Are cancer patients’ hopes for chemo too high?

Source: http://www.themalaysianinsider.com/features/article/are-cancer-patients-hopes-for-chemo-too-high/ 

NEW ENGLAND, Oct 25 — At least two thirds of people with advanced cancer believed the chemotherapy they were receiving might cure them, even though the treatment was only being given to buy some time or make them comfortable, according to a US survey.

Researchers reported in the New England Journal of Medicine that 69 per cent of patients who were terminally ill with lung cancer, and 81 per cent with fatal colorectal cancer, did not understand that their chemotherapy was not at all likely to eliminate their tumours.

“Their expectations are way out of line with reality,” said lead researcher Deborah Schrag of the Dana-Farber Cancer Institution in Boston, speaking to Reuters Health.

Perhaps ironically, the patients who had the nicest things to say about their doctors’ ability to communicate with them were less likely to understand the purpose of their chemotherapy than patients who had a less-favourable opinion of their communication with their physicians.

“This is not about bad doctors and it’s not about unintelligent patients,” said Schrag. “This is a complex communication dynamic. It’s hard to talk to people and tell them we can’t cure your cancer.”

She added that doctors find it uncomfortable to hammer home grim news and patients don’t want to believe it.

The findings are based on interviews with 1,193 patients, or their surrogates, who had been diagnosed with cancer that had spread. All were receiving chemotherapy.

“The fact that 20 to 30 per cent of respondents recognized that chemotherapy was not at all likely to cure them shows that at least some patients were able to accept this reality and to acknowledge it to an interviewer,” the researchers wrote in the New England Journal of Medicine.

The results are probably due, in varying degrees, to patients not being told their disease is incurable, patients not being told in a way that lets them understand, patients choosing not to believe the message, or patients being too optimistic, wrote Thomas Smith and Dan Longo of Johns Hopkins University School of Medicine.

“If patients actually have unrealistic expectations of a cure from a therapy that is administered with palliative intent, we have a serious problem of miscommunication we need to address,” they added in a commentary with the report.

Many patients think they are going to beat the odds.

“What are you supposed to do, stand in front of someone with advance disease and argue with them? It’s not productive,” said Hossein Borghaei, an oncologist at the Fox Chase Cancer Center in Philadelphia. “But I hear that all the time, especially from the younger patients.”

Schrag said it was a reminder to doctors to slow down and take some time to realize how hard the issue is.

“Recognize that this is not one conversation, but typically a series of conversations to see if they’ve understood it, and how they’re acting on it,” she added. — Reuters

 

 

Mobile phones can cause brain tumours, court rules.

A landmark court case has ruled there is a link between using a mobile phone and brain tumours, paving the way for a flood of legal actions.

“I was on the phone, usually the mobile, for at least five or six hours every day at work.I wanted it recognised that there was a link between my illness and the use of mobile and cordless phones.

Parents need to know their children are at risk of this illness.”

British scientists have claimed there is insufficient evidence to prove any link to mobiles.

But the respected oncologist and professor of environmental mutagenesis Angelo Gino Levis gave evidence for Mr Marcolini — along with neurosurgeon Dr Giuseppe Grasso. They said electromagnetic radiation emitted by mobile and cordless phones can damage cells, making tumours more likely.

Read more: http://www.telegraph.co.uk/health/9619514/Mobile-phones-can-cause-brain-tumours-court-rules..html

The Cancer Lobby

By NICHOLAS D. KRISTOF, Published: October 6, 2012

WHO knew that carcinogens had their own lobby in Washington?

Don’t believe me? Just consider formaldehyde, which is found in everything from nail polish to kitchen countertops, fabric softeners to carpets. Largely because of its use in building materials, we breathe formaldehyde fumes when we’re inside our homes. According to government scientists, it causes cancer.

The chemical industry is working frantically to suppress that scientific consensus — because it fears “public confusion.” Big Chem apparently worries that you might be confused if you learned that formaldehyde caused cancer of the nose and throat, and perhaps leukemia as well.

The industry’s strategy is to lobby Congress to cut off money for the Report on Carcinogens, a 500-page consensus document published every two years by the National Institutes of Health, containing the best information about what agents cause cancer. If that sounds like shooting the messenger, well, it is.

“The way the free market is supposed to work is that you have information,” said Lynn Goldman, dean of the school of public health at George Washington University. “They’re trying to squelch that information.”

The chemical industry is represented in Washington by the American Chemistry Council, which is the lobbying front for chemical giants like Exxon Mobil, Dow, BASF and DuPont. Those companies should understand that they risk their reputations when they toy with human lives.

Last month, 76 scientists wrote a joint letter to Congress noting that the World Health Organization also listed formaldehyde as a known carcinogen, and styrene as a possible carcinogen. They defended the Report on Carcinogens as “consistent with international scientific consensus.” “The American Chemistry Council is working to delay and ultimately destroy” the Report on Carcinogens, the scientists wrote.

The basic strategy is an old one. As David Michaels notes in his book “Doubt Is Their Product,” the first evidence that asbestos causes cancer emerged in the 1930s. But three decades later, industry executives were still railing about “ill-informed and exaggerated” press reports, still covering up staggering cancer rates, and still denouncing regulation of asbestos as “premature.” Huge numbers of Americans today are dying as a result.

Do we really want to go through that again?

Read more:  http://www.nytimes.com/2012/10/07/opinion/sunday/kristof-the-cancer-lobby.html?_r=1&nl=todaysheadlines&emc=edit_th_20121007

Fraud in the Scientific Literature

Last year, Nature, a leading scientific journal, calculated that published retractions had increased tenfold over the past decade — to more than 300 a year — even though the number of papers published rose only 44 percent. It attributed half of the retractions to embarrassing mistakes and half to “scientific misconduct” such as plagiarism, faked data and altered images.

Now a new study, published in the Proceedings of the National Academy of Sciences, has concluded that the degree of misconduct was even worse than previously thought. The authors analyzed more than 2,000 retracted papers in the biomedical and life sciences and found that misconduct was the reason for three-quarters of the retractions for which they could determine the cause.

There are many theories for why retractions and fraud have increased. A benign view suggests that because journals are now published online and more accessible to a wider audience, it’s easier for experts to spot erroneous or fraudulent papers. A darker view suggests that publish-or-perish pressures in the race to be first with a finding and to place it in a prestigious journal has driven scientists to make sloppy mistakes or even falsify data.

Read more:  http://www.nytimes.com/2012/10/06/opinion/fraud-in-the-scientific-literature.html?_r=1&nl=todaysheadlines&emc=edit_th_20121006