Thursday, January 03, 2008

Another resurrection for Thalidomide

It's already been found useful in treating leprosy etc.

NOTORIOUS morning sickness drug Thalidomide, which caused severe birth defects in the 1950s and 1960s, is about to be trialled as a treatment for asbestos-related mesothelioma. Cancer specialist Nick Pavlakis said Thalidomide had been shown to inhibit blood vessel growth within tumours and he planned to test its value in mesothelioma patients.

He hopes to recruit about 100 patients Australia-wide for the study, which will compare those receiving chemotherapy with others given the standard treatment as well as Thalidomide. "We want to find out after they've had chemotherapy . . . if we give Thalidomide can we then control the disease for longer and maintain quality of life for longer?" Professor Pavlakis said. He said the results of the trial would be combined with a similar study taking place in the Netherlands. Thalidomide is already listed on the Pharmaceutical Benefits Scheme as a treatment for multiple myeloma, a type of blood cancer.

Studies have found the standard chemotherapy cocktail increases survival of mesothelioma patients by an average of three months as well as improving quality of life. Professor Pavlakis, of Sydney's Royal North Shore Hospital, said even if Thalidomide extended that to five months, it would be considered significant. "That doesn't sound like a lot but . . . everything's a stepping stone," Professor Pavlakis said. "If you look at breast cancer and other diseases where there's been major changes, at any given time point the changes didn't seem as big when they actually were discovered. "It's the cumulative effect of little changes over time that add up to a big effect."

About 600 Australians are diagnosed with the disease each year but that is expected to double by 2020. "Everyone acknowledges it's going to get worse . . . based on when the maximum asbestos exposures in the community were," Professor Pavlakis said. "There's a lag time of 30 to 40 years on average from the time of exposure to the time of disease." Only about 5 per cent of those diagnosed with mesothelioma were alive five years later, Professor Pavlakis said.

Mesothelioma patient Trevor Stagg, 70, and his wife, Eileen, of Victoria Point, said they were grateful for every extra day they had together after his diagnosis in June. "I really feel more for the families of people who go out one day, have an accident and don't come home. I wonder how they cope with that," Mrs Stagg said. "Each day is really precious to us. We've been married 51 years last Saturday. We've even got closer."


Fussy foodie

Strong on ideology but no sign of science. But America's supposedly highbrow and impartial NPR is promoting it. How surprising! (NOT)

"Eat food. Not too much. Mostly plants." That's the advice journalist and author Michael Pollan offers in his new book, In Defense of Food. "That's it. That is the short answer to the supposedly incredibly complicated and confusing question of what we humans should eat in order to be maximally healthy," Pollan tells Steve Inskeep.

The implication of Pollan's advice, however, is that what we're eating now isn't food. "Very often, it isn't," he says. "We are eating a lot of edible food-like substances, which is to say highly processed things that might be called yogurt, might be called cereals, whatever, but in fact are very intricate products of food science that are really imitations of foods."

Pollan acknowledges that distinguishing between food and "food products" takes work. His tip: "Don't eat anything that your great-grandmother wouldn't recognize as food." Take, for example, the portable tubes of yogurt known as Go-Gurt, Pollan says. "Imagine your grandmother or your great-grandmother picking up this tube, holding it up to the light, trying to figure out how to administer it to her body - if indeed it is something that goes in your body - and then imagine her reading the ingredients," he says. "Yogurt is a very simple food. It's milk inoculated with a bacterial culture. But Go-Gurt has dozens of ingredients."

A large part of the conversation about food - like debating low-fat and low-carb diets - serves as a way of avoiding the idea that maybe we're just eating too much, Pollan says. He says his advice about how to limit consumption is based less on science, which he says "has failed us when it comes to food, by and large," and more on culture. "Cultures have various devices to help people moderate their appetite," he says. "Once upon a time, there was scarcity. We don't have that anymore; we have abundance. But if you go around the world, you find very interesting tricks and devices."

One is small portion sizes, Pollan says. "The French manage to eat extravagantly rich food, but they don't get fat, and the reason is that they eat it on small plates, they don't have seconds, they don't snack." In Okinawa, Japan, a cultural principle called "Hara Hachi Bu" instructs people to eat until they are just 80 percent full, Pollan says. "You do know when you are full, and the idea of stopping eating before you reach that moment . if you do that, you will actually reduce your caloric intake quite a bit," he says.

Finally, eating plants is very important, Pollan says. "There is incontrovertible but boring evidence that eating your fruits and vegetables is probably the best thing you can do for preventing cancer, for weight control, for diabetes, for all the different, all the Western diseases that now afflict us," he says.

But can you follow Pollan's advice and avoid processed foods without spending a ton of time and money? "You're going to have to spend either more time or more money, and perhaps a little bit of both," Pollan says. "And I think that's just the reality. It's really a question of priorities, and we have, in effect, devalued food. And what I'm arguing is to move it a little closer to the center of our lives, and that we are going to have to put more into it, but that it will be very rewarding if we do.

"And if we don't, by the way, we are going to suffer from this - you know, we hear this phrase so many times - this epidemic of chronic disease. But the fact is, we are at a fork in the road. We're either going to get used to chronic disease, and be . in the age of Lipitor and dialysis centers on every corner in the city, or we're going to change the way we eat. I mean, it's really that simple. Most of the things that are killing us these days - whether it's heart disease, diabetes, obesity, many, many cancers - are directly attributed to the way we're eating."



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

9). And how odd it is that we never hear of the huge American study which showed that women who eat lots of veggies have an INCREASED risk of stomach cancer? So the official recommendation to eat five lots of veggies every day might just be creating lots of cancer for the future! It's as plausible (i.e. not very) as all the other dietary "wisdom" we read about fat etc.

10). And will "this generation of Western children be the first in history to lead shorter lives than their parents did"? This is another anti-fat scare that emanates from a much-cited editorial in a prominent medical journal that said so. Yet this editorial offered no statistical basis for its opinion -- an opinion that flies directly in the face of the available evidence.

Even statistical correlations far stronger than anything found in medical research may disappear if more data is used. A remarkable example from Sociology:
"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."
So we must be sure to base our conclusions on ALL the data. But in medical research, data selectivity and the "overlooking" of discordant research findings is epidemic.

"What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken". Who said that? Joe Stalin? Adolf Hitler? Orwell's "Big Brother"? The Spanish Inquisition? Generalissimo Francisco Franco Bahamonde? None of those. It was Dr Colin Waine, chairman of Britain's National Obesity Forum. What a fine fellow!


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