Healing Versus Curing

Source: https://glennsabin.com/cancer-healing-versus-curing/

The oncology community considers a patient cured after no sign of disease for five years after achieving a complete remission. It’s an arbitrary number since several types of cancers can return after 5, 10 or even 20 years.

I don’t have much use for the term ‘cure’. To me it’s a meaningless descriptor, full of caveats.

Healing, however, is a responsible term with a progressive definition. I believe that some level of healing is possible for every cancer patient.

Currently there are over 14 million cancer survivors in the U.S. alone. Some are in remission and many live full lives with cancer as a treatable, manageable chronic disease.  While active cancer treatment can be debilitating, with numerous harmful side effects, many patients at different stages of care and recovery can create an environment conducive to healing.  

Healing Takes Many Forms

Many think of cancer healing as the recovery process from invasive interventions such as surgery, radiation or chemotherapy.  It’s a common mindset of ‘I’ll endure the conventional treatment then heal from it’. While that’s certainly a true form of physical healing, there are numerous ways in which healing takes place. 

A 360 degree approach to cancer healing—one that comprehensively provides an environment in which true healing can occur—ought to be the overarching goal for those that provide and receive cancer care.

Of the many paths to healing, quality of life with emphasis on positive relationships is crucial. Regular physical activity, tailored to a patient’s condition, ability and interest can greatly affect one’s ability to heal at all levels. Nutritious meals, sufficient hydration, stress-reducing exercise and activities, and restorative sleep, are essential combinations for healing mind, body and spirit.

With the help of their friends, families, and caregivers, patients can participate in healing activities that may include journaling, listening to music, nature walks, and regularly spending time with family and friends. Even interaction with pets can be powerfully therapeutic for those who are animal lovers. 

Psycho-oncology, Stress Reduction and Living in the Present

Many cancer survivors will find solace working with psychotherapists and psychologists trained in oncology patient care. This can help patients gain and develop specific tools with which to deal with the uncertainty of a cancer diagnosis and the continuum of care along the journey into survivorship.

Notably, mind-body stress reduction therapies, under the guidance of a qualified practitioner, promote ‘living fully in the present’, where deep healing can occur.

Equally important is resolution within relationships. Addressing longstanding interpersonal issues can result in a healthier and more ‘settled’ mind; a tremendous healing benefit.

In summary, most qualitative lifestyle enhancing therapies, applied synergistically, can create a less toxic physical and emotional environment. Less toxicity equals a stronger base from which to deal with the challenge of underlying disease. 

While not everyone can be cured, we can all, at some level, be healed.

Modern science only identifies active disease once there are enough cancer cells to be picked up in a CT or PET scan, a blood test or, in my case, a bone marrow biopsy.  However, cancer stem cells are immortal; they can divide forever.

I go about my life as if micro-metastatic disease still exists. But of emphasis: this is not a fatalistic approach. We all have cancer cells in our bodies—it’s the job of our immune system to kill cancer cells around the clock. I endeavor to keep my system perpetually supercharged by closely adhering to my integrative health regimen.

Cure is an outmoded, useless word to describe disease-free survivors.  This is why I do not use the ‘cure’ word when describing my personal course with an ‘incurable’ cancer and the remarkable outcomes I have achieved with only natural approaches. It is not because I am afraid to tempt fate; it is based upon my intimate experiences with and understanding of healing.

I experience healing every day. Restorative therapies are available to us all. It’s time to reframe our thoughts and focus our actions.



Is curing patients a sustainable business model?

Read more: https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patients-a-sustainable-business-model.html

Tae Kim@firstadopter

Published 3:15 PM ET Wed, 11 April 2018  Updated 7:20 PM ET Wed, 11 April 2018CNBC.com

Goldman Sachs analysts attempted to address a touchy subject for biotech companies, especially those involved in the pioneering “gene therapy” treatment: cures could be bad for business in the long run.

“Is curing patients a sustainable business model?” analysts ask in an April 10 report entitled “The Genome Revolution.”

“The potential to deliver ‘one shot cures’ is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies,” analyst Salveen Richter wrote in the note to clients Tuesday. “While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow.”

Richter cited Gilead Sciences’ treatments for hepatitis C, which achieved cure rates of more than 90 percent. The company’s U.S. sales for these hepatitis C treatments peaked at $12.5 billion in 2015, but have been falling ever since. Goldman estimates the U.S. sales for these treatments will be less than $4 billion this year, according to a table in the report.

“GILD is a case in point, where the success of its hepatitis C franchise has gradually exhausted the available pool of treatable patients,” the analyst wrote. “In the case of infectious diseases such as hepatitis C, curing existing patients also decreases the number of carriers able to transmit the virus to new patients, thus the incident pool also declines … Where an incident pool remains stable (eg, in cancer) the potential for a cure poses less risk to the sustainability of a franchise.”


Can Doctors Choose Between Saving Lives and Saving a Fortune?


America is great, they say! America is medically advanced — they have the best medicine, the best brains, etc. etc. But American is burdened by the most expensive health care cost in the world. Many Americans go bankrupt after being sick — especially after getting medical treatments for their cancer.

We in the developing countries are going to suffer similar fate like the Americans if we follow the so called Great American medical system!

Dr. Siddhartha Mukherje wrote this article in the New York Times.

Can Doctors Choose Between Saving Lives and Saving a Fortune?

To understand something about the spiraling cost of health care in the United States, we might begin with a typical conundrum:

Imagine a 60-something man — a nonsmoker, overweight, with diabetes — who has just survived a heart attack. Perhaps he had an angioplasty, with the placement of a stent, to open his arteries. The doctor’s job is to keep the vessels open.

The doctor has two choices of medicines to reduce the risk for a second heart attack.

  • There’s Plavix, a tried-and-tested blood thinner, that prevents clot formation; the generic version of the drug costs as little as 25 cents a pill.
  • And there’s Brilinta, a newer medicine that is also effective in clot prevention; it costs about $6.50 a pill — 25 times as much.

Brilinta is admittedly more effective than Plavix — by a 2 percentage points.

In a yearlong trial of 18,600 patients, 10 percent died from vascular causes, heart attack or stroke on Brilinta, while about 12 percent did on Plavix.

Should the doctor prescribe the best possible medicine, assuming that the man has private health insurance that will pay the bulk of the costs? Or should the doctor try to conserve health care costs by prescribing the cheaper medicine that is nearly as good?

“We thought about this nearly every day when discharging patients from the cardiology unit,” Dhruv Khullar, a newly minted hospital attending, told me. “Some of us believed that a doctor’s job is to deliver the best possible care.

Others argued that doctors should aim to find some balance between medical benefit, financial cost and social responsibility.

It’s the kind of question that we aren’t really trained to solve. Are costs something that an individual doctor should do something about? What is a doctor supposed to do?”

The authors, Irene Papanicolas, Liana Woskie and Ashish Jha, wrote …. the United States is a sore-thumb outlier among 11 wealthy nations in medical spending. We spend 18 percent of our G.D.P. on health care, while Australia, Canada, Denmark and Japan seem to make do with about half that amount.

Yet life expectancy in the United States is the lowest in the group, and infant mortality is the highest. Our out-of-control prices have a stifling effect on the economy.

So what is driving the cost? Each time we did go to a doctor, it seems, we managed to spend more. Tests were ordered more frequently: We sat inside M.R.I. and CT scanners more often than patients in most other countries.

We had high-cost surgical procedures performed more often than most other populations in the world. Knee replacements, cataract surgeries, cesarean deliveries, coronary-bypass grafts, angioplasty.

On average, though, the United States ranked among the highest in most operations. Many of these procedures cost more in America (an M.R.I. costs $1,150 in the United States and $140 in Switzerland; it’s hard to insist that an American M.R.I. is eight times as good).

And some of these procedures inevitably led to complications, and then we paid for those complications. The impact on overall life expectancy was evidently minimal.

The United States leads developed nations in what the surgeon and writer Atul Gawande has called an epidemic of “overtesting, overdiagnosis and overtreatment.”

If expensive procedures explain some of the costs accrued by Americans, pharmaceutical prices and spending offer an even more alarming explanation. We spent $1,443 annually per person (yes, you read that number right) on drugs — in part because each medicine costs us more, and in part because we used new drugs that weren’t even available in many other countries.

Humira, the treatment for rheumatoid arthritis, was priced at $2,500 per month in the United States versus $980 in Japan and France.

Lantus, the long-acting form of insulin, cost us $186 per month, four times the price in France. Adding pharmaceutical insult to injury, many more expensive drugs were invented in America — and yet we paid more than any other rich nation to use them ourselves.

Source: https://www.nytimes.com/2018/04/03/magazine/can-doctors-choose-between-saving-lives-and-saving-a-fortune.html?em_pos=small&emc=edit_ma_20180406&nl=magazine&nl_art=0&nlid=54459356emc%3Dedit_ma_20180406&ref=headline&te=1


New Cancer Drugs — Beware!!!

Source: http://cancerworld.net/wp-content/uploads/2018/02/CW81_Cover_Story.pdf

Should regulators insist on robust evidence that a new drug shows clear benefit to patients as a condition of approval, or are demands for such levels of certainty unrealistic, or even unethical? Marc Beishon reports.

  • two studies from the US and Europe that show that a majority of drugs enter the market without showing Overall Survival or Quality of Life, and only about 15% of these have since done so. The majority of cancer drugs enter the market without showing evidence of benefit on overall survival or quality of life.
  • Other studies have shown no relationship between price and clinical benefit of FDA-approved drugs.
  • There are just not many new cancer drugs that qualify as real game changers, particularly for solid tumours, although some are certainly huge money spinners for the pharmaceutical companies, owing to eye-watering price-tags.
  • A recent and “ridiculous” example, he says, is FDA approval for using adjuvant sunitinib for renal cancer. “Of the two trials, a larger one of 2,000 or so patients was totally negative, and a smaller one of 600 was only positive for progression-free survival but not for overall survival, and it has substantial toxicity.” 
  • “We do have some great new drugs,” says Tannock. “But I am concerned for patients who have little idea how to judge which ones are effective and end up selling everything to get them.” 
  • He argues that the progression-free survival (PFS) findings from trials may be biased, citing the BOLERO-2 trial, which showed that adding everolimus … to exemestane, doubled PFS in patients with advanced HER2+ breast cancer. “But toxicity was such that 25% of patients left the trial – and while the PFS was impressive, longer-term survival was negative. 
  • If you have an agent that improves PFS with minimal toxicity, such as aromatase inhibitors, that’s fine, but for those with high toxicity such as everolimus or sunitinib it is misguided to approve them.”



Starbucks must add cancer warning to coffee, says US court





Bad news, coffee drinkers: A California judge has ruled that coffee companies across the state will have to carry a cancer warning label because of a carcinogen that is present in the brewed beverage.

Starbucks Corp and other coffee sellers must put a cancer warning on coffee sold in California, a Los Angeles judge has ruled, possibly exposing the companies to millions of dollars in fines.

A little-known not-for-profit group sued some 90 coffee retailers, including Starbucks, on grounds they were violating a California law requiring companies to warn consumers of chemicals in their products that could cause cancer.

One of those chemicals is acrylamide, a byproduct of roasting coffee beans that is present in high levels in brewed coffee.


Prostate screening saves no lives and may do more harm than good




Screening for prostate cancer does not save lives, and may do more harm than good, a major study has concluded.

The largest ever trial of PSA (prostate specific antigen) tests – which all men over 50 can obtain on request from their GP – found that death rates were identical among men, whether or not they underwent screening.

Inviting symptomless men for the one-off blood test detects some tumours unlikely to be harmful – while still missing others that were fatal, researchers warned.

PSA tests do not save lives, but they do generate enormous revenues for cancer treatment clinics

The researchers studied 400,000 British men between the ages of 50 and 69 during a ten year follow-up period. The control group, representing 219,439 men, were not screened and had 7,853 cases of prostate cancer (3.6 percent). The 189,386 men who were invited for a PSA test were diagnosed more frequently (4.3 percent). In the follow up period, the same percentage died from prostate cancer (.29 percent), suggesting that PSA screening does not save lives and only leads to dangerous over-treatment.

Lead author Professor Richard Martin, a Cancer Research U.K. scientist at the University of Bristol said, “We found offering a single PSA test to men with no symptoms of prostate cancer does not save lives after an average follow up of 10 years.”





A lot of what is published is incorrect … science has taken a turn towards darkness

Dr. Richard Horton (2015), Editor-in-Chief of The Lancet, wrote in 2015

“A lot of what is published is incorrect.” I’m not allowed to say who made this remark because we were asked to observe Chatham House rules.

The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.

As one participant put it, “poor methods get results”.

The apparent endemicity of bad research behaviour is alarming. In their quest for telling a compelling story, scientists too often sculpt data to fit their preferred theory of the world. Or they retrofit hypotheses to fit their data.

Journal editors deserve their fair share of criticism too. We aid and abet the worst behaviours.

Our acquiescence to the impact factor fuels an unhealthy competition to win a place in a select few journals. Our love of “significance” pollutes the literature with many a statistical fairy-tale. We reject important confirmations.

Journals are not the only miscreants. Universities are in a perpetual struggle for money and talent, endpoints that foster reductive metrics, such as high-impact publication.

National assessment procedures, such as the Research Excellence Framework, incentivise bad practices. And individual scientists, including their most senior leaders, do little to alter a research culture that occasionally veers close to misconduct.

Can bad scientific practices be fixed? Part of the problem is that no-one is incentivised to be right. Instead, scientists are incentivised to be productive and innovative.

Would a Hippocratic Oath for science help? Certainly don’t add more layers of research red-tape.

But as to precisely what to do or how to do it, there were no firm answers. Those who have the power to act seem to think somebody else should act first. And every positive action (eg, funding well-powered replications) has a counterargument (science will become less creative). The good news is that science is beginning to take some of its worst failings very seriously. The bad news is that nobody is ready to take the first step to clean up the system.

Source: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2960696-1/fulltext?rss%3Dyes