Six hours of establishment history rolled out by public television
New era of progress heralded as gene targeted drugs multiply
Will the series tell us of other, more promising approaches? Probably not.
Following the Pulitzer prize winning book published in 2010, Emperor of All Maladies, connoisseurs of misinformation, having enjoyed the Vaccine Wars repeat last week, can now settle down this Monday, Tuesday and Wednesday at 9pm on the East Coast for Ken Burns’ version of Emperor on PBS.
Judging from Burns’ WNYC radio interview in advance of this watershed event in cancer history, things are not promising. Guess what? From the sound of it, it wasn’t Peter Duesberg who found the first supposed oncogene and sequenced it (and later debunked it and all such specific cancer gene theory) any more. He is not to be mentioned. Instead we are to be told that Harold Varmus, the varmint at NCI, found with Bishop the src gene as the first supposed human oncogene. Well, we do know that Varmus, who headed the NIH after his Nobel and then Memorial Sloane-Kettering, and has ruled the NCI as director since 2010, is still denying Duesberg any money for his work, which is probably the only cancer lab research worth funding given the field’s continuing obsession with the inherited gene theory of cancer, which has yet to yield one actual oncogene consistently shown to mutate to originate any cancer (though scores of “confirmed” candidates last time we looked).
Now we have PBS doing its usual job of swallowing current leading publicly funded scientists’ story whole, without checking behind the scenes in any way. Here’s a talk by Peter Duesberg which might have shed more light on the real cancer research story and its scandalous misdirection today, Controversies in Cancer Research by Peter Duesberg.
Line up for your mastectomys, girls – now that Angelina Jolie has had her ovaries removed too, she has shown the way, and we will continue to ignore decades old clinical studies showing it doesn’t help at all – in fact it worsens outcomes.
But hey. if you have the gene it’s the best thing to do, reports Ken, advised by Siddhartha Mukherjee who has his Pulitzer in hand for the original book.
Is this what PBS supporters deserve for their support which they fondly believe frees PBS reporting from the money game? When will the progressive TV news program Democracy Now learn to handle the big scandals of science and expose all this nonsense? Not soon enough, sadly, given the mental paralysis in questioning that so often afflicts the left as soon as they hear the word science. Even though Amy Goodman, the admirable Democracy Now host and personification, has a biochemistry undergrad degree from Harvard, and planned a career in science before leading the way in progressive news coverage, it doesn’t seem likely she will investigate, though she has managed some coverage of scientific issues.
The truth is that this is still the greatest scourge of humanity just as it was for the Pharaohs, and PBS has a duty to investigate the topic as thoroughly as possible if there is any chance of saving women from the grotesque suffering it brings them either personally or through their children.
Times adds Op-Ed perspective
All is not lost at the Times, at least, since that generally admirable paper (except in its science coverage of HIV/AIDS, another giant boondoggle) allowed a small bit of enlightened skepticism to peek through on its Op Ed pages in the Weekly Review section yesterday. In Trying to Fool Cancer Mikkaela Sekeres, director of the Cleveland Clinic program on leukemia and an oncologist, is permitted to say that a national cancer policy focusing on drugs targeted on individual gene mutations may be something of a wild goose chase, since the cancer picture appears to be, from Cleveland Clinic research, a lot more complicated.
The problem is, cancer is rarely that simple, or that easily fooled.
Three recent studies, all published or presented late last year, highlight the challenges of building a national cancer therapy policy around precision medicine…..
Ten genetic mutations. So if you’re developing a drug to treat these cancers, which mutation would you choose to target? If your drug attacked the ninth or 10th mutation, the cancer would quickly regrow, because one through eight would still thrive…..
Targeting these mutations would be the best way to fight these cancers, right?
But what if it turns out that the founder mutations are part of a given person’s normal human genome — what are called “germline” mutations, which are present in both cancerous and noncancerous cells? Killing them could wreak havoc……
When we looked back to our database of more than 1,000 patients with similar disorders, we were able to identify eight others with this mutation who had already been treated with the drug I gave to my identical twin patients, and all had improved blood counts. This would seem to argue in favor of a national cancer policy focusing on targeted drugs.
Or does it? True, the twins had a founder genetic mutation for which we identified (by accident) a drug that worked really well, and neither had major side effects. But despite the improvement in their blood counts, when we examined their bone marrow after they had been treated, the twins’ cancer never went away, and one died from an infection related to his disease only months later……
One final study should give us all pause. Researchers from Harvard and M.I.T. analyzed genomic tests from more than 17,000 patients enrolled in diabetes or heart disease studies. They found that many had mutations more commonly associated with blood and bone marrow cancers, despite the fact that the patients did not have any known blood disorders…..
Even for patients who have a genetic mutation and a clearly defined cancer, that mutation might have nothing to do with causing the cancer. Targeting it with a drug could just damage cells that might be innocent bystanders.
Without doubt, therapies that target genetic abnormalities have made huge inroads in the survival of cancer patients, most notably in some chronic leukemias, melanomas and lung and breast cancers.
But they haven’t been curative. And we shouldn’t delude ourselves, or our patients, in thinking that standard chemotherapy is a thing of the past. Or that a few more months of life, which is what many targeted drugs have been able to deliver on average, is a panacea in cancer care.
Let’s see how many of these caveats are featured in Ken Burns’ six hour saga, which he produced. More intimately responsible for the level of new information and the perspective of the coverage is the director, Barak Goodman, perhaps. But whoever had the final say, the signs are not promising.
The horrible infliction of radical mastectomy, where the whole breast is removed and a good deal else, is recognized in this six hour history as having been uselessly savage for many years. Halsted’s desperate attempt at the turn of the century to prevent the cancer spreading was sadly misdirected, because it couldn’t block metastasis which had already happened through the blood. The problem was known since the 1940s, and mastectomy was confirmed by Bernard Fisher of the University of Pittsburgh in large scale trials in the 1970s as no better than lumpectomy. Not that that has stopped many doctors and surgeons from still perpetrating this barbaric piece of sadism on many women today, though the prophylactic double mastectomy that Angelina Jolie recently experienced, with typical female enthusiasm for maximum intervention, was undertaken for different reasons.
The motive for the operation in her case was not preventing metastasis but heading off the potential failure of her immune system to block cancer, which was reckoned a strong possibility owing to her possessing a BRCA1 gene (ie BReast CAncer 1). But the severe operation remains questioned by some for its possibly exaggerated statistical rationale, and more decisively, for its similar inability to prevent the cancer coming up in the chest wall or anywhere else. Jolie followed with a second operation removing her ovaries for the same reason a fortnight ago, again open to the same objection.
On this topic, a review paper in March last year showed that in general mastectomy is not only a treatment which results in nil advantage over lumpectomy, or ‘BCT – breast conservation therapy’, it actually worsens outcome in terms of death when used on early stage breast cancer (Effect of Breast Conservation Therapy vs Mastectomy on Disease Specific Survival for Early-Stage Breast Cancer, Agarwal et al., JAMA Surg. 2014;149(3):267-274.)
Skepticism on mammography, new drugs
It has already been made clear that the upbeat conclusion of this standard piece of establishment self congratulation is that a whole new wave of advance in the standard, oncogene fixated strategy against the Emperor’s cellular armies of the night can be expected. The wave will wash over the haplessly trusting patients as an armory of new and profitable drugs targeted against specific gene mutations will pad the billing of hospitals. But will they help, or will the great wave be to no real avail? As indicated above, this is by no means a sure thing.
After all, the earlier wave of early (before age 50) mammograms built up by advertising and promotion has run up against a seawall of reassessment in the last decade, leaving its benefits debatable in terms of risk and reward, for like chemotherapy, mammography itself risks cancer.
Alternatives without side effects
Any mention of dietary treatments and phytochemicals (plant constituents) will probably be absent, we expect, in the same way as they will no doubt be neglected in Memorial Sloane Kettering’s free lecture coming up shortly on Targeted Therapies for Breast Cancer: What Are They and How Do They Work?. Last time we attended a MSK briefing on breast cancer, the topic was entirely omitted, and one of the specialists presenting, a woman, said that diet was not addressed in treatment with any regard to what phytochemicals might be especially relevant to breast cancer.
That’s a pity, given the impressive lab results that have come through in the last two decades showing that phytochemicals can kill cancer cells in petri dishes faster than chemo. But of course, these are manufactured for free by Mother Nature, so no one can make enough money out of them to justify a billion dollar clinical trial to satisfy the authorities they are safe and have no side effects, even though we eat our veggies every day and prove otherwise.
Recent notable findings of interest in this regard include Resveratrol increases BRCA1 and BRAC2 mRNA expression in breast tumour cell lines Fustier et al Br J Cancer. 2003 Jul 7;89(1):168-72; BRCA1 and BRCA2 as molecular targets for phytochemicals indole-3-carbinol and genistein in breast and prostate cancer cells by Fan et al Br J Cancer. 2006 Feb 13;94(3):407-26 ;and the latest one to emphasize synergy in phytochemical action, here on breast cancer cells, Simultaneous Inhibition of Cell-Cycle, Proliferation, Survival, Metastatic Pathways and Induction of Apoptosis in breast cancer cells by a phytochemical super-cocktail: genes that underpin its mode of action, by Ouhtit et al, J Cancer. 2013 Nov 14;4(9):703-15. doi: 10.7150/jca.7235. eCollection 2013 .
The abstract of the last one emphasizes the advantages that Mother Nature offers over traditional chemotheray and radiation, let alone sadistic surgery:
Traditional chemotherapy and radiotherapy for cancer treatment face serious challenges such as drug resistance and toxic side effects. Complementary / Alternative medicine is increasingly being practiced worldwide due to its safety beneficial therapeutic effects…..
This investigation indicates the potential for development of a highly effective phytochemical combination for breast cancer chemoprevention / chemotherapy.
Optimistic, perhaps, but surely it is a tragedy that any avenue to progress should be blocked simply because it won’t make any money.
Tell that to Angelina Jolie.