HERE AT THE MOSS REPORTS

The sheer volume and complexity of the medical information that the newly diagnosed cancer patient must quickly absorb can be overwhelming. Often, decisions must be made in a hurry, and under great stress. It is not easy under these circumstances to make a careful and fully informed decision.

I have made it my life's work to study the medical literature critically and to question the basis for those cancer treatments that have become universally adopted without ever having been shown to prolong life. I have written and published extensively on the subject of cancer and its treatment, including compiling a comprehensive series of individual reports on more than 200 different cancer diagnoses – The Moss Reports – each one of which examines both the standard treatment options that are likely to be offered for a particular cancer diagnosis, and the possible alternative and complementary approaches to that disease.

If you would like to order a Moss Report for yourself or someone you love, you can do so from our website, www.cancerdecisions.com.

I also offer phone consultations to clients who have purchased a Moss Report. A phone consultation can be enormously helpful in drawing up an effective treatment strategy and getting one's options clearly prioritized. To schedule an appointment, please send an email to: Jacquie@cancerdecisions.com.

Also downloadable from our website are our special reports. Currently available are the following:

• Mammography, Biopsy and the Diagnosis of Breast Cancer
• Herceptin – or Deceptin?
• Do Antioxidants and Chemotherapy Conflict?
• Mexican Cancer Clinics in the Era of Evidence-Based Medicine

We look forward to helping you.

NEW CHAIR IN ORTHOMOLECULAR MEDICINE AT UNIVERSITY OF KANSAS

It has just been announced that a new chair in orthomolecular medicine and research has been endowed at the University of Kansas, in memory of Hugh D. Riordan, MD. Dr. Riordan's pioneering work in the use of vitamin C to combat cancer is thus fittingly commemorated and honored. It is especially gratifying that the first Riordan Professor of Orthomolecular Medicine and Research will be Jeanne Drisko, MD, who has herself done outstanding work in the field of vitamin C research. This appointment will allow Prof. Drisko to train fellows and carry forward the valuable and promising research that was begun by Dr. Riordan and others.

Readers who would like to do something practical to further this work can do so by making a bequest or donation to the Riordan Professorship Endowment at the University of Kansas. Such donations and bequests are tax deductible.

PLAYING WITH NUMBERS, CONTINUED

Last week we began a discussion of the alleged improvement in cancer statistics in the US, and showed that the small changes in cancer mortality rates that have been recorded may have been due the overdiagnosis of pseudo-disease and underdiagnosis of occult (hidden) cancer. We conclude this week with a consideration of the American Cancer Society's projections for 2006.

Cancer Facts and Figures

The statistical report on the absolute decline in cancer deaths coincided with publication of the American Cancer Society's 2006 Cancer Facts and Figures. This is a very useful compendium of cancer statistics. This year's issue, together with several back issues, are available at the ACS Web site, www.cancer.org. It is instructive to look at the projected deaths for 2006 for the various categories of cancer and then compare them to the 2005 figures.

Table 1
Changes in US Cancer Mortality, 2005-2006 (projected)

Source: Cancer Facts & Figures 2005 and 2006, available at www.cancer.org

If ACS's projections for 2005-2006 are correct, more major diagnostic categories will actually register an increase in the absolute number of cancer deaths than will see a decrease. (In the HTML version of this newsletter, decreases are highlighted in red). True, the total number of cancer deaths will decrease by 5,420. But that is mainly because the number of deaths from cancers of the respiratory system will decline by 1,090 and cancers of the genital system will decline by 3,860. Thus, these two types of cancer will account for 4,950 less deaths, which is 91.3 percent of the entire projected decline. So let us look more specifically at where that decline is taking place.

Table 2
Changes in US Respiratory Cancer Mortality, 2005-2006 (projected)

Source: Cancer Facts & Figures 2005 and 2006, available at www.cancer.org

While all the subcategories of respiratory cancers show a decline in deaths, the greatest reduction is in lung and bronchus cancer among women. This decline of 890 deaths is still only about 1.2 percent of the female lung cancer death total. But even so, it represents a favorable trend, paralleling the earlier sustained decline in lung cancer deaths among men. It is not hard to predict where this decline is coming from - reduced smoking. The ACS itself admits: "These trends in lung cancer mortality reflect decreased smoking rates over the past thirty years" (ACS, 2006 Cancer Facts & Figures, p.16), thereby undercutting the self-congratulatory message of ACS officials that the decline in deaths results in part from improved screening, early diagnosis and treatment.

What about the decline in mortality from cancers of the genitourinary system?

Table 3
Changes in US Genitourinary Cancer Mortality, 2005-2006 (projected)

Source: Cancer Facts & Figures 2005 and 2006, available at www.cancer.org

Again, we can see that many subcategories actually experienced increases in cancer mortality. What accounted for the relatively large decline in genitourinary cancer was a considerable reduction in the number of deaths from prostate cancer, which accounts for over three-quarters of the overall decline. The reason for this improvement is unknown. Again, it has been suggested that the decline is due to improved screening and early diagnosis, through digital rectal examinations (DRE) and prostate specific antigen (PSA) testing. However, this is unlikely, in the light of the recent data showing no actual survival benefit from either form of mass screening (Concato 2006). It may be due to improved treatment, such as the wider use of complete androgen blockade therapy, although I am unaware of any proof that this is so. Or, as I have suggested, it could possibly be due to improvements in life style factors (including supplement use) among men with the disease.

Conclusions

If the ACS figures given above are accurate, there does seem to be a slight downward trend in the overall cancer mortality in the US. But the operative word is "slight," being a fraction of one percent of the total. Between 2005 and 2006, judging from projected figures, there will continue to be a decline in the number of deaths, but this will also total a little less than one percent. Most of that decline will be registered in two particular categories: lung cancer in women and prostate cancer in men. The decline in female lung and bronchus cancer can be ascribed to a beneficial decline in cigarette smoking over the past few decades, which is now starting to have an impact on mortality rates. The reason for the modest decline in prostate cancer deaths in men is uncertain. However, to ascribe it to the increase in mass screening goes against the conclusions of the recent large-scale study on PSA and DRE from Yale University (Concato 2006). It may also be due to improvements in treatment (such as complete hormonal blockade), to lifestyle changes (including food supplements), or to factors yet unidentified.

To congratulate oneself for turning a corner in cancer deaths at this point is both premature and hubristic. This is especially so as the Baby Boom generation enters its golden years, a demographic trend which according to Dr. Jack Mandel, chairman of epidemiology at Emory University's Rollins School of Public Health, may lead to an increase in both cancer incidence and mortality.




--Ralph W. Moss, Ph.D.

References:

Concato J, Wells CK, Horwitz RI, et al. The effectiveness of screening for prostate cancer: a nested case-control study. Arch Intern Med. 2006;166:38-43.

Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345: 725-730.

Schroder FG, Roobol MJ, Boeve ER, et al. Randomized, double-blind, placebo-controlled crossover study in men with prostate cancer and rising PSA: effectiveness of a dietary supplement. Eur Urol. 2005;48:922-930.

Seben, Larry. Cancer deaths decline, Valley News Dispatch, Feb. 10, 2006. Available at:
http://pittsburghlive.com/x/tribune-review/trib/newssummary/s_422704.html

Welch HG, Black WC. Are deaths within 1 month of cancer-directed surgery attributed to cancer? J Natl Cancer Inst. 2002 Jul 17;94(14):1066-70.

Welch, H. Gilbert. Should I Be Tested for Cancer? Berkeley: University of California Press, 2004,

Welch HG, Schwartz LM, Woloshin S. Prostate-specific antigen levels in the United States: implications of various definitions for abnormal. J Natl Cancer Inst. 2005;97:1132-1137.

IMPORTANT DISCLAIMER

The news and other items in this newsletter are intended for informational purposes only. Nothing in this newsletter is intended to be a substitute for professional medical advice.

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