Cancer Decisions - Free Newsletter

HERE AT THE MOSS REPORTS

People facing a diagnosis of cancer typically must make a series of crucial treatment decisions in very short order. It can be hard to choose wisely at a time when one is under such intense pressure. The widely praised Moss Reports are an invaluable source of information on the currently available conventional and alternative treatments. There are now well over 200 individual Moss Reports, each one on a different, specific kind of cancer. For the cancer patient, a Moss Report offers a truly comprehensive resource. These reports can be ordered and downloaded directly from our Web site, www.cancerdecisions.com.

For those who have already purchased a Moss Report on their specific cancer diagnosis, a phone consultation with Dr. Ralph Moss can be enormously helpful in narrowing down the options and arriving at a coherent treatment strategy. If you are a Moss Report client and would like to schedule a consultation with Dr. Moss, please send an email to: Jacquie@cancerdecisions.com.

Also available from our Web site are Current Topics, a series of concise special reports on specific cancer-related subjects. We currently offer the following:

Mammography, Biopsy and the Diagnosis of Breast Cancer
Do Antioxidants and Chemotherapy Conflict?
Herceptin – or Deceptin? (An evaluation of the use of Herceptin in breast cancer)
Avastin – Your Money or Your Life (A clear-eyed look at the 'targeted' drug Avastin)
The Politics of Hope: Andrew von Eschenbach and the Decline of the National Cancer Institute
Mexican Cancer Clinics in the Era of Evidence-Based Medicine

I also offer phone consultations. A phone consultation can be enormously helpful in drawing up a treatment strategy and getting one's options clearly prioritized. To schedule an appointment 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.

WHEN WILL NCI FACE REALITY?

[Dear Reader--Last week I began a multi-part article on the new Chinese gene therapy drug, Gendicine. I have more to say on that topic. Meanwhile, there have been some newsworthy developments that take precedence and that I want to bring to your immediate attention. We will pick up the Gendicine story again in the near future. –RWM]

The game around the National Cancer Institute (NCI) these days is to guess how long it will take the acting director, John Niederhuber, MD, to remove some of the embarrassing statements of his predecessor, Andrew von Eschenbach, MD, from the Institute's Web site.

For the past three years, Dr. von Eschenbach touted what he called his "challenge goal" of eliminating all suffering and death due to cancer by the year 2015. Nobody in the cancer field really believed that lofty goal was attainable. How, just to give one example, could the federal government hope to eliminate lung cancer within a dozen years when the American Lung Association's "report card" gives it three Fs and a D in the area of tobacco control?

To view the American Lung Association's State of Tobacco Control report card, please click here or go to:
http://lungaction.org/reports/national05.html

Yet, undeterred, Dr. von Eschenbach continued to recite his 2015 mantra – and further, as if the 2015 goal might in fact be too pessimistic (rather than the opposite), von Eschenbach at one point declared, in published correspondence with Sen. Arlen Specter (R-PA), that NCI could actually accomplish the elimination of all cancer deaths by 2010 - if only Congress would provide $600 million additional funding per year!

A few intrepid scientists spoke out publicly against this ludicrous goal, most notably Sir Paul Nurse, President of Rockefeller University, NY. "This cannot be justified even as a statement of aspiration because when we fail to deliver, as we surely will with such a claim, we will lose the confidence and trust of both the politicians and the public," Nurse said (Nurse 2006).

Dr. Nurse's comments can be read in full at:
http://www.cell.com/content/article/fulltext?uid=PIIS0092867405014613

But most cancer scientists felt it wiser to remain silent because funding for cancer research comes largely from the NCI. Even the National Cancer Advisory Board (NCAB), which is supposed to oversee the operations of the NCI's war on cancer, remained subservient. The members knew that in his dealings with critics, von Eschenbach could be vindictive, as when he cancelled NCI's group subscription to the well-respected Cancer Letter after that publication criticized his 2015 goal as unrealistic. The NCI publicly began referring to Dr. von Eschenbach's goal as a "Vision," as if it had come to him as a divine revelation, and was not simply the flawed and overreaching projection of an imperious government bureaucrat.

Another of von Eschenbach's dubious decisions was his appointment of Anna D. Barker, PhD, as his deputy director. Not only does Dr. Barker have insufficient scientific background to hold such an important post (just a dozen scientific articles, all dating from the 1970s), but she has publicly expressed opposition to the rigorous testing of new medicines. However, the acting NCI head, John Niederhuber, has defended this appointment and expressed the desire to continue her tenure. "Of course, Anna Barker has scars all over her body," Dr. Niederhuber said recently, "because she's 'the terrible witch of Bethesda' that created all these huge, big projects, and we know that these big projects have sapped the strength of NCI....Anna and I have defended this on a numerous occasions, and I think all of you know the importance of NCI continuing to lead biomedical research."

In fact, much of NCI's money has been poured into exactly the sort of huge favored projects that Niederhuber criticizes. Big laboratories doing genomics, proteomics, informatics and nanotechnology have received massive funding, leaving other critical areas, and young researchers, woefully under-funded.

"The success rate of awards compared with applications has slipped from close to one in three in the late 1990s to nearly one in five," said Sir Paul Nurse. "When many applications are of a high quality, low success rates increase to an undesirable level the influence of chance in decision making. This is bad for the overall research enterprise and is demotivating for the investigators making applications" (Nurse 2006).

I have nothing against the fields of genomics, informatics, proteomics or nanotechnology. Indeed, they are all important new areas of medical science. However, none of them is poised to make a big dent in cancer mortality and suffering in the foreseeable future. If you go to another government Web site, clinicaltrials.gov, and search for 'nanotechnology' you come up empty-handed. There is not even a single, small phase I clinical trial underway on the topic, or at least not one known to this comprehensive database. Yet it is precisely these fields that NCI is counting on to make historic treatment breakthroughs in record time.

Adding Insult to Injury

Adding insult to injury, in September, 2005, Pres. Bush appointed von Eschenbach to head the Food and Drug Administration (FDA), after then-commissioner Lewis Crawford, DVM, abruptly left. For a while, Von Eschenbach ran the NCI and the Food and Drug Administration (FDA) simultaneously. This put him in the position of heading both the agency responsible for developing new drugs (NCI) and also the agency with responsibility for approving them (FDA). He finally resigned from NCI on June 8, 2006, to concentrate on his job as acting commissioner of the FDA and also to prepare for confirmation hearings to become full commissioner of that massive agency. But that confirmation may never come to pass. It has been held up by two Democratic Senators, Hilary Clinton (D-NY) and Patty Murray (D-WA), who want a public declaration that the FDA will approve the so-called "morning after" contraceptive, Plan B. (Many Democrats feel they were deceived on this issue in the past, and don't want to be fooled again.) Without venturing into the merits of their case, it seems to me that the far more important issue is von Eschenbach's lack of suitability for any high office based upon his astonishingly poor record at NCI. Yet the fact that he has left NCI in disarray, after misusing the agency's resources in pursuit of his Quixotic goals, seems to have escaped Congressional attention entirely.

In my recent report on von Eschenbach, I wrote as follows about this growing fiasco:

"How long would a new director maintain the 2015 fiction in the face of growing criticism within the scientific community? Without von Eschenbach to support it, the 2015 deadline will certainly collapse under the weight of its own implausibility. Predicting the future is a notoriously unscientific enterprise, but I will predict that when the Times Square ball descends this New Year's Eve, the number "2015" will have disappeared from the NCI home page."

To purchase my recent Current Topic report on the situation at NCI click or go to:
http://www.cancerdecisions.com/041606.html

There are indeed signs that the 2015 "Vision" is tottering. In fact, I think the only question now is how to remove that baleful date gracefully from the NCI's Web site. At the June 14, 2006 meeting of the National Cancer Advisory Board (NCAB), there was zero mention of the 2015 goal. Acting NCI Director Niederhuber informed the NCAB, which has primary responsibility for advising NCI, that, last year, cancer center directors around the country had actually gone into revolt against von Eschenbach's meaningless plan and were drafting a report of their own seeking to provide an "honest" alternative to his goal. (This counter report is due to be released in September, 2006.) At the NCAB meeting, according to the Cancer Letter, Dr. Niederhuber went through verbal gymnastics simply to avoid mentioning the embarrassing 2015 deadline.

Here is how he worked around it: In the fall of 2005, he said, the rebellious center directors "felt that they wanted to have greater input into some of the strategic goals and priorities that they felt would be necessary to advance towards our goals and to make a difference in the burden of cancer in this country." Whew – it can't be easy to criticize your predecessor without appearing to be criticizing anything!

But as Cancer Letter's veteran reporter Kirsten Boyd Goldberg commented: "The de-2015-ization at the institute isn't complete. The NCI Web site is yet to be cleansed of now-antiquated agitprop" (June 15, 2006).

What Goldberg is referring to is the fact that if you visit www.cancer.gov, you will still find a three-column banner headline advertising "NCI Challenge Goal for 2015: Eliminating the Suffering and Death Due to Cancer." Clicking on this link, you are taken to a whole page of further links to verbose articles extolling the 2015 goal. The most surreal touch is that, as of at least June 18, NCI's "Director's Message" is not from the Acting Director, Dr. Niederhuber, but from the departed von Eschenbach.

http://www.cancer.gov/aboutnci/NCI-Strategic-Plan-2015

His presence still haunts the NCI. The Web site still carries a dozen or so articles elaborating on the "realistic goal" (as NCI calls it) of eliminating all cancer suffering and death in less than a decade. "We believe that the Vision is within our grasp," the erstwhile Director states. In fact, the Vision was and is a will-o'-the-wisp, which has led nowhere over the past four years.

To be concluded, with references, next week

--Ralph W. Moss, Ph.D.

**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.