Is Chemotherapy Given to Cancer Patients Helping or Hurting?

The above picture is of an Oncologist with his wife who was diagnosed with breast cancer that metastasized.  The article is called, “The Day I Started Lying to My Wife.” http://nymag.com/news/features/cancer-peter-bach-2014-5/

A new published research article in The Journal of the American Medical Association puts Into question the efficacy of chemotherapy and the doctors who prescribe it!

Chemotherapy Use, Performance Status, and Quality of Life at the End of Life

[Holly G. Prigerson, PhD1,2; Yuhua Bao, PhD3; Manish A. Shah, MD4; M. Elizabeth Paulk, MD6; Thomas W. LeBlanc, MD, MA5; Bryan J. Schneider, MD7; Melissa M. Garrido, PhD8,9; M. Carrington Reid, MD, PhD2; David A. Berlin, MD10; Kerin B. Adelson, MD13; Alfred I. Neugut, MD, PhD11,12; Paul K. Maciejewski, PhD1,14 [+] Author Affiliations

JAMA Oncol. 2015;1(6):778-784. doi:10.1001/jamaoncol.2015.2378.]  Read the JAMA article here: http://oncology.jamanetwork.com/article.aspx?articleid=2398177

While there are many non-published articles pointing out the clear disingenuous agendas of chemotherapy, there are not many mainstream publications which decidedly call it out – until know. The paper was published in The Journal of the American Medical Association (JAMA) in their September, 2015 issue.

The mainstream media is coming unravelled as a JAMA’s publication is making the rounds which calls out chemotherapy as “ineffective” versus late stage or end-stage cancers where patients are nearing death.

Of course, the “late stage” and “nearing death” variables aren’t an open admission to the entire chemotherapy application, but they are rare for publications which often take sides with chemo as the absolute best treatment for cancer in all FOUR stages.

This article states, “Physicians have voiced concerns about the benefits of chemotherapy for patients with cancer nearing death.[1– 5] In 2012, an American Society of Clinical Oncology (ASCO) expert panel identified chemotherapy use among patients for whom there was no evidence of clinical value [6] as the most widespread, wasteful, and unnecessary practice in oncology.

Let’s put this into perspective – having a major medical journal widely viewed as the top of the medical science food chain calls the application of chemotherapy under these specific circumstance as “widespread, wasteful, unnecessary” is incredibly telling. Think of the money which chemotherapy producers make by peddling chemo to people who are clearly at a state of near death. The study finds it is, “widespread, wasteful, unnecessary” and telling everyone that the for profit aspect of the treatment supercedes any real life-goals for helping people live longer or live better.

Specifically, ASCO guidelines recommend against the use of chemotherapy in solid tumor patients who have not benefited from prior treatment and who have an Eastern Cooperative Oncology Group (ECOG)[7]

Prior to this statement, the study has found that people who haven’t responded to chemo were given chemo again even after the chemo did NOT work the first time! So the chemotherapy treatment failed and yet they were put through the treatment again.

Despite the lack of evidence to support the practice, chemotherapy is widely used in cancer patients with poor performance status and progression following an initial course of palliative chemotherapy.[1,4,10,11]

Chemotheroapy has no evidence in working with people at this late or end stage cancerous condition, and yet the oncologist would administer the treatment expecting a different result? This is the definition of insanity. Doing the same thing over and over again and expecting a different result!

Chemotherapy’s willingness to rake in billions of dollars from Big Pharmaceutical companies at the expense of those who have cancer could not be more egregious than in this case. This study loudly states egregious, contemptible actions yet with no responsibility to those who have so often contributed to the issue.

Resources:

[1] Kelly RJ, Smith TJ. Delivering maximum clinical benefit at an affordable price: engaging stakeholders in cancer care. Lancet Oncol. 2014;15(3):e112-e118. doi:10.1016/S1470-2045(13)70578-3. Published online February 14, 2014.

[2] Meier DE. ‘I don’t want Jenny to think I’m abandoning her’: views on overtreatment. Health Aff (Millwood). 2014;33(5):895-898.

[3] Bach PB. The day I started lying to Ruth.2014. http://nymag.com/news/features/cancer-peter-bach-2014-5/. Accessed June 10, 2015

[4] Braga S. Why do our patients get chemotherapy until the end of life? Ann Oncol. 2011;22(11):2345-2348.

[5] Anders CK, Peppercorn J. Treating in the dark: unanswered questions on costs and benefits of late line therapy for metastatic breast cancer. Cancer Invest. 2009;27(1):13-16.

[6] Schnipper LE, Smith TJ, Raghavan D, et al. American Society of Clinical Oncology identifies five key opportunities to improve care and reduce costs: the top five list for oncology. J Clin Oncol. 2012;30(14):1715-1724.

[7] Eastern Cooperative Oncology Group. ECOG performance status.http://ecog-acrin.org/resources/ecog-performance-status. Acessed June 3, 2015.

[8] Stanley KE. Prognostic factors for survival in patients with inoperable lung cancer. J Natl Cancer Inst. 1980;65(1):25-32.

[9] Pater JL, Loeb M. Nonanatomic prognostic factors in carcinoma of the lung: a multivariate analysis. Cancer. 1982;50(2):326-331.

[10] Wright AA, Zhang B, Keating NL, Weeks JC, Prigerson HG. Associations between palliative chemotherapy and adult cancer patients’ end of life care and place of death: prospective cohort study. BMJ. 2014;348:g1219. doi:10.1136/bmj.g1219.

[11] Emanuel EJ, Young-Xu Y, Levinsky NG, Gazelle G, Saynina O, Ash AS. Chemotherapy use among Medicare beneficiaries at the end of life. Ann Intern Med. 2003;138(8):639-643.
PubMed | Link to Article

[12] Salloum RG, Smith TJ, Jensen GA, Lafata JE. Survival among non-small cell lung cancer patients with poor performance status after first line chemotherapy. Lung Cancer. 2012;77(3):545-549.

[13] Massarelli E, Andre F, Liu DD, et al. A retrospective analysis of the outcome of patients who have received two prior chemotherapy regimens including platinum and docetaxel for recurrent non-small-cell lung cancer. Lung Cancer. 2003;39(1):55-61.

[14] Anshushaug M, Gynnild MA, Kaasa S, Kvikstad A, Grønberg BH. Characterization of patients receiving palliative chemo- and radiotherapy during end of life at a regional cancer center in Norway. Acta Oncol. 2015;54(3):395-402.

[15] Jones SE, Erban J, Overmoyer B, et al. Randomized phase III study of docetaxel compared with paclitaxel in metastatic breast cancer. J Clin Oncol. 2005;23(24):5542-5551.

[16] Cortes J, O’Shaughnessy J, Loesch D, et al; EMBRACE (Eisai Metastatic Breast Cancer Study Assessing Physician’s Choice Versus E7389) investigators. Eribulin monotherapy versus treatment of physician’s choice in patients with metastatic breast cancer (EMBRACE): a phase 3 open-label randomised study. Lancet. 2011;377(9769):914-923.

[17] Fumoleau P, Largillier R, Clippe C, et al. Multicentre, phase II study evaluating capecitabine monotherapy in patients with anthracycline- and taxane-pretreated metastatic breast cancer. Eur J Cancer. 2004;40(4):536-542.

[18] Kassam F, Enright K, Dent R, et al. Survival outcomes for patients with metastatic triple-negative breast cancer: implications for clinical practice and trial design. Clin Breast Cancer. 2009;9(1):29-33.

[19] Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;23(10):433-441.

[20] Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-383.

[21] Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5(6):649-655.

[22] Zhang B, Nilsson ME, Prigerson HG. Factors important to patients’ quality of life at the end of life. Arch Intern Med. 2012;172(15):1133-1142.

[23] Abbott CH, Prigerson HG, Maciejewski PK. The influence of patients’ quality of life at the end of life on bereaved caregivers’ suicidal ideation. J Pain Symptom Manage. 2014;48(3):459-464.

[24] Greer JA, Pirl WF, Jackson VA, et al. Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non-small-cell lung cancer. J Clin Oncol. 2012;30(4):394-400.

[25] Teno JM, Gozalo PL, Bynum JP, et al. Change in end-of-life care for Medicare beneficiaries: site of death, place of care, and health care transitions in 2000, 2005, and 2009. JAMA. 2013;309(5):470-477.

[26] Institute of Medicine. Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. Washington, DC: The National Academies Press; 2014.

[27] Earle CC, Neville BA, Landrum MB, Ayanian JZ, Block SD, Weeks JC. Trends in the aggressiveness of cancer care near the end of life. J Clin Oncol. 2004;22(2):315-321.

[28] Saito AM, Landrum MB, Neville BA, Ayanian JZ, Earle CC. The effect on survival of continuing chemotherapy to near death. BMC Palliat Care. 2011;10:14.

[29] Tunis SR, Stryer DB, Clancy CM. Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy. JAMA. 2003;290(12):1624-1632.

[30] Bach PB, Schrag D, Begg CB. Resurrecting treatment histories of dead patients: a study design that should be laid to rest. JAMA. 2004;292(22):2765-2770.

[31] Lamont EB, Schilsky RL, He Y, et al; Alliance for Clinical Trials in Oncology. Generalizability of trial results to elderly Medicare patients with advanced solid tumors (Alliance 70802). J Natl Cancer Inst. 2015;107(1):336.

– See more at: www.phoreveryoung.com

The Cure for Cancer? That’s an easy question to answer! The Cure for Cancer is Found in its Prevention NOT in its Treatment! – Dr. Robert O. Young

Do you know what rotten apples, grapefruit or bananas look like? If you do then you know what cancer cells look like. Cancer cells are nothing more that healthy cells that are spoiling because of a compromised environment! Look at the picture below and you will see colorized cancerous body cells rotting in their toxic acidic environment.

What compromises the internal environment of a human body that causes body cells to begin spoiling and rotting? The answer is simple! The body’s build-up of acidic metabolic and dietary waste that has not been properly eliminated through the four channels of elimination – urination, defecation, respiration and perspiration!

Cancer is not a noun but an adjective that describes what is happening to body cells in an acidic environment due to an acidic lifestyle and diet. www.phoreveryoung.com
To learn more about Dr. Robert O. Young go to: https://www.linkedin.com/in/drrobertoyoung
To read more of Dr. Young’s articles go to: www.phoreveryoung.wordpress.com
To join Dr. Young on Twitter go to: @drrobertyoung
To watch more videos on YouTube go to: https://www.youtube.com/user/pHMiracleCenter
Join Dr. Young on Facebook at: The PH Miracle Medical Association or The pH Miracle
To purchase Dr. Young’s books or nutritional productts go to: www.phoreveryoung.com or www.phmiracle.com

Conventional Diagnostic Scans for Breast Cancer Cause Breast Cancer! There is a Better Non-Invasive and Non-Radioactive Way! Say NO MAM to MAMMOGRAMS!

Life Saving rule change on mammograms

The U.S. Preventative Services Task Force is doing women a favor by issuing a draft recommendation that will put a C grade on breast-cancer screening mammograms for women ages 40 to 49. If this happens, health plans will no longer be required to cover mammograms for women falling within this age range. The task force is committed to providing the best evidence based information to help patients make informed decisions regarding health screenings.

This proposal is exciting news because mammograms can be very detrimental to a woman’s health and well-being. The Harms include false-positive and false-negative mammography results, false reassurance, anxiety and worry over diagnosis and resulting overtreatment, and large amounts of radiation exposure. The USPSTF after examining the old studies; new studies and evidence show that women who get mammograms have a mortality ( death ) rate 4% higher than women who don’t get mammograms, have proposed downgrading their recommendations that women in this age group receive annual mammogram screening. This proposal would also save on a huge amount of insurance money that is being spent on this unnecessary testing.

It is important to understand the risks versus rewards when making an important decision regarding your health. I encourage you to do some research yourself on the issue of mammogram testing. If you are interested in supporting this proposal along with me, you can submit a comment by visiting http://screeningforbreastcancer.org/

You will find the comment section below the video and there will be a small maze of links to click through. Your contribution may be greatly beneficial here. Evidence that may not have been considered is especially important. You have until Monday May 18th to get your thoughts in and help make a difference regarding this issue.

This rule change would hopefully decrease the pressure from health clinics/hospitals to force women into unwanted mammograms and hopefully allow them to get ultrasounds which is a better diagnostic test and without the harmful radiation and compression of the breast. My personnel recommendation is ultrasound combined with a thermogram which will yield a 95% sensitivity compared to 52% sensitivity for mammograms.

Ben S Johnson MD DO NMD

To learn more – read, like and share the following link:

http://store.phoreveryoung.com/collections/testing/products/full-body-medical-diagnostic-imaging

http://www.phoreveryoung.com

Fruit and Vegetables High in Lycopene Protect Against Cancer!

Tomatoes may lower breast cancer risk

Newswise — Chevy Chase, MD—A tomato-rich diet may help protect at-risk postmenopausal women from breast cancer, according to new research accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

Breast cancer risk rises in postmenopausal women as their body mass index climbs. The study found eating a diet high in tomatoes had a positive effect on the level of hormones that play a role in regulating fat and sugar metabolism.

“The advantages of eating plenty of tomatoes and tomato-based products, even for a short period, were clearly evident in our findings,” said the study’s first author, Adana Llanos, PhD, MPH, who is an Assistant Professor of Epidemiology at Rutgers University. Llanos completed the research while she was a postdoctoral fellow with Electra Paskett, PhD, at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. “Eating fruits and vegetables, which are rich in essential nutrients, vitamins, minerals and phytochemicals such as lycopene, conveys significant benefits. Based on this data, we believe regular consumption of at least the daily recommended servings of fruits and vegetables would promote breast cancer prevention in an at-risk population.

The longitudinal cross-over study examined the effects of both tomato-rich and soy-rich diets in a group of 70 postmenopausal women. For 10 weeks, the women ate tomato products containing at least 25 milligrams of lycopene daily. For a separate 10-week period, the participants consumed at least 40 grams of soy protein daily. Before each test period began, the women were instructed to abstain from eating both tomato and soy products for two weeks.

When they followed the tomato-rich diet, participants’ levels of adiponectin – a hormone involved in regulating blood sugar and fat levels – climbed 9 percent. The effect was slightly stronger in women who had a lower body mass index.

“The findings demonstrate the importance of obesity prevention,” Llanos said. “Consuming a diet rich in tomatoes had a larger impact on hormone levels in women who maintained a healthy weight.”

The soy diet was linked to a reduction in participants’ adiponectin levels.

Researchers originally theorized that a diet containing large amounts of soy could be part of the reason that Asian women have lower rates of breast cancer than women in the United States, but any beneficial effect may be limited to certain ethnic groups, Llanos said.

Other authors of the study include: J. Peng and M.L. Pennell of The Ohio State University; M.Z. Vitolins of Wake Forest School of Medicine in Winston-Salem, NC; and J.L. Krok, C.R. Degraffinreid and E.D. Paskett of The Ohio State University Comprehensive Cancer Center. The study was funded with grants from the Breast Cancer Research Foundation and The Ohio State University Clinical and Translational Science Award.

The study, “Effects of Tomato and Soy on Serum Adipokine Concentrations in Postmenopausal Women at Increased Breast Cancer Risk: A Cross-over Dietary Intervention Trial,” was published online, ahead of print.

– See more at: http://www.stonehearthnewsletters.com/tomatoes-may-lower-breast-cancer-risk/cancer

breast/#sthash.lh6Al6mV.dpuf

Mammograms or Ultrasounds for Detecting Breast Cancer?

New science shows ultrasounds work better than mammograms at detecting breast cancer.
Contact PH Miracle for your Breast Ultrasound and Thermography.
http://www.phmiracleliving.com/t-MedicalImaging.aspx

Debating Value of Ultrasound In Breast Cancer Screening

San Antonio—Results from a Connecticut study have some clinicians proclaiming that all women with dense breasts who have a negative mammogram should be offered an ultrasound. The study, presented at the…

CLINICALONCOLOGY.COM|BY KATE O’ROURKE

Debating Value of Ultrasound In Breast Cancer Screening

by Kate O’Rourke

San Antonio—Results from a Connecticut study have some clinicians proclaiming that all women with dense breasts who have a negative mammogram should be offered an ultrasound. The study, presented at the 2014 San Antonio Breast Cancer Symposium (SABCS; abstract S5-01), found that ultrasound identified an additional 3.2 cancers per 1,000 women.

“It is time to think of a new paradigm of utilizing screening ultrasound,” said the lead author of the study Jean Weigert, MD, a radiologist and the director of Breast Imaging at the Hospital of Central Connecticut, in New Britain.

Since October 2009, Connecticut law has required clinicians to use certain language when providing mammographic results to women with dense breasts (approximately 40%-50% of women). Clinicians are required to say, “Your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, and you might benefit from supplementary screening tests, which can include a breast ultrasound screening or a breast [magnetic resonance imaging] examination, or both, depending on your individual risk factors.”

Connecticut is one of 19 states, to date, that mandate that clinicians include information on breast density when providing mammogram results to patients, according to Jafi Lipson, MD, an assistant professor of radiology at Stanford University Medical Center, in Palo Alto, Calif. Additionally, Dr. Lipson said, “Insurance coverage for supplemental tests is now mandated [for patients with dense breasts] in four states, and there is federal legislation pending at this point.”

This flurry of legislation was spurred, in part, by a multicenter 3,000-patient study that demonstrated that adding a single, bilateral screening ultrasound to mammography detected an additional 4.2 cancers per 1,000 in women with dense breast tissue and a family history or prior history of breast cancer (JAMA 2008;299[18]:2151-2163, PMID: 18477782). This almost doubled the number of cancers found by mammography alone.

In the new study, researchers evaluated the effect of the new Connecticut law at two radiology practices with multiple sites in the state during the first four years after the legislation was enacted. Overall, 30% of women with dense breasts and a negative mammogram chose to have an ultrasound, and this rate was steady over the four years. “This may be due to lack of education and insurance issues,” said Dr. Weigert, who thought the rate should have been higher. “There are many high-deductible plans, and women do not want to pay for the test.”

The positive predictive value (PPV) of ultrasound improved over time, indicating that, as expected, there was a learning curve in determining which identified lesions needed to be followed and which needed to be biopsied (Table). By year 4, the PPV was 17.2%, with 3.2 additional cancers detected per 1,000 women. “The first three years, we were still doing a significant number of biopsies on patients with findings that we didn’t know whether they were positive or negative, but in the fourth year, there was a significant [improvement],” said Dr. Weigert.

Table. Positive Predictive Value of Ultrasound in Connecticut Practices Studied Year PPV of Ultrasound, % Screening Mammogram Screening Ultrasound BIRADS 1 or 2 BIRADS 3 BIRADS 4 or 5 Positive Biopsy 1 7.1 30,679 2,706 2,377 174 151 11 2 6.1 32,500 3,351 3,000 168 180 11 3 8.1 32,230 4,128 3,819 168 148 13 4 17.2 27,937 3,331 2,889 358 53 11 BIRADS, Breast Imaging Reporting and Data System; BIRADS 1, negative; BIRADS 2, benign; BIRADS 3, probably benign; BIRADS 4, suspicious abnormality; BIRADS 5, highly suggestive malignancy; PPV, positive predictive value

The cancers detected were of all histologic grades but predominantly grade 2 and 3, hormone-positive and node-negative. Very few patients had risk factors other than dense breast tissue. Cancers were detected in patients who were in their mid-40s to mid-70s.

Although the study was limited in that it did not include a cost analysis, she pointed out that it is easier and less costly to treat a cancer if it is detected at an early stage, noting that in patients who returned for an ultrasound in a subsequent year, the cancers detected were extremely small, typically less than 1 cm.

A recent study estimated that supplemental ultrasonography screening for women with extremely dense breasts would cost $246,000 per quality-adjusted life-year gained (Ann Intern Med 2014 Dec 9. [Epub ahead of print], PMID: 25486550). This is well above $50,000, often touted as a reasonable threshold for cost-effective care (N Engl J Med 2014;371[9]:796-797, PMID: 25162885).

Dr. Lipson, who served as the discussant of the Connecticut study, pointed out that most of the PPV improvement in Dr. Weigert’s study was due to a shift of patients from a recommendation for biopsy to a recommendation for short-term follow-up, and this could be seen as a benefit or harm. “It’s not that the patient is returned to annual screening. She is kind of sucked into a vortex of short-term follow-up,” said Dr. Lipson.

Dr. Lipson also noted that none of the breast cancer ultrasound studies conducted so far have used a control group, and none have long-term follow-up. “The true clinical impact of finding these additional cancers is really unknown,” Dr. Lipson said. “Specifically,” she added, “would these additional cancers otherwise be detected at the next mammography screen while still small, node-negative, and at the early stage, and does the detection of these early cancers have an impact on mortality?”