Cutting cancer rates: Data, models and a happy ending?

Thank you

I think that's all I need to say here

Excellent

Another thank you for a genuinely interesting article.

Well-written. Thanks!

+1

Just wanted to say that if this is the sort of article we can regularly expect in the Weekend Edition then I'm all for it.

More please.

Informative and useful

No tech angle but who cares. Thanks

"Statistics are one thing, but actually having a randomised controlled trial is still the gold standard in medicine."

And it can not be stated too emphatically - this is the difference between medicine and homeopathy (and similar bunkum).

randomised controlled trial is still the gold standard in medicine

If theory were practice it would be but as it is currently, it is emphatically not. I used to work in clinical trialling, at the randomisation and data collection end, and it was totally broken. What happened there was unforgivable.

This was reviewed by the very large well-known drugs companies (the ones who used us) and they would regularly inspect it and sign the process off because they just didn't have a clue (they sent executives rather than statisticians or IT people).

Finally, after I left someone sent a slightly competent team and they laid down the law, but it took too long.

I also worked with a guy who knew what happened earlier in the process and he said it was typically crap even before it reached us.

Maybe everything's changed in the 15 years since. Maybe.

(good article though, more please)

Chemo and radiotherapy before surgery

A very interesting article. I had a run in with bowel cancer 7 years ago. The treatment at the time recommended Chemo and radiotherapy BEFORE the surgery. Fortunately for me it worked! The thinking was that cancer is an uncontrolled multiplication of cells and that the healing process is itself cell growth as it repairs the cuts. Some mechanism may cause the healing process to rum amok. Using chemo and radiotherapy after surgery slows the healing process and this may have some effect on the possibility of uncontrolled cell division happening. However the consultant surgeon warned me that if possible never to have surgery in that area again. Quoting him, "cancer loves an open wound" which fits in with the more detailed explanation in the article.

False history, artificial conflict

Everything in research gets re-invented every 30 years, due to the natural turn-over of staff. And, due to the exponenctial increase in medical knowledge and research technique, research avenues that were dead-ends 30 years ago often reveal new insites when revisited.

But having said that, you don't need to pretend that anyone in the last 50 years ever thought that surgery didn't trigger metatisation in some cases. The article would still have been interesting and informative without the faux conflct between 'old ideas' and 'new ideas'

Interesting, if slightly concerning.

My sister has recently been through breast cancer surgery at 38. I really hope it was the right thing.

Reading this article - which I found fascinating, I'm left wondering how many of the health issues associated with breast implants are actually due to the silicon implants, and how many due to the surgery disturbing near sleeping dogs. :-(

I read recently that there is a similar debate concerning screening for prostate cancer, can't remember where.

Cancer - we're looking at the wrong mechanism

I think we're looking in the wrong direction here.

I'm with a charity that focuses on Vitamin B12, so I'll talk about cancer from the B12 point of view, although there are other causes. The mechanism will be much the same.

Vitamin B12 is the primary methylation agent for DNA. Methylated DNA can switch genes off, if DNA is short of methylation then it can't switch genes off. The metaphor I use is that the cell is like a kitchen, and the DNA like a cook book - if the pages blow freely, then every time the cook comes up to the cookbook to check what to make next, it reads a different recipe and makes a different protein. And 99% of genes in the DNA are supposed to be switched off at any one time, because they are all for building new cells. Result, lots of energy used up making random components (the weight loss of cancer sufferers), and lots of growth of new cells (because the materials are there) leading to tumours, active ones.

Add lots of Vitamin B12, and it sticks the pages of the cookbook down so the cookbook functions correctly. Cell stops making random components. Cancer stops. So much so, that cells naturally disappear and the tumour goes too.

So on to the model for the spread of cancer. Well it isn't due to cells migrating from the site of the surgery or from the site of the original tumour - it's simply that the next batch of cells have too low Vitamin B12 to be able to methylate their DNA. Just like draining the swamp (as the water level goes down, you find all the stumps and tangles).

Any evidence? when you give mice with cancer high doses of B12, they stop getting worse and in many cases the tumour actually disappears eventually. Any risk? none (obviously you need to keep an eye out for co-morbidities that need treating, but high B12 has no risk).

So what about the connection with surgery and chemotherapy? The first thing that B12 does (DNA methylation is probably the longest term) is to get rid of toxins from the body, and it does this by escorting them out. Blood full of tobacco? You've probably used up all of your B12 taking the tobacco out. Lead, arsenic, cyanide, organic poisons, etc - all take B12 out. Radicals from surgery? Yup. Chemotherapy? Yup. Less B12 = more cancer.

I know this is a very biassed view, and I expect lots of flames to follow, but have a look at it. It explains the mechanism and it has been shown in experiments, however it is low cost and there's no profit to be made so it's generally opposed.

Inflammation

So basically the argument is made that inflammation facilitates cancer (there are secondary effects like the mechanical spreading, an excellent if gruesome example being the use of morcellation for reducing fibroids).

In the distant past inflammation reduced mortality by facilitating defense against infectious organisms. Now that is not so necessary, but it seems like medical practice hasn't quite caught up to modulating inflammation but more typically suppresses pain (opioid use then causing addictions and adding to morbidity... but that is another thread. Survive the injury and end up ruined on drugs).

The link to inflammation might be more direct than just the insult of surgery, since it is well known that low dose NSAID (Aspirin or aspirin) reduces the incidence of several cancers.