Friday, September 23, 2005

Healthy Skepticism on Cancer

Here are some stats from a new book called “What Canadians Think about Almost Everything
  • 7 out of 10 Canadians are confident that within their life-time scientists will find a cure for cancer.
  • 68% think that , within the next ten years, cancer will become something you live with, rather than something you die from.
  • 9 in 10 Canadians would like to know more about latest advances in cancer research.
And here is a comment about this data from Dr. Ralph Faggotter, an Australian General Practioner who is on the management team of the organization Healthy Skepticism. These are comments he made on a private listerv I am a member of. He’s given me permission to share his opinion.

“The results of this poll are not surprising since we are constantly being bombarded by the media with stories of scientific breakthroughs which have just occurred or are just about to occur. These stories usually predict that massive benefits for humankind will flow from these impending discoveries. This constantly replayed mantra serves to reinforce the essential underlying theme of modernity, which is the notion of constant progress through science and technology.

It is not surprising, therefore, that most people believe that technology will 'cure cancer' soon.

It is also not surprising that people can’t cope with the following facts.

1/. Over-all technology creates much more cancer than it stops. Modern humans are living in a thick soup of chemical carcinogenic toxins created by the same system which claims to be working on 'curing cancer.' The dramatic rise in the incidence of cancers in the developed world over the last 60 years FOLLOWS the dramatic rise in technology.

2/. Digital technology and DNA technology have been very successful in recent years and this tends to obscure the fact that there has actually been very little change in the rest of technology over the last 25 years. (Even with digital and DNA technology, the basic science was worked out well before the last 25 years.) The real wonder is that that millions of scientists/researchers working with huge budgets all over the world have, after 25 years, been able to come up with so little.

The main drugs used to treat cancer have not changed much since I worked in oncology as an intern in 1980. Yes, there appear to be new drugs based on understanding the human genome in the pipeline, but these will be incredibly expensive and targeted to very specific situations as is the nature of DNA based technology. Furthermore, the same technology which enables these medications to be produced, also enables genetic engineering of a range of organisms in which the inherent dangers of increasing the rates of cancer creation even further are obvious. It is therefore probable that in the long-run, DNA based technologies will increase the incidence of cancer mortality not reduce it.

3/. Surely it makes more sense to reduce the risk of developing cancer, which can be done very cheaply ( in fact your society can save money in the process) rather than spending massive amounts of money and effort on pointlessly trying to find that forever elusive cure? What we need is less technology, not more. Over 20,000 different chemicals are commonly used by industry and we are exposed to these. Most of them have not been properly studied long-term. (You force feed the chemical to some rats and if they don’t all die within 24 hours you declare the chemical safe .) We need less carcinogenic chemicals in our food, clothing, agriculture, houses, gardens, workplaces, schools and transport systems.

5/. Technology makes us lazy and fat so that even if the carcinogens don’t get us, coronary artery disease and diabetes will. It makes me sad to see China industrializing according to the Western pattern and making the same errors. Out go the bicycles and in come the cars. Out goes fitness and in comes unfitness, respiratory disease from pollution, cancer heart disease and diabetes! Disaster! That's progress. ”

Indeed. Thank you, Doctor.

Wednesday, September 21, 2005

The Precautionary Principle

When I worked at one of Canada’s leading environmental organizations, the application of something called the “precautionary principle” was part of daily life.

The concept is simple: if you have enough scientific evidence to suggest that an action may cause harm to the environment or human health, but not enough evidence to assert the connection, you act in a way that protects the environment or human health, even if it has a negative impact on economic health.

(For definitions from a variety of places, type the following into Google – define: precautionary principle).

The problem with the concept of the precautionary principle is that it’s darned hard to convince industry and government to apply it.

Today in the New York Times, an old story with a new twist. California Wants to Serve a Warning With Fries

French fries and potato chips that are fried at high heat create acrylamide. Acrylamide has been linked to cancer in lab mice and rats. Do chips and fries cause cancer in humans? We’re not sure, but we do know that many substances that turn cells cancerous in mice and rats do the same to human cells. This is a situation where the precautionary principle should apply.

According to the article, the number one, most consumed food in American restaurants is French fries. Americans spend an estimated $4 billion a year on fries and $3 billion a year on potato chips.

The FDA and, of course, industry, are opposed to any labeling which would tell consumers that fries may be linked to cancer. But the state of California is going to court to force the issue under Proposition 65, which forces the state to regulate chemicals that are known to cause cancer or reproductive harm and to force manufacturers to label their products or otherwise warn consumers. Acrylamide is a chemical that has a variety of industrial uses, such as paint solvents and fertilizer, which all carry warning labels.

But, industry argues, the acrylamide that is found in chips and fries is not added, but happens as part of the natural cooking process (now, many would argue that deep frying at high heat is not actually a very natural cooking process, being quite a new way to prepare food, and, as most agree, not usually a healthy cooking style, regardless of acrylamide), and so should not be regulated - that is, warning labels should not apply.

The New York Times article is worth reading. And once you’ve read it, I defy you to put forth an argument that convincingly asserts that cancer is NOT a political disease.

Tuesday, September 20, 2005

A Canadian Hero Working for the Wrong Cause

I’ve been thinking about cancer a great deal this past few weeks. You know, Terry Fox Day and all the requisite activities and school homework related to raising money for cancer research that hits us every September. “Back to school” is synonymous with “cancer cure fundraising” when you have an elementary school-age kid in British Columbia (Terry’s home province).

So, at our school last year, the teachers set the goal of raising $500 for cancer research in the name of Terry Fox. A mighty feat, one would think, at an inner-city school with just 100 kids. Well, the rascals did it – and then some, raising almost $1,500 for the Terry Fox Foundation and cancer research. So this year the fundraising target has been set at $2,000, with the promise that if the kids succeed, the principal will allow one of the Grade 5 kids to shave his head (the principal’s head). My son, who is in the Grade 4/5 split class says that they all agree the principal will be sporting a mohawk if they succeed. Of course, the kids want to make the target.

So, how much effort have I made to help my son get his pledge sheet filled in and money raised to support cancer research and the shaving of the principal’s head? Zero. Nada.

Now, before you get all, “It’s Terry Fox…a Canadian icon…one our true heroes…how can you be such a heartless person…one in two people will develop cancer in their lifetime” on me, here’s why I cannot support fundraising for cancer research – especially fundraising done by kids who are fed only the line about how heroic Terry was, and that’s why they should raise the money.

Canadians (and I can assume Americans and Europeans as well) have been assured that a cure for cancer will be found in the foreseeable future. I’m sure I heard that when my own grandmother lost a breast to cancer back in the 80s. Twenty years later, the cure is still around the corner. How much money have well-meaning individuals, governments, charitable foundations and businesses contributed to finding this elusive yet at-our-fingertips cure? Billions of dollars.

A cure…spoken of as though cancer were one disease with one cause. While all the researchers are looking for a cure for cancer, who is out there addressing the causes of cancer? Why aren’t billions of dollars being invested in preventing cancer?

Cancer is caused by many things we know and lots of things we haven’t pinpointed. Of those things we know cause cancer, why haven’t government, industry and well-meaning individuals stepped up to stop the manufacture and use of cancer-causing chemicals?

Number one most obvious: the chemicals added to cigarettes. Why is this allowed? Why does the government continue to allow the tobacco industry to add proven cancer-causing chemicals to cigarettes?

This past summer I bought sunscreen for my son. Got it home and compared the ingredients to a list of chemicals known to cause cancer. Two of the six ingredients were identified as cancer-causing. Yet this product is allowed on the market.

Look at the ingredients in highly-processed foods. Many have been linked to cancer.

Think of the toxins spewed into the air by certain industries. Known cancer-causing fumes that we still allow to be released into the air we breathe.

Water polluted by chemical run-off from farms. Pesticides and herbicides sprayed directly on the food we eat – known to increase risk of cancer.

There’s no day to commemorate all the activists who work with miniscule resources to reduce the causes of cancer in our environment. Why don’t we have an Erin Brockovich Day where kids raise money and awareness about the industry in their hometown that employs and ruins the health of their moms, dads, aunts, uncles?

My own family used to own a paint and wall-board manufacturing company in the small town I grew up in, Cowansville, Quebec. A few years ago I checked a Pollution Probe website (which I can’t find now) to find the environmental ranking of my hometown. Cowansville, was listed as the major contributor to water and air pollution in the region. I told my mom.

“Yeah,” she said, “The big problem is the JJ Barker Company. You know, almost every one of the men who worked in that factory has had cancer? It was a terrible place to work.”

Pah! (Can’t point the finger at my dad though, because he got out of that business in the sixties, before anyone really understood how poisonous the manufacturing process actually was.)

So, aside from all the typical conspiracy theory tiatribe that you’ve no doubt heard and discounted, why would all the cancer agencies be so focused on curing cancer, rather than preventing it to begin with? Check out this eye-opening article about how tied to industry the American Cancer Agency is at

And the links in a post I made in May called, Cancer is a Political Disease

And when that cute little kid comes knocking at your door, asking for five bucks to support cancer research and Terry Fox and shaving the principal’s head: smile nicely and tell the little sucker that he’s been duped. Pat him on the shoulder and be the first to tell him the truth:

“Son, there is no cure for cancer. Eat your organic vegetables and pray that the winds are blowing in the opposite direction when the PVC-sided house next door goes up in flames. The only cure for cancer is prevention, my child.”

Monday, September 19, 2005

Calling all Canadian Bloggers

Help out a fellow Canuck who is doing his Master's thesis on Canadian blogs.

Do his short survey.

Thursday, September 15, 2005

Ditziness - it's not just blondes

It’s a pandemic. Adults, getting half-way to work before they remember that they forgot to stop by Starbucks on their way in. They were distracted. They have adult Attention Deficit Disorder. All the papers reported it today with headlines like “Adult Use of ADHD Medicines Surges.”

Golly – use among women aged 20-44 rose 113% between 2000 and 2004. How on earth were all those ditzy broads coping before they were diagnosed and treated for their ditziness? And how did it happen that all of a sudden, women in that age group started dropping brain cells to the degree that they needed pills to help them remember to keep at least one hand on the steering wheel while applying lip stick?

A quick trip to the Shire Pharmaceuticals website sheds some light on this shocking new phenomenon.

In March 2005, Shire’s CEO made a presentation to Merrill Lynch folks in New York. Slide 5 notes the 2004 FDA approval for adult use of Adderall XR, their ADD/ADHD drug. The slide also indicates that the FDA has granted them 6 months of additional market exclusivity.

And Slide 6 is a list of bullets related to the New River Agreement. I’m not sure what that is, but it is clearly a financial winner for Shire and is directly related to selling Adderall XR to the new adult market.

Shire’s March 2004 presentation to the Bear Stearns London Healthcare Conference indicates that sales of Adderall XR are still one of the company’s strengths and that something to look forward to, emerging data, is that “SPD503 is a novel non-stimulant for the treatment of ADHD.”

What is SPD503? you ask. I’ll tell you what Shire states as the profile:
-- Guanfacine originally used off-label in refractory ADHD patients or in those with contraindications to stimulants
-- Non-scheduled, non-stimulant compound
-- Established safety profile for active ingredient in adults
-- On approval, will be the first guanfacine product licensed for ADHD
-- Novel, patent protected, once-daily formulation of guanfacine
-- Shire holds license to use-patent in ADHD
-- Paediatric phase III started February 2003

Oh – and that the target filing date to get approval of this drug is in 2005 and that patent protection will last until 2015 (slide 25).

Then there’s the presentation Mr. Shire CEO made to Lehman Brothers Global Healthcare in March 2005 where he shares information that Adderall XR Adult which received FDA approval in August 2004, remains Shire’s “largest opportunity” (slide 4). While Slide 9 shows that Shire has four more ADHD drugs in Phase 3 development. Slide 12 indicates that Adderall XR is Shire’s most profitable drug with $606.7 million in sales in 2004, a 28% increase over 2003 sales of just $474.5 million.

I could go on. I won’t. But is it any surprise given what you now know about Shire’s passion for developing ADHD medicines, and their promise to shareholders to create a new adult market for ADHD, that adult ADHD diagnoses and prescriptions for treatment have increased by over 100% between 2000 and 2004? The kids prescribing rate has “only” increased by 54% in that same period.

Since most kids outgrow being kids, the rascals, Shire strategically set about to patent the first adult ADHD medication. The beauty of adult ADHD is that once you’ve been diagnosed, you never outgrow it! You’re an Adderall customer for life! Goodness knows you don’t want to return to your previous, pre-drug state of ditziness…

Get a life. Take our pills.

Monday, September 12, 2005

The kids are bummed...grab the zoloft

What the hell is this teaching moment all about?

In January 2004, Dr. Andrew Mosholder, an epidemiologist in the FDA's Office of Drug Safety, analysed 22 clinical trials of nine antidepressants and uncovered some damning evidence that indicated that SSRI antidepressants used by children caused a doubling in suicide attempts over kids who were given a placebo (sugar pill).

These studies had been done over the course of many years and then buried by the drug-makers. Dr. Mosholder blew the lid off the data which lead to the FDA holding meetings with industry, parents whose kids had been on SSRIs and killed themselves, doctors and others.

The result: the FDA ordered drug-makers to place black box warnings on all antidepressants that include the following information:
  • Antidepressants increase the risk of suicidal thinking and behavior (suicidality) in children and adolescents with MDD and other psychiatric disorders.
  • Anyone considering the use of an antidepressant in a child or adolescent for any clinical use must balance the risk of increased suicidality with the clinical need.
  • Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior.
  • Families and caregivers should be advised to closely observe the patient and to communicate with the prescriber.
  • A statement regarding whether the particular drug is approved for any pediatric indication(s) and, if so, which one(s).

So a Teaching Brief recently posted at has me a little baffled. Recall that positions itself as the leading source for doctor education.

The Tecahing Brief is called, Childhood Depression Is Understudied and Under-treated. It's a review of an article that just appeared in The Lancet, a British medical journal. The review talks about all the deficits in understanding and treating childhood depression and how many depressed kids are left untreated. And then, there’s this quote from the author, a doctor:
Although tricyclic antidepressants such as Elavil (amitriptyline), selective serotonin reuptake inhibitors such as Prozac and Zoloft (sertraline) and specific norepinephrine reuptake inhibitor (SNRI) such as Strattera (atomoxetine) all appear to work equally well in adults, there is little evidence to support the use of any but the selective serotinin reuptake inhibitors (SSRIs) in kids, Dr. Ryan asserted. (My emphases)

Dr. Ryan! Did you miss the memo? SSRIs lead to kids killing themselves! Oops. You must be pretty embarrassed, Dr. Ryan. Wait 'til the editor of The Lancet finds out that he, too, missed the memo. What an oversight…

...oh, unless you’re an industry shiller. An expert paid to help swing opinion about SSRI prescribing back into a favourable light…but that couldn't be... a doctor putting his self-interest before the patient's? The editor of a major meidcal journal blinded by junk science? No... that doesn't happen...

And as a very nice irony – or clever marketing strategy – the ad that accompanies this article is for Zoloft, an SSRI antidepressant, of course. (Check it out here). This animated antidepressant looks like it's straight from one of the crazy Neopets / Pokemon / Digimon series of animated characters my son loves. Just who are they trying to grab with this ad campaign? Moms or their kids?

Wednesday, September 07, 2005

Ah, Sugar! A Math Quiz?

According to a story at News Target, the average American consumes 150 pounds of sugar each year. I read that and thought, "okay, so the average American east my body weight in sugar every year. Big deal."

Here's the quiz: how much sugar would you have to eat each week to make it to 150 pounds of the white stuff in a year?

Hmmm...150 pounds in 365 days is just under half-a-pound a day...or, one teaspoon of sugar every hour of every day for the whole year. Eeech!

Of course, one can of soda will give you several of your hours' teaspoons. A chocolate bar a few more. So you can sleep sugar-free.

And that's the average - some Americans eat much less sugar which means...others eat much more.

Pass the sugar-free potato chips, please.