Research
Prevention
Conflicts of Interest
Solutions / Obstacles
Patient Support / Education
Research
Lies, Damned Lies, and Medical Science
An 'astonishing' breadth of error in medical research, painstakingly sleuthed by Dr. John Ioannidis and his team. Conflicts of interest, bias and fraud, bad results buried and 'good' ones exaggerated.
"If we don't tell the public about these problems, then we're no better than nonscientists who falsely claim they can heal." - Dr. John Ioannidis
Why Haven't We Cured Cancer Yet?
This is tough reading on several levels, well worth it to understand why giving a greater national priority to cancer prevention should go without saying. And yet does not. 'Evolution rules' is one compelling conclusion of this well-written entry by breast-cancer surgeon Dr. David Gorski.
He incorporates this point-of-view from a NEJM editorial:
"A serious flaw in the imagined future of oncology is its underestimation of tumor heterogeneity ... within an individual tumor." - Dr. Dan L. Longo, Deputy Editor, cancer researcher
Progress in linking genes to disease: yes and no
Big strides, technically. Baby steps, clinically.
"In pointing at everything, genetics would point at nothing." - Dr. David B. Goldstein
Cancer Sleeper Cells
A glimpse into cancer stem cells. This is masterful at helping readers understand cancer as cells that don't die.
"Universal cures and theories of cancer have so often failed that we may as well spend time talking about specific theories for specific forms of cancer." - Sean Morrison
Prevention
Silent Spring
Researches links between environmental chemicals and health, breast cancer in particular. For example, a recent study analyzed hormone disruptors and asthma-related chemicals in 50 types of household products whose labels did not fully disclose their existence. This institute disseminates their findings widely and pushes for specific policy actions.
Cancer Prevention Coalition
A coalition of experts, activists and others fighting to stop cancer before it starts. Dr. Samuel Epstein continues at the helm, writes a blog on the Huffington Post, and is a straight-talking, densely informed critic of the cancer industry. Copious information on this site. Start, perhaps, with a click on Avoidable Cancers.
Environmental Working Group
A research and advocacy firm with teeth, dogged persistence, and notable accomplishments toward shaping a less toxic environment or at the least, helping us understand what we're really breathing, eating, drinking.
The Center for Science in the Public Interest
Generally focused on food safety and 'transforming the American diet', CSPI puts out a subscription health letter, litigates to change industry practice, and acts as a watchdog on food and drink ingredients. Witness this 2012 public health exposure to carcinogenic caramel coloring in Coke and Pepsi products.
Conflicts of Interest
Oncology is a business
In an effort to bring down costs, Medicare cut back on reimbursements to oncologists for chemotherapy drugs. It didn't work; physicians adjusted in other ways. This 2007 article demonstrates the system's skewed incentives.
"There's pretty good evidence at this point that there are plenty of patients for whom there's little hope, who are terminally ill, whom chemotherapy is not going to help, who get chemotherapy." - Dr. Richard Deyo
"People go where the money is, and you'd like to believe it's different in medicine, but it's really (not)." - Dr. Robert Geller
Fraud at Duke
So many lessons in this one. The limitations of genomics and of human nature. The runaway momentum of bad research moving unchecked into human trials.
A silent quid pro quo
The influence of pharmaceutical money on physicians.
'Menopause, as Brought to You by Big Pharma'
Containment and sleight of hand to protect a 'hormone franchise'.
Continuous Chemotherapy
A trend and a debate.
'The Man Who Did the Math'
This link references Dr. John Ioannidis' analysis of sub-standard research, already listed above yet it bears repeating.
"...the more that money or politics is involved in the research, the less likely the results are to be valid."
The Politics of Cancer Revisited
People can now buy this book for cheap on Amazon. It's a treasure and a reference tome. This link will display two other of Dr. Epstein's books. This one is a stunning, exhaustive expose of the forces he deems responsible for feeding instead of fighting the cancer epidemic.
Solutions / Obstacles
'There is a moon shot here'
Dr. Donald Berwick, chief of Medicare and Medicaid for too short a time, gave this exit interview to the New York Times at the close of 2011. While he expressed hope for the mission of the new health care law, he also pointed to huge waste -- up to 30 percent of spending every year -- and cited these 5 reasons: overtreatment of patients; failure to coordinate care; administrative complexity; burdensome rules; and fraud.
'Why We're Losing the War on Cancer (And How to Win It)'
This remarkable 2004 article, which first ran in Fortune Magazine, explores in detail a 'dysfunctional cancer culture' and remains highly recommended reading.
'I like looking for funny things'
Parallels to the chemosensitivity controversy explored in A Test of Survival can be found in the story of two persistent Australian scientists who went to extraordinary measures to prove that ulcers are caused by bacteria and do not require lifetime injestion of expensive anti-acid drugs. In 2005, Barry Marshall and Robin Warren were awarded the Nobel Prize. In his acceptance speech, Marshall alluded to the resistance he and Warren encountered via this quote from historian Daniel Boorstein:
'The greatest obstacle to knowledge is not ignorance; it is the illusion of knowledge.'
Patient Support / Education
CancerCare
Rich with information and resources for patients, survivors, and caregivers. The workshops concentrate in the northeast. Good search mechanisms for help by diagnosis and topic.
Patients Like Me
This site has been described as Facebook for the chronically ill. Patients contribute specific and detailed disease profiles in order to compare experiences and outcomes with others in similar circumstances. Names and identifying characteristics are extracted for privacy before the site shares all data with nonprofits, research hospitals, and drug companies. Three MIT engineers launched it in 2004. The mission of this transparency is to 'transform the way patients manage their own conditions, change the way industry conducts research, and improve patient care.'
Commonweal
A California health and environmental research institute whose objectives center around human and ecosystem health, in balance. They concentrate on five initiatives, including a weeklong residential program for people with cancer.
Science-Based Medicine
The thrust of this independent blog, managed by a core group of 8 physicians, is to promote higher standards of science in medicine, and to offer up for the general public a 'much needed scientific balance to the often credulous health reporting' on medicine and health.
Medline Plus
Offers patients a searchable array of NIH-sponsored information on disease and health topics, drugs, and current news.
Cancer Support Community
This is a merged entity of the Wellness Community and Gilda's Club Worldwide. You can search here for a CSC affiliate nearest you. Gilda's is generally a home-like meeting place offering free programs of emotional and social support for cancer patients, their families and friends.
End-of-Life Care: Need vs Reality
This NCI Journal article reaches several discouraging conclusions about end-of-life cancer care in America.
- Most people want to die at home but do not
- Most doctors are not discussing palliative care and other options with their patients
- Too many die in pain, and too many continue on chemotherapy in the last month of life
- There is a cause-and-effect relationship between avoiding frank discussions of death, and a patient's (and/or family's) willingness to undergo new or additional treatment
Breast Cancer Action
'A national, feminist grassroots education and advocacy organization working to end the breast cancer epidemic'
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