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Abiraterone news 
Reply With QuoteSue Mullen wrote:
> Yesterday Kevin's med. onc. told us tht Abiraterone should be available
> by December 2010!!
>
> This could be the best holiday present next year for many on this group.
http://www.guardian.co.uk/commentisf.../cancer.health
Appalling hype of a drug for prostate cancer
It seems good news: a new weapon against an invidious disease. But the
reality is much less straightforward
watched a good friend die a strange death from prostate cancer. He was
diagnosed with the cancer in his late 60s, and already the cancer was
throughout his body. In the hope that the cancer was hormone sensitive, he
was treated by castration. And it worked dramatically: starved of
testosterone, the cancer melted away. Unfortunately his spine was being held
together by the cancer, and the disappearance of the cancer meant that his
neck became completely unstable. Surgeons thought that there was some chance
that they could stabilise his neck with a complex operation. My friend knew
that he might not survive the operation, and he didn't.
I tell this story to make two points. First, I've been touched personally by
the pain of losing a friend to prostate cancer. Second, a drug that caused
the cancer to melt away would not have saved my friend.
So I thought of my friend as I read the front-page headline in yesterday's
Times: "Cancer drug could save the lives of 10,000 a year". My immediate
reaction was to think that this was appalling hype, and as I dug into the
details I decided I was right.
The story follows on from publication of a very small study in the Journal
of Clinical Oncology of testing the drug, abiraterone, in 21 patients.
Nobody would have noticed this study, but Dr Johann S de Bono, one of the
authors of the study and a consultant to Cougar Biotechnology, the
manufacturers of the drug, held a "briefing". Journalists are very grateful
for stories that allow them to fill Monday's papers, and the Times had
enough material to fill two pages, including a story from a patient who had
taken the drug and was photographed behind what looked like lilies.
Dr de Bono told journalists that the drug was "spectacularly active ... we
believe we have made a major step forward in treating patients who have
failed all other treatments". Recognising the need for some human interest,
he added: "Within three months I have had men stop their morphine and say
I'm going to see my daughter living in Australia."
But all that we have apart from De Bono's understandable enthusiasm is
what's called a "phase 1 trial". Such a trial is designed simply to find out
if patients can tolerate the drug, whether there are any side-effects that
would stop patients from taking the drug, and what dose of the drug should
be used in the large, controlled, randomised trials that are needed to
determine for real whether a drug is effective and to get it onto the market
so that it can be prescribed. These phase 1 trials are not designed to
evaluate whether the drug is effective, but they do give some information on
what happens to the patients.
The 21 patients were admitted into the trial between December 2005 and
February 2007. The patients all had prostate cancer that did not respond to
castration or treatment with anti-androgens. (So my friend could not have
entered this study as he did respond to castration – rather too
dramatically.) Patients who had other severe diseases – like heart failure –
could not enter the trial, which is important because most patients with
prostate cancer are elderly men and many do have other conditions.
Several of the men developed side-effects to the drugs – high blood
pressure, low blood potassium, and swelling of the legs – but these
side-effects could mostly be controlled with other drugs. One man developed
a severe headache. Although these phase 1 trials look at safety, they are
most unlikely to detect side-effects that may be very severe but occur only
in, say, one in 500 patients. Such side-effects are often discovered later –
meaning that a drug that looks promising in a phase 1 study never reaches
the market.
Of the 21 patients, five are still being treated with abiraterone alone and
seven with the drug plus dexamethasone, a strong steroid. So nine are
presumably either dead or have stopped the treatment for some reason. Half
of the patients had a 50% decline in their prostate specific antigen, a
marker in the blood of the size and activity of the cancer. What this means
to patients in reality is impossible to know: "I'm not interested in what
some chemical is doing in my blood – I want to know whether I'm going to
live or die and be in pain." Some of the patients showed some shrinkage of
their cancer on X-ray examination, and of the 11 patients who had pain,
eight were able to reduce the amount of painkillers they took or stop them
altogether.
So we might legitimately conclude that there is some evidence that the drug
will act against the cancer, but we are a very long way from being able to
conclude that it will save 10,000 lives a year. The drug may never reach the
market, and even if it does it could take many years and may prove
impossibly expensive.
Years ago I used to be the BBC Breakfast Time doctor, and I had to struggle
every week with how to present the results of these sorts of studies to an
audience only half awake. My conclusion was that I did much more harm by
hyping treatments than I did by being over cautious – because new treatments
famously go through phases of being "a major breakthrough" to being
"terrible poison" to ending up as "a treatment of limited effectiveness that
has some use in some patients".
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Richard Smith: Appalling hype of a drug for prostate cancer
This article was published on guardian.co.uk at 11.30 BST on Wednesday 23
July 2008.
's comment
Comments in chronological order (Total comment)
Comments are now closed for this entry.
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Koolio Koolio
23 Jul 2008, 11:54AM
Headlines of "wonder drugs" sell more newspapers and generate more
clicks than "research suggests molecule might be of use". The media in
general is appalling at handing data but when it comes to managing
percentages, examining risk and probability, most journalists are hopeless.
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RayNoble RayNoble
23 Jul 2008, 12:11PM
Many thanks to Richard Smith for this article. It highlights a growing
problem with biomedical and clinical science in recent times, the tendency
to go public on research at the earliest stage and to use hyperbole in an
attempt to gain media attention. But what drives this tendency? The
biomedical journals do it in press releases, the universities do it and the
hospitals involved do it too. But what drives this tendency? I think the
answer lies in research funding and PR and not a little in self promotion.
University web sites are very revealing in this regard. They are full
of cover stories about the latest advance in research, the major grant
funding obtained, and each day there are new stories of success. It serves
at least two motives: to boost morale by developing a corporate identity and
it boosts the international and national image of the institution attracting
more students and helps recruit top flight academics, and it drives funding
on the principle that success breeds further success.
Biomedical science funding has changed substantially over the last two
decades. First the funding is heavily directed. That is the funding agencies
set up objectives and invite applications for major funding under those
initiatives. It means that to be successful the groups have to demonstrate
sufficient critical mass and expertise and you are more likely to do that if
you are part of a bigger success story. Such massive funding of several
millions requires justification by the funding agencies, by the academics
and clinicians involved and by the universities. All this drives the
tendency for exaggerated claims from early and incomplete studies. Their
careers depend on it.
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Gigolo Gigolo
23 Jul 2008, 12:12PM
At least prostate cancer has now been given some limited media
coverage, even though it may be completely misinformed. Compare that with
way breast and cervical cancers have been very well reported and made the
subjects of highly vocal fundraising campaigns. I guess a disease of mainly
elderly men isn't sexy enough to compete for such attention.
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Quixotematic Quixotematic
23 Jul 2008, 12:13PM
including a story from a patient who had taken the drug and was
photographed behind what looked like lilies.
Better than being photographed behind your orchids . . .
When science meets journalism, it is always the science that gets
bent. I've developed a working hypothesis that all journalists are halfwits,
or believe that their readership are.
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MrPikeBishop MrPikeBishop
23 Jul 2008, 12:17PM
Richard, just mailed a colleague who I was talking with yesterday
about this story, to say that, IMO, your article was "bang on". Without
going into the detail of who has bigged up this story, and why, I think
what's very shocking is the way in which the media swallowed the line
entirely uncritically and without any apparent understanding of procedure or
status - the nature, as you discuss, of a phase 1 trial.
Well done CiF - an expert balancing view to media hype.
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iquit iquit
23 Jul 2008, 12:24PM
My immediate reaction was to think that this was appalling hype,
and as I dug into the details I decided I was right.
But it wasn't just The Times. It was the BBC and The Guardian. I'm
sure you're correct in saying that the drug will end up "a treatment of
limited effectiveness that has some use in some patients". So why doesn't
The Guardian run it past the like of you before running the story? The media
is awash with appalling science reporting. Why don't you ask the editors
what they're going to do about it? (They'll probably just show you this)
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MarvinThePA MarvinThePA
23 Jul 2008, 12:45PM
I noticed this story on the BBC website-- and did not have time to
look into it further.
However I quickly came to a snap judgement that it was not that
important because it was in the Journal of Clnical Oncology-- and not the
NEJM.
It is shocking how journalists swallow this stuff again and again and
again. Don't they have any professional pride?
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Grahamesme Grahamesme
23 Jul 2008, 12:48PM
iquit - actually the Guardian report was quite balanced - it was quite
clear, for example that trials were not yet large enough to identify rare
side effects, and it was also clear that extending lifespan had not been
demonstrated.
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halfbakedno1 halfbakedno1
23 Jul 2008, 12:49PM
Even if this drug gave 1 out of the 21 people tested (even though on
reading it is more like 250) at least 1 year of life to live out, then it is
worth shouting about. Why not give hope even if it does turn out to be
false. I'd rather have hope than nothing which is what we currently have.
Shame on you. Be positive! If this exposure brings more eyes and more money
to the drug's progress then great! If it turns out to be "a treatment of
limited effectiveness that has some use in some patients" then what have we
lost?
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Cormaic Cormaic
23 Jul 2008, 12:50PM
The biomedical journals do it in press releases, the universities do
it and the hospitals involved do it too. But what drives this tendency?
Actually, many new drugs originate in a shady world of small startup
companies on the periphery of academia. Their directors compete in a lottery
that will see most of them go under (only for the same directors to start a
new company) and occasionally one will hit on a bankable product, be bought
out by one of the major league pharmaceutical companies and retire on the
proceeds. In such circumstances share prices mean a lot and such stories
make a considerable amount of money, regardless of the long-term fate of the
product.
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ardennespate ardennespate
23 Jul 2008, 12:58PM
Gosh! Another truly excellent, well written article on CIF (alongside
Sarfraz's). Thank you.
"Years ago I used to be the BBC Breakfast Time doctor, and I had
to struggle every week with how to present the results of these sorts of
studies to an audience only half awake. My conclusion was that I did much
more harm by hyping treatments than I did by being over cautious..."
And you're not the 'BBC Breakfast doctor' any more as result, I'll
bet.....
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ardennespate ardennespate
23 Jul 2008, 1:03PM
@Cormaic (12:50pm):
"Actually, many new drugs originate in a shady world of small
startup companies on the periphery of academia. "
Now that is an article the Guardian/CIF should commission - getting to
all the real reasons for the premature medical hype we see in the tabs.
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iquit iquit
23 Jul 2008, 1:03PM
Grahamesme -
Fair point, The Guardian wasn't so effusive as The Times with it's
'10,000 a year'. But The Guardian did say that the drug "could put thousands
of men into remission" admittedly with a more cautious tone. This was on the
same day that they ran a piece headed 'Can brocolli cure cancer?" which
concluded "Singling out broccoli as an anti-cancer superfood is therefore
meaningless". Fair enough, but headlines with stark words 'cancer', 'cure',
'hope' are a bit disingenuous i think.
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tangerinedream tangerinedream
23 Jul 2008, 1:11PM
Contributor Contributor
An excellent article. The mainstream media needs more qualified
doctors and scientists and less arts graduates.
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hideandseeker hideandseeker
23 Jul 2008, 1:22PM
Excellent article.
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LondonFido LondonFido
23 Jul 2008, 1:27PM
"But all that we have apart from De Bono's understandable enthusiasm
is what's called a "phase 1 trial".
I'm not sure this is correct. If you look a little further down the
linked Guardian article, you see revealed the following:
"So far 250 men have been treated with the drug worldwide and a global
trial of 1,200 is under way which researchers hope will be followed by rapid
licensing."
A couple of minutes with Google reveals that it's actually been
through Phases I and II (hence the 250 patients treated) and the Phase III
(referred to as "the global trial of 1,200" in the article) commenced in
April. It seems that the encouraging results continued in the Phase II
trials
The Guardian article also goes on that De Bono was protesting that :
"that the drug regulatory system is too slow - requiring data on the
numbers of deaths prevented by cancer drugs. He is hoping to establish a new
measure - of the drop in the number of cancer cells in the blood which could
mean faster registration."
Who knows whether De Bono's enthusiasm is linked to the fact that he
is a Cougar Biotech consultant or a clinician who thinks he and his
colleagues have come up with a useful new drug but I think it would have
been wise for Richard Smith to have conducted a little more research on this
story.
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AstroFungalInfection AstroFungalInfection
23 Jul 2008, 1:40PM
Well said.
Advertising and spin is bad enough- but when it comes to hype over
medical treatments I think it becomes immoral.
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tellusthetruth tellusthetruth
23 Jul 2008, 1:44PM
Richard, thanks for this.
My partner was diagnosed in January last with prostate cancer -
thankfully easily treated with bog standard drugs and excellent care because
it was diagnosed early. We are
told that there is every chance of a cure. I helped train the
consultant so I doubt that he is trying to put the best spin on it rather
than telling us the truth.
I have worked for years in the oncology field and mainly on clinical
trials. I get furious when the press goes to town about an alleged miracle
cure when anyone with any savvy knows that from Phase 1 trials right through
to marketing can take years.
I also agree that not every "miracle" works on every sort of cancer.
When I began my research work my then consultant was often in the press
trying to push the reality of this. It is very difficult to have to give
this news to desperate patients and equally desperate patients who have read
half-researched articles about it in the press.
As regards prostate cancer, often hormonal ablation can cure or at
least hold the disease in check, (but, as you found out in the case of your
friend, not invariably, or it can come with a sting in the tail), and often
effect a cure or considerably long disease-free interval.
As with most cancers, early diagnosis is often the defining factor in
a good outcome, so
Moderators, may I please use this space to set out when men, of
whatever age, ought to consult their GP? PLEASE DON'T DELETE THIS! THIS
REALLY COULD SAVE LIVES:
Poor urine flow or difficulty in urinating
Frequency in urinating or feeling of incomplete emptying of the
bladder
Urgency in urinating and/or poor control
Blood in the urine
Blood in the ejaculate
Pain in the lower back or testes
Bone pain
History of prostate cancer in first degree relatives.
PLEASE NOTE THAT THESE DO NOT NECESSARILY INDICATE CANCER OF THE
PROSTATE (they can also be indicative of infection of the prostate or the
urinary tract) but any or a combination or all of them certainly indicate
the need for further investigation.
Thanks, moderators. And Richard, an excellent, measured article
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MrPikeBishop MrPikeBishop
23 Jul 2008, 1:45PM
LondonFido, there are regulatory restrictions with regard to PR and
publication in the mainstream media, and what can or canot be said by drug
manufacturers depending on not only what stage has been passed, but also
what stage has been written up and published in peer reviewed journals.
What you'll find in google may not yet be suitable for formal
publication.
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Smiffy55 Smiffy55
23 Jul 2008, 1:48PM
A new product that is targeted at men's health needs? It'll never be
adopted by the NHS....
Cynicism aside, it does depress me that so many members of the health
industry see the output of the pharmaceutical companies as automatically
untrustworthy presumably because they are underpinned by the profit motive.
Leaving aside one dodgy headline I gained a very clear and un-hyped view of
this drug from the coverage on the Today Programme and reading online. This
seems to be just another attempt to criticise the industry rather than to
cast light on the matter.
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johnband johnband
23 Jul 2008, 1:51PM
"An excellent article. The mainstream media needs more qualified
doctors and scientists and less arts graduates."
Bollocks. You don't need to be a qualified doctor or scientist to
evaluate facts critically, nor to do 15 minutes' research into the meaning
of 'Phase I trial'. And arts graduates are just as equipped and trained for
critical evaluation of source material as scientists (not to mention, far
more so than doctors...).
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whippersnapp whippersnapp
23 Jul 2008, 1:59PM
'Now that is an article the Guardian/CIF should commission - getting
to all the real reasons for the premature medical hype we see in the tabs.'
Yeah, good point, Ardennespate, although could be kind of tricky
seeing that the Guardian has been running a prominent GSK ad campaign at the
top of Comment Is Free for the past week or so. Now, let's see, could that
be the same GSK that was never properly sanctioned for not revealing the
dangers which its best known antidepressant posed to children? And this
antidepressant, could it be the same one which has spread distress and
disfigurement to hundreds of thousands of people across the world? Really
cannot imagine. Of course the Guardian woudln't know about these sorts of
things, I don't imagine....
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LondonFido LondonFido
23 Jul 2008, 2:00PM
MrPB - thanks for the advice.
Results from Phase I and II were presented at the American Society of
Clinical Oncology 2008 Genitourinary Cancers Symposium in Feb 2008 - not
everything revolves around peer review papers.
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Aetius Aetius
23 Jul 2008, 2:01PM
While I agree with most of what Richard Smith has said I think it's
worth remembering that this is an important development in prostate cancer
research, even if the story has been over-hyped. Unfortunately government
policy with regard to the sciences (not just medical research) is driven
more and more by the need to yield results in the short term, and it's true
that when they're next applying for a grant the researchers involved will be
able to point to the media coverage as evidence of the value of their work.
The same applies to institutions, you can't blame them since they work in a
very competitive environment and many of the ideas are good even if not all
make it through to the finish.
It's a pity that the current government, which has done a lot to
increase science funding, should through it's obsession with targets and
deliverables undermine the long term benefits of that funding increase.
Incidently I thought the Guardian's coverage of the story was better
than most, though I would have liked to see an expert opinion brought in to
balance Dr. de Bono's contention that proxy endpoints should be accepted for
the registration of a drug, rather than reduced or delayed mortality and
decreased pain. Such proxy endpoints may be useful in research and even as
supplementary information during trials but IMHO should only be used as the
primary evidence of efficacy when deciding whether to register a drug if it
is very impractical to assess the clinical outcome (for example in
conditions that progress slowly over many years).
I actually feel some sympathy with journalists over science reporting,
the line between saying to the public "this is interesting, you should be
aware of it" and over-hyping can be pretty thin.
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venerablejohn venerablejohn
23 Jul 2008, 2:01PM
I have a more pressing question:
Given the comparable number of deaths in the UK between breast and
prostate cancer and the lower survival rates for prostate cancer, can
someone explain the disproportionate publicity and money channelled towards
breast cancer prevention, screening and treatment?
I believe that Breast cancer research receives about twice as much
funding - $900 million annually for breast cancer compared to $438 million
annually for prostate cancer
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tpw101 tpw101
23 Jul 2008, 2:22PM
An excellent article. The mainstream media needs more qualified
doctors and scientists and less arts graduates.
Bollocks. You don't need to be a qualified doctor or scientist to
evaluate facts critically, nor to do 15 minutes' research into the meaning
of 'Phase I trial'. And arts graduates are just as equipped and trained for
critical evaluation of source material as scientists (not to mention, far
more so than doctors...).
Ok, so maybe it's facetious to suggest that arts graduates can't
evaluate their information analytically but you still have to ask why this
misinformed pap pervades every media outlet going. I'm sure all journalists
are capable of grapsing some perspective on a story but I'm less sure there
is the motivation there to do so. If the problem is lazy journalism then at
least a doctor or scientist with some backgound in the area already knows
the limitations of a Phase 1 Trial without having to look it up.
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WoollyMindedLiberal WoollyMindedLiberal
23 Jul 2008, 2:23PM
A second dose of Ben Goldacre's Bad Science!
Hurray!
in this case it looks like the Guardian's Sarah Boseley has done
rather well and written a properly informed and balanced piece that explains
the excitement as well as why caution is needed.
http://www.guardian.co.uk/society/20.../health.cancer
The excitement stems from the paucity of drugs to treat men who
have the aggressive form of the cancer. Some prostate cancers hardly
progress and men are advised to watch and wait rather than undergo surgery
and chemotherapy which can leave them impotent and incontinent.
iquit
But it wasn't just The Times. It was the BBC and The Guardian. I'm
sure you're correct in saying that the drug will end up "a treatment of
limited effectiveness that has some use in some patients". So why doesn't
The Guardian run it past the like of you before running the story? The media
is awash with appalling science reporting. Why don't you ask the editors
what they're going to do about it? (They'll probably just show you this)
The BBC and The Times are doubtless guilty as charged but I think you
have maligned Sarah Boseley and The Guardian most unfairly. This paper for
all its faults is a lot less bad than all the others at science reporting
thanks to Alok, James, Ian, Adam and the rest.
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johnband johnband
23 Jul 2008, 2:47PM
"I believe that Breast cancer research receives about twice as much
funding - $900 million annually for breast cancer compared to $438 million
annually for prostate cancer"
AIUI, because breast cancer [on aggregate] kills people at a much
younger age than prostate cancer, and therefore causes the loss of far more
QALYs.
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Quixotematic Quixotematic
23 Jul 2008, 2:55PM
coverage on the Today Programme
In which the presenter kept referring to 'prostrate' cancer.
I was horrified.
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Kasilas Kasilas
23 Jul 2008, 2:59PM
Good article. Thou it's only part of a much wider issue about how the
media reports science. Especially cancer research which is practically
always small steps forward and not well separated headline stories.
To reply to the comment
"Bollocks. You don't need to be a qualified doctor or scientist to
evaluate facts critically, nor to do 15 minutes' research into the meaning
of 'Phase I trial'. And arts graduates are just as equipped and trained for
critical evaluation of source material as scientists (not to mention, far
more so than doctors...)."
Im afraid thats not true. Cancer research is more often about
presenting statistics not facts. And despite what many think critical
evaluation of statistics is not easy. Check out the link between Abortion
and crime rate for an interesting example. On average science graduates are
much better at statistics. Partly as statistical analysis is a numerical
skill which science graduates traditionally have. Some arts graduates have
excellent numerical skills but many don't.
As to the statement that an arts student can evaluate source material
better than a trained doctor. Probably in many cases but when the bloody
source material is a Phase 1 (it's 1 not I by the way) trial of a clinical
cancer drug I would doubt it. Given virtually all medical knowledge comes
from previous "trials" I guess you should do your own trials and use arts
graduates instead or doctors next time your seriously sick. I mean,
honestly, think about what your saying.
I just noticed even the language makes a statement. I made a comment
on average trends. You made an sweeping and false statement on all arts
graduates.
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puzzlebobble puzzlebobble
23 Jul 2008, 3:02PM
@johnband
"And arts graduates are just as equipped and trained for critical
evaluation of source material as scientists (not to mention, far more so
than doctors...)."
Cobblers. There's rather more to it than knowing what a phase one
trial is. You need to understand statistics, evidenced based medicine and
atleast the basics of the underlying pathophysiology, not to mention the
experience of having read hundreds of articles previously, before you can
possibly be considered good at critically analysing research papers.
An arts graduate with a bit of common sense might see some of the
obvious errors but there's a lot of very clever ways people lie with
statistics. More people of a scientific or medical background writing for
newspapers would certainly be a welcome change.
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LondonFido LondonFido
23 Jul 2008, 3:09PM
Kasilas - you undermine your case with your failed pedantry - most
common usage is "I" not "1"
see http://www.ct-toolkit.ac.uk/glossary.cfm?cit_id=544
and
http://clinicaltrials.gov/ct2/info/glossary#phasel
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MrPikeBishop MrPikeBishop
23 Jul 2008, 3:25PM
Today prog in which the presenter kept referring to 'prostrate'
cancer.
'Cus it was Nick Robinson moonlighting, and as I've said on a great
many occasions, the bloke is an idiot.
http://www.bbc.co.uk/blogs/nickrobin...8/07/oops.html
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Quixotematic Quixotematic
23 Jul 2008, 3:50PM
Kasilas - you undermine your case with your failed pedantry - most
common usage is "I" not "1"
Well . . . the National Research Ethics Service seems to favour the
arabic numeral over the roman. I think that in 'common usage' you will find
them used pretty interchangeably.
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stevejones123 stevejones123
23 Jul 2008, 4:33PM
A sensible article from Richard Smith with no covert agenda and that I
can agree with.
What have I been smoking?
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RodMunch RodMunch
23 Jul 2008, 5:01PM
Hype in the media Mr Smith? How jolly dare they
Speculation and conjecture in our newspapers? What is the world coming
to?
Exactly how long have you been a journalist?
It might not be with wonderdrug we are led to belive but I bet this
kind of 'good news' headline does a hell of a lot more for the population's
general health and well-being than the usual scare stories we get in our
newspapers.
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johnband johnband
23 Jul 2008, 5:37PM
@ Kasilas: your snide and wrong correction is appreciated. @
Puzzlebobble, I respectfully disagree.
The point is, it's not a journalist's job [even assuming we mean a
journalist who's good at classically-defined journalism, rather than a hack
delivering what his proprietor wants to see] to carry out or interpret the
results of Phase I trials. It is, however, a journalist's job to speak to
informed experts on the area they're writing about, whether it's science or
transport or finance. And it's their job to evaluate the credibility of the
written and primary sources they use.
In this case, five minutes talking to the right person would have told
them the real story: "this could be promising but it's extremely early doors
yet". If they'd spoken to me, I'd've run them through the drug approval
process, through the fact that an oncology drug that enters Phase II trials
[Roman numerals were house style when I worked as a pharmaceuticals industry
journalist, so that's how I spell it] has a 12% chance of actually reaching
the market, and so on; and I'm a long way from the best person to speak to.
With a few honourable exceptions like Ben Goldacre and Phil Hammond,
most doctors would be almost as bad at journalism as the average journalist
would be at doctoring...
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puzzlebobble puzzlebobble
23 Jul 2008, 6:31PM
@johnband
"With a few honourable exceptions like Ben Goldacre and Phil
Hammond, most doctors would be almost as bad at journalism as the average
journalist would be at doctoring..."
You've shifted the goalposts. Before you were talking about 'arts
graduates', not 'journalists':
"And arts graduates are just as equipped and trained for critical
evaluation of source material as scientists (not to mention, far more so
than doctors...)."
Good journalists can come from a variety of backgrounds. I don't see
why someone with a photography degree is very much more likely to make a
good journalist than a medic. It's also arrogant nonsense for you to say
that a journalist who had previously been a scientist or doctor wouldn't be
able to use any of what they had learnt in their years of training and work
to write better stories.
"It is, however, a journalist's job to speak to informed experts
on the area they're writing about, whether it's science or transport or
finance. And it's their job to evaluate the credibility of the written and
primary sources they use."
How do you evaluate the primary sources, when they are original
science articles, if you don't understand the statistics or have the basic
science knowledge to interpret it? The level of journalism on
science/medicine is in general very poor and I think that a good part of
that is because they just don't get it.
I'm not arguing that all journalists should come from science
backgrounds but that the proportion should more representative. Do you think
the arts would be well reported if 98% of the journalists covering the arts
were science graduates, however thorough their journalistic method was?
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Kasilas Kasilas
23 Jul 2008, 6:37PM
Fair enough Fido, it was pedantic. However it was because I recently
had "phase I" corrected to "phase 1" on a paper. Plus I was probably a bit
annoyed at the silliness of the original point. But excuses aside, you are
undoubtedly correct that the majority use is I. Anyway you say the point
undermines my case. Well hopefully my most sincere apology will undo this
damage.
Now for something different:
Since you called me pedantic, I feel I should live up to this, and ask
to prove that the most common usage is "I". I assumed by usage you mean the
number of times it's used (or written) in this context. As I am generally
helpful I would like you to start at this link.
ttp://rapidshare.com/files/131896760/GetThePoint.zip.html
This is a link to a file were I have wrote the phrase. "I prefer phase
1 trials" about 100 million times (it's ~1.8Gb but don't worry I compressed
it, thou given it's size you might not want use Vista to open it). If you
want I can split it into 10 million files or and zip those up to send to you
instead. I will also have 1800Gb worth of this on my hard drive by tomorrow.
So whilst 2 links is a good start, to scientifically prove your point you
should reply with the other 100 billion occurrences of "phase I".
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GeorgeBall GeorgeBall
23 Jul 2008, 8:24PM
LondonFido is correct in stating that abiraterone has passed its phase
1 and 2 trials and has now started phase 3, so Richard Smith has clearly not
researched this.
The drug patents are owned by the British Technology Group, which gave
this update yesterday:
http://www.advfn.com/p.php?pid=nmona...symbol=L%5EBGC
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bettysenior bettysenior
23 Jul 2008, 9:31PM
It is a known fact that pharmaceutical companies always hype up their
so-called breakthroughs but where unfortunately the majority fail over time.
Indeed, a very small part of a percent ever become close to what one could
consider to be a 'wonder' drug.
But when one considers that overall the modern pharmaceutical industry
has only been around for a mere 100 years or so, it is understandable that
there are very few revolutionary cures.
But what astounds me is that traditional medicines are seen as
secondary medicines in the UK but where in fact if the regulators allowed
them to see the light of day, then there would be something to improve the
health of humans in the 'West' and dramatically. China for instance has a
history in traditional medicines going back over 2,000 years and where the
trial and error technique to determine which cures and which kills has been
undertaken extensively through the test of time. Indeed, the fatalities are
a mere fraction of what modern drugs produce worldwide.
Unfortunately the large modern drug companies have our politicians in
their back pocket and where the real traditional medicines that work are
simply banned.
That okay for the big firms but bad for our people in general. The
reason, traditional medicines really do work but where we cannot use them
due to government legislation that prohibits their use. The irony of all
this is that the modern drug industry evolved out of traditional medicines
in the first place but where now they stifle their original creator. The
reason again, if introduced they would threaten the very large bottom-line
of the huge players.
Having travelled SE Asia I have seen at first hand these incredible
traditional medicines in action and where they have miraculous curative
properties. Therefore these medicines other than being seen as unacceptable
are really what one can consider as the medicines of the future. Once that
is of course when common sense eventually prevails and our governments stop
taking notice of the powerful drug lobbying groups. One of these wonder
medicines that I have seen and witnessed in action several times is a herbal
cure for drug addition that within 48 hours detoxified long-standing hard
drug addicts. But the beauty of this herbal treatment is that there is no
'cold turkey' that all drug addicts dread and the main reason why they do
not come off heroin et al.
Indeed, it is a humane treatment with no side effects and where over
20,000 hard drug addicts have already been cured to date over the last
10-years since its introduction in SE Asia.
No chance of it coming here though as the government and big drug
companies don't want it. Strange but true.
Dr David Hill
World Innovation Foundation Charity (WIFC)
Bern, Switzerland
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SkepticMedic SkepticMedic
23 Jul 2008, 9:53PM
<I>arts graduates are just as equipped and trained for critical
evaluation of source material as scientists (not to mention, far more so
than doctors...)</I>
Got any proof? Sounds like the protestations of a Redbrick 2:2 in
English lit to me.
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puzzlebobble puzzlebobble
23 Jul 2008, 10:06PM
@bettysenior
"But when one considers that overall the modern pharmaceutical
industry has only been around for a mere 100 years or so, it is
understandable that there are very few revolutionary cures.
But what astounds me is that traditional medicines are seen as
secondary medicines in the UK but where in fact if the regulators allowed
them to see the light of day, then there would be something to improve the
health of humans in the 'West' and dramatically. China for instance has a
history in traditional medicines going back over 2,000 years and where the
trial and error technique to determine which cures and which kills has been
undertaken extensively through the test of time"
You sound very confident about the powers of chinese medications. Care
to provide evidence that any of them work? Care to provide a single piece on
information proving a chinese medication has ever been a 'revolutionary
cure'?
"Indeed, the fatalities are a mere fraction of what modern drugs
produce worldwide."
Yes, there are iatrogenic deaths but then proper medicine can also
prove that it saves lives. Unlike chinese medicine where it can only be
shown that it can kill.
"Having travelled SE Asia I have seen at first hand these
incredible traditional medicines in action and where they have miraculous
curative properties."
Have you ever heard of the words coincidence or placebo? If so then
how do you know you didn't just see those in action?
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FredSmith01 FredSmith01
23 Jul 2008, 10:55PM
Prostate cancer is one of four "intake" cancers that are more common
in Western than non-Western societies (three seem to be related to diet -
breast, colorectal, prostate; one to smoking - lung). Mediterranean, vegan
and African diets are found to be "protective"; inhabitants of Xi-Dong
province in China avoid both breast and prostate cancers.
Poorly differentiated breast and prostate cancer may simply depend on
an initiaitng event supplemented by an excessive intake of dietary growth
factors (meat and dairy products from force fed cattle and poultry). Poorly
differentiated cancers - as described by Dr Smith - may simply reflect a
21st century diet. Excluding growth factors, avoiding further autonomic
distress and getting on with your life may be preferable to orchidectomy,
chemotherapy, radiotherapy and new wonder drugs.
Big Food and Big Pharma may have much to answer for ?
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puzzlebobble puzzlebobble
23 Jul 2008, 11:57PM
@fredsmith01
"Poorly differentiated cancers - as described by Dr Smith - may
simply reflect a 21st century diet. Excluding growth factors, avoiding
further autonomic distress and getting on with your life may be preferable
to orchidectomy, chemotherapy, radiotherapy and new wonder drugs."
sounds like poppycock to me. Care to try and convince us with evidence
for that?
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RogerINtheUSA RogerINtheUSA
24 Jul 2008, 1:03AM
Cormaic posted
Jul 23 08, 12:50pm (about 12 hours ago)
The biomedical journals do it in press releases, the universities do
it and the hospitals involved do it too. But what drives this tendency?
Actually, many new drugs originate in a shady world of small startup
companies on the periphery of academia. Their directors compete in a lottery
that will see most of them go under (only for the same directors to start a
new company) and occasionally one will hit on a bankable product, be bought
out by one of the major league pharmaceutical companies and retire on the
proceeds. In such circumstances share prices mean a lot and such stories
make a considerable amount of money, regardless of the long-term fate of the
product.
hi Cormaic
certainly if new drugs originate in this "shady world", this
innovation should be stamped out. If there are to be new drugs, perhaps they
should only be developed by the large drug companies or by the
ultracompetent government labs that have created so many of the drugs we use
today.
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gavinbullock gavinbullock
24 Jul 2008, 1:54AM
I can see Dr Smith's point (nice to see him off his privatisation
hobby horse). However, these patients had a more or less hopeless prognosis,
so these results have to be applauded. The thing is that a good proportion
of the patients were free of pain and feeling well. Objective shrinkage of
tumours on X-ray is nice to see but cessation of tumour growth is almost as
impressive - it is continued growth of aggressive tumours that kill.
Is some hope better than no hope? Present sufferers won't benefit and
they know it, but men who are well at present who will develop the disease
in the next year of so might do so.
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yoda26 yoda26
24 Jul 2008, 8:46AM
My name is Simon Bush and I am one of the patients highlighted this
week. I have been on this trial since May 2007.
Here are some important points Mr Smith needs to consider.
! was one of 5 patients chosen to represent the trial for the press, I
was not on the phase 1 trial, I am part of the wider phase 2. The fact is
that this drug works.
I had failed all standard treatments, including 6 months of chemo
(Docetaxel and ECarboF). My PSA was rising 10 a month and my bone markers
(Alkaline Phosphatase) had risen to 1,750 (normal being below 100). I was
being given no chance of survival and was preparing for a painful death.
My PSA fell as far as 3 and although it has crept up, it is still only
12 and my bone markers are 127.
To varying degrees in terms of PSA falls a high percentage of
trialists have had similar results.
Of course the press will hype it up, but don't knock the drug or the
researchers. The fact is that this drug gives hope to thousands of men in
pain with little hope.
Support the Marsden's efforts and have a go instead at why it takes so
long to get drugs like this into public use.
Simon Bush
