Cancer Decisions - Free Newsletter -July 11, 2004

THE MOSS REPORTS

Last year, Dr. Allen Roses, a worldwide Vice President at GlaxoSmithKline (GSK), Europe's largest drug company, gave an interview to the respected British national newspaper, the Independent, in which he stated that more than 90 percent of drugs only work in 30-50 percent of people (Independent, Dec 8, 2003). To many in the alternative medicine community, who have long been pointing out the ineffectiveness of many standard medical interventions, Roses' statement was remarkable as much for its source as for its content. For here was someone from the highest echelons of the drug industry – and a high-ranking academic scientist to boot (Dr. Roses is leading geneticist at Duke University) – admitting that a staggeringly high proportion of what is done in the name of medical science is known to be essentially useless.

But how are patients to know what works and what does not? How are people to make informed treatment choices if they cannot rely on the efficacy of the treatments that are recommended to them by their physicians?

For thirty years I have been studying and writing about cancer and its treatment, sifting through the medical evidence, analyzing the published data in order to ascertain what works and what does not. The Moss Reports, a series of more than two hundred separate reports on different types of cancer and their treatment, represents the distillation of the knowledge and insight I have acquired.

If you or your family are dealing with cancer, a Moss Report can provide you with the key to understanding the best that conventional and alternative medicine have to offer. You can order a Moss Report on your specific cancer type by calling Diane at 1-800-980-1234 (814-238-3367 from outside the US), or by visiting our website: http://www.cancerdecisions.com

We look forward to helping you.

UPDATE ON DR. MICHAEL HOLICK

I never conceived of this newsletter as a political tool. My primary aim has always been to educate patients and others who need current and accurate information on cancer treatment and prevention. But sometimes situations arise that require urgent action. Thus, several weeks ago I brought to your attention the case of Michael Holick, MD, PhD, a professor of dermatology at Boston University who was fired for simply advocating a few minutes of sunlight exposure per week. I offered you the chance of responding, with your own thoughts in your own way, to Boston University's dermatology department.

The response has been heartening. First of all, over 1,000 of you clicked on the link to Dr. William Grant's SUNARC website, which explores the connection between a lack of sunlight exposure and an increased risk of several diseases, including multiple sclerosis (MS) and several types of cancer. Second, many of you wrote to Boston University to complain about Dr. Holick's firing. We received copies of 56 such letters, many of which were very eloquent, and this week we are reprinting selected excerpts.

By the way, Dr. Holick's cause is not just fading away like last month's suntan. On June 14, he received two pages of favorable coverage in People magazine. The article began: "For Galileo, it was that whole earth-goes-round-the-sun thing. Michael Holick's scientific claim seems far less radical—he thinks getting a little sun now and then is good for you." People magazine has a paid circulation of 3.6 million and an overall readership more than ten times that. And so Holick's message, and news of the outrageous treatment meted out to him by his academic and professional colleagues, are now coming to the attention of a broader audience. Prof. Holick was recently in the United Kingdom promoting his new book, the UV Advantage, and his work has been the focus of in-depth articles in the Guardian, the BBC News, the Times of London, etc. Perhaps all this attention will convince Boston University to reverse its intemperate decision.

YOUR THOUGHTS ON PROFESSOR HOLICK'S FORCED RESIGNATION

A large majority of those who sent us copies of letters they had written expressed alarm at the trend toward political correctness and the curtailment of academic freedom that was exemplified in the way that Dr. Holick was treated by Boston University.

"I suggest that such a violation of Prof. Holick's academic freedom is shocking and repugnant," wrote Dr. Donald D [Note: Unless we have been specifically authorized to cite full names we are only using people's first names and initials to protect their privacy]. "I think it impugns your department's commitment to intellectual honesty, and I hope your department will reconsider its unwise action."

Dr. David M. wrote that this was "a reflection of an attitude that can only hurt legitimate scientific discourse." He added: "I am embarrassed as an alumnus of Boston University to see this kind of dogmatic ruling against a legitimate researcher."

"Dr.Holick has been fired simply because he does not agree with current sentiment," wrote Cheryl W. "This is hardly scientific! A university should be a place where ideas can be freely aired and discussed, not regulated."

Dr. Bill M. expressed similar sentiments: "Since the science on this issue is mixed, reversing Boston University School of Medicine's current position by reinstating Dr. Holick would be interpreted by this writer as a rational action based on science, not on dogma that is not well supported by the literature."

George R. also urged BU to reconsider its decision, and felt that the firing of Dr. Holick was "an instance of institutional suppression and punishment of researchers whose work challenges generally accepted principles of clinical practice. While a healthy dialogue about such subjects, and of course the revelation of the funding sources and conflicts of interest of the author(s) are crucial to the healthy progress of science, punishing those who have non-mainstream opinions runs directly counter to the ethical standards...which further scientific discovery and awareness."

Dr. Nan Fuchs, clinical nutritionist and editor of the Women's Health Letter, agreed: "Your action is a sad commentary on the state of education and the dissemination of information. I would hope you are open enough to reconsider your decision," she wrote.

Other correspondents drew on their own areas of professional expertise in order to express their alarm. For example, David G. pointed out that in negligence law there is a concept called 'res ipsa loquitur' (a Latin phrase meaning 'the thing speaks for itself'), referring to a situation in which there is no need to establish the cause of a mishap that led to injury because that cause is self-evident.

"For instance," he writes, "my piano falls on your head from my 4th floor apartment. No need to determine the cause of your injuries. The piano did it and it belongs to me. A clear case of res ipsa loquitur." He continues: "Dr. Holick's forced resignation is a case of academic res ipsa loquitur. It is perfectly obvious that Boston University has set the quest for truth aside to pursue other goals. Whatever those goals are, they have nothing to do with truth, science or respectable medical research."

Dr. Abram H., MD, one of the founders of orthomolecular medicine, drew parallels with the case of Dr. Thomas Sydenham, a seventeenth-century British physician who drew the ire of his medical contemporaries by challenging the prevailing philosophy of smallpox treatment, yet who is now recognized and revered as the father of clinical bedside medicine. "I thought that today surely we are much more enlightened than our former colleagues were and that we are prepared to reason with evidence even if it goes against the old paradigm," writes Dr. H. Not only is this an issue of academic freedom of speech, he continues, but also one of urgent clinical importance since the deliberate avoidance of sunlight is contributing to an alarming increase in overt vitamin D deficiency, one of the consequences of which is the development of the crippling bone disease rickets. "In Canada," Dr. H. writes, "pediatricians are being warned to deal with the increase in rickets following the advice of the dermatologists. Until now rickets was extremely rare."

Several others were also reminded of historical precedents for the hounding of scientific mavericks. "Looking back over the vast history of all scientific research and knowledge," wrote Karen McI., "major breakthroughs have often come after much persecution of those who proffer an opposing view." If what [Dr Holick] advocates has no merit, it will quietly fail on its own. But if it indeed has merit that is eventually proven, then your [Boston University's] criticism will come back to haunt you."

Dr. Andrea Z. expressed a similar sentiment. She urged BU to "[p]lease immediately rehire Dr Holick. Members of the scientific community must be able to hold varying opinions. Saying that the sun is bad is like saying the earth is flat... Old beliefs must be re-examined via research and debate."

The entrenched resistance to change exemplified by BU's decision also alarmed Jocelyn P-A, who wrote: "I am absolutely shocked that Boston Medical would fire a physician, Dr Holick, whose ideas and research do not mirror the paradigm of thinking within the institution. How else are advances in medicine ever made but when dogma...is challenged?"

Janine Z. put it succinctly: "The forced resignation of Dr. Holick for his intelligent scientific vision is just another example of medical dogma passing for science."

Another correspondent, Terry T., felt that Dr Holick might actually be better off out of BU: "Any reasonably literate person can see that Dr. Holick was fired as a result of a agenda-driven political position having absolutely nothing do with science, nothing to do with ethics, and certainly nothing to do with contributing to the open dialogues that are essential to research. I presume Dr. Holick will survive and prosper, having been relieved of the daily drudgery of forced interaction with such disagreeable and unethical associates."

Others were acutely aware, on a personal level, of the inhibiting effect that Dr Holick's firing may have on clinical research as a whole. Glenn N., himself a cancer survivor, expressed the view that BU's attempt "to strangulate a certain direction of medical research is unethical and is directly harming me and other cancer patients who need all the help we can get. Please reinstate Dr. Holick and allow him to continue his research, which could potentially save lives, including mine."

Another correspondent, Michael G., a clinical pharmacist who works primarily with geriatric patients, drew attention to the fact that a recent meta-analysis published in the April, 2004, issue of the Journal of the American Medical Association (JAMA) found that taking vitamin D supplements reduced the risk of falls in older people. Falls are the largest single cause of death from injury in older people and account for 40 percent of all nursing home admissions. Costs from fall-related injuries are projected to increase to 32.4 billion dollars by the year 2020. Michael G. continues: "Recent research has found that the incidence of such falls is increased in nursing home populations due to low vitamin D levels (possibly at least in part because of a lack of sun exposure). This is one more reason that a dogmatic approach to sun exposure is premature and based on insufficient information. I ask you to reconsider your actions against Dr. Holick."

People Who Live in Glass Houses...

Some correspondents were stung by the apparent double standard implicit in criticizing Dr. Holick for the research support he has received from the indoor tanning industry, when medical research at every level is financed and supported by the pharmaceutical industry. "Those who object to Dr. Holick's connections to indoor tanning should open their eyes to the fact that without funds there can be no research," wrote June R. "I would ask the Department of Dermatology if the funding of research from the chemical sunscreen industry should also be prohibited?" And, as Ed M. pointed out: "It is becoming clearer every day that allopathic medicine is bought and paid for by the pharmaceutical companies. If allopathic medicine and its total orientation to 'legalized' drug use - at the expense of 106,000 deaths per year by adverse drug reactions - were really healing people, the population wouldn't be running so fast to seek alternatives." (Note: see reference to Lazarou, 1998, below.)

Susan C. expressed the hope that one day this kind of corrupting, destructive association between industry and research will be a thing of the past. "I can only hope that the intellectual and scientific myopia engendered by these collaborations with industry among the major research institutions will give way to a greater curiosity about the many differing possibilities for the treatment of human disease and suffering," she wrote.

Just What the Doctor Ordered

Two more readers, both physicians, felt that the Holick firing raised important questions concerning the nature of medical practice. William L., MD, himself a cancer survivor, pointed out that the actions of the dermatology community in demonizing sunshine arise from a misguided and simplistic attempt to pinpoint a single cause for skin cancer. "We must feel some empathy for the poor dermatologists, whose approach to medicine is indeed 'superficial,' and who for the most part fail to realize that the skin disorders they attempt to treat are more than skin deep."

Dr. Sean M. wrote "I make a point of getting full body exposure to sunlight every day for a brief period in order to promote vitamin D synthesis. The hype over sun block lotions is just another example of the power of advertising in our lives today; not good science, just hysteria."

The patient's perspective was well put by Debi S., who wrote: "Are we not continually revising medical 'facts'? I would rather have a doctor like Dr. Holick who thinks for himself instead of just trusting as gospel the current ideas on medicine. There is still too much we don't know about human physiology to dismiss new concepts. To do so is a grave disservice not only to us, but to future generations. We need 'out-of-box' thinkers like Dr. Holick to challenge the accepted."

The Last Word

The last word goes to Allen K., of Temecula, CA, who summed up the sentiments of many when he wrote: "I once heard Dr. John R. Lee say, 'When you hear reports that 99 out of 100 doctors believe in a specific idea, I always ask myself, what does that one doctor know that the other 99 don't know?' Without the right of dissent, how is medicine to advance? I don't think it was appropriate to fire Dr. Holick for what really amounts to a very moderate deviation from that of orthodox dermatology."

I want to thank all of you for taking the time to express your feelings on this issue with such eloquence. There were dozens more messages, but the constraints of space prevent me from printing them all. I am sure that your letters will cause Boston University officials to think long and hard about the consequences of forcing Dr. Holick's resignation.

--Ralph W. Moss, Ph.D.

References:

Dr. Allen Roses interview reported in British Medical Journal:
http://bmj.bmjjournals.com/cgi/content/full/bmj;327/7428/1366

(Full text of interview can be purchased from The Independent:
http://news.independent.co.uk/low_res/story.jsp?story=471139&host=3&dir=505 )

Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA. 1998 Apr 15;279(15):1200-5).

Dr. William Grant SUNARC Foundation – http://www.sunarc.org

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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.