Cancer Decisions - Free Newsletter -April 11, 2004

THE MOSS REPORTS

In the words of the immortal Mark Twain, "there are three kinds of lies - lies, damned lies and statistics. "

Once a set of data has been statistically analyzed and the results expressed numerically, we tend to think of these numbers as being bedrock truths. However, this is very far from the case. Two statisticians could take the same set of data and come to startlingly different conclusions as to what the data show. Statistics, in short, do not tell the full story. And when we are told – as we repeatedly are – that progress is being made in the treatment of cancer and that fewer people are dying from cancer than they were ten, twenty or thirty years ago, we need to look at these figures critically, and analyze very carefully how they were arrived at and what they really mean.

In this week's newsletter, Dr. Moss reviews a recent article on progress in the cancer wars and casts a critical eye on the now-familiar mantra of soothing reassurances that form the basis of most journalistic reports on the subject.

For the past thirty years, Dr. Moss has monitored the field of cancer treatment and research, a field replete with opportunities for statistical obfuscation and linguistic double-talk. His observations on the current status of both conventional and alternative medicine have been carefully distilled into the Moss Reports – a series of 200-plus detailed reports on different kinds of cancer. If you or a loved one have been given a cancer diagnosis, a Moss Report on that particular kind of cancer can prove to be a valuable guide and friend through the long and sometimes difficult journey ahead.

To order a Moss Report, or to schedule a phone consultation with Dr. Ralph Moss, please call Diane at 1-800-980-1234 (814-238-3367 when calling from outside the US). You can also order reports through our website, http://www.cancerdecisions.com

CANCER MONTH

Despite an unexpected snowstorm here in the Northeast, spring has definitely arrived. And with spring comes the return of robins to the lawn, the first chartreuse shoots of the daffodils -- and the inevitable "Cancer Month" stories on TV and newsstands.

In April, in the United States, we traditionally endure a barrage of propaganda on behalf of the cancer establishment. A long-ago President (I think it was FDR) originally named April "Cancer Month" because that hopeful time was when the giant American Cancer Society (ACS) concentrated its annual fund-raising efforts. Canada followed suit.

Since then many patient interest groups have lobbied for their own causes, and succeeding Presidents have proclaimed "Awareness Months" for colorectal (March), ovarian (September), childhood (October), and prostate (November) cancers. Historically, the major media have always "done the right thing" during the month of April by expanding their favorable coverage of the war on cancer. It has been seen as almost a patriotic duty. (The ACS, said one editor, is no more political than God.)

In the past, this usually meant obligatory stories about the great progress being made through the standard treatments, especially chemotherapy. And this kind of story is still a journalistic mainstay. But clearly times are changing. This year, two major news magazines featured cancer treatment on their front covers, but gave little aid and comfort to cancer fundraisers. I dealt with Fortune's blistering critique of the war on cancer in last week's newsletter. But equally surprising is US News & World Report's cover story on "Cancer: The New Survivors" (April 5, 2004).

Ostensibly, this article is a paean to modern treatment. The subheading reads, "True stories of men and women who beat the odds—and how they did it." The main article is entitled "Beating A Killer," with the tagline: "Cancer was once the end of the line. Today, it can be managed and defeated." Anticipating undiluted optimism, I plunked down my $3.99 for this issue somewhat reluctantly. I figured I was in for another dose of eyewash on the miracles of Erbitux, oxaliplatin and Avastin.

And, as expected, the issue does contain standard bows towards America's long-running war on cancer. "The field of cancer medicine is nothing short of breathtaking," enthused Bernadine Healy, MD, a former National Institutes of Health (NIH) director, who now writes the "On Health" column for the magazine. The caption of a photograph accompanying her column tells us that "investment in basic cancer research has helped create a generation of survivors." But simply repeating this, no matter how often, nor how passionately, does not make it so…as last month's Fortune cover story revealed so trenchantly.

The US News article further claims that "nearly 10 million Americans…are living with cancer. Most were diagnosed five or more years ago; many who would have died just 15 or 20 years ago are alive today…." This is highly misleading. As the Fortune article showed, it is METASTATIC cancer that kills the great majority of those who die, and for the most common forms of the disease (such as cancers of the breast, colon, lung, and prostate) metastasis is still the relentless killer it always was. There has been virtually NO change in the survival from metastatic cancer over the last 50 years. The apparent improvement in the survival figures has mainly been due to the earlier detection of illness: people appear to be living longer, whereas in fact what has often happened is that they have received a diagnosis earlier, and have been officially on record for longer before metastasis overtakes them. In other words, many of them are the beneficiaries of a statistical artifact.

Sophisticated screening and early detection tests have also succeeded in finding many patients who have conditions that are not life-threatening (for example, some very early precancerous or encapsulated lesions of the breast or prostate). These people are often labeled as cancer patients, thereby weighting the statistics to make it appear that people with cancer are living longer overall. But many if not most of these people would not have died of cancer even if their tumors had not been detected. Of course, none of these statistical irregularities is a secret to the biostatisticians who are the gatekeepers of data analysis in the cancer field. But these are not the sort of facts that it is considered wise to share with the general public, upon whose generosity vast enterprises such as the American Cancer Society depend.

"Beating a Killer" repeats other familiar shibboleths of the cancer establishment. For instance, it defines five-year survival as "the marker of a successful cure." This endlessly-repeated fallacy has been exposed often. For example, here is what I wrote in my 1980 book, The Cancer Industry: "[A] person who is treated for cancer and survives five years is entered into the record books as a ‘cure.' What happens, however, if he has a recurrence of this cancer sometime later? What happens if he dies? He will then be in the paradoxical situation of having been officially cured of cancer, and dying of it at the same time" (p. 26).

Even the American Cancer Society, which once vigorously promulgated this five-year benchmark, has quietly modified its position. "While five-year relative survival rates are useful in monitoring progress in the early detection and treatment of cancer," it now writes, "they do not represent the proportion of people who are cured permanently since cancer can affect survival beyond five years after diagnosis" (ACS 2003)

Alas, the word on five-year survival has still not reached some of those who write about cancer in the mass media. There was, and is, no magic that occurs at the five-year survival point. In fact, reliance on such an arbitrary benchmark may engender an unwarranted sense of complacency among patients, who need to remain vigilant against a recurrence of cancer for the rest of their lives.

Rarely Spoken Truths

But don't get me wrong. Overall, this is an excellent article. The magazine's statutory knee-bends to orthodoxy are offset by the main article's refreshing outspokenness. For instance, the authors write, cancer and its treatment "often leave in their wake debilitating physical and emotional scars." The "very therapies that cured [patients, ed.] can also create a whole new set of problems—some, many years later."

"One major source of later problems," the authors state, "is radiation." As early as 1981, they write, scientists at the University of Pennsylvania learned that pediatric leukemia patients whose treatment included head irradiation (as it usually did) later suffered significant drops in their IQ. (The practice of routinely irradiating the brains of such patients went on for years, but has now largely been abandoned. So, in that sense at least, progress is being made.)

The article also reveals that children who were diagnosed with the form of lymphoma known as Hodgkins' disease are now known to have an 18 times greater risk of developing other cancers, mainly of the breast or thyroid, than healthy people. "Again," the article unambiguously states, "radiation was the culprit." Now there's a point of view rarely heard in mainstream publications!

There are also a few exposés of the long-term effects of chemotherapy. "It was once thought that healthy tissue surrounding the tumor would survive…a chemical assault, and in some parts of the body that's true. But it turns out the delicate white matter of the brain is not so resilient." It was frequently stated that the "blood-brain barrier," a layer of cells that keep larger molecules from entering the brain, would protect against most such damage. But "this protective barrier," write the authors, "isn't foolproof; it can be broken down by, among other things, radiation and inflammation that many of the chemotherapies cause." So here was another major miscalculation on the part of oncologists. The result, say many observers, is the widespread occurrence of so-called "chemo-brain," which is a highly distressing loss of memory and other cognitive functions often experienced by patients undergoing chemotherapy.

It was a condition that was discovered—and named—by the patients themselves. Conventional doctors are only now beginning to acknowledge and address the psychological needs of such patients. Psychiatrists at Sloan-Kettering Institute, for instance, have found that cancer and its aggressive treatment cause serious depression in 15 to 25 percent of cancer patients. "The depression itself can often be worse than the disease…." they say.

The US News article offers no solutions. But it deserves kudos for highlighting important aspects of the cancer problem that are rarely dealt with in the fluff pieces that usually fill the newsstands during America's original "Cancer Awareness Month."

--Ralph W. Moss, Ph.D.

References:

American Cancer Society, Cancer Facts & Figures 2003. Retrieved April 4, 2004 from: http://health.yahoo.com/health/centers/cancer/7

Healy, Bernadine. Yes, I am still here! (On Health column), US News and World Report, April 5, 2004, p. 68.

Szegedy-Maszak, Marianne and Hobson, Katherine. Beating a killer. US News and World Report, April 5, 2004, pp. 56-67. Retrieved April 5, 2004 from:
http://www.usnews.com/usnews/issue/040405/health/5cancer.htm

**NOTE** To view this page in a more printable format, please CLICK HERE.

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.