Drug Companies & Doctors: A Story of Corruption

A Review by:  Marcia Angell

Read more: http://www.nybooks.com/articles/2009/01/15/drug-companies-doctorsa-story-of-corruption/

Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial

by Alison Bass Algonquin Books of Chapel Hill, 260 pp., $24.95

Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs

by Melody Petersen Sarah Crichton/Farrar,  Straus and Giroux, 432 pp., $26.00

Shyness: How Normal Behavior Became a Sickness

by Christopher Lane, Yale University Press, 263 pp., $27.50; $18.00 (paper)

Indeed, most doctors take money or gifts from drug companies in one way or another. Many are paid consultants, speakers at company-sponsored meetings, ghost-authors of papers written by drug companies or their agents,4 and ostensible “researchers” whose contribution often consists merely of putting their patients on a drug and transmitting some token information to the company.

Still more doctors are recipients of free meals and other out-and-out gifts. In addition, drug companies subsidize most meetings of professional organizations and most of the continuing medical education needed by doctors to maintain their state licenses.

No one knows the total amount provided by drug companies to physicians, but I estimate from the annual reports of the top nine US drug companies that it comes to tens of billions of dollars a year.

By such means, the pharmaceutical industry has gained enormous control over how doctors evaluate and use its own products. Its extensive ties to physicians, particularly senior faculty at prestigious medical schools, affect the results of research, the way medicine is practiced, and even the definition of what constitutes a disease.

Consider the clinical trials by which drugs are tested in human subjects.5 Before a new drug can enter the market, its manufacturer must sponsor clinical trials to show the Food and Drug Administration that the drug is safe and effective, usually as compared with a placebo or dummy pill.

The results of all the trials (there may be many) are submitted to the FDA, and if one or two trials are positive—that is, they show effectiveness without serious risk—the drug is usually approved, even if all the other trials are negative.

Drugs are approved only for a specified use—for example, to treat lung cancer—and it is illegal for companies to promote them for any other use.

But physicians may prescribe approved drugs “off label”—i.e., without regard to the specified use—and perhaps as many as half of all prescriptions are written for off-label purposes.

After drugs are on the market, companies continue to sponsor clinical trials, sometimes to get FDA approval for additional uses, sometimes to demonstrate an advantage over competitors, and often just as an excuse to get physicians to prescribe such drugs for patients. (Such trials are aptly called “seeding” studies.)

Since drug companies don’t have direct access to human subjects, they need to outsource their clinical trials to medical schools, where researchers use patients from teaching hospitals and clinics, or to private research companies (CROs), which organize office-based physicians to enroll their patients.

Although CROs are usually faster, sponsors often prefer using medical schools, in part because the research is taken more seriously, but mainly because it gives them access to highly influential faculty physicians—referred to by the industry as “thought-leaders” or “key opinion leaders” (KOLs). These are the people who write textbooks and medical journal papers, issue practice guidelines (treatment recommendations), sit on FDA and other governmental advisory panels, head professional societies, and speak at the innumerable meetings and dinners that take place every year to teach clinicians about prescription drugs. Having KOLs … on the payroll is worth every penny spent.

A recent survey found that about two thirds of academic medical centers hold equity interest in companies that sponsor research within the same institution.6 A study of medical school department chairs found that two thirds received departmental income from drug companies and three fifths received personal income.

Because drug companies insist as a condition of providing funding that they be intimately involved in all aspects of the research they sponsor, they can easily introduce bias in order to make their drugs look better and safer than they are.

Before the 1980s, they generally gave faculty investigators total responsibility for the conduct of the work, but now company employees or their agents often design the studies, perform the analysis, write the papers, and decide whether and in what form to publish the results. Sometimes the medical faculty who serve as investigators are little more than hired hands, supplying patients and collecting data according to instructions from the company.

In view of this control and the conflicts of interest that permeate the enterprise, it is not surprising that industry-sponsored trials published in medical journals consistently favor sponsors’ drugs—largely because negative results are not published, positive results are repeatedly published in slightly different forms, and a positive spin is put on even negative results.

The suppression of unfavorable research is the subject of Alison Bass’s engrossing book, Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial. This is the story of how the British drug giant GlaxoSmithKline buried evidence that its top-selling antidepressant, Paxil, was ineffective and possibly harmful to children and adolescents.

Bass, formerly a reporter for the Boston Globe, describes the involvement of three people—a skeptical academic psychiatrist, a morally outraged assistant administrator in Brown University’s department of psychiatry (whose chairman received in 1998 over $500,000 in consulting fees from drug companies, including GlaxoSmithKline), and an indefatigable New York assistant attorney general. They took on GlaxoSmithKline and part of the psychiatry establishment and eventually prevailed against the odds.

Many drugs that are assumed to be effective are probably little better than placebos, but there is no way to know because negative results are hidden.

One clue was provided six years ago by four researchers who, using the Freedom of Information Act, obtained FDA reviews of every placebo-controlled clinical trial submitted for initial approval of the six most widely used antidepressant drugs approved between 1987 and 1999 — Prozac, Paxil, Zoloft, Celexa, Serzone, and Effexor.10 They found that on average, placebos were 80 percent as effective as the drugs.

The difference between drug and placebo was so small that it was unlikely to be of any clinical significance. The results were much the same for all six drugs: all were equally ineffective. But because favorable results were published and unfavorable results buried (in this case, within the FDA), the public and the medical profession believed these drugs were potent antidepressants.

Clinical trials are also biased through designs for research that are chosen to yield favorable results for sponsors. For example, the sponsor’s drug may be compared with another drug administered at a dose so low that the sponsor’s drug looks more powerful. Or a drug that is likely to be used by older people will be tested in young people, so that side effects are less likely to emerge.

A common form of bias stems from the standard practice of comparing a new drug with a placebo, when the relevant question is how it compares with an existing drug.

In short, it is often possible to make clinical trials come out pretty much any way you want.

Conflicts of interest affect more than research. They also directly shape the way medicine is practiced, through their influence on practice guidelines issued by professional and governmental bodies, and through their effects on FDA decisions.

A few examples: in a survey of two hundred expert panels that issued practice guidelines, one third of the panel members acknowledged that they had some financial interest in the drugs they considered.11

In 2004, after the National Cholesterol Education Program called for sharply lowering the desired levels of “bad” cholesterol, it was revealed that eight of nine members of the panel writing the recommendations had financial ties to the makers of cholesterol-lowering drugs.12

Of the 170 contributors to the most recent edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), ninety-five had financial ties to drug companies, including all of the contributors to the sections on mood disorders and schizophrenia.13

Perhaps most important, many members of the standing committees of experts that advise the FDA on drug approvals also have financial ties to the pharmaceutical industry.14

In recent years, drug companies have perfected a new and highly effective method to expand their markets. Instead of promoting drugs to treat diseases, they have begun to promote diseases to fit their drugs.

The strategy is to convince as many people as possible (along with their doctors, of course) that they have medical conditions that require long-term drug treatment. Sometimes called “disease-mongering,” this is a focus of two new books: Melody Petersen’s Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs and Christopher Lane’s Shyness: How Normal Behavior Became a Sickness.

To promote new or exaggerated conditions, companies give them serious-sounding names along with abbreviations. Thus, heartburn is now “gastro-esophageal reflux disease” or GERD; impotence is “erectile dysfunction” or ED; premenstrual tension is “premenstrual dysphoric disorder” or PMMD; and shyness is “social anxiety disorder” (no abbreviation yet).

Note that these are ill-defined chronic conditions that affect essentially normal people, so the market is huge and easily expanded.

Melody Petersen, who was a reporter for The New York Times, has written a broad, convincing indictment of the pharmaceutical industry.16 She lays out in detail the many ways, both legal and illegal, that drug companies can create “blockbusters” (drugs with yearly sales of over a billion dollars) and the essential role that KOLs play.

Her main example is Neurontin, which was initially approved only for a very narrow use—to treat epilepsy when other drugs failed to control seizures. By paying academic experts to put their names on articles extolling Neurontin for other uses—bipolar disease, post-traumatic stress disorder, insomnia, restless legs syndrome, hot flashes, migraines, tension headaches, and more—and by funding conferences at which these uses were promoted, the manufacturer was able to parlay the drug into a blockbuster, with sales of $2.7 billion in 2003.

The following year, in a case covered extensively by Petersen for the Times, Pfizer pleaded guilty to illegal marketing and agreed to pay $430 million to resolve the criminal and civil charges against it. A lot of money, but for Pfizer, it was just the cost of doing business, and well worth it because Neurontin continued to be used like an all-purpose tonic, generating billions of dollars in annual sales.

er their other properties, are sedating, and nearly all of which have potentially serious side effects.

Similar conflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices. It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.

One result of the pervasive bias is that physicians learn to practice a very drug-intensive style of medicine. Even when changes in lifestyle would be more effective, doctors and their patients often believe that for every ailment and discontent there is a drug.

Physicians are also led to believe that the newest, most expensive brand-name drugs are superior to older drugs or generics, even though there is seldom any evidence to that effect because sponsors do not usually compare their drugs with older drugs at equivalent doses.

In addition, physicians, swayed by prestigious medical school faculty, learn to prescribe drugs for off-label uses without good evidence of effectiveness.

It is easy to fault drug companies for this situation, and they certainly deserve a great deal of blame. Most of the big drug companies have settled charges of fraud, off-label marketing, and other offenses.

Physicians, medical schools, and professional organizations have no such excuse, since their only fiduciary responsibility is to patients. The mission of medical schools and teaching hospitals—and what justifies their tax-exempt status—is to educate the next generation of physicians, carry out scientifically important research, and care for the sickest members of society. It is not to enter into lucrative commercial alliances with the pharmaceutical industry.

As reprehensible as many industry practices are, I believe the behavior of much of the medical profession is even more culpable.19 Drug companies are not charities; they expect something in return for the money they spend, and they evidently get it or they wouldn’t keep paying.

So many reforms would be necessary to restore integrity to clinical research and medical practice …. Members of medical school faculties who conduct clinical trials should not accept any payments from drug companies except research support, and that support should have no strings attached, including control by drug companies over the design, interpretation, and publication of research results.

Medical schools and teaching hospitals should rigorously enforce that rule, and should not enter into deals with companies whose products members of their faculty are studying.

Finally, there is seldom a legitimate reason for physicians to accept gifts from drug companies, even small ones, and they should pay for their own meetings and continuing education.

After much unfavorable publicity, medical schools and professional organizations are beginning to talk about controlling conflicts of interest, but so far the response has been tepid. They consistently refer to “potential” conflicts of interest, as though that were different from the real thing, and about disclosing and “managing” them, not about prohibiting them.

But if the medical profession does not put an end to this corruption voluntarily, it will lose the confidence of the public.

Source: http://www.nybooks.com/articles/2009/01/15/drug-companies-doctorsa-story-of-corruption/



Book Review: Leaving No Stone Unturned

“To leave no stone unturned” is an idiom that means to do everything possible to find something or to solve a problem.


The Author: This book is write by Dorit Rishoni-Mandil, artist and author. She lives in Israel with her two sons and her partner. website: www.heal4cancer.com

At age 43,in 2007, Dorit was diagnosed with Stage 2 breast cancer. The doctor assured her that the cancer was likely to be suppressed after surgery, radiotherapy (28 sessions) and six months of chemotherapy. It was not to be. Less than two years after the medical treatments the cancer recurred in her backbone. Dorit underwent surgery and radiotherapy again. And again the cancer came back after three years. She was again treated with radiation. A year later, the cancer recurred for the fourth time — it is now defined as Stage 4. She suffered severe abdominal pain, nausea and severe weight loss.

Perhaps enough is enough? Remember what Albert Einstein said?

Dorit decided to investigate non-conventional ways of dealing with the disease. She said, I find it hard to understand why people turn to alternative medicine so late. If it’s a result of ignorance, then I will now contribute my share to the mass of knowledge. Perhaps it is due to a prejudice that only doctors and drugs can resolve health problems.

Why Did She Write this Book? I wrote this book because I wanted to propagate the fact that it’s possible to live with cancer in full health. January 15, 2017

Dorit decided to know more about alternative treatments for cancer. For three months, day and night, I sat at the computer and read stories of American survivors. I crossed-referenced my information and searched for articles that confirm the effectiveness of the substance they take.

In her face book she posted a notice asking cancer survivors in Israel to share their experiences. She said, In doing so, you will encourage others … In other words, you can help save the lives of cancer victims — perhaps a new one every day! Thus I began my search …. it was not an easy task.

To start with, here are some inspiring words that inspired Dorit.

  • Recovery depends on many factors, including mental factors and the type and severity of the cancer ~
  • You deserve to be healthy. You are blessed beyond your wildest dreams ~ Luoise Hay.
  • We take 100 percent responsibility over our lives, acquiring the power to release and fix things that are stuck in our lives ~ Ho’oponopopo method of healing.
  • Cancer starts from the soul, and that the combination of mental healing and proper nutrition is critical ~
  • Severe emotional events could remove an organ from the right frequency, hindering its optimal functioning. That’s when a disease appears ~ Hamer, New Medicine.
  • If you get cancer, know that you can live with it in harmony for years. Living with cancer in perfect health ~ Gershom Zajicek.

Dorit sought and went on to meet many cancer survivors in Israel. She learned and noted down the methods they used to “win” over cancer. Knowing or reading is of no value if you don’t practise what you know! Dorit practised and tested on herself what she learned from these cancer survivors.  As a result of her strong commitment  Dorit healed herself. She survived beyond her prognosis

In this book, Dorit shared the experiences of her cancer journey. In addition, she documented the healing stories of 28 other people who survived their cancers. They are “heroes” and they are unique in their own ways solving their life’s challenges BUT they showed some basic similarities.

  1. Taking responsibility of your own health. If you don’t help yourself no one can help you. You reap the consequences of your decisions and actions.
  2. Change of diet is essential to your healing. Eating only natural, unprocessed foods and removing sugar from the menu.
  3. Using herbs and dietary supplements – plants have tremendous healing power.
  4. Following your intuition. Use your heart not your head to be constantly attentive to what’s right for me and makes me feel good.
  5. Letting go of repressed emotionseven if it seems everything is fine now, there are some things from my past that I should process, deconstruct, and let go.
  6. Living a full life with cancer. Elevating positive emotions on a daily basis – constantly searching for what I already have, what’s good, what pleases me, and what I’m thankful for. Always acknowledging what’s good in my life.
  7. Getting help – I have learned and still learn every day how important it is to ask people for help and to tell those dearest to me about the path that I chose, in regards to physical aspects and when making decisions about various treatments.


I am glad that Dorit had found the path to her healing. She tried medical treatments thrice — surgery, chemo and radiation. Thrice she failed.

She decided to look at the “other side” (the so call unproven, unscientific, quackery) and Dorit found healing and survived to write this book.

Her path to healing is not easy. She put in her heart and soul to make her well and she was well rewarded. Success does not come to patients who are only interested in easy “handouts” by just sitting under a coconut tree hoping for some magic potions to fall from the sky. Dorit worked hard, day and night with full commitment to find her healing. And she found it. I salute her. I recommend that you read her book. You can get it from amazon.com.

I admired her desire to share what she learned with others. How many of us want to “waste” time doing that? I once told a cancer patient, By sharing and helping others you also cure yourself. From my own experience, by talking with patients and writing their stories, I too benefit and learn to heal my life. It is more blessed to give than to receive!

We started CA Care in 1995 — more than two decades ago. At that time I knew nothing about cancer. I did not even know the difference between radiotherapy and chemotherapy! I started with a blank slate. I read and read. I talked to cancer patients who are really my teachers. With time, I learned a lot and later could write more than a dozen books on the subject. There over 600 articles in our website and almost 900 videos in YouTube. And I have not stopped learning. I am still reading and writing.

The CA Care Therapy which we advocated some twenty-years plus ago benefited many patients.

The core of CA Care Therapy


The journey we went through was very much like Dorit’s journey in Israel.  The language of healing is universally the same, no matter where you are on this planet.

If you are sincere and honest in wanting a find a solution to cancer, you don’t need to be a rocket scientist. You don’t have to go to a medical school. Just read and use your commonsense and you can come up with a near correct answer.

Dorit is a artist. When she had cancer she went through surgery, chemo and radiation which did not cure her. In short, she learned life’s lesson the hard way. After a few months of intense reading, talking and researching she found something to save and prolong her life. And yet for many, they are we still saying that medical treatment is the only answer to cancer! Wake up, please.


He Died Of Lung Cancer — Treated by the Best Oncologist in One of the Best Hospitals in the World

It was 3 a.m. when I finished reading the last page of this 224-page-New York Time #1 Bestseller.

When breath becomes air

The Author: Dr. Paul Kalanithi was an outstanding neurosurgeon with very impressive academic credentials. He graduated from Stanford University with a BA and MA in English literature and a BA in human biology. He earned an MPhil in history and philosophy of science and medicine from the University of Cambridge. Later, he went to Yale School of Medicine where he graduated with a cum laude. Paul then returned to Stanford to complete his residency training in neurosurgery.

To Paul, being a neurosurgeon is a noble calling. You can’t see it as a job, because if it’s a job, it’s one of the worst jobs there is.

Unfortunately, fate has it that Paul did not end up being a full-fledged neurosurgeon. Well into his six-year-residency  he was diagnosed with stage 4 metastatic lung cancer. Less than two years (22 months) after the diagnosis he died — just when he was ready to graduate.

I read this book with a heavy heart — sad that such a brilliant and caring doctor like Paul had to leave so soon.  Lucy — Paul’s wife wrote, When I see the hospital where Paul lived and died as a physician and a patient, I understand that had he lived, he would have made great contributions as a neurosurgeon and neuroscientist. He would have helped countless patients and their families.

Such is the sad, cruel reality about life. Lucy wrote, What happened to Paul was tragic, but he was not a tragedy. True indeed. I always believe for anything that happens, there must be a reason if only we look at the bigger picture.

Salute the Neurosurgeon!

Paul did well in life — he studied literature, history and philosophy before doing medicine. With such academic background he was well prepared to become a caring doctor — a cut above others. Here are some quotations of what Paul wrote in his book:

  • As a resident, my highest ideal was not saving lives — everyone dies eventually — but guiding a patient or family to an understanding of death or illness. Where there’s no place for the scalpel, words are the surgeon’s only tool.
  • Our patients’ lives and identities may be in our hands, yet death always wins. Even if you are perfect, the world isn’t. The secret is to know that the deck is stacked, that you will lose, that your hands or judgment will slip, and yet still struggle to win for your patients.
  • Like my own patients, I had to face my mortality and try to understand what made my life worth living. With limited time, Paul wrote this book. He did not get to finish it.

Prognosis and Statistics

As a neurosurgery resident Paul had operated on brain cancer. After surgery it is the standard practice to send patients for follow up chemo and/or radiation. Here doctors often talk about prognosis with their patients and family members.

This is something Paul wanted us to know. He wrote, By this point, I had learned a couple of basic rules. First, detailed statistics are for research halls, not hospital rooms … Second, it is important to be accurate, but you must always leave some room for hope — Median survival is eleven months or You have 95 percent chance of being dead in two years — I come to believe that it is irresponsible to be more precise than you can be accurate. Those apocryphal doctors who gave specific numbers (The doctor told me I had six months to live): Who were they, I wondered, and who taught them statistics?

Limitation of Science

  • Although I had been raised in a devout Christian family …I, like most scientific types, came to believe in the possibility of material conception of reality, an ultimately scientific worldview that would grant a complete metaphysics, minus outmoded concepts like souls, God, and bearded white men in robes.
  • Scientific methodology is the product of human hands and thus cannot reach some permanent truth. We build scientific theories to organize and manipulate the world, to reduce phenomena into manageable units.
  • Science is based on reproducibility and manufactured objectivity.
  • Science … its inablity to grasp the most central aspects of human life: hope, fear, love, hate, beauty, honor, weakness, striving, suffering, virtue.
  • Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete. 

Stage 4 Lung Cancer

  • At age thirty-six, I had reached the mountaintop; I could see the Promised Land …. then a few weeks later I began having bouts of severe chest pain … my weight began dropping … from 175 to 145 pounds. I developed persistent cough. Little doubt remained.
  • In May 2013, it was confirmed that Paul had a stage 4 non-small cell EGFR-positive lung cancer. At that time he was in his sixth year of residency — one more year to
  • The irony was that Paul had never smoked.

The World’s Best Oncologist

  • The search was on — to find who was the best lung cancer oncologist (USA). Houston and New York had major cancer cancers …The replies came back quickly and more or less unanimously: Emma (also in Stanford) not only was one of the best — a world-renowned oncologist who served as the lung cancer expert on one of the major national cancer advisory boards — but she was also known to be compassionate, someone who knew when to push and when to hold back.
  • On many occasions when consulting Emma, it was clear that this compassionate oncologist did not “dictate things” to her patient. I could hear Emma’s voice again: You have to figure out what’s most important to you.
  • Emma once told Paul: I’m totally happy for us to make your medical plan together; obviously, you’re a doctor, you know what you’re talking about, and it’s your life.
  • At their initial consultation, Paul wanted to discuss the prognosis — possibly how much time left. Emma evaded the question and said, We’re not discussing that.
  • Two months in, Emma remained vague about any prognostication, and every statistics I cited she rebuffed with a reminder to focus on my values.

Temporary Response

Paul had an EGFR-positive tumour. No intravenous chemotherapy was indicated for the moment. He was put on an oral targeted drug called Tarceva.

His cancer responded to the treatment — My lungs, speckled with innumerable tumours before, were clear except for a one-centimetre nodule in the right upper lobe … there had been a clear, dramatic reduction in tumour burden.

Paul regained strength and he returned to work in late 2013, completing his seventh year of residency.

Relapse — Chemotherapy: Too many cooks spoil the broth?

In spring of 2014, the cancer relapsed. The only option left was chemotherapy.  This was what happened after one of his chemo sessions.

  • I began to deteriorate, my diarrhea rapidly worsening … my kidneys began to fail. My mouth became so dry I would not speak or swallow … my serum sodium had reached a near-fatal level. Part of my soft palate and pharynx died from dehydration and peeled out of my mouth … I was transferred to the ICU. I was in pain …. a pantheon of specialists was brought together to help: medical intensivists, nephrologists, gastroenterologists, endocrinologists, infectious disease specialists, neurosurgeons, general oncologists, thoracic oncologists, otolaryngologist …. 
  • I was acutely aware that with this many voices, cacophony (unpleasant mixture of loud sounds) In medicine, this is known as the WICOS problem: Who Is the Captain Of the Ship? The nephrologists disagreed with the ICU doctors, who disagreed with the endocrinologists, who disagreed with the oncologists, who disagreed with the gastroenterologists. I felt the responsibility of my care… tried to corral all the doctors to keep the facts and interpretations straight.

It is hard to tell laymen, like you and me, to take charge of your own health and treatment when you are in the hospital surrounded by all those experts. But yet, that should be the way it should be!

Chemotherapy took a heavy toll on Paul. He wrote: Withered, I could see my bones against my skin, a living X-ray. At home, simply holding my head up was tiring. Lifting a glass of water required both hands. Reading was out of question.

Chemo Failed – He Died

  • Treatment wasn’t an option — not until I regained some strength.
  • Emma, I said, what’s the next step?
  • Get stronger, That’s it.
  • But when the cancer recurs … I mean, the probabilities …. I paused. First-line therapy (Tarceva) had failed. Second-line therapy (chemo) had nearly killed me. Third-line therapy, if I could even get there, made few promises.
  • You have five good years left, she (Emma) said. She pronounced it, but without authoritative tone of an oracle, without any confidence of a true believer. She said it, instead, like a plea… Doctors, it turns out, need hope, too.

Paul did not live to write the closing chapter of his book. It was left to his wife, Lucy, to document his last hours on earth in the Epilogue. Paul died, two months short of two years (on Monday, 9 March  2015) after his diagnosis. He was 37 years old.

  • In the Epilogue Lucy said, Writing this book was a chance for this courageous … (Paul) to teach us to face death with integrity.

To us who is still living, I also say, Let us learn to embrace death with courage and understanding.

Lessons from Paul’s Experience

As I read this book, I learned many things. And I kept thinking and asking. Let me share my thoughts with you.

Family of Doctors

Paul came from a family of doctors. His father, brother, uncle, wife  are all doctors. Paul was not any ordinary doctor. He was trained in one of the best medical schools in the country. When he had cancer, he had the best oncologist in the world to treat him. Few of us would not have that privilege and opportunity. Perhaps we don’t need the best when it comes to cancer? What difference would that make?

Modern medicine had contributed very much to lighten human sufferings. Let no one doubt about that. But when it comes to cancer and its treatment, perhaps we need to take a step backward, pause and explore more.

43 Wrong-battle-wrong-weapons


Yes, many people wrote about the need to rethink the war on cancer, but there are many others who would strongly defend the status quo. Why change? Why look for something else when the present ways serve the Cancer Industry so well?

When my wife and I started CA Care in 1995, to help cancer patients, I knew absolutely nothing about cancer and its treatment. No, I did not go to medical school. I relied on my Ph.D. and my research experience on plants to do what is right for those helpless and hopeless patients. After 20 years of dealing with cancer patients, I can say this to all and sundry. As far as cancer treatment is concerned, there  are other options than just chemo and radiation. Perhaps by taking the non-conventional path, you could live longer, with less suffering and not having to deplete your life’s saving to pay for the medical bills.

I have written numerous studies in these two comic books.


Available at http://bookoncancer.com/productDetail.php?P_Id=75

In Lung Cancer – What Now?  I have documented 12 cases of lung cancers – nine of which are about patients who failed to find the cure that they wanted, in spite of spending hundreds of thousands of ringgit on their medical treatments.

Meaningless shrinkage of tumour by Iressa

1 2

Meaningless shrinkage of tumour by Tarceva


These two cases happened with patients in Jakarta (above) and in Malaysia (below). And this also happened some years later with Dr. Paul in Stanford. What can we learn from such cases?


Available:  http://bookoncancer.com/productDetail.php?P_Id=73

In Lung Cancer – Success Stories, I presented 12 cases of patients who opted for “alternative” treatment for their lung cancer.

Statistics of Lung Cancer Survival

4 5 6 7


Dr. Paul had Tarceva. This drug helped him for about a year. Then the cancer came back again. He then had chemotherapy and died. He survived 22 months after his initial diagnosis. That happened in Stanford under the care of the best oncologist in the world.

Back in Malaysia, there is also a professor who is the best for lung cancer. According to him, most of his patients who were treated in his clinic died after two years.

The same achievement as in Stanford?

If you do the same thing over and over again. You can expect the same results. Is that not what science teaches us? Remember what Henry Ford and Einstein said.

Insanity both

In this story above, mom opted for CA Care Therapy. She declined chemotherapy even though she was told that without chemo she would die within six months. Professor X was surprised how mom had survived for four years without chemo. Is that an achievement or quackery (like many in the medical industry want us to believe)?

Why haven’t you die yet?

89 10 11

CA Care has been around for about 20 years now.  Like Dr. Paul, my wife and I went into this because it was a “calling” — an answer to my prayer. Looking back, we have no regrets. Instead, we feel blessed to be able to help patients who need our help. They come from far and near.





Study finds half of breast cancer patients don’t need chemo

The MINDACT phase 3 clinical trial involved nearly 6,700 women at 111 medical centers in nine countries.

In the clinical trial, researchers sorted breast cancer patients into four groups, based on whether MammaPrint testing or traditional clinical assessment recommended chemotherapy (from a tool that oncologists use called Adjuvant! Online).

The shocking results of the long awaited MINDACT clinical trial are in.

  • Many breast cancer patients have been receiving chemotherapy treatments they didn’t need.
  • And that chemotherapy made no difference in their survival.
  • After surgery to remove their tumors, early-stage breast cancer patients (0-3 positive nodes) with a MammaPrint score recommending against chemotherapy had a 95% survival rate.
  • “That’s very high, and we showed that it doesn’t differ between those who are treated and those who are not treated by chemotherapy,” said van ‘t Veer, leader of the breast oncology program at the University of California, San Francisco Diller Family Cancer Center.

“This study is telling us in a very clear way we can spare many women chemotherapy,” said Baselga, chief medical officer of Memorial Hospital at Memorial Sloan Kettering Cancer Center, in New York City.

  • MammaPrint reduced chemotherapy prescriptions by 46% among the more than 3,300 patients in the trial categorized as having a high risk of breast cancer recurrence based on common clinical and pathological criteria, the researchers said.
  • Further, just over 2,700 patients who had a low MammaPrint risk score but a high clinical risk score wound up with a 94.7 percent five-year survival rate, whether they got chemo or not, the researchers said.
  • “If we can select those patients that don’t need chemotherapy, unneeded treatment can be avoided and we will be one step closer to making sure treatment for breast cancer is tailored to the individual,” said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City.
  • Young women have been more likely to receive chemotherapy in standard breast cancer care, even though it can destroy their fertility and leave them open to long-term health problems, Vogel said.
  • “In my training, if you had a young woman with breast cancer, she got chemotherapy,” Vogel said. “But now we can be selective, and we know there’s a very large number of young women with small hormone-responsive tumors who do not need chemotherapy.”

Read more: http://www.chrisbeatcancer.com/groundbreaking-study-finds-half-of-breast-cancer-patients-dont-need-chemo/





Cancer – what to do next?

In early 1995 Larry Burkett, founder and president of a nonprofit ministry — Christian Financial Concepts, was diagnosed with kidney cancer which had spread to his shoulder blade. Larry had surgery – his right kidney and  left shoulder blade were removed. No radiation or chemo was indicated because these treatments would not be helpful for this type of cancer. Larry ventured into alternative therapies. He lived for 8 years. According to the facebook information, Larry died in mid-2003.  In his book, Hope When It Hurts, Larry shared his cancer experiences and provided many helpful and insightful advices. I learned a lot from him! If you have a chance, take time to read this great book!

Hope when it huerts Larry Burkett

In Chapter 12, Time Out! Larry shared his wisdom, as follows:

When people find themselves in a medical crisis … the result is confusion or what I call “systems overload.” There are people to call, doctors to see, decisions to be made — usually under stress and in a short period of time. Add to that the clouds of emotion and shock.  That’s how I felt, and I needed to take a time-out — just to get away by myself, in a attempt to regain my equilibrium and sort out the impact of what I was facing.

  • Feeling overwhelmed: I felt overwhelmed – I had to make some major decision in a very short period of time, based on a limited amount of information. I knew very little about cancer. Yet, before me stood two highly trained doctors, suggesting that I have my kidney and shoulder blade removed.
  • If I had to do it all over again, I think I would diffuse these feelings by allowing some time to pass before I made any major decisions. I would stand back and say, “Okay, I’ve had this cancer for a while … maybe up to three years or more. What difference would it make if I waited another month? Well, now I know it probably wouldn’t have made any difference.
  • One of the best things any cancer patient could do is to take a time-out, get a medical reference book and read it. I encourage anyone to take the time to thoroughly analyse his or her situation.
  • What, if any, alternative treatments were available for this? You wouldn’t buy an automobile the first time you saw it, so don’t buy an operation the first time you hear of it. Take time to pray about it.
  • The news of a serious illness can throw people into a frantic pace to do things. Emotions become exaggerated. Everything becomes urgent and must be settled immediately — trigger a flurry of activities that tend to minimize, deny or fix the situation. Unfortunately, usually none of our solutions can remedy or change the truth of what we’re really facing.
  • The rush of anxiety: I know people can’t be laughing all the time in the midst of critical health situations, but laughing every once in a while surely can lighten the load, keep things in perspective, and relieve built-up tension. So, I passed the time with one of my favourite activities: watching old movies … and laughed until my sides hurt! But I think laughing helps. We know that it releases endorphins in the body that actually help you to feel better.
  • Rely on others: Many of the decisions I faced were beyond my ability to comprehend. Not only could I not comprehend all the medical data involved in making some decisions, I was not able to concentrate as I normally would. How was I supposed to make a major decision about metastatic kidney cancer when, in fact, I didn’t even know what it was a short time before?
  • So I had to rely on other people. I began by calling friends in medicine and asking their advice …. seek out a second or even third opinion. At the very least buy a good guide to medical terminology.
  • Relinquish matters beyond your control. Don’t worry about things that are beyond your control. Stop worrying about the things you can’t change and concentrate on getting well. I just had to tell myself that over and over again, “Don’t worry about it.” That’s a hard task for someone with my personality, but I had to keep a clear perspective of the things I could control and yield to God the things I couldn’t.
  • Don’t worry about the future. You may be in a situation in which you have several small children and naturally one big concern will always be, How will my children make it without me? Of course that preoccupies your mind because you love them. But God’s not going to abandon them. Will your children face difficulties and sorrows in the time ahead? I’m sure they will. But isn’t that true of life anyway? You can’t spend your time worrying about it because, in the end, you can’t change it. If there is anything within your reasonable ability to do, then do it.
  • Take time to back off. To accommodate the changes taking place with your health, you need to back off and change your priorities. Either you fight change and be miserable, or you can go with the flow an enjoy to the fullest each day God provides. You don’t have to control everything. Take time to face one’s own mortality can really bring the essential issues of life into focus … I resigned as God’s manager of the universe — a position to which I was never appointed anyway.

At CA Care we tell you not to panic after being told that you have cancer. http://www.cacare.com/

CANCER ! Don’t panic !

Haste is from the Devil ~ Arab saying.

Why do you visit this website? We believe you are seeking information to enable you or your loved ones to make certain decisions about his/her cancer. Our advice is: Read as much as possible. Gather information from different sources. Cast your net wider and read what others from different disciplines have to say about the same subject.

Get out of the box and view your problem in a different light. Often, in the face of fear, hopelessness and panic we forget to use our commonsense. Calm down. A decision made in haste or under pressure is never a good decision.

Remember, you don’t get cancer just only yesterday

When helping patients at CA Care, I sometime get a note requesting that I do not tell the patient that he/her has cancer. I am indeed saddened by such attitude but to respect the family’s privacy and wish, I refrained from telling patients the truth! In Chapter 3, Larry wrote about the need to Talk About It.

  • It was not easy for me to tell my family and friends that I had cancer. The counsel I had from some friends was NOT to tell anybody about my health condition. If you have an initial resistance to talking about troubling medical news, you’re not alone. I know what that feels like. But let me encourage you that the healthiest thing to do is to talk out the situation you’re facing with those who are closest to you. There are a number of reasons why:
  • Telling others about your predicament helps you peel back layers of denial. It’s easy to think there’s a mistake with the tests, that it’s all a bad dream, or to rationalize it all away. Talking about it … had a powerful, beneficial impact on me: It helped me to face reality. You can have a thousand different thoughts and intentions floating around in your head, but they never seem to become reality unless your vocalize the thoughts. Obviously you can overdo discussion, and some people dwell so much on their problems that’s all they ever want to talk about. I think it’s one thing to talk about your problems and to be honest with people, but it’s quite another thing to make that the centre of all your conversation for the rest of your life.
  • Problems can multiply exponentially if we ignore reality. For instance, it’s not unusual for people to ignore symptoms of poor health — blood in urine, rectal bleeding, etc — hoping that the problems will go away. And rather than talk to their doctors or even their families about the symptoms, a mental wall of denial is constructed, leaving a smoldering fire to erupt into a huge, perhaps life-threatening inferno.
  • If you talk about your health, your family and friends also will feel free to talk about it.. If you clam up, deny it, or act like nothing is wrong, it’s likely others will too.
  • I think sometimes people hold back from talking about the prospect of dying, believing that if they talk about dying, it might make it happen; or if they don’t talk about it, that might prevent it from happening.
  • Pretending that nothing is wrong will not make your circumstances change.
  • I don’t what to talk about cancer. I don’t have cancer. I choose to deny it. I rather suspect that a great many people who have done that in the past have died of their illnesses when, in fact, God had a cure that would have worked for them.
  • When you talk about your real needs, others may know how to help you. I’ve seen people sit around and sulk … because they have needs that are being overlooked. Even though they are desperately lonely or afraid, their pride confines them to silence, thus cutting off the very help they need. Often overtime they become bitter and resentful because their needs are not being met. It that sounds childish, it is. That’s just the way little children act.   
  • If you know what your needs are, then say so. Even if you don’t know what your needs are, voice the fact that you are hurting. That’s why God put other people in the world — to be able to help you when you aren’t functioning at 100 percent.
  • Talking encourages honesty with yourself, with your family and with God. From that day forward, I have tried, to the best of my ability, to be totally honest with everybody …. My goal has been .. “What you see is what you get,” rather than “What you hear is different from who he is.” Talking with others about your situation breeds honesty and I would encourage you to be honest about your thoughts and feelings.
  • One piece of advice I would give anyone: Open up, share with your family and let them help. Make them insiders to what is going on. Don’t make them outsiders. They’ll feel a lot more comfortable, they’ll understand better, and they’ll be there to help.
  • We helped one another to be strong. When one of us got down, others could comfort, console, encourage and pray. The ability to talk openly was the key that allowed us to minister to one another.

Read more:

Larry Burkett’s Cancer Experience: The Undemocratic and Monopolistic  American Medical System for Cancer Treatment

Looking at Cancer From a Christian Perspective by Larry Burkett




Why the ‘Best’ Conventional Cancer Treatment Will Never Cure You from Cancer

Posted by: A Von Butz in Cancer 101Treatments/Healing

Chemotherapy Doesn’t Cure Cancer − It Causes It!

By pumping patients full of toxic chemicals, it was believed, cancer tumors wouldn’t stand a chance at survival. And for some types of cancer, it appeared as though this hypothesis was correct − at least to an extent, and in the short-term. Chemotherapy does, in fact, kill cancer cells. But it also kills healthy cells, along with a patient’s immune system and, really, anything else that crosses its path.

Truth be told, chemotherapy … damages human DNA. And damaged DNA is a leading cause of cancer, as per the “mutational theory” of cancer that is widely accepted among scientists as the impetus behind cancer’s emergence and spread.

What this means is that when chemotherapy is introduced into a person’s body, it causes mutational changes to occur at the cellular level that actually promote the growth and spread of malignant cancer cells. Unlike the various selectively cytotoxic anti-cancer compounds found naturally in certain herbs and plants, non-selectively cytotoxic chemotherapy chemicals destroy both good and bad cells leaving aggressive cancer cells behind and leaving patients prone to more cancer.

Most popular chemotherapeutic drugs currently on the market are classified by the World Health Organization (WHO) as human carcinogens illustrates the backwards nature of conventional cancer treatment. Tamoxifen, for instance, one of the leading chemotherapy drugs used in the treatment of breast cancer, not only causes more cancer (along with more than 24 other deadly side effects), it is also often ineffective.

Radiation is Equally Ineffective as a Cancer Treatment

The same is true for radiation treatments, which are increasingly being shown to trigger secondary cancers in patients within years after administration. Let’s use breast cancer as an example. Women who opt for radiotherapy often end up developing more serious cancers like cancer of the lungs later on down the road. This is due to the fact that irradiating breast tissue induces cancer-causing DNA damage at the cellular level.

When a breast tumor is exposed to radiation, the cells within that tumor are not uniform, but have great heterogeneity,” writes Sayer Ji of GreenMedInfo about the intricacies of how cancer tumors work, and the failure of currently accepted cancer medicine to properly address them.

Some of the cells are fast-replicating, whereas some are slow-replicating and benign. Some cells are older, technically senescent, and by their very existence are keeping neighboring cells within the tumor and with great potential for malignancy from breaking out into invasive growth.”

In other words, the idea that simply blasting an area of tissue with radiation in the hopes of eradicating all malignant cells and curing cancer is exceptionally short-sighted. Cancer cells are smarter than both radiation and chemotherapy. They tend to find other ways of surviving and growing stronger when targeted with poisonous therapies that destroy the body’s own natural line of defense against cancer − the immune system.

This is why we rarely hear about patients actually being cured from cancer when opting for chemotherapy and radiation. At best, these treatments might help extend a person’s lifespan by a few weeks, months, and sometimes years − albeit with serious side effects and greatly reduced quality of life. At worst, such treatments kill patients more quickly than if they had chosen not to undergo them at all.

There’s No Money in Cancer Prevention, Only Cancer Treatment

So why do oncologists continue prescribing chemotherapy drugs like tamoxifen and deadly radiation treatments to their patients? Because these are the only cancer treatment methods accepted and endorsed by the federal power structure as legitimate cancer medicine. Even though evidence continues to mount showing their ineffectiveness.

Ever since former president Richard Nixon declared a national “War on Cancer” in 1971, very little progress has been made in actually curing cancer − and this is no accident. The primary focus has remained on how to capitalize on cancer rather than cure it. Hence the reason why the general public has been offered only drugs and radiation as opposed to curative protocols centered around therapeutic nutrition and lifestyle changes.

As many as 90% of all cancer-related deaths have nothing whatsoever to do with cancer − that’s right, 90 percent! Cancer-related deaths are a product of cancer treatments killing patients over time through the destruction of immunity and a failed “management” system that gives patients a false hope of survival, all while enriching the drug industry.

“The focus is on fine-tuning drugs rather than investigating how cancer functions,” maintains physician and cancer expert Dr. Josh Axe. “The most narrow focus is rewarded rather than a systemic view; cooperation and collaboration are absent and there is too much emphasis on some magic bullet of a cure (pharmaceutical drugs) rather than prevention.”

There’s no money to be made in prescribing prevention advice like eating fewer chemicals and exercising more. The “bread and butter” of the cancer industry is unleashing the next, latest-and-greatest cancer drug. Not telling you how to avoid cancer in the first place.

This is why it’s up to you to take matters into your own hands, rather than rely on a failed corporate system that’s more concerned with making money than with keeping you and your loved ones healthy and cancer-free.

Read more:  http://thetruthaboutcancer.com/conventional-cancer-treatment-never-cure-cancer/






Do you know the right questions to ask?
This free guide could save your life.


In 2003, I was diagnosed with stage III colon cancer.
I was 26 years old, and clueless about cancer treatment.

The first oncologist I saw didn’t tell me the risks, lied to me about the success rate, and told me I was “INSANE” if I didn’t do what he recommended.

I was afraid that I had no other options, but my wife and I accidentally asked two questions that in hindsight helped save my life….

In the last 12 years, I’ve talked with hundreds of cancer patients. Many reach out to me after treatments have failed them, worse off than when they started, and wishing they had taken the time to read and research before blindly following their doctors advice.

Here’s what I’ve learned.

Most cancer patients have NO IDEA what they are geting into

They have no idea how effective the treatments will be. They have no idea what the real risks are. They have no idea how much suffering is involved. They have no idea about the long-term damage the treatments will inflict on their body…

Patients are often mislead and misinformed, and told they have no other options

Doctors aren’t telling patients everything they need to know, and patients don’t know the right questions to ask. Like I said, my wife and I accidentally asked two questions that helped save my life.

You need the truth, the whole truth, and nothing but the truth

The truth is your compass. With it, you can make an informed decision, and chart your course of treatment with confidence.

Without the truth, you are like a ship lost at sea, hoping and praying you’re headed in the right direction… Sadly, this is the position that many cancer patients find themselves in, because they didn’t ask the right questions in the beginning.

This free guide will arm you with POWERFUL questions that cut straight to the truth

20 Questions For Your Oncologist is a compilation of essential questions submitted by doctors, survivors, patients and their loved ones. The guide includes a 1-hour audio program, a transcript to follow along and take notes, and a printable question list.

Your next steps could be critical to your survival, or the survival of someone you care about. Don’t let fear, uncertainty and helplessness influence the decision-making process. Get the guide.

To your life and health,

Click here: http://www.chrisbeatcancer.com/20-questions-for-your-oncologist


Why do cancer drugs get such an easy ride?

BMJ 2015350 doi: http://dx.doi.org/10.1136/bmj.h2068 (Published 23 April 2015)Cite this as: BMJ 2015;350:h2068

Donald W Light, professor and Joel Lexchin, professor 

Rushed approvals result in a poor deal for both patients and cancer research

Unlike most other diseases, cancer instils a special fear and “is treated as an evil, invincible predator, not just a disease.”

The ability of drug companies to charge very high prices, even when most approved cancer drugs provide little gain for patients, drives much of the research, as desperate patients lead some governments and private insurers to pay whatever companies charge.

Officials within the US Food and Drug Administration are enthusiastic about new cancer drugs. Richard Pazdur, who oversees oncology activities for the FDA says that new cancer drugs are so effective that “We don’t have a lot of questions on [these] drugs because they’re slam dunks. It’s not if we’re going to approve them. It’s how fast we’re going to approve them.”

The methodological weaknesses in oncology trials do not support such enthusiasm.

Trials for cancer drugs were 2.8 times more likely not to be randomised, 2.6 times more likely not to use a comparator (single arm), ….

and to READ MORE ….. Article access for 1 day: Purchase this article for £23 $37 €30 * http://www.bmj.com/content/350/bmj.h2068

If you don’t have the money to pay for a one day access to this article, try “googling” the subject matter, and with some luck you get a “free ride” and enjoy comments from various sources.

From http://www.sciencedaily.com/releases/2015/05/150507135917.htm: Highly priced cancer drugs get rushed approvals despite poor trial methodology and little effect on the longevity of patients, cautions York University Professor Dr. Joel Lexchin in the School of Health Policy and Management.

“Patients and their doctors should demand that regulators require pharma companies to provide clear evidence of clinical effectiveness of the drugs, resulting from rigorous methodology,” suggests Lexchin. “Drug agencies like the Food and Drug Administration (FDA) and the European Medicine Agency (EMA) don’t actually look at whether people live longer.”

In an article in the British Medical Journal, titled “Why do cancer drugs get such an easy ride?,” Lexchiin and co-author Donald Light, a professor in the School of Osteopathic Medicine, Rowan University in New Jersey, note that accelerated approval and shortened review times also make it a smooth sail for cancer drugs.

Lexchin cites earlier research reviewing solid cancer drugs within 10 years of EMA approval to point out that these drugs improved survival by just over a month.

“Similarly 71 drugs approved by the FDA from 2002 to 2014 for solid tumours have resulted in median gains in progression-free and overall survival of only 2.5 and 2.1 months, respectively,” he says adding, “Also, only 42 per cent met the American Society of Clinical Oncology Cancer Research Committee’s criteria for meaningful results for patients.”

From: http://www.yourhealthbase.com/ihn260.pdf: How Effective Are Newer Chemotherapy Drugs?

  • An editorial in the April 23, 2015 British Medical Journal examined the recent accelerated drug approval process for cancer drugs in both the US and Europe. The subtitle was “Rushed approvals result in a poor deal for both patients and cancer research.”
  • This editorial contains some extremely disturbing statistics and information the authors obtained from reviewing the chemotherapy clinical study literature and other papers over the last 8 to 10 years.
  • Between 2007 and 2010, … almost 9000 oncology clinical drug trials were compared with trials for other diseases, the former were 2.6 times more likely not to use a comparator and 1.8 time more likely not be blinded (open to bias from the investigators) … this undermine the validity of the outcomes, it also reflect what regulators will allow. (In lay man language this means bad research. And the regulators — FDA, allows that!).
  • The European Medicine Agency … found that new oncology drugs improved survival by a mean of 1.5 months and a median of 1.2 months.
  • The 71 drugs approved by the US FDA from 2002 to 2014 for solid tumors have resulted in median gains in progression-free survival of 2.5 months and overall survival of 2.1 months. (Pay thousands of ringgit plus suffer side effects and you live 2.5 months longer? Not cured? As you told about this before you started paying though your nose?).
  • Post-marketing changes in the package insert (so-called label) were substantially greater for oncology drugs given priority approval as compared to those going through the much longer standard process, which the authors suggest reflects deficiencies in the accelerated review process. (In layman language it means, quicky, sloppy job — a rush to make quick bucks?)
  • Both the European and US regulators allow companies to test cancer drugs using a surrogate endpoint rather than survival or other more patient-centered outcomes. Tumor size is given as an example of an unreliable endpoint since it is highly variable in predicting overall survival. (In layman language the measure of trial outcome is not reliable. Just making the size of tumor smaller — or tumour shrinkage — may not mean anything. Surely it does not mean the cancer is cured! So, the measure of effectiveness is faulty).
  • In 2013, two peer-reviewed papers appeared where a total of over 100 oncologists protested against the high prices being charged for cancer drugs when 11 out of 12 approved in 2012 provided only small benefits for patients. (Do you realize that chemo drugs are getting more expensive …the prices of the newer drugs are beyond our imagination. But are they effective? Yes, make you live longer by 2 or 3 months????? But patients want a CURE)
  • The authors term the approval process an “Easy Ride” and suggest that this serves both patients and research badly.
  • It can also be argued that the majority of cancer drug development research currently leading to new drug approval is bogged down in merely getting more ineffective drugs approved in the hope that marginal improvements in survival will lead to enhanced profits. (The root of this evil is greed! They go after your cancer or after your money?)
  • … generally priced so high that the choice is between bankruptcy or declining treatment except for the wealthy.
  • The results discussed above are consistent with those presented in 2004 by Morgan et al14. Based on reports from Australia between 1992 and 1997, the contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was 2.3% whereas in the US it was 2.1%. These results suggest that over this period in these two countries chemotherapy made little contribution to cancer survival. (Yes, they tell you … chemo will give 60% chance, 99% chance, bla, bla …the Australian showed chemo is only 2 or 3% effective).
  • Furthermore, not much appears to haves changed between 1992 and 2014 from the patient’s perspective. It is important to note that we are talking about cancers that involve solid tumors. (Why change or improve? As it is – the drug companies are happy, hospitals and doctors are happy! And patients believe and trust them!)
  • BOTTOM LINE: When offered one of the new “wonder” chemotherapeutic drugs, it is important to ascertain the actual expected life extension in order to weigh this against the side effects. Trivial life extensions are sufficient to gain regulatory approval and allow patients to be told the treatment will extend their life. Unless carefully qualified, such an approach appears unethical.



More on the Questionable Value of Chemotherapy for Terminally Ill Patients

Let us look at more research articles on this often neglected subject of treatment for near death patients.

The effect on survival of continuing chemotherapy to near death

Akiko M Saito, Mary Beth Landrum, Bridget A Neville, John Z Ayanian and Craig C Earle

BMC Palliative Care 2011, 10:14   http://www.biomedcentral.com/1472-684X/10/14

  • Overuse of anti-cancer therapy is an important quality-of-care issue. An aggressive approach to treatment can have negative effects on quality of life and cost, but its effect on survival is not well-defined.
  • We have previously shown that the aggressive use of chemotherapy in patients who are close to death has been increasing over time.
  • In fact, aggressive approach to treatment during the last week of life is linked to psychological and physical distress for advanced cancer patients.
  • Other studies have also shown that chemotherapy use during near death irrespective of the cancer’s responsiveness to therapy has been associated with potentially negative effects, including higher numbers of emergency room (ER) visits, hospitalizations, and admissions to the intensive care unit (ICU), and less hospice service. These results beg the question of whether aggressive care leads to improved outcomes.
  • Using the Surveillance, Epidemiology, and End Results-Medicare database, we identified 7,879 Medicare-enrolled patients aged 65 or older who died after having survived at least 3 months after diagnosis of advanced non-small cell lung cancer (NSCLC) between 1991 and 1999.
  • Receipt of chemotherapy was associated with a 2-month improvement in overall survival. However, based on three different statistical approaches, no additional survival benefit was evident from continuing chemotherapy within 14 days of death.
  • Conclusions: 1. We could not detect a benefit in survival from continuing chemotherapy close to death. Continuing chemotherapy for advanced NSCLC until very near death is associated with a decreased likelihood of receiving hospice care but not prolonged survival.
  • Conclusion 2. Oncologists should strive to discontinue chemotherapy as death approaches and encourage patients to enroll in hospice for better end-of-life palliative care.

Losing “Losing the Battle With Cancer”

Lee M. Ellis, MD; Charles D. Blanke, MD; Nancy Roach

JAMA Oncol. 2015;1(1):13-14.  http://oncology.jamanetwork.com/article.aspx?articleid=2108855

  • Patients with cancer lose many things of importance. As soon as they hear the words “you have cancer,” they lose control over their lives, as medical appointments immediately begin to shape their daily schedules.
  • They may lose the ability to participate in activities that bring them joy, as a result of chronic treatment adverse effects such as neuropathy, bowel issues, or lymphedema.
  • Too many lose their lives.
  • We also commonly hear the statement that a patient has lost “his or her battle” with cancer.
  • Since President Nixon declared a “War on Cancer” back in 1971, many have used some variant of the term battling cancerin describing all sorts of oncologic treatment, from undergoing locoregional therapies such as surgery and/or radiation therapy, to seeking systemic chemotherapies or biologic therapies, and even pursuing alternative regimens.
  • This is particularly common in advertising campaigns for hospitals or oncology programs. Almost daily we experience some written or broadcast news story on a patient wholost his or her battle with cancer.
  • However, we wish to revisit this topic because there is the need to explain that receiving a diagnosis of cancer should not deny anyone their dignity; no one with cancer should be considered a “loser” in any way during the course of neoplastic disease, including those patients who die of their cancer or effects of their therapy.
  • Using the battle metaphor implies that if a patient fights hard enough, smart enough, and/or long enough, he or she will be able to win the war.
  • Unfortunately, and with rare exceptions, patients with metastatic cancer cannot conquer cancer (win the “war”) no matter how hard they fight. We have far too few effective curative treatments and interventions.
  • We can celebrate occasional long-term survivors, but for the most part, we do not know why one person is alive 15 years after the diagnosis of advanced cancer, whereas another dies 9 months after the diagnosis.
  • Patients with “curable” disease are cured because treatment eradicates every last cell, not because the patient did or did not somehow fight valiantly.
  • Once someone receives a cancer diagnosis, especially advanced-stage disease, a journey begins; sometimes the journey requires patience, tolerance, and courage, but at some point, most patients with advanced disease end that journey with loss of life.
  • Although this difficult and tumultuous journey may have come to an end, dying should not be viewed as being defeated in some kind of skirmish.
  • Many patients themselves adopt the battle metaphor when they receive the diagnosis. If one needs to assume a warlike attitude to face the challenges of cancer, so be it; anything goes in helping a patient (and his or her family) cope during this journey.
  • We have all had the experience of patients stating (paraphrased) “I want curative treatment, not palliative treatment, because I’m going to beat this thing.” The litany of imaging, appointments, examinations, blood sampling, pills, infusions, surgery, and radiation treatments can make a patient feel as if he or she has been in a fight.
  • However, thinking about it from a different perspective, the use of the battle metaphor implies a level of control that patients simply do not have.
  • When we talk about the “battle,” we minimize the real issues faced by patients every day. Patientsdeal with and sometimes overcome nausea, pain, fatigue, and weight loss. They suffer the isolation that comes with a diagnosis.
  • For those with potential curative disease, theylive with the fear of recurrence and impact of chronic adverse effects.
  • Unless you have been in their shoes, it is often hard to imagine the challenges faced every day by our patients, and we oftentimes do not fully credit patients for their persistence and resilience in their journey.
  • Let us recognize them for all the challenges that they overcame in their journey. Let us not declare themlosers at the end of this journey.
  • Similarly, the continuous urge to win the battle extends to oncologists, who actively treat patients for too long. The fact is that 8% of patients receive chemotherapy within 2 weeks of dying of cancer, and 62% within 2 months.
  • Late chemotherapy is associated with decreased use of hospice, greater use of emergency interventions (including resuscitation), and increased risk of dying in an intensive care unit vs at home.This all clearly reflects our society’s need to battle until the end.
  • But let us take a closer look at this mentality. Most of our therapies are toxic: they cause depression of the immune system, fatigue, rash, nausea, vomiting, neuropathy, and so forth. In addition, in today’s insurance landscape, many of our therapies can lead to financial toxicity.
  • Patients are willing to deal with these adverse effects as a trade-off for “hope”— but are we honest with them about the true potential benefit of the treatment?
  • For many therapies, there is little evidence that life is substantially prolonged.
  • We have seen patients who are determined to win their battle. As they turn from treatment to treatment, they are not spending time with loved ones; rather, they are chasing the illusive “win,” a path that affects not only them but also their family and caregivers, as well as family finances.
  • There are patients who face their mortality with clear eyes and, yes, courage. They make choices and can opt to die on their own terms: they can choose to die without a drug-induced rash, diarrhea, or fatigue.
  • They may also choose to spend their remaining time doing what they wish, without an intravenous line or infusion port.
  • They may choose not to be confined to weekly infusions and repeated blood sampling and imaging.
  • Or did she choose to control how she spent her final days? We would venture to say that she made an informed, reasoned decision to say “no more”—no more pain, no more marginal treatment, no more treatment-induced adverse effects: no more!
  • Of course, the choice to end one’s treatment and even one’s life … belongs with the patient. The patient’s decision is informed by their health, their family, their belief system, and, from a pragmatic point of view, their location.
  • We firmly believe that health care professionals owe their patients the difficult and honest discussions that come as patients grapple with their mortality.
  • We also believe that patients’ decisions should be honored and supported by their health care team.
  • Let us respect patients who are already suffering from the effects of cancer and cancer-related therapy.
  • Stuart Scott died of cancer at the age of 49 — seven years after his initial diagnosis and aggressive therapy. In July 2014, in the midst of enduring his cancer and therapy, Mr. Scott told the audience, “When you die, it does not mean that you lose to cancer. You beat cancer by how you live, why you live, and in the manner in which you live.”
  • We will all die one day; perhaps the winner … the person who does it under his or her own terms; the person who dies peacefully and not at war. 

Our last words …

Indeed the above are well-written articles by doctors and scientists. Of course, the world view is that if you have cancer, you need all these stuff — surgery, chemo and radiation or other expensive toxic drugs. Other world views are a no, no — unproven and unscientific, quackery, snake oil, etc. etc. But, after having helped hundreds and hundreds of cancer patients over the past 20 years  with our CA Care Therapy, we have enough evidence to show that non-medical ways to manage cancer, in some cases, are just as effective if not MORE effective, MORE humane and MORE cost effective than the present day chemo and radiation. Why don’t we explore these alternatives? A taboo question indeed to the medical fraternity.

At CA Care, we tell patients. Learn to live with your cancer.” Cancer is not your enemy. So there is no need to wage a war. In war, nobody wins.

We also  tell patients, Everybody has to die — it does not matter if you have cancer or not. So, death is not an issue but a certainty. The important point to consider is how you want to die when the times comes. Don’t die suffering, stripped off human dignity. If you can eat, can sleep, can move about and have no pain … consider yourself blessed. Don’t ask for more. We are indeed very glad to know that most of our patients die in peace without suffering. They also don’t die because of “treatment toxicity” and /or “financial toxicity”.



Miracle Healing

Here are some interesting quotes from Miracle Healing, a book written by Harald W. Tietze of Australia.

Miracle healing

Reflex on these words ….

  • I have to say that there is no other medicine, modern or traditional, as powerful as the healer within — the mind.
  • When I talk about old healing methods and get questions such as “where is the scientific proof?”, I only can answer that it is not the patient’s main concern how it works but THAT it works.
  • Ill people cannot wait until science can explain why it works.
  • … about medical treatments of our day, such as cancer treatment with rays and chemicals … A doctor friend said to me, “the healthiest person can’t survive these treatments.”
  • I know hundreds of people given up by modern medicine and sent home …But what happens if that person “gets rid” of the “incurable disease … The answer I often hear is:
  • There was a wrong diagnosis.
  • We do not understand how this could happen.
  • What disappoints me personally is that these professionals showed no interest as to why it happened! Patients tell me quite often that the treating doctors say,
  • Continue with whatever you are doing, but when the patient wants to tell WHAT they do, the doctor is not interested.
  • Fifty to 70 percent of hospital beds are occupied by patients with self-inflicted diseases like “suicides” with fork and knife. Miracle healing can be done by changing the contents of shopping trolley.
  • One method of “miracle healing” for the majority of modern diseases is better EDUCATION instead of Medication.

Medicine Can’t Heal by Professor Dr Janos Pasztorfi

Think and Practise — Change

  • Dear reader! This book was only written for people who can think and practise the same. They belong to a dwindling minority.
  • Your thinking is … indispensable if you want to gain some value from this book.
  • Neither should you read (this book) when you are determined not to change yourself.

Heal Yourself

  • From whom can you expect help in receiving or restoring your health? The book tells you that in this world there is only one person who is both interested and capable of doing this. That only person is you yourself! Medicine does not have that capacity. Quite apart from the fact that such is its job. The task of medicine is to alleviate suffering. Its main concern and its business is illness, not health.
  • You have to look after your own health.
  • Your health or disease is solely your own creation.
  • Are you willing to do something active during healthy times to maintain good health? Almost 80 percent of people … will answer NO to the question.
  • They said: No, I will do something for my health only when I am sick.
  • Why? Because our consumer-society tells us that we can buy health from medical specialists through a pharmacist like we can buy bread and sugar from the grocery store.
  • That is nonsense. Each individual has to work strongly on his own health.

Medicines Can Cause Problems

  • Since there are almost no active medicines which at the same time have no negative side effects, medicines should only be prescribed or taken if it is absolutely necessary.
  • Unnoticed, an industry that was created to heal diseases became a source of new diseases.
  • According to the FDA 1.5 million Americans were treated in hospitals for diseases caused by medications. The death caused by medication are estimated to be from 60,000 to 140,000 in the USA each year.
  • The medical industry thrives on suffering due to disease. If the suffering is lowered, the basis of this industry is threatened.
  • It would be equally foolish for medicine — which is today an industry like any other — to expect protection from disease or cure. One can compare this to companies who produce razor blades that never go blunt.

What Is Health

  • Health is Balance in Mind, Body and Spirit. If we treat only one part of the body, the mind or the spirit, we are not successful in the long-term.
  • I do not know why churches turn their back on facts. For example, in the Bible herbal treatments are mentioned approximately 3000 times. Do, for example, Christians as followers of the Bible, hear anything about health treatments when they go to church …..
  • Or did you, at your last visit to your doctor, get spiritual advice,
  • Or do you get from your psychologist advice on diet and other means of gaining health?
  • How can anyone specializing on one small aspect help a person by overlooking nearly the lot?
  • Health is not only a “clean bill of health” issued by the doctor! Disease starts in the mind and becomes only “visible” after it is manifested and displays symptoms.
  • Treating the symptoms does not heal.
  • For long-term healing YOU have to work for it, nobody else can do it for you.



The Disease Delusion – conquering the causes of chronic illness for a healthier, longer and happier life



The Author: Dr. JEFFREY S. BLAND, PhD is a biochemist by training. He served as Director of Nutritional Research at the Linus Pauling Institute of Science and Medicine in the early 1980’s, working directly with two-time Nobel Laureate Dr. Linus Pauling, whom he considers his lifelong mentor. Dr. Bland  is a renown leader in  nutritional medicine. He co-founded the Institute for Functional Medicine and is known to many as the “father of functional medicine.” Over the past 35 years, Dr. Bland has traveled more than six million miles teaching more than 100,000 healthcare practitioners in the USA, Canada, and 50 other countries about functional medicine.

In his book, The Disease Delusion, Dr. Bland introduces the reader to the medicine of the 21st century. It is a medicine that is personalized to the specific needs of the person to result in health, not just the treatment of the symptoms of disease.  In Chapter 11 of his book Dr. Bland wrote about A new approach to your health. Here are some quotations.

  • Health, according to the World Health Organization (WHO) “is a state of complete physical, mental and social well-being, and not merely the absence of disease and infirmity.” That’s a great definition and it is a lofty goal — one we all hope to achieve. The question is how.
  • Hippocrates … formulated an answer …. the healing power of nature … the idea that if organisms are provided the right environment, diet and lifestyle support, they can heal themselves.
  • This new approach to health requires “that individual participate fully in managing his/her health. By changing our diet, lifestyle and environment … we can directly affect how our genes are expressed and thus the pattern of our health.

Dr. Bland outlined five basic concepts in the practice of functional medicine.

  1. Our health is not predetermined by our genes. No single gene controls the presence or absence of a chronic disease … but families of genes. The expression of these gene can be influenced and indeed altered by a range of lifestyle, diet and environmental factors — exercise, stress, pollutants, radiation, specific foods, phytonutrients, etc.
  2. Chronic illness is a result of an imbalance in one or more of the core physiological processes. Over time such imbalance resulted in altered function as evidenced by specific signs and symptoms which we call disease. Changes to lifestyle, diet and environment can bring our core physiological processes back into balance.
  3. The absence of illness does not necessarily equate to the presence of wellness. A diagnosis of chronic illness comes after a period of declining function.
  4. Each person’s physiological response to lifestyle, dietary and environmental factor is unique to his /her genetic makeup. What this means, there is no such thing as one size-fits-all formula.
  5. Drugs effective for the management of acute disease may be inappropriate for the long-term management of chronic illness.

Functional medicine focuses on treating the cause of a chronic illness — that is, imbalances in the core physiological processes — not the symptoms and signs that are the effect of the cause. This approach is not new! Practitioners of Traditional Chinese Medicine and Ayurvedic medicine are saying the same thing …”indeed, long before anything was known about cellular biology, genetics or pathology, Eastern medical practitioners, through observation, embraced concepts very similar to those we apply in functional medicine.” 


Diet: Too many of us are malnourished — not from eating too little, but rather from eating too much of too little. It is called overconsumptive undernutrition … it is not a deficiency of calories but a surfeit of empty calories. This is the malnutrition characterized by obesity, diabetes, heart disease, osteoporosis, dementia and other chronic illnesses associated with inflammation.

Lifestyle: Smoking kills; alcohol and drug abuse mess up your life very badly— then kill. Exercise is extremely important … a rock-bottom minimum of 120 minutes a week. The standard should be 5 to 6 sessions of at least 20 minutes per session, 5 to 6 times a week. The excuse of not enough time is unwarranted.

No one can avoid stress altogether. What we now know is that it isn’t the stressor itself but rather our response to it that can amplify our cellular communication process to alarm status. The ways to deal with such responses …. through various techniques of relaxation and mindfulness.

Environment: How can an individual control his /her environment? We can do the best we can for ourselves even though we have no control over the bigger issues. At least we try to do the following:

  • eat organic foods as much as possible.
  • avoid excessive sun exposure.
  • drink purified water.
  • use headset with our cell phones.
  • avoid processed foods and personal care products with synthetic ingredients.
  • wash our hands before eating.
  • avoid environments that supports bad health habits.
  • design our own environment to be safe places to live. 

Supplements and pharmaceuticals: Use nutritional supplements as nutraceuticals and medical foods over-the-counter therapies … these are the therapies of choice.

The twelve-week time (3 months) frame:  There is no magic bullet.

  • Years of experience and many clinical studies make it pretty clear that this is the average time it takes to make a real change to your cellular biology and patterns of genetic expression.
  • Some people notice the benefits of personalized changes to lifestyle, diet and environment right away; for others progress is slow in coming. …
  • Changing of your lifestyle, diet and environment is not like taking a drug to cure a specific symptoms (which can be quick or immediate).
  • A program of change is aimed at transforming a pattern of genetic expression and the nature of the control those genes exercise over the physiological network. Such change happens across a sequence of multiple changes –one change deriving from another in a chain of action and reaction — and it occurs over a longer period of time.

In the Foreword of this book, Dr. Mark Hyman, M.D. wrote:

  • As we spend more and more for health care, we get less and less. The answer to this paradox should be obvious to all of us: what we are doing is not working. Our current medical model was constructed to treat acute disease … we identified a single agent for illness — a microbe—and a single agent to treat it — antibiotics. Since then, medicine has pursued a quest — to find a pill for every ill. This quest has failed. We need a different paradigm, a different model for diagnosing and treating this new epidemic of chronic disease.
  • Paradigm shifts are hard, detractors abound, yet the evidence is in and the failure of our current (medical) approach is evident.


Read carefully what Dr. Jeffrey Bland wrote! We are glad to say that for the past 20 years since the existence of CA Care, we have been telling patients a similar message! We also tell patients: If you are on our therapy for some 2 to 4 weeks and do not benefit from it, do not take our herbs anymore — please go and find someone else for help. We want to be honest and truthful about this!





The Good Old Days When They Could Cure Cancer in America: Part 2

Dr. Eli G. Jones was an Eclectic physician whose main work was published in 1911. Over the course of his long career, he treated 20,000 patients with cancer. He claimed a 95% success rate.

Here are more excerpts from his book, Cancer- Its Causes, Symptoms and Treatment, published in 1911.

a b c d e f g h

What Can We Learn From This 100-Year-Book

One hundred years after Dr. Eli Jones, here are what many people say about cancer treatment!

 1 Doctors sell their soul 2 Doc-cause-more-harm-not-p 3 a Failure-of-modern-medicin 3b We-fought-ca-Cancer-won 4 wrong-war-wrong-bullet 5-remove-tumourno-use 6 Surgery-as-last-resort 7 Surgery-does-not-cure-ca 8 False-security 9 B babara-Radia ation-does-not-c 9 b Chemo-worthless 9 c Chemo kill patient 9 d Chemo-drug-makes-cancer-wor 9 e Chem-spreads-9 e cancer-Fred-Hu 9 f Chemo-is-odd-UK-doctor


Why are we in a limbo up to this day — 100 years after Dr. Eli Jones? Why are we stuck and don’t seem to make much progress?

9 g Misled-by-magic-bullet-of-c 9 h  High-tech-mentality 9 i Sick-Greedy-Medical-profess





The Good Old Days When They Could Cure Cancer in America: Part 1

I first know the work of Dr. Eli Jones after reading an article by Don Yance: The wisdom of Dr. Eli Jones ….

Eli Jones (1850-1933) was an American medical doctor in the 19th-20th centuries. He claimed to be able  cure cancer. Jones studied conventional medicine and practiced for five years before deciding that the medicine of the day was harmful. He then turned to eclectic medicine, which relied upon herbal extracts including those of the Native Americans. He went back to school, graduated, and practiced eclectic medicine for another five years. He decided to learn homeopathy, went back to school, and then practiced as a homeopath.

Here are some excerpts from his book, Cancer- Its Causes, Symptoms and Treatment -Giving the Results of over Forty Years’ Experience in the Medical Treatment of this Disease. This book was published in 1911 — one hundred years ago! Read it … and see if you can learn anything from Dr. Jones experiences!

1 title 2 3 4


Are we winning the war against cancer?5 Cancer Global stat 6 Cancer US stat 7 8 9 a 9 b 9 c


What Can We Learn From This 100-Year-Book

  1. Some people may say: This book is outdated, science today has progressed beyond all those things that were written!

My response: Agreed – the language lacked “scientific flavour” but the wisdom remained intact and valid.  ARROGANCE, PRIDE and EGO stand in the way for some people who don’t want to learn from others or the past.

x a Know-the-past x b Examine-the-past

  1. To be a successful cancer specialist, a person must know the materia medica from A-Z …not from one school of medicine but of all Schools. In simple language, if treating is only about cutting, poisoning (chemo) and burning (radiation) – what do who end up with?
  2. No all doctors are suitable to be cancer specialists — many are called but few are chosen! The successful treatment of cancer is the study of a lifetime and should not be attempted by a lazy man, for it means constant study. Can we also add — not only it is not for a lazy man but also men who only go for the money and not for the patients’ wellbeing!

x c Medicine-not-noble-but-self x d Half-truth-and-propaganda x e Oncology-all-about-money

4. Vast sums of money have been expended in erecting cancer hospitals; institutes for “cancer research” Remedies have been lauded time and again as a cure for this disease, yet the people keep on dying in the same old fashioned way. Does this statement sound very familiar — even after 100 years?

x f New-breakthroughs-but-not-r x g High-tech-not-necessarily-g

5. What our people need is to be taught how to live … A return to the “simple life” of our forefathers in what we need. Modern civilization, with all is luxury, high living and drinking …. is only encouraging the inroads of cancer.

One hundred years after Dr. Eli Jones, here are what many people say about cancer

9 d Cancer-is-a-man-made 9 e Modern lifestyle cause cancer 9 f You-cause-your-cancer-Paula 9 g Vested-interest-suppress-re







How To Decide What Is Right For You


Jerome Groopman, is an oncologist who guides his patients through life-or-death decisions. His wife, Pamela Hartzband is a noted endocrinologist and educator at Harvard Medical School who helps patients make critical decisions about their long-term health.

The authors wrote:

  • In our role as doctors, our aim is to help our patients understand what makes sense for them, what treatment are right given their individual values and goals. We are especially mindful not to impose our preferences about our own health on our patients.


We are drowning in information, while starving for wisdom ~ E.O. Wilson

Making the right medical choices is harder than ever. Whether we’re deciding to take a cholesterol drug or choosing a cancer treatment, we are overwhelmed by information from all sides: our doctors’ recommendations, dissenting expert opinions, confusing statistics, conflicting media reports, the advice of friends, claims on the Internet, and a never ending stream of drug company ads.

Some assert that you need more — more tests and more treatment. Others insist that you need less.

There are many facets of human nature.

Naturalism vs Technology

  • Some are naturalism orientated believing that the body can often heal itself if given the proper environment, harnessing the mind-body connection and supplementing with herbs, vitamins, and other natural products.
  • On the opposite end of the this spectrum is the technology orientated believing that cutting-edge research yielding new medications and innovative procedures holds the answers.

Maximal vs Minimal Treatment

  • Some people are profoundly proactive about their health, believing that more is usually better.
  • In contrast, those with a minimalist mind-set aim to avoid treatment if at all possible, and if not possible, they try to use the fewest medications at the lowest possible doses or to select the most conservative surgery or procedure. Minimalists hold to the notion that “less is more.

Believers vs Doubters

  • Believers approach their options with the sense that there is a successful solution for their problem somewhere.
  • Doubters approach all treatment options with profound skepticism. They are deeply risk-averse, acutely aware of the potential side effects and limitations of drugs and procedures.

Understand the numbers behind the words

  • Stating that 35 percent of people with a serious illness are cured by a certain treatment has a hopeful resonance, while stating that 65 percent of people die despite that therapy has a pessimistic sound. But both statements are factually correct and describe the same data.
  • Stating that a drug works “in the majority of patients” sounds quite different from specifying that 51 percent of people responded to the treatment, yet both are accurate.
  • To clearly understand the true benefit of a treatment, try to learn the “number needed to treat,” how many people with a condition similar to yours need to receive a therapy in order to improve or cure one person.

The authors related a patient who used his scientific analytical knowledge to make decisions about his medical treatment. I am a scientist. I understand how research is conducted, what statistics show and don’t show. I was well aware of all the garbage that’s out there on the Internet. So I decided to go with top-tier journal, well-accredited papers, authored by specialists who are at recognized institutions.

After experiencing the medical system himself this patient suddenly came to this conclusion.

  • Clinical medicine is an area that moves away from clarity, an area that I think of as having higher uncertainty. You can’t really make rational decisions in this world. Doctors like to have what I call a “badge of rationality,” because it gives them authority, and they try to appear competent for the patients … even if the situation is highly uncertain, they go out of their way to appear certain, to ooze rationality?
  • They told me I had a 50 percent chance of getting graft-versus-host disease, with a 10 percent change of it affecting my liver, a 40 percent chance hurting my intestine, a 30 percent change involving my skin. I have no way to understand what all that means.

Who is the best doctor

  • We are often asked who is the “best doctor” to treat a particular condition. One criterion is a physician’s knowledge about your condition and its treatments, his or her command of the scientific data, so-called evidence-based medicine.
  • But we believe the best doctors go one step further and practice “judgment-base medicine,” meaning they consider available evidence and then assess how it applies to the individual patient.
If medicine were an exact science like mathematics, there would be one correct answer for each problem …. But medicine is an uncertain science.

How do you know what is right for you? The answer often lies not with the experts, but within you.

You can choose the right treatment, the one that fits your values and way of living. Understanding your preferences begins with reflecting on your mind-set.

Dr. Groopman’ Experience

…the culture of my upbringing and the trauma of my father’s death made me a believer in modern medicine, is power and is promise …. My mentors at UCLA were maximalists in treatment, firmly committed to doing everything all the time.

And it was that maximalist mind-set that resulted in the signature medical mistake of my life. One Sunday morning in Los Angeles, feeling fine, I stood up from a chair and nearly collapsed from excruciating back pain. The pain persisted for weeks, and the doctors I consulted had no ready explanation for it.

But I was sure that medical science could pinpoint the cause of my pain. There had to be a fix somewhere in the universe of physicians and procedures.

I lacked the patience to wait. I was headstrong, intolerant of the lack of explanation for my misery. And I didn’t believe that my body would heal itself …. I underwent the most aggressive operation, a spinal fusion …..disastrous consequences: worsening pain and increased debility.

The aggressive and unsuccessful surgery was a hard lesson …. it now seems self-evident … mistakes are often necessary to bring insights. I learned to pay more attention to risk, to take time to consider side effects.

Read more: http://jeromegroopman.com/your-medical-mind.html

The Wrong Prescription: Wisdom of a medical doctor


Medical doctor, Dr. Manoj Kapoor of India wrote an interesting book, sharing with us his experiences and wisdom. Here are some of the quotes which you may wish to ponder on. Is this something that is happening today, not only in India but also in other countries (no matter where you are)?

  • This is a book about doctors by a practising doctor who honestly did not want to be a doctor. Strange, isn’t it?
  • … my father said that he wanted me to … study medicine. I submitted to his wishes …. I succeeded and became a doctor. I completed an M.S. in Surgery … I practise in the field of gastrointestinal surgery … and set up a rudimentary kind of hospital in 1991. It took seven years of struggle to get reasonable results.

Reality of Present-day Medicine

  • All doctors do not treat all patients successfully all the time.
  • Medicine is a tough, demanding profession, but God has created a machine which has an in-built auto-healing processes. Human race is older than …. (modern) medicine. Patients survived then and will continue to survive and live.
  • Medicine still remains an art in applied common sense while treating most ailments. The moment we leave reasoning and correlation out and start applying modern technology advances, we get trapped in misdiagnosing.
  • A clinical diagnosis is followed by technology to prove that we are on the right track. After diagnosing correctly, the treatment modality may vary from conservative through wildly flamboyant to utterly nonsensical. Example: They used an AK-47 to kill a fly rather than something lighter like a plastic spatula.
  • Patients are the best teachers. All successful clinicians are first excellent history takers.
  • Science has progressed by leaps and bounds. A paradigm shift has happened. It is ” I treat and I cure”. However, the irony is that a cure for diseases like the common cold has still not been found.
  • Science has fantastic treatments for all the symptoms, but the disease has not been eradicated…. and new ones are emerging.

Four Kinds of Doctor

  • What kind of a doctor would you like to consult? The directory of doctors is akin to …. four types of eating outlets.
  • At the top of the category come the ones which serve the best food and are famous because of that.
  • The second … consists of the ones which are famous because of their marketing and business skills and not necessarily the …food they offer.
  • The third … comprises of the ones who serve fantastic cuisine and are authentic in taste but are not famous.
  • The fourth category …which neither serve good food nor are famous.
  • Take your pick. If you can get and afford those who are famous and also good, you are lucky. And if you get any of the other three categories without knowing, God be with you.

Drug Company and its Sales or Medical Rep

  • The focus of the pharmaceutical industry … is definitely growth and profit.
  • It should be admitted that a multinational and national company official knows more about … drugs than the doctors themselves who profess to treat patients.
  • Good reps teach doctors about the molecule, its pharmacology, its powers, its side effects and the indications for using it.
  • The marketing guys are very reticent about the side effects of a molecule. They try to avoid any adverse comment till a new more advanced molecule of the same family of medicines in launched. The older molecule is dumped because it had limitations, they then venture to say.

Reality of Life

  • I realised that brilliance in one’s subject, honesty and hard work need not translate into success always. We are good doctors but not marketing experts.
  • Survival of the fittest is the order of the day in the profession of healing.
  • The need to earn is there in every profession and every business.
  • To-day’s world is fast-paced and everything is materialistic … but the greed for luxury and the lust for earning a lot of money to feed that greed is driving sane people towards insanity.
  • Experience has taught me that free counsel is least appreciated and rarely acknowledged.
  • The definition of a successful person in today’s world is “one who has money and knows how to flaunt it.”
  • Somebody wrote … Money can buy a house, but not a home; money can buy amusement but not happiness; money can buy medicine but not health.

Rabbit, Tortoise and Fox Ways of Earning Money

  • There are numerous ways of earning money and getting rich … the way of the rabbit, the way of the tortoise and the way of the fox.
  • Who these quick foxes are in something that is largely known to the medical fraternity, but there has been a tendency in the profession to close ranks and, in effect, shield such persons.
  • An effective system of checks and balances has to be evolved to see that patients are not exploited for the purpose of earning more money. If a reasonable option is available, the patient should be told about it.
  • The quick foxes may be an outcome of the system which is slowly being taken over by money-minded, non-medical businessmen and administrators.
  • The rich businessman and entrepreneur create the best working places and employs good professionals. As the doctor gets trapped in working at the best places where the elite of society come, he is forced to adopt the tricks of the trade.
  • The quick money game is run in the name of these credulous doctors. These naive brethren of the fraternity end up being puppets in somebody else’s hands. Professionally competent people who know nothing beyond patient welfare get exploited.
  • Targets are given to these main doctors who become the power lobbies and earners of the hospital. Little does this gullible set of doctors realize that it is their reputations which is at stake.
  • The administrators patronized and promote the ones who toe their line. No doubt a good earning potential is realized and a hand in glove policy gets initiated.

Honesty and Ethics

  • Do we knowingly mislead those who do not know what we know?
  • Does the professional get away with it all because everything has several answers and multiple angles?
  • … if any decay has set in, then we need to acknowledge collective responsibility – society, governance machinery, the socioeconomic milieu, the increasingly competitive medical industry, all have contributed to the way things are.
  • I count myself as a part of the entire system. I blame the system and not the individual who falls prey to it. All I want to do now is to wake up and work together with my medical brethren, unite for a clean and ethical medical fraternity.
  • … the appeal is not to make it a money-spinning machine at the cost of fellow human beings’ sufferings.

A living problem is better than a death certificate

How many of us understand the above wisdom? We don’t. Let Dr. Kapoor explain what that means!

A rich and famous person woke up in the middle of the night complaining of chest pain. One of the best physicians … was summoned to his bungalow. The patient’s blood pressure and electrocardiogram (or ECG — a test that checks for problems with the electrical activity of your heart)  turned out to be normal. He was given anti-acidity medications with a sleeping pill. He slept well.

However, in cardiology, protocols of chest pain investigation are such that any pain in the chest is considered to be heart related until proven otherwise.

The patient visited the hospital as per the advice.

A repeat cardiogram was normal. Blood enzyme studies … was normal. He was nonetheless asked to get an echocardiography done (a sonogram of the heart.  This  is not abbreviated as ECG. Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart. Echocardiography has become routinely used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases).  It turned out to be normal.

…. Stress test or TMT was requested by the doctors … this too was absolutely normal.

Nonetheless, angiography was advised (Note:  Angiography is an X-ray exam of the arteries and veins to diagnose blockages and other blood vessel problems. During the angiogram, the doctor inserts a thin tube into the artery through a small nick in the skin. Contrast agent (X-ray dye) is injected to make the blood vessels visible on the X-ray).

In those days (in India) angiography could itself lead to complications. It is after all an invasive procedure.

Unfortunately, the patient died after this procedure.

The dividing line between valid investigations and unnecessary investigations with commercial motive … is difficult to draw. To what extent does an action by a doctor in the course of treating a patient qualify under the fox category?