The 6 minuscule trials… asked only whether Procrit (one of the ESA drugs) had the ability to prevent blood transfusion. Not a shred of data said anything about “fatigue” or its opposite “strength” (page 77).
There were a lot of unanswered questions such as: was their anemia corrected? Did their underlying cancer recur? Did they die sooner? Did they face a higher risk of blood clots? (page 77).

Soon after hemoglobin-drugs were approved, a German radiation therapist named Michael Henke decided to test one of the fundamental tenets of his subspecialty: that patient with higher hemoglobin levels have better responses to radiation therapy. Henke believed in the connection between hemoglobin and response to radiation. However the study’s results didn’t come out the way Henke expected. The result of Henke’s study, which was initiated in 1997, was published in 2003. The study showed that patients who received the hemoglobin-building drug didn’t live as long as those on placebo. Also, the disease progressed more rapidly in patients receiving the drug. Henke concluded that he had encountered a biological phenomenon: the drug seemed to be encouraging tumors to grow (page 81).

In August 2003, researchers had to stop another study, the Breast Cancer Erythropoietin Survival Trial (BEST), when more women died on Procrit than on the control arm. In both the Henke trial and BEST trial, the survival curve showed an increased risk of death from cancer, which suggested something you don’t want to see in patients you are treating for cancer – tumour growth (page 82).

In other words, pharmaceutical companies were promoting an untested therapy that was supposed to make patients feel better and stronger when, in fact, it caused stroke and heart attacks and in some cases made tumors grow (page 73).

According to Dr Brawley, FDA approved these drugs to reduce the risk of blood transfusion in patients with solid tumours treated with chemotherapy. That’s it. Not a word was said about “tiredness”, not a word about “cancer fatigue”

In Chapter 6, Red Juice and Chapter 7, Tumour Progression, Dr Brawley described how cancer patients are routinely “offered” hemoglobin-building drugs to even borderline anemia, a common side effect of cancer drugs. The drug companies manufactured a medical condition called “cancer fatigue” and nurses were trained to “suggest” “erythropoiesis-stimulating agents (ESA)” to all patients undergoing chemotherapy – “the red juice” to fight anemia by stimulating red blood cell production and “the white juice” to fight neutropenia, a deficiency of white blood cells.

With powerful incentives set in motion, many hospitals and oncology practices in the US instructed nurses to ask leading questions about “fatigue” with the intent of expanding sales to a growing number of patients and upping the dosage to each patient. This is referred to as “an ESA treatment opportunity”
These drugs are still being prescribed routinely. According to Dr Brawley,” these ESA drugs were not used to cure disease or make patients feel better. They are used to make money for doctors and pharmaceutical companies at the expense of patients, insurance companies and taxpayers “(page 97)
Also the disease progressed more rapidly in patients receiving the drug (page 81) i.e. the drug seemed to be encouraging tumors to grow…this compound is a stimulant, a “tumor fertilizer”. A patient with active disease is more likely to suffer tumour progression: the more tumor you have, the more tumor there is to stimulate!! (page 97).

Commenting further on ESA drugs, some doctors didn’t bother to check what the patient’s hemoglobin was and erred on the side of giving the ESA every time they give chemotherapy. Doctors routinely prescribed the drugs for uses in which it had not been studied-such as anemia caused by cancer itself, as opposed to anemia caused by chemotherapy (page 78).

Besides Dr Brawley’s comments in the book, we searched further for sound scientific validation of ESAs causing tumor promotion. These are extracted from prominent sources like the FDA, Journal of Clinical Cancer Research, Annals of Oncology, British Journal of Cancer, PubMed Medline, Journal of Oncology Practice, etc. There are lots more. The following are some of the links you may be interested to read:

1) THE FOOD AND DRUG ADMINISTRATION (FDA) of the US issued a Drug Safety Communication dated 26/2/2010 under the following title: “Erythropoiesis-Stimulating Agents (ESAs): Procrit, Epogen and Aranesp.”

In the article, the FDA warned that cancer patients using ESAs should understand the risks associated with the use of ESAs. These risks include:

ESAs may cause tumors to grow faster.
ESAs may cause some patients to die sooner.
ESAs may cause some patients to develop blood clots, and serious heart problems such as a heart attack, heart failure or stroke.

http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm200297.htm

2) In July 2011, THE AMERICAN ASSOCIATION FOR CANCER RESEARCH, in its journal, Clinical Cancer Research published an article entitled: “The Role of Erythropoietin and Erythropoiesis-Stimulating Agents in Tumor Progression” It reported that:

Erythropoiesis-stimulating agents (ESA) are used clinically for treating cancer-related anemia [chemotherapy-induced anemia (CIA)].
Recent clinical trials have reported increased adverse events and/or reduced survival in ESA-treated cancer patients receiving chemotherapy, potentially related to EPO-induced cancer progression.

http://clincancerres.aacrjournals.org/content/17/20/6373.abstract

3) THE EUROPEAN SOCIETY FOR MEDICAL ONCOLOGY in its journal, Annals of Oncology (2010) published the following guidelines: “Erythropoiesis-stimulating agents in the treatment of anemia in cancer patients: ESMO Clinical Practice Guidelines for use.” The lead author, Professor Schrijvers, although on the Advisory Board of Johnson and Johnson admitted the following:

The influence of ESAs on tumour response and overall survival in anemic cancer patients remains unclear. Several randomized trials have demonstrated decreased survival times and poorer loco-regional control or progression-free survival
Other recent meta-analyses showed that ESAs increase and worsened overall survival when given to cancer patients.

http://annonc.oxfordjournals.org/content/21/suppl_5/v244.full

4) In September 2007, THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY published the following article in its Journal of Oncology Practice: “Erythropoiesis-Stimulating Agents: Continued Challenges” in which:

· The FDA revised both the epoetin alfa and darbepoetin alfa product labels, with new “black box” warnings and expanded information on safety, tumor progression, and survival.

· Additionally, the new warning states that ESAs are not indicated for patients with active malignant disease receiving neither chemotherapy nor radiotherapy.

http://jop.ascopubs.org/content/3/5/248.full

5) In March 2012, THE BRITISH JOURNAL OF CANCER (of the CANCER RESEARCH of UK) published several research studies done on the usage of ESAs and concluded that….”several trials have reported an association between ESA use and increased disease progression and/or mortality” The article is entitled: “Effects of erythropoietin receptors and erythropoiesis-stimulating agents on disease progression in cancer”

http://www.nature.com/bjc/journal/v106/n7/full/bjc201242a.html

In another book, A WORLD WITHOUT CANCER, Dr Margaret Cuomo, a radiologist also stated that… “even drugs used to treat the side effects of chemotherapy have been linked to secondary cancers”. For example, patients who need medication to raise their white blood cell counts may be injected with granulocyte colony stimulating factor (G-CSF), a substance normally found in the blood. Researchers observed that this doubled the risk of developing myelodysplastic syndrome (MDS) or acute myelogenous leukemia (AML)… (page 69)

READ THE FOLLOWING LINKS FOR MORE INFORMATION ON MDS/AML:

1) THE STORY OF ROBIN ROBERTS:

http://abcnews.go.com/Health/robin-roberts-myelodysplastic-syndrome-diagnosis-beat/story?id=16540293#.UZnTWaKLC-U

2) In 2007, THE NATIONAL CANCER INSTITUTE (US) published the following article in its Journal (JNCI J Natl Cancer Inst Volume 99, Issue 3 pp. 196-205).…. “Acute Myeloid Leukemia or Myelodysplastic Syndrome Following Use of Granulocyte Colony-Stimulating Factors during Breast Cancer Adjuvant Chemotherapy” The article concluded that….”the use of G-CSF was associated with a doubling in the risk of subsequent AML or MDS among the population that we studied”……

http://jnci.oxfordjournals.org/content/99/3/196.short

FOOTNOTE: In Malaysia, these ESAs (and G-CSF) are commonly referred to as “booster” or “booster jabs” and are generally given after the 3^rd or 4^th cycle of chemotherapy when the patient’s RBC, WBC, Platelets, Hemoglobin, etc are low. These booster jabs are costly…..and that is why patients are warned not to use cheaper and (safer) methods (because it will clash with the chemo drugs!!)

A POINT TO PONDER UPON:

When a patient decides on chemotherapy treatment, he or she expects to be healed and not to have the cancer spread or suffer second malignancies shortly after completion of the scientifically tested and proven treatments. And to be given ESAs or G-CSFs which later promotes tumour growth isn’t it too much for the patients to bear? Is this a double bonus or a double whammy for the patients? (Please note we have not factored in the damaging side effects of radiotherapy into the above scenario).

We welcome your views.

Liver Cirrhosis & Periampullary Cancer: She Lived 2 years 3 months While on Herbs

The last time I talked to KL (H-596) was on 9 June 2013. She was doing fine. She had just gone to see her doctor on 3 June 2013 and her ultrasound result did not show anything amiss. Her health had not deteriorated either.

Video recorded on 9 June 2013

Ultrasound of Abdomen

25 April 2011 – first visit

3 June 2013 – last visit

1. Liver cirrhosis with portal hypretension

2. Cholelithiasis

3. Dilated CBD, due to distal CBD stones.

1. Liver cirrhosis

2. Dilated CBD and distended gallbladder due to periampullary tumour at the head of pancreas.

The results of her Liver Function Test showed improvements over a period of time after KL was started on our therapy (see Table below).

Parameter	29 Apr 2011	6 May 2011	1 September 2012	3 June 2013
Total bilirubin	143.6	111.4	71.0	41.2
Direct bilirubin	105.1	83.9	36.3	25.0
Alanine transaminase	132	102	60	55
Alkaline phosphatase	171	177	143	192
GGT	147	127	321	217
AST	197	161	96	80
CA 19.9	nil	nil	33.7	21.8

When KL first came to seek our help she was severely jaundiced (yellowing) but over time her biliburin dropped to 41 from 143. Her CA 19.9 had also improved. When she last came on 9 June 2013, KL was her normal self. The only concern we had at that time was she still had jaundice — even though her bilirubin level had decreased substantially.

Another concern was whether the stent which was installed earlier had to be changed. It appeared at that point in time nothing was amiss. I suggested to her family that in the event that there was a blockage, KL had to be brought to the hospital immediately.

It was with sadness to learn that on 14 July 2013, her family members woke up in the morning to find her in a pool of blood. A blood vessel must have ruptured. KL was immediately sent to the hospital but the doctors could not do much. A day later, KL passed away.

KL managed to live a pain-free life for 2 years and 3 months while on our therapy.

Medical History

KL ‘s problems surfaced in April 2011 when she became jaundiced. She went to the hospital and was diagnosed with liver cirrhosis with moderate ascites. Her CBD (common bile duct – see diagram below) was dilated probably due to a lesion. Further investigation revealed presence of multiple stones in the gallbladder and distal CBD.

A biopsy of the Papilla of Vater was performed and indicated villous adenoma with high grade dysplasia, highly suggestive of underlying periampullary tumour at the head of the pancreas.

Subsequently ERCP (endoscopic retrograde of cholangiopancreatography) was done and a by-pass stent was installed. KL was told that surgery to remove the tumour could not be done at this (Penang) hospital. If she wanted to undergo an operation, she could go to a university hospital in Kuala Lumpur.

KL refused surgery and came to seek our help on 29 April 2011.

What You Should Know About Liver Cirrhosis

Cirrhosis is scarring of the liver as a result of continuous, long-term liver damage. Scar tissue replaces healthy tissue in the liver and prevents the liver from working properly.
The damage caused by cirrhosis is permanent and can’t be reversed. Cirrhosis cannot be cured.
Cirrhosis progresses slowly, over many years, gradually causing your liver to stop functioning. http://www.nhs.uk/conditions/cirrhosis/Pages/Introduction.aspx

After heart disease and cancer, cirrhosis is the third most common cause of death in people aged 45-65 years.

http://www.natap.org/2002/Oct/103002_2.htm

Liver cirrhosis is usually far advanced before it is diagnosed.
Medicines do not help regenerate new liver cells.
Causes of liver cirrhosis: alcoholism, chronic hepatitis B/C.
Certain other diseases like nonalcoholic fatty liver disease (NAFLD) and certain medications can cause liver cirrhosis. Autoimmune inflammation of the liver, abnormal levels of iron and copper leading to metabolic disorders, and disorders of the biliary system can lead to liver cirrhosis.
Cirrhosis prognosis is poor.
Life expectancy of patients diagnosed with cirrhosis in the second stage, will be about 6 to 10 years. When cirrhosis of the liver is diagnosed during the last stage, the life expectancy is about 1-3 years.
Lifestyle changes are the cornerstone of the treatment for the disease.

http://www.buzzle.com/articles/cirrhosis-prognosis.html

People with liver cirrhosis may develop complications:

When the liver is heavily scarred, the blood cannot get through the liver at the normal pace due to obstruction presented by the scar tissue, thus creating a higher than normal pressure in the portal vein – the main vein feeding the liver (portal hypertension).
The portal hypertension often causes ascites (accumulation of fluid in the abdominal cavity).
The portal hypertension may lead to the formation of varices. Varices have thin walls and they may rupture and bleed. The two main locations where bleeding is likely to occur are the lower oesophagus /upper stomach and the perianal region. Oesophageal varices are likely to bleed most heavily, and is often difficult to control.
Cirrhosis sometimes may lead to jaundice (yellowing of the whites of the eyes and/or the skin) due to the accumulation of bilirubin in the blood. If the bilirubin is excreted in the urine, the urine may turn dark.
Cirrhosis may also lead to hepatic encephalopathy, which manifests as fatigue or confusion.
People with cirrhosis often bruise easily. The level of platelets in the blood may be lower than normal if the spleen is enlarged.

http://www.hepatitis.org.uk/s-crina/cirrhosis-main-f3.htm

Treatment for Liver Cirrhosis

Although there is no cure for cirrhosis of the liver, there are treatments available that can stop or delay its progress, minimize the damage to liver cells, and reduce complications.The treatment used depends on the cause of cirrhosis of the liver.

For cirrhosis caused by alcohol abuse, the person must stop drinking alcohol to halt the progression of cirrhosis.
If a person has hepatitis, the doctor may prescribe steroids or antiviral drugs to reduce liver cell injury.
For people with cirrhosis caused by autoimmune diseases, Wilson’s disease, or hemochromatosis, the treatment varies.
Medications may be given to control the symptoms of cirrhosis. Edema (fluid retention) and ascites (fluid in the abdomen) are treated, in part, by reducing salt in the diet. Diet and drug therapies can help improve the altered mental function that cirrhosis can cause. Laxatives such as lactulose may be given to help absorb toxins and speed their removal from the intestines.

http://www.webmd.com/digestive-disorders/cirrhosis-liver

What You Should Know About Periampullary Cancer

The Ampulla Vater is a nipple like projection into the duodenum (the first portion of the intestine) into which the pancreatic and bile ducts open. All of the pancreatic and biliary secretion enter the duodenum through the Ampulla Vater.

Blockage of the Ampulla Vater by the tumor leads to obstruction of drainage of the pancreatic and biliary secretions into the intestine. Blockage of drainage of bile into the duodenum leads to the development of jaundice.

Carcinoma of the ampulla of Vater is a rare malignancy.

For patients with unresectable disease, endoscopic stenting to achieve biliary decompression is an appropriate palliative procedure.

Surgical resection with curative intent is the only option for long-term survival.
Pancreaticoduodenectomy is the procedure of choice for patients with resectable disease.
Unfortunately, most patients with carcinoma of the ampulla of Vater die of recurrent disease. Treatment fails in nearly 70% of patients with poor prognostic features, and these patients ultimately die of their disease.
Distant metastasis to the liver, peritoneum, and pleura was the dominant failure pattern after surgery.
Radiotherapy, chemotherapy, and chemoradiotherapy have been tried, but response rates probably are low, and an effect on survival is questionable.

Sae Min Kim et al of the College of Medicine, Korea University, Seoul, Korea (in J. Korean Medical Science, 7:295-303, 1992) reviewed 766 cases of surgically treated periampullary cancers in their paper entitled Surgical Treatment of Periampullary Cancer. They noted the following:

66 percent of patients were in Stage 3
8 percent were in Stage 2
26 percent were in Stage 1
Not all cancers can be resected. Resectability rate was 32 percent.
Mean post-operative complications was 44 percent.
Survival rate at 1, 3, and 5 years in the resected group were 68 percent, 25 percent and 15 percent.
In the non-resectable group, survival rate at 1 and 2 years were 7 percent and 0 percent. Non survived 18 months after treatment.

Source:

http://www.uptodate.com/contents/ampullary-carcinoma-treatment-and-prognosis

http://emedicine.medscape.com/article/282920-overview

http://emedicine.medscape.com/article/276413-treatment

Comments

KL had both liver cirrhosis and a rare cancer called periampullary cancers. Even the doctor in a private hospital here was not able to handle the case, preferring to refer her for surgery at a university hospital in Kuala Lumpur. KL refused further medical treatment.

Take time to ponder on the following:

What could have happen if KL was to undergo surgery? Would her quality of life be better off or would the procedure make life more miserable?
Would surgery extend her life?

Medical doctors in Korea could give us some idea of what could happen. To start with not all such cancer can be resected — even more so with an underlying liver cirrhosis. KL might not be a candidate for surgery at all.

If KL were to undergo surgery, the chances of post-operative complications is very high indeed. So surgery might not be an attractive option for her case.

KL chose to do nothing — just took herbs and changed her diet. She lived another 2 years and 3 months. According to the Korea study above, even with medical treatment (but without surgery) no one survived after 18 months.

So, KL had her blessing and herbs are not “unproven” or hocus pocus like many “educated” experts may want you to believe.

And above all the family did not have to pay through the nose to keep her well until the last day of her life.

Ovarian Cancer 3: Intimidation and Misinformation

Lucy, after recurrence of her ovarian cancer, still insisted on forgoing chemotherapy. She had her reasons for refusing the invasive treatment. She had seen her friend suffering a relapse even after undergoing the treatment . Her father died after two cycles of chemo. It is difficult to convince a person with such experiences to go for chemotherapy! So Lucy came to seek our help and took herbs. She promised to change her lifestyle and diet.

Over a period of a year, I got to see Lucy thrice. Below is our conversation on 2 August 2012 – almost a year after her first visit.

To know her progress, Lucy on her own initiative, went to do an ultrasound. The tumor had shrunk by more than 20 percent. From the original 5.8 cm it decreased to 4.5 cm.
Lucy clarified that last year (2012) before our therapy, she had gone to three doctors and all of them confrimed that the tumour was 5.8 cm in size. All the doctors she consulted with had urged her to undergo chemotherapy, warning that without chemo her condition would deteriorate. Lucy refused chemo and told the doctors that she would go for herbs.
After about a year, in August 2013, Lucy went back to one of the doctors who had treated her and had kept her previous records. He did the USG and the tumour was 4.5 cm in size. Lucy reminded the doctor that originally it was 5.8 cm and that the tunour has shrunk and she was taking herbs not chemo. After hearing that, the doctor warned Lucy that the result of the USG that he had just done was not accurate! He insisted that Lucy go for chemotherapy! Why do you believe in herbs? Lucy replied that it was doing her good, that is why she believe in it.
Unfortunately Lucy was not easily “cowed.” She was brave enough to challenge her doctor. If the result was not accurate why do you charge me RM 70 for doing it? Lucy asked for a print out of the result. The doctor replied, I had deleted it. Is this not shifting the goal post?
Lucy was not ready to give up easily. She has a mind of her own. Lucy immediately went to another doctor and did another USG. The result was the same, 4.5 cm. And she was given the print out of the result without any fuss.
Without doubting the result of her present condition, Lucy told her doctor that all the more she felt she was on the right tract by refusing chemotherapy. Her logic was simple: Why do I have to undergo all the sufferings? This past one year, Lucy was living a problem-free life. She was able to travel everywhere she wanted. She spent time in Shanghai, China. In addition she was able to continue with her teaching job. The only problem she faced is having to wear a sanitary pad everyday due to her discharge.
Lucy asked her doctor if chemo can cure her. The doctor dared not answer that question. This was exactly what happened to professor Michael Gearin-Tosh.

Misinformation

To justify their advice, Lucy was told by her doctors that chemotherapy would kill all the cancer cells in her.

Of course if you are living in your own world oblivious to the progress around you, such advice appears attractive. You would swallow that wholesale! But that idea is now outdated. Read below my short review of the medical literature understand what I mean — chemo DOES NOT and CANNOT kill all the cancer cells.

Lucy was also told that in the event that chemo did not cure her, at least it kept cancer at bay and not spread. This again is not true. This is a recycled argument fed to naive cancer patients. The truth is chemotherapy SPREADS cancer and can even make the cancer more AGGRESSIVE. Read more below.

To be fair to Lucy, we have warned her on the day when she first came to seek our herbs that we could not promise her a cure. After a year, her conditions did not turn any worse. In fact it seems to be encouraging. The turmour shrunk. She started to discharge smelly, rotten “minced-meat” everyday. There must be a reason why this happened after she was on this therapy.

Lucy told her doctor, Don’t worry, I shall you see in six months!

Let’s see if Lucy can repeat the feat of Ella of Melbourne. Ella too had surgery of endometrium cancer and was asked to undergo chemotherapy. She was told by her surgeon, Based on my experience, If you don’t do chemo, you have only three months. If you do chemo you have two and a half years. Ella as of today (almost FIVE years) is still living a healthy and adventurous live. Yesterday, we received a card from her, sent from Pearl Beach in northern Australia. She and her husband took off for some months driving around the country enjoying the wilderness and outback of her beautiful country. (More on this story, https://cancercaremalaysia.com/2012/01/28/cancer-of-the-endometrium-no-chemo-you-live-only-three-months-with-chemo-two-and-a-half-years-with-herbs-she-is-still-having-fun-after-more-than-three-years/)

What You Need to Know About Cancer and Chemotherapy

Is our present-day outdated cancer treatment effective?

Robert Weinberg of MIT and world’s leading authority in cancer biology wrote (in The Biology of Cancer):

Most of the anti-cancer treatment in widespread use today were developed prior to 1975, at the time when the development of therapeutics was not yet informed by the genetic and biochemical mechanisms of cancer pathogenesis.

Heiko Enderling of Center of Cancer System Bioogy, Tufts University School of Medicine, 736 Cambridge St., Boston, MA, wrote:

Standard treatment options share the philosophy of delivering the maximum tolerable dose to inflict maximum gross tumor reduction. When the tumor shrinks below clinical detection complete response or complete remission is declared.
Often the tumor has been eradicated and treatment indeed was successful; in other cases the tumor will grow back more aggressively than the primary tumor, thus worsening patient prognosis.

(http://www.researchgate.net/publication/233396155_Cancer_Stem_Cells_and_Tumor_Dormancy

Karen Weintraub reported in the Boston Globe:

Chemotherapy and other traditional cancer therapies do a great job of shrinking most tumors. But some cancer cells manage to escape and seed new tumor growth — a problem that has vexed scientists for years.

http://www.bostonglobe.com/business/2013/02/17/stemcell/auB8rajwFf3LvAIAdwxtaM/story.html

Heterogeneity: Cancer cells are not the same

Andriy Marusyk and Kornelia Polyak wrote:

Many tumors are composed of mixtures of distinct subclones rather than being monoclonal.
Tumors originate from a single cell. Yet, at the time of clinical diagnosis, the majority of human tumors display startling heterogeneity in many morphological and physiological features, such as expression of cell surface receptors, proliferative and angiogenic potential.
Cancers are not static entities: they start from a genetically normal cell and conclude with billions of malignant cells that have accumulated large numbers of mutations in “driver” and “passenger” genes.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814927/

Cancer scientists led by Dr. John Dick at the Princess Margaret Cancer Centre have found a way to follow single tumour cells and observe their growth over time.

By tracking individual tumour cells, they found that not all cancer cells are equal: only some cancer cells are responsible for keeping the cancer growing.
Within this small subset of propagating cancer cells, some kept the cancer growing for long time periods (up to 500 days of repeated tumour transplantation), while others were transient and stopped within 100 days.
They also discovered a class of propagating cancer cells that could lie dormant before being activated. The dormant cells were not killed by drug treatment and became activated, causing the tumour to grow again.
They found that genetic mutations, regarded by many as the chief suspect driving cancer growth, are only one piece of the puzzle. Biological factors and cell behaviour – not only genes – drive tumour growth, contributing to therapy failure and relapse.

http://vonpurdy-cancerpage.typepad.com/weblog/2012/12/chemo-kills-cancer-cells-but-activates-dormant-cancer-cells.html

For over a century, scientists have known that circulating tumor cells, or CTCs, are shed from tumors and move through the bloodstreams of cancer patients.

Researchers at Stanford University School of Medicine led by Stefanie Jeffrey, MD, professor of surgery and chief of surgical oncology research, took a look at so-called circulating tumor cells one by one, rather than taking the average of many of the cells. These are what they have found:

The cells that slough off from a cancerous tumor into the bloodstream are a genetically diverse bunch. Even within one patient, the tumor cells that make it into circulating blood vary drastically.
Some have genes turned on that give them the potential to lodge themselves in new places, helping a cancer spread between organs.
Others have completely different patterns of gene expression and might be more benign, or less likely to survive in a new tissue.
Some cells may even express genes that could predict their response to a specific therapy.
The diversity means that tumors may contain multiple types of cancer cells that may get into the bloodstream, and a single biopsy from a patient’s tumor doesn’t necessarily reflect all the molecular changes that are driving a cancer forward and helping it spread.
Moreover, different cells may require different therapies.

http://med.stanford.edu/ism/2012/may/jeffrey.html

One reason certain tumors can be hard to eliminate is that they contain a variety of different cells.

http://www.the-scientist.com/?articles.view/articleNo/33640/title/Cancer-More-Diverse-than-Its-Genetics/

Cancer Stem Cell

Nicholas Wade reported in the New York Times:

Many researchers believe that tumor growth is driven by cancerous stem cells that, for reasons not understood, are highly resistant to standard treatment.
Chemotherapy agents may kill off 99 percent of cells in a tumor, but the stem cells that remain can make the cancer recur or spread to other tissues to cause new cancers.
Stem cells, unlike mature cells, can constantly renew themselves and are thought to be the source of cancers.

http://www.nytimes.com/2009/08/14/health/research/14cancer.html?_r=0

Dormant Cancer Cell

Kleffel and Schatton of Harvard Institutes of Medicine, Boston, USA, .wrote:

Increasing evidence suggests that tumor dormancy represents an important mechanism underlying the observed failure of existing therapeutic modalities to fully eradicate cancers.
In addition to its more established role in maintaining minimal residual disease after treatment, dormancy might also critically contribute to early stages of tumor development and the formation of clinically undetectable micrometastatic foci.
There are striking parallels between the concept of tumor dormancy and the cancer stem cell (CSC) theory of tumor propagation.

Joseph Hall reported in the Star:

Researchers at the Princess Margaret Cancer Centre have shown that some of the cells that drive tumour growth hide from common chemotherapy drugs by going “dormant” — reigniting the disease when they awaken after treatments end.
This finding add more depth (and) complexity to why cancers come back, why they recur.

http://www.thestar.com/news/gta/2012/12/13/cancer_cells_hide_by_going_dormant_princess_margaret_study_finds.html

Malgorzata Banys et al from Germany wrote:

Tumor dormancy describes a prolonged quiescent state in which tumor cells are present, but disease progression is not yet clinically apparent.
Breast cancer is especially known for long asymptomatic periods, up to 25 years, with no evidence of the disease, followed by a relapse.
Factors that determine the cell’s decision to enter a dormant state and that control its duration remain unclear.

http://www.dovepress.com/dormancy-in-breast-cancer-peer-reviewed-article-BCTT

Naumoy et al of the Department of Medical Biophysics, University of Western Ontario, Canada, wrote:

Breast cancer is noted for long periods of tumor dormancy and metastases can occur many years after treatment. Adjuvant chemotherapy is used to prevent metastatic recurrence but is not always successful.
Apparently effective chemotherapy may spare non-dividing cancer cells, and these cells may give rise to metastases at a later date. This study has important clinical implications for patients being treated with cytotoxic chemotherapy.

http://www.ncbi.nlm.nih.gov/pubmed/14703067

Chemotherapy SPREADS and MAKES cancer more AGGRESSIVE.

Doctors who treat patients with breast cancer have known that tumors that develop resistance to chemotherapy are also more likely to grow larger and to spread, or metastasize, to other parts of the body.

http://www.mskcc.org/blog/study-links-s-ability-spread-chemotherapy-resistance

Chemotherapy drugs kill by first order kinetics (half life)

First-order kinetics, when applied to the concept of cytotoxicity, means that … a specific dose kills a specific fraction of tumor cells regardless of the population. For example, we could put a person on a course of 3 chemotherapy drugs and kill 99.9% of the cancer cells. This sounds awfully good, doesn’t it? So why isn’t there curing going on all the time? A person that has a disseminated metastatic disease has somewhere in the vicinity of 1 trillion cancer cells (10^12). If one good course of chemotherapy kills off 99.9% of the 1 trillion tumor cells, what’s left? One billion cancer cells left (10^9). Here’s the math:

100% – 99.9% = 0.1%.
0.1% = 0.001
0.001 x 1,000,000,000,000 (1 trillion) = 1,000,000,000 (1 billion)

Historically our problem had been that we had to wait several weeks before the next course of chemotherapy because we were also affecting the normal cells and the person was susceptible to infection and we had to wait for them to recover. In that course of time, since cancer cells grow fast, the tumor would be back up to 10^12 ( 1 trillion) cells before the next course of therapy, which would again, kill 99.9% and they would go back down again. If we keep doing this and can get it down to 10^6 (1 million cells) and hopefully stimulate the person’s immune system to try to fight off the remaining cancer cells, we could get them into remission. That’s the goal. If we could get them down to zero, then we are finally in remission. After 5 years of remission, they would be deemed to be cured. But in reality, that’s not actually true because there have been lots of horror stories of it coming back beyond 5 years later. Why are we only 0.1% away from killing off all the cancer cells? The reason we couldn’t kill all 100%, was because some of the cells were in that dormant G0 phase.

http://antranik.org/chemotherapy-treatment/

Conventional Chemotherapy Can Do More Harm than Good

From the website of Envita Medical Centers. Scottsdale, Arizona (http://www.envita.com/) Let me repeat, it is from a Medical Centre. It has the following message:

Chemotherapy agents will destroy cancer cells temporarily, but it is known that there is a rebound “metastasis effect” that nearly always takes place at the same time. A patient may see an explosive growth of the cancer, months later, which was not visible by imaging before. Those new cancer cells would exist in a micro-dormant phase.
In addition, chemotherapy crushes the patient’s immune system, and can create chemo resistant cancer cells! Typically, a strong immune system would take care of the metastasis, but after conventional chemotherapy a patient’s immune system is so debilitated, it cannot hold them back from growing and spreading.
If you notice in the clinical studies of new chemotherapy drugs, they may extend life in late-stage cancer for up to two or three months at the most. These drugs will create hundreds of millions in sales. However, for most individuals, the cancer will return more resistant and more difficult to treat. So the question is: Did the new blockbuster drug solve the problem? NO.

Ovarian Cancer 2: After Recurrence She Again Refused Chemo. Why?

Lucy was asked to undergo chemotherapy after the cancer had recurred. She again declined and came to seek our help on 7 September 2012. We cautioned Lucy to seriously consider undergoing chemotherapy. After all the cancer had spread and she should not expect much from us. Also, please don’t blame us if things don’t work out the way she wanted!

She was not receptive to chemo. Listen to our conversation that day.

The doctor in the government hospital asked Lucy to undergo chemotherapy immediately. She hesitated and asked for some time to think over it. The doctor also queried why she did not do chemotherapy the previous year after she had the surgery.

Lucy asked the doctor what would happen if she do not want to do the chemo. The doctor said he would not see her again if she declined chemo this time. Next time when it becomes serious, sorry! Don’t come and see me.

In spite of this stern warning, Lucy was adamant and refused chemotherapy. She came to seek our help on 7 September 2012.

Chris: Okay, let me ask you. You have been taking the Sabah Snake Grass – did it help you?

Lucy: If it helped me, I don’t have to come and see you anymore. See, the good of this plant has been published widely in the papers!

C: The problem is just because it is published in the newspapers, you beiieve it all. I never read the newspapers these days.

Surgery did not cure,

Sabah Snake Grass did not cure,

Chemo would not cure,

My herbs would not cure!

Why don’t try chemo then?

Please don’t blame me if things don’t work out the way you want!

This is what I told Lucy:

From my reading, surgery does not cure ovarian cancer. It can recur if you don’t take care properly.
A lady underwent surgery for her cervical cancer and had radiotherapy and chemotherapy. The doctor said she would have a 89 percent chance cure. Barely four months later the cancer recurred in her right lung. (Read more: Cervical Cancer: Eighty-nine Percent Chance of Cure Vanished With the Collapse of Her Right Lung Four Months After Radiotherapy and Chemotherapy, Ovarian Cancer: “After chemo, 99 percent of cancer will be gone!” Do you believe that? How much truth has to be told?)
Chemo does not cure ovarian cancer.
If you take herbs, it is not going to cure you either!
So why not try chemotherapy! Perhaps it may help you temporarily.
If you take my herbs, and if the results did not meet your expectations, you will blame me. And if you face any problem you will blame the herbs.
The reason why I say this is simple. The cancer has already spread rather extensively.
From my experience, nobody in this world can cure cancer! (Cure means cancer is totally gone and will not come back ever again).
I suggested that Lucy go back and think about it.

Lucy was again adamant. She said, Today I come here, of course, I am not going to go for chemo. And of course, I am not going to blame you if something went wrong.

Lucy admitted that before this she had been taking all kind of food. After meeting us, she decided to take care of her diet and change her lifestyle. Yes, this we hope she would do!

Why Do You Not Want to Undergo Chemotherapy?

I did not ask Lucy specifically this question. It was not one year later that I got to meet up with Lucy and learnt the answer to this question.

Lucy had a friend who underwent surgery and then chemotherapy. After the treatment – and after much suffering from the side effects – the cancer came back again. So according to Lucy, why go for chemo if it would not cure? Why go through all these and suffer?

Then probably more relevant was her father’s experience. Lucy’s 60-yer-old father had nose cancer. He underwent radiotherapy and then chemotherapy. After two cycles of chemo, he was not able to withstand the treatment anymore. The family stopped the treatment. One month later, he died.

To this I told Lucy, I understand you.

Comments

Those who do not know anything about chemotherapy could not understand Lucy. If you have a family member or close friend undergoing this treatment, there is no need for anyone to say much. You know the difficulties and agony. I too have not gone through such experience but from my readings, I learnt from other people’s experience to be able to know what it is like. Some told me it was HELL.

The following are information and data obtained from the internet and oncology text books regarding ovarian cancer.

What You Need to Know About Ovarian Cancer

http://emedicine.medscape.com/article/255771-overview#aw2aab6b2b5aa http://www.acancer.net/ovarian_cancer/stage3.php

http://health.nytimes.com/health/guides/disease/ovarian-cancer/chemotherapy.html http://www.webmd.com/ovarian-cancer/features/ovarian-cancer-chemo-options?page=2

http://www.malaysiaoncology.org/article.php?aid=10

Around the world, more than 200,000 women are estimated to develop ovarian cancer every year and about 100,000 die from the disease.
According to the National Cancer Registry, ovarian cancer is the fourth most common cancer among women in Peninsular Malaysia, making up five per cent of all female cancer cases.
Epithelial tumors represent the most common histology (90%) of ovarian tumors. This type of cancer often spreads on the peritoneal surfaces – e.g., undersurface of the diaphragms, paracolic gutters, bladder, surface of the liver, mesentery and serosa of the large and small bowel, omentum, uterus, and para-aortic and pelvic lymph nodes.
Most ovarian cases are diagnosed in an advanced stage and their prognosis is closely related to the stage at diagnosis. Overall, prognosis for advanced-stage patients remains poor. Overall 5-year survival of ovarian cancer is 45 percent.
As I have always told patients – we don’t have to believe this statistics but we also don’t want to bury our heads in the sand and pretend that everything will be okay. We need to know the reality and then try hard to beat the odds.

Treatment:

Currently, the standard treatment for stage 3 ovarian cancer consists of both surgery (surgical debulking) and chemotherapy.
Unfortunately, less than 40% of patients experience long-term survival following standard treatment.
Approximately 60-80% of patients with stage 3 cancer will experience a recurrence of their cancer, even after complete surgical removal of cancer.
Nearly all patients with stage 3 disease have small amounts of undetectable cancer that have spread outside the ovary and were not removed by surgery. These cancer cells cannot be detected with any of the currently available tests and are referred to as micrometastases. The presence of micrometastases causes cancer recurrence.

Chemotherapy for Stage 3 Ovarian Cancer

The chemotherapy drugs used to treat ovarian cancer are fairly standard. Typically doctors combine a platinum-based drug such as carboplatin or cisplatin with a taxane such as paclitaxel (Taxol) or docetaxel (Taxotere).

Perez, C.P. et. al, (in Clinical Oncology, 8^th Edition, Health Science Asia, pg. 489) wrote: The combination of paclitaxel plus a platinum compound is considered by most to be the first-line adjuvant chemotherapeutic regimen in patients with advanced ovarian cancer. The pathologic complete response is only 20 to 26 percent (Table below).

Source: Thigpen, J.T. (in Clinical Oncology Pt.2, 2^nd Ed., Harcourt Asia, pg. 2026)

Ovarian cancers are very sensitive to chemotherapy and often respond well initially. Unfortunately, in most cases, ovarian cancer recurs.
Fewer than 20% of patients treated with a platinum compound and paclitaxel survive without evidence of cancer recurrence 5 years following treatment.
Unfortunately, even in patients who respond, the disease eventually becomes resistant to the first-line drugs, and the cancer returns. Some ovarian tumors are resistant to platinum drugs. Once cancer recurs or continues to progress, the patient may be treated with more chemotherapy.
Despite the development of several new chemotherapy drugs over the past few years, there is no substantial evidence that any of the treatments have increased the number of women cured of ovarian cancer.
Gemcitabine (Gemzar) is also used in combination with carboplatin for women with advanced ovarian cancer that has relapsed. Other drugs include doxorubicin (Adriamycin, Doxil), etoposide (Vepesid), and vinorelbine (Navelbine).

Side Effects of Chemotherapy

Chemotherapy can cause side effects during and after treatment. The type and severity of these side effects depends upon which chemotherapy drugs are used and how they are administered.
The most common side effects are nausea, vomiting, mouth soreness, temporary lowering of the blood counts, and hair loss.

Surveillance After Treatment

At the end of treatment (both surgery and chemotherapy), a patient is considered to have a “complete response” if her physical examination is normal; there is no evidence of cancer on imaging studies (such as a CT scan); and the blood level of the tumor marker like CA-125 is normal.
However, even when all of these criteria are met, microscopic amounts of residual cancer (i.e., not visible on imaging studies) can still be present. Growth of these microscopic tumor cells is probably responsible for tumor recurrence at a later date.
To monitor for the possibility of recurrence, blood tests, physical examinations, and imaging tests are to be done.

Signs of Recurrence

The likelihood of a tumor recurrence is highest in women with more advanced-stage disease at diagnosis, particularly if the initial debulking surgery was unable to remove all visible tumor.
The earliest evidence of recurrent ovarian cancer can be indicated by a rising blood level of one of the tumor markers (CA-125) and symptoms such as abdominal pain or bloating with or without back pain, or presence of pelvic mass.

What Can I Expect After Chemotherapy Treatment?

Surgery plus chemotherapy drugs can get rid of ovarian cancer, but often they can’t keep it away forever.
Surgery and chemotherapy are usually effective in treating the cancer so it will go away for a while, but in most cases the cancer ends up coming back.
Often, the cancer will return within one to two years after treatment is finished. If the cancer does return, another round of chemotherapy is necessary.

Ovarian Cancer 1: Romance with Sabah Snake Grass

Lucy (not real name – H974) is a 52-year-old female. She was diagnosed with ovarian cancer in March 2011 and had undergone a TAH-BSO (Total Abdominal Hysterectomy Bilateral Salpingo Oophorectomy) at a private hospital. The medical report indicated the following:

A huge single right ovarian cyst 15 to 18 cm
Intact capsule
No ascitis, no peritoneal / omentum / liver deposit
Lateral pelvic wall clear
No adhesioin
Left ovary normal
Both fallopian tubes normal
Clear cell carcinoma of right ovary, Stage 1

Lucy was asked to undergo follow up chemotherapy. She declined. She said, I did it my way and went for traditional method. She embarked on taking Sabah Snake Grass (SSG) since much has been said about its goodness in the local mass media. Lucy started with 300 leaves but when she began to have joint pains, she reduced the consumption to 30 leaves each time. Lucy had been taking this fresh herbs for more than a year – from May 2011 until September 2012 (when she came to seek our help).

Recurrence: Extensive spread

In May 2012, Lucy had lower abdominal discomforts and did an USG. The result indicated a possible presence of a mass in the Pouch of Douglas. The echodensity measures 3.3 x 3.6 x 5.2 cm. She went to consult three doctors.

Doctor 1 said there was nothing wrong! No mass.

Doctor 2 said there was something in there but unsure of what it was!

Doctor 3 also said the same – something in there!

Knowing that her cancer had recurred, Lucy started to take the SSG again and this time more seriously at 300 leaves each time.

Eventually Lucy ended up in the government hospital performing a CT and PET scan. The results of the CT scan indicated:

a heterogenous mass – 5.3 x 4.0 x 4.4 cm – at the pelvis suggestive of tumour recurrence.
possible infiltration into the adjacent sigmoid colon and right pelvic nodal metastasis.
enlarge lymph node along the right pelvic – largest 1.9 x 1.1 cm.
the peritoneal soft tissue nodule – 1.4 x 1.2 cm – may represent peritoneal metastasis.

Comment

Sabah Snake Grass (SSG) is not new to me. I know this plant since 1995 when I started CA Care and has been using it as one of the 350 herbs used in our centre. However what is new to me is the idea that only ONE herb is used as if it is a magic bullet. This unfortunately is against the basic principle of herbal therapy. Nevertheless this is what happened when one has a “magic bullet” mentality.

Over the years, I receive emails from people asking for my opinion about this “hot” topic of SSG. See below:

Hi Dr. Chris, recently I read from newspaper regarding Sabah Snake Grass (Clinacanthus) herb which can help in cancer treatment. Do you have any comment on this … for cancer?

Good News!!!
Recently, I met a man who had Lymphatic Cancer – Stage 4 with lymph nodes affected. His cancer started in March 2008.

Affected parts: 1st: Right lung, 2nd: Left lung, 3rd: Groin, 4th: Eye and 5th Mouth.
After 9 chemo therapies he stopped the treatment on 10/11/2008 because 5 specialists said he can only survive for 3 months. Today, after more than 2 years, he has recovered and is still living.

Thanks to the Sabah Snake Grass (Clinacanthus) which he planted outside his house.
He blended the leaves with green apple (minus skin and seeds) and drank them after breakfast every day.

After 3 days, 6 tumours disappeared. After 13 days, he went for a blood test. The oncologist said that he was 96% cured. So far more than 200 people who had taken the herbs showed improvement.

Case 1) Man – age 54, Lung Cancer: 3rd stage.
Chemotherapy 6 times. Tumour before taking Sabah Snake Grass 29mm, 44mm, 76mm. Tumour two weeks after taking Sabah Snake Grass reduced to 20mm, 27mm, 67mm respectively

Case 2) Woman with Uterus cancer – tumour size 6cm
Scheduled for surgery. After taking SSG, reduced to 3.5cm. Doctor said no need to operate. Continue taking the SSG, the tumour disappeared.

Case 3) Man with Prostate Cancer.

After taking SSG for 11 days, the tumour disappeared.

Case 4) Woman from KL, Breast and Lung Cancer

Both breasts removed – 4 stage. Very weak, cannot eat, on drip and lying in hospital. Family member poured SSG juice into her mouth through tube. After a few days, could eat and was discharged. 28 days later was all tumours disappeared.

Case 5) Woman from Taiping with Breast Cancer
After taking SSG for 3 days, the wound dried up.

Case 6) Leukemia Patients
So far 4 cases have been cured after drinking SSG juice. They also drank juice from 3 leaves of Guo Sai Por (Ti Tham Tou) once per week.

This was my reply to the person who wrote me:

Scientists in Thailand have been studying this plant. There is also a company making cream from this plant. I also grow this plant in my garden for many years already. I also use this plant for cancer but not in the way it is being publicised much less getting “instant, magic” results as claimed.

Does the plant really cure cancer like written above? I HOPE IT IS TRUE … but I am not sure and it is very, very difficult for me to believe such stories without clear, hard evidence. Let me say it clearly: I want to believe these stories but I cannot. My training as a scientist just tell me it does not make sense – they are too good to be true. As a scientist, I also find such claims more of a “joke.” Nobody with a scientific mind would be able to swallow such success stories as the way these are written! Let me say it here — I am not saying they are not true but what is questionable is the way the stories were written and presented. I am sorry to say this but I still have to say it. But unfortunately many of us only want to hear what we want to hear, throwing away logic and common sense out the window.

In this video, a lady related her experience with SSG. She had been taking it for over a year and she suffered a recurrence. SSG could not even prevent a recurrence let alone make tumours disappear.

The above patient is not the only one who experienced such failure. I have many others who came with similar failed stories. I have also personally given SSG to a lady with small lumps in her breast. The leaves were harvested from the plants that I grew at home. I asked her to take the juices every day. It did not work. She had to go for chemotherapy.

Let me be clear about this. I am not against anyone taking SSG. By all means take it if that makes you happy or feel good. Take it if you benefit from it. You could be the lucky one. After all you don’t have to sell your house to pay for the herb. So there is nothing much to lose. But if you have problems after taking it, you may want to stop taking it. Some patients told me that they experienced joint pains or muscle cramps and could not walk after taking SGG. Again, this can happen to some people, while others have no problem.

To those of you out there. Let me know if you have any good healing stories about SSG. As a reminder, whenever we want to make any claim of efficacy, we must present our case with a certain degree of credibility. Our story must be substantiated by medical reports, CT scan, blood tests, etc. Let us document such success stories properly so that others would not laugh at us. Shoddy work makes us look cheap! We give others all the reasons to say we are quacks. Let us do our work correctly!

According to the above stories, you need to take SSG for only 3 days, 14 days, 11 days or 28 days and the cancer all disappeared. Wow, Malaysians have “beaten” all American scientists at curing cancer with a magic bullet!

Prostate Cancer: RM 200K treatment that extends life by 3.5 months!

Last week, I read a reports about a new FDA-approved treatment for advanced prostate cancer. The New York Times (17 July 2013) article has this title, New Radiation Therapy Prolongs Prostate Cancer Survival.

A new radiation therapy can extend the lives of men with the most advanced form of prostate cancer, a large new study has found.
Those who were given the drug saw their median survival time increase to nearly 15 months, a “substantial 30 percent improvement,” said Dr. Chris Parker, the lead author of the new study and a consultant clinical oncologist at the Royal Marsden Hospital and the Institute of Cancer Research, both in London.

Another article by Rachael Rettner, Senior Writer of Huffington Post had this headline: Xofigo, Targeted Radiation Treatment, May Help Men With Advanced Prostate Cancer Live Longer.

Wow, read the key words: Live nearly 15 months; 30 percent improvement! Great numbers. You cannot help but conclude that there is another great breakthrough which most patients are waiting for, right?

What is the treatment about?

Xofigo is given as injection into a vein, once a month. It is a radioactive drug that specifically targets tumors in the bone. The new drug, called radium-223 dichloride (marketed as Xofigo), mimics calcium, and binds to parts of the bone that are rapidly dividing — a characteristic of tumor sites. Because the radiation is targeted to the bone tumors, damage to other tissue, including bone marrow, is minimized, the researchers said.

The treatment also had the additional benefit of improving quality of life, such as relief from pain, for some patients.

FDA Approval Given Ahead of Schedule

Xofigo was approved by the US FDA under the priority review program, three months ahead of schedule. Xofigo is for
late-stage (metastatic) castration-resistant prostate cancer that has reached the bones but not other organs, i.e. with no known visceral metastatic disease.

Basis of FDA Approval

FDA experts gave their approved based on the data from ONE human study. It was tested on 809 patients with symptomatic castration-resistant prostate cancer that spread to bones but not other organs.

Patients were randomly selected into one of two groups – the Xofigo group or placebo plus best standard of care group (the second group received nothing, except best standard care).

The main endpoint of the study was overall survival.
Patients given Xofigo lived for an average of 14.9 months.
Patients given Placebo lived for an average of 11.3 months.
Meaning this new drug extended life by about 3.5 months.

The most common side effects of the drug are:

nausea,

diarrhea,

vomiting,

and swelling of the leg, ankle, or foot.

The most common abnormalities detected are:

low levels of red blood cells (anemia), lymphocytes (lymphocytopenia), white blood cells (leukopenia), platelets (thrombocytopenia) and infection-fighting white blood cells (neutropenia).

Comments

Is this really a breakthrough that cancer patients are hoping for?

Like all targeted therapies that came before Xofigo, the price is mind-boggling. A course of treatment, administered over roughly six months in the form of six injections, costs US$69,000 (RM 210,000). Please don’t complain because this is roughly the price tag for present day cancer treatment!

The argument often put forward to cancer patients and their families is that, for someone who is dying what is life worth? An additional time of two to three months is worth that cost? Yes, the doctors and the drug company may want us to think that the extra 3.5 months is worth more than RM 200K! Of course it is worth it if someone is paying for the bill. But if it has to come out from your own hard earned life saving would you think twice? It is not for me to comment on that. You decide whether it is worth it?

Perhaps compared to another treatment, called Sipuleucel-T (Provenge), a prostate cancer vaccine, which costs nearly US$100,000 and extends life by about four months, this new drug is a bargain?

Besides the high cost what about the side effects?

Source: http://well.blogs.nytimes.com/2013/07/17/new-radiation-therapy-prolongs-prostate-cancer-survival/

http://www.huffingtonpost.com/2013/07/18/xofigo-prostate-cancer-drug-targeted-radiation-_n_3617448.html

http://www.medicalnewstoday.com/articles/260692.php

http://www.cancer.org/cancer/news/fda-approves-xofigo-for-advanced-prostate-cancer

HOW WE DO HARM: PART 3: CASE OF PROSTATE CANCER

Shortly after he turned 70, Mr. Ralph De Angelo, a retired department–store manager in the heart of black America, saw a newspaper advertisement that claimed that prostate cancer screening saves lives. The advertisement also mentioned that 95% of men diagnosed with localized disease are cured. (So, was Dr Albert Lim, Malaysia’s leading oncologist who died of prostate cancer on March 8 2013, in the unfortunate 5 % ?)

The following is the tragic story of Mr. De Angelo after his prostate screening and how unnecessary harm can be done to those who go for screening of the prostate, breast, etc. This is a classic example of collateral damage (due to overtreatment) described in the book “HOW WE DO HARM” by Dr Otis Webb Brawley, MD a medical oncologist and Executive Vice President of the American Cancer Society.

In 2005, Mr. De Angelo, after his prostate screening, was diagnosed with prostate cancer, with a PSA reading of 4.3 ng/ml (just 0.3 above is considered normal). He was urged to have a biopsy. Two of the 12 biopsies showed cancer. The Gleason score was 3 plus 3 which is associated with the most commonly diagnosed and most commonly treated form of prostate cancer. There is no way to know whether a patient with this diagnosis will develop metastatic disease or live a normal life unaffected by the disease.

With this uncertainty, Mr. De Angelo was persuaded by his urologist to perform a radical robotic prostatectomy which he (the urologist) thought was the gold standard of care. After the operation, he was told he had a small tumour 5mm by 5mm x 6mm in a moderate size (50cc) prostate. The tumour was all in the right side of the prostate. This means that the tumor didn’t appear highly aggressive under the microscope. Good news? Unfortunately, Ralph realized that he was then incontinent. Three months later, the incontinence was still there and he had to wear pampers continuously. Besides incontinence, Ralph was also impotent and given Viagra.

With a lingering 0.95 ng/ml (even though his prostate has been removed), a radiation oncologist suggested “salvage radiation therapy” to the pelvis. Four weeks into the radiation, Ralph saw blood in his stool. This was due to radiation proctitis, i.e. radiation damage to the rectum. He continued having incontinence, but also developed a burning sensation upon urination. Later, Mr. De Angelo stopped his radiation with one more week to go. For the rectal proctitis, he went to a gastroenterologist, who prescribed steroids in rectal foam that he had to put up his rectum four times a day.

About three weeks after stopping the radiation, Mr. De Angelo realised that whenever he passed gas, some of it came out of his urethra. He also sensed liquid from his rectum soiling his diapers. He was confirmed having a rectal fistula into the bladder…there was a hole between Ralph’s rectum and his bladder. After several urinary infections and when the fistula didn’t seem to be healing, he had to see a GI surgeon. He performed a colostomy to keep stool off the inflamed rectum and the hole into the bladder. The next step was an ureterostomy, a surgery that will bring urine to abdominal wall and collect it in a bag, just like his bowel movements.

In Dec 2009, Mr. De Angelo’s daughter called Dr Brawley to inform that her father had “urinary tract infection” which later progressed to sepsis, a widespread bacterial infection in the blood. On the fifth day of hospitalisation, Ralph passed away (only 4 years from diagnosis). Interestingly…”the death certificate reads that death was caused by a urinary tract infection. It doesn’t mention that the urinary tract infection was due to his prostate-cancer treatment and a radiation-induced fistula….Mr. De Angelo’s death will not be considered a death due to prostate cancer, even though his death was caused by the cure. (We just wonder how the hospital in KL recorded the cause of Dr Albert Lim’s death).

In conclusion, Dr Brawley strongly believed that… “the majority of these men, who are treated with radiation or hormones or both, got no benefit from treatment. They get only the side effects including those that Mr. De Angelo had: proctitis i.e. inflammation and bleeding from the rectum, cystitis, burning sensation on urination and a feeling of urgency, a rectal fistula in which bowels and bladder are connected. The side effects of hormones can be diabetes, cardiac diseases, osteoporosis, and muscle loss.

In the case of Mr. Ralph De Angelo, both the surgeon and the radiation oncologist got paid handsomely. They both likely thought they were doing the right thing. However, Ralph got the side effects, and his quality of life was destroyed (too much collateral damage?).

One parting remark by Dr Otis Webb Brawley which is very relevant to this article:

“Prostate-cancer screening and aggressive treatment may save lives, but it definitely sells adult diapers “

Got the message?

FOOTNOTE:

Dr Albert Lim, Malaysia’s leading oncologist, died on March 8 2013 from prostate cancer, in less than a year after diagnosis. At the time of his death, he had metastasis to the bones and liver (some said his lungs were affected as well). We just wonder whether he died because of the cancer or because of the scientifically tested and evidenced-based cancer treatment.

FURTHER REFERENCES:

If you wish to find out more about prostate cancer, screening and/or prostate cancer treatment, we recommend the following:

1) PROSTATE CANCER HEALED NATURALLY by Dr Chris Teo, PhD. (If you follow the advice in this book, you will not have to suffer the same fate as Mr Ralph De Angelo or Dr Albert Lim) ISBN No. 978-9832590-248

2) A WORLD WITHOUT CANCER by Dr Margaret Cuomo, MD…In Chapter 3, “The Promise and Limits of Cancer Screening” Dr Cuomo quoted:-

NCI’s Dr Barnett Kramer – “PSA testing finds many silent tumours that never would have caused problems had they not been detected”
Dr Richard J. Ablin, PhD, who discovered the PSA said “…it is hardly more effective than a coin toss. Testing should absolutely not be deployed to screen the entire population of men over the age of 50…I never dreamed that my discovery would lead to such a profit-driver public health disaster”. ISBN NO: 978-10609-618858.

3) MORE HARM THAN GOOD by Dr Alan Zelicoff, MD, a physician and physicist. Notes on Prostate Cancer screening/treatment can be found in:

Chapter 5 – Screening out Common Sense
Chapter 6 – News from the Front: The War on Prostate Cancer and Other Cancers. The most notable statement by Dr Alan Zelicoff, MD is found on page 117:-

“…studies to-date involving over 55,000 men with prostate cancer does not validate the hypothesis that early aggressive treatment will save lives. This is very puzzling, no doubt. How is it possible that this treatment has not led to better outcomes?” ISBN NO: 978-0814-400272

(Question: Did Dr Albert Lim opt for early aggressive treatment?)

4) OVER-DIAGNOSED: MAKING PEOPLE SICK IN THE PURSUIT OF HEALTH by Dr H. Gilbert Welch, MD. (Chapter 4 is entitled “We look harder for Prostate Cancer – read how screening made it clear that over-diagnosis exists in cancer. According to Dr Welch, “the decision to use a PSA cutoff of greater than 4 as the threshold for biopsy was purely arbitrary” (Page 50) ISBN NO: 978-0-8070-2199-6

5) SHOULD I BE TESTED FOR CANCER by Dr H Gilbert Welch, MD. (This is Dr Welch’s earlier book – learn what total body scans, mammograms, PSA checks, and other common tests can and can’t do and discover why screening can do more harm than good). ISBN No. 978-0520248-366

6) WHAT YOUR DOCTOR MAY NOT TELL YOU ABOUT PROSTATE CANCER by Dr Glenn J. Babley, MD, Professor of Medicine, Harvard Medical School. (According to Dr Babley, “PSA testing in its present form has not yet been shown to save lives, and its use definitely leads to more procedures and tests, many of which carry risks and side effects…most men die with prostate cancer, rather than from prostate cancer). (page 25) ISBN NO: 978-446690-805

7) THE DEFINITE GUIDE TO PROSTATE CANCER by Dr Aaron E. Katz, MD, Professor of Clinical Urology at Columbia University College of Physicians and Surgeons. (Dr Katz also believes that screening…may cause more harm than good because they can lead to aggressive treatment of disease that might not otherwise cause any harm. Allopathic treatment applied to cure early-stage disease may cause side effects that are worse than the disease itself (page 59). Not all prostate cancers that are diagnosed require medical treatment. (page 62) ISBN NO: 978-1-60961-310-5

8) INVASION OF THE PROSTATE SNATCHERS by Dr Mark Scholz, MD and Dr Ralph Blum, Ph/d. (Read why the risks of prostatectomy may be greater than the threat of the disease (page 43). ISBN NO: 978-159051-5150

9) EARLY DIAGNOSIS AND TREATMENT OF CANCER – PROSTATE edited by Li-Ming Su….Read about Overdiagnosis and Insignificant Cancer:-

There is mounting evidence that a substantial proportion of men with screen-detected prostate cancer would otherwise not have known about the disease during their lifetime in the absence screening (page 20).
Cancer detection does not need to immediately trigger a treatment since men in low-volume and low-grade diseases may also be managed expectantly (page 20).
Most of the previously discussed studies examining watchful waiting as a treatment option come out in favour of watchful waiting…(page 93) ISBN No. 978-1-4160-4575-5

10) DR PETER SCARDINO’S PROSTATE BOOK by Dr Peter Scardino, Chairman of the Department of Surgery at the Memorial Sloan-Kettering Cancer Center. (In Chapter 13, Watchful Waiting, Dr Scardino commented that “…many prostate cancers are so slow-growing, they are unlikely to cause symptoms during the remainder of a man’s natural life…also, all the treatment we currently have for this disease carry a risk of troublesome side effects, so you do not want to have treatment unless you absolutely want it.” (page 251) ISBN No. 978-1583333-938

VIEW THE FOLLOWING LINK FOR DR BRAWLEY’S VIEWS ON PROSTATE CANCER SCREENING: https://www.youtube.com/watch?v=wYvUU9XJDU0

Great minds think alike, and fools seldom differ: Eat anything you like!

Quoted from Never Fear Cancer Again by Raymond Francis, pages 112-113 & 145

Unfortunately, conventional physicians have almost no training in nutrition and biochemistry and give patients advice that makes matters worse. Most oncologists will tell their patients that cancer has nothing to do with nutrition and that it doesn’t matter what they eat.

Typical is the case of Stacy, a forty-eight-year-old cancer patient who was suffering a recurrence of metastasized melanoma. Stacy questioned her physicians about diet. She was told she could eat whatever she wanted. One doctor told her that nutrition had absolutely nothing to do with cancer. He told her to eat whatever made her happy, and he jokingly said he would write her a prescription for ice cream. Like most doctors, he was simply unaware of the critical role nutrition plays in causing disease.

Stacy’s oncologist actually served candy to the cancer patients in his waiting room, oblivious to the fact that sugar drives cancer like gasoline drives fire.

Stacy’s recurrence of melanoma was diagnosed as a “significant metastasis …” She was advised to undergo immediate surgery – she refused. Her oncologist was adamant. He followed her out of the office into the hall saying, “Schedule the surgery now! Schedule the surgery now!” Stacy was sufficiently well informed to know that her metastasized melanoma was a death sentence. Given the grim statistics on that type of cancer, she knew that conventional medicine could not save her. If she wanted to live, Stacy would have to take charge of her own health.

Stacy purchased organic vegetables, juiced them, and took vitamin supplements. Three months after the “significant metastasis” diagnosis, all testing showed her to be cancer free. After her radiologist called her with the good news of her test results, she told him what she had done to rid herself of the cancer. He simply stated “Well, whatever it is you are doing, keep doing it.” He didn’t ask her any questions and was not curious about how she had accomplished this incredible feat.

Seven years later, with no medical treatment, she is still in robust health.

Since Stacy’s original melanoma diagnosis in 2003, four family friends were diagnosed with melanoma. Despite pleading with them to take a more natural approach to healing … they all chose conventional treatment with surgery, chemo, and radiation – they were all dead.

Dairy

When I tell people not to drink milk, they often ask, “Where will I get my calcium?” I inform them that 70 percent of the world’s people do not drink milk. Where do they get their calcium? They get if from plant foods. Green vegetables, such as kale, broccoli and collard greens, are loaded with calcium.

Comments:

Why don’t you ask the cows where they get their calcium from? They only eat grass but only drank their mother’s milk when there were calves … they don’t drink other people’s milk! The only animal species that drink other people’s milk is the Homo sapiens (i.e. human being).

The above story happened in the United States. It also happened in this country … exactly! Perhaps the quotation … great minds think alike, and fools seldom differ … is true?

Quotations from other people