Sanitation, Not Vaccine, Best Way to Improve Public Health, Says Poll of BMJ Readers

SCIENCE
Notebook
Monday, January 22, 2007; Page A08

http://www.washingtonpost.com/wp-dyn...012101145.html

Medical Breakthrough? The Laurels Go to Sewers
--------------------------------------------------------------------------------
What was the most important medical breakthrough of the last 167 years?
The structure of DNA? Nope. The invention of vaccines? Nope.
Antibiotics? Sorry.

According to a poll by the British Medical Journal, the answer is:
Sewers.

To mark a redesign of the prestigious medical journal, the editors
decided to poll readers about what they considered the greatest medical
milestone since 1840, the year the forerunner of the journal started
publishing.

More than 11,000 readers responded, and sanitation won with 1,795
votes. London was one of the first modern cities to improve public
sanitation after John Snow showed that cholera was spread by water, and
Edwin Chadwick came up with the idea of sewage disposal and piping
water into homes.

Antibiotics was a close second with 1,642 votes. Anesthesia came in
third with 1,574 votes, followed by vaccines and the discovery of the
structure of DNA.

"The general lesson which still holds is that passive protection
against health hazards is often the best way to improve population
health," said Johan Mackenbach of Erasmus University Medical Center in
the Netherlands, who nominated sanitation.

The journal noted that inadequate sanitation is still a major problem
in the developing world. In 2001, unsafe water, sanitation and hygiene
accounted for more than 1.5 million deaths from diarrheal diseases.

-- Rob Stein
© Copyright 1996-2007 The Washington Post Company

The subject line is misleading, the question answered in the article was
what single practice had the biggest health impact. Getting the disease
vectors reduced in the human environment was the easy bit in improving
health.

However it did not eliminate them completely and some vectors are not
directly sanitation related. Smallpox and tb are examples of the latter
and it was not until medical practice had methods to deal with them
directly did rates fall.

This has the strong smell of an agenda about it.

capmack@shipper.com wrote:
> The subject line is misleading, the question answered in the article was
> what single practice had the biggest health impact. Getting the disease
> vectors reduced in the human environment was the easy bit in improving
> health.

Sloshing dead germs around in a test tube and getting it to patent was
harder than creating cities with municipal water and indoor plumbing?

> However it did not eliminate them completely and some vectors are not
> directly sanitation related. Smallpox and tb are examples of the latter
> and it was not until medical practice had methods to deal with them
> directly did rates fall.

Got any proof of that?

> This has the strong smell of an agenda about it.

Seen any black helicopters outside your bedroom lately? That was me.

"PeterB" <pkm@mytrashmail.com> wrote in message
news:1169497925.464057.30150@51g2000cwl.googlegrou ps.com...
>
> capmack@shipper.com wrote:
>> The subject line is misleading, the question answered in the article was
>> what single practice had the biggest health impact. Getting the disease
>> vectors reduced in the human environment was the easy bit in improving
>> health.
>
> Sloshing dead germs around in a test tube and getting it to patent was
> harder than creating cities with municipal water and indoor plumbing?
>
>> However it did not eliminate them completely and some vectors are not
>> directly sanitation related. Smallpox and tb are examples of the latter
>> and it was not until medical practice had methods to deal with them
>> directly did rates fall.
>
> Got any proof of that?
>
>> This has the strong smell of an agenda about it.
>
> Seen any black helicopters outside your bedroom lately? That was me.
>

PeterB, the point is that sanitation only works against enteric pathogens.
It does nothing at all for bugs that are spread aerially or by direct person
to person contact, as is quite forcibly illustrated by the persistence of
epidemics of colds and 'flu and the epidemics of whooping cough and and
other such illnesses that still occur in well-sanitised but poorly
vaccinated populations. (The flu vaccine is relatively less effective
partly because of its ability to mutate into myriads of different strains,
which doesn't apply with most other bugs that are vaccinated against).

Furthermore, vaccinations wiped out smallpox in India and Africa well before
there were any meaningful changes in the level of sanitation there. I dare
you to go to India even now and eat and drink as the locals do.

Why not face simple facts like this? Look at ALL the evidence -- read more
widely -- and only then make a judgement..

Peter Moran




..

>> The subject line is misleading, the question answered in the article was
>> what single practice had the biggest health impact. Getting the disease
>> vectors reduced in the human environment was the easy bit in improving
>> health.

>Sloshing dead germs around in a test tube and getting it to patent was
>harder than creating cities with municipal water and indoor plumbing?

An otherwise meaningless quip, civil sanitation was a snap because being
able to identify what germ was the source of a disease and then finding
an effective method to deal with it are much more difficult and until
recently science was not up to the task. Simple observation and trial
and error methodsgave us civil sanitation..

>> However it did not eliminate them completely and some vectors are not
>> directly sanitation related. Smallpox and tb are examples of the latter
>> and it was not until medical practice had methods to deal with them
>> directly did rates fall.

>Got any proof of that?

As I recall, providing or understanding scientific evidence is not your
strong suite so how would you know if it were provided you? Just stop
and think a minute, compared to sewage borne disease how are smallpox
and tb spread and would the best sewers in the world make any
difference?

>> This has the strong smell of an agenda about it.

>Seen any black helicopters outside your bedroom lately? That was me.

No, but I have seen your unsupported assertions aplenty, the laetril
defence was an instant classic in agenda driven posts.

On Jan 24, 3:59 pm, "Peter Moran" <pmo...@bordernet.com.au> wrote:
> "PeterB" <p...@mytrashmail.com> wrote in messagenews:1169668479.386096.140750@s48g2000cws.g ooglegroups.com...
>
>
>
>
>
>
>
> > On Jan 24, 2:15 pm, "mainframetech" <chough...@insidefsi.net> wrote:
> >> Huh? I thought colds and flu were being spread by big pharma. A
> >> different strain every year so you have to get the latest version of
> >> vaccine and thimerosal annually. This year they're even pushing 'bird
> >> flu' so they get a twofer ths time. )
>
> >> For you excitable folks, I'm just kidding...I have no proof that any
> >> company is actually dosing people with flu like the government did with
> >> LSD and other nasty chemicals.
>
> >> Chris
>
> > Don't mind Moran, a retired cancer surgeon. When asked for data
> > supporting the use of chemo in the majority of cancers, he responded
> > with data on metabolic cancer diets as "evidence" that drugs works in
> > inverse proportion to chicken soup. He's so old school that when with
> > faced with the new direction of medicine, he leaks formaldehyde. I
> > would say we should give him time, but I don't think he has any.
>
> > PeterBDon;t make things up, PeterB. I asked you to specify a cancer and the
> circumstances (curative, adjuvant, or palliative) I would supply what data
> exists. With some cancers the data is not strongly supportive, with
> others, it is.

I'm not making it up. Your defense of chemotherapy was to cite the
evidence on metabolic cancer diets. Your statement that *some* cancers
are not responsive to chemotherapy is meaningless because no RCT
studies exist to correlate the effects of chemotherapy to survival
outcomes in the first place. So-called palliative chemotherapy is
attributed to the benefits of a reduction in tumor size (when it
occurs, which isn't often), but again, such a view is unproven because
the concomitant use of palliative nutrition confounds the claim.
Mainstream oncology is co-opting the effects of therapeutic nutrition
while disparaging such factors outside of standard treatment. In light
of your refusal to provide chemotherapy data, I located something of
interest from the University of Wisconsin. See the chart at
http://www.eperc.mcw.edu/fastFact/ff_099.htm. There are several
interesting things about this table. The most obvious is that it shows
how broadly ineffective chemotherapy is in terms of improving survival
times in cancer patients. Note that "Median Survival" figures
represent survival times for BOTH "responders" and "non-responders"
(ie., those who experience a tumor reduction while undergoing
chemotherapy, and those who do not.) No effort was made, however, to
statistically separate the effects of chemotherapy in either group.
Again, this is not a comparison between non-treated and treated
patients, but a comparison *among* treated patients. Footnoted is the
authors' comment that "patients who respond to chemotherapy typically
live longer than those who do not." How do they know this? If tumor
reduction is meaningfully correlated with improved survival times, why
are these effects not precisely measured and reported? What is
"typical?" Do we not get beneficial outcomes from the use of placebo,
making those effects "typical?"

Furthermore, the "Response Rate" (tumor reduction) column shows breast
cancer to be the most associated with (but not corrrelated to) a
chemotherapy response, somewhere around 40% for the average treated
patient. This is *associated* with a range of survival from 24 months
to 36 months. Again, no RCT data exists to show that a definitive
correlation exists -- even empirically-derived percentages are not
provided except in aggregate. In other words, we have no way to know
what percentage of "responders" are found in the longer-surviving
group, or what percentage of "non responders" can be found in the
low-end group. I would refer to that as a conspicuous omission. Let's
do a little meta study ourselves using the data we do have. Compiling
the average percentage of "responders," we get 24.44% of patients who
experience tumor reduction during (but not necessarily resulting from)
treatment. This amounts to about 1 in 4. If we compile the average
number of months representing low-end and high-end survival times (we
have no choice because the data is blended that way) we get a figure of
about 4.3 months, or 17 weeks of additional survival *associated* with
a reduction in tumor size. What can we derive from these numbers?
Not much. All we can say for sure is that one in every four patients
treated for these particular cancers will experience a tumor reduction
(some of which *may* be associated with chemotherapy.) Since tumor
regressions can occur without treatment, we cannot conclude that such
shrinkage is solely attributable to administration of chemotherapy. We
cannot even say that survival time will average 4.3 months of
additional life for that fourth person because the survival data for
both "responders" and "non responders" has been aggregated. We are
only told that survival times will be "typically" greater for those
whose tumors shrink. Due to the absence of data, I would venture a
guess that one in 50 such cases might actually be *associated* with the
use of chemotherapy, but even that is being generous. Put simply, the
evidence that chemotherapy is beneficial in the vast majority of
cancers is very, very poor. Note also the statement that "response
rate data that is generally quoted to patients comes from clinical
trials using GOOD PERFORMANCE STATUS [emphasis mine] who are closely
monitored patients; the response rates for patients outside of clinical
trials can be expected TO BE LOWER [emphasis mine]." [ref.
http://www.eperc.mcw.edu/fastFact/ff_014.htm.]

If I ever develop cancer, and I pray that I don't, here is what I would
personally do. 1. Seek a naturopath familiar with intravenous vitamin
C and laetrile therapy and begin treatment immediately. 2. Take 2g
daily Lysine, as this amino acid interferes with cancer's ability to
spread. 3. Take 2g N-acetylcystein daily, to boost overall immunity.
4. Abstain from food entirely every other day, or at least 12 hours on
the second day to reduce unnecessary metabolic activity. 5. Visualize
the elimination of cancer cells several times while lying down with the
eyes closed. If nothing else, biofeedback techniques have been proven
to reduce stress, and that will support immunity.

PeterB

Correction: Near the end of the second paragrah above, the word
"associated" is used when the word "linked" was intended. It should
have read: "Due to the absence of data, I would venture a guess that
one in 50 such cases might actually be *linked* with the use of
chemotherapy, but even that is being generous."

In misc.health.alternative PeterB <pkm@mytrashmail.com> wrote:

: Your statement that *some* cancers
: are not responsive to chemotherapy is meaningless because no RCT
: studies exist to correlate the effects of chemotherapy to survival
: outcomes in the first place.

: If I ever develop cancer, and I pray that I don't, here is what I would
: personally do. 1. Seek a naturopath familiar with intravenous vitamin
: C and laetrile therapy and begin treatment immediately. 2. Take 2g
: daily Lysine, as this amino acid interferes with cancer's ability to
: spread. 3. Take 2g N-acetylcystein daily, to boost overall immunity.
: 4. Abstain from food entirely every other day, or at least 12 hours on
: the second day to reduce unnecessary metabolic activity. 5. Visualize
: the elimination of cancer cells several times while lying down with the
: eyes closed. If nothing else, biofeedback techniques have been proven
: to reduce stress, and that will support immunity.

Have any RCT studies been done to correlate the effects of the above
therapy to survival outcomes?


-----
Richard Schultz schultr@mail.biu.ac.il
Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel
Opinions expressed are mine alone, and not those of Bar-Ilan University
-----
". . . for while he was not dumber than an ox, he was not any smarter."
-- James Thurber, _My Life and Hard Times_

Richard Schultz wrote:
> In misc.health.alternative PeterB <pkm@mytrashmail.com> wrote:
>
> : Your statement that *some* cancers
> : are not responsive to chemotherapy is meaningless because no RCT
> : studies exist to correlate the effects of chemotherapy to survival
> : outcomes in the first place.
>
> : If I ever develop cancer, and I pray that I don't, here is what I would
> : personally do. 1. Seek a naturopath familiar with intravenous vitamin
> : C and laetrile therapy and begin treatment immediately. 2. Take 2g
> : daily Lysine, as this amino acid interferes with cancer's ability to
> : spread. 3. Take 2g N-acetylcystein daily, to boost overall immunity.
> : 4. Abstain from food entirely every other day, or at least 12 hours on
> : the second day to reduce unnecessary metabolic activity. 5. Visualize
> : the elimination of cancer cells several times while lying down with the
> : eyes closed. If nothing else, biofeedback techniques have been proven
> : to reduce stress, and that will support immunity.
>
> Have any RCT studies been done to correlate the effects of the above
> therapy to survival outcomes?

Your sponsors have managed to criminalize our study of laetrile, or had
you forgotten? The data we do have persuades me that laetrile is a
better choice than chemotherapy. Pauling and Cameron demonstrated
substantial improvements in survival times for cancer patients using
intravenous vitamin C, whereas large population studies have shown
substantial lifespan gains for those in the highest quartile of
*supplemental* vitamin C intake. Later vitamin C studies were frought
with charges of fraud, an echo of earlier press leaks regarding
positive laetrile data coming out of Sloan-Kettering. NAC is in
professional use already, though not typically for its ability to raise
white blood cell count. The infection-limiting affects of NAC are well
documented, however. Reduction in metabolic activity through caloric
restriction has an excellent chance of slowing cancer, as studies have
shown dramatic lifespan gains in animals. Human volunteers in caloric
reduction are demonstrating equivalent improvements in biomarkers for
aging, suggesting they will derive a similar effect. For several
reasons, the use of RCT data in managed healthcare is not relevant to
the use of natural medicine approaches. First, the high cost of
chemotherapy drugs should be compensated for by results, in terms of
both efficacy and safety. As only a small fraction of cancer patients
appear to benefit from the use of chemotherapy, use of these in the
majority of cancer patients constitutes fraud. Second, natural
medicine approaches using nutrients that are food-derived and the
product of biosynthesis are not held to the same threshold of evidence
as regulated drugs, because those nutrients drive homeostatis in the
first place. It thought you were a scientist. Notice the question was
purely rhetorical.

PeterB

"Your sponsors have managed to criminalize our study of laetrile, or had
you forgotten? The data we do have persua laetrile is a better choice
than chemotherapy."

Smile, have you forgotten so quickly? In another thread about this
classic poster child for "alternative drugs" you agreed that the
research said to be in support was of dismal quality, now you are
"persuaded", which is it dismal or not?

No surprise here, you at first did not know anything about the poster
child "alternative drug" except some book was anti scientific medicine
and supported it so you were for it on those grounds alone. Then you
tried to claim there was no evidence for or against it so the
testimonial from the doctors selling it must stand as the best we knew.
Then you were shown that scientific tests were done and it failed
completely. Of course you tried the old "they were flawed" tactic but
got nowhere.

So here you are again with "persuasive" evidence, dare we ask to see it
please? Does it include those who died from the toxic levels of poison
it can contain? Would that have anything to do with it not being legal,
not to mention it does not work and desperate people spend thousands in
mexican "clinics" and do not survive anyway?

"PeterB" <pkm@mytrashmail.com> wrote in message
news:1169749273.338538.34270@v33g2000cwv.googlegro ups.com...
>
>

> If I ever develop cancer, and I pray that I don't, here is what I would
> personally do. 1. Seek a naturopath familiar with intravenous vitamin
> C and laetrile therapy and begin treatment immediately. 2. Take 2g
> daily Lysine, as this amino acid interferes with cancer's ability to
> spread. 3. Take 2g N-acetylcystein daily, to boost overall immunity.
> 4. Abstain from food entirely every other day, or at least 12 hours on
> the second day to reduce unnecessary metabolic activity. 5. Visualize
> the elimination of cancer cells several times while lying down with the
> eyes closed. If nothing else, biofeedback techniques have been proven
> to reduce stress, and that will support immunity.

But you will surely also have the cancer cut out, if that were possible?
There is no good evidence that any of the above methods work, whereas
surgery probably accounts for 90% of the 50-60% of cancers that are cured by
present methods.

A simple lumpectomy will many breast cancers, for example..

Peter Moran

Peter Moran wrote:
> "PeterB" <pkm@mytrashmail.com> wrote in message
> news:1169749273.338538.34270@v33g2000cwv.googlegro ups.com...
>>
>
>> If I ever develop cancer, and I pray that I don't, here is what I would
>> personally do. 1. Seek a naturopath familiar with intravenous vitamin
>> C and laetrile therapy and begin treatment immediately. 2. Take 2g
>> daily Lysine, as this amino acid interferes with cancer's ability to
>> spread. 3. Take 2g N-acetylcystein daily, to boost overall immunity.
>> 4. Abstain from food entirely every other day, or at least 12 hours on
>> the second day to reduce unnecessary metabolic activity. 5. Visualize
>> the elimination of cancer cells several times while lying down with the
>> eyes closed. If nothing else, biofeedback techniques have been proven
>> to reduce stress, and that will support immunity.
>
> But you will surely also have the cancer cut out, if that were possible?
> There is no good evidence that any of the above methods work, whereas
> surgery probably accounts for 90% of the 50-60% of cancers that are cured by
> present methods.
>
> A simple lumpectomy will many breast cancers, for example..
>
> Peter Moran
>
>
I believe that PeteyB will not bother with that, and go straight to the
pine box cure.

"PeterB" <pkm@mytrashmail.com> wrote in message
news:1169749273.338538.34270@v33g2000cwv.googlegro ups.com...
>
>
> On Jan 24, 3:59 pm, "Peter Moran" <pmo...@bordernet.com.au> wrote:
>> "PeterB" <p...@mytrashmail.com> wrote in
>> messagenews:1169668479.386096.140750@s48g2000cws.g ooglegroups.com...
>>
>>
>>
>>
>>
>>
>>
>> > On Jan 24, 2:15 pm, "mainframetech" <chough...@insidefsi.net> wrote:
>> >> Huh? I thought colds and flu were being spread by big pharma. A
>> >> different strain every year so you have to get the latest version of
>> >> vaccine and thimerosal annually. This year they're even pushing 'bird
>> >> flu' so they get a twofer ths time. )
>>
>> >> For you excitable folks, I'm just kidding...I have no proof that any
>> >> company is actually dosing people with flu like the government did
>> >> with
>> >> LSD and other nasty chemicals.
>>
>> >> Chris
>>
>> > Don't mind Moran, a retired cancer surgeon. When asked for data
>> > supporting the use of chemo in the majority of cancers, he responded
>> > with data on metabolic cancer diets as "evidence" that drugs works in
>> > inverse proportion to chicken soup. He's so old school that when with
>> > faced with the new direction of medicine, he leaks formaldehyde. I
>> > would say we should give him time, but I don't think he has any.
>>
>> > PeterBDon;t make things up, PeterB. I asked you to specify a cancer
>> > and the
>> circumstances (curative, adjuvant, or palliative) I would supply what
>> data
>> exists. With some cancers the data is not strongly supportive, with
>> others, it is.
>
> I'm not making it up. Your defense of chemotherapy was to cite the
> evidence on metabolic cancer diets.

Bullshit. Show me where I did this.

>Your statement that *some* cancers
> are not responsive to chemotherapy is meaningless because no RCT
> studies exist to correlate the effects of chemotherapy to survival
> outcomes in the first place.

Bugger! I hate being pushed into a defence of chemotherapy, because I am no
great fan of it myself, outside of a few areas where it has great benefits
and actually cures people of their cancers and every time I do so I am
accused of being paid by someone!

But for God's sake let us have truthful information!

Actually there is a LOT of data showing a correlation between chemotherapy
response rates and length of survival, even in the cancers with the very
poorest results with chemotherapy such as colon cancer and NSCLC. I will
put one such at the end of this.

There are also numerous studies comparing chemotherapy with "best supportive
care" (BSC), as you would find out if you put these terms into Medline. It
is thus not true that chemotherapy has never been shown to have benefits
over no chemotherapy in controlled trials (although in some specific
instances there were no worthwhile beneifts and those methods would not now
be ever used for those purposes). I will put an illustrative example below.

But you are making two other wrong assumptions in this long spiel of your
(if it is yours, which I doubt). When used in a palliative role
chemotherapy is used mainly in patients who already have *symptoms* of their
cancer or who are very likely to soon have symptoms. Often the only way of
obtaining relief from cancer symptoms is to induce remission. Even if
survival was not significantly prolonged in some patients those responding
to the chemotherapy may still derive substantial benefits for this reason.
The quality of their remaining life may thus be improved. Most modern
studies on chemotherapy also look at quality of life indicators. .

The other thing you fail to realise is that a median duration of response of
a mere few months obscures some far longer responses for some patients.
Responses are in truth very variable and chemotherapists cannot be blamed if
a few excellent, prolonged, complete responses play a part in their minds
whenever they are facing a patient for whom they have nothing else to
offer. WHere they may mainly go wrong is if they persist with chemotherapy
if there is no obvious response within a couple of cycles.

Coll Antropol. 2005 Dec;29(2):583-8. Links
Gemcitabine in the first and second-line chemotherapy of advanced non-small
cell lung cancer.
a.. Cucevic B,
b.. Samarzija M,
c.. Baricevic D,
d.. Jakopovic M,
e.. Redzepi G,
f.. Samija M.
University Hospital for Lung Diseases "Jordanovac", Zagreb, Croatia.
branka.cucevic@zg.htnet.hr

Aim of this study was to estimate efficacy of gemcitabine in first and the
second-line chemotherapy for patients with advanced non-small cell lung
cancer (stage III and IV). In first-line chemotherapy, 120 patients were
treated with different chemotherapy regimens. Fifty-nine patients were
treated with gemcitabine / cisplatin (PG), 41 with cisplatin / etoposide
(PE) and 20 with mitomycin / ifosfamide / cisplatin (MIC). Forty patients,
unsuccessfully treated with PE and MIC in first-line therapy were treated
with PG (24 pts) and with best supportive care (BSC) (16 pts). In first-line
therapy PG was superior to PE and MIC protocol (mean survival (MS) 10 vs. 7
vs. 8.5 months). Response rate (RR) for PG in first-line therapy was 46% and
21% in second-line. We showed also significantly better survival in patients
treated with PG in second-line chemotherapy comparing to best supportive
care (MS 9 vs. 5.5 months). Toxic side effects for combination PG was
acceptable. This study confirmed that PG combination is safe and effective
as first and second-line chemotherapy for patients with advanced non-small
cell lung cancer.

PMID: 16417165 [PubMed - indexed for MEDLINE]


1: Lancet. 2000 Jul 29;356(9227):373-8. Links

Comment in:
Lancet. 2000 Jul 29;356(9227):353-4.
Lancet. 2000 Nov 18;356(9243):1771.
Relation between tumour response to first-line chemotherapy and survival in
advanced colorectal cancer: a meta-analysis. Meta-Analysis Group in Cancer.
a.. Buyse M,
b.. Thirion P,
c.. Carlson RW,
d.. Burzykowski T,
e.. Molenberghs G,
f.. Piedbois P.
International Institute for Drug Development, Brussels, Belgium.
mbuyse@id2.be

BACKGROUND: Treatment of advanced colorectal cancer has progressed
substantially. However, improvements in response rates have not always
translated into significant survival benefits. Doubts have therefore been
raised about the usefulness of tumour response as a clinical endpoint.
METHODS: This meta-analysis was done on individual data from 3791 patients
enrolled in 25 randomised trials of first-line treatment with standard bolus
intravenous fluoropyrimidines versus experimental treatments (fluorouracil
plus leucovorin, fluorouracil plus methotrexate, fluorouracil continuous
infusion, or hepatic-arterial infusion of floxuridine). Analyses were by
intention to treat. FINDINGS: Compared with bolus fluoropyrimidines,
experimental fluoropyrimidines led to significantly higher tumour response
rates (454 responses among 2031 patients vs 209 among 1760; odds ratio 0.48
[95% CI 0.40-0.57], p<0.0001) and better survival (1808 deaths among 2031 vs
1580 among 1760; hazard ratio 0.90 [0.84-0.97], p=0.003). The survival
benefits could be explained by the higher tumour response rates. However, a
treatment that lowered the odds of failure to respond by 50% would be
expected to decrease the odds of death by only 6%. In addition, less than
half of the variability of the survival benefits in the 25 trials could be
explained by the variability of the response benefits in these trials.
INTERPRETATION: These analyses confirm that an increase in tumour response
rate translates into an increase in overall survival for patients with
advanced colorectal cancer. However, in the context of individual trials,
knowledge that a treatment has benefits on tumour response does not allow
accurate prediction of the ultimate benefit on survival.

PMID: 10972369 [PubMed - indexed

Peter Moran

www.cancerwatcher.com


>So-called palliative chemotherapy is
> attributed to the benefits of a reduction in tumor size (when it
> occurs, which isn't often), but again, such a view is unproven because
> the concomitant use of palliative nutrition confounds the claim.
> Mainstream oncology is co-opting the effects of therapeutic nutrition
> while disparaging such factors outside of standard treatment. In light
> of your refusal to provide chemotherapy data, I located something of
> interest from the University of Wisconsin. See the chart at
> http://www.eperc.mcw.edu/fastFact/ff_099.htm. There are several
> interesting things about this table. The most obvious is that it shows
> how broadly ineffective chemotherapy is in terms of improving survival
> times in cancer patients. Note that "Median Survival" figures
> represent survival times for BOTH "responders" and "non-responders"
> (ie., those who experience a tumor reduction while undergoing
> chemotherapy, and those who do not.) No effort was made, however, to
> statistically separate the effects of chemotherapy in either group.
> Again, this is not a comparison between non-treated and treated
> patients, but a comparison *among* treated patients. Footnoted is the
> authors' comment that "patients who respond to chemotherapy typically
> live longer than those who do not." How do they know this? If tumor
> reduction is meaningfully correlated with improved survival times, why
> are these effects not precisely measured and reported? What is
> "typical?" Do we not get beneficial outcomes from the use of placebo,
> making those effects "typical?"
>
> Furthermore, the "Response Rate" (tumor reduction) column shows breast
> cancer to be the most associated with (but not corrrelated to) a
> chemotherapy response, somewhere around 40% for the average treated
> patient. This is *associated* with a range of survival from 24 months
> to 36 months. Again, no RCT data exists to show that a definitive
> correlation exists -- even empirically-derived percentages are not
> provided except in aggregate. In other words, we have no way to know
> what percentage of "responders" are found in the longer-surviving
> group, or what percentage of "non responders" can be found in the
> low-end group. I would refer to that as a conspicuous omission. Let's
> do a little meta study ourselves using the data we do have. Compiling
> the average percentage of "responders," we get 24.44% of patients who
> experience tumor reduction during (but not necessarily resulting from)
> treatment. This amounts to about 1 in 4. If we compile the average
> number of months representing low-end and high-end survival times (we
> have no choice because the data is blended that way) we get a figure of
> about 4.3 months, or 17 weeks of additional survival *associated* with
> a reduction in tumor size. What can we derive from these numbers?
> Not much. All we can say for sure is that one in every four patients
> treated for these particular cancers will experience a tumor reduction
> (some of which *may* be associated with chemotherapy.) Since tumor
> regressions can occur without treatment, we cannot conclude that such
> shrinkage is solely attributable to administration of chemotherapy. We
> cannot even say that survival time will average 4.3 months of
> additional life for that fourth person because the survival data for
> both "responders" and "non responders" has been aggregated. We are
> only told that survival times will be "typically" greater for those
> whose tumors shrink. Due to the absence of data, I would venture a
> guess that one in 50 such cases might actually be *associated* with the
> use of chemotherapy, but even that is being generous. Put simply, the
> evidence that chemotherapy is beneficial in the vast majority of
> cancers is very, very poor. Note also the statement that "response
> rate data that is generally quoted to patients comes from clinical
> trials using GOOD PERFORMANCE STATUS [emphasis mine] who are closely
> monitored patients; the response rates for patients outside of clinical
> trials can be expected TO BE LOWER [emphasis mine]." [ref.
> http://www.eperc.mcw.edu/fastFact/ff_014.htm.]
>
> If I ever develop cancer, and I pray that I don't, here is what I would
> personally do. 1. Seek a naturopath familiar with intravenous vitamin
> C and laetrile therapy and begin treatment immediately. 2. Take 2g
> daily Lysine, as this amino acid interferes with cancer's ability to
> spread. 3. Take 2g N-acetylcystein daily, to boost overall immunity.
> 4. Abstain from food entirely every other day, or at least 12 hours on
> the second day to reduce unnecessary metabolic activity. 5. Visualize
> the elimination of cancer cells several times while lying down with the
> eyes closed. If nothing else, biofeedback techniques have been proven
> to reduce stress, and that will support immunity.
>
> PeterB
>

"Mark Probert" <markprobert@lumbercartel.com> wrote in message
news:Wkwuh.19$li4.2@trndny08...
> Peter Moran wrote:
>> "PeterB" <pkm@mytrashmail.com> wrote in message
>> news:1169749273.338538.34270@v33g2000cwv.googlegro ups.com...
>>>
>>
>>> If I ever develop cancer, and I pray that I don't, here is what I would
>>> personally do. 1. Seek a naturopath familiar with intravenous vitamin
>>> C and laetrile therapy and begin treatment immediately. 2. Take 2g
>>> daily Lysine, as this amino acid interferes with cancer's ability to
>>> spread. 3. Take 2g N-acetylcystein daily, to boost overall immunity.
>>> 4. Abstain from food entirely every other day, or at least 12 hours on
>>> the second day to reduce unnecessary metabolic activity. 5. Visualize
>>> the elimination of cancer cells several times while lying down with the
>>> eyes closed. If nothing else, biofeedback techniques have been proven
>>> to reduce stress, and that will support immunity.
>>
>> But you will surely also have the cancer cut out, if that were possible?
>> There is no good evidence that any of the above methods work, whereas
>> surgery probably accounts for 90% of the 50-60% of cancers that are cured
>> by present methods.
>>
>> A simple lumpectomy will many breast cancers, for example..
>>
>> Peter Moran
> I believe that PeteyB will not bother with that, and go straight to the
> pine box cure.
>

Yep, cut it off.
Is that what they did for your brain cancer?

"Peter Moran" <pmoran@bordernet.com.au> wrote in message
news:45ba9717$0$16552$afc38c87@news.optusnet.com.a u...
>
> "PeterB" <pkm@mytrashmail.com> wrote in message



There are many very aggressive methods that seem, statistically to work. I
have seen little evidence that one works much better than the other. I put
PeterB therapy in the same category.

Assuming that no one in this thread HAS cancer, the primary point should be
prevention or getting it in its very infancy.

What is absolutely sickening is the refusal by all with their pet theories
to recognize cancer for what it is and not have major efforts at prevention
or constant , aggressive resistance.

Absolutely sickening and unconscionable.

"Mark Probert" <markprobert@lumbercartel.com> wrote in message
news:Wkwuh.19$li4.2@trndny08...
PeteyB

vernon wrote:
> "Mark Probert" <markprobert@lumbercartel.com> wrote in message
> news:Wkwuh.19$li4.2@trndny08...
>> Peter Moran wrote:
>>> "PeterB" <pkm@mytrashmail.com> wrote in message
>>> news:1169749273.338538.34270@v33g2000cwv.googlegro ups.com...
>>>> If I ever develop cancer, and I pray that I don't, here is what I would
>>>> personally do. 1. Seek a naturopath familiar with intravenous vitamin
>>>> C and laetrile therapy and begin treatment immediately. 2. Take 2g
>>>> daily Lysine, as this amino acid interferes with cancer's ability to
>>>> spread. 3. Take 2g N-acetylcystein daily, to boost overall immunity.
>>>> 4. Abstain from food entirely every other day, or at least 12 hours on
>>>> the second day to reduce unnecessary metabolic activity. 5. Visualize
>>>> the elimination of cancer cells several times while lying down with the
>>>> eyes closed. If nothing else, biofeedback techniques have been proven
>>>> to reduce stress, and that will support immunity.
>>> But you will surely also have the cancer cut out, if that were possible?
>>> There is no good evidence that any of the above methods work, whereas
>>> surgery probably accounts for 90% of the 50-60% of cancers that are cured
>>> by present methods.
>>>
>>> A simple lumpectomy will many breast cancers, for example..
>>>
>>> Peter Moran
>> I believe that PeteyB will not bother with that, and go straight to the
>> pine box cure.
>>
>
> Yep, cut it off.
> Is that what they did for your brain cancer?

Projecting again? Try to use something other than a refrigerator bulb.
That is not very bright.

"Mark Probert" <markprobert@lumbercartel.com> wrote in message
news:n5Quh.78$li4.62@trndny08...
> vernon wrote:
>> "Mark Probert" <markprobert@lumbercartel.com> wrote in message
>> news:Wkwuh.19$li4.2@trndny08...
>>> Peter Moran wrote:
>>>> "PeterB" <pkm@mytrashmail.com> wrote in message
>>>> news:1169749273.338538.34270@v33g2000cwv.googlegro ups.com...
>>>>> If I ever develop cancer, and I pray that I don't, here is what I
>>>>> would
>>>>> personally do. 1. Seek a naturopath familiar with intravenous vitamin
>>>>> C and laetrile therapy and begin treatment immediately. 2. Take 2g
>>>>> daily Lysine, as this amino acid interferes with cancer's ability to
>>>>> spread. 3. Take 2g N-acetylcystein daily, to boost overall immunity.
>>>>> 4. Abstain from food entirely every other day, or at least 12 hours on
>>>>> the second day to reduce unnecessary metabolic activity. 5. Visualize
>>>>> the elimination of cancer cells several times while lying down with
>>>>> the
>>>>> eyes closed. If nothing else, biofeedback techniques have been proven
>>>>> to reduce stress, and that will support immunity.
>>>> But you will surely also have the cancer cut out, if that were
>>>> possible? There is no good evidence that any of the above methods work,
>>>> whereas surgery probably accounts for 90% of the 50-60% of cancers that
>>>> are cured by present methods.
>>>>
>>>> A simple lumpectomy will many breast cancers, for example..
>>>>
>>>> Peter Moran
>>> I believe that PeteyB will not bother with that, and go straight to the
>>> pine box cure.
>>>
>>
>> Yep, cut it off.
>> Is that what they did for your brain cancer?
>
> Projecting again? Try to use something other than a refrigerator bulb.
> That is not very bright.

"CURE" cancer --- cut it off.
"Cure" a stomach ache --- remove it.
"Cure" short sighted --- remove the eyes
"Cure" cataracts ---- remove the cornea.

"Cure" breast cancer --- remove the breast and a half dozen lymph nodes.
"Cure" Testicular cancer --- Castrate

In misc.health.alternative PeterB <pkm@mytrashmail.com> wrote:
: Richard Schultz wrote:
:> In misc.health.alternative PeterB <pkm@mytrashmail.com> wrote:

:> : Your statement that *some* cancers
:> : are not responsive to chemotherapy is meaningless because no RCT
:> : studies exist to correlate the effects of chemotherapy to survival
:> : outcomes in the first place.

:> : If I ever develop cancer, and I pray that I don't, here is what I would
:> : personally do.

:> Have any RCT studies been done to correlate the effects of the above
:> therapy to survival outcomes?

: Your sponsors have managed to criminalize our study of laetrile, or had
: you forgotten?

Stop weaseling and answer the question.

[example of Mr. B taking a paragraph to avoid providing the correct answer
to my question -- i.e. "no" -- deleted]

-----
Richard Schultz schultr@mail.biu.ac.il
Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel
Opinions expressed are mine alone, and not those of Bar-Ilan University
-----
"I love people. But I don't suffer fools gladly."
-- Deborah Lipstadt

Peter Moran wrote:
> "PeterB" <pkm@mytrashmail.com> wrote in message
> news:1169749273.338538.34270@v33g2000cwv.googlegro ups.com...
> >
> >
> > On Jan 24, 3:59 pm, "Peter Moran" <pmo...@bordernet.com.au> wrote:
> >> "PeterB" <p...@mytrashmail.com> wrote in
> >> messagenews:1169668479.386096.140750@s48g2000cws.g ooglegroups.com...
> >>
> >>
> >>
> >>
> >>
> >>
> >>
> >> > On Jan 24, 2:15 pm, "mainframetech" <chough...@insidefsi.net> wrote:
> >> >> Huh? I thought colds and flu were being spread by big pharma. A
> >> >> different strain every year so you have to get the latest version of
> >> >> vaccine and thimerosal annually. This year they're even pushing 'bird
> >> >> flu' so they get a twofer ths time. )
> >>
> >> >> For you excitable folks, I'm just kidding...I have no proof that any
> >> >> company is actually dosing people with flu like the government did
> >> >> with
> >> >> LSD and other nasty chemicals.
> >>
> >> >> Chris
> >>
> >> > Don't mind Moran, a retired cancer surgeon. When asked for data
> >> > supporting the use of chemo in the majority of cancers, he responded
> >> > with data on metabolic cancer diets as "evidence" that drugs works in
> >> > inverse proportion to chicken soup. He's so old school that when with
> >> > faced with the new direction of medicine, he leaks formaldehyde. I
> >> > would say we should give him time, but I don't think he has any.
> >>
> >> > PeterBDon;t make things up, PeterB. I asked you to specify a cancer
> >> > and the
> >> circumstances (curative, adjuvant, or palliative) I would supply what
> >> data
> >> exists. With some cancers the data is not strongly supportive, with
> >> others, it is.
> >
> > I'm not making it up. Your defense of chemotherapy was to cite the
> > evidence on metabolic cancer diets.
>
> Bullshit. Show me where I did this.

The post at http://groups.google.com/group/misc.health.alternative/
browse_frm/thread/e054990e03082cc4/9921d0cc524a9db7?lnk=gst&q=Gerson
+PeterB&rnum=1&hl=en#9921d0cc524a9db7 refers to your earlier rebuttal
using a discussion of metabolic diets, a response not relevant to the
discussion of chemotherapy. Although I couldn't find your original
comments, my rebuke in the earlier post condemns your website for
skating around the facts exactly as you do on mha.

> >Your statement that *some* cancers
> > are not responsive to chemotherapy is meaningless because no RCT
> > studies exist to correlate the effects of chemotherapy to survival
> > outcomes in the first place.
>
> Bugger! I hate being pushed into a defence of chemotherapy, because I am no
> great fan of it myself, outside of a few areas where it has great benefits
> and actually cures people of their cancers and every time I do so I am
> accused of being paid by someone!

Of course you are being paid, otherwise you wouldn't be doing it.

> But for God's sake let us have truthful information!

Oh, let's.

> Actually there is a LOT of data showing a correlation between chemotherapy
> response rates and length of survival, even in the cancers with the very
> poorest results with chemotherapy such as colon cancer and NSCLC. I will
> put one such at the end of this.

With the volume of data you claim is available, offering one little
study seems awfully selfish of you.

> There are also numerous studies comparing chemotherapy with "best supportive
> care" (BSC), as you would find out if you put these terms into Medline.

I do not regard BSC studies as meaningful, for several reasons.
First, the heterogeneity of BSC terms means that comparing
chemotherapy to such effects is no more clear than using aggregated
data for chemo "responders" and "non-responders." More importantly,
the methods and protocols used to assess outcomes in patients in whom
chemotherapy is deemed inappropriate suggests their prognosis is poor
to begin with. A study is only as good as its design.

> It
> is thus not true that chemotherapy has never been shown to have benefits
> over no chemotherapy in controlled trials (although in some specific
> instances there were no worthwhile beneifts and those methods would not now
> be ever used for those purposes).

I can create a study that "proves" cigarettes are safer than chewing
on ice, especially in those who do both. Your sponsors are notorious
for funding studies like this.

> I will put an illustrative example below.
>
> But you are making two other wrong assumptions in this long spiel of your
> (if it is yours, which I doubt).

I write everything you see attributed to me. I seriously doubt that
is equally true of you.

> When used in a palliative role
> chemotherapy is used mainly in patients who already have *symptoms* of their
> cancer or who are very likely to soon have symptoms. Often the only way of
> obtaining relief from cancer symptoms is to induce remission. Even if
> survival was not significantly prolonged in some patients those responding
> to the chemotherapy may still derive substantial benefits for this reason.
> The quality of their remaining life may thus be improved. Most modern
> studies on chemotherapy also look at quality of life indicators. .

You make your premise and your conclusion the same thing, without
supporting either. You provide no evidence for the palliative effects
of chemotherapy, nor do you provide data that chemotherapy "induces
remission." It's all in your head.

> The other thing you fail to realise is that a median duration of response of
> a mere few months obscures some far longer responses for some patients.

But the average patient represents what is typical, and exceptions are
not proof of causation. Here's an illustration. Let's say that 1% of
traffic accident fatalities occur after one full year of
hospitalization, whereas the other 99% of fatalities occur within 3
days after the accident. Does this mean that 99% of victims are more
responsive to treatment, or does it mean they are simply less injured
to begin with? For most, it means they are less seriously injured.
Likewise, cancer is highly variable in terms of illness severity,
whereas chemotherapy remains poorly correleated to remission. You
cannot give treatment credit simply because it was applied.

> Responses are in truth very variable and chemotherapists cannot be blamed if
> a few excellent, prolonged, complete responses play a part in their minds
> whenever they are facing a patient for whom they have nothing else to
> offer. WHere they may mainly go wrong is if they persist with chemotherapy
> if there is no obvious response within a couple of cycles.

Let's rewrite this to make the same point about people wearing green
shirts. Here goes:

Responses are in truth very variable and clothes salespeople cannot be
blamed if a few lucky, lottery winning, people with green shirts play
a part in their minds whenever they are faced with a customer for whom
they have nothing else to sell. So, let's persaude them to buy green
shirts because they, too, could be a lucky winner.

That's all you said.

> Where they may mainly go wrong is if they persist with chemotherapy if there is no obvious response
> within a couple of cycles.

The false premise continues.

> Coll Antropol. 2005 Dec;29(2):583-8. Links
> Gemcitabine in the first and second-line chemotherapy of advanced non-small
> cell lung cancer.
> a.. Cucevic B,
> b.. Samarzija M,
> c.. Baricevic D,
> d.. Jakopovic M,
> e.. Redzepi G,
> f.. Samija M.
> University Hospital for Lung Diseases "Jordanovac", Zagreb, Croatia.
> branka.cucevic@zg.htnet.hr
>
> Aim of this study was to estimate efficacy of gemcitabine in first and the
> second-line chemotherapy for patients with advanced non-small cell lung
> cancer (stage III and IV). In first-line chemotherapy, 120 patients were
> treated with different chemotherapy regimens. Fifty-nine patients were
> treated with gemcitabine / cisplatin (PG), 41 with cisplatin / etoposide
> (PE) and 20 with mitomycin / ifosfamide / cisplatin (MIC). Forty patients,
> unsuccessfully treated with PE and MIC in first-line therapy were treated
> with PG (24 pts) and with best supportive care (BSC) (16 pts). In first-line
> therapy PG was superior to PE and MIC protocol (mean survival (MS) 10 vs. 7
> vs. 8.5 months). Response rate (RR) for PG in first-line therapy was 46% and
> 21% in second-line. We showed also significantly better survival in patients
> treated with PG in second-line chemotherapy comparing to best supportive
> care (MS 9 vs. 5.5 months). Toxic side effects for combination PG was
> acceptable. This study confirmed that PG combination is safe and effective
> as first and second-line chemotherapy for patients with advanced non-small
> cell lung cancer.
>
> PMID: 16417165 [PubMed - indexed for MEDLINE]

This study is observational, compares two drug regimens, evalutes very
narrow disparities in survival, and might easily have contributed to
the table of aggregated "responders" and "non responders" in the
citation I provided earlier. In other words, it's quite meaningless.

> 1: Lancet. 2000 Jul 29;356(9227):373-8. Links
>
> Comment in:
> Lancet. 2000 Jul 29;356(9227):353-4.
> Lancet. 2000 Nov 18;356(9243):1771.
> Relation between tumour response to first-line chemotherapy and survival in
> advanced colorectal cancer: a meta-analysis. Meta-Analysis Group in Cancer.
> a.. Buyse M,
> b.. Thirion P,
> c.. Carlson RW,
> d.. Burzykowski T,
> e.. Molenberghs G,
> f.. Piedbois P.
> International Institute for Drug Development, Brussels, Belgium.
> mbuyse@id2.be
>
> BACKGROUND: Treatment of advanced colorectal cancer has progressed
> substantially. However, improvements in response rates have not always
> translated into significant survival benefits. Doubts have therefore been
> raised about the usefulness of tumour response as a clinical endpoint.
> METHODS: This meta-analysis was done on individual data from 3791 patients
> enrolled in 25 randomised trials of first-line treatment with standard bolus
> intravenous fluoropyrimidines versus experimental treatments (fluorouracil
> plus leucovorin, fluorouracil plus methotrexate, fluorouracil continuous
> infusion, or hepatic-arterial infusion of floxuridine). Analyses were by
> intention to treat. FINDINGS: Compared with bolus fluoropyrimidines,
> experimental fluoropyrimidines led to significantly higher tumour response
> rates (454 responses among 2031 patients vs 209 among 1760; odds ratio 0.48
> [95% CI 0.40-0.57], p<0.0001) and better survival (1808 deaths among 2031 vs
> 1580 among 1760; hazard ratio 0.90 [0.84-0.97], p=0.003). The survival
> benefits could be explained by the higher tumour response rates. However, a
> treatment that lowered the odds of failure to respond by 50% would be
> expected to decrease the odds of death by only 6%. In addition, less than
> half of the variability of the survival benefits in the 25 trials could be
> explained by the variability of the response benefits in these trials.
> INTERPRETATION: These analyses confirm that an increase in tumour response
> rate translates into an increase in overall survival for patients with
> advanced colorectal cancer. However, in the context of individual trials,
> knowledge that a treatment has benefits on tumour response does not allow
> accurate prediction of the ultimate benefit on survival.
>
> PMID: 10972369 [PubMed - indexed

No one should find this to be persuasive evidence for the
effectiveness of chemotherapy. Like the other observational study,
this one compares two drug regimens. The survival benefit is razor
thin, so it's remarkable to read the study author comment that "the
survival benefits could be explained by the higher tumour response
rates." Just read the interpretation to see that all this study shows
is that drugs can induce tumor shrinking. Unfortunately, this effect
is meaningless. Like most disease, cancer is not confined to a
localized event -- it's systemic. Shrinking a tumor is sort of like to
shaking a rattler off your arm after he bites. Where's the poison?

PeterB

Peter Moran wrote:
> "PeterB" <pkm@mytrashmail.com> wrote in message
> news:1169749273.338538.34270@v33g2000cwv.googlegro ups.com...
> >
> >
> > On Jan 24, 3:59 pm, "Peter Moran" <pmo...@bordernet.com.au> wrote:
> >> "PeterB" <p...@mytrashmail.com> wrote in
> >> messagenews:1169668479.386096.140750@s48g2000cws.g ooglegroups.com...
> >>
> >>
> >>
> >>
> >>
> >>
> >>
> >> > On Jan 24, 2:15 pm, "mainframetech" <chough...@insidefsi.net> wrote:
> >> >> Huh? I thought colds and flu were being spread by big pharma. A
> >> >> different strain every year so you have to get the latest version of
> >> >> vaccine and thimerosal annually. This year they're even pushing 'bird
> >> >> flu' so they get a twofer ths time. )
> >>
> >> >> For you excitable folks, I'm just kidding...I have no proof that any
> >> >> company is actually dosing people with flu like the government did
> >> >> with
> >> >> LSD and other nasty chemicals.
> >>
> >> >> Chris
> >>
> >> > Don't mind Moran, a retired cancer surgeon. When asked for data
> >> > supporting the use of chemo in the majority of cancers, he responded
> >> > with data on metabolic cancer diets as "evidence" that drugs works in
> >> > inverse proportion to chicken soup. He's so old school that when with
> >> > faced with the new direction of medicine, he leaks formaldehyde. I
> >> > would say we should give him time, but I don't think he has any.
> >>
> >> > PeterBDon;t make things up, PeterB. I asked you to specify a cancer
> >> > and the
> >> circumstances (curative, adjuvant, or palliative) I would supply what
> >> data
> >> exists. With some cancers the data is not strongly supportive, with
> >> others, it is.
> >
> > I'm not making it up. Your defense of chemotherapy was to cite the
> > evidence on metabolic cancer diets.
>
> Bullshit. Show me where I did this.

The post at http://groups.google.com/group/misc.health.alternative/
browse_frm/thread/e054990e03082cc4/9921d0cc524a9db7?lnk=gst&q=Gerson
+PeterB&rnum=1&hl=en#9921d0cc524a9db7 refers to your earlier rebuttal
using a discussion of metabolic diets, a response not relevant to the
discussion of chemotherapy. Although I couldn't find your original
comments, my rebuke in the earlier post condemns your website for
skating around the facts exactly as you do on mha.

> >Your statement that *some* cancers
> > are not responsive to chemotherapy is meaningless because no RCT
> > studies exist to correlate the effects of chemotherapy to survival
> > outcomes in the first place.
>
> Bugger! I hate being pushed into a defence of chemotherapy, because I am no
> great fan of it myself, outside of a few areas where it has great benefits
> and actually cures people of their cancers and every time I do so I am
> accused of being paid by someone!

Of course you are being paid, otherwise you wouldn't be doing it.

> But for God's sake let us have truthful information!

Oh, let's.

> Actually there is a LOT of data showing a correlation between chemotherapy
> response rates and length of survival, even in the cancers with the very
> poorest results with chemotherapy such as colon cancer and NSCLC. I will
> put one such at the end of this.

With the volume of data you claim is available, offering one little
study seems awfully selfish of you.

> There are also numerous studies comparing chemotherapy with "best supportive
> care" (BSC), as you would find out if you put these terms into Medline.

I do not regard BSC studies as meaningful, for several reasons.
First, the heterogeneity of BSC terms means that comparing
chemotherapy to such effects is no more clear than using aggregated
data for chemo "responders" and "non-responders." More importantly,
the methods and protocols used to assess outcomes in patients in whom
chemotherapy is deemed inappropriate suggests their prognosis is poor
to begin with. A study is only as good as its design.

> It
> is thus not true that chemotherapy has never been shown to have benefits
> over no chemotherapy in controlled trials (although in some specific
> instances there were no worthwhile beneifts and those methods would not now
> be ever used for those purposes).

I can create a study that "proves" cigarettes are safer than chewing
on ice, especially in those who do both. Your sponsors are notorious
for funding studies like this.

> I will put an illustrative example below.
>
> But you are making two other wrong assumptions in this long spiel of your
> (if it is yours, which I doubt).

I write everything you see attributed to me. I seriously doubt that
is equally true of you.

> When used in a palliative role
> chemotherapy is used mainly in patients who already have *symptoms* of their
> cancer or who are very likely to soon have symptoms. Often the only way of
> obtaining relief from cancer symptoms is to induce remission. Even if
> survival was not significantly prolonged in some patients those responding
> to the chemotherapy may still derive substantial benefits for this reason.
> The quality of their remaining life may thus be improved. Most modern
> studies on chemotherapy also look at quality of life indicators. .

You make your premise and your conclusion the same thing, without
supporting either. You provide no evidence for the palliative effects
of chemotherapy, nor do you provide data that chemotherapy "induces
remission." It's all in your head.

> The other thing you fail to realise is that a median duration of response of
> a mere few months obscures some far longer responses for some patients.

But the average patient represents what is typical, and exceptions are
not proof of causation. Here's an illustration. Let's say that 1% of
traffic accident fatalities occur after one full year of
hospitalization, whereas the other 99% of fatalities occur within 3
days after the accident. Does this mean that 99% of victims are more
responsive to treatment, or does it mean they are simply less injured
to begin with? For most, it means they are less seriously injured.
Likewise, cancer is highly variable in terms of illness severity,
whereas chemotherapy remains poorly correleated to remission. You
cannot give treatment credit simply because it was applied.

> Responses are in truth very variable and chemotherapists cannot be blamed if
> a few excelle