Cancer Stats, Cancer Screening, Cancer Chemo

My mother died of cancer when she was 64; my sister died of cancer when she was 57. Because of a possible genetic predisposition to cancer, the “dreaded disease” is never far from my mind, as I know it is on the minds of many other people.

In 1999, cancer replaced heart disease as the leading cause of death among men and women aged younger than 85 years. Yet, though the general population stats are disquieting, and my own personal stats are beyond disquieting (downright alarming), I actually don’t believe that I will get cancer. After my mother’s diagnosis, through intensive detoxification and improving her nutritional habits, she was able to completely reverse her terminal cancer that had put her in a wheelchair, and was then able to resume her tennis game. My mother’s cancer came back again only after my father unexpectedly died (actually killed by medical science). It became all too painfully clear to me that my mother no longer had the will or fight left in her to continue her successful battle against her disease. After spending a full year bed-ridden, she died a mere two years after my father’s death.

The information I have compiled here is in the spirit of assisting all those on my radar to have the ability to make informed decisions about cancer diagnoses and treatments. In this Musings, I take you from the initial screening process all the way to the decision of treatment.

Cancer Screening:

For many decades, it has been thought that the best way to protect oneself from getting cancer was early detection. Detection begins with screening. The most prevalent screenings are the mammogram for breast cancer, the Pap test for cervical and uterine cancers, and the P.S.A. for prostate cancer. Recent studies, however, have resulted in a dramatic shift of thinking that is leading even mainstream cancer researchers to question the accuracy and validity of these screening techniques. As Dr. Otis Brawley, the chief medical officer of the American Cancer Society, has said: “Screening is always a double-edged sword. We need to be more cautious in our advocacy of these screening tests.”

A recent analysis of mammography concluded that while mammograms find cancer in 138,000 women each year, as many as 120,000 to 134,000 of those women either have cancers that are already lethal (and thus the detection has come too late for effective allopathic treatment), or they have cancers that grow so slowly that they do not need to be treated. The United States Preventive Services Task Force, which evaluates evidence and publishes screening guidelines, has concluded that women in their 40′s should avoid mammograms altogether; further, the group revised their recommendation on mammograms for women ages 50 to 74, suggesting a reduction in the previously recommended frequency of the test. The Task Force also concluded that women should have Pap tests for cervical cancer at a reduced frequency.

But even these recommendations do not go far enough. What is not being talked about is that the very test that is supposed to detect breast cancer actually causes breast cancer.
A new study presented at the annual meeting of the Radiological Society of North America, concludes that the radiation emitted and absorbed by the body from annual mammographies significantly increases breast cancer risk in women with a genetic or familial predisposition to breast cancer. Those of you who have followed my Musings know that I have done extensive research on the therapeutic effects of low-dose radiation. I have written a book about this healing technology (called Because People Are Dying) as well as made a documentary film (by the same name). And, although the medical establishment refers to mammography radiation as “low-dose,” in fact, it is not. Compared to the low dosages where we see therapeutic response, called “radiation hormesis,” mammographies reflect quite high-dose exposures. The results of this new study are particularly worrisome because women who are at high genetic risk for breast cancer are encouraged to start having mammograms at a younger age — as early as 25 — and this means they are exposed to high-dose radiation early in life and, thus, for an extended period of time, longer than all previous recommendations.

Another study compared genetically high-risk women who were exposed to mammography radiation with others who, similarly, were genetically at high risk but did not have mammographies. The results: the women who had been exposed to mammographies before the age of 20, or those who had five or more exposures to mammographies were 2.5 times more likely to develop breast cancer than the control group of high-risk women who did not have mammographies.

Peter Gøtzsche is the director of the Nordic Cochrane Collaboration, and has spent more than 10 years investigating and analyzing data from the trials of breast screening. The recently published book, Mammography Screening: Truth, Lies and Controversy, from Radcliffe Publishing, spells out the findings of the Nordic Cochrane group. The data does not support mass screening as a preventive measure. Gøtzsche says: “The collective denial and misrepresentation of facts about over-diagnosis and the little benefit there is of screening, if any, coupled with the disregard of the principles for informed consent and national laws, may be the biggest ethical scandal ever in healthcare…Hundreds of millions of women have been seduced into attending screening without knowing it could harm them. This violation of their human rights is the main reason we have done so much research on mammography screening and also why I have written this book.”

A recent study out of England showed no difference in death rates between similar pairs of countries that had introduced or not introduced screening, From analyzing the data gathered over this ten year period, Gøtzsche concludes that for every life that screening may save, it harms 10 others. Gøtzsche found that one in three cancers detected by screening was misdiagnosed. And, again, the point is made that cancerous cells may go away on their own, or may never progress to disease in the woman’s lifetime, yet the tumors are excised with surgery and in six times out of 10, the woman will lose a breast. Treatment with high-dose radiation and/or drugs, as well as the surgery itself inflict a heavy mental and physical cost on the patient. “I believe the time has come to realize that breast cancer screening programs can no longer be justified,” Gøtzsche said. “I recommend women to do nothing apart from attending a doctor if they notice anything themselves.” Gøtzsche’s book also tells of personal attacks on him and on other researchers by the pro-screening lobby in England, some of whom had financial interests in the continuation of screening programs.

Regarding the P.S.A. test for prostate cancer, the Preventive Services Task Force concluded that P.S.A. screening does “not save lives and causes enormous harm.”

It is clear that researchers have begun to see what those of us in the holistic field have been observing, and consequently have arrived at this conclusion: many, if not most, cancers are indolent. They grow very slowly or stop growing altogether. Some even regress spontaneously, and do not need to be treated. When I was Ruth Sackman’s assistant at the Foundation for Advancement of Cancer Therapies, she told me about a study that had been conducted on cadavers. Researchers discovered through autopsies that 30% of the random assortment of bodies they were dissecting had undetected cancerous tumors in their bodies, and that the cause of death was unrelated to the cancers. Of course, Lewis Thomas’ (former head of Sloan-Kettering) theory on cancer is entirely consistent with this finding. Thomas proposed that we all have cancer cells within us all the time, and much of the time, we don’t know about these pathogenic cells, and they don’t cause us any trouble. Thomas thought that the cancer cells grow — and conglomerate into the formation of tumors, and invade tissues and organs — only when the immune system is not doing its normal job of neutralizing all the various pathogens that our bodies cope with (essentially sleeping on the job, one might say).

Improvement of Mammograms?

One of the so-called “advancements” in cancer detection is the introduction of computer-aided detection (CAD) technology, which analyzes mammography images and marks suspicious areas for radiologists to review. CAD software was first approved by the Food and Drug Administration in 1998, but its use skyrocketed after Medicare began covering the procedure in 2001.The technique has been enthusiastically endorsed by physicians as a way to insure that invasive breast cancer is spotted on mammograms. CAD has grown into a huge industry, and is now applied to the majority of screening mammograms in the U.S. Medicare alone pays out $30 million a year for the utilization of this screening technique.

Yet, according to a 2010 study (“Effectiveness of Computer-Aided Detection in Community Mammography Practice,” Journal of the National Cancer Institute), scientists have concluded that the technology is not only ineffective in finding breast tumors, but gives a substantial increase in the number of false positives.

Benign Biopsies or Not?

One of my patients has a rare form of cancer. There are only 50 people on the planet who have been diagnosed with this specific form of cancer. She has been on holistic therapies, and had successfully contained her tumor from growing or metastasizing for over seven years. Recently, however, she detected some growth of the tumor, and she was influenced to have a biopsy to see if the cancer was spreading. Since the biopsy, she has had an open wound that will not heal, will not close – and her skin tissue at the tumor site seems to be disappearing, as though something were eating it.

One of the many lessons I learned from Ruth Sackman was that biopsies are not innocuous. And now recent research and stats are confirming her idea. Biopsies are commonly conducted for prostate cancer. According to a study just published in the online edition of The Journal of Urology, prostate biopsies are landing more and more men in the hospital where they are dying, not from the cancer that was discovered but from what happens to them while hospitalized.

The researchers noted there has been a steady rise in the rate of serious infection-related complications involving prostate biopsies over the past couple of decades. When their investigation began in 1991, less than 0.5 percent of men were admitted to the hospital because of an infection diagnosed after a prostate biopsy was performed. This infection rate remained stable until 2000 at which point the rate of infection-related complications began to increase to more than 1.2 percent by 2007. The infections are often serious, and implicate antibiotic resistance germs: superbugs, as they have come to be named.

Here are some of the disturbing facts: using Medicare records, Johns Hopkins scientists performed the largest analysis ever conducted of American men age 65 and older who underwent prostate biopsies over the last 20 years. In all, the researchers examined the number of biopsy-related complications that resulted in hospitalization of more than 17,400 of these men from 1991 to 2007. They then compared these rates to a group of 134,977 men (matched for age and other characteristics) during the same time period who did not undergo a prostate biopsy. Their findings indicate that prostate biopsies were linked with approximately a 7 percent rate of hospitalization within 30 days of the procedure; this is compared to a 2.9 percent hospitalization rate among the control group of men who didn’t have prostate biopsies. Biopsies resulted in more than doubling the need for immediate post-operative hospitalization. And once hospitalized, the men were at an increased risk of serious complications including bleeding and infection, flare-ups of underlying medical conditions (such as heart failure or breathing disorders) and death. The investigators found that men hospitalized with biopsy-related infections had 12 times greater risk of dying compared to men who did not have biopsies.

Another problem with biopsies is their inaccuracy. Thyroid cancer is a type of cancer that is typically diagnosed with a biopsy. Statistics show thyroid cancer as the fastest growing cancer today. Keith Heller, M.D., a surgeon who has performed over 1,000 thyroid operations in 28 years, says: “I do not believe that this epidemic of is real. It is due to…the increasing use of ultrasound-guided needle biopsy of thyroid nodules.”

Heller’s point has to do with the fact that ultrasound guided needle biopsy is usually not conclusive about any small tumors or growths found in the thyroid gland. Malignancy of thyroid cancer cannot be determined until after the thyroid is partially or wholly removed. Yet, physicians order the biopsy, and with inconclusive results, still recommend removal of the thyroid.

Many of us carry tiny nodules in our thyroids without any health impact (shades of the autopsy study Ruth Sackman told me about). Even if cancerous, these tend to be benign or not an immediate danger. In Finland, these tiny nodules are considered normal when discovered, and removal of the thyroid is not conducted.

Dr. John Cronan, in a June 2008 issue of Radiology, says the (often) unnecessary surgery leaves patients with a lifelong dependency on thyroid medications, often after the surgery reveals there was no cancer. He adds that this is done to “control a cancer with a 99% 10 year survival.”

If You Want to Know Something Is Wrong with You, Keep Looking until You Find It

This story was reported in the New York Times, Oct 30, 2011. Dr. James Andrews, a sports medicine orthopedist, wanted to test his suspicion that M.R.I.‘s have a high degree of inaccuracy. He scanned the shoulders of 31 perfectly healthy professional baseball pitchers.

The pitchers were not injured and had no pain. But the M.R.I.’s found abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent. Dr. Andrews conclusion: “If you want an excuse to operate on a pitcher’s throwing shoulder, just get an M.R.I.”

The moral of the story holds true for certain cancers, too.

Ductal carcinoma in situ (DCIS) is the most common type of non-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts; carcinoma refers to any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs; in situ means that the pathogenic material is found in its original place. DCIS is called “non-invasive” because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue.

DCIS isn’t life-threatening, but it is thought among most physicians that having DCIS can increase the risk of developing an invasive breast cancer later on. Since the advent of CAD technology, the rate of diagnoses of DCIS has an ever-expanding circle. Up to 33 percent of new breast cancer diagnoses obtained through x-ray mammography are classified as DCIS. Because DCIS is almost invariably asymptomatic and has no palpable lesions, it would not be known as a clinically relevant entity were it not for the use of x-ray diagnostic technology. The correlation between DCIS and mammography rates is not surprising: because the United States has one of the highest x-ray mammography rates in the world, it also has the highest rate of diagnosed DCIS.

Yet, a solid body of evidence has emerged suggesting that when DCIS is left undiagnosed and untreated, rarely will it become malignant — by some estimates, the progression to invasive cancer is as low as 2-4 percent. According to one study, the 10-year survival rate of patients with DCIS post-treatment — 96 percent to 98 percent — suggests a relatively benign nature of the condition. Another study found that at the 40-year follow-up period, 40 percent of DCIS lesions still had no signs of invasiveness. Adding even more uncertainty, another study showed that coexisting DCIS (a DCIS diagnosis that accompanies another form of cancer) may even serve a protective function against the other more aggressive forms of cancers.

The specific problem with a mammographically-inspired diagnosis of DCIS is that detection often leads to over-kill in terms of the standard protocol for medical treatment, which is always toxic and stressful for the body.

The Latest Unnecessary Butchery to Women

One of the recent therapeutic measures to take as an attempt to prevent the metastatic spread of breast cancer is the removal of the healthy breast as well as the diseased breast. This procedure, known as contralateral prophylactic mastectomy (CPM), is offered to women as a kind of insurance. Supposedly, it will greatly reduce the odds they will not get breast cancer again.
Although the rates of this surgical procedure are soaring – 150 percent increase in the procedure in recent years — the real proof of whether it is worthwhile has been lacking. However, recently a research team headed by Robert G. Prosnitz, MD, MPH, from the Perelman School of Medicine at the University of Pennsylvania announced that CPM provides little significant benefit — but it can have significant negativeeffects on women. The study revealed that the additional surgery appears to reduce the quality of life as the result of surgical complications, loss of sensation in the breast, and other medical problems. In addition, the study shows that the surgery actually reduces the measure of life expectancy that takes into account quality of life (technically called “quality-adjusted life expectancy”) among women who do not have hereditary breast cancer. About 90 percent of women with breast malignancies do not have cancers known to be caused by genetic factors. Thus, these findings apply to the vast majority of women diagnosed with breast cancer who are treated with mastectomy.

Meaning of Cancer Statistics about Chemo Effectiveness

There have been many studies on cancer – not only on how to detect it, but also what cures it (or doesn’t). A particularly interesting study looked at over a quarter of a million women (Journal of Clinical Oncology:16:549-560). The researchers found that chemotherapy improved the 5-year cancer survival rate by an average of 2%. But even this very small percentage of usefulness of chemotherapy is an elevated statistic for most cancers. Two rarer cancers show a significantly higher rate of improvement: Hodgkin’s has a 40.3% improvement rate; testicular cancer has a 37.7% improvement rate. I have been aware of these statistics for quite a while, and have often wondered why the results of chemo are better for these uncommon cancers. My thought is that one possible reason for the better results is that these cancers are typically found more in younger people. The young body is still more vital, the cells are still reproducing at a faster rate in youth than in middle and old-age. It seems likely, then, that the recovery process from the assault on the body from the chemo is more efficient. As we age, we notice this slowing down of recovery in a variety of ways. Even a simple skin wound recovery is more arduous. I have no scars on my legs from all the childhood falls and scrapes my skin took. But I still have the scar I got from the fall I took five years ago when I was running and failed to notice a cracked sidewalk. I will likely die with that scar on my knee.

The two cancers of Hodgkin’s and testicular, though far less common than the leading cancer killers, raise the over-all average of chemotherapy effectiveness. For the most common cancers, the rates of chemo effectiveness were: breast cancer 1.4%; prostate cancer 0.0%; lung cancer 2.0%; and colon cancer 1.0%. The conclusion: chemotherapy has an over-all failure rate of 98%.

Probably the best thing you can do if you are unfortunate enough to get a cancer diagnosis is to understand that cancer is a systemic disease. In order to not be host to pathogenic cells (wherever they decide to take up residence in your body), you must make your entire body an inhospitable host to pathogenic cells. Eating organically, falling in love with green (all the green veggies), and actively detoxing on a regular basis – these all assist the body in returning back to the healthy state that it wants to be in.