Fwd: THE MOSS REPORTS Newsletter (11/22/03)

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Cancer Decisions

THE MOSS REPORTS Newsletter (11/22/03)

 

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Ralph W. Moss, Ph.D. Weekly CancerDecisions.com

Newsletter #109 11/22/03

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Last week I reported on the results of a recently

published European study of the drug NeoRecormon, a

synthetic form of the hormone erythropoietin,

manufactured by Hoffmann-La Roche. NeoRecormon is a

member of a class of drugs called epoetins, which are

commonly given to cancer patients who are undergoing

radiation and chemotherapy. These drugs effectively

stimulate red blood cell production and raise blood

hemoglobin levels - but, as the European study clearly

demonstrated, patients on epoetins fare significantly

worse in terms of overall survival than do patients who

are not given these drugs. (Henke, M., et al. Lancet

2003, Oct. 18).

 

 

The outcome of this study is clearly inimical to the

economic interests of the companies that produce

epoetin, including Hoffmann-La Roche, the company that

sponsored the Lancet study. I therefore take my hat off

to the authors, including several Hoffmann-LaRoche

scientists, who had the courage to publish these

carefully described, albeit negative, results. This is

the way science should be practiced - but increasingly

seldom is.

 

 

I realize that this finding may disturb some of our

readers who feel they have benefited from this drug.

But while I do not for one minute belittle the

importance of attending to the overall well-being of

patients who are receiving cancer treatment, the

alarming subtext of this study is that the cancers of

patients treated with epoetin tend to recur more

frequently; these patients have a higher incidence of

other serious illnesses, and they die sooner than those

who do not receive the hormone.

 

 

Medical research such as this has a certain beauty to

it. Steadfastly refusing to indulge in wishful

thinking, it presents us instead with unvarnished

facts, some of which may be uncomfortable. It is as if

Science continually repeats to us Groucho Marx's famous

quip: " Who are you going to believe: me…or your own

eyes? " In this case, we are forced to reject the

testimony of " our own eyes, " or the facile assumptions

of our intuition, and instead must accept what rigorous

scientific experimentation reveals. It may be

discouraging in the short term, but in the long run it

will enable scientists to come up with more effective

treatments.

 

 

 

What Are Patients to Do?

 

 

According to a recent article in a medical journal

(Lucia 2003), about 70 percent of people with cancer

report feelings of fatigue after surgery or during

radiotherapy or chemotherapy. This fatigue can

devastate the patient's quality of life and aggravate

other symptoms such as pain and nausea. Common sense

and intuition may dictate that exhausted cancer

patients should get plenty of rest and avoid physical

activity. However, by coincidence, in the October issue

of Lancet Oncology (the Lancet's sister publication),

exercise physiologists and fitness specialists discuss

how to use low or moderate exercise to benefit cancer

patients, reducing or even eliminating the need for drugs.

 

 

The quality of life for cancer patients, they say, can

be greatly improved with the right exercise program.

The authors cite the example of Lance Armstrong, who

bounced back from his own chemotherapy-related fatigue

to win the Tour de France ( " the hardest endurance

race…that human beings can undertake " ) not just once

but for the last five years in a row.

 

 

" Both people with cancer and their physicians should

view his achievements as a highly motivating reference

and a testimony to the usefulness of exercise in

promoting physiological function, " the authors write.

We must keep faith that there are non-pharmacological

solutions to the common problems of cancer patients,

although our drug-oriented mainstream media is unlikely

to tell us about them during prime time.

 

 

Pass This Along

 

 

It is interesting to compare media coverage of the

negative findings on epoetin with the somewhat positive

news about letrozole (Femara), which appeared a week or

so earlier. The Femara study, as you know if you've

been reading this newsletter, received top billing all

over the world. Even weeks after the story broke, there

were still 420 articles on Femara in the news section

of Google, most of them lauding the clinical trial that

showed a decreased rate of breast cancer recurrence in

women who took the drug after successful treatment for

the disease. An article in Newsweek on the Femara

" breakthrough " was typical in that it totally failed to

inform readers that the drug had no significant impact

on survival in the patients who were treated.

 

 

By contrast, the Lancet study on epoetin has generated

just four stories (derived from a total of 4,500 news

sources), and none of these is in a major media outlet.

Apparently, no one in a position of authority is

inclined to deliver any negative news about

conventional cancer treatments, not even to patients

who may urgently need this sort of information.

 

 

Here at The Moss Reports we are not afraid to face the

facts about cancer, even if the news is not of the

" feel good " variety. Every week we deliver information

and analysis in a clear and balanced way to those who

need it the most, as our editor, Dr Ralph Moss, has

consistently done for over a quarter of a century. If

you know others who need this sort of information

please remember to forward the newsletter to them, with

a recommendation that they . (The newsletter

is free of charge.) In that way, we can help

individuals get the information they need, while

simultaneously building an educated public that can

help redirect the faltering war on cancer.

 

 

 

--Ralph W. Moss, PhD

 

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References:

 

 

Glaser CM, Millesi W, Kornek GV, et al. Impact of hemoglobin

level and use of recombinant erythropoietin on efficacy of

preoperative chemoradiation therapy for squamous cell

carcinoma of the oral cavity and oropharynx. Int J Radiat

Oncol Biol Phys. 2001 Jul 1;50(3):705-15.

 

 

Henke M, Laszig R, Rube C, et al. Erythropoietin to treat

head and neck cancer patients with anaemia undergoing

radiotherapy: randomised, double-blind, placebo-controlled

trial. Lancet. 2003 Oct 18;362(9392):1255-60.

 

 

Leyland-Jones B; BEST Investigators and Study Group. Breast

cancer trial with erythropoietin terminated unexpectedly.

Lancet Oncol. 2003 Aug;4(8):459-60.

 

 

Littlewood TJ, Bajetta E, Nortier JW, Vercammen E, Rapoport

B; Epoetin Alfa Study Group. Effects of epoetin alfa on

hematologic parameters and quality of life in cancer

patients receiving nonplatinum chemotherapy: results of a

randomized, double-blind, placebo-controlled trial. J Clin

Oncol. 2001 Jun 1;19(11):2865-74.

 

 

Lucia A, Earnest C, Perez M. Cancer-related fatigue: can

exercise physiology assist oncologists? Lancet Oncol. 2003

Oct;4(10):616-25. Accessed at:

http://oncology.thelancet.com/journal/journal.isa#section1

 

 

FDA criticism of J & J:

http://www.fda.gov/cder/biologics/adpromo/epoamg062003.htm

 

See also:

http://ragingbull.lycos.com/mboard/boards.cgi?board=JNJ & read=1243

 

 

" From the Heart " advertising campaign:

http://216.239.41.104/search?q=cache:EelxcHFfM4EJ:www.ogilvy.com/viewpoint/pdf/v\

3_lee.pdf+procrit+advertising+campaign & hl=en & ie=UTF-8

 

 

Herper, Matthew. European Woes May Hit J & J's Earnings,

Forbes.com, 12/02/02. At:

http://www.forbes.com/2002/12/02/cx_mh_1202jnj.html

 

 

Tagliabue, John. Mystery Effect in Biotech Drug Puts Its

Maker on Defensive. New York Times 2nd October, 02. At:

http://www.nytimes.com/2002/10/02/business/02DRUG.html

 

 

 

 

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IMPORTANT DISCLAIMER

 

 

 

The news and other items in this newsletter are

intended for informational purposes only. Nothing in

this newsletter is intended to be a substitute for

professional medical advice.

 

 

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