Part 3
"Keep in mind that the 5 year mark is still used as the official guideline for "cure" by mainstream oncologists. Statistically, the 5 year cure makes chemotherapy look good for certain kinds of cancer, but when you follow cancer patients beyond 5 years, the reality often shifts in a dramatic way."Dr. John Diamond MD
The MD Anderson Comprehensive Cancer Center was sued in August,1998, for making unsubstantiated claims that it cures "well over 50% of people with cancer." Professor Emeritus Dr. Samuel Epstein
Dr Roehrich was on his way to the John Hunter Childrens Hospital to visit Lisa and to have a conference with her treating oncologist Dr. A. The last court order had stated that Dr. Roehrich had visiting rights to Lisa as her primary care doctor. However, the last time he tried to visit, he was told he would have limited access to her and a hospital staff member would supervise his visits. This was by order of Dr. A, who had also refused to allow Dr. Roehrich access to Lisas pathology results. Today however, he had finally been successful in getting an appointment with Dr. A to discuss a matter that was becoming of increasing concern to him.
Dr. Roehrichs appearance was that of a kindly 59-year-old doctor, bespectacled and conservative. His mild mannered demeanour, however, belied the fact that he was a board certified specialist general surgeon and trauma surgeon, which hed practiced in a busy European teaching hospital until 1982 when he opened his practice on the NSW Central Coast. He also held a Ph.D in Medical Physiology and was particularly knowledgeable in biochemistry and the role of nutrients in disease.
In his medical practice he was used to liasing with specialists and found it important for the sake of all concerned, to maintain good relationships with colleagues. That was the basis for a multidisciplinary approach, where a team worked together for a good patient outcome. But the Eastleighs case was unusual for a number of reasons. And now he had a new role as arbitrator between Lisas treating doctor and the parents. By now, the Eastleighs were clearly upset about what they considered a heavy handed approach and lack of convincing information about the chemotherapy treatment Lisa was forced to undergo.
Worlds Best Practice
According to the National Cancer Institute, about one-third of all cancer deaths are related to malnutrition. For cancer patients, optimal nutrition is important. Cancer can deplete your body's nutrients and cause weight loss. Cancer and cancer treatment can also have a negative effect on your appetite and your body's ability to digest foods. These factors may leave you in a vulnerable condition - high nutrient need, and low nutrient intake.
Dr. Roehrich had many patients in his own practice who were undergoing chemotherapy and some of them came to him for additional complementary treatments such as nutritional support and acupuncture. This was called integrative medicine and it combined orthodox medicine with proven complementary and alternative approaches. More recently he had done post-graduate studies in orthomolecular (nutritional) medicine, which he employed successfully in his practice on patients with a variety of conditions. (50) In combining these approaches he was in keeping with best practices in major cancer treatment centres around the world including the Memorial Sloan-Kettering Cancer Centre which states on its website: The Integrative Medicine service at Memorial Sloan Kettering was established in 1999 to complement mainstream medical care and address the emotional, social and spiritual needs of patients and families Integrative medicine combines the discipline of modern science with the wisdom of ancient healing.
The worlds largest cancer institutions have had to integrate their approaches because too many people were opting for the proven benefits of complementary and alternative medicine. To ignore those approaches would have meant a loss of trust on the part of discriminating patients who want every possible opportunity for recovery. A US study at M.D. Anderson Cancer Centre showed that 83% of cancer patients used alternatives. The Huston Texas based cancer centre is the worlds largest with over 13,000 patients and offers a wide variety of orthodox, alternative and complementary treatments.
Like top cancer treatment centres Dr. Roehrichs experience also showed that cancer is a complex disorder that requires a multidisciplinary approach. He believed that a patients survival was dependent on being able to have faith and trust in their caregivers and in the treatments they were receiving. That meant patients needed to have a choice in their treatment so they could participate in the process of recovery. He doubted a positive outcome could be achieved if a particular treatment was forced on a patient.
So far, Dr. Roehrich was very impressed with the skill of both surgeons, Dr.Cassey and Dr. Dilley, who had operated on Lisa. As a surgeon, he realised how successful skilled cancer surgery could be in producing good survival rates. Following the surgery Lisa reverted back to the control of the oncologists, Dr. A and Dr. M whose treatment modality is chemotherapy. As far as Dr. Roehrich was aware, the parents also felt grateful to the surgeons, but the chemotherapy, mandated by the oncologists was another matter and it had become the sticking point for them. In his role as peacemaker, he found it ironic that he was now in a position of defending the use of chemotherapy and explaining its use to the Eastleigh family so they could be reassured. Being their doctor he was keenly aware of the sleepless nights they were having, and he felt they needed help in dealing with Lisas treatment.
However, in order to help the family understand the basis for Dr. As prescribed chemotherapy for Lisa, he felt duty bound to first review the medical literature himself. Not long after Lisas attempt to flee the hospital, Dr. Roehrich took some time one evening to conduct a search of the worlds scientific studies on outcomes for treatment of Lisas type of cancer using the chemicals she had been prescribed. The most prominent study was the same UK study, (UK CCSG (GC2), that both Dr. M and Dr. A cited was the basis for their decision to implement Lisas present chemotherapy by Court order.
Apart from his medical degree and specialist qualifications Dr. Roehrich had spent several years conducting scientific research. He was versed in strict laboratory protocols and statistical language. He became immersed in the scientific study the oncologists cited and soon was troubled by what he saw. Both oncologists claimed that Lisa would have an 85% chance of a cure from cancer if she had their chemotherapy treatment. Both based this on the UK CCSG (GC2) study (51)
On December 12th 2002, Dr. A had made a note in Lisas medical records that she had 0% chance of survival if she did not have his treatment. The abovementioned study he based this on did not have a control group to compare other treatments, which meant there was no evidence in that study to support Dr. As assertions that she would die without his treatment. As to the claim of an 85% cure rate with this treatment, the figures given in the study pertained to a five-year survival rate only. In the science of epidemiology the word cure means an event free normal lifespan comparable to a healthy peer group. A five-year survival rate does not by any standard support the oncologists assertions of a cure. Dr. Roehrich came to realise that those unsubstantiated claims had formed the basis for the DoCS intervention and Court order to treat Lisa against her will. This compounding error had had a devastating effect on all concerned. The family was broken up by DoCS. The parents were facing mounting and crippling legal costs to defend themselves against the relentless legal battering from DoCS. Their medical costs were escalating. James had missed months of work, which further worsened their financial situation. Lisas health was deteriorating. She was beside herself with worry. Since shortly after the last court order Lisa was put on suicide watch.
Dr. Roehrich arrived at the hospital Wednesday August 6th at 4:30 pm. Dr. A had allowed him 20 minutes with Lisa. The hospital had a list of people who could visit or phone her. Lisa could not see her friends, as they were not on the list of people allowed to visit. Only immediate family, and only for two hours. It was done by court order for Lisas protection. Dr. Roehrich was not prevented access to Lisas records by court order but rather by the order of Dr. A.
He sat at Lisas bedside and a nurse sat on the other side of the bed, watching closely. Conversation was difficult. Lisa seemed reluctant to say anything at all, a far cry from the elfin pranksterism shed displayed around the doctor before she was made a ward of the Court. Shed had her room searched previously and staff had confiscated from her carry case, the vitamins Dr. Roehrich had prescribed for her two months previously. She seemed keenly aware of her lack of privacy and had made no notations in her journal. The doctor asked if she had gone to play therapy. She said no and indicated she doesnt feel like it. She had not participated in music or art therapy. Once an excellent student, she told him she attended hospital school occasionally, but did not seem interested in the subject. She played with her key ring and fingernails and ignored the nurse, making no attempt to interact with her. Dr. Roehrich made a mental note that Lisa seemed anxious at times but appeared primarily shut down emotionally. He did not know how she would tolerate another few months under these conditions of captivity. He had on a previous visit asked the nurses permission for the three of them to go for a supervised walk around the hospital grounds so Lisa could get some fresh air and sunshine, not only to lift her spirits but also to provide her with adequate vitamin D from the sunshine. However, this was refused. He noted that Lisa looked frail. She had lost 20% of body weight since she had had the first chemotherapy treatment, which placed her significantly underweight for her height and age.
Dr. A and Dr. V, director of Hunter Childrens Health Network, came to collect Dr. Roehrich after his 20-minute allotted visit and took him to a private conference room. The hospital doctors both expressed their surprise that Dr. Roehrich, as the family GP had taken such a keen interest in the case of Lisa. Dr. Roehrich agreed that the case is indeed unusual. He usually did not feel the need to get involved with a patients hospital treatment. And though he was not part of the specialist team, he had never felt so disturbed by a case before. Dr. A explained the reason for the strict supervision was that they were intent on preventing any alternative therapy from being administered. Dr. Roehrich assured him he had no intention of administering complementary or alternative therapy at this time, let alone on the sly, (despite the fact that major cancer centres all over the world integrate these modalities). Dr. Roehrichs concern however was the fact that Lisa suffered from major nutritional deficiencies owing to her illness and two operations, the present stress, a diet that is foreign to her, her refusal to eat due to her unhappiness, and her very significant weight loss. This could diminish her chances of survival due to malnutrition alone. Dr. Roehrich explained that this could be rectified by allowing her to have the essential supplements to correct this, and to allow her to eat the diet to which she is accustomed. This required only a phone call to the dietician. Dr. A declined this suggestion. You may talk to my dietician, he said. But she will report to me, and right now we want Lisa on the hospital diet.
Dr. V was mostly silent throughout. Dr. Roehrich decided to broach the subject that made him feel most uneasy about the matter. He said hed reviewed the scientific literature upon which Dr. A is basing his treatment and prognosis, and upon which DoCS has intervened with such force, and upon which the Court has made its decision to uphold these plans. Dr. Roehrich told him of the lack of evidence for his assertions that Lisa would die without his treatment and with them she would be cured. Dr. A replied, Well thats all weve got.
Dr. Roehrich spent the next hours drive home immersed in his thoughts. He could not imagine what medical reason the doctors had for keeping Lisa confined for months in the hospital when other children are allowed to go home between cycles of chemotherapy. He could not imagine how any doctor could sleep at night knowing there was a child under his care who was a captive of his treatment; a treatment whose scientific basis he had misrepresented. Was his colleague not perturbed by a child who wanted to take her own life because she could not imagine living without her family? Dr. Roehrich could not imagine, even in war torn countries, that children would deliberately be denied essential nutrients to prevent the effects of malnutrition. He could not account for a reason why Dr. A would insist on a treatment that is so far outside the best practice of mainstream cancer treatments, as to be at odds with not only good medical practice, but that also denies this child her most basic human rights.
Dr. Roehrich had petitioned the court to allow him to brief an oncologist with an integrated approach, to address Lisas debilitating health problems. A number of colleagues had already expressed an interest and many doctors have expressed their concern as to the way this matter has been handled.
On Friday the 8th of August the DoCS legal representative met with James and Elizabeth. He told them that they would never have another opportunity of giving their daughter vitamin or mineral supplements again. He told them she could be placed into a foster home. Permanently.
[email protected] Shadow Minister previously for DoCS, now Science
[email protected] Human Rights Commissioner
Contact Parents: [email protected]
Contact Author: [email protected]
The author asserts copyright, but this article may be distributed for non-commercial purposes. For any other purpose please contact the author at; [email protected]
About Eve Hillary
Eve Hillary is based in Sydney. She a medical analyst and writer on issues pertaining to the health care industry and environmental health.
She is the author of Children of a Toxic Harvest: An Environmental Autobiography, and numerous articles relating to health issues. Her most recent book is Health Betrayal; Staying away from the sickness industry. She is also a public speaker.
Eve has spent 25 years in health care where she has observed the medical industry at first hand from the inside.
End Section Contains:
Source Materials for Further Study
Websites for Further Information
References for Professionals
Chemotherapy quotes
Cancer Chemotherapy
"Two to 4% of cancers respond to chemotherapy .The bottom line is for a few kinds of cancer chemo is a life extending procedure---Hodgkin's disease, Acute Lymphocytic Leukemia (ALL), Testicular cancer, and Choriocarcinoma."----Ralph Moss, Ph.D. 1995 Author of Questioning Chemotherapy.
"NCI now actually anticipates further increases, and not decreases, in cancer mortality rates, from 171/100,000 in 1984 to 175/100,000 by the year 2000!"--Samuel Epstein.
"A study of over 10,000 patients shows clearly that chemos supposedly strong track record with Hodgkins disease (lymphoma) is actually a lie. Patients who underwent chemo were 14 times more likely to develop leukemia and 6 times more likely to develop cancers of the bones, joints, and soft tissues than those patients who did not undergo chemotherapy (NCI Journal 87:10)."John Diamond
Children who are successfully treated for Hodgkin's disease are 18 times more likely later to develop secondary malignant tumours. Girls face a 35 per cent chance of developing breast cancer by the time they are 40----which is 75 times greater than the average. The risk of leukemia increased markedly four years after the ending of successful treatment, and reached a plateau after 14 years, but the risk of developing solid tumours remained high and approached 30 per cent at 30 years (New Eng J Med, March 21, 1996)
"Success of most chemotherapy is appalling There is no scientific evidence for its ability to extend in any appreciable way the lives of patients suffering from the most common organic cancer chemotherapy for malignancies too advanced for surgery which accounts for 80% of all cancers is a scientific wasteland."---Dr Ulrich Abel. 1990
The New England Journal of Medicine Reports War on Cancer Is a Failure: Despite $30 billion spent on research and treatments since 1970, cancer remains "undefeated," with a death rate not lower but 6% higher in 1997 than 1970, stated John C. Bailar III, M.D., Ph.D., and Heather L. Gornik, M.H.S., both of the Department of Health Studies at the University of Chicago in Illinois. "The war against cancer is far from over," stated Dr. Bailar. "The effect of new treatments for cancer on mortality has been largely disappointing."
"My studies have proved conclusively that untreated cancer victims live up to four times longer than treated individuals. If one has cancer and opts to do nothing at all, he will live longer and feel better than if he undergoes radiation, chemotherapy or surgery, other than when used in immediate life-threatening situations."---Prof Jones. (1956 Transactions of the N.Y. Academy of Medical Sciences, vol 6. In a fifty page article by Hardin Jones of National Cancer Institute of Bethesda, Maryland, he surveyed global cancer of all types and compared the untreated and the treated, to conclude that the untreated outlives the treated, both in terms of quality and in terms of quantity.
"With some cancers, notably liver, lung, pancreas, bone and advanced breast, our 5 year survival from traditional therapy alone is virtually the same as it was 30 years ago."---P Quillin, Ph.D.
"1.7% increase in terms of success rate a year, its nothing. By the time we get to the 24 century we might have effective treatments, Star Trek will be long gone by that time." Ralph Moss.
" .chemotherapys success record is dismal. It can achieve remissions in about 7% of all human cancers; for an additional 15% of cases, survival can be "prolonged" beyond the point at which death would be expected without treatment. This type of survival is not the same as a cure or even restored quality of life."John Diamond, M.D.
"Keep in mind that the 5 year mark is still used as the official guideline for "cure" by mainstream oncologists. Statistically, the 5 year cure makes chemotherapy look good for certain kinds of cancer, but when you follow cancer patients beyond 5 years, the reality often shifts in a dramatic way."Dr. John Diamond MD
"Most cancer patients in this country die of chemotherapy Chemotherapy does not eliminate breast, colon or lung cancers. This fact has been documented for over a decade. Yet doctors still use chemotherapy for these tumours Women with breast cancer are likely to die faster with chemo than without it."Alan Levin, M.D.
"The five year cancer survival statistics of the American Cancer Society are very misleading. They now count things that are not cancer, and, because we are able to diagnose at an earlier stage of the disease, patients falsely appear to live longer. Our whole cancer research in the past 20 years has been a failure. More people over 30 are dying from cancer than ever before More women with mild or benign diseases are being included in statistics and reported as being "cured". When government officials point to survival figures and say they are winning the war against cancer they are using those survival rates improperly."---Dr J. Bailer, New England Journal of Medicine (Dr Bailers answer to questions put by Neal Barnard MD of the Physicians Committee For Responsible Medicine and published in PCRM Update, sept/oct 1990.
"I look upon cancer in the same way that I look upon heart disease, arthritis, high blood pressure, or even obesity, for that matter, in that by dramatically strengthening the body's immune system through diet, nutritional supplements, and exercise, the body can rid itself of the cancer, just as it does in other degenerative diseases. Consequently, I wouldn't have chemotherapy and radiation because I'm not interested in therapies that cripple the immune system, and, in my opinion, virtually ensure failure for the majority of cancer patients."---Dr Julian Whitaker, M.D.
"Finding a cure for cancer is absolutely contraindicated by the profits of the cancer industrys chemotherapy, radiation, and surgery cash trough."Dr Diamond, M.D.
"We have a multi-billion dollar industry that is killing people, right and left, just for financial gain. Their idea of research is to see whether two doses of this poison is better than three doses of that poison."Glen Warner, M.D. oncologist.
John Robbins:
- "Percentage of cancer patients whose lives are predictably saved by chemotherapy - 3%
- Conclusive evidence (majority of cancers) that chemotherapy has any positive influence on survival or quality of life - none.
- Percentage of oncologists who said if they had cancer they would not participate in chemotherapy trials due to its "ineffectiveness and its unacceptable toxicity" - 75%
- Percentage of people with cancer in the U.S. who receive chemotherapy - 75%.
- Company that accounts for nearly half of the chemotherapy sales in the world - Bristol-Meyers Squibb.
- Chairman of the board of Bristol-Meyers - Richard L. Gelb.
- Mr. Gelb's other job: vice chairman, board of overseers, board of managers, Memorial Sloan-Kettering Cancer Center, World's largest private cancer treatment and research center.
- Chairman, Memorial Sloan-Kettering's board of overseers, board of managers - John S. Reed.
- Reed's other job - director, Philip Morris (tobacco company).
- Director, Ivax, Inc., a prominent chemotherapy company - Samuel Broder.
- Broder's other job (until 1995) - executive director, National Cancer Institute."from Reclaiming Our Health: Exploding the Medical Myth and Embracing the Source of True Healing by John Robbins.
"If you can shrink the tumour 50% or more for 28 days you have got the FDA's definition of an active drug. That is called a response rate, so you have a response...(but) when you look to see if there is any life prolongation from taking this treatment what you find is all kinds of hocus pocus and song and dance about the disease free survival, and this and that. In the end there is no proof that chemotherapy in the vast majority of cases actually extends life, and this is the GREAT LIE about chemotherapy, that somehow there is a correlation between shrinking a tumour and extending the life of the patient."---Ralph Moss
"The majority of publications equate the effect of chemotherapy with (tumour) response, irrespective of survival. Many oncologists take it for granted that response to therapy prolongs survival, an opinion which is based on a fallacy and which is not supported by clinical studies. To date there is no clear evidence that the treated patients, as a whole, benefit from chemotherapy as to their quality of life."---Abel.1990.
"For the majority of the cancers we examined, the actual improvements (in survival) have been small or have been overestimated by the published rates...It is difficult to find that there has been much progress...(For breast cancer), there is a slight improvement...(which) is considerably less than reported."---U.S. Federal Government General Accounting Office
"As a chemist trained to interpret data, it is incomprehensible to me that physicians can ignore the clear evidence that chemotherapy does much, much more harm than good."---Alan Nixon, Ph.D., Past President, American Chemical Society.
"He said, "I'm giving cancer patients over here at this major cancer clinic drugs that are killing them, and I can't stop it because they say the protocol's what's important." And I say, "But the patient's not doing well." They say, "The protocol's what's important, not the patient." And he said, "You can't believe what goes on in the name of medicine and science in this country." --Gary Null
The Politics of Cancer--- Professor Emeritus Dr. Samuel Epstein
www.preventcancer.com/
That in spite of over $20 billion expenditures since the "War against Cancer" was launched by President Nixon in 1971, there has been little if any significant improvement in treatment and survival rates for most common cancers, in spite of contrary misleading hype by the cancer establishment---the National Cancer Institute (NCI) and American Cancer Society (ACS).
That the cancer establishment remains myopically fixated on damage control _diagnosis and treatment _ and basic genetic research, with, not always benign, indifference to cancer prevention. Meanwhile, the incidence of cancer, including nonsmoking cancers, has escalated to epidemic proportions with lifetime cancer risks now approaching 50%.
That the NCI has a long track record of budgetary shell games in efforts to mislead Congress and the public with its claim that it allocates substantial resources to cancer prevention. Over the last year, the NCI has made a series of widely divergent claims, ranging from $480 million to $1 billion, for its prevention budget while realistic estimates are well under $100 million.
That the NCI allocates less than 1% of its budget to research on occupational cancer the most avoidable of all cancers which accounts for well over 10% of all adult cancer deaths, besides being a major cause of childhood cancer.
That cancer establishment policies, particularly those of the ACS, are strongly influenced by pervasive conflicts of interest with the cancer drug and other industries. As admitted by former NCI director Samuel Broder, the NCI has become "what amounts to a governmental pharmaceutical company."
That the MD Anderson Comprehensive Cancer Center was sued in August, 1998 for making unsubstantiated claims that it cures "well over 50% of people with cancer."
That the NCI, with enthusiastic support from the ACS the tail that wags the NCI dog has effectively blocked funding for research and clinical trials on promising non-toxic alternative cancer drugs for decades, in favor of highly toxic and largely ineffective patented drugs developed by the multibillion dollar global cancer drug industry. Additionally, the cancer establishment has systematically harassed the proponents of non-toxic alternative cancer drugs.
That, as reported in The Chronicle of Philanthropy, the ACS is "more interested in accumulating wealth than saving lives." Furthermore, it is the only known "charity" that makes contributions to political parties.
That the NCI and ACS have embarked on unethical trials with two hormonal drugs, tamoxifen and Evista, in ill-conceived attempts to prevent breast cancer in healthy women while suppressing evidence that these drugs are known to cause liver and ovarian cancer, respectively, and in spite of the short-term lethal complications of tamoxifen. The establishment also proposes further chemoprevention trials this fall on tamoxifen, and also Evista, in spite of two published long-term European studies on the ineffectiveness of tamoxifen. This represents medical malpractice verging on the criminal.
That the ACS and NCI have failed to provide Congress and regulatory agencies with available scientific information on a wide range of unwitting exposures to avoidable carcinogens in air, water, the workplace, and consumer products food, cosmetics and toiletries, and household products. As a result, corrective legislative and regulatory action has not been taken.
That the cancer establishment has also failed to provide the public, particularly African American and underprivileged ethnic groups with their disproportionately higher cancer incidence rates, with information on avoidable carcinogenic exposures, thus depriving them of their right-to-know and effectively preventing them from taking action to protect themselves a flagrant denial of environmental justice
www.ciss.org.au Cancer Inormation and Support Society Sydney, Aust.
www.cancerresourcecenter.com
www.canceranswers.com
www.cancerdecisions.com
www.alternative-cancer-treatments.com
www.ralphmoss.com
www.alternative-cancer.net
www.oasisofhope.com/resources/alternative_cancer_treatment_statistics.htm
www.handpen.com/Cancell/alternatives.htm
www.cancercenter.com Integrated cancer hospital.
www.cancer-info.com
According to the National Cancer Institute, about one-third of all cancer deaths are related to malnutrition. For cancer patients, optimal nutrition is important. Cancer can deplete your body's nutrients and cause weight loss. Cancer and cancer treatment can also have a negative effect on your appetite, and your body's ability to digest foods. These factors may leave you in a vulnerable condition - high nutrient need, and low nutrient intake.
At Cancer Treatment Centers of America, we believe that nutrition plays an important role in the treatment of cancer. That's why each patient who comes to us for help receives a nutrition assessment and an individualized plan designed to prevent malnutrition, reduce side effects and enhance his or her overall well being. Cancer Treatment Centres of America.
www.naturalstandard.com/ Database on natural cancer therapies for health professionals. Pay site.
References
- Einhorn, J., Nitrogen mustard: the origin of chemotherapy for cancer, Int. J. Radiat. Oncol. Biol. Phys., 1985, 11(7), 1375-1378.
- Goodman, L. S.; Wintrobe, M. M.; Dameshek, W.; Goodman, M. J.; Gilman, A.; McLennan, M. T., Landmark article Sept. 21, 1946: Nitrogen mustard therapy. Use of methyl-bis(beta-chloroethyl)amine hydrochloride and tris(beta-chloroethyl)amine hydrochloride for Hodgkin's disease, lymphosarcoma, leukemia and certain allied and miscellaneous disorders. J. Am. Med. Assoc., 1984, 251(17), 2255-2261.
- Delayed Administration of Sodium Thiosulfate in Animal Models Reduces Platinum Ototoxicity without Reduction of Antitumor Activity
Leslie L. Muldoon, Michael A. Pagel, Robert A. Kroll, Robert E. Brummett, Nancy D. Doolittle, Eleanor G. Zuhowski, Merrill J. Egorin and Edward A. Neuwelt
- In an especially dramatic table, Dr. Abel displays the results of chemotherapy in patients with various types of cancers, as the improvement of survival rates, compared to untreated patients. This table shows:
a) In colorectal cancer: no evidence survival is improved.
b) Gastric cancer: no clear evidence.
c) Pancreatic cancer: Study completely negative. Longer survival in control (untreated) group.[emphasis
mine:rsc]
d) Bladder: no clinical trial done.
e) Breast cancer: No direct evidence that chemotherapy prolongs survival; its use is "ethically questionable."
(That is particularly newsworthy, since all breast cancer patients, before or after surgery, are given
chemotherapy drugs.)
f) Ovarian cancer: no direct evidence.
g) Cervix and uterus: No improved survival.
h) Head and neck: no survival benefit but occasional shrinkage of tumours
- Sankila, Risto, et al. "Risk of cancer among offspring of childhood cancer survivors." New England Journal of Medicine 338, no. 19 (1998): 1339-44.
- Sklar, C.A. "Growth and neuroendocrine dysfunction following therapy for childhood cancer." Pediatric Clinics of North America 44 (1997): 489-503.
- Wallace, W.H., and C.J. Kelnar. "Late effects of antineoplastic therapy in childhood on growth and endocrine function." Drug Safety 15, no. 5 (Nov 1996): 325-32.
- Sklar, C.A. "Growth and neuroendocrine dysfunction following therapy for childhood cancer." Pediatric Clinics of North America 44 (1997): 489-503.
- Wallace, W.H., and C.J. Kelnar. "Late effects of antineoplastic therapy in childhood on growth and endocrine function." Drug Safety 15, no. 5 (Nov 1996): 325-32.
- Goldiner, P.L., and O. Schweizer. "The hazards of anesthesia and surgery in bleomycin-treated patients." Seminars in Oncology 6, no. 1 (Mar 1979): 121-4.
- Hulbert, J.C., J.E. Grossman, and K.B. Cummings. "Risk factors of anesthesia and surgery in bleomycin-treated patients." Journal of Urology 130, no. 1 (Jul 1983): 163-4.
- Miller, R.W., et al. "Pulmonary function abnormalities in long-term survivors of childhood cancer." Medical Pediatric Oncology 14, no. 4 (1986): 202-7.
- Farrell, G.C. "Drug-induced hepatic injury." Journal of Gastroenterology and Hepatology 12, no. 9-10 (Oct 1997): S242-50.
- Aisenberg, J., et al. "Bone mineral density in young adult survivors of childhood cancer." Journal of Pediatrics Hematology/Oncology 20, no. 3 (May-Jun 1998): 241-5.
- Arikoski, P., et al. "Reduced bone mineral density in long-term survivors of childhood acute lymphoblastic leukemia." Journal of Pediatrics Hematology/Oncology 20, no. 3 (May 1998): 234-240.
- Halton, J.M., et al. "Altered mineral metabolism and bone mass in children during treatment for acute lymphoblastic leukemia." Journal of Bone Mineral Research 11, no. 11 (Nov 1996): 1774-83.
- Hanif, I., H. Mahmoud, and C.H. Pui. "Avascular femoral head necrosis in pediatric cancer patients." Medical Pediatric Oncology 21, no. 9 (1993): 655-60.
- Henderson, R.C., C.D. Madsen, C. Davis, and S.H. Gold. "Bone density in survivors of childhood malignancies." Journal of Pediatrics Hematology/Oncology 18, no. 4 (Nov 1996): 367-71.
- Henderson, R.C., et al. "Longitudinal evaluation of bone mineral density in children receiving chemotherapy." Journal of Pediatrics Hematology/Oncology 20, no. 4 (Jul-Aug 1998): 322-6.
- Hesseling, P.B., et al. "Bone mineral density in long-term survivors of childhood cancer." International Journal of Cancer 11 Supplement (1998): 44-7.
- Hoorweg-Nijman, J.J., et al. "Bone mineral density and markers of bone turnover in young adult survivors of childhood lymphoblastic leukaemia." Clinical Endocrinology (Oxford) 50, no. 2 (Feb 1999): 237-44.
- Muller, H.L., M. Klinkhammer-Schalke, and J. Kuhl. "Final height and weight of long-term survivors of childhood malignancies." Experimental and Clinical Endocrinology and Diabetes 106, no. 2 (1998): 135-9.
- Talvensaari, K., and M. Knip. "Childhood cancer and later development of the metabolic syndrome." Annals of Medicine 29, no. 5 (Oct 1997): 353-5.
- Talvensaari, K., et al. "Clinical characteristics and factors affecting growth in long-term survivors of cancer." Medical Pediatric Oncology 26, no. 3 (Mar 1996): 166-72.
- Mauch, P.M., et al. "Second malignancies after treatment for laparotomy staged IA-IIIB Hodgkin's disease: a long-term analysis of risk factors and outcome." Blood 87, no. 9 (1 May 1996): 3625-32.
- Neglia, J.P., et al. "Second neoplasms after acute lymphoblastic leukemia in childhood." New England Journal of Medicine 325, no. 19 (7 Nov 1991): 1330-6.
- Nicholson, H.S., et al. "Late effects of therapy in adult survivors of osteosarcoma and Ewing's sarcoma." Medical Pediatric Oncology 20, no. 1 (1992): 6-12.
- Novakovic, B., et al. "Late effects of therapy in survivors of Ewing's sarcoma family tumors." Pediatric Hematology/Oncology 19, no. 3 (May-June 1997): 220-5.
- Nyandoto, P., T. Muhonen, and H. Joensuu. "Second cancer among long-term survivors from Hodgkin's disease." International Journal of Radiation Oncology and Biological Physics 42, no. 2 (1 Sept 1998): 373-8.
- Nygaard, R., et al. "Second malignant neoplasms in patients treated for childhood leukemia. a population-based m cohort study from the Nordic countries, The Nordic Society of Pediatric Oncology and Hematology (NOPHO)." Acta Pediatrics Scandinavia 80, no. 12 (Dec 1991): 1220-8.
- Pratt, C.B.B., et al. "Second malignant neoplasms occurring in survivors of osteosarcoma." Cancer 80, no. 5 (1 Sept 1997): 960-5.
- Rich, D.C., et al. "Second malignant neoplasms in children after treatment of soft tissue sarcoma." Journal of Pediatrics Surgery 32, no. 2 (Feb 1997): 369-72.
- Robison, L.L. "Survivors of childhood cancer and risk of a second tumor." Journal of the National Cancer Institute 85, no. 14 (21 Jul 1993): 1102-3.
- Sankila, R., et al. "Risk of subsequent malignant neoplasms among 1,641 Hodgkin's disease patients diagnosed in childhood and adolescence: a population-based cohort study in the five Nordic countries. Association of the Nordic Cancer Registries and the Nordic Society of Pediatric Hematology and Oncology." Journal of Clinical Oncology 14, no. 5 (May 1996): 1442-6.
- Scaradavou, A. "Second malignant neoplasms in long-term survivors of childhood rhabdomyosarcoma." Cancer 76, no. 10 (15 Nov 1995): 1860-7.
- Witherspoon, R.P., H.J. Deeg, and R. Storb. "Secondary malignancies after marrow transplantation for leukemia or aplastic anemia." Transplantation Science 4, no. 1 (Sept 1994): 33-41.
- Wolden, S.L., et al. "Second cancers following pediatric Hodgkin's disease." Journal of Clinical Oncology 16, no. 2 (Feb 1998): 536-44.
- Wong, F.L., et al. "Secondary brain tumors in children treated for acute lymphoblastic leukemia at St. Jude Children's Research Hospital." Journal of Clinical Oncology 16, no. 12 (Dec 1998): 3761-7.
- Barakat, L.P., et al. "Families surviving childhood cancer: a comparison of posttraumatic stress symptoms with families of healthy children." Journal of Pediatric Psychology 22, no. 6 (1997): 843-59.
- Gray, R.E. "Psychologic adaptation of survivors of childhood cancer." Cancer 70, no. 11 (Dec 1992): 2713-21.
- Greenberg, H.S., et al. "Psychologic functioning in 8-16-year-old cancer survivors and their parents." Journal of Pediatrics 114, no. 3 (Mar 1989): 488-93.
- Hollen, P.J., and W.L. Hobbie. "Risk taking and decision making of adolescent long-term survivors of cancer." Oncology Nursing Forum 17 (1994): 137-48.
- Kazak, A.E., et al. "Posttraumatic stress, family functioning, and social support in survivors of childhood leukemia and their mothers and fathers." Journal of Consulting and Clinical Psychology 65 (1997): 120-9.
- Kazak, A.E., et al. "Young adult cancer survivors and their parents: adjustment, learning problems, and gender." Journal of Family Psychology 8, no. 1 (1994): 74-84.
- Lansky, S., et al. "Psychosocial consequences of cure." Cancer 58 (1986): 529-33.
- Mulhern, R.K., et al. "Social competence and behavioral adjustment of children who are long-term survivors of cancer." Pediatrics 83 (1989): 18-25.
- Stuber, M.L., et al. "Posttrauma symptoms in childhood leukemia survivors and their parents." Psychosomatics 37, no. 3 (May-Jun 1996): 254-61.
- Zeltzer, L.K., et al. "Comparison of psychologic outcomes in adult survivors of childhood acute lymphoblastic leukemia versus sibling controls: A cooperative Children's Cancer Group and National Institutes of Health study." Journal of Clinical Oncology 15 (1997): 547-56.
- The chemicals used for chemotherapy are scheduled by the government regulator (TGA) as Schedule 4 drugs (S4). The regulator has placed antibiotics into the same category. Interestingly, the mineral selenium, freely found in yeast and many other foods has now also been classed as a schedule 4 drug.
- The key idea in orthomolecular medicine is that genetic factors are central not only to the physical characteristics of individuals, but also to their biochemical milieu. Biochemical pathways of the body have significant genetic variability in terms of transcriptional potential and individual enzyme concentrations, receptor-ligand affinities and protein transporter efficiency. Diseases such as atherosclerosis, cancer, schizophrenia or depression are associated with specific biochemical abnormalities which are either causal or aggravating factors of the illness. In the orthomolecular view, it is possible that the provision of vitamins, amino acids, trace elements or fatty acids in amounts sufficient to correct biochemical abnormalities will be therapeutic in preventing or treating such diseases.
Studies Relating to Chemotherapy
- Knox RA. Response is slow to deadly mixups. Too little done to avert cancer drug errors. Boston Globe. June 26, 1995:29-33.
- O'Donnell J. Hospital sued for not giving rescue agent. Hosp Pharm Rep. 1993;7:29.
- Cohen M, Anderson R, Attilio RM, et al. Preventing medication errors in cancer chemotherapy. Am J Health Syst Pharm. 1996;53:737-746.
- Koren G, Beatty K, Seto A, et al. The effects of impaired liver function on the elimination of antineoplastic agents. Ann Pharmacother. 1992;26:363-371.
- Calvert AH, Vewell DR, Gumbrell LA, et al. Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol. 1989;7:1748-1756.
- Kintzel P, Dorr RT. Anticancer drug renal toxicity and elimination: dosing guidelines for altered renal function. Cancer Treat Rev. 1995;21:33-64.
- AHFS Drug Information. American Society of Health-System Pharmacists 1994-1998.
- Ewer MS, Benjamin RS. Cardiotoxicity of chemotherapeutic drugs. In: Perry MC, ed. The Chemotherapy Source Book. 2nd ed. Baltimore: Williams & Wilkins; 1996:652.
- Ginsberg SJ, Comis RL. The pulmonary toxicity of antineoplastic agents. In: Perry MC, Yarbro JW, eds. Toxicity of Chemotherapy. Orlando, Fla: Grune and Stratton; 1984:227-268.
- Patterson WP, Reams G. Renal and electrolyte abnormalities due to chemotherapy. In: Perry MC, ed. The Chemotherapy Source Book. 2nd ed. Baltimore: Williams & Wilkins; 1996:730-734.
- Grochow BL, Ames MM. A Clinician's Guide to Chemotherapy Pharmacokinetics and Pharmacodynamics. Baltimore: Williams & Wilkins; 1998:93-471.
- DeVita VT, Hellman S, Rosenberg SA. Cancer: Principles & Practice of Oncology. 5th ed. Philadelphia: Lippincott-Raven Publishers; 1997:333-512.
- Mitchelson F. Pharmacological agents affecting emesis: a review (part I). Drugs. 1992;43:295-315.
- Mitchelson F. Pharmacological agents affecting emesis: a review (part II). Drugs. 1992;43:443-463.
- Grunber SM, Hesketh PJ. Control of chemotherapy-induced emesis. N Engl J Med. 1993;329:1790-1795.
- Aapro MS. Review of experience with ondansetron and granisetron. Ann Oncol. 1993;4(suppl 3):S9-S14.
- Navari RM, Kaplan HG, Gralla RJ, et al. Efficacy and safety of granisetron, a selective 5-hydroxytryptamine-3 receptor antagonist, in the prevention of nausea and vomiting induced by high-dose cisplatin. J Clin Oncol. 1994;12:2204-2210.
- Italian Group for Antiemetic Research. Dexamethasone, granisetron, or both for the prevention of nausea and vomiting during chemotherapy for cancer. N Engl J Med. 1995;332:1-5.
- Gralla RJ. Adverse effects of treatment. In: DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles & Practice of Oncology. 4th ed. Philadelphia: Lippincott-Raven Publishers; 1994:2338-2347.
- American Society of Clinical Oncology. Recommendations for the use of hematopoietic colony-stimulating factors: evidence-based clinical practice guidelines. J Clin Oncol. 1994;12:2471-2508.
- Rowinsky EK, Gilbert MR, McGuire WP, et al. Sequences of taxol and cisplatin. A phase 1 and pharmacologic study. J Clin Oncol. 1991;9:1692-1703.
- Balmer CM. Combination chemotherapy. In: Finley RS, Balmer CM, Dozier N, et al, eds. Concepts in Oncology Therapeutics. A Self-Instructional Course. Bethesda, Md: American Society of Hospital Pharmacists; 1991:102.
- Browman GP. Clinical application of the concept of methotrexate plus 5-FU sequence dependent synergy: how good is the evidence? Cancer Treat Rep. 1984;68:465-469.
- Koh DW, Castro M. Pulmonary toxicity of chemotherapeutic drugs. In: Perry MC, ed. The Chemotherapy Source Book. 2nd ed. Baltimore: Williams & Wilkins; 1996:674.
- Ewer MS, Benjamin RS. Cardiotoxicity of chemotherapeutic drugs. In: Perry MC, ed. The Chemotherapy Source Book. 2nd ed. Baltimore: Williams & Wilkins; 1996:654.
- Lindley CM, Bernard S, Fields SM. Incidence and duration of chemotherapy-induced nausea and vomiting in the outpatient oncology population. J Clin Oncol. 1989;7:1142-1149.
- Gralla RJ, Navari RM, Hesketh PJ, et al. Single-dose oral granisetron has equivalent antiemetic efficacy to intravenous ondansetron for highly emetogenic cisplatin-based chemotherapy. J Clin Oncol. 1998;16: 1568-1573.
- Perez EA, Hesketh PJ, Sandbach J, et al. Comparison of single-dose oral granisetron versus intravenous ondansetron in the prevention of nausea and vomiting induced by moderately emetogenic chemotherapy: a multicenter, double-blind, randomized parallel study. J Clin Oncol. 1998;16:754-760.
- Kris MG, Gralla RJ, Tyson LB, et al. Controlling delayed vomiting: double-blind, randomized trial comparing placebo, dexamethasone alone, and metoclopramide plus dexamethasone in patients receiving cisplatin. J Clin Oncol. 1989;7:108-114.
- Singh SS, Cartmell A, Caldwell J. Efficacy and tolerance of low dose dexamethasone in combination with granisetron for prophylaxis of emesis with high dose cisplatin containing chemotherapy. Int Pharm Abstracts. 1998;35:2284.