More Profit than Progress in Cancer Research
June 25, 2008
NBC's Chief Medical Correspondent Robert Bazell wrote the following commentary, "More Profit than Progress in Cancer Research: With so many expensive drugs available, why aren't we doing better?" published on June 10, 2008 on the MSNBC website. His comments were written at the American Society of Clinical Oncology's annual meeting, a gathering I attended in 2000 and 2001 when I worked for cancer advocacy non-profits in Washington, DC. As Bazell writes, some progress has been made in the "war on cancer." However, as Bazell states, there has been "shockingly little progress." Bazell asserts that in order to confront cancer, scientists need far more understanding about basic biology. I suggest that along with the micro, far more emphasis should focus on the macro. Cancer is not a disease in isolation. Cancer exists within the context of an entire body and being. I assert that more advances will be made when research and treatments are focused on the whole person.
More Profit than Progress in Cancer Research: With so many expensive drugs available, why aren't we doing better?
By Robert Bazell
As I do every year at this time, I have been covering the annual meeting of the American Society of Clinical Oncology, the world’s biggest gathering of cancer specialists. At least 33,000 medical professionals registered for this year’s meeting. The number of attendees has been climbing yearly for decades, an indication of the enormous growth of the cancer treatment industry.
In the massive commercial exhibits area, drug companies vie to attract attention for their treatments and diagnostics. Many of those products sell for tens of thousands of dollars a year for each patient and bring in billions of dollars for their manufacturers.
During conference session breaks the seemingly endless hallways of Chicago’s monstrous McCormick Place Convention Center become gorged with doctors walking at slightly crooked angles. The gait results from each carrying a conference bag filled with the huge printed programs, books of study abstracts, as well as the drug company handouts they accumulate. Those doctors, considered "thought leaders" whose prescribing patterns influence other doctors, score invitations to drug company parties at some of the cities most elegant restaurants and clubs.
In the midst of this annual frenzy, it's appropriate to ask a question that has become a cliché of medical journalism: Are we winning the war on cancer?
The inquiry has been recurring since December 23, 1971 when President Nixon signed into law the National Cancer Act, called the "War on Cancer" by those who backed it in Congress and the White House. At the signing Nixon declared, "I hope in the years ahead we will look back on this action today as the most significant action taken during my Administration."
The Act made the National Cancer Institute separate from the rest of the National Institutes of Health, with the NCI director reporting to the President. And it vastly increased funding for the NCI to $230 million that year. Today, the NCI’s annual budget is about $5 billion.
Difficult to eliminate
There is of course no simple answer to the question of progress against cancer. The word cancer applies to some 200 diseases characterized by uncontrolled cell growth. Today, a diagnosis of cancer is not the automatic death sentence that many saw it to be at the time of Nixon’s signing. Some 10 million Americans, in fact, are living with cancer.
In addition, the death rates from lung cancer — the biggest killer of all — have been dropping in men and have leveled off in women. That is due almost entirely to changes in smoking patterns that occurred decades ago.
The treatments that the lung cancer specialists here apply have little effect. In fact, one of the news announcements from this conference was that the drug Erbitux, which sells for about $17,000 a month, prolonged survival in lung cancer patients by an average of one month.
There have been small, but steady declines in other major killer cancers such as breast, colon, and prostate. Those have to do with better methods of early detection and treatment.
But when looking at the overall picture there has been shockingly little progress. In the United States between 1950 and 2005 (the last year for which data are available) the death rate from cancer declined by 5 percent, an amount that is mostly due to the decline in cigarette smoking. By contrast the death rate from heart disease fell in the same period by 64 percent!
As the population ages, more people will die of both cancer and heart disease so these figures from the American Cancer Society are adjusted to account for the aging population.
If so many more doctors are treating cancer with so many more expensive drugs why are they not doing better?
Basic research has revealed how similar cancer cells are to normal cells. That similarity makes it enormously difficult to eliminate cancer without destroying normal tissue.
There is no question that the $5 billion the government spends on cancer research is a good investment and should be increased. Indeed, adjusted for inflation it has been falling dramatically in recent years. In order to truly confront cancer, scientists need to understand far more about its basic biology.
Some cancer activists and politicians are starting to talk about a second war on cancer, or an immense, ongoing government-backed effort like the Apollo space program. If there is such a program, it would be very useful to have a discussion on how much we spend on basic research and prevention, compared to how much we spend on marginally useful treatments.
Like so many other conflicts, the "War on Cancer" does not have a clear outcome. But there is no question many have found it financially profitable.
©2008 MSNBC Interactive
Medicare's Influence on Cancer Care in America
June 24, 2008
The following article, "Medicare's Decisions May Affect Cancer Treatment" by Marc Garnick, M.D., was published in the Harvard Health Letter on May 5, 2008. This article illustrates how health insurance carriers, and in this example Medicare, can dictate cancer treatments in the United States.
Medicare's Decisions May Affect Cancer Treatment
By Marc Garnick, M.D.
Medicare is far and away the biggest health insurer. So Medicare decisions about how doctors and hospitals get paid influence care. Read this article, written by my colleague Dr. Howard LeWine, and then check out my take on this matter by reading my comments at the end of the article, which are in bold.
The male hormone testosterone promotes the growth of prostate cancer. A standard part of treatment for many men with prostate cancer includes lowering testosterone levels as much as possible. This can be done surgically, by removing the testes. It also can be done with periodic injections that stop testosterone from being made. The treatments are equally effective and have similar side effects.
During the 1990s and early 2000s, the injections became quite popular. The injections are done in the doctor's office, and can be given once per month, or once every three to four months.
Medicare found that the injections were helping men with prostate cancer live longer—a good thing for sure. But, these men had to continue getting the injections or else the testes would start making testosterone again. So it turned out that the long-term costs of the injections were much higher than the one-time cost of surgery.
There are two ways Medicare could have approached this. It could have agreed to pay only for the less expensive option, castration. But Medicare decided that was unfair because many men would find the surgery distressing and would much rather have injections.
So Medicare cut the amount of money it would pay to doctors for the injections. A study published in the journal Cancer found that after Medicare reduced these payments, fewer men got the shots and more men started getting surgery to stop testosterone instead.
This is just one example of how economics sometimes creeps into decision making. In all fairness, often times testosterone lowering therapy need be give for only a short period of time, and then is stopped. This allows the body to make testosterone again, and provided that the cancer has been treated successfully, should pose no problems and allow more normal functioning. Thus, surgical removal of the testicles would not be appropriate here, since the effect would be permanent.
The financial implications that could benefit a physician when he or she makes a recommendation to a patient regarding one treatment versus another is certainly an issue today. While there is no foolproof method in determining if your physician is acting is this manner, it may be helpful for you to raise this issue during your discussion with your doctor.
© 2008 Harvard Health Newsletter
Unstuck
June 10, 2008
Check out a superb new book called Unstuck by Jim Gordon, MD!
Here is a synopsis from the book.
Each year, as many as twenty million Americans are diagnosed with clinical depression. Tens of millions more have low energy, or feel unhappy and dissatisfied with their lives. And each year, American doctors write 189 million prescriptions for anti-depressant drugs for these people. Dr. James Gordon, a Harvard Medical School-educated psychiatrist who founded and directs The Center for Mind Body Medicine in Washington, DC, has been helping his patients find their way out of the darkness of depression for the past forty years. He has worked with everyone from high-powered Washington politicians to Hurricane Katrina victims, from overstressed doctors, lawyers, and stay-at-home moms to orphans from war-ravaged Kosovo and Gaza. Each one of Dr. Gordon’s patients is unique, but all suffer from some level of depression, and none are getting the relief they want from the anti-depressant drugs their doctors keep prescribing or the psychotherapy they’ve been receiving.
Dr. Gordon believes that depression is not an end point, a disease over which we have no control. It is a sign that our lives are out of balance, that we’re stuck. It’s a wake-up call and the start of a journey that can help us become whole and happy, one that can change and transform our lives. Unstuck is a practical, easy-to-use guide explaining the seven stages of Dr. Gordon’s approach and the steps we can take to exert control over our own lives and find hope and happiness. Unstuck is designed for anyone who is suffering from depression, from mild subclinical depression (“the blues”) to its severest forms. Using dramatic and inspiring examples from the patients he has worked with over the years, he explains the practical, mood-healing benefits of: food and nutritional supplements; Chinese medicine; movement, exercise and dance; psychotherapy, meditation and guided imagery; and spiritual practice and prayer. He concludes each chapter with a carefully designed prescription for Self-Care, guidelines to help each person play an active, effective role in their own healing. The result is Unstuck, an incredibly thoughtful, practical, and meditative guide to the difficult but rewarding journey out of depression.
And here is what I have to say about Jim's work.
As a 10 year brain tumor survivor and someone that has dealt with some depression over many years, my work with Jim Gordon, MD and the Center for Mind Body Medicine has been both revelatory and revolutionary. When we began working together, Jim encouraged me to utilize a number of simple and effective tools to empower me in becoming my own healer. Meditation, deep breathing, dancing, shaking, somatic release, exercise, yoga, dietary changes, and enhanced communication were some of Jim’s suggested strategies. In particular, Jim emphasized the power of becoming more authentic through identifying and honoring my feelings and needs as well as dropping my fears. Jim’s guidance has allowed me to further perceive depression and ailments as an invitation into the deeper self. Learning core life skills through self-awareness and self-care has invited me to integrate into my own wholeness. The work of Jim and the Center goes far beyond treating the malady in isolation. It is a whole body and being approach, and one that invites a pure and open heart— the ultimate catalyst in navigating through chambers of darkness.
Ode to Ode Magazine
June 3, 2008
Since I continue to have people contact me that have read the September 2006 “Vaccine Against Cancer” by Tina Touber in Ode Magazine featuring information about Robert Gorter and the Medical Center of Cologne, I need to express the following.
As you might have read in my September 2007 blog “In the Across the World Search for Cancer Treatments, No Guarantees,” Ode’s “Vaccine Against Cancer” article contains a number of significant inaccuracies about Robert Gorter and the Medical Center of Cologne. Ode Magazine needs to issue corrections to false information in their “Vaccine Against Cancer” article.
In November 2007, I contacted Ode’s Editor-in-Chief Jurriaan Kamp by letter and followed up with two voicemail messages about inaccuracies in “Vaccine Against Cancer”. I received no response. I know other people that have also contacted Ode about the Gorter article. They, too, received no response.
It is unfortunate that the media can report whatever they choose and not be held responsible for inaccuracies. Any factual errors by the media require corrections. The public deserves this level of integrity and accountability. As a freelance writer, I understand this principle, and know from first hand experience the challenges of crafting balanced articles. I’ve also experienced editors that sometimes, and perhaps unknowingly, create hype from how they choose to frame information for readers. I also recognize that I might be criticized by varied parties, including potential employers within the media, since I’ve been very outspoken about the Ode article. My interests here are truth, justice, and not deceiving vulnerable people affected by cancer.
The following text comes from the letter I wrote to Mr. Kamp in November 2007. And if you have not already, you may wish to read my September 2007 blog “In the Across the World Search for Cancer Treatments, No Guarantees” for additional information.
I am contacting you about the Ode September 2006 article “Vaccine Against Cancer” by Tina Touber about Robert Gorter and the Medical Center of Cologne (MCC).
Ode needs to be aware of the false information in the article, especially since “Vaccine Against Cancer” had a detrimental impact on a number of readers affected by cancer. Vulnerable and desperate patients and their loved ones have decided to pursue Gorter’s treatments based on the content of “Vaccine Against Cancer.” People affected by cancer continue to read the Ode article and contact Gorter about his treatments.
Mr. Kamp, I will be very honest with you and convey that I’ve been extremely frustrated about the content of the Ode article about Gorter. I have now moved beyond that anger and feel compassion for Ode’s intentions to spread hope into the world. With that said, the consequences of the Gorter article, especially due to the factual errors and inappropriate tone about Gorter having fantastically effective therapies for cancer, go far beyond what I think Ode is really about.
I have listed some of the inaccuracies as follows.
1. Ode wrote, “oncologist Robert Gorter.”
Correction: Robert Gorter is not an oncologist.
2. Ode wrote, “Gorter developed the cancer treatment using dendritic cells in co-operation with Professor Wolfgang Köstler of the University of Vienna in Austria and Professor Hinrich Peters of the University of Göttingen in Germany.”
Corrections: Robert Gorter did not develop dendritic cell vaccine therapy with Köstler or Peters. According to Peters, Gorter did not participate in dendritic cell vaccine development. Peters, who retired from the University of Göttingen and now consults with the Institute for Tumor Therapy (ITT), discovered how to isolate monocytes from dendritic cells and cultivate vaccines in the 1990s. Gorter pays a private laboratory to manufacture MCC patient vaccines.
3. Ode wrote, “He tested his findings in a study involving 171 women with metastasized breast cancer who had undergone many forms of chemotherapy and radiation treatment and were considered hopeless cases. Following Gorter’s treatment, about 10 percent of the patients were in remission—a surprising result in patients considered terminal. In 60 percent of the women, the treatment greatly extended and enhanced the quality of their lives although they did not recover. According to Gorter, no other treatment offers similar results.”
Corrections: Robert Gorter’s success rates communicated in Ode are unsubstantiated, and severely inflammatory. His results are not published, and he cannot produce any evidence to support such tremendous success.
4. Ode wrote, “Whether he’s in San Francisco, where he is a professor at the University of California, or one of the clinics he heads in Cape Town, Istanbul, Cologne or (shortly) Dubai and Shanghai—he is always on hand to help.”
Corrections: Robert Gorter is an associate clinical professor at the University of California at San Francisco as of May 2007. He does not have clinics in Cape Town, Istanbul, Dubai, or Shanghai.
5. Ode wrote, “Germany’s High Court in Karlsruhe ruled unanimously that qualified physicians have complete freedom to treat seriously ill patients as they see fit and that insurers must pay for the prescribed treatments.”
Corrections: Physicians in Germany do not have complete freedom to treat seriously ill patients as they see fit. Most insurers do not pay for the prescribed treatments.
6. Ode wrote, “So Joe Pacini flew from the U.S. to Germany. After a single treatment, he was able to walk a little. Two days later, he no longer needed any pain medication. On the third day, Gorter suggested they might be celebrating his 80th birthday together.”
Question and Clarification: Is it appropriate for any physician to suggest after three days of treatment that the patient might be celebrating their 80th birthday? Sadly, this patient Ode called Joe died in November 2006.
7. Ode wrote, “When, at the age of 26, he was diagnosed with an aggressive form of cancer that had spread to his stomach and lungs, he decided to heal himself.”
Question: Does Ode have any evidence that Robert Gorter indeed had cancer?
Call to Action
I invite you to contact Ode Magazine about their September 2006 article “Vaccine Against Cancer” by Tina Touber asking them to investigate the content and publish accurate information about Robert Gorter and the Medical Center of Cologne.
And please note it is without any pleasure that I continue to give an ounce of energy to my knowledge about Robert Gorter and the Medical Center of Cologne. Since I have gathered the data, and since I’m one of a small number of patients treated by Gorter that is still alive, I’ll use my voice in pursuit of truth and justice. |
