Category: Medicine, Naturopathic
In clicking on the link today, I saw this story highlighted from the NY Times:
"Despite promising discoveries and multibillion-dollar investments, cancer research is quietly undergoing a crisis. Few drugs are being marketed, and most of those that have been introduced are enormously expensive and provide few of the benefits that patients expect. Officials of the Food and Drug Administration suggest that the failures may result from an obsolete testing system.â€?
Any adult with half a brain could have, and probably already has, arrived at the same conclusion. We are in a scientific quagmire of our own design.
"Although every field has suffered, cancer has had the greatest chasm between hope and reality. One in 20 prospective cancer cures used in human tests reaches the market, the worst record of any medical category. Among those that gained approval in the last 20 years, fewer than one in five have been shown to extend lives, life extensions usually measured in weeks or months, not years.â€?
"True cancer cures are still exceptionally rare. Medicines have been approved for colorectal cancer. Patients who take every one of the high-tech drugs has to spend, on average, $250,000, suffer serious side effects and gain, on average, months of life, according to studies.â€?
Here's another interesting fact: There has not been a significant new development in antibiotic therapy in over two decades, yet we have probably over twenty different drugs that your doctor can prescribe to lower your cholesterol.
Ever wonder why?
Well, it is simple math. Getting a pharmaceutical house interested in researching a drug that people take for a week is less likely to excite the in-house accountants than a drug that people take for the rest of their lives.
Add to that the increasing drug resistance seen to virtually all antibiotics and we have a formula for disaster. Thirty years ago, I remember Dr. Bastyr turning to me during a clinic shift and muttering that '"these things are not going to work forever" after we had examined a child who was on his seventh different antibiotic for a slew of ear infections.
In my early years of practice, I worked with Dr. Jules Harran, an archetypical kindly Jewish Brooklyn neighborhood MD, who often regaled me with stories of his medical years in the army during World War II. Dr. Jules was fond of recounting how 10,000 units of penicillin would completely erradicate a case of venereal disease back then, compared to the often ineffectual doses of over several million units used nowadays.
Natural product research? Forget about it. Going nowhere. As one Drug Company researcher told me in a blunt aside during a conference at which we both were presenting: "We're not interesting in things people can grow on their window boxes.â€?
The harsh reality is that in current day dynamics, doctors prescribe drugs developed by the pharmaceutical interests based upon sophisticated market analysis, and which have their path to market cleared by pharmaceutical insiders that flit back and forth between jobs at the drug companies, academia and the federal regulatory agencies. This is then parsed to the insurance interests, who bestow further scientific credibility by agreeing to pay for the whole thing.
Reminds me of a quote from the famous English artist William Hogarth:
"The sad thing about the ancient physicians is that they attempted to make medicine an art and failed; but the even sadder thing about our modern physicians is that they have attempted to make medicine a business, and have apparently succeeded."
Received my complementary copy of the Textbook Of Natural Medicine edited by my friend and mentor, Dr.Joseph Pizzorno. It was a real treat to see how well the new chapter on the Non Transfusion Significance of Blood Type (that I authored for this new edition of the Textbook) looks on real paper. I'm very happy with the information, which is clear and up to date. As far as I know the only new information on blood types that did not make this article was the association reported between blood types and p-glycoprotein that I had written about in an earlier blog. If you work with natural medicines, or just want the most authoritative reference work on the subject, you'll probably want to invest in a copy of the Textbook.
Hey, today is the winter solstice, first day of winter, at least for all of us on the upper half of the planet. Enjoy the next few days, in whatever manner works for you!
Yesterday I cleaned an old brass plaque that says:
Peter J. D'Adamo, ND
It was severely tarnished, and it took a long time to shine it up, but after a while it really came to life.
The plaque once hung on the door of my first office in Connecticut, at 54 Lafayette Place in Greenwich. After I moved from that location there never seemed to be an appropriate place to hang it, so, as sort of a joke, I hung it on the door to my home office.
Then the other day I thought, "I'd like to hang that plaque on the outside of the new clinic."
So I pulled it down, shined it up, and went over to the worksite to tell the carpenter where I wanted it hung.
Interestingly, the last time it hung on a office:
1. I was just starting in private practice.
2. The practice was in a house.
3. I was spiritually invested.
Perhaps that old plaque will bring some of the old energy with it.
On another note, I reformatted and cleaned up the Clinic Website. There are some neat things over there, such as downloadable pamphlets, etc. Give it a look.
Been reading about a new class of cancer chemotherapy drug, called the epothilones, which seem to offer the promise of greater efficacy, with perhaps a special relevance for blood group A cancer patients. The epothilones are much like the taxol class of chemotherapy drugs in that they inhibit mitotic spindle degradation in the malignant cell (mitotic spindles are the delicate network of tubes that act as a scaffold for the migration of the split chromosomes as the become two new â€˜daughter cells.' In essence, promoting tubulin polymerziation prevents the mitotic spindle from being broken down by stabilizing the microtubule bundles, so the cell cannot replicate.
Taxol class chemotherapy drugs represent one of the most effective classes of anticancer therapeutics; however many human cancers either do not respond or become resistant to taxol-based therapy. Since 1995 Epothilone B, a new drug class sharing the same mechanism as taxol, has been in development. But, unlike taxol type drugs, epothilones have cytotoxic activity on cells overexpressing P-glycoprotein. P glycoprotein is rewsponsible in part, for drug resistance associated with many anti-cancer treatments.
This may be important for type A individuals, who appear to have increased level of p-glycoprotein in their malignancies, which may explain why in my clinical observances, they tend to be under-represented in the long term survivor groups. A drug that does not appear to be inhibited by p-glycoprotein may be just what the patient ordered.
In contrast to taxol class drugs, epothilones demonstrate a 2.5-fold greater potency than taxol, cause virtually complete cell-cycle arrest and are active in a large panel of cell lines and multi drug-resistant cancer types.
Obviously, I'm not a big fan of chemotherapy. But, as of right now, it is a part of the cancer treatment landscape and if it can be made to work better in certain individuals, so much the better.
Spent yesterday's austere training session working on something called a 'jump spin back kick,' a strange gyration that involves spinning in the air as you jump, ultimately kicking into a direction that you cannot actually see.
Interesting how easy something like this appears to a twelve year old, versus, say, a forty-eight year old. A kid just jumps, much like a cat, knowing that he is springy enough to get up and around, and flexible enough to not be troubled by the thought of a posterior landing. By the time you get to my age, you start to ponder the osseous consequences of this sort an action, which is why you hesitate and fail.
Napoleon once said that it was amazing what you could get an eighteen year old to do for a piece of ribbon.
The immortality thing.
The forty-eight year old is more likely to say 'Uh, no thanks. I have enough ribbon right now.'
Last night my sister in law Rita, an nurse with an extensive background in research, sent me an abstract from the Journal of Clinical Oncology, titled 'Herbal Remedies in the United States: Potential Adverse Interactions With Anticancer Agents' (J Clin Oncol 2004;22 2489-2503). The crux of the article being the potential threat to chemotherapy drug effectiveness posed by such botanicals as garlic and echinacea, which may influence the body's ability to metabolize chemotherapy drugs, and compromise their effectiveness. She asked me what I thought about the article.
When I finally got a full version, two things stuck out immediately. One, this was a review article, meaning that there was no proof of any such activity being presented, but rather a tenuous connection between the known, but rather modest, effects of certain herbs on the cytochrome p450 system (drug detoxification) and the p-glycoprotein levels (drug delivery).
More accurately an editorial, it provided absolutely no evidence to back up any of its assertions. C'mon guys, talking about garlic interfering with p-glycoprotein and blocking a drug like taxol is like saying that a paper bag containing your lunch has the 'hidden potential' to derail an Amtrak train. Hey, if garlic or herbal antioxidants and p-450 modulators were all that effective at blocking cell damage (chemically programmed or not), there wouldn't be any need for oncologists and oncology journals in the first place.
Amazingly, the article then goes on to advise physicians to look into herbal use in non-responding cancer patients as a rationale for treatment failure, a rather cruel balm to the fact that greater than 99% of those non-responders are simply not going to be cured by chemotherapy, herbal medicine or no herbal medicine.
An article published in the Archives of Internal Medicine (Archive Int Med; 1998;20: 2187-2191) may help explain why medical academics spend their time worrying about garlic blocking chemotherapy. It looked at conventional attitudes toward supplementation. Their conclusions: Throughout 20th century American academic medicine has resisted the concept that supplementation with micronutrients might have health benefits.
According to the authors, this resistance is evident in several ways:
(1) by the uncritical acceptance of news of toxicity, such as the belief that vitamin C supplements cause kidney stones;
(2) by the angry, scornful tone used in discussions of micronutrient supplementation in the leading textbooks of medicine; and
(3) by ignoring evidence for possible efficacy of a micronutrient supplement, such as the use of vitamin E for intermittent claudication.
Part of the resistance stems from the fact that the potential benefits of micronutrients were advanced by outsiders, who took their message directly to the public, and part from the fact that the concept of a deficiency disease did not fit in well with prevailing biomedical paradigms, particularly the germ theory. Similar factors might be expected to color the response of academic medicine to any alternative treatment.
I boldfaced the line about 'outsiders' as I can relate to that one personally, since I am a naturopathic physician (strike one!) posit a diet theory that does not fit in well with the prevailing paradigm (strike two!) and wrote a book on the subject for the public (yer out!)
Instead of wasting time looking for herbal inactivators of chemotherapy these folks should look at ABO polymorphism to help explain cancer treatment variation. Type A individuals may have as much as seven fold higher levels of p-glycoprotein, 30% higher levels of von Willebrand Factor and significantly higher levels of e-selectin and ICAM --all know modifiers of metastasis, drug delivery or resistance.
There is a certain lack of candor in a medical community that rebukes supplements as weak and ineffective medicines, yet warns that these same supplements are dangerously blocking chemotherapy drugs.
Reminds me of the joke about the two oldtimers at the early bird special:
The first one turns to the other and says 'The food here is terrible.'
The second oldtimer turns to the first and says 'Yeah, and the portions are small, too.'
Have been furiously designing and programming the IfHI 2005 conference website.
I happen to like programming in a furious manner. For example, I have developed the ability (at the expense of creeping myopia) to read code very fast, usually accomplished by holding down 'down arrow' on the scroll bar and letting the program just roll the code faster and faster until I find something I'm looking for.
This also works for screening research on MEDLINE. Set the results to say, 200 titles per page, then just scroll and scroll, faster and faster. I read somewhere that the mind is better able to 'see' things in movement, perhaps a leftover from when seeing moving things was a survival advantage. I also think it is a bit easier on the eye muscles to let the type move, rather than keep scanning back and forth with my increasingly senescent occulii.
The social downside of all this is that after a while you can get a bit trite with people, but that is another blog.
Went with Martha to a 'sparring clinic' last night. Well over 150 people of all belt ranks.
Guess who didn't pack his belt?
Anyway, since it wasn't a formal class, they let me stay, but strangely enough, not having that belt on left a weird 'open' feeling, sort of like my pants kept wanting to fall down, although they had their own draw-strings. Learned a few cool things.
Working on IfHI 2005 is getting me back into almost daily contact with Laura Mittman, IfHI's executive director, which is always a pleasure. Laura and Paul Mittman are two of our closest 'naturopathic type' friends, and as the years progress, they've just become great friends. Memories of the great IfHI 2003 conference are making me nostalgic for the future.
Paul, as the president of Southwest Naturopathic College, has given the Blood Type Diet a true home, unlike my alma mater Bastyr College, which has clearly lost its way.
Bastyr is locked in the one-size fits all, whole-grain/Ornish world that didn't work when I was a student there twenty years ago. Sadly, as they have become more 'accepted' (aka 'scientific') they have become less naturopathic, although there is certainly no reason why the two cannot coexist. They did there once a very long time ago.
Well, off the the cottage. Winter frost blew out an outdown water spigot I want to replace, and my daughter Emily, who apparently has no temperature receptors in her skin, wants to jump in the lake.
Guess who didn't turn off the inside valve to the outside water spigot?