Ra[ph Moss's Review of Fortune Magazine article about Losing The War On Cancer

[Guest guest]

For those who may not know, Ralph Moss is the ex-head of publicity

for Memorial Sloan-Kettering Cancer Center in New York City. Mr. Moss

resigned his position after he was told by Sloan-Kettering to

deliberately skew his reportage to the negative on research done on

the efficacy of laetrile/amygdalin. Subsequent to that, he wrote his

well-known book, " The Cancer Industry. "

 

 

" LOSING THE WAR ON CANCER "

 

 

" An article of great importance has appeared in Fortune magazine. It

istitled " Why We're Losing the War on Cancer. " The author, Clifton

Leaf, is Executive Editor of the magazine and is himself a survivor of

adolescent Hodgkin's disease. So he is no stranger to cancer or to the

potential of modern treatment to cure some of its less common

manifestations.

 

Leaf recognizes that he himself was extraordinarily lucky in

surviving.

But he still has the courage to ask, " Why have we made so little

progress in the war on cancer? " He readily acknowledges the flood of

recent favorable publicity for drugs such as Gleevec, Herceptin,

Iressa, Erbitux and most recently Avastin. " [T]he cure has seemed

closer than ever, " he says.

 

" But it's not, " he continues. " Hope and optimism, so essential to this

fight, have masked some very real systemic problems that have made

this

complex, elusive, relentless foe even harder to defeat…[W]e are far

from winning the war. So far away, in fact, that it looks like

losing. "

 

Leaf gives some facts about cancer that are well known to insiders but

will come as a shock to many readers:

 

--More Americans will die of cancer in the next 14 months than have

died from every war that the US has fought…combined.

 

--Cancer is about to replace heart disease as the number one US

killer.

It is already the biggest killer in many age groups.

 

--Even adjusting for age, the percentage of Americans dying from

cancer

is about the same as it was in 1971 (when Nixon declared the war on

cancer) or even back in 1950! Meanwhile, age-adjusted deaths from

heart

disease have been slashed by 59 percent and from stroke by 69 percent

during that same half-century.

 

--The much-vaunted improvement in survival from cancer is largely a

myth. " Survival gains for the more common forms of cancer are measured

in additional months of life, " says Leaf, " not years. "

 

--Most of the improvement in longevity of cancer patients can be

attributed to life style changes (the promotion of which has not been

a

conspicuous priority for the National Cancer Institute) and especially

to early detection.

 

--The few dramatic breakthroughs (such as in Hodgkin's disease) mainly

occurred in the early days of the war on cancer. There has been little

substantial progress in recent decades…despite nearly ubiquitous

claims

to the contrary.

 

--According to one biostatistician at M.D. Anderson Cancer Center,

long-term survival from common cancers such as prostate, breast,

colorectal and lung " has barely budged since the 1970s. "

 

--According to Andy Grove, the chairman of the Intel corporation and a

major " player " in funding research, " It's like a Greek tragedy.

Everybody plays his individual part to perfection, everybody does

what's right by his own life, and the total just doesn't work. "

 

Today, Leaf concludes, the cancer effort is " utterly fragmented - so

much so that it's nearly impossible to track down where the money to

pay for all this research is coming from. " And what money! Leaf

estimates that US $14.4 billion is spent each year on cancer research.

" When you add it all up, Americans have spent…close to $200 billion,

in

inflation-adjusted dollars, since 1971. " It is certainly justifiable

to

ask for an accounting of that one-fifth of a trillion dollars.

 

 

Irrelevant Research

 

 

What have we gotten for that huge sum? In fact, research has become

increasingly irrelevant to the real-life problems faced by cancer

patients. " The narrower the research niche, " says Leaf, " the greater

the rewards the researcher is likely to attain. " Particularly

thought-provoking is his assertion that cancer research is

fundamentally flawed in its orientation. Cancer scientists have

self-confidently created " animal models " and artificial cell lines

that

supposedly mimic an equivalent human disease, such as breast, colon or

lung cancer. These scientists then triumphantly " cure " cancer in these

laboratory models. But cell lines and tumors growing in mice are

drastically different from spontaneous human tumors, the kind that

afflict us and our loved ones. A flawed model is not likely to yield

useful results. Those who closely follow the cancer field have become

inured to an endless series of " breakthroughs " in mice that almost

never pan out when tried in the clinic.

 

According to one of America's most celebrated cancer researchers, Dr.

Robert Weinberg of the Massachusetts Institute of Technology (MIT), " a

fundamental problem which remains to be solved in the whole cancer

research effort, in terms of therapies, is that the pre-clinical

models

of human cancer, in large part, stink. "

 

Prof. Bruce Chabner of Harvard University expressed similar

frustration: " Cancer researchers say, 'I've got a model for lung

cancer!' Well, " says Chabner, " it ain't a model for lung cancer,

because lung cancer in humans has a hundred mutations. It looks like

the most complicated thing you've ever seen genetically. "

 

Why then are these artificial and intrinsically misleading systems

still being used? The answer is simple. These artificial models are

" …very convenient, easily manipulated, " says Vishva Dixit of the

Genentech company. " You can assess tumor size just by looking at

[them,

ed.]. " There's no thought, still less acknowledgement, given to the

fact that shrinking a tumor, especially in a mouse, has little to say

about human survival or well-being.

 

" Hundreds of millions of dollars are being wasted every year by drug

companies using these models, " says Weinberg. But with the huge

profits

to be made from tumor-shrinking drugs like Avastin, Erbitux and

oxaliplatin, what incentive do they have to stop?

 

 

Shrinking Tumors

 

 

Leaf also tackles the subject of cancer regression, or shrinkage of

tumors, pointing out that it is a totally inadequate measure of the

effectiveness of a drug. (This is a theme I dealt with in depth in my

book, Questioning Chemotherapy, and many times since then.) " It is

exciting to see a tumor shrink in mouse or man and know that a drug is

doing that, " says Leaf. " It is a measurable goal. " But, he

adds, " tumor

regression by itself is actually a lousy predictor for the progression

of disease. " The sad truth is that " regression is not likely to

improve

a person's chances of survival. " Read those words over carefully - you

do not encounter such ideas often in mainstream publications.

 

By contrast, what really matters, says Leaf, is stopping metastases

(secondary growths), which kill the great majority of cancer patients.

" So you'd think that cancer researchers would have been bearing down

on

this insidious phenomenon for years, " he says. In reality quite the

opposite is true. Fortune magazine's examination of NCI grants, going

back to 1972, revealed that less than 0.5 percent of study proposals

focused primarily on metastases. Half of one percent! Of nearly 8,900

grant proposals awarded last year, 92 percent didn't even mention the

word metastasis.

 

According to I.J. (Josh) Fidler of M.D. Anderson, the study of

metastases is avoided by cancer researchers because it is a tough and

so far unfruitful field, and not likely to yield quick and easy

results. Instead, researchers focus on techniques and avenues that

they

know will produce measurable results in the laboratory. The attitude,

Fidler says, is " Here's an antibody I will use, and here's

blah-blah-blah-blah, and then I get the money. " (Fidler, to his great

credit, has published over 250 scientific articles on combatting

metastases.)

 

The current crop of new drugs comes in for scathing criticism as well.

A study done in Europe showed that twelve new anticancer drugs

approved

in Europe between 1995 and 2000 were no better in terms of improving

survival, quality of life, or safety than those they replaced. But as

far as the drug companies were concerned they had one big advantage:

they were several times more expensive to purchase than the old drugs.

" In one case, " says Leaf, " the price was 350 times higher. "

 

Leaf points out that two new blockbuster drugs, Avastin and Erbitux,

are lacking in substantial effectiveness. Avastin, he says, " managed

to

extend the lives of some 400 patients with terminal colorectal cancer

by 4.7 months. " And Erbitux? " Although it did indeed shrink tumors, it

has not been shown to prolong patients' lives at all. " Still, a weekly

dose costs $2,400.

 

The article then features a list of " Miracle Cures That Weren't, "

including radiation therapy, interferon, interleukin-2, endostatin and

Gleevec. As Leaf himself admits, Fortune itself once featured

Interleukin-2 on its cover with a huge headline reading: " Cancer

Breakthrough. "

 

Yet despite the profound importance of what Leaf has to say in this

article, you are unlikely to see the article cited as front-page news.

I was dismayed to find that, this morning, for example, the total

number of citations at Google News for this article was three (out of

4,500 news sources). By comparison, at the time of its announcement

Erbitux was generating over 1,000 articles per day in the same search

engine.

 

Leaf's article can be ordered online at

http://www.fortune.com/fortune/articles/0,15114,598435,00.html (The

March issue of Fortune in which it appeared may still be available at

some newsstands.) However, excellent though this article is, and

delighted though I am to see this subject aired so prominently, I do

regret the fact that Leaf did not take his arguments quite far enough.

For instance, he includes a section on " how to win the war, " but this

seems anemic and hard to follow compared to his previous incisive

analysis. In my opinion, he doesn't deal with the basic economic and

political underpinnings of the war on cancer. The emphasis on

ever-more-profitable drugs is dictated by the very nature of Big

Pharma

and its unhealthy influence on the whole research and approval

apparatus.

 

Also, Leaf fails to cite the most prominent critics of the war on

cancer, especially those with an orientation towards complementary and

alternative medicine (CAM). Thus, while he hits the nail squarely on

the head in many instances (as, for example, when he discusses the

danger of equating temporary tumor shrinkages with increased

survival),

he also misses many other important aspects of the problem that are

well known to people who have followed this field for decades.

 

When he quotes a scientist as saying, " We have a shortage of good

ideas, " this is likely to elicit incredulity from the CAM community.

There are scores of excellent researchers who have proposed exciting

new ideas for treating cancer over the last few decades. Most of them

have been ignored or dismissed out of hand. Some have even been

persecuted. My 1980 book, Cancer Industry, discussed eight such cases.

A dozen years later I published Cancer Therapy, which contains reviews

of over a hundred unconventional treatments, most of which could still

be usefully pursued. Many treatments discussed in my book Antioxidants

Against Cancer have still not been examined, much less acted upon.

 

Let me give one example of an original idea that has been studiously

ignored by the mainstream. I recently received a reprint from my

colleagues Eva and Laszlo Csatary, MD, of their latest results using

MTH-68. This treatment is based on the non-toxic Newcastle disease

virus vaccine and is seemingly quite beneficial in select cases,

especially in brain cancer. The article appears in the most recent

issue of the Journal of Neuro-Oncology, with co-authors from respected

institutions in Germany, Hungary and California. It is not the first

such article that Dr. Csatary has published. I myself co-authored a

best case series with him on this topic in 1999, which appeared in a

respected peer-reviewed journal. Admittedly, this is not exactly a

" new " idea, simply an unrecognized one. In fact, the name of the

compound, MTH-68, refers to the date of its discovery...1968, three

years before the war on cancer was launched, and before many of

today's

cancer researchers were even born. Despite repeated articles and

letters, press releases, news conferences and appeals to governmental

authorities, this promising treatment has made little progress in the

world of conventional medicine. The response from the American " cancer

establishment " to the Csatarys' work has been a thundering silence.

 

But this June, 25,000 oncologists will once again gather at the

American Society of Clinical Oncology (ASCO) meeting for their annual

four-day convention. Don't expect any center-stage attention, though,

for promising non-toxic treatments, such as MTH-68, which could

provide

true departures from the quagmire of the stalled war on cancer. Even

Mr. Leaf, for all his trenchant criticism, seems unaware or

unconcerned

that there are many other treatments that are potentially valuable,

yet

are being systematically ignored. And they will continue to be ignored

until the public, Congress and scientific community wake up to the

fact

that the most powerful force driving cancer research is Big Pharma's

need for a hefty bottom line and a quick return on its investments.

 

It is enough to make the angels weep. "

 

 

--Ralph W. Moss, PhD

 

=======================

 

References

 

Csatary LK, Moss RW, Beuth J, et al. Beneficial treatment of patients

with advanced cancer using a Newcastle disease virus vaccine

(MTH-68/H). Anticancer Res. 1999 Jan-Feb;19(1B):635-8.

 

Csatary LK, Gosztonyi G, Szeberenyi J, et al. MTH-68/H Oncolytic viral

treatment in human high-grade gliomas. Journal of Neuro-Oncology

2004;67:83-93.

 

Leaf, Clifford. Why we're losing the war on cancer. Fortune

2004;149(6):76-97..