Cancer Decisions - Free Newsletter

RINGING IN A NEW YEAR

My staff and I would like to wish all our readers happiness and peace in the coming year.

HERE AT THE MOSS REPORTS

The one thing we all seem to be short of these days is time. This is as true for the medical profession as it is for everyone else. While your doctor would almost certainly like to spend more time with you, to explain things in more depth and answer your questions more fully, the constraints imposed by the increasingly prevalent managed care system conspire to make the allocated time per visit ever shorter.

Robbed of the opportunity to discuss their medical needs thoroughly with their physicians, people often turn to the Internet for answers. Certainly, the Internet has unlocked the medical libraries and made vast quantities of medical literature accessible to everyone. But it has also made a great deal of unreliable information available. Often such information is couched in deceptively pseudoscientific language, whose concealed purpose is to sell the unwary a product or service that is essentially worthless. Without the necessary background in the life sciences, it can be extremely hard to discern the fallacies in the sales talk or make sense of journal articles and technical literature.

For thirty years I have been studying cancer and its treatment, monitoring emerging research and writing about new approaches to cancer in the fields of both conventional and alternative medicine. The Moss Reports are the distillation of my long involvement with the field of cancer. Each report presents the available treatment options for a particular cancer diagnosis, discussing the rationale behind the treatment and objectively analyzing the expected success rate, drawbacks and alternatives.

If you would like to order a Moss Report for yourself or someone you love, you can do so from our website, 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 have been diagnosed with an indolent form of non-Hodgkins lymphoma and am not receiving any conventional treatment - I am on "watch and wait." I am therefore exploring all the complementary therapy options in order to avoid ever having to receive chemotherapy. I found the range of CAM options daunting. A telephone consultation with Dr Moss was absolutely invaluable in helping me put together a prioritized plan of action and to discard many options which were inappropriate for my condition. Dr Moss` wisdom, experience and helpful manner have been a tremendous help to me." - M.B.

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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ARE ANTHRACYCLINES ON THEIR WAY OUT?

One of North America's leading cancer researchers has delivered a major blow against a group of chemotherapy drugs that are widely used in the treatment of cancer. These drugs, known as anthracyclines, include epirubicin (Ellence, Pharmarubicin), idarubicin (Idamycin), and doxorubicin (Adriamycin).

Adriamycin is currently a mainstay of breast cancer chemotherapy. However, earlier this year, at a private forum held at the American Society of Clinical Oncology (ASCO) meeting, Dennis Slamon, MD, PhD, director of the Revlon/UCLA Women's Cancer Research Program of the University of California at Los Angeles, revealed that his research had shown anthracyclines to be effective only in a small minority of women with breast cancer. For perhaps 90 percent of women, these drugs have little or no benefit - and carry the risk of some potentially very serious adverse effects, including cardiac damage.

For our previous reporting on Slamon's work, see our newsletter at:
http://www.cancerdecisions.com/070107.html

Slamon, whose research played a pivotal role in the development of the targeted anticancer drug Herceptin, presented dramatic new data on anthracyclines in mid-December 2007 at the San Antonio Breast Cancer Symposium.

Speaking at the conference, he remarked that continued use of anthracyclines on a "one-size-fits-all approach is just crazy and it's medically dangerous." According to his presentation, both retrospective and prospective data show that the anthracyclines only benefit women who have a specific tumor profile that includes an amplification of both the HER2 receptor and the topoisomerase IIa gene (Topo IIa). Such dual gene amplifications occur together in only 8 percent of breast cancer patients. This means that 92 percent of women who receive this toxic drug derive no benefit from it whatsoever.

"When we didn't have an alternative and when we didn't know how to identify the women who would benefit, it made sense to use the drugs," Slamon told the San Antonio gathering.

The anthracyclines - particularly Adriamycin - yield about a 5 percent improvement in overall survival, explained Slamon. But that is because they have a big effect in a small minority of patients, with no effect at all in 92 percent.

Some oncologists (such as Jerome Groopman, MD) have dubbed Adriamycin "the red death," because of its striking rose-red color and its potentially fatal side effects. Adriamycin and the other anthracyclines are especially damaging to the heart. Adriamycin's label contains this dire warning:

"Myocardial [i.e. heart muscle] toxicity manifested in its most severe form by potentially fatal congestive heart failure may occur either during therapy or months to years after termination of therapy. The probability of developing impaired myocardial function… is estimated to be up to 20 percent at the highest doses. This toxicity may occur at lower cumulative doses in patients with prior mediastinal irradiation or on concurrent cyclophosphamide therapy or with pre-existing heart disease."

I think this FDA-sanctioned warning speaks for itself.

Slamon also discussed new data showing that when Herceptin was added to standard chemotherapy the results were as good as when Adriamycin was included. Essentially, the latter drug is unnecessary for all women who are candidates for Herceptin. Similar results have been seen in eight other studies.

Critics point to the fact that Slamon is a paid consultant for Genentech, the drug company which manufactures Herceptin. They also point out the fact that his data and conclusions have so far only been presented as an abstract, and as an informal discussion in the context of a meeting, rather than in the form of a paper published in the peer-reviewed medical literature. But given Slamon's status in the world of breast cancer research and treatment, his work, preliminary though it is, should have a major impact on oncologists' prescribing practices.

Eric Winer, MD, of Boston's Dana-Farber Cancer Center, who moderated the San Antonio Breast Cancer Conference session at which Slamon presented his data, told the Associated Press: "We are backing off on chemotherapy and using chemotherapy more selectively" (Marchione 2007). He further remarked: "It will make me very happy if we can get rid of Adriamycin and its inherent cardiac toxicity." But he stopped short of endorsing Slamon's attack on the anthracyclines. "I'm not ready to say that this is an agent that doesn't have a role - yet." Dr. Winer also said the debate over Adriamycin doesn't signal a "rift in the breast cancer community." Right. It's more like a chasm.

--Ralph W. Moss, Ph.D.

References:

Marilynn Marchione. Fewer Breast Patients May Need Chemo. Associated Press December 13th 2007; Accessed from:
http://news.yahoo.com/s/ap/20071213/ap_on_he_me/breast_cancer_chemo

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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.