Beating Cancer: Does Early Detection Help?

[polycarp]

By Michael Masterson

I've often wondered whether modern medicine's approach to cancer makes any sense. The usual routine: You have a pain. Your doctor sends you to a specialist for diagnosis. You are told you've got a deadly disease. And the rest of your life is ruined by surgery; chemotherapy, radiation, and the horror of thinking you are going to die.

I've been thinking about this a lot lately, because of my father's recent death from lung cancer and two other battles that friends are waging now. When I see the pain and suffering they are enduring - and notice the nonchalant (see Word to the Wise, below), almost smug, manner in which their doctors deliver the news and treat them - I wonder if it wouldn't be better if they had never been told at all.

I think about these people and I can imagine their response: "I'd rather fight it. Even if my chances are slim, I'm glad I have a chance to try to beat it."

That perspective is based on a common perception: that early detection can prevent cancer. It's a belief that's been drummed into our heads by the medical industry since I was a kid. And like many other commonly held medical beliefs, it is widely held without, apparently, a shred of evidence.

A recent Wall Street Journal essay by Sharon Begley made this point:

"Nothing has greater intuitive appeal than the claim that cancer screening leads to early detection, which leads to longer survival. Whether it is the PSA test for prostate cancer, mammograms, endoscopies for colon cancer or - in the wake of Peter Jennings' untimely death - X-ray screening for lung cancer, intuition screams that the earlier a cancer is caught, the better the odds that you'll be alive in five years."

For a long time this was, as I suggested, a widely held professional view based on intuition, not proof. In recent years, scientists have been attempting to substantiate it with studies. But the data that is evolving from these studies is contradicting expectations.

The impact of cancer screening on reducing cancer mortality, a spokesman for the National Cancer Institute (NCI) told Begley, "still isn't proven."

Here's what is being learned: Many cancerous tumors don't cause cancer - or they take so long to develop that the patient can live a full life waiting for them to activate. These slow-growing tumors - "indolent" tumors, scientists call them - occur with neuroblastomas (cancer of the nervous system), prostate cancer, lung cancer, and even breast cancer.

I asked Jon Herring, ETR's Health Editor, to look into the latest research on this subject. Here's some of what he found:

Breast Cancer
In 2002, The New England Journal of Medicine published a long-term follow-up study of women who had mastectomies compared to women who simply had the lump itself removed (lumpectomy). After 20 years, the death rates from all causes and the death rates from breast cancer were virtually identical for both groups of women. In other words, the radical surgery so often performed did not increase survivability at all compared to the more minor procedure.

Prostate Cancer
The Agency for Healthcare Policy Research produced evidence showing that men who had their prostate gland removed had an average survival of 14 years after surgery. This appears to suggest the surgery provides life-extending benefits - until you consider what happened to the men who did nothing. The men who chose "watchful waiting" over surgery also lived an average of 14 years after diagnosis. Apparently, the surgery does not increase survivability - though it certainly does increase the risk of complications.

In fact, the credit many cancer survivors attribute to early detection and treatment is often likely due to the fact that their tumors were indolent, and thus wouldn't have killed them even without the treatment.

How common is this? "Over-diagnosis of cancer as a result of screening is the rule rather than the exception," the NCI representative told Begley.

Over-diagnosis, Begley points out, is different than "false positives." A false positive is an incorrect diagnosis: You are told that you have tested positive for a cancerous tumor, but the test was wrong. False positives cause unnecessary stress and grief, not to mention the pain, suffering, and financial costs of unnecessary procedures.

But over-diagnosis is "arguably worse" than false positives, because it affects so many people. Over-diagnosis not only leads to a huge number of unnecessary procedures, it has another negative effect. As Begley points out: It creates a false perception "of progress in the war on cancer."

"Let's say that, as a result of such a screening, a patient begins treatment on August 26, 2005. She does well, and celebrates her five-year survival rate on August 26, 2010. If she succumbs to a recurrence or a spread of her initial cancer in, say, 2015, she still counts as a five-year survivor. But if she had a slow-growing cancer, she might have made it to 2015 anyway, without early diagnosis and treatment. She is scored as a victory for cancer warriors, but in fact they didn't buy her a single extra day of life. All she got was more years knowing she had a dread disease."

Thus, the improvement that studies have been attributing to early detection may be simply because screening methods have improved and more of these slow-growing tumors are being spotted.

Spotting an increased number of indolent tumors means that the number of five-year cancer survivors will go up too - since indolent tumors don't kill you in five years. In the lungs, for instance, CT scans are detecting almost as many lung lesions in non-smokers as they find in smokers. But most of the lesions in non-smokers are indolent. By adding those indolent tumors into the data pool, a greater number of five-year lung cancer survivors are listed. But there are no fewer deaths, a Mayo Clinic study reported.

According to Jon, the same trends are evident with skin cancer, which is now diagnosed at double the rate it was in 1986. An article in The New York Times suggests that instead of an epidemic in skin cancer, perhaps we are "experiencing an epidemic of skin cancer screening." Undoubtedly, mention of the word "pre-cancerous" has scared countless people into having harmless moles removed.

Renowned dermatologist Dr. A. Bernard Ackerman, emeritus director of the Ackerman Academy of Dermatopathology in New York, believes that dermatologists have gone too far. Regarding their "excessive zeal" in diagnosing melanoma, he said:

"There has been a mania for taking off these moles that are of no consequence. We're talking about billions and billions of dollars being spent, based on hype."

This would be fine ... if it led to fewer deaths. But according to a study published in The British Medical Journal , it has not. Researchers at Dartmouth analyzed changes in the incidence of melanoma. Here is what they found:

Since 1986, skin biopsies have risen by 250%.

The incidence of early-stage melanoma has risen by the same amount.

However, there was no change in the melanoma death rate or incidence of the later stages of the disease
It is a delusion to equate longer survival rates to progress. What matters is the number of actual deaths. And that number has not been reduced by most forms of early-detection and treatment.
So what does this mean?

First, we have to recognize that much of what we take for granted in modern medicine is simply false.

Second, we have to recognize that a number of widely practiced medical treatments have no medical basis and may not have any beneficial effect ... except to fatten doctors' wallets.

Third, we must accept responsibility for our own health. And that means not relying on what we are told just because the government, the AMA, or some other "trustworthy" institution says it's so.

Relying on yourself is tough. But when it comes to staying alive, it's foolish to do anything else.

[michelleevans]

good evening,

i am a colon rectal cancer survivor.

I would not be in the shape that i am in if the doc had done what she was suppose to in the first place.

i had been seeing alot of what look like chunks of meat in my soft stools. there was blood also.

went to the doc and she told me that she would examine me. she did. and she said that she did not feel anything but sent me for a colonoscopy anyway the next week.

that doctor examined me, upon examination he felt the tumor.
when they done the test the tumor was what i was seeing in my stools.

my reg. doc. said that there was nothing wrong.

that ended my life as i knew it.

but how could a tumor as large as mine not be felt by the reg. doc.

so i dont think alot of nurse practioners know alot about how to detect cancer or other diseases.

this reg. doc. told me that i had an std sent me to a gyn and guess what it was not an std it was precancerous tumors growing on my woman hood.

so now i have to be watched real close to catch it before it does turn to cancer.

so i dont think that anyone can tell you what you have or dont have.

i think that it is up to the LORD what and when you will get whatever HE has planned in your life

[Lon]

I am a Prostate Cancer survivor (10 years) and feel that I am alive and physically active today all because of one smart Internist that noted a very modest increase in my PSA test from the previous year and referred me to a Urologist for a biopsy despite my not have any other symptoms.

[Lon]

[quote=polycarp]By Michael Masterson





That perspective is based on a common perception: that early detection can prevent cancer.

It will not prevent cancer, but if caught early the cancer may be cured.

Cancer is it just a word?................not on your life once you are told you have that baby your life changes.Some changes are good ones,as in nothing else you are going to get told will ever send you numb like that,ever again.

I have tried to laugh & joke my way through the whole cancer thing,but it all came crashing down on me last year & I had to finally admit I can't laugh it of.

I am a survivor well I am still here so I guess that is the main thing,I sometimes get really angry about the cancer .But one thing is for sure .

I will not give up without one hell of a fight I will win this fight.

[tedhutchinson]

Cancer is often the result of natural processes of cell replacement/renewal getting out of control. As your body gets older the number of times your cells have been replaced or renewed increases and the chances of a failure in the control system are greater.

As cells are on a continual renewal/replacement schedule and blips in the control mechanism are inevitable I think rather than fighting a war on cancer, (or terrorism for that matter) we need to pay far more attention to the circumstances which enable the body to better control the aggressive processes involved and thus prevent the occurance of cancers and enable those with cancer to live with their cancers in a controlled manner.

I am not a doctor, what I say here is simply based on my reading of abstracts from Pubmed and The Vitamin D Council.

Fundamental to the control of cell growth is the ability to stop a cell replicating when the essential work is done. (If we put troops into a war situation can we stop them behaving with excessive zeal?) In the body this process is controlled to some extent by the presence of vitamin D3 cholecalciferol. We know not only that certain cancers(and other disabling conditions ) occur more frequently in areas of low sunlight (latitudinal, seasonal, industrial, or based on colour of skin which affects D3 synthesis) but also that exposure to bright sunlight can in some cases end the cancer process.

The reason why those who are diagnosed and treated for cancer in the Winter months have a worse prognosis/life expectancy than those with similar cancers give the same treatment in the Summer months is because the summer cancer diagnosis and treatment cases are conducted in bodies with higher natural control mechanisms in place that the winter cases. There is no reason why anyone with a cancer diagnosed in the Winter shouldn't achieve the same life expectancy as the Summer individuals by ensuring they visit a suntan palour and expose their naked bodies to UVB rays sufficiently to achieve a slight tan. (There is no need to get burnt as this will increase your melanoma risk or take sufficient vitamin D3 CHOLECALCIFEROL (not d2 ergocalciferol) to raise your circulating D3 levels. More at The Vitamin D Council but do be aware there is a lot of misinformation about D3 coming from official sources. You really do need to read the information from those scientists who have studied the D3 deficiency scandal and discount the advice from doctors who tell you "there's no such thing as a healthy tan" or who believe the RDA for Vit D3 is anywhere like reasonable. If you took TEN TIMES the official RDA in the winter or when you couldn't go outside, you would be nearer the mark for producing the levels your body achieves in the summer with modest but regular exposure.

More on Vitamin D3 and cancer control here
Should Cancer Patients Die Vitamin D Deficient

[tedhutchinson]

Linked to the theory of exposure to bright sunlight/vitamin d3 status & decreased cancer risk and improved prognosis, I detailed in my previous post in this thread is the relationship to bright light and your bodies natural melatonin cycle.

Waking up to a bright sunny morning you will feel more alive and energetic, if you stay outside most of the day by evening you will feel reasonably tired and should you stay in subdued lighting your body will create melatonin which should help you go to sleep quickly, stay asleep and wake refreshed.

People who aren't able to go outside into bright light during the morning and benefit from subdued light during the evening will have more trouble sleeping. They also have a higher risk of getting cancer, and a worse prognosis for those cancers than people who sleep the longest.

If breast cancer cells are placed in a test tube with higher levels of melatonin the rate of cell proliferation decreases. Cancer cells sleep when you sleep. If you are not able to alter your work/life balance to enable you to experience a natural melatonin cycle then you should consider supplementing with melatonin to assist this process. Taking melatonin an hour before you want to sleep and trying to increase the amount of time you spend sleeping will give your body and prescribed medicines more chance to deal with your cancer cells properly.

There is no good reason why light sleepers with cancer shouldn't achieve the same life expectancy by ensuring that their melatonin cycle is improved to give them and their cancer cells more and better sleep by using this supplement.

[tedhutchinson]

In my previous posts I've detailed the links between Cancer and vitamin d3 level and a corresponding link between outside exposure to bright sunlight and melatonin cycle. A similar association between your level of circulating vitamin d3 and your level of OMEGA 3 can be made. While it's fairly clear that levels of sunlight vary due to location and season in present supermarket shopping we would not expect to see a significant variation in omega 3 levels arising from location and season as most of us use frozen or canned when fresh isn't available. However we know that levels of suicide, violence, abuse marital stress are higher in the Winter when levels of omega 3 in the brain are lower. Give aggressive children high omega 3 doses and their behaviour is improved. Give prisoners proper food and supplement with omega 3 and violent incidents in prison decrease by up to 40%. Domestic abuse is almost always perpetrated by individuals with low DHA status. This is in no way an excuse for domestic abuse, bad behaviour or violence. It is an EXPLANATION that should enable intelligent individuals to modify the diets of their loved ones to help them deal more intelligently/rationally and less impulsivly in stressful situation.

Why DHA and EPA (Omega 3 Essential Fatty Acids) levels should vary seasonally puzzled me until I read a paper demonstrating that rat brain cells put in a test tube with high VIT D3 levels absorbed more dha than cells in tubes with no D3 present. It is argued that astrocyte cells exchange ions with DHA in the presence of D3 to enable the passage of DHA through the cells walls.

Vitamin d3 receptors occur all over the body and in the most unexpected places. The role for these D3 receptors may well be not only to achieve the benefits that D3 brings but also to enable those cells to absorb more OMEGA 3 EFAs. Omega 3's have benefits thoughout the body not just with regard to mental health but the involvment with cancer prognosis may also be beneficial and because of the other health benefits resulting from high omega status it should be overlooked. One of the main benefits is omega 3's are ANTI-INFLAMMATORY. When cells are challenged the first response is often inflammation, if cells are properly primed with omega 3s the chances of the flammatory process getting out of control are much less. It becomes your bodies sprinkler system. I doubt that omega 3 directly reduces your cancer risk or improves prognosis but indirectly, by reducing opportunities for inflammation to occur it will improve your health prospects. It certainly will do more good than harm. (people on blood thinning agents will need to consult their health professionals so current medication is adjusted to incorporate the effects of omega 3 supplementation)

Dosage with Omega 3 is an area where ill informed folk are seriously ripped off.
A 125g tin of Sardines in tomato sauce will contain a drained weight of 80g and this will contain approx 2g omega 3s. A "portion" of oily fish is generally regarded as 140g so 2-4 portions of oily fish a week represents 280-560g and as sardines/herring contain approx 2.3g omega per 100g between 7 and 14g of omega 3 a day is reasonable, there are very few reports showing more than 5g a day are helpful so there's little point in taking excessive amounts.
Where people usually go wrong is in thinking that cod liver oil is the same as or better than fish oil. Cod liver oil is undoubtedly good for you but as it contains large amounts of vitamin a you cannot use it to provide your OMEGA 3 as doing so would give you an overdose of vitamin A.
To check you are getting 1 to 2 grams of OMEGA 3 daily via supplements you need to ADD together the content of EPA and DHA. In the UK

ZIPVIT sell Omega Juice which contains 900EPA+600DHA=1.5g Omega 3 per 5ml teaspoonful so one teaspoon of this is adequate however many supplement companies sell capsule with as little as 77mgEPA+55mgDHA=only 132mg OMEGA 3 To achieve 1.5g of omega you would have to take 11 or 12 capsules daily.

I think rather than taking 12 fish oil capsules it would probably be cheaper and less time consuming to ensure you ate half a tin of sardines daily or one tin every other day. There are in the UK several premium brands of Omega Fish Oils which cost an arm and a leg but provide very little actual omega so folk do have to pay attention to the actual amount of active ingredient their particular purchase contains and compare the total cost of an effective daily dose providing 1-2grams of OMEGA 3s and compare that with the price of a tin of sardines in tomato sauce.

I keep on about the tomato sauce as sardines are also sold packed in oil. Whatever oil the fish is packed in will alter the RATIO of omega 3 to omega 6 and this will defeat some of the point of taking omega 3. Cutting down on other fats is another strategy for increasing the impact of omega3s. Transfats and hydrogenated oils have no place in a healthy diet as they take up and block the place of omega3s. Its a bit like downloading a programme to your PC which created dead pixels on your monitor or faulty segments on your hard drive. Transfats in the brain are as much use as a dead pixel on your monitor. The more you get the worse the screen will look. No one would do so knowingly download such a program yet most consumers stuff their brains with Transfats unaware of the fact that this has the same effect as having a hard drive full of dead segments or a monitor sprinked with dead pixels.

[alobar51]

ZIPVIT sell Omega Juice which contains 900EPA+600DHA=1.5g Omega 3 per 5ml teaspoonful so one teaspoon of this is adequate however many supplement companies sell capsule with as little as 77mgEPA+55mgDHA=only 132mg OMEGA 3 To achieve 1.5g of omega you would have to take 11 or 12 capsules daily.

I think rather than taking 12 fish oil capsules it would probably be cheaper and less time consuming to ensure you ate half a tin of sardines daily or one tin every other day. There are in the UK several premium brands of Omega Fish Oils which cost an arm and a leg but provide very little actual omega so folk do have to pay attention to the actual amount of active ingredient their particular purchase contains and compare the total cost of an effective daily dose providing 1-2grams of OMEGA 3s and compare that with the price of a tin of sardines in tomato sauce.



Three capsules of VitaminWorks Max EPA http://www.vitaminworks.com 1-800-543-5710 contain 1080mg EPA and 720mg DHA. They are pharmaceutical grade, which means free of heavy metals, molecularly distilled, and they aren't gross to take, unlike a teaspoon of the oil.

Cheap fish oils require many capsules and you risk impurities. Good ones don't require taking an inordinate number of capsules.

[tedhutchinson]

Originally Posted by alobar51

Three capsules of VitaminWorks Max EPA http://www.vitaminworks.com 1-800-543-5710 contain 1080mg EPA and 720mg DHA. They are pharmaceutical grade, which means free of heavy metals, molecularly distilled, and they aren't gross to take, unlike a teaspoon of the oil.

Cheap fish oils require many capsules and you risk impurities. Good ones don't require taking an inordinate number of capsules.

Your link to VitaminWorks isn't functioning.

I always feel that people who knock cheaper products (which meet the very highest UK/European Standards) and have to resort to knocking copy in order to justify their excessively high prices must have something to hide. Perhaps when your site it up and running I'll hopefully see the prices are reasonable. In the meantime those who want their omega in the most natural form should consider eating more oily fish and the varieties not canned in oil will be most beneficial and cost effective and probably cheaper than VitaminWorks alternative though I have no grounds for that cynical remark.
Just suspicious of knocking copy.