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May 24, 2017

The "Cure" for Cancer

Scott Stockdale

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While cancer has overtaken heart disease as the number one killer of Canadians - as many as two in five Canadians are expected to by diagnosed with cancer at some point in their lives - over-diagnosis and treatment of this disease is becoming an increasing part of the problem.

The National Cancer Institute defines over-diagnosis as: “Finding cases of cancer with a screening test (such as a mammogram or PSA test) that will never cause any symptoms. These cancers may just stop growing or go away on their own.”

Over-diagnosis is a problem because it exposes people to the potential side effects of treatment, but without an equal expectation of benefit, because the cancer is unlikely to advance. In the absence of screening, many of these cancers would not present symptomatically during one’s lifetime. Thus, their detection and subsequent treatment is unnecessary and detrimental.

While cancer screening with modern technology such as CT's and MRI's detects cancer sooner than ever before, it doesn't distinguish between cancers that will cause patients to develop symptoms or even die from their conditions and the cancers that will just stop growing or disappear on their own.

Moreover, because modern screening techniques are able to detect more of these types of cancer that were never going to cause symptoms or death -  it has led to a false impression that the medical profession is having more success curing cancer.

Dr. Gilbert Welch, an American cancer researcher said: “The fastest way to increase five-year survival rates is to diagnose more and more people with cancer.”

The World Health Organization estimates that half a million people in 12 countries including Canada, have been over- diagnosed with thyroid cancer alone in the past 20 years.

Considering that thyroid cancer is but one of many cancers being over-diagnosed, it is fair to say that millions of people the world over are being over-diagnosed and thus over-treated for cancer which usually involves chemotherapy and radiation.

Over-diagnosis, or identification of indolent cancer, is common in breast, lung, prostate, and thyroid cancer. Whenever screening is used, the fraction of tumours in this category increases. By acknowledging this consequence of screening, approaches that mitigate the problem can be tested.

Such diagnostic procedures for lung cancer can themselves be life-threatening: in 2005, former Canadian prime minister Brian Mulroney (a long-time heavy smoker) spent several weeks in the intensive care unit after postoperative complications from surgery to remove two lung nodules found on a screening CT scan that turned out to be non-cancerous.

The link between chemotherapy and radiation and the development of second cancers has been known for decades. Even the American Cancer Society acknowledges these treatments are carcinogens and that the risk is even higher when both therapies are given together.

Radiation therapy has been linked to the occurrence of solid tumours of the lung, stomach, and bone, and to various types of leukemia such as AML (acute myelogenous leukemia), CML (chronic myelogenous leukemia), and ALL (acute lymphoblastic leukemia).

The American Society of Clinical Oncology (ASCO) says the long-term effects of chemo treatments include various heart complications, lung problems, issues with the hormone system and problems with the digestion system. The side effects mostly depend on the type of treatments the patient receives.

Heart problems is another of the long-term effects of chemo treatments cited by the ASCO: including inflamed heart muscles, heart disease and congestive heart failure. Moreover, the likelihood of heart problems can increase if the individual was on certain types of medication during treatment.

Individuals who received chemo treatments in the past may experience trouble breathing, thickened lung lining, swollen lungs and a decrease in overall lung efficiency, says the ASCO. Such lung problems are common for a person who received chemo treatments to the chest or took certain prescription drugs.

However, in an effort to mitigate these serious side effects the ASCO recommends cancer survivors should receive regular checkups after chemo treatments so these long-term effects can quickly be identified and treated.

American Society of Clinical Oncologists suggests oncologists, should not use chemotherapy for patients very near the end of life, particularly when treatment has not been proven to be effective.  However, this is unlikely to constrain the use of chemotherapy in advanced cancer significantly, because although it’s good advice, it’s difficult to put into practice because it just doesn't seem right to be telling patients they can’t have further treatment, after a certain point.

Interestingly enough, there are some people in society who have concluded, base solely on anecdotal evidence, that cancer treatments such as chemotherapy and radiation are worse than no treatment at all. My uncle, the late Ron Stockdale, was diagnosed with bowel cancer in 1983 and told he had six months to live and had to get in for chemotherapy and radiation right away. He refused and walked around for 33 years and sold real estate for most of those years. Moreover, he didn't die of cancer. When I told this story to a group of labourers, one of them said: “Scott there's lots of stories like that going around.”

This was news to me because my uncles was the only one I'd heard, in no small part because one doesn't find such stories in the media. It occurred to me that it's rather ironic that uneducated people are more likely to refuse treatment, regardless of the result. My uncle said: “Everybody I know who went for chemo and radiation very soon died.” When I tell people this, most of them agree. Granted, this is merely anecdotal evidence which can't stand up against scientific research, at least not as far as educated people are concerned. In his book “Understanding Media” Marshall McLuhan said the middle class are susceptible to propaganda, not the working class.

Witness the cases of former Toronto Mayor Rob Ford and former NDP leader Jack Layton, who both went for extensive chemo and radiation treatments and very soon died. Hindsight is twenty-twenty, but Mr. Ford had an aggressive form of cancer with a life-expectancy of 18 months. He died in 18 months, after many rounds of life-sapping chemotherapy and radiation treatments.

Mr. Layton didn't look too bad in has last election, but shortly after a very good showing in the election his doctors told him his prostate cancer had spread to other (undisclosed) areas of his body. And of course, chemotherapy and radiation was the treatment he received. He soon appeared on television, looking like a totally different person than the one who was so ebullient on election night and, a few weeks after that he died. In his last days, Mr. Layton kept saying: “The treatment didn't work,” indicating that he was led to believe it would. One can only wonder why.

Plato said: ““Those who are able to see beyond the shadows and lies of their culture will never be understood, let alone believed, by the masses.”

Of course, this was long before the advent of the term “conspiracy theory”.

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