The Failure of Orthodox Medicine Revisited

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The Failure of

Orthodox Medicine

Revisited

 

Reporting and Commentary © By Peter Barry Chowka

All rights reserved

 

 

 

 

(August 1, 2002) In 1977, I wrote a feature article for a national magazine,

part of a series on the politics of cancer (Cancer: A Metaphor for Modern Times

– Probing the Medical-Pharmaceutical Complex), that was titled " The Failure of

Orthodox Medicine. " The article examined leading conventional cancer treatments

of the period. The unmistakable conclusion, citing both the scientific

literature and the experience of many patients, was that the treatments were

abject failures.

 

The limitations of conventional medicine in fact have long provided an

inspiration, a thematic underpinning, and a raison d'être for people to explore

alternative therapies. Even today, with complementary alternative medicine (CAM)

- the purported union of the " best " of conventional and alternative medicine –

becoming the accepted model, it is still the uneven quality and questionable

effectiveness of mainstream therapies that motivate millions of people to look

elsewhere for some or all of their therapeutic options.

 

Writing a quarter century later now, it might be said that the more things

change, the more they remain the same. In a period of less than one month during

the summer of 2002, there has been an avalanche of big stories that could easily

fit under the heading of " the failure of orthodox medicine " - suggesting not

only that lack of success in the conventional medical model persists but that

the corollary is still very much true: the need for primary medical alternatives

has never really gone away.

 

On July 15, I reported about a particularly jarring challenge to medical

orthodoxy: the positive and unprecedented cover story article about Robert

Atkins, MD in the July 7 Sunday New York Times Magazine. Atkins, the

controversial New York City clinician and one of the most successful non-fiction

authors in history, has maintained since 1972 that orthodoxy is wrong on the

question of diet, cardiovascular health, and weight loss. In effect, the Times

article was the shot heard 'round the world, asserting that Atkins may in fact

be onto something important after all - and during the ten days following its

publication, other newspapers and US TV networks and cable news channels seemed

to be falling over themselves to do a 180 degree turn from their previous points

of view on the subject. For instance, on one night alone, Friday, July 19, two

prime time network news programs, 48 Hours on CBS and the venerable 20/20 on

ABC, both broadcast positive feature reports on Atkins and his long-standing

critique of medical orthodoxy. The tone of the reporting suggested that Atkins

is now the one to beat.

 

Two days after the New York Times Magazine article was published, another

seismic development occurred - the first news reports about the imminent

publication in the Journal of the American Medicial Association (JAMA) of a

study and an editorial that challenged the safety and effectiveness of hormone

replacement therapy (HRT). An estimated six million women are currently taking

the drugs estrogen and progestin to replace the hormones they lose at menopause.

HRT treatment has become an article of faith - sold to all middle-aged women on

the hope that the drugs would not just relieve the hot flashes, night sweats and

vaginal dryness that can plague females at menopause but that they would also

improve women's health.

 

The multi-billion dollar-a-year drug industry that has grown up around this, as

it turns out unproven, treatment was called into question overnight by the JAMA

article. Based on a large study, The Women's Health Initiative involving 16,000

women, it was the first major clinical trial to compare the effects of HRT with

placebo. It was originally scheduled to continue until 2005 but was ordered

stopped (and the participants were told to stop taking the drugs) when

preliminary data, according to Jacques E. Rossouw, MD, the study's acting

director, showed that " The breast cancer risk exceeded the predefined boundary

for safety. "

 

As the New York Times reported (July 9) with considerable understatement,

" Hormone replacement therapy, once thought to be a way for women to remain

forever young, protect them from heart disease and from osteoporosis, and

generally leave them healthier than they would otherwise be, may be fast losing

its allure. "

 

A companion article in the Times on July 9 titled " Hormone Replacement Study a

Shock to the Medical System " noted, " The announcement yesterday that a hormone

replacement regimen taken by six million American women did more harm than good

was met with puzzlement and disbelief by women and their doctors across the

country. "

 

On July 11, two days after the JAMA study was publicized, the first class action

suit against a principal maker of HRT drugs, Wyeth, Inc., was announced. The law

firm Schiffrin & Barroway filed a lawsuit in U.S. District Court in Philadelphia

seeking the establishment of a medical monitoring fund for all women who have

taken Prempro, Wyeth's best-selling HRT drug, plus refunds for all Prempro users

and compensation for " all victims for personal injuries and death. "

 

In the suit, plaintiff June Bloch contends that Wyeth officials knew that

Prempro caused " serious side effects " in some users. " Nevertheless, they

continued to market the product by providing false and misleading information

with regard to its safety, " the suit maintains. According to news reports, Bloch

has not been diagnosed with breast cancer or other HRT-linked illness. She is

seeking the federal court to order Wyeth to pay for her medical checkups.

 

Last year, Prempro had sales of more than $2 billion. In 1999, Wyeth reserved

billions of dollars to settle lawsuits by users of its discredited diet drug

fen-phen (Redux) following the publication of studies that the drug damaged

heart valves. In 1997, the Food and Drug Administration removed fen-phen from

sale. The company changed its name from American Home Products Corp. to Wyeth

earlier this year.

 

 

Challenging the Accepted Wisdom

 

On July 14, the Times published an editorial titled " Challenging the Accepted

Wisdom. " A medical issue must be significant for the " newspaper of record " to

address it in a full-blown editorial: " These have not been good times for

established medical practices. In realms as disparate as breast cancer,

menopause, arthritis and weight control, the prevailing orthodoxy finds itself

under attack. For the past several months a controversy has raged over whether

mammograms to detect tiny tumors in the breast have any proven value in reducing

breast cancer mortality. Last week a federal study of hormone pills to treat

postmenopausal women for a wide range of ailments was terminated when prolonged

use of the pills was found to do more harm than good. A day or so later

researchers reported that a popular operation for arthritis of the knee worked

no better than a sham procedure that left patients thinking they had received

treatment when in fact they had not. "

 

Across the pond, the news for orthodox medicine was also not good. On July 2, a

variety of British media, including the BBC, reported that " The UK has the worst

survival rates for cancer of any developed country, a major survey reveals.

Research by market analysts Datamonitor shows Britons who develop cancer are

more likely to die from the disease than people living in other Western

countries. . .[The report] warns that the situation is likely to get worse

before it gets better, even though the government has pledged to spend

significantly more on cancer care in the coming years. "

 

In response to the report, defenders of orthodoxy insisted that lack of adequate

spending contributed to the poor outlook for people with cancer in the UK. It

should be noted, however, that Britain has had centralized national health care

for all of its citizens since the late 1940s and, for most of those years, an

abundance of spending including the creation of a huge bureaucracy that

accompanies such programs. An earlier article by the BBC (November 29, 1999),

" Report confirms UK cancer shame, " notes, " Research by a leading think-tank

confirms that the UK is one of the worst places in Europe in terms of cancer

survival rates. The document, from the Institute of Economic Affairs, said that

lack of competition meant there was no incentive to raise standards. . .And the

death rates [in Britain] for stroke and heart disease for the under-65s are also

among the highest. "

 

Another study by Datamonitor hit the media on July 15. As Reuters Health

reported from London, " More than half of all cancer patients are using

complementary or alternative therapies to cope with the difficult side effects

of hospital-based treatment, according to a report released on Sunday. The

market consultancy, Datamonitor, said as many as 60% of cancer patients in

certain European countries, and 80% in the United States, use special diets,

vitamin supplements, herbal remedies or acupuncture. . .Datamonitor estimated

the global market for both complementary and alternative medicines used by

cancer patients could be as high as $18 billion annually, rivaling the sales of

many traditional [conventional] pharmaceutical approaches. "

 

 

Unhealthy Hospitals

 

Another Sunday in July, and another major new – and negative - report about

conventional medicine, this time from the Chicago Tribune. On July 21, the paper

began publishing a detailed, three-part series titled " Investigation: Unhealthy

Hospitals. " The series and its findings received major national attention.

 

Part one of the series began, " A hidden epidemic of life-threatening infections

is contaminating America's hospitals, needlessly killing tens of thousands of

patients each year. These infections often are characterized by the health-care

industry as random and inevitable byproducts of lifesaving care. But a Tribune

investigation found that in 2000, nearly three-quarters of the deadly

infections--or about 75,000--were preventable, the result of unsanitary

facilities, germ-laden instruments, unwashed hands and other lapses. The

industry's stance also obscures a disturbing trend buried within government and

private health-care records: Infection rates are soaring nationally, exacerbated

by hospital cutbacks and carelessness by doctors and nurses. Deaths linked to

hospital germs represent the fourth leading cause of mortality among Americans,

behind heart disease, cancer and strokes, according to the federal Centers for

Disease Control and Prevention. These infections kill more people each year than

car accidents, fires and drowning combined. "

 

The reaction of one major hospital cited in the Tribune series was to file a

lawsuit against the husband of a woman who died at the hospital in 1997 from an

infection she contracted during surgery at the hospital. The man was a source

for the Tribune article. According to the New York Times (July 27), " The Tribune

article detailed an outbreak of staphylococcus infections at [the hospital] in

late 1996 and 1997. According to the report, the infections were the result of

numerous unsanitary practices and conditions. Among other problems, the Tribune

reported that a faulty ventilation system allowed dust and flies to be in the

air during surgery and some doctors wore dirty clothes and did not wash their

hands. " The hospital in question reversed course and withdrew the lawsuit within

days of filing it after adverse publicity.

 

 

Codex Alimentarius

 

In another sign that, like the 1970s, things in the world of medicine may not

have really changed all that much, Christopher Booker wrote a column in the UK

newspaper The Telegraph on July 21, a section of which should interest

alternative medicine proponents.

 

" Representatives of Britain's 2,000 health shops, " Booker wrote, " have been told

in Brussels that there is now no chance of stopping an EU directive which will

close most of them down. "

 

Booker wrote that the enforced closings are a result of " part of an avalanche of

EU legislation which is being 'fast-tracked' to give eastern European countries

a chance to comply with it before they join an enlarged Union. "

 

He added, " pharmaceutical companies have been lobbying behind the scenes for

years. . .[for] this 'Herbal Medicines Products' directive. . .Although it is a

British initiative, championed by our Medicines Control Agency, it seeks to

apply to herbal remedies the principle of continental law that things can only

be allowed when they are specifically authorised. This reverses the British

tradition that everything is allowed unless specifically prohibited. Under the

directive such herbal remedies as hypericum, rhodiola and echinacea, used by

five million people in Britain for a wide range of conditions, could only be

sold if they had been through the MCA's prohibitively expensive licensing

procedures. Thousands of safe herbal products will thus have to be removed from

the market, which is why many health shops will be forced to close. "

 

Booker notes a final irony: " There are no health reasons for banning the 3,000

herbal preparations currently on sale in Britain. Almost all adverse reactions

linked to herbal remedies (infinitely fewer than those due to synthetic drugs

made by pharmaceutical firms) are caused by preparations made up by Chinese

practitioners. These are specifically exempted from the directive. "

 

Maybe the people who were challenging the " Codex Law or Codex Alimentarius

Attempts to Outlaw Access to Vitamins, and Other Nutritional Supplements " in the

mid- to late-1990s were on to something after all.

 

Can it happen here? Stay tuned for developments.

 

 

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