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Vol. XIII No.3 - Sunday february 9, 2014 - Saturday february 22, 2014


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Doctor's Consultation  by Dr. Iain Corness

 

Beware of “Breakthroughs”

Right at the end of 2013 I came across an article trumpeting “Cancer therapy is breakthrough of the year.” Naturally, I read this with interest, as cancer and its treatment/cure is always an attention grabber. After all, we managed to get rid of smallpox, and polio is almost eradicated, so obviously “cancer” is next.
This new “breakthrough” is in the field of immunotherapy, where it is claimed that it is possible to convert your own T-Cells into “killer” cells, and these converted T-Cells then attack the cancer cells, leading to a cure, or remission.
However, remember that if you want to attract some funding for your medical project, just mention the word “cancer” and get an item in the popular press and you’ve got your foot in the door. You see, the popular media also like the C word because it helps sell newspapers.
How many times have you read “breakthrough” as regards some form of cancer treatment (which will require another five years of expensive testing)? For many people, this will give them the hope that “cancer” has finally been beaten. Unfortunately, this is not so. Certainly there have been positive reports following use of the new drug called epilimumab, but there’s two sides to the coin. The drug only works in certain cancers, but that does include melanoma and leukemia. Even then, the percentage of people responding to the treatment was only around 30 percent. Taking the figures for melanoma, it is reported that the statistics derived from 1,800 people with melanoma indicated that 22 percent of sufferers were still alive three years later. Looking at it another way, that is 78 percent died before three years. The final downside is the cost. Try 3.8 million THB per treatment.
Here’s another carcinogen (cancer producing substance). Exhaust from diesel engines causes lung cancer, a World Health Organization (WHO) agency claimed, citing a review of studies. (Baht busses to grind to a halt?)
Diesel exhaust also was linked to an increased risk of bladder cancer, said the International Agency for Research on Cancer, based in Lyon, France. The group published the findings after a review over eight days by a panel of scientists. An earlier review, in 1988, classified diesel engine exhaust as “probably carcinogenic.”
Hundreds of years ago, a very smart doctor called Paracelsus came up with the observation that “dosage alone determines poisoning.” This was a real breakthrough. To poison someone, there was a certain dose necessary for this to happen.
Lots of reasons for this. With human beings there is a characteristic we all have called ‘homeostasis’. This is where the body will try to return itself to its original condition. In other words, repair itself. Broken bones mend, lungs will expel foreign material and livers even regenerate themselves. Provided the rate of repair is faster than the rate of destruction, the body will be fine. However, if the rate of destruction exceeds the rate of repair, then you are in trouble.
Now let’s get back to the shock-horror headlines that exhaust from diesel engines causes lung cancer. It probably does, but at what dose? How many of us are subjected to diesel exhaust 12 hours a day, for example? I suppose a baht bus driver might be, but it would be rare. Most are parked at the side of the road for at least six of the 12 hours in their shift. Do our diesel baht bus drivers have more lung cancers than anyone else around here? Has anyone taken the time to look?
But, remember that according to the WHO, cancer killed around eight million people worldwide, and was the leading cause of death globally. Lung cancer was the most lethal type, and accounted for 18 percent of all cancer deaths.
Unfortunately, even though we understand more of the nature of cancer, there is no universal “cure” as yet. However, catching cancers at an early stage gives you a much better prognosis (outcome). And you can only do that if you look. Check-ups are of value. And finally, don’t smoke - we have shown that the incidence of all cancers is greater in smokers compared to non-smokers. Make a positive decision today to give up cigarettes.


HEADLINES [click on headline to view story]

Beware of “Breakthroughs”
 

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