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So chemotherapy does work, after all

One thing I’ve learned over the years is that there is a palpable hostility in the “alternative” medicine world towards chemotherapy. Many are the times I’ve posted examples, including rants by Mike Adams, cartoons, and a post about what I like to call the “2% gambit” that claims that chemotherapy only contributes 2% to survival in cancer. Basically, that last gambit uses and abuses a rather mediocre study whose design almost seemed intended to minimize any detected benefit from chemotherapy. On second thought, strike the word “seem.” It was pretty much designed to minimize any apparent benefit from chemotherapy, as it left out chemotherapy-responsive tumors without a good justification and didn’t look at ten year survivals, where chemotherapy effects are often more apparent.

Sadly, it’s not just the alt-med cranks who harbor a hatred of chemotherapy. There are otherwise rational people, some of them doctors even, who don’t like chemotherapy at all either, for example, Reynold Spector, who blighted Skeptical Inquirer with a depressingly nihilistic view of medicine, which earned him a heapin’ helpin’ of some rough and ready not-so-Respectful Insolence. I get it. I do, believe it or not. I understand why chemotherapy is one of the easiest aspects of science-based medicine to demonize. There’s no doubt about it; chemotherapy is toxic. Depending upon the specific drug, it can make your hair fall out, induce vomiting, result in immune suppression, and occasionally result in death. However, when weighed against the prospect of dying from cancer, the side effects, while extensive, can be considered in many cases to be an acceptable risk considering the alternative. Still, the toxicity of current cancer treatments clearly fuels the burgeoning alternative medicine cancer cure industry. People are afraid of chemotherapy and are thus susceptible to promises that they can be cured of cancer without chemotherapy.

That’s one reason why I’m always interested in studies that try to look objectively at the efficacy of chemotherapy in decreasing mortality from cancer. A doozy of just such a study was published yesterday. You’re not likely to see it on Mike Adams’ site, Joe Mercola’s site, or any other alt-med site, except in order to attack it or lie about it, which is why I can’t resist this little pre-emptive strike in which I discuss the study.

Basically, what I’m referring to is a large meta-analysis that appeared in The Lancet yesterday as an E-pub ahead of print. Funded by Cancer Research UK; British Heart Foundation; UK Medical Research Council, this study was carried out by the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) at the Clinical Trial Service Unit at the University of Oxford, United Kingdom and entitled Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100 000 women in 123 randomised trials. Before I discuss the meta-analysis itself, I think it’s worth briefly noting exactly what the EBCTCG is:

400,000 women in 400 randomised trials
Every five years, CTSU brings together updated data on each woman randomised into all trials of the treatment of operable breast cancer. The EBCTCG process was initiated in 1983 and the first cycle collected data for hormonal and cytotoxic therapy in 1985 [6a, 6b]. The collaboration was extended in the 1990s to all aspects of early breast cancer management [7a – 7f] and its results informed the year 2000 NIH consensus development conference on the treatment of early breast cancer [8]. The 2005 report on chemotherapy and endocrine therapy [9a] shows the substantial effects on 15-year survival of the chemotherapy regimens (such as about 6 months of FAC or FEC in women aged <70) and hormonal regimens (such as at least 5 years of tamoxifen in women with ER+ disease) that were being tested in the 1980s. The 2005 report on surgery and radiotherapy [9b] shows that treatments that substantially improve local control have little effect on breast cancer mortality during the first few years, but definite effects by 15 years. Results from the fifth cycle are emerging (ER-poor [10a], DCIS [10b], aromatase inhibitors [10c], endocrine therapy [10d], radiotherapy after breast-conserving surgery [10e], chemotherapy [in preparation]) while the sixth (2010-2012) cycle of data collection is in progress.

It’s really quite an incredible effort, looking as it does at patient-level data for so many women in so many clinical trials. I sometimes say about meta-analyses the prototypical complaint about meta-analyses, namely that the quality of the output is critically dependent on the quality of the input. In other words, “garbage in, garbage out.” However, the inclusion criteria for the EBCTCG are actually pretty stringent. More importantly, the EBCTCG has access to unpublished data and patient-level information. As is explained here, this is very important as a means of avoiding bias as much as possible:

Where there are several trials that address similar, although not necessarily identical, questions, it is possible to obtain estimates of the differences between treatments by combining the data from them. This approach is much more precise than the estimates given by any individual trial. Inevitably, trials with extreme results tend to receive more attention than those with more moderate results. This produces a natural tendency for unduly selective emphasis on those trials or subcategories of patients where, by chance alone, the results are misleadingly positive or misleadingly negative. Most such biases can be avoided by appropriate combination of the results of all trials that address similar questions. This combination cannot be done satisfactorily from published data alone (Stewart and Parmar 1993), and the inclusion of unpublished as well as published data is necessary to avoid bias. Furthermore, the information available from the published trials is not sufficient to allow a uniform analysis of all the available data with appropriate stratification for factors that will affect survival such as age, time since diagnosis, or nodal status. Thus, analysis based on individual patient data is necessary.

The EBCTCG also goes to great lengths to try to include data from every randomized trial ever published, or an unbiased subset of them, in order to try to minimize selection bias that all too often results from too rigid selection criteria used for meta-analyses. All in all, it’s an enormous effort.

The name of the EBCTCG means exactly what it says, too. Basically, by “early” the EBCTCG means early stage breast cancer; i.e., breast cancer that can be cured by surgery alone. By concentrating on this subset of breast cancer the EBCTCG is able to concentrate on what factors impact survival in conjunction with surgery. The study that was published yesterday was thus designed to estimate the effect of adding various chemotherapy regimens to breast cancer treatment on survival. There are two common chemotherapy regimens for breast cancer. The first, commonly known as ACT, consists of Adriamycin (doxorubicin) and Cytoxan (cyclophosphamide), given together for several doses, followed by a taxane, such as paclitaxel. The other common regimen, more often used in Europe than here in the U.S., is known as CMF and consists of cyclophosphamide, methotrexate, and 5-fluorouracil.

Overall, this meta-analysis involved over 100,000 patients involved in 123 randomized trials over 40 years, and the authors made these comparisons: (1) taxane-based versus non-taxane-based regimens (data for 33 trials, begun in 1994-2003); (2) any anthracyclinebased regimen versus standard or near-standard CMF (20 trials, begun in 1978-97); (3) higher versus lower anthracycline dosage (six trials, begun in 1985-94); and (4) polychemotherapy versus no adjuvant chemotherapy (64 trials, begun in 1973-96, including 22 of various anthra cycline-based regimens and 12 of standard or near-standard CMF). Several meta-analyses were performed, which produced five main findings:

  1. Standard CMF and standard 4AC (ACT without the “T,” which is an older chemotherapy regimen used before taxanes were developed) were roughly equivalent in efficacy. Both of the roughly halved two-year recurrence rates and resulted in a proportional decrease in recurrence over the next eight years by approximately one-third. Overall, breast cancer mortality rates were reduced proportionally by 20-25%.
  2. Regimens were lower chemotherapy doses per cycle were less effective.
  3. Regimens with a lot more chemotherapy than the old standard 4AC (but not so nasty that they required stem-cell rescue) were somewhat more effective. They further decreased breast cancer mortality by 15-20%. the most prominent of these regimens is 4AC plus four cycles of “T” (a taxane), which became the standard of care for node-positive breast cancer after taxanses were developed.
  4. In all chemotherapy comparisons, the ten year overall mortality was reduced because there was not very much excess mortality due to causes other than breast cancer during the first year.
  5. In all meta-analyses looking at taxane-based regimens or anthracycline-based regimens (doxorubicin is an anthracycline), the proportional reductions in early recurrence, any recurrence, and breast cancer mortality were more or less independent of age, nodal status, tumor size, or even estrogen receptor status.

This latter finding is actually somewhat surprising, because more recent trials suggest that ER(+) tumors, although sensitive to antiestrogen therapy such as Tamoxifen, are less sensitive to chemotherapy than ER(-) tumors. Yet according to the findings of this meta-analysis, ER(+) and ER(-) tumors, the reduction of approximately one-third in mortality due to breast cancer due to modern chemotherapy regimens like ACT is the same. The autnors conclude:

While awaiting the results of these new trials, it appears that ER status, diff erentiation, and the other tumour characteristics available for the present meta-analyses had little eff ect on the proportional risk reductions with taxane-based or anthracycline-based regimens. The more effective of these regimens offer on average a one-third reduction in 10-year breast cancer mortality, roughly independently of the available characteristics. The absolute gain from a one-third breast cancer mortality reduction depends, however, on the absolute risks without chemotherapy (which, for ER-positive disease, are the risks remaining with appropriate endocrine therapy). Although nodal status and tumour diameter and differentiation are of little relevance to the proportional risk reductions produced by such chemotherapy (and by tamoxifen therapy), they can help in treatment decisions as they are strongly predictive of the absolute risk without chemotherapy, and hence of the absolute benefit that would be obtained by a one-third reduction in that risk.

One aspect of this trial that needs to be emphasized is that there were very few trials of patients with ER(+) tumors with favorable histology. These are the sorts of tumors that probably do not benefit much, if at all, from chemotherapy and can be effectively treated with estrogen-blocking drugs. There are a number of clinical trials right now looking at this very question, using signatures based on a number of genes to classify tumors as high, low, or intermediate risk. The Oncotype DX assay produces one such signature.

The bottom line is that, contrary to what you will hear from cranks and alt-med supporters who believe in “alternative” cancer cures, in the case of early stage breast cancer, chemotherapy saves lives. In women with breast cancer, it decreases the risk of their dying from breast cancer by approximately one-third. This is nothing to sneeze at, as it means thousands upon thousands of women who would have died but did not, thans to chemotherapy. This study simply represents yet another in a long line of studies, another strand in the web of evidence, that support the efficacy of chemotherapy in prolonging the lives of women with breast cancer. It’s not perfect, and it has a lot of potential complications, but it works and in many cases it’s better than the alternative.

While it’s true that chemotherapy decreases a woman’s risk of dying from her breast cancer, the vast majority of women do not individually benefit from chemotherapy. That decrease in risk is based on populations and probabilities. We can’t predict in advance whether chemotherapy will help in an individual patient with an acceptable degree of accuracy, only apply probabilities based on population data. In order to save that one-third, we have to treat most women, who segregate into three groups: those who would have done well without chemotherapy, who are treated unnecessarily; those who would do poorly regardless of chemotherapy, who are also treated unnecessarily; and those for whom chemotherapy is the difference between life and death. What would be far more effective (and far more desirable) would to be able to identify in advance which women would do poorly without chemotherapy but are likely to respond to chemotherapy. Fortunately, with the emerging era of genomic medicine, we are finally developing the tools necessary to identify these women. When that happens, we’ll finally be able to make sure that only the women who can be saved by chemotherapy are the women who receive chemotherapy. I’m hoping that day is not too far off.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

193 replies on “So chemotherapy does work, after all”

My sister’s breast cancer was ER(+), however she was already Stage 4 when it was found & removed. She went through standard chemo and responded reasonably well; her tumors went from 5 cm down to less than 1 (they were present on the ovaries and liver). But when she switched over to Tamoxifen during the pause in standard chemo, they came storming back larger than before. All in all, she went 18 months with the disease before we lost her Dec 21st 2005.

It’s hard to believe it’s been nearly 6 years already. It still feels like yesterday.

I can’t say I’ve known anyone who opted for a course of chemotherapy and later announced “Oh that was a mistake — I wish I’d never had the therapy and lived for that extra 6 months / 2 years / 30 years and counting”.

It’s too bad that Steve Jobs wasn’t a reader of your blog. It might have led him to a wiser course.

I was the primary caregiver for my mother as she went through chemo this summer. I understand why people are so afraid of chemo. It was very hard on her, and made her very sick. I would not wish that experience on even my worst enemy.

However, it was worth every additional day that she may get to spend with my 5 year old son. It makes me feel a little better knowing that research continues to support the treatment she went through.

It’s funny, I found and continued to read Respectful Insolence for all of the Anti-vax debunking and snark. However, everything I learned about breast cancer here really helped me emotionally when my mother was diagnosed with breast cancer. So, thanks Orac, for providing an education and comfort in addition to great entertainment.

I’ve seen a lot of people get chemo for a lot of different cancers. I’ve also seen responses ranging from “I feel SO much better! When can I have more!” to “You mean that’s it? I got all worried about side effects for nothing!” to “That was horrible! I don’t care if I die-I just don’t want to go through that again.”

Chemo isn’t homeopathy-it’s active, dangerous drug. But it doesn’t necessarily lead to the “puking your guts out and wanting to die” scenario that people who want to sell you “natural” treatments pretend. Quite a lot of people find it tolerable and it can improve quality of life as well as extend life expectancy and improve cure rates.

Dianne @5 — Homeopathy enthusiasts over at the Wretched Hive (Huffington Post) occasionally point out that their treatments have no side effects. As far as I’m concerned, that’s the only one of their claims that’s credible. Problem is, the adjective “side” isn’t really necessary.

On another point, I was following one of the links above (“better than the alternative”) and read about the Daniel Hauser case, which happened before I tuned into all this. As far as I could tell, in the end the boy was treated and declared cancer-free a year later. I hope that’s accurate, and that he’s still OK! It’s so rare that those gnarly “mom knows best” things actually do end well.

Er, sorry, but there’s a bit of a typo in there. Instead of “hair fall out,” you put, “hear fall out.”

Otherwise, another great article. 🙂 I’ve, too, have heard a lot of people say that chemotherapy is BS and is much too dangerous. I wonder how effective their alternative medicine is if they get cancer themselves.

You do realize, don’t you, how much spelling/typo Nazis irritate the crap out of me, even when they’re telling me I wrote a good post.

Yo Orac- Apologies for the digression but: Do you have any interest in going after outrageous veterinary quackery? Someone I frequently run into on another blog reports she has run into an individual who has been engaging in blatant fraud re. health care for horses in boarding stables. “Activating their DNA,” remote “healing” by whatever magical nonsense, faked claims of cures for various diseases of horses, secret knowledge and huge fees for “service” included, and last but not least, discouraging people from getting their horses vaccinated or going to real vets. Where should someone go to turn in a blatant veterinary quack?

I think that one of the reasons lay-people are so susceptible to the outdated “alt-med” canards about cancer therapies being terrible and ineffective (they once were, about fifty years ago) is that the science is so nuanced and detailed. It doesn’t have a good punch line, a slogan or even a beat you can dance to.

Most people expect to hear – “We found a cure for cancer!”, because so many people still believe that “cancer” has a single cause and should respond to a single treatment The “War on cancer” rhetoric hasn’t done the field of oncology any favors, as it (at least early on) promised more than could be delivered.

A number of “alternative” cancer therapy promoters have claimed on this ‘blog that their treatments are “natural”, not to mention safe, effective and free from side effects. Yet, to a one, their supporting “data” are only testimonials or – at best – open-label uncontrolled “studies” with no indication of how many were treated to get the number of “successes”.

Anecdotes such as testimonials are fine if you’re looking for a good mechanic or plumber, but they can be (and are) deceptive. For example, I had a great uncle who was diagnosed (in 1972) with pancreatic cancer and went on to live for eleven years after diagnosis, finally dying at the age of 73. His only “therapy”? Jack Daniels whiskey.

Now, does that mean the folks in Lynchburg, Tennesee can claim that their product is an effective treatment for cancer of the pancreas? Probably not. More likely, he was misdiagnosed. I don’t think that even the “alt-med” crowd is so far from reality that they’d believe whiskey is effective for treating cancer.

Still, people – especially people who have cancer or loved ones with cancer – want a “cure” for cancer that doesn’t involve the unpleasantness of current therapies and – even more importantly – doesn’t involve probabilities.

I think what often scares people most about cancer – even more than the prospect of surgery, radiation or chemotherapy – are those damned probabilities. You know, stuff like “the five-year survival of people with stage X disease treated with regimen ABC is 65%”.

People have become so used to modern medicine being so safe and effective, so used to hearing things like “gorillacillin is effective in 99% of all infections…” and “the risk of serious adverse side effects is 1 in ten million” that they are often shocked to their core when they hear their chance of being alive in five years being given odds that seem more appropriate for Los Vegas than modern medicine. They want a treatment that is effective and permanent; and so do we all, especially oncologists and cancer researchers.

However grim current cancer therapies might be – and there is reason for great enthusiasm, given the strides being made every year – they are still better than doing nothing at all or, worse yet, trying some “alternative” therapies. Remember: what happens to “alternative medicine” when it is proven to work? It becomes just plain “medicine”.

Prometheus

Uh-oh. Zombie Hitler is going to get really, really pissed off at this comparison of Nazis with mere typos!

“So chemotherapy does work, after all.”

That it works or doesn’t work are really generalizations. Sometimes it does sometimes it doesn’t, what the heck, sometimes it even kills you before the cancer does. Sometimes it makes the symptoms go away but not the root of the problem, and soon after it returns. Chemotherapy is a treatment that merely addresses the symptoms. When it works it only takes away the tip of the iceberg.

Of what use is to undergo chemotherapy and surgery if your diet is not balanced and full of poison devoid of nutritional value? …not to mention exposing yourself to carcinogens by other means.

Alternatives
————

A mini documentary by David Triplett in which he documents his treatment of melanoma using cannabis (flower) oil. He was advised by his doctor to undergo “chemotherapy” though the use of some toxic creams and after researching he found an alternative which got rid of the cancer without chemo nor surgical removal.

http://www.youtube.com/watch?v=JPm0Jq9bj98

Another documentary that is really interesting is “Forks over Knives” which explore studies on cancer of different populations and the links to diet.

Shelby @7 It also would have been helpful if you didn’t have a typo in your post complaining about a typo.

“I’ve, too, have heard…”

Isn’t there an internet law about all comments complaining about typos always containing typos?

Jojo — that would be Muphry’s Law (yes, spelled like that).
http://en.wikipedia.org/wiki/Muphry%27s_law
“If you write anything criticizing editing or proofreading, there will be a fault of some kind in what you have written.”

Palindrom — “Homeopathy enthusiasts over at the Wretched Hive (Huffington Post) occasionally point out that their treatments have no side effects. As far as I’m concerned, that’s the only one of their claims that’s credible.”

And even that’s not always true. There was a recent uptick in infants admitted to ERs with atropine poisoning not too long ago. It’s unusual, and it was traced to the use of homeopathic teething drops. The drops were supposed to contain absurdly diluted belladona (nightshade). Problem is, it wasn’t absurdly diluted; there was enough there to cause atropine poisonings. Fortunately, despite its reputation, atropine is a fairly well understood chemical (it even has legitimate medical uses) and poisonings are treatable. This was apparently an accident; however, Zicam is a known example of a faux homeopathic remedy — though it meets the legal definition of a homeopathic remedy (it’s in the homeopathic pharamcopeia), 2X Zinc is really not very dilute at all, and can cause loss of smell.

Homeopathy *should* have no side effects. This leads people to be a bit less cautious with it than perhaps they should, as manufacturers may make mistakes, and as the term can and is misused (irony, there) by con artists wanting to evade FDA scrutiny.

Do you have any interest in going after outrageous veterinary quackery?

You could try running it past SkeptVet.

Of what use is to undergo chemotherapy and surgery if your diet is not balanced and full of poison devoid of nutritional value? …not to mention exposing yourself to carcinogens by other means.

Because it can save your life / extend your survival chance / improve your quality of life? You do realize that at time when you consider chemotherapy it is usually many years too late to prevent cancer by lifestyle changes?

And regarding lifestyle changes, there is very interesting article at BBC about cancer causes: http://www.bbc.co.uk/news/health-16031149

Unsurprisingly, tobacco and diet are listed as major offenders.

Alternatives

Anecdotes are not data, show us hard facts not propaganda… Actually, I’m not going to bother with addressing that. Just read comments in almost any other thread.

My pet duck is sounding kind of hoarse. I think I’ll take him to a quack veterinarian.

[email protected]
Have you got any more of those fantastic sciency youtube clips you could put up as citation?

So Chemo works huh. No surprise here, millions of us knew this already because it has worked for us. 3 years and 6 months for me now and I am bloody grateful to big Pharma for giving me the chance, all you alties can go and stick coffee up your arse. I also hope Morgan G, Ward R and Barton M of ‘The contribution of cytotoxic chemotherapy to 5-year survival in adult malignancies’ fame took note of this study, it certainly was intellectually sound and honest which is more than can be said for that sad study.

Thanks Orac much appreciated

Thank you, Orac, for this review. I will pass the link along to a number of my colleagues. The alt world always fails to mention the diseases where chemotherapy is the ONLY cure. Advanced Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma, advanced testicular cancer, and acute leukemia are all cured by chemotherapy. There is no substitute. Chemotherapy is hard and it is toxic, but modern supportive care reduce vastly reduce the side effects and risks. Vomiting is rare now. The incidence of serious, life-threatening infection has been drastically reduced. Most of my patients tell me that their chemo treatments were not as difficult as they feared. Thank you for being a clear, intelligent voice in defense of modern medicine and oncology.

ha ha ha ha ha.. oh gee.You guys really do live in a box together don’t you. And I can’t understand how you think you are a writer Orac. You have very little time for another’s point of view, unless of course two letters appear before the surname, then a bit slack can be given hey? So my point of view is a piece of shit but if a well respected surgeon with over 40 years experience says something, no problem because these people are classified as ‘rational’.

You need a shower, hug a tree perhaps to find something in you – ‘your heart’ to find some love somehow. In fact, here is something that you will not believe – that hugging trees is actually good for you, but you wouldn’t know because it’s alternative!!

Once again I got bored after your first section as you have no respect for humanity.You dissect people in two parts like surgery.

There should be no alternative and conventional. There should be Medicine that works and medicine that doesn’t.

And as I said previously, if you were confident with yourself and truly believed what you were doing is right, you wouldn’t even mention alternative medicine, but you are clearly afraid of it because even you and your family use it otherwise you would be dead by now. Just what do you actually classify as alternative? Organic food? Massage? Essential oils, Uncontaminated water? Organic vegetable juice? If you are truly against alternative (or whatever you want to call it) then have the guts to live off everything else but – so, for breakfast I would like you to have 16 panadols with tap water; lunch, some toxins and medications of your choice and for dinner some osteo-eze. You are not allowed to exercise like me, because this is alternative isn’t it? And stop depleting what bees are left in the world will you please by not having any honey ever again,this is alternative – leave it for the caring people of the world who understand about health. Even though bees are smarter and more important than your medicines you would not know about this, because it’s alternative!!

I see above a one Dr Brocco Lee has also mentioned ‘Forks over knives’, but just don’t watch it – it’s alternative!!! It will probably save millions of lives, but it’s alternative!!!

My uncle had liver cancer due to a horrible habit of drinking in his earlier years. Because of chemotherapy, his symptoms lessened and he was able to see his two sons off to college, even though it was from the hospital. Although I do understand that chemotherapy can be considered putting “toxins into one’s body” I think that the loss of hair and sometimes the queasy feelings (in which my uncle often complained about) were worth it, because he was able to live an extra year, when doctors claimed that 7 months was the limit.

And regarding lifestyle changes, there is very interesting article at BBC about cancer causes: http://www.bbc.co.uk/news/health-16031149

Articles like that always annoy me. OK, too little fruit and veg increases the risk of cancer. So how little is too little? Is it a linear function where the more fruit the better until you explode? Or is there an adequate level above which increased consumption has no effect? Or what?

@22 Andreas Johansson

Articles like that always annoy me. OK, too little fruit and veg increases the risk of cancer. So how little is too little? Is it a linear function where the more fruit the better until you explode? Or is there an adequate level above which increased consumption has no effect? Or what?

It’s a popular news article aimed at general public. Of course they are not going into details. There is a link to the original report at the bottom of the article. You can find there excerpts like this:

The advice from the Department of Health (2005) is to increase the average consumption of a variety of fruit and vegetables to at least five portions per day, corresponding to 5 × 80 or 400 g per day. In this section, we estimate the population-attributable fraction (PAF) of these five cancers (and of all cancer) that results from consumption of fruit and vegetables lower than this target.

Just two mouse clicks away.

I’ve had chemo, and really it wasn’t too bad. I know that for some people it’s worse, but there’s a lot the medics can do to damp down the worst symptoms, and taking care of yourself, resting and eating the right stuff (for you) helps.
I really think we need to shout about this, and also how curable cancer is now. People still have a huge fear of it, and lazy journalists always use the word “gruelling” to describe chemo (really – I’ve never seen another adjective attached to it!) OK, it’s no picnic, but who ever promised you a rose garden?

OK, where the heck did “neil” come from? He obviously forgot HIS meds when he posted.

@Neil: I’ll say this in short words, because obviously Orac’s technological terms are too tough for you.

Eating well (lots of fruits and vegetables, decrease fats, watch proteins, increase fiber, etc) are NOT alternative. Any normal doctor recommends this because IT IS A PART OF DOCUMENTED, RESEARCHED PROOF THAT IT HELPS.

Exercise, stopping smoking, drinking in moderation are ALSO not alternative. I don’t know what kind of doctors YOU go to, but I’ve never been to a doctor who didn’t recommend these things because they are NOT alternative medicine.

However: There is very little proof that “organic” foods are better than the same foods not labeled organic. Filtered water is not better than most municipal waters (of course, exceptions may occur with water line breaks, but then at least the municipality warns the people to use bottled water/boil water until the supply is tested and found safe again.)

Massages are nice. I like massages, and essential oils often smell nice. They don’t cure anything except maybe muscle tension. Still not alternative unless you’re claiming they cure all sorts of health problems.

Alternative medicine are treatments that have not been proven effective against the disease state they are claimed to cure/treat. Or they go against all logical sense, like homeopathy (Avogadro’s number, anyone?). Or they claim to cure things they can’t, like chiropractors curing diabetes by spinal manipulation. Theraputic touch. Reiki. THOSE are alternative medicines.

As the saying goes: do you know what we call alternative medicines that are tested and proven to work? Scienced-based medicine! Anecdotes aren’t data. Scientific PROOF will change anyone’s mind here. Orac says that, we all say that. Give us proof something works, and “allopathic” medicine will accept it.

Neil:

In saying that there should be no alternative, only medicine that works and medicine that doesn’t, you are telling Orac something he has told us many a time. But I suppose that’s not surprising, given that you boast of having gotten bored partway through reading the post you comment on. If you looked around here a bit, you’d know that one of Orac’s objections to “alternative” medicine is that its promoters won’t define what it includes, and move the boundaries for rhetorical purposes.

Darn. Wrote a long response to Neil that hit moderation. Oh well, I know Orac will release it when he can…

Yes Neil, there is medicine that works (backed by published studies, replicated results, etc) and crap that doesn’t – which “woo-docs” call alternative medicine.

If what they did was proven to work, it wouldn’t be “alternative” it would only be medicine. Obviously, you’ve glossed over or just ignored the fact that diet & exercise has been a part of the modern medical practice for quite some time.

I think Neil’s objection is that, in the absence of functional alternatives, diet and exercise appear higher on the wooist’s list of recommendation. Maybe if we could somehow elevate the idea of diet and exercise, Neil would be happier with SBM.

What’s that I smell? Ah, it’s another organic vegan brain-fart from our newest altie troll! Really Neil, it’s like someone ordered you from an alt-med stereotype catalog. There isn’t a single idea in that post that hasn’t been flogged to death previously by other crunchy granola types who believe that the right diet can magically protect you from all illness and misfortune.

The reality is that there is nothing “alternative” about the notion that following a healthy diet and exercising is good for you. As Orac has written many, many times, that’s been standard medical advice for decades and is supported by plenty of reliable research. Alties have co-opted the advice on diet and exercise and then taken it to absurd extremes, mostly to sell unnecessary vitamin supplements and dubious “immune-boosting” treatments to credulous people. If you can cite some credible research showing that diet works better than chemotherapy for treating cancer, please share it. Youtube videos don’t count.

The basic problem with recommendations concerning diet and exercise is this: people won’t follow them. If we had a drug with a compliance rate as poor as that of most diet recommendations, we’d abandon it as hopelessly poorly tolerated. Even for extreme cases such as diabetes, where an immediate benefit can be seen, it’s virtually impossible to get people to be really compliant with diet. Hence, the search for better tolerated treatments. Like, say, statins or metformin. Neither is perfect, but you can get people to actually take them. Which makes them far more helpful than recommending diets that people simply can’t follow.

I had 7 monthly sessions of chemo, followed by remission, followed by more chemo, and then a huge dose to entirely kill off my bone marrow before a transplant.

It was a nasty scary experience, but I’m alive. It was toxic and it damaged me, but I’m alive. It was traumatic for me and my family, but I’m alive. My wife has a husband, my daughter a father, my parents a son, siblings a brother.

When I went in for the transplant I signed a waiver saying I knew there was a 1 in 4 chance the drugs would kill me. But that’s better than a 100% chance that the leukaemia would in a slightly longer time frame.

It changed my life. I’m a slower, physically damaged, more accepting person than I was before it happened. But among the few things that still get me worked up to boiling frustration and anger are well meaning idiots who preach that cancer is cause by ‘self hate’ or repressed anger’ some similar platitude, and those who tell me I would have been better off trying natural cures, diets and treatments which wouldn’t have been so hard on my body.

Sure chemo’s harsh – but it works, and it’s a lot easier than it was a generation ago, and it’s only going to get better. Sure it’s harsh and it kills some people – but they wouldn’t be taking it if they had other plausible choices – they were dying anyway. Sure it’s harsh – but so’s dying early.

Cancer’s hard and forces hard choices, but I’m glad I chose chemo and a couple of decades more life (insha’allah 😉 over natural foods, reiki, and an inscription reading “1963 – 2006”

It’s a popular news article aimed at general public.

I’m part of the general public (at least as far as medicine and health are concerned). If it leaves me confuzzled, I figure it probably so leaves most people.

Am I alone in doubting everything? Alt med is rubbish; and I’ll believe in chemo when I see the huge “CURE FOR CANCER” headline on the front page of the Times. There are too many ways to nudge the results in the tests. For-profit pharma knows them all.

I’ll believe in chemo when I see the huge “CURE FOR CANCER” headline on the front page of the Times.

Been there. Done that. Don’t you remember angiogenesis inhibition? Hailed in the popular press as the cure for cancer. It’s not. It’s another useful tool, but not the cure for cancer. Which is unsurprising since it would be a lot more surprising if anything were THE cure for the multiple diseases that go under the heading of “cancer.” There will never be A cure for cancer any more than there will ever be A cure for infectious disease: it’s simply not a single problem with a single solution. So don’t believe the popular press’ declaration of a cure any more than you believe the alties. Or Merck’s for that matter.

And yes there are ways to manipulate results, but if you really think that imatinib is no improvement over hydroxyurea for CML or that cisplatin does nothing to help cure testicular cancer then you just don’t understand science at all. You’ve gone past skepticism and all the way to denial in your “doubting everything”.

Chris:

That’s like saying you don’t believe in seatbelts because they haven’t completely eliminated deaths in car crashes, and ignoring that the automobile death rate is down significantly even in absolute numbers, and moreso per capita or per million passenger-miles.

More seriously, I doubt that you doubt everything. At least, I hope you have sufficient confidence in consensus reality to eat sometimes, drink sometimes (water is good), and sleep sometimes (though “eat when hungry, drink when thirsty, sleep when tired” may be difficult). If you have no confidence in any health advice, eat what tastes good. You may not take any drugs, prescription or over the counter, but you probably will use a bandage if you cut yourself.

I am personally amazed that people, like chris, still think cancer is just one disease, or that will be one treatment for all of its forms.

You will believe in Chemo if you are ever diagnosed with Lymphoma

Or die. There are people out there who chose “die”. If Daniel Hauser had been a bit older he would have been one of them.

Am I alone in doubting everything? Alt med is rubbish; and I’ll believe in chemo when I see the huge “CURE FOR CANCER” headline on the front page of the Times.

You doubt everything but would believe obvious journalistic exaggeration? Please grow whatever organ produces consistency.

My aunt has stage 4 colon cancer. Generally regarded as treatable, not curable. She is in chemo to try and help prolong her life by staving off the progression of the cancer. I don’t know what I’d do in her situation- I don’t know if I had cancer that was most certainly terminal if I’d pursue treatment or paliative care or something inbetween. But I do know that I would make an informed decision, one free of woo and snake oil, as well as overly optimistic projections, which many people do not have the option of. I also know that I would make sure to receive the standard of care regarding cancer screenings, unlike my other aunt who is refusing to have a colonoscopy and instead relying on herbs and prayer.

Hey folks I am another chemo, radiation, bone marrow transplant survivor (oh yeah also got a new drug via a clinical trial THANK YOU BIG PHARMA you got me in enough remission to get a transplant!) I just want to tell you that I feel fine. None of it was really that bad. As a matter of fact, I am catching up on my scans that aren’t related to my cancer(lymphoma) such as a mammogram. I had one today and it hurt like hell. Much worse than any pain I had as a transplant patient. Seriously. Even a bone marrow biopsy wasn’t that bad. My point is that pain is so individualized. I hate hearing alt med folks who have never had chemo talk about how bad it is. Really?? not for me.

@Mi Dawn

You sound very normal.

I love the bold part first. If this was true, and you feel so strongly about it, why isn’t nutrition more involved in a Medical Doctors training AND recommend it more to patients? Here is one example of god knows how many – My mother has recently had bowel cancer – not one word about what she eats by her oncologist, not even after her operation! That’s because it is has nothing to do with the food obviously! Ah, yes, I always knew the colon was heavily involved in lifting weights and eye vision, nothing to do with nutrition.

As for the rest of your report, you haven’t got a clue about health.Water is more powerful than you will know, and more powerful than most medical doctors understand about – only a teeny weeny bit of the planets water is safe for drinking, yet it appears all clear for you to drink. There is a huge disparity between even public water supplies in the world, much of Europe has been against fluoride and so on and so on. If it was safe, why are so many experts against it. You are short on facts big on opinions.

If you are like a lot of people looking for this ‘proof factor’ all the time you are going to go to your grave unchanged. This is because every person on this planet is different, they are unique. What works for one may not work for another.

The only people who go forwards in this world and get through the clutter of information/ material wealth around them are those who are proactive and not reactive; they discover things, they learn about things, they practice things, and ahve a go at things. The last time I checked no one ever achieved anything great sitting on their ass on the sofa. The biggest problem is most people have been conditioned and brainwashed – they are a closed shop.

Do you think it is possible for a human being to survive without not drinking or eating anything for many many years. Is this healthy? I can tell you that it is true, and this person exists, but humanity has brainwashed themselves to limit their ability to the possibilities.

@ Narad…It gets worse. The breatharian has all sorts of conspiracy theories…I think Neil is hitting the bottle again.

Oh, great, a breatharian.

I first learned about them from the Taoist version in one of Barry Hughart’s novels—but they were an object of ridicule even there.

The Very Reverend Battleaxe of Knowledge…Yesterday, in the wee hours of the morning he went off on a rant against Orac and I cautioned him about drinking. It’s all about anti-intellectualism, “natural medicine” and our snarky comments.

Water is more powerful than you will know, and more powerful than most medical doctors understand about

Is this leading up to an announcement that Brawndo contains electrolytes?

the Taoist version in one of Barry Hughart’s novels

I yield to none in my admiration for “Bridge of Birds”.

I can tell you that it is true, and this person exists, but humanity has brainwashed themselves to limit their ability to the possibilities.

C’mon, Neil, is it Jasmuheen, HRM, Koot Hoomi, or some crank of your own devising that is too potent even to speak of before the brainwashed masses?

“I don’t know if I had cancer that was most certainly terminal if I’d pursue treatment or palliative care or something inbetween.”

Something in between works wonders for some. A friend has managed to spin out nearly 10 years. Yes, I’ll have this treatment because …. I want to see my daughter married, then the other daughter, then a grandchild, then a holiday!, then another grandchild.

She really looked as near death as her doctors warned her she was each time. Several episodes of rush to the hospital because this time really looks like ‘it’.

But she did all the things she wanted to do. Just one step, treatment, procedure at a time.

Anyone interested to answer questions with intelligence without arrogance.
1) Why do you feel nutrition is not an integral part of a medical doctors training?
2)What do you think of Henry Gadsden’s( former head of Merck) comments many many years ago when he said that he wanted make drugs available for even healthy people.
3)Is there really ‘bad cholesterol’?
4) Vitamin C was successfully used by Medical Doctors many many many years ago to treat diseases? Why not now?
5) If you were in charge to significantly improve human health in the USA in one year via a government funded program and you had only two choices – which would you choose? a)Selectively position 1 million new orthadox medical Doctors throughout the USA OR b)selectively position 200,000 Naturopaths, 200,000 Nutritionists, 200,000 health Educators in schools, 200,000 Professional Fitness trainers, 200,000 truck drivers delivering organic food to peoples homes every week.

@Neil

1) I don’t know what doctors you go to, but my doctor does bring up diet and nutrition at every checkup.
2) I don’t know enough about the quote or its context, so cannot answer.
3) Yes.
4) Perhaps because they realized that much of what they observed was coincidence, and that vitamin C wasn’t actually a wonder drug after all.
5) I’d probably go with option b, with the change that instead of naturopaths, I’d have real medical professionals. Also, while organic food may be better as far as farming practices go, I haven’t seen any evidence that it is necessarily healthier than food grown in a different fashion, so I wouldn’t place that restriction on things. I’d also replace nutritionists with dietitians. If those changes in option b aren’t allowed, then I’d go with a.

Todd – zero from 5.
1)x Thats not what i asked you
2)x
3)x Its a myth
4)x insufficient
5)x Again, thats not what was asked. You had 2 options, not the option of changing things to suit yourself. Besides your health strategy has not improved the health of the USA because there it is nothing different than the current system. All you are doing is adding more Doctors and waiting for people who are sick to visit them. Option B is proactive and can only improve the state of health of the population. Einstein did say, keep doing what you have always done and you will keep getting the same results.

“1) Why do you feel nutrition is not an integral part of a medical doctors training?”

That should be more reasonably asked of you, Neil. There are a number of people who comment on this site, in addition to Orac himself of course, who are medical doctors (not me, I hasten to add). They don’t “feel” whether nutrition was an integral part of their education; they know that it was.

You “feel” that nutrition is not an integral part of a medical doctor’s training because you, so far as I can tell, have never met a medical doctor and know nothing about them except the rumors whispered by your alt-med chums.

@ Neil
“3)x Its a myth”
and I presume that you can back this up with adequate references? And just to remind you YouTube and HuffPo references are worth diddely squat.

1) Why do you feel nutrition is not an integral part of a medical doctors training?

It is.

2)What do you think of Henry Gadsden’s( former head of Merck) comments many many years ago when he said that he wanted make drugs available for even healthy people.

Businessman being a businessman. You obviously hate businessmen. What are you, a communist?

3)Is there really ‘bad cholesterol’?

LDL. LOL. (Couldn’t resist)

4) Vitamin C was successfully used by Medical Doctors many many many years ago to treat diseases? Why not now?

It worked very well to treat scurvy. Ask the British Navy. It still does, except that scurvy is extremely rare except in the severely disadvantaged. Was there something else you had in mind?

5) (long question deleted)

Neither – option 1 would produce an oversupply of doctors, which is not a good thing. (however, you could send a few of ’em up to Canada, we’re pretty short of them)
– option 2 would produce an oversupply of naturopaths, which is also not a good thing. One naturopath, however, is an oversupply.

Yes, I flunk. I’m honoured.

P.S. Einstein didn’t say that. He also didn’t say the CORRECT form of the quote which is: Insanity is doing the same thing over and over again and expecting a different result. It’s from AA or NA.

Subtext is clearly lost on Neil. And his grading assessment? Who’s the one being arrogant? I mean, I did the best I could answering poorly formed questions, especially the last one. Two untenable situations. It’s like if I asked him would he rather be cemented into the pavement in front of an oncoming big rig or stuck on the ledge of a skyscraper with no way to get down but to jump.

Perhaps Neil has played “Would you rather…” a few too many times.

@ Neil: thanks for the compliment, I guess. I can’t say why your mother’s oncologist didn’t discuss diet with her; why don’t you ask him? Maybe he did and she didn’t remember. Maybe he figured her primary doctor would so he didn’t need to. Maybe he just doesn’t care (some doctors don’t).

Yes, water is important. No one here denies water is important, and that it needs to be as free as possible from bacteria, heavy metals, etc. but just because you get water from a “pure” source does not mean the water is pure. As far as fluoride in Europe – true, they don’t put it in water, because they put it into salt there. They still get supplements.

I really don’t know what you know about medical training. Every medical program I have met graduates from teaches nutrition. Nutrition is usually integrated into the modules, rather than being 1 specific course. So, no, most doctors don’t have a “course” in nutrition, it’s taught along with other pieces. So I don’t “feel nutrition isn’t an integral part of medical training” when I KNOW it is an integral part of medical training.

2)citation needed, please, so I can read the comment in context before answering.
3)I believe that some studies have shown this to be true, but studies are still ongoing. At this time, I will go with yes.
4)please tell me when this was. My grandfather practiced for many years and I never knew him to use vitamin c (except to treat scurvy). He also recommended a little extra (about 500 mg, IIRC) in winter to decrease the incidence of colds but stopped doing that when more research showed it really had no effect.
5) get rid of the naturopaths and I’ll choose selection b. Make it nurse practitioners or physician assistants or whatever. But I want someone who doesn’t believe in quack treatments. (and yes, to my shame, I do know many nurses who believe in quack treatments….)

If I ever get diagnosed with cancer, I’ll make a decision regarding treatment based on research. I’ll definitely use conventional treatments if they’ve been proven effective. I would consider going into a research trial. I might try to improve my diet in some ways (add more fruit/veggies, decrease red meat). But I wouldn’t go to some quack clinic.

That was not a question intended for fact finding or clarification. It was a rhetorical tool being used with the intention of mocking the posters on this thread.

Neil, do you actually have any idea what is taught in med school? Judging from the fact that you “feel” (not “know“) that “nutrition is not an integral part of a medical doctors training”, I’d say that you are not really aware of what is taught in med school.

By “bad” cholesterol, did you mean “evil” cholesterol? If so, then yes, it is a myth.

What a “businessman” whishes to do for his business has usually no bearing upon what a medical doctor practices.

Anyone interested to answer questions with intelligence without arrogance.

It’s ironic how your response to those answering your questions is filled Arrogance and shows little intelligence. Are you trying to get some ‘yang’ for your ‘yin’ to ‘harmonize’ your ‘qi’?

1. It is.
2. Don’t know exactly what he said or the context, but given that life inevitably ends in death, I’d say that there are situations in which “healthy” people might benefit from drugs.
3. I can’t top TBruce’s answer. If you have some evidence that high levels of LDL are not detrimental to health, please present it.
4. Yes, vitamin C has been successfully used to treat…scurvy. It doesn’t work in virtually any other context. Also get with the program. The miracle vitamin of this decade is D not C.
5. Ick. None of the above. The US is adequately supplied with doctors so option A is out and option B could only worsen health on the population level.

Naturopaths are a danger to public health. Organic food often isn’t (a food can be labelled “organic” and still have been exposed to a number of different “natural” pesticides and herbicides) and even if it is, there’s not much evidence that organic food is in any way better. Also, get with the program, again. Local foods are the hot new trend in crunchy nutrition so your truck drivers won’t be needed.

If I were in a position with a mandate to improve public health, I’d work on ensuring adequate supplies of critical drugs, including generics and getting decent health insurance for everyone. If I were specifically asked to reduce obesity and related nutritional problems, my first move would be to increase the minimum wage and reduce working hours so that people have time, energy, and resources to buy good food, cook it, and engage in exercise and active recreational activities. That seems to me more likely to help than a bunch of nutritionists giving advice that people can’t follow.

If you were in charge to significantly improve human health in the USA in one year via a government funded program and you had only two choices – which would you choose? a)Selectively position 1 million new orthadox medical Doctors throughout the USA OR b)selectively position 200,000 Naturopaths, 200,000 Nutritionists, 200,000 health Educators in schools, 200,000 Professional Fitness trainers, 200,000 truck drivers delivering organic food to peoples homes every week.

This is actually pretty tricky question. I can’t help but wonder whether 200k health educators and 200k fitness instructors, if properly trained, could not only balance the detrimental effect of 200k naturopaths and 200k nutritionist, but increase the net effect on general population health. After all properly educated and fit youth would eventually left 400k quacks without job anyway.

The problem are truck drivers. Compound effect of direct delivery and organic farming would be devastating from ecological point of view.

@ Neil:

A while back, I asked two fellows who supported alternative medicine a question- neither answered. Perhaps you will.

You have strong views: how did you come to support them? What were the influences that were formative? It could be books, websites, a particular writer/ teacher, studies, or personal ( family) experiences. Beliefs and attitudes don’t just *happen*: they are formed over time being intricately inter-woven with our experiences. As an example, I could say that my own ( opposing) views were formed through undergrad courses I took, family history, and working with seriously ill people.

If you support something it might be interesting to understand from whence those attitudes originated. That’s true for *all* of us, despite our varying ways. Thank you in advance.

Neil,
If you think ‘bad cholesterol’ is a myth, you really need to look at some reliable sources of information. I suggest you read Daniel Steinberg’s ‘An interpretive history of the cholesterol controversy’ in the Journal of Lipid Research, it’s available free on-line. Part 1 is here.

Go on, prove to us that you are one of those people who “learn about things”. When you have read all five parts (you may have to learn some medical terminology as well I’m afraid) do feel free to come back and explain why you still believe that LDL cholesterol is a myth and is not connected to cardiovascular disease.

Neil (#55):

“Anyone interested to answer questions with intelligence without arrogance.[sic]”

In this case, the arrogance appears to be in Neil’s answers, but I’ll have a go at it.

“1) Why do you feel nutrition is not an integral part of a medical doctors training?”

Ah! A trick question! Nutrition is part of modern medical education, but it is part of courses titled “Physiology” and “Biochemistry”. As has been pointed out already, almost every real physician asks their patients about (and, sad to say, lectures them about) their diet, exercise, etc.

What Neil really means is “Why doesn’t medical education teach the nonsensical belief that ‘proper nutrition’ can prevent and cure all diseases?” The answer to that question is “Because it’s a fantasy.”

“2)What do you think of Henry Gadsden’s…”

I have no idea what he meant by that – why don’t you ask him?

“3)Is there really ‘bad cholesterol’?”

Another trick question! The cholesterol molecule is the same whether it is part of a LDL or HDL agglomeration. However, scientific research has found that people with elevated LDL levels are more likely to have atherosclerotic disease, so the popular press has – in its usual way – taken to calling that “bad cholesterol”.

“4) Vitamin C was successfully used by Medical Doctors many many many years ago to treat diseases? Why not now?”

Unless Neil is referring to the treatment of scurvy with vitamin C, the reason vitamin C has fallen “out of fashion” is that scientific research – that bane of fantasy – has shown that vitamin C doesn’t treat or prevent anything apart from scurvy.

“5) If you were in charge to significantly improve human health in the USA in one year via a government funded program and you had only two choices…”

This is a strange choice – add a million extra real doctors in a country where access to a physician isn’t a problem (although paying for medical care is) or add 400,000 fantasy-based practitioners (naturopaths and “nutritionists”; a “dietician” is a medically trained specialist in nutrition, a “nutritionist” can be someone who printed up their “certificate” at home) plus 200,000 school health educators and 200,000 fitness instructors.

Do we really need a bunch more “practitioners” advising people to waste their money on herbal remedies and dietary fads? And do you really think that kids in school don’t already know that they should eat fewer crisps and hamburgers and more fruits and veggies? Or that they should put down the Xbox and get out for a run?

Let me pose an alternative choice:

Which would improve the health of the nation more: a million more real doctors or a million fewer fantasy-based naturopaths, chirpractors, homeopaths, acupuncturists and nutritionists?

Prometheus

Both my mother and a good friend of mine are currently undergoing chemo (breast cancer and uterine/very early pancreatic cancer respectively*). Aside from that they’ve both lost (most of) their hair, and a few other minor side effects, they’re both fine. My mother’s tumour has shrunk radically, and my friend’s oncologists are actually talking about “permanent remission.”

I’m tremendously grateful, because I’m not looking at having to attend the funerals of both my mother and one of my best friends in the next little while, especially since I’m only a few years out from having to attend the funerals of my dad’s best friend, both my grandfathers, and my great-aunt, as well as losing my beloved old cat to lymphoma, all within the same 8 months… I’m only now feeling recovered from that, and it’s been almost two years since I had to have Nero put down.

__________
* When they did the surgery on the uterine tumour(s), they found she had a completely different and very early-stage cancer on her pancreas, and resected that, too. In a sense, you could argue that being diagnosed with uterine cancer saved her life, since they were able to catch the pancreatic cancer long before it would have become apparent otherwise.

Regarding Neil’s “just asking questions” post:

1) Why do you feel nutrition is not an integral part of a medical doctors training?

I don’t, because it is.

2)What do you think of Henry Gadsden’s( former head of Merck) comments many many years ago when he said that he wanted make drugs available for even healthy people.

I hold no opinion because I don’t know the context, or even if your summary is an accurate description what was actually said by Gadsen.

3)Is there really ‘bad cholesterol’?

Sort of, in that “bad” cholesterol is an oversimplification but it’s close enough to get the general point across.

4) Vitamin C was successfully used by Medical Doctors many many many years ago to treat diseases? Why not now?

We have a lot less scurvy now. Seriously, though, “vitamin therapy” is best used to correct dietary shortfalls, and we have a lot fewer now with the advent of enriched flour and iodised salt. Any other use of vitamin C, particularly the megadose fad of latter years, just makes your urine darker.

5) If you were in charge to significantly improve human health in the USA in one year via a government funded program and you had only two choices – which would you choose? a)Selectively position 1 million new orthadox medical Doctors throughout the USA OR b)selectively position 200,000 Naturopaths, 200,000 Nutritionists, 200,000 health Educators in schools, 200,000 Professional Fitness trainers, 200,000 truck drivers delivering organic food to peoples homes every week.

Neither, as both are sorely wrong-headed. (Though as a Canadian I’d like to have more doctors… we do have a slight shortfall, particularly in family practitioners and ED staff.) If you changed “naturopaths” to “primary care physicians” and changed “organic food” to “healthy and nutritionally-balanced food” the latter option would be better and probably cheaper than the mess you Yanks have today… but it’s dirty-dirty-soshulizm so there’s no risk of that coming true.

— Steve

I am in awe with all the many testimonials offered on this blog about survival from serious cancers. Best wishes to you for continued good health.

@ Interrobang: Your mom’s “case” reminds me of Supreme Court Justice Ruth Bader Ginsburg. She underwent treatment (excision, radiation and chemo) for colon cancer in 1999 and during a follow-up abdominal CT or MRI…February 2009, a small resectable pancreatic tumor was found which was excised. After she had her first child in 1955, her husband Martin was diagnosed with testicular cancer. They were both in law school at the time and she cared for her child, her husband, took class notes for both of them and was on the Harvard Law Review.

Martin fathered another child with Ruth, they celebrated their 56th wedding anniversary and he died June, 2010.

I see Neil hasn’t ponied up his breatharian yet. Here’s another question for you Neil: Why didn’t a “Forks over Knives,” whole-foods, vegan diet of 25 years’ standing prevent my best friend from being diagnosed with colon cancer at age 40 and succumbing so quickly that he didn’t even have a chance to *start* chemo?

Narad – Vegans can still be totally unhealthy and eat crap. A vegan simply means in a basic sense someone who has elected to not eat animal products, not necessarily nanna’s apple pies. Being a Vegan also does not have anything to do with avoiding stress, trauma, violence, being a child molestor etc.

I have also rarely met an adult who says ” I eat poorly and need to improve”. The average person I meet who thinks they eat ‘quite well’ or ‘quite healthy’, is interesting because when I open their fridge and look in the pantry, I would only eat about 5% – 10% of what I see. The entire philosophy of eating including the food pyramid has completely mislead people down the wrong path.

Denice Walter – My interest is purely as a Health and Fitness specialist is to determine what is the best habits for life of disease free and disability free longevity. I ampersonally what some people may classify as ‘middle aged’- I am never ill including all my travels except India for 1 day, have no health insurance, never go to a MD, and I performed in front of 100 million people in 2011.

I vist many Countries, cultures and talk with the people; my own practice on myself and others( the only real way to test theories), Dr Colin Campbell( China Study), A mountain of books on the Brain; Marcia Angell MD; Dr Andrew Weil MD; Human Evolutionary studies, biology; Dr Joe Kosterich MD, Dr Bruce Lipton; Dr William Howard Hay MD ………………………….and so on.
Then what I do is what Bruce Lee said ” Adapt what is useful, reject what is useless and add what is specifically your own”.

“My interest is purely as a Health and Fitness specialist is to determine what is the best habits for life of disease free and disability free longevity. I ampersonally what some people may classify as ‘middle aged’- I am never ill including all my travels except India for 1 day, have no health insurance, never go to a MD, and I performed in front of 100 million people in 2011.”

And Neil, what if you get hit by a car and need care in a hospital trauma center? Do you have enough money to pay for your care…or are you just going to plead poverty and have taxpayers foot the bill?

It seems to me that I would know about a person who performed in front of 100 million people in 2011. Elvis Presley performed in front of 2.5 million people during 800 or so individual performances over several years in Las Vegas…and he made the headlines with that paltry number.

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