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  1. #1

    Is the system killing us?

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    Spectrums friends death reminded me of this article, is the system killing us?

    ZNet Commentary
    Beat Cancer? November 20, 2004
    By Yves Engler

    Want to help beat cancer? Here?s a simple answer: provide lots of money to big corporations?and don?t bother worrying about probable causes.

    That more or less summarizes the October 16th Economist magazine issue titled ?beating cancer,? which reports that the cancer rate is rising but manages to completely bypass any discussion regarding why this may be the case. Instead the articles jump straight to the billion-dollar question, namely, ?how can we cure it??

    It is unclear how useful this line of questioning has been. Since Richard Nixon launched the ?war on cancer? in 1971 the US has given $70 billion ? almost entirely for research on pills and diagnostics - to the National Cancer Institute. Yet from 1971 to 2001 the US cancer mortality rate increased from 163 per hundred thousand individuals to 194. (Economist)

    The pattern is similar around the world. Cancer killed 6.6 per cent of Canadian males and 8.6 per cent of females in 1921. Now the death rate has risen to 27.4 per cent and 23.1 per cent respectively. (Canadian press 2004-03-04)

    The Economist explains away the rising cancer rate by calling cancer a ?disease of affluence?. But, cancer mortality rates are adjusted for life expectancy, meaning that cancer is increasing faster then longevity.

    The Economist?s jump from the rising cancer rate to how drugs and diagnostics can beat it ? sidestepping why ? is for a good reason: Corporations have got to get paid. And there is a lot of money to be made from cancer treatments. The Financial Times reports that ?3,000 of the 7,300 medicines under development are for cancer.? (Oct.27th 2004)

    The bio-medical industrial complex is a rapidly expanding mammoth. Pharmaceutical companies brought in $466 billion worldwide last year and according to the Wall Street Journal ?the cost of diagnostic scans in the US is approaching $100 billion a year.? (August 2004) Medical technologies around the world are a burgeoning industry.

    Yet when it comes to cancer the bio-medical industry has not had much success, as evidenced by rising cancer mortality. Additionally, there is evidence to suggest that many tests are of little medical use and may, in fact, pose health risks. Samuel Epstein emeritus professor of environmental medicine at the University of Illinois School of Public Health provides an alarming example:

    ?We have excellent data showing that pre-menopausal mammography is not only ineffective, but is also dangerous for a variety of reasons, including the high doses of radiation. Two films of a breast in a pre-menopausal woman give that woman about 500 times the dose of a chest X-ray. If a pre-menopausal woman gets a mammography every year over a ten-year period, the dosages of radiation can well amount to about ten rads?a rad is a ?radiation absorbed dose,? a measure of radiation exposure. Radiation from routine pre-menopausal mammography reaches reasonably close to the kind of dosage that women got in Hiroshima and Nagasaki outside of the major epicenter where the atom bomb was exploded.?

    The bio-medical industrial complex?s economic importance helps to explain the Economist?s sole focus on pills and diagnostic equipment as chief cancer fighting agents. In an issue devoted to beating cancer, The Economist did not use the word carcinogen even once. And the only time the Economist used the word toxic was to mention possible complications associated with the simultaneous use of two anti-cancer drugs. This kind of writing allows the Economist to remain a loyal subject of powerful industries, particularly chemical corporations.

    Obviously big tobacco prefers not to highlight the link between smoking and cancer, especially as they expand by exporting to less-regulated poor countries. The same goes for nuclear power and chemical industries.

    This doesn?t change the fact that smoking causes cancer. (The Economist admits in passing that ?the biggest success [fighting cancer] has been due to people giving up smoking, rather than to new treatments.?) Likewise, on the 21st of October the Guardian newspaper reported that, ?plutonium particles discharged by nuclear plants? can cause damage to DNA and increase the risk of cancer.? This increased risk is substantially higher than had previously been accepted in England.

    The chemical industry ? from household solvents to pesticides, pharmaceuticals to plastics ? is probably the biggest producer of carcinogens. There are about 100,000 different chemicals in use and companies are releasing an average of 2 to 5 new ones into our environment each day, with little testing done for safety. (Cambridge quarterly p.446) Worldwide production of chemical substances has increased enormously from 1 million tones in 1930 to 400 million tones today. (Le Monde Feb 14 2004)

    The Canadian Press explains: ?manmade chemicals in air, water, food and the workplace are largely to blame for a devastating cancer epidemic which will strike 41 per cent of Canadian males and 38 per cent of females.? For instance, we know there is a significant relationship between the consumption of dairy and animal fats and a number of cancers. ?But?, according to Samuel Epstein, ?that?s a reflection of the fact that these are highly contaminated with a wide range of industrial, chemical, and petrochemical carcinogens.?

    Despite this knowledge, attempts to halt the flow of known carcinogens or to expand chemical testing are countered at every turn. During a recent meeting of the Rotterdam convention, both Canada and Russia blocked a proposal to ban exports of Chrysotile asbestos -a well-known carcinogen - to poor countries. They both happen to be the biggest asbestos exporters in the world.

    In a far-reaching effort to chip away at the application of the ?cautionary principal? to their products, the chemical lobby has made great efforts to undermine the European Union?s comprehensive Chemical review program, known as Reach. Rather than requiring regulators to prove why a chemical should be banned, Reach puts the onus on the businesses to test the chemicals and prove their safety. Yet after heavy lobbying by European chemical companies and the US, the proposal to review 30, 000 chemicals was weakened last year. Reach?s estimated testing costs to businesses were reduced from more than $14 billion over 11 years to $3.7 billion. (WSJ October 1)

    And after additional pressure, it will be diluted further. Last March, Colin Powell organized US diplomats in a lobby aimed at European governments in order to counter ?controversial European Commission plans for new regulations on the chemicals industry.?(Financial Times)

    On October 1st the Wall Street Journal quoted the New European Union industry commissioner, who had the following to say about Reach: ?we may need to do a little bit more to lighten the burden on business.?

    Perhaps more important than asking which pharmaceuticals to ingest in a bid to cure cancer, we should be wondering about the burden of disease caused by untested chemicals.

  2. #2

    Re: Is the system killing us?

    I usually leave my day job at home, but let me chime in on this one. I currently work in the medical profession and have done cancer research prior to that. That article illustrates just how out of touch journalists are with the reality of medicine. I'm a big picture guy, so let's outline in broad terms what's going on with the increasing cancer mortality rates; the causes, the fallacies in thinking about this problem, and ultimately, what solutions are out there.

    Q: Are cancer mortality rates increasing? Yes.

    But one cannot look at that in isolation. The three main causes of death in this country are 1) heart disease, 2) cancer and 3) strokes. Since the early 1960s, due to an increasing awareness of the causes and the eventual development of therapies towards those causes, heart disease mortality rates have dropped steadily. A full two thirds of patients survive heart attacks today, a simply amazing statistic given the aging population and a real triumph of the medical establishment. Where do you think the percentage points that heart disease has dropped have gone to? You got it - cancer mortality. But this is relative, and the article rightly states that the age-adjusted rates have increased.

    Here's why. Let's take a look at the leading causes of death in 1900 versus now:

    1900 - pneumonia, tuberculosis, diarrhea, heart disease, stroke, liver disease, injuries, cancer, senility, diphtheria
    2003 - heart disease, cancer, stroke, chronic lung disease, accidents, diabetes, pneumonia/influenzae, Alzheimer's, renal disease, septicemia

    It would seem what doesn't kill you DOES make you stronger. Today, pneumonia has been relegated to number 7 (<5% of all deaths) because of antibiotic use (which we use too much, but that's another discussion). The most important thing to look at in the 1900 list is this: tuberculosis, diarrhea, and diptheria have disappeared from the modern death list. They don't even crack the current top 15. And this has to do with advances in diagnosis and treatment.

    We've gotten so much better at diagnosing disease that cancers that would have slipped under the radar in years past are being found and attributed to the death of a patient. Where in 1971 the official cause of death for a patient may have been heart failure, today, on PET scan, we may have found a metastatic carcinoid tumor. Subtract one from the heart disease column and add one to the malignancy column. This is not relative, this is a shift in absolute numbers. The cycle goes like this:

    With MRI, CT, PET, routine colonoscopies, routine chest x-rays, and routine blood work, we are picking up cancers at rates that have never been seen before. A large part of all these expensive tests is CYA medicine (cover-your-*ss). God forbid we miss a diagnosis of inoperable non-small cell carcinoma of the lung in an 85 year old patient with vascular dementia - the family and their lawyers will be all over us - so off to the CT scan they go, and then for bronchoscopy, etc. In the past, these patient's would have been allowed to die at home, with dignity and with the cause of death as pneumonia, and today they languish in the ICU with usually well-meaning family members clinging to each breath of the ventilator, angry at the system that let their loved one reach this point and looking for someone to point the finger at. And it's usually us. So yes, we made the correct diagnosis, but it hasn't improved the patient's life and everyone loses - health care costs sky-rocket, malpractice costs push doctors out of business, and we end up prolonging death instead of life.

    The upside is that the patient's family, after their loved one is diagnosed with malignancy, is much more likely to go to a doctor for cancer screening, and lo and behold, the cancer rate goes up. It has to do with more and better screeing and greater accuracy in diagnosis. This cycle plays out indefinitely.

    Q: That's all well and good, but what about these greedy corporations? They must be doing something wrong here.

    Fact: European drug companies haven't produced an innovative drug in decades. Why? The EU holds down the cost of medications so there's no incentive for the kind of research we do here in the United States. Necessity is the mother of invention, and the necessity of businesses is to get paid. Somewhere there is a happy medium between the service and the business of medicine, but socialism isn't it. Fast, good, and cheap; you can only choose two. If you want health care that's fast and good (United States), it won't be cheap. If you want health care that's good and cheap (Europe), it won't be fast (months to see your primary care physician, wait-lists for non-emergent surgeries, age limits on surgery and cardiac care).

    I can't believe the article took a swipe at the NCI. The National Cancer Institute is the envy of the world. No one is doing more productive and cutting edge research into all aspects of cancer, yes even environmental causes. In the States, we focus our research on understanding the mechanisms of cancer proliferation, rather than cancer prevention, because with few exceptions, cancer is not preventable. Do you want to know the leading cause, environmental or otherwise, of human cancers? The sun. The number 1 and 2 cancers that happen in humans are basal and squamous cell carcinomas of the skin. These cost billions of dollars to treat and are, bar none, the most preventable causes of cancer. But people don't listen when we tell them to use sunscreen (at least on their children, for pete's sake), avoid the noonday sun, and not to tan. It just doesn't jive with their lives. The second leading environmental cause of cancer? Cigarettes. Do you see a trend here? People would rather blame imaginary polluting corporations (I'm not defending pollution...businesses should pay dearly if a link is found between their waste and health problems, but the scientist in me says show me the studies) than look in the mirror for the easiest ways to prevent cancer.

    Finally, people need to understand that cancer is not like an infection. It is not some clear target that you aim at and hit to get rid of. While a few cancer types have a clearly defined mechanism, with a target for a magic bullet-type therapy, most don't. Several of the most common cancers can develop from a myriad of cellular defects (some of which we don't even know at this point). The only answer is to keep studying, to develop newer and better animal models, and keep plugging away at the problem with the same drive and intensity that has led to the breakthroughs in science in the past century. But please realize that part of that drive is money on the part of the pharmaceutical and medical technology corporations which fund a good deal of the bleeding-edge research. They're not doing it out of the goodness of their own hearts, nor would they exist if it weren't for capitalism. Regarding the name of the article: the system depends on us for cash; it has no incentive to kill us.

    jazzbozo

  3. #3

    Re: Is the system killing us?

    Thanks Jazzbozo, i really have no experience in this area, and i posed the question to encourage discussion, i value your contribution.

    Could you put the following into proper perspective, in terms of our health, i mean you say that corporations are essentially functioning as expected and that they are doing a good job, but is this balanced out with what the article claims.

    Quote Originally Posted by article
    The chemical industry ? from household solvents to pesticides, pharmaceuticals to plastics ? is probably the biggest producer of carcinogens. There are about 100,000 different chemicals in use and companies are releasing an average of 2 to 5 new ones into our environment each day, with little testing done for safety. (Cambridge quarterly p.446) Worldwide production of chemical substances has increased enormously from 1 million tones in 1930 to 400 million tones today. (Le Monde Feb 14 2004)

    The Canadian Press explains: ?manmade chemicals in air, water, food and the workplace are largely to blame for a devastating cancer epidemic which will strike 41 per cent of Canadian males and 38 per cent of females.? For instance, we know there is a significant relationship between the consumption of dairy and animal fats and a number of cancers. ?But?, according to Samuel Epstein, ?that?s a reflection of the fact that these are highly contaminated with a wide range of industrial, chemical, and petrochemical carcinogens.?
    Could the balance of Corporate incentives be working against us in the long run?

  4. #4

    Re: Is the system killing us?

    Great response, jazzbozo.

    When I read the article I had the feeling that they had ignored improved cancer detection.

    Still, I'm not pleased at all with the current state of affairs in cancer treatments. My sister-in-law recently died from stage 4 melanoma. Calling that disease "skin cancer" gives the wrong message. It's everything cancer. It spreads everywhere and it spreads fast.

    Looking back, Charlie would have been better off with pain medication and other symptom treatment alone. She might have lost a few weeks, but she would have spent better weeks with her husband and kids up until the end. The correlation of her quality of life declines and her radiation and chemo treatments were one to one. It just wasn't worth it.

    The same month that Charlie died, my mom's neighbor had brain radiation treatment - the same variety that tied to Charlie's steep decline. He was older, and his cancer was of the slow-growth variety. He died the day after the treatment. Charlie lived for two weeks after the treatment, but was in constant dimentia. The doctors never discussed the risk or side effects fully. It was just the next step in the regimine.

    I'd like to see more work on the prevention side. Sure, it won't help tan smokers who eat lard with preservatives and work at the nuclear chemical plant, but it can help those of us who choose to modify our lifestyles for our health.

    I certainly won't be going down the traditional treatment path if I ever reach stage 3 anything. Not with today's "cures", anyway.

    -JF

  5. #5

    Re: Is the system killing us?

    Quote Originally Posted by jazzbozo
    I usually leave my day job at home, but let me chime in on this one. I currently work in the medical profession and have done cancer research prior to that. That article illustrates just how out of touch journalists are with the reality of medicine. I'm a big picture guy, so let's outline in broad terms what's going on with the increasing cancer mortality rates; the causes, the fallacies in thinking about this problem, and ultimately, what solutions are out there.

    Q: Are cancer mortality rates increasing? Yes.

    But one cannot look at that in isolation. The three main causes of death in this country are 1) heart disease, 2) cancer and 3) strokes. Since the early 1960s, due to an increasing awareness of the causes and the eventual development of therapies towards those causes, heart disease mortality rates have dropped steadily. A full two thirds of patients survive heart attacks today, a simply amazing statistic given the aging population and a real triumph of the medical establishment. Where do you think the percentage points that heart disease has dropped have gone to? You got it - cancer mortality. But this is relative, and the article rightly states that the age-adjusted rates have increased.

    Here's why. Let's take a look at the leading causes of death in 1900 versus now:

    1900 - pneumonia, tuberculosis, diarrhea, heart disease, stroke, liver disease, injuries, cancer, senility, diphtheria
    2003 - heart disease, cancer, stroke, chronic lung disease, accidents, diabetes, pneumonia/influenzae, Alzheimer's, renal disease, septicemia

    It would seem what doesn't kill you DOES make you stronger. Today, pneumonia has been relegated to number 7 (<5% of all deaths) because of antibiotic use (which we use too much, but that's another discussion). The most important thing to look at in the 1900 list is this: tuberculosis, diarrhea, and diptheria have disappeared from the modern death list. They don't even crack the current top 15. And this has to do with advances in diagnosis and treatment.

    We've gotten so much better at diagnosing disease that cancers that would have slipped under the radar in years past are being found and attributed to the death of a patient. Where in 1971 the official cause of death for a patient may have been heart failure, today, on PET scan, we may have found a metastatic carcinoid tumor. Subtract one from the heart disease column and add one to the malignancy column. This is not relative, this is a shift in absolute numbers. The cycle goes like this:

    With MRI, CT, PET, routine colonoscopies, routine chest x-rays, and routine blood work, we are picking up cancers at rates that have never been seen before. A large part of all these expensive tests is CYA medicine (cover-your-*ss). God forbid we miss a diagnosis of inoperable non-small cell carcinoma of the lung in an 85 year old patient with vascular dementia - the family and their lawyers will be all over us - so off to the CT scan they go, and then for bronchoscopy, etc. In the past, these patient's would have been allowed to die at home, with dignity and with the cause of death as pneumonia, and today they languish in the ICU with usually well-meaning family members clinging to each breath of the ventilator, angry at the system that let their loved one reach this point and looking for someone to point the finger at. And it's usually us. So yes, we made the correct diagnosis, but it hasn't improved the patient's life and everyone loses - health care costs sky-rocket, malpractice costs push doctors out of business, and we end up prolonging death instead of life.

    The upside is that the patient's family, after their loved one is diagnosed with malignancy, is much more likely to go to a doctor for cancer screening, and lo and behold, the cancer rate goes up. It has to do with more and better screeing and greater accuracy in diagnosis. This cycle plays out indefinitely.

    Q: That's all well and good, but what about these greedy corporations? They must be doing something wrong here.

    Fact: European drug companies haven't produced an innovative drug in decades. Why? The EU holds down the cost of medications so there's no incentive for the kind of research we do here in the United States. Necessity is the mother of invention, and the necessity of businesses is to get paid. Somewhere there is a happy medium between the service and the business of medicine, but socialism isn't it. Fast, good, and cheap; you can only choose two. If you want health care that's fast and good (United States), it won't be cheap. If you want health care that's good and cheap (Europe), it won't be fast (months to see your primary care physician, wait-lists for non-emergent surgeries, age limits on surgery and cardiac care).

    I can't believe the article took a swipe at the NCI. The National Cancer Institute is the envy of the world. No one is doing more productive and cutting edge research into all aspects of cancer, yes even environmental causes. In the States, we focus our research on understanding the mechanisms of cancer proliferation, rather than cancer prevention, because with few exceptions, cancer is not preventable. Do you want to know the leading cause, environmental or otherwise, of human cancers? The sun. The number 1 and 2 cancers that happen in humans are basal and squamous cell carcinomas of the skin. These cost billions of dollars to treat and are, bar none, the most preventable causes of cancer. But people don't listen when we tell them to use sunscreen (at least on their children, for pete's sake), avoid the noonday sun, and not to tan. It just doesn't jive with their lives. The second leading environmental cause of cancer? Cigarettes. Do you see a trend here? People would rather blame imaginary polluting corporations (I'm not defending pollution...businesses should pay dearly if a link is found between their waste and health problems, but the scientist in me says show me the studies) than look in the mirror for the easiest ways to prevent cancer.

    Finally, people need to understand that cancer is not like an infection. It is not some clear target that you aim at and hit to get rid of. While a few cancer types have a clearly defined mechanism, with a target for a magic bullet-type therapy, most don't. Several of the most common cancers can develop from a myriad of cellular defects (some of which we don't even know at this point). The only answer is to keep studying, to develop newer and better animal models, and keep plugging away at the problem with the same drive and intensity that has led to the breakthroughs in science in the past century. But please realize that part of that drive is money on the part of the pharmaceutical and medical technology corporations which fund a good deal of the bleeding-edge research. They're not doing it out of the goodness of their own hearts, nor would they exist if it weren't for capitalism. Regarding the name of the article: the system depends on us for cash; it has no incentive to kill us.

    jazzbozo
    Really insightful post. But what happens when natural, readily available cancer cures threaten profits of the medical corporation? I'll tell you. The corporation, due to it's inhumane capitalist structure tries to bury the cheap cure that threatens their business. Even if it would save lives. This is the world we live in. Corporations would rather kill people than lose money. This is the problem with the corporation. No one takes responsibility for such an act. It's murder and we celebrate corporations that make profits at any expense. Even murder.

  6. #6

    Re: Is the system killing us?

    Thanks, charles.

    The only corporations I think are acting as expected are the pharmaceuticals and med tech firms (so-called big drug companies) - they're trying to make a buck out of treating what ails ya, sometimes looking only at trials that present the "truth" as they want to hear it and ignoring other trials that are just as valid (see Merck with Vioxx).

    What I take issue with in this article is the thinking that eliminating industrial waste will bring down the cancer rate significantly. It won't. Risk estimates by the EPA in recent years show that a decrease in occupational exposure to carcinogens (aluminum smelters, folks working with high levels of formaldehyde and vinyl chloride, etc.) will at best net a 1 or 2% reduction overall (and that means putting these companies out of business, costing tens of thousands of jobs). The risk of environmental carcinogens, except in extreme cases like Erin Brokovich situations, is negligible because it takes decades of exposure to reach levels far below those needed in ANIMAL models to elicit cancer. By which time people are still more likely to develop the common visceral cancers - breast, prostate, colon, lung - anyway.

    Don't get me wrong. Regulation is a good and necessary thing. But come on, 41 percent of Canadian males will develop cancer largely from man-made chemicals? This is bad, alarmist journalism. I can trump that. The truth is, with our increasing life expectancy, half of all men, Canadian or otherwise, actually will have cancer by age 70. Prostate cancer. But less than 3% of us will die from it.

    jazzbozo

  7. #7

    Re: Is the system killing us?

    There's not enough profit margin in a cure

    The same reason why we cannot purchase light bulbs that burn forever (even though it's possible).

  8. #8

    Re: Is the system killing us?

    Actually, they're preparing to release a 37-year (based on a 4-hour per day burn) light "bulb" (it's not actuallya bulb, per se) made from LEDs. So that blows that theory.

    I do realize some may try to bury cures to sustain their markets, but it must come out eventually. The only way they could keep it under wraps forever is by the use of force. And fortunately, that's illegal. We just have to make sure no mafia-style strong arming is going on.

  9. #9
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    Re: Is the system killing us?

    Quote Originally Posted by Nick Phoenix
    Really insightful post. But what happens when natural, readily available cancer cures threaten profits of the medical corporation? I'll tell you. The corporation, due to it's inhumane capitalist structure tries to bury the cheap cure that threatens their business. Even if it would save lives. This is the world we live in. Corporations would rather kill people than lose money. This is the problem with the corporation. No one takes responsibility for such an act. It's murder and we celebrate corporations that make profits at any expense. Even murder.
    It is not up to drug companies to study "cheap natural cures" if there's no profit, nor is it their job to point out the existence of alternatives to their product. This is the responsibility of the system, society, government.

    The problem is that there is too little "independant" money made available to study natural treatments, especially in the UK and Europe. This should come from government, but it currently relies on charity.

    I'm not defending the drug industry, but if you're attacking them then also shoot at the system.

    Also: make no mistake: large profits are made from poorly studied "natural treatments" and "supplements", that would not necessarily stand up to proper scientific scrutiny.

    It's very easy to produce evidence that backs up a claim for an explanation and treatment for common problems, write a book and make a fortune, -and be wrong. Proper scientific evaluation including peer review is not required for a book.

    Although I have healthy scepticism for modern medicine, you're much more likely to be sold a lemon by the alternative medicine sector. Yes, it's true they're less likely to harm you, but I know where I would take my cancer.

  10. #10

    Re: Is the system killing us?

    I pretty much agree with you entirely here, Beckers, but I would just point out one thing:

    Quote Originally Posted by Beckers
    This should come from government, but it currently relies on charity.
    Charity - money given freely and voluntarily.
    Government (funding) - money taken from people by threat of force.

    Just so we're not fooling ourselves as to the true nature of things.

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