HERE AT THE MOSS REPORTS
Last October, the prestigious New England Journal of Medicine published the results of a study showing that lung cancer could be effectively detected while in its earliest stages by screening with a new kind of chest X-ray called helical, or spiral, CT scanning. The study, whose principal author was Claudia I. Henschke, MD, a professor of radiology at Weill Medical College of Cornell University, concluded that this type of screening was capable of preventing up to 80 percent of lung cancer deaths (Henschke 2006).
Naturally, that study generated tremendous media attention. However, by no means all of Henschke's medical colleagues were as confident as she was about the lifesaving potential of mass spiral CT screening for lung cancer. Indeed, last week another prestigious medical journal, the Journal of the American Medical Association (JAMA) published a study led by Peter B. Bach, MD, a leading pulmonologist and epidemiologist at Memorial Sloan-Kettering Cancer Center, strongly suggesting that the hope engendered by the earlier Henschke study was misplaced (Bach 2007). According to this latest study, spiral CT screening for lung cancer not only does not save lives, it may even result in more harm than good. "We don't think there is a hint of benefit," said Dr. Bach, bluntly, in an interview with the New York Times (Kolata).
Contradictions of this kind are very common in the field of clinical and epidemiological research. Over my long career in the field of cancer I have seen many theories arrive in a blaze of glory only to be discredited and quietly discarded a short time later. What are people to believe? How can cancer patients be sure that the choices and decisions they make are based on sound information?
By going to primary sources and carefully studying the scientific literature itself, I am able to provide my readers with the best possible synopsis of the current state of knowledge in the sphere of cancer prevention and treatment. My aim, and that of my organization, Cancer Communications, Inc., is to maintain the sort of consistent, reliably objective analytical standard that will allow my readers to make truly informed decisions.
In the past 30 years I have written and published extensively on the subject of cancer and its treatment. I have compiled a comprehensive series of more than 200 individual reports on different cancer diagnoses – The Moss Reports – each 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. These reports also contain extensive dietary and nutritional information for those who are actively dealing with cancer as well as for those who are recovering from treatment and hoping to prevent recurrence.
Typical of the comments we receive from those who have purchased a Moss Report is the following:
"It was heartening to receive a well-researched unbiased opinion from Dr. Moss. I thank you for being a watchdog over the business of cancer with an objective outlook that is a very useful resource to many. I will recommend your report to anyone with a diagnosis of cancer. Thank you." — M. R.
If you would like to order a Moss Report for yourself or someone you love, you can do so easily and securely from our website, www.cancerdecisions.com, or by calling 1-800-980-1234 (814-238-3367 from outside the US).
To those who have already purchased a Moss Report I also offer phone consultations. A phone consultation can be enormously helpful in drawing up an effective treatment strategy and getting one's options clearly prioritized. A recent phone consultation client wrote:
"Dr. Moss was such a pleasure to speak with. It was as if I was talking with an old friend. I always felt that I had his full attention as he patiently addressed each of my concerns and questions - something we don't often get from the experts. There is a vast sea of cancer information out there, oftentimes confusing and conflicting, which makes it hard for the lay person to process. Dr. Moss sifted and separated the information, making it so much easier for me to understand what my true needs might be. He validated many of my healthcare decisions, without advocating or pushing me in any particular direction. The word that comes to mind is "honor." I felt deeply honored by Dr. Moss. Cancer is not a linear path. I never know from day-to-day how I will feel or what new issues (oftentimes frightening) will be in front of me. The fact that I can email him at anytime should new questions arise is deeply appreciated.
He is a purpose-driven man, one whom I'm deeply indebted to for his many years of dedicated research and unselfish desire to help his fellow human beings deal with a devastating and frightening disease." — L.V.
To schedule an appointment for a phone consultation, please call 1-800-980-1234 (814-238-3367 from outside the US), or send an email to Jacquie@cancerdecisions.com.
We look forward to helping you.
CURRENT TOPICS
Recently we launched a new report in our popular Current Topics series – "On Guard – Gardasil" – focusing on the controversial new anti-cervical cancer vaccine, Gardasil. This report, and the others in the series (listed below), can be purchased for $9.95 each and downloaded directly from our Web site, www.cancerdecisions.com:
We look forward to helping you.
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BREAKING THE CAMEL'S BACK - PART TWO
(Last week I began a discussion of the launch by R. J. Reynolds, Inc., the giant tobacco company, of Camel No. 9, a brand of cigarettes deliberately designed and packaged to appeal to women. I conclude that discussion this week.)
The statistics on lung cancer among both women and men are grim. The age-adjusted lung cancer death rate, which was extremely low at the time of World War One, is currently 40 per 100,000. This may not seem like a lot, but lung cancer now accounts for most US cancer-related deaths in both men and women. An estimated 160,390 lung cancer deaths will occur in 2007. Since 1987, more women have been dying each year of lung cancer than of breast cancer. In men, lung cancer deaths have declined a bit, about 1.9 percent per year from 1991-2003, largely due to effective anti-smoking campaigns. But women, who started smoking later, have been playing catch-up with their male counterparts. Death rates among women who smoke have risen alarmingly for several decades and have only recently begun to plateau.
Taking into account the long latency period of the disease, lung cancer trends mirror the smoking habits of both men and women. The risk increases with the number of cigarettes smoked and the duration of the habit. There are other contributory causes and co-factors as well, and more should be done to explore and control these. But tobacco is responsible for between 80 and 90 percent of all lung cancers, and a host of other diseases as well.
Other cancers - for example, of the larynx, mouth and esophagus - are also associated with tobacco use. The risk of bladder and cervical cancer is similarly greater among smokers. In fact, according to the Centers for Disease Control and Prevention (CDC) more deaths are caused each year in the US by tobacco use than by all deaths from human immunodeficiency virus (HIV/AIDS), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined. On average, adults who smoke cigarettes die 14 years earlier than nonsmokers. Cigarette smoking results in a two- to three-fold increased risk of dying from coronary heart disease and a ten-fold increase in the risk of dying of chronic obstructive pulmonary disease (COPD).
Young people who are tempted to take up the habit (and currently 28 percent of high schoolers do) should know the odds: while early-stage lung cancer is sometimes curable through surgery, later-stage disease is usually not amenable to surgical cure, even with added radiation or chemotherapy. The five-year survival rate for all stages of lung cancer combined is 16 percent. However, patients with advanced lung cancer have a five-year survival of between 2 and 15 percent.
Given these grim facts, there is simply no excuse for us as a society to tolerate the introduction of ever-more-alluring tobacco products into the marketplace. At what point do we say "enough"? Maybe Camel No. 9 will be the straw that breaks the camel's back.
Granted, the US government has already banned TV and radio advertising of tobacco. However, this worked to the advantage of the biggest companies, for it made it virtually impossible for new brands to break into the market. There are also so many other media outlets at Madison Avenue's disposal that the TV and radio advertising ban has hardly made a dent in the overall problem. Nor have the warnings on tobacco packs made much of an impact. Young people just ignore them.
Better late than never, on Thursday, Feb. 15, 2007, a bipartisan group of Congressmen introduced legislation to give the FDA authority over tobacco products. This bill would, among other things, prevent advertising aimed at children and young adults; prevent the sale of tobacco products to minors; reduce tobacco product toxicity; and prevent misleading claims about smoking's many dangers. A similar Senate bill passed the Senate in 2004, but its companion measure failed to pass in the House of Representatives. However, this time, with the Democrats in control on Capitol Hill, observers feel the bill could indeed become law.
Not only are Edward Kennedy (D-MA) and John Cornyn (R-TX) sponsoring the bill in a bipartisan way in the Senate, along with Henry Waxman (D-CA) and Tom Davis (R-VA) in the House, but the Altria Group, manufacturer of Marlboro, the world's leading brand of cigarettes, wants the FDA to have authority over tobacco.
"We wholeheartedly support the FDA legislation introduced today in its entirety," said Marlboro (Altria) spokesman Steven Parris. "This thoughtful legislative approach offers the best way to advance real solutions to the many complex issues involving tobacco." This seems counterintuitive. But, apparently "Big Tobacco" yearns for a peaceful, albeit regulated, environment in which to pursue its long-term business strategy. The numerous lawsuits against tobacco interests threaten to undermine or even bankrupt the tobacco companies. Of course, once this legislation is passed, Big Tobacco may find ways to go on killing people out of the public eye, and without as much hubbub. On the other hand, at that point the struggle will pass to the Congress, to get them to tighten up regulatory loopholes.
I know that some people involved in complementary and alternative medicine (CAM) will rankle at this, since they distrust anything that empowers the FDA. But the real enemies here are lung cancer and other deadly smoking-related diseases, along with all those who promote tobacco usage; the FDA is the main regulatory weapon we have in this fight. Until recently, the tobacco industry flaunted scientific opinion with their claims that tobacco is not addictive. But it is addictive - highly addictive - and when you are dealing with addictive substances the ordinary rules of the free marketplace simply do not apply. You need vigilant regulation.
Unless blocked by the government, thousands of today's young women will start buying alluring "feminine" brands like Camel No. 9 in the same spirit in which they now buy Chanel No. 19. But cigarettes are not sexy. For many, those hot-pink fuchsia and minty-green teal smokes will deliver a devastating surprise in the form of lung cancer or other fatal diseases. And many young girls of the future will be missing their own mothers and grandmothers because they fell for the allure of Camel No. 9. Some women's liberation!

--Ralph W. Moss, Ph.D.
References:
Bach PB, Jett JR, Pastorino U, et al. Computed tomography screening and lung cancer outcomes. JAMA. 2007 Mar 7;297(9):953-61.
Henschke C, Yankelevitz DF, Libby DM, et al. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med. 2006 Oct 26;355(17):1763-71.
Kolata Gina. Researchers dispute benefits of CT scans for lung cancer. New York Times, Mar 7 2007.
Available at:
http://www.nytimes.com/2007/03/07/health/07lung.html
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