Cancer Decisions - Free Newsletter

HERE AT THE MOSS REPORTS

We are dedicated to bringing our readers and clients the latest and most interesting developments in the field of cancer research and treatment.

The Moss Reports is a comprehensive series of detailed individual reports on more than 200 different kinds of cancer. Each of these reports analyzes the currently available treatments, both conventional and alternative, for that particular type of cancer and offers the cancer patient a clear-eyed, truthful assessment of the available options. If you would like to purchase a Moss Report for yourself or someone you love, you can do so securely from our Web site (www.cancerdecisions.com), or by calling 1-800-980-1234 (814-238-3367 from outside the US).

PHONE CONSULTATIONS

I also offer phone consultations to clients who have bought a Moss Report. A phone consultation can be enormously helpful in drawing up a treatment strategy and getting one's options clearly prioritized. A recent client offered the following comment:

"I want to express my thanks to Ralph Moss for the telephone consultation. I had done a fair amount of research before our conversation and had received advice about the treatments the oncologists felt I needed. The oncologists did not take into consideration my specific case, so it was so good to discuss my situation with Ralph Moss and receive advice and information I believe is not biased toward any specific treatment. It was so helpful and I have no doubts about the course I have chosen. Thank you so much." - S. F.

To schedule an appointment for a phone consultation, please call 1-800-980-1234 (814-238-3367 from outside the US), or email: Jacquie@cancerdecisions.com.

We look forward to helping you.

CURRENT TOPICS

A question that comes up very frequently in phone consultations with my clients is the issue of whether or not it is safe to take antioxidants while undergoing standard cancer treatments such as chemotherapy or radiation.

While there is mounting evidence to suggest that antioxidants are both safe and effective in counteracting the unpleasant side effects of chemotherapy and radiation, by and large the oncology profession tends to recommend strongly against the use of such supportive measures, citing concerns that antioxidants may interfere with the cancer-killing ability of standard treatments.

I have written an investigative report on this controversial subject, exposing the flaws in the arguments so often leveled against the use of antioxidants during cancer therapy. The report - Do Antioxidants and Chemotherapy Conflict? - is available for download from the Cancer Decisions web site: www.cancerdecisions.com.

This report is one of our Current Topics series - a growing list of in-depth analyses that focus on issues of importance to all who are interested in cancer prevention and treatment. Other Current Topics include:

On Guard - Gardasil (A discussion of the anti-cervical cancer vaccine Gardasil)
Do Antioxidants and Chemotherapy Conflict?
Mammography, Biopsy and the Diagnosis of Breast Cancer
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
The Mexican Cancer Clinics in the Era of Evidence-Based Medicine

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TAXOL DOES NOT HELP PREVENT RECURRENCE OF MOST COMMON BREAST CANCERS- PART TWO

(Last week we began a two-part newsletter on a newly-released study concluding that the chemotherapy drug Taxol, which is commonly used in the adjuvant treatment of breast cancer, brings no benefit to the majority of women for whom it is currently prescribed. We conclude the discussion, with references, this week.)

"The days of 'one size fits all' therapy for patients with breast cancer are coming to an end," said Anne Moore, MD, of Weill Cornell Medical College, who wrote an editorial accompanying the study in the New England Journal of Medicine.

"We should have done this [analysis, ed.] a long time ago," said study co-author, Donald Berry, MD, of the University of Texas M.D. Anderson Cancer Center, but the tools were lacking and researchers now have the advantage of longer follow-up of these women. Now, he added, "We can begin to use the biology of the cancer to decide whether the chemotherapy will work" before subjecting women to it.

"We want to make sure these data are correct before withholding it [Taxol] from some patients... the stakes are high," said the lead researcher, Daniel Hayes, MD, of the University of Michigan. "On the other hand, we don't want to keep a therapy that doesn't work."

Should women with HER2-negative and ER-positive cancers reject the use of Taxol? Probably, according to the current data. Yet, despite this study's surprising findings, there are indications that many doctors will continue to give Taxol to most women with breast cancer, according to Julie Gralow, MD, of the University of Washington School of Medicine. Some doctors fear lawsuits if the cancer recurs and chemotherapy was withheld. "It's just so much easier to give the chemotherapy and know you've been super-aggressive."

Women who have less aggressive types of breast cancer should also realize that the absolute benefit of chemotherapy in this situation might in any case be rather small. For instance, take the case of a 50-year-old woman of average health, who has a 1.1-2.0 centimeter, grade I tumor, and 1-3 positive lymph nodes. According to adjuvantonline.com, the risk assessment and prognostic tool used by many oncologists, this woman will typically have an 86.6 percent chance of being alive 10 years later, even if she does not receive adjuvant chemotherapy treatment after surgery. Her chance of dying of cancer over this 10 year period is 8.8 percent and her chance of dying of other causes in the same period is 4.6 percent.

If she takes hormonal therapy alone (typically, tamoxifen or an aromatase inhibitor) she will improve her chances of being alive at 10 years by 2.7 percent. If she takes adjuvant chemotherapy, such as ACT, she will improve her chances of being alive by a similar 2.8 percent. But if she takes both hormonal therapy and chemotherapy then her odds improve by 4.6 percent. In other words, chemo improves the odds of survival over surgery plus hormonal treatment by just 1.7 percent.

If this woman opted for the older CMF regimen (instead of ACT or one of the other so-called second or third generation chemotherapy regimens) then her benefit would be 1.4 percent and the improvement over hormonal treatment alone would be 0.9 percent. According to adjuvantonline.com, she would thereby lose a mere 0.8 percent survival benefit. But at least she would avoid the more serious potential side effects of both Adriamycin and Taxol.

Of course, this is just one scenario out of a large number of possibilities. Tumors vary in their size, grade, genetic characteristics, degree of invasiveness, etc. And, yes, there are clearly instances in which aggressive adjuvant chemotherapy is justifiable. But most of those cases involve HER2 positive and ER negative tumors, where, as we have seen, Taxol (and also Herceptin) can improve the survival figures and make them closer to those experienced by women with the more common HER2 negative and ER positive tumors.

In addition, I would call the reader's attention to a pending, as yet unpublished, study that is still hanging over the heads of oncologists. According to reputable press reports, scientists affiliated with the BCIRG 006 clinical trial have found that anthracyclines such as Adriamycin (doxorubicin) also provide no benefit to 92 percent of breast cancer patients (Bazell 2007). Only 8 percent of all women with breast cancer - those who over-express a specific gene called Topoll-2 (topoisomerase II alpha) - are said to benefit from anthracycline-based chemotherapy, since these drugs work by directly targeting Topoll-2. This paper was fully discussed in a previous newsletter:

http://www.cancerdecisions.com/070107.html

If that is the case, then it appears that Adriamycin - nicknamed "the red death" by some oncologists - will also need to be eliminated from the adjuvant treatment of the great majority of women with breast cancer. From the much-vaunted ACT regimen this would then leave only cyclophosphamide (Cytoxan), an old and somewhat less toxic drug that was first approved by the Food and Drug Administration (FDA) in November 1959 - 48 years ago this month! Wouldn't this be an opportune time for oncologists to step up efforts to individualize the treatment of all patients - and to seriously examine the use of nontoxic treatments from the realm of complementary and alternative medicine?

--Ralph W. Moss, Ph.D.

References:

Casarella WJ. A patient's viewpoint on a current controversy. Radiology 2002;224:927

Hayes DF, Thor AD, Dressler LG, et al. HER2 and Response to Paclitaxel in Node-Positive Breast Cancer. N Engl J Med 2007;357:1496-1506.

FDA tabulation of Taxol side effects:
http://www.fda.gov/cder/foi/label/1998/20262s24lbl.pdf

"Red death" attribution is taken from Jerome Groopman's book, How Doctors Think. Available at:
http://buybox.amazon.com/exec/obidos/redirect?tag=cancerdecisio-20&link_code=
xsc&creative=23424&camp=2025&path=/dt/assoc/tg/aa/xml/assoc/-/0618610030/
cancerdecisio-20/ref=ac_bb6_,_amazon

Robert Bazell's report on the problems facing the use of Adriamycin can be found at:
http://www.nbc11.com/msnbchealth/13470863/detail.html

My book, Questioning Chemotherapy, is available in bookstores or from Amazon:
http://buybox.amazon.com/exec/obidos/redirect?tag=cancerdecisio-20&link_code=
xsc&creative=23424&camp=2025&path=/dt/assoc/tg/aa/xml/assoc/-/188102525X/
cancerdecisio-20/ref=ac_bb6_,_amazon

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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.