November 2008 Health in the News Archive
Cancer rates increase with mammography screening
November 25, 2008
Breast cancer rates increased significantly in four Norwegian counties after women there began undergoing mammography every two years, according to a report in the November 24 issue of Archives of Internal Medicine. Rates among regularly screened women remained higher than rates among women of the same age who were screened only once after six years, suggesting that some of the cancers detected by mammography may have spontaneously regressed had they not been discovered and treated.
Throughout Europe, the start of screening mammography programs has been associated with increased incidence of breast cancer, according to background information in the article. "If all of these newly detected cancers were destined to progress and become clinically evident as women age, a fall in incidence among older women should soon follow," the authors write. "The fact that this decrease is not evident raises the question: What is the natural history of these additional screen-detected cancers?"
Of every 100,000 screened women, 1,909 had breast cancer during the six-year period, compared with 1,564 of every 100,000 in the control group. Screened women were more likely to have breast cancer at every age.
"Although many clinicians may be skeptical of the idea, the excess incidence associated with repeated mammography demands that spontaneous regression be considered carefully," they continue. "Spontaneous regression of invasive breast cancer has been reported, with a recent literature review identifying 32 reported cases. This is a relatively small number given such a common disease. However, as some observers have pointed out, the fact that documented observations are rare does not mean that regression rarely occurs.
Dr. Grouts Comment:
Something is fishy here. They conclude that mammograms detect some cancers that just go away, handled successfully by the immune system.
Researchers say they can't blame the increased incidence of breast cancer on more cases being found. So, two questions: Do some cancers go away on their own? Could the incidence of cancer be 22 percent higher in the group regularly screened because radiation is carcinogenic? Odd there was no mention of that documented possibility.
X-rays, the kind in mammography, can break the chemical bonds in molecules, including DNA molecules, thereby disturbing their normal functioning. In 2005, the National Toxicology Program classified X-radiation and gamma radiation as known human carcinogens. A 2005 National Research Council report stated, "The risk of cancer proceeds in a linear fashion at lower doses of ionizing radiation without a threshold and that the smallest dose has the potential to cause a small increase in risk to humans."
According to Dr. Sam Epstein, Chairman of the Cancer Prevention Coalition, The premenopausal breast is highly sensitive to radiation, each 1 rad exposure increasing breast cancer risk by about 1 percent. Radiation risks are some four-fold greater for the 1 to 2 percent of women who are silent carriers of the A-T (ataxia-telangiectasia) gene; by some estimates this accounts for up to 20 percent of all breast cancers diagnosed annually.
Since 1928, physicians have been warned to handle "cancerous breasts with care -- for fear of accidentally disseminating cells" and spreading the cancer. Nevertheless, mammography entails tight and often painful breast compression, particularly in premenopausal women, which could lead to distant and lethal spread of malignant cells by rupturing small blood vessels in or around small undetected breast cancers.
At the Arizona Center for Advanced Medicine, we use thermography for breast cancer screening. Read more about it. Thermography does not use radiation or compression and can detect suspicions of cancer years earlier than a mammogram can.
"Organic" farmed fish coming our way
November 21, 2008
The U.S. government is a step closer to labeling farmed fish "organic," a move that pleases some aquaculture producers and angers environmentalists, consumer advocates, and many Alaskan fishermen.
A USDA advisory panel said producers should be allowed to put organic labels on farmed fish even if their diets include wild fish and other feed that isn't organic itself definitions that environmentalists say depart from the criteria for other certified organic animal food products. The labeling criteria allow up to a quarter of farmed fish feed to consist of wild fish, though not from endangered species.
Alaskan fishermen generally agree that if farmed fish that eat wild fish get the magic organic label, then wild fish in supermarkets should get that marketing benefit, too. But the proposed rules don't allow for that. Wild fish can be labeled organic if sold as fish feed, but not if sold for human consumption. "I think this does make a mockery of the organic program," said Dale Kelley, Alaska Trollers Association executive director and a commercial fisherman.
The rules would also allow farmers to raise fish in open-net cages, which raises concerns about the spread of sea lice into nearby waterways, a trend that could drive wild salmon to extinction.
Consumers Union, the outfit that publishes Consumer Reports, says, "The board recommends that fish can be labeled 'organic' even if they've been fed wild fish, which come from polluted environments and are high in mercury and PCBs. Potentially toxic organic fish? That defeats the whole purpose."
Dr. Grout's Comment:
We are looking at a huge fight for access to a very profitable market: Organic food was worth $4.7 billion in sales in 2007, and that until the last few months, has grown between 13 percent and 33 percent a year, according to the Nielsen Co.
An organic tomato must flourish without conventional pesticides; an organic chicken cannot be fed antibiotics. What exactly will make a fish organic? Apparently, one that feeds on a non-organic diet.
But consider the other side of the coin: As a food label, "organic" has in the past basically required that the plant or animal be controlled throughout its life, because that's a sure way to know what's in it. If that applies to fish, then "organic" farmed fish has room to make an argument since the oceans are polluted.
Farmed fish are a consequence of the loss of worldwide fish harvests and increasing demand. However, we must be careful what we ask for. In agriculture, Monsanto promised to solve the supply and demand problem with genetically modified foods, and got the government to turn a blind eye to the hazards to human health when you tamper with Mother Nature. Now we want to hijack the organic standards to make farmed fish more attractive to consumers. Might "wild" fish just might go by the wayside because no one will be the wiser?
Hawaii ends universal health care for children
November 20, 2008
Hawaii is ending the only state universal child health-care program in the country, after just 7 months.
The Keiki (Child) Care Plan was designed to offer health care insurance to the children of parents who earn too much to qualify for Medicaid or Hawaii's State Children's Health Insurance Program (SCHIP), but are felt not to be able to afford private coverage.
State officials found that families were dropping private coverage in order to enroll their children in the "free" plan. In fact 85 percent of the children in Keiki Care were previously in a private, nonprofit plan costing $55 per month. When Gov. Linda Lingle saw the data, she pulled the plug on funding. With Hawaii facing budget shortfalls, she realized it was unwise to spend public money to replace private coverage that children already had.
Yet Lingle is facing a political firestorm in the state from critics who say that she's denying children health insurance - notwithstanding the fact that children in Hawaiian families earning up to $73,000 a year are eligible for Medicaid.
"All this is a lesson for political leaders in Washington who are drafting plans now to expand SCHIP to children in families earning up to $82,000 a year or more. That expansion would wind up doing what Keiki Care did: mainly crowd out the private coverage that millions of middle-income kids already have," writes Grace-Marie Turner in the New York Post.
Dr. Grout's Comment:
Hawaii just had a vivid lesson in health-care economics, learning that if you offer people insurance for free, they'll quickly drop other coverage to enroll.
Universal coverage in any form is an increasingly elusive goal. Several states (including California, Pennsylvania, Illinois and Wisconsin) have attempted major efforts to advance toward health coverage for all citizens. All have had to turn back because the costs were prohibitive.
Massachusetts enacted a universal-coverage law in 2006 - but state officials no longer claim that achieving that goal is even possible.
The health care debate needs to get beyond the issue of better insurance coverage for more people. We also need fewer people who need to go to the doctor, fewer prescriptions filled to simply "manage" diseases. We need a healthier population. To get there, a more holistic approach toward the whole concept of insurance and health care is needed.
We need to turn around the epidemic of chronic disease in this country. I shudder when I see people walk in to my office saying how terrible they feel, and pulling out their five or six bottles of prescription medication. It doesn't have to be that way.
What would it look like if we made it priority to have a healthier population in America? What if "health" insurance really believed in, and paid for, treatments which promote health?
New Rules on GE and Pharmaceutical Crops
November 17, 2008
In the waning months of the Bush administration, the U.S. Department of Agriculture (USDA) has joined the ranks of federal agencies rushing through new, eleventh-hour regulations. USDA released a proposed rule that would significantly weaken oversight of all genetically engineered crops, including food crops engineered to produce drugs and industrial chemicals.
As food advocates like Center for Food Safety interpret the suggested rule changes, biotech companies will assess their own crops to determine whether the USDA should regulate them, and grow untested GE crops with no oversight.
Meanwhile, the National Academy of Sciences, Consumers Union, and many others have proposed mandatory USDA oversight of all experimental GE crops.
Dr. Grout's Comment:
As the Center for Food Safety says, "There has been a complete abdication of any responsible legislative or regulatory oversight of genetically engineered foods
genetic engineering is looming as one of the greatest and most intractable environmental challenges of the 21st Century. Already, this novel technology has invaded our grocery stores and our kitchen pantries by fundamentally altering some of our most important staple food crops. It is estimated that upwards of 60 percent of processed foods on supermarket shelves--from soda to soup, crackers to condiments--contain genetically engineered ingredients."
A number of studies over the past decade have revealed that the health effects of genetically engineered foods can include higher risks of toxicity, allergies, antibiotic resistance, immune-suppression and cancer.
Eat Your Statins
November 17, 2008
Forbes Magazine reports that the American Heart Association (AHA) advises that if you want to avoid a heart attack, stop taking your vitamins and switch to a cholesterol-lowering statin drug instead.
Forbes was enthusiastically reporting on the new Crestor study, touted by the AHA, that is likely to lead to a surge in use for one of the drug industry's best inventions. That includes branded entrants, like AstraZeneca's Crestor and Pfizer's Lipitor, and cheaper generic versions of Zocor and Pravachol. Sales of cholesterol-lowering drugs last year totaled $34 billion globally.
"It's spectacular," says John J.P. Kastelein of Academic Medical Center in Amsterdam, a co-author of the Crestor study. "We finally have strong data" that a statin prevents a first heart attack. Christie Ballantyne of Baylor College of Medicine predicts the results will "invigorate doctors and patients" to use statins more often.
One statin critic not backing down is John Abramson, author of Overdosed America. He points out that patients on Crestor had the same rate of serious illnesses requiring hospitalization as those on placebo. "You haven't improved their net health," says Abramson. Instead, he argues, you're trading heart attacks and strokes for other serious illnesses. And he contends that not offering weight-loss counseling to an overweight population created an "artificial situation" that exaggerated the benefits of the drug. He's not alone. Stephen Colbert of Comedy Central's fake news show The Colbert Report joked the study was "a great breakthrough in the battle to find things to prescribe to people who don't need them."
Dr. Grout's Comment:
Stop the presses! Forbes didn't report both sides of the story. First, they failed to tell you the study was paid for by the drug company AstraZeneca which makes Crestor. Second, there was an editorial accompanying the study in which Mark Hlatky, a Stanford University health-policy professor, said the study was poorly controlled and excluded people with diabetes and uncontrolled high blood pressure. He said the study also failed to explain how heart disease risk changed for particular groups, such as women.
Harried primary care physicians often pay attention to a high cholesterol number. They simply can write a prescription for a drug and move on to the next patient. Boom. No interest in what is causing the inflammation in the patient. And likewise, Forbes had no interest in mentioning any of statins' nasty side effects like cognitive difficulties and muscle weakness.
And apparently Forbes overlooked the January 17th, 2008 cover story of Business Week which finally openly questioned the high cholesterol issue. "(Doctors) are being pushed by the national guidelines, by patients' own requests, and by pay-for-performance rules that reward physicians for checking and reducing cholesterol," says University of Texas' Dr. Howard Brody. "I now see it as myth that everyone should have their cholesterol checked," he says. 'In hindsight it was obvious. Duh! Why didn't I see it before?"
Clearly efforts are being made to hype the statins. Wall Street analysts estimate this study could end up doubling Crestor's sales by 2015, to $6.3 billion.
John Abramson makes an excellent point, that prescribing drugs does not improve net health. This kind of reporting perpetuates the philosophy that putting more people on more drugs is the thing to do. Perhaps Forbes could have mentioned this year's study from the University of Pennsylvania Health System where researchers found that alternative therapy with fish oils and yeast rice supplements lowered bad cholesterol better than statins. The group given supplements saw their cholesterol reduced 42.4 percent reduction; the statin group experienced a 39.6 percent reduction. The study was reported in the July issue of Mayo Clinic Proceedings.
Salute to a fallen leader
November 15, 2008
The American Medical Association (AMA) announced this week that Immediate Past President and public health leader Ronald M. Davis, M.D., 52, died Thursday at his home in Michigan. He was diagnosed with pancreatic cancer last February. Dr. Davis, a preventive medicine physician, served as the 162nd president of the AMA from June 2007 to June 2008. He led the AMA's focus on preventive medicine and had been a longtime public health and anti-tobacco advocate.
Dr. Grout's Comment:
Dr. Davis challenged the medical community to begin to practice "green" medicine - recycling and other ways of controlling medical waste in an ecologically sound manner.
Last year, the Arizona Homeopathic and Integrative Medicine Association wrote an open letter to Dr. Davis, as President of the AMA, pledging that we would undertake recycling in our offices.
In our office, the Arizona Center for Advanced Medicine, we make every effort to leave as small an environmental footprint as possible. We designed the office space to be eco-friendly. How can we expect to stay healthy if we are breathing toxic materials every day? And how can we possibly expect our patients to get healthy if they have to come to a toxic office space for their appointments? All the office furniture is recyclable and contains no formaldehyde or any other organic outgassing materials. The flooring is made of recyclable materials, without any volatile organic compounds (VOCs) in the materials or in the adhesives. We used energy-efficient full-spectrum fluorescent lighting. Our janitors use cleaning products which are free of chlorine, ammonia and chemical fragrances.
We have switched to recyclable glass bottles (in all sizes available) instead of plastic bags for our intravenous treatments. We recycle all our paper and plastic trash. We recycle our printer cartridges. We recycle all our bottled water bottles. I confess that we do use a medical waste disposal company for our needles and any blood-contaminated products or devices.
The office park where my office is located has a huge recycling bin which is used by the entire complex.
Our staff almost always brings lunch to work in recyclable containers. The food they bring is home cooked for the most part. We have no sodas or drinks made with anything artificial in the office. We test for allergies with preservative-free antigen so that we are not injecting preservatives into our patients. We recommend supplements which contain no additional or artificial ingredients. We hardly ever use pharmaceutical medications, and when we do use them, we generally have them compounded, to keep them free of sugar, artificial sweeteners, other chemicals and food colorings.
Toxicity of any kind produces inflammation, which is the first step toward the development of cancer, a disease of chronic inflammation. You can read about one form of inflammation leading to increased incidence of cancer in the attached article which demonstrates an association between gum disease and cancer.
The longest journey does indeed start with the first step. We, as physicians, have an obligation to teach in fact that is the definition of "doctor" a teacher. Let us all pledge to teach healthy living, healing working conditions, healthy foods, healthy environments; and let us teach by example.
Obese children with high cholesterol may develop heart disease
November 12, 2008
A new study, presented Tuesday at the American Heart Association conference, "finds striking evidence that children who are obese or have high cholesterol show early warning signs of heart disease." The researchers "found that the thickness of artery walls of children and teenagers who are obese or have high cholesterol resembled the thickness of artery walls of an average 45-year-old."
Since no one knows how thick a 10-year-old's artery should be, due to the fact that most are not regularly checked for signs of heart disease...researchers used tables for 45-year-olds, who often do.
The researchers, from the University of Missouri Kansas City School of Medicine and Children's Mercy Hospital, reported that the "children's average [carotid artery intima-media thickness] was 0.45 millimeters, which is typical of adults in their mid-40s. Some had CIMT readings as high as 0.75 millimeters."
Dr. Grout's Comment:
It is telling that the study, which has not yet been published, was small, involving 70 children ages 6 to 19, and several experts said the results would need to be replicated to be considered conclusive. And who funded this study so eagerly trotted out? Is this good science or more of a PR move to deflect criticism from the American Academy of Pediatrics' recent recommendation urging cholesterol screenings and statins for children? But drugs aside, there is a real problem with the state of children's health. Is anyone besides me thinking of Pottenger's cats? We are into at least the third generation of poor nutrition and excessive chemical exposure. Now it's not just the brain that is affected (as in autism and AD/HD). Now it's the body as well. If you recall, Pottenger's cats did not reproduce a 4th generation. It is time to WAKE UP and get rid of the chemicals, put good food into our bodies, add supplements to replace all those things that our grandmothers and mothers did not have in sufficient quantity, and hope that we can turn this around. I look forward to getting to know my grandchildren.
What the Chemical Industry Doesn't Want You to Know about Everyday Products
November 12, 2006
It takes a lot of nerve to go up against the $3 trillion-a-year global chemical industry.
Ask University of Missouri-Columbia scientists Frederick Vom Saal and Wade Welshons. They've been in the industry's crosshairs for more than a decade, since their experiments turned up the first hard evidence that miniscule amounts of bisphenol A (BPA), an artificial sex hormone and integral component of a vast array of plastic products, caused irreversible changes in the prostates of fetal mice.
Their findings touched off a steady drumbeat that has led to a ban on BPA-laden baby bottles in Canada, mounting support for a similar ban in the U.S., major retailers pulling plastic products off their shelves, a consumer run on glass baby bottles and a blizzard of scientific reports raising increasingly disturbing questions about the chemical's dangers at the trace levels to which people are routinely exposed.
But back in early 1997, when the Missouri team produced its pioneering research on low-dose BPA, challenging the chemical-industrial complex seemed quixotic, even risky. Soon after the report appeared, a scientist from Dow Chemical Company, a major BPA manufacturer, showed up at the Missouri lab, disputed the data and declared, as Vom Saal recalls, "We want you to know how distressed we are by your research."
"It was not a subtle threat," Vom Saal says. "It was really, really clear, and we ended up saying, threatening us is really not a good idea." Click for remainder of the article
Dr. Grout's Comment:
The 600 pound gorilla is big true - and could kill you if it sat on you also true. But that doesn't make it right for it to sit on you when you are in your house, or a concert hall. We cannot put a fence around the gorilla none of us is big enough to do that. However, we don't have to feed it bananas. We ALL have a choice of which products we purchase. If enough of us don't purchase products with BPA in them, then the chemical companies will get the message. Let us concentrate on what we CAN do to change the world, one step at a time, because we only have control of our own actions.
Diabetes causes more kids to take drugs
November 3, 2008
According to a study in Pediatrics, "The number of children who take medication for chronic diseases has jumped dramatically, another troubling sign that many of the youngest Americans are struggling with obesity."
America's tweens and teens more than doubled their use of type 2 diabetes medications between 2002 and 2005, with girls between 10 and 14 years of age showing a 166 percent increase.
"Our study findings indicate that these increased levels of chronic medication use are symptoms of broader underlying issues affecting children today," said Emily R. Cox, Ph.D., RPh, senior director of research at Express Scripts. "These trends are worrisome given that many of these therapies are treating conditions with modifiable risk factors and if not addressed, many of these children will carry these chronic conditions into adulthood."
For example, the use of asthma medications increased 46.5 percent and ADD/ADHD medication use increased 40.4 percent. Cholesterol and blood pressure medications saw a more moderate growth of 15 percent and 1.8 percent, respectively.
Dr. Grout's Comment:
This comes on the heels of last year's Harvard study published in the Journal of the American Medical Association that said America's perceived progress in conquering disease is refuted by the statistics: Childhood obesity has increased by almost fourfold in the past three decades, asthma rates increased by twofold since the 1980s, and the number of attention-deficit disorder cases are increasing.
No one wants to take on the corporate entities whose ads pay for children's TV shows and sponsor groups like the American Academy of Pediatrics. There is little political will yet to do what must be done. But the good news is that bit by bit, parents are looking at what makes up "kid food" and are learning how to feed their children better nutrition. You can't pick up a newspaper today without reading a "green" story because people are interested now in what we can do to lower the body burden of chemicals that assault us every day.
Wall Street Journal supports a yes vote on AZ Proposition 101
November 1, 2008
A Wall Street Journal editorial points out that Arizonans will vote on a ballot initiative that could resonate in the national debate over the future of health care, Proposition 101, the Freedom of Choice in Health Care Act.
"Who could be against an initiative that protects the right of patients to choose and pay for a doctor or a health plan? The answer is proponents of a health-care system run by the government. For them, enshrining into law protections for private health plans is anathema. Believe it or not, the Phoenix Chamber of Commerce also opposes the initiative. Its big health-insurance members want to protect their interests as contractors to the state's Medicaid plan."
Eric Novack, a physician and chairman of Proposition 101, responds, "The only option that our initiative rules out is a mandatory single-payer system." Single-payer health-care systems, as in Canada, make it illegal in most cases for people to go outside the government's system and contract for their own medical services." Arizona's proposition forbids those kinds of restrictions.
"Universal coverage plans, regulated by government, nearly always try to restrain costs by restricting the choices individual can make. This assumes a uniformity in the real-world of patients or the practice of medicine that simply doesn't exist, especially amid rapid developments in medical science. Who should decide -- the patient or a government treatment schedule -- whether a cancer sufferer should be able to try an experimental therapy or under what circumstances a senior citizen gets a hip replacement? Allowing patients to choose their own medical treatment, get third or fourth opinions, or seek out experimental medicines saves lives". Courageous patients and innovative medical clinicians find each other constantly this way. The patient-clinician interface is one reason the U.S. remains a locus of medical progress. Ensuring this progress continues depends on maximizing patient choices. A publicly bureaucratized system will slow it."
Dr. Grout's Comment:
The future holds even less potential when everyone is shoe-horned into one health care plan. The medical establishment is notoriously slow to adopt new ideas. The history of medicine is replete with examples of forward thinkers Linus Pauling of vitamin C fame for example being tarred and feathered by the mediocre in their ranks. Only decades later, when colleagues catch up, are forward thinkers finally recognized with a Nobel Prize. Studies show some 68 percent of the American public has departed from mainstream allopathic medicine and sought answers from complementary and alternative doctors. Many people see that conventional medicine is too much about drugs and invasive procedures for their taste, not enough about cures and prevention. We watched with amazement as the American Academy of Pediatrics recommended a few months ago that at-risk children be screened at age 2 for high cholesterol, and given statin drugs at age 8. The AAP could have help cut health care costs if they had recommended that parents stop buying food products with sugar and high fructose corn syrup. But that would have offended corporate sponsors who include soft drink companies. This is an example of the problem with government run health care proposals; government officials are too beholden to corporate sponsors to advocate for the public good. Thank you Dr. Novack for leading the way.
Study suggest drugs for anxious children
November 1, 2008
According to a study just published in the New England Journal of Medicine, children and adolescents with disabling anxiety are most likely to recover when treated with a combination of talk therapy and Zoloft (sertraline), an antidepressant medicine.
John Walkup, M.D., of John Hopkins University, and colleagues, recruited almost 500 children ages 7 to 17 whose anxiety over separation from parents, social situations, or other things was causing problems. Researchers split them into four groups: one receiving Zoloft; another engaging in cognitive behavioral therapy (CBT); a third receiving both; and a group receiving dummy pills and monitoring by the psychiatrist."
The study showed that, "of children receiving both Zoloft and CBT, 80.7 percent showed improvement, compared to 59.7 percent for CBT alone, 54.9 percent for Zoloft alone, and 23.7 percent given a placebo.'
Dr. Grout's Comment:
It is pretty sad commentary on the state of "modern" medicine that the only two options considered for children with depression are talk therapy and drugs. What about looking at food allergies, toxicity, neural development, auditory processing, neurotherapy? All these can have an enormous effect on mood and cognition. If the terrain is not properly prepared and fertilized, then we can plant all the seeds we want, and they will still grow up stunted if they grow at all. At the Arizona Center for Advanced Medicine we test for allergies and toxicities, and we offer a program designed to repair the brain connections which have been distorted, so that both children and adults can heal from their anxiety without drugs.