A Dilemma in Medicine in the USA

 

A Dilemma in Medicine in the USA

This below was my response to a question about an alternative treatment for cancer that had been administered to a U.S. resident who had been diagnosed with a cancer that was advanced and for which there was no approved treatment that could save him in the U.S.A.  So he had gone to Mexico and had been treated there, using a drug not approved for cancer treatment in the U.S.A. This had resulted in a truly significant improvement. However, on return to the U.S.A., his physician refused to approve continued treatment with the drug, despite being presented with the documented evidence. 

Physicians in the USA will only prescribe or openly go along with treatments using drugs approved by the FDA. Federal oversight of medicines and treatments is of course needed. There have always been a lot of scams around, including lethal ones.  However, the FDA is not always right. For instance, how often has a licensed MD you have gone to here in the USA prescribed or even suggested the use of herbs as a treatment or preventive?  Yet this happens quite frequently, I am told, even in countries such as Germany, home to some of the biggest pharmaceutical companies. But in this country this could get the MD into a lot of trouble. 

When it comes to cancer, the paradigm that has been very successful in the treatment of infectious diseases--that of identifying a pathogen and then trying to kill it--is flawed for obvious reasons. The "invading organisms" are the body's own cells. If the cancer is localized enough and identified early enough, then surgery and/or localized radiation may get rid of it. If it has spread, various forms of chemotherapy and in some cases wider use of radiation are utilized, often with many adverse and even lethal consequences. 

While there have been advances in immunotherapy and even gene therapy, there is a basic lack of understanding of the more general reasons behind the growth of cancers (which are part of the lives of most multicellular organisms, with various direct or indirect causes). 

We also do not have any real understanding of how to try to "normalize" cells that are behaving abnormally. In most cases, this is not from any damage or mutation to genetic material. Genes have been switched on and off and we do not know how to enable the body to communicate better with the affected cells to reverse these changes.

It should also be clear that cancers have become much more prevalent in our times, especially in areas that have become industrialized or urbanized or where there have been major changes in diet and/or heavy use of pesticides and herbicides in agriculture. This remains a crucial issue, even taking into account increases in average life span and improvements in detection. 

So a certain degree of humility and openness to other approaches is needed in this and other matters.

Of course, there is no substitute for replicable evidence. 

But here we run into a problem that arises out of the fields of finance ans economics. In order to get FDA approval for the use of a drug in humans, a company has to invest, typically, many millions of dollars in research and development, especially in field trials with humans. Why should any commercial company do this if the treatment cannot be patented? It would be a hugely expensive investment in altruism. That is not what commercial companies are built to do.

Higher levels of homocysteine (a product of protein metabolism) in the blood have long been known to be associated with increased rates of heart attacks and strokes. 

Folic acid (a B vitamin, also marketed as folate) has also long been known to reduce the level of homocysteine in the blood, without any adverse affects--although B12 levels should also be monitored as folic acid can mask the effects of B12 deficiency.

But how many MD's would prescribe folic acid for this purpose? Is it because they are ignorant or perverse? No, it is because such a treatment is not an approved protocol in which they have been trained in medical school. Nor do any of the pharmaceutical company drives they are exposed to during their practice bring this to their attention. 

There is no point in blaming the company executives, the physicians, or even the government. They are all to blame in part for the situation but there is little they can do individually about it. 

So one should of course be very wary of unusual cancer treatments. But one should not have a closed mind about those, whether they are FDA approved or not, provided one has at least some evidence to go on.

Substances meant to cure parasitical infections appear unlikely to help treat cancers. The only general way they might work that I (with very limited knowledge) can think of is that cancer cells may be more adversely affected by the substance than normal tissue cells.

So again, caution is needed, along with some degree of openness. In a case where conventional treatment offers no hope, it may not be imprudent to try other approaches, with due caution.