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Fourfold Healing Newsletter Exploring
the Fourfold Path to Healing
December
2005 |
Hello, As we move
into the busy holiday season, I hope you'll
take a few minutes to read our latest newsletter. In this
edition, I've taken a hard look at heart disease and heart
attacks, with a close examination of the theories that form
the basis of much of today's treatment. I'm particularly
pleased to share with you a report from a dynamic study group
in Brazil, Infarctcombat.org. If you have any interest in this
topic, I think you'll find the information of great
value.
As an addition to the newsletter, I've included
a book review this round, something I've been wanting to do
for months. I hope you'll find this useful as well.
No
holiday season is complete without a cheery and nutritious
recipe, this time a very simple but delicious Cranberry sauce.
Enjoy!
Warmest wishes to
you and your family for the holiday and coming year. Tom
Cowan |

The
Fourfold Path to Healing A great holiday gift for family,
friends and yourself!
http://www.newtrendspublishing.com/
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IN THIS ISSUE:
|
| Focus:
Redefining Heart
Dis-ease |
Therapeutics: Digitalis and
Strophanthus |
I would venture that there are not five
western trained physicians on the planet who are not completely
convinced that the cause of heart attacks are the blockages in the
coronary arteries. In fact, a common synonym for a heart attack is
to say the patient has had a coronary, meaning he has an illness of
his coronary arteries. The whole edifice
of cardiology, whether conventional or alternative, is based on
strategies for detecting, stopping, clearing, or bypassing blockages
in the coronary arteries. The presumption of all this is the “fact”
that it is the coronary arteries that are the root of the trouble.
Meanwhile studies continue to show that arterial blockage is the
CONSEQUENCE, not the cause, of the heart
attack. Because of my interest in the
heart, I have been studying this seeming paradox for a long
time.
Read
on… |
Is there any way to affect the
heart cells so that they are able to extract oxygen more efficiently
and therefore be less susceptible to the acidosis that is the
underlying basis of a heart attack? One thing, of course, is to
avoid stress, but there is another perhaps more straightforward
possibility. It has been known for
centuries that there are a few plant medicines that clearly increase
the efficiency of the heart cells. The medicines in these plants are
called cardiac inotropes because they increase the ability of the
heart to “pump” blood by increasing the efficiency of the cells and
improving the overall contractibility and elasticity of the heart.
The two main plants that do this are Strophanthus, an African vine,
and Digitalis, common foxglove, which makes the heart glad, and is a
good friend of the old man.
Continue... |
| Guest
Report: Two Heart Disease Theories, Same
Therapeutic Treatment by Carlos Monteiro,
independent researcher and president
of Infarct Combat Project. He is a defender of the Myogenic Theory
of myocardial infarction since its development in 1972. |
|
Book Review:
"Should I Be Tested for
Cancer?" Nourishing
Recipe: Cranberry
Sauce Update: WAPF Conference
Report |
| Focus:
Redefinng Heart Dis-ease |
I would venture that there are not five western
trained physicians on the planet who are not completely
convinced that the cause of heart
attacks are the blockages in the coronary arteries. In fact, a
common synonym for a heart attack is to say the patient has had a
coronary, meaning he has an illness of his coronary arteries. The
whole edifice of cardiology, whether conventional or alternative, is
based on strategies for detecting, stopping, clearing, or bypassing
blockages in the coronary arteries. Some say the blockages are from
cholesterol, others say it is homocsyteine, still others say it is
inflammation that causes the blockages, even perhaps in the form of
an undetected infection. When therapeutic strategies based on these
fail, the next step is to bypass the blockages with an operation
called a coronary artery bypass graft (or CABG for those into
sauerkraut), or roto-rooter them out with the whole array of modern
devices available to the modern cardiologists. The presumption of
all this is the “fact” that it is the coronary arteries that are the
root of the trouble. I, and others, beg to differ.
In a 1998 editorial in The American Journal of
Cardiology (1998 Oct 1; 82(7):
896-897), Dr. W.W. O’Neill commented about a
paradox in recent findings. In a number of trials of myocardial
infarctions (hereafter referred to as MIs, more commonly known as
heart attacks), many of the patients who suffered recent MIs were
not found to have blockages in the arteries that led to the area of
the heart that had suffered the infarction. This should have been
big news, for what this cardiologist was saying was that when we
look carefully at the angiograms (the test where we squirt dye into
the arteries in the heart to see if they are blocked) of people who
are having or who have recently had an MI, in some we find the
artery is blocked and in others we don’t. This is actually a
shocking statement, but to realize how shocking and controversial it
really is we need to look at some history here.
Back in the late 1930s and early 1940s, heart
attacks were first becoming prominent in American society, due
largely to the rapid change in the American diet. Doctors wondered
what was causing this relatively new phenomenon. Many theories were
proposed, but the one that stuck was called the Thrombogenic Theory
of Myocardial Infarction. Essentially this theory postulated that
heart tissue, like any other tissue in the body, has a blood supply.
When this blood supply is compromised by, say, plaque buildup in
that blood vessel, then the cells “downriver” from the blockage will
have their blood supply choked off, and under certain situations
those cells will be deprived of their necessary food and oxygen and
eventually will die. When they are dying because of inadequate flow,
there is a painful feeling around the heart which we call Angina.
When the cells actually die, we can that an Infarction. This is
often a catastrophic event and many patients die as a result of the
dysfunction of the heart itself as a consequence of their MI, or
heart attack.
Many cardiologists and other doctors disagreed early
on with this theory. They asked why it is only the heart that
infarcts in this way. After all, this plaque development is in no
way specific to the coronary (heart) arteries. Why do we not hear of
liver attacks, foot attacks, and so on? Another criticism of the
theory revolved around the well known phenomenon of collateral
circulation: In many parts of the body, when an artery is blocked,
the body “bypasses” the blocked vessel and makes a secondary
(so-called collateral) circulation. Why not in the heart as well?
These were the two main reasons many physicians didn’t buy the
blocked coronary artery theory.
Since the thrombogenic theory was accepted in the
early 40s as bottom line fact-of-the-matter, there have been a
number of studies that have attempted to document that all people
having MIs have blocked arteries to that area of the heart. But
these studies have all failed miserably to show this connection. In
a paper by Murakami in 1998 (Am J Cardiology,
1998;82 :839-44), the author found that, of
those with an acute MI, 49% have a recent thrombus (blockage), 30%
have no thrombus, 14% had moderate plaque (not considered enough to
cause an MI), and 7% had “another condition”. Roberts, in an earlier
paper (Circulation, 1972; 49:1), showed that in cases of acute MI with sudden death, 50-60%
had evidence of sufficient thrombus to account for the MI. Spain and
Bradess’s 25-year autopsy study of patients who died of heart
attacks found 25% had sufficient thrombus to account for their MI
and 75% had atherosclerosis (arterial blockages of some degree)
(Am J Med Sci, 1960; 240:701). And finally and perhaps most importantly, these same
authors in another paper (Circulation 1960, 22:
816) found that the longer the time elapsed
between the MI and the autopsy, the more likely they were to find
blockages. After one hour only 16% had sufficient blockage to
account for the MI, whereas after 24 hours the total increased to
53%. The authors concluded that the arterial blockage is the
CONSEQUENCE, not the cause, of the heart attack. This is why in
every study I have seen, the longer the time interval between the MI
and either the angiogram or autopsy, the more likely you are to see
the blockage. How can we account for the results of these studies?
Even if the number is 75%, the highest in the literature, what
happened to the other 25%? Why did they also have an MI if their
arteries weren’t blocked?
Because of my interest in the heart, I have been
studying this seeming paradox for a long time. The usual
explanations for this inconsistency between the theory and the facts
is that some people have a spasm of their coronary arteries which,
in the absence of the plaque, is enough to kill them in some cases.
The trouble with this theory is that as far as I know no one has
ever seen this occur, and it seems a bit implausible that a
completely healthy artery somehow goes into a spasm, and next thing
you know, the person dies. The more I thought about it, I felt
something was wrong with this whole story.
Very recently, through a serendipitous internet
encounter, I ran across a different theory which may explain the
whole series of facts surrounding the cause and thus the treatment
of MI/angina. The myogenic theory proposed by the Brazilian
cardiologist Dr. Mesquita states that, rather than coronary artery
disease causing MIs, the blockages are actually the consequence of
the MI. According to Mesquita’s theory, the heart, because it is
such an active organ and has such a high oxygen demand (like the
brain, the other site of “infarctions” which we call strokes), is
always a bit tenuous in its ability to extract enough oxygen from
the blood. Exercise or other physical or mental activity increases
the need for the heart cells to extract even more oxygen. As a
result of stress, particularly chronic stress, the small blood
vessels in the heart become constricted, which then compromises what
we call the micro-circulation in and around the heart cells. This
leads to decreased oxygen supply, especially with physical exertion,
then anaerobic metabolism (meaning without air), then acidosis as
the lactic acid builds up through this metabolism with an oxygen
deficit and eventual death of the cells. After the cells die, an
inflammatory reaction occurs which eventually compromises the artery
leading to that artery, filling it with inflammatory debris that we
see on autopsy and angiograms.
Let me try to explain this in another way. Under
stress, especially chronic stress, the body over-excretes adrenaline
and other stress hormones. These hormones cause the small blood
vessels all over the body to constrict, which is why doctors and
dentists, when they don’t want a tissue to bleed while they are
suturing, inject Adrenaline in the area. Constricted blood vessels –
and these are the small vessels, capillaries, not the coronary
arteries – choke off the blood flow and hinder the removal of the
wastes, predominantly acidic waste products. If this continues for
many years and is exacerbated by increased demand like exercise,
then the heart cells can die or become infarcted. It has nothing to
do with plaque or blockages in the bigger arteries as these the body
can easily bypass as they build up very slowly through the years.
This explanation fits all of the known facts about the timing and
development as well as the epidemiology of MIs, particularly in
relationship to the crucial role that chronic stress plays on the
development of MIs. I would also add that it is perfectly compatible
with my claim that the heart is not the “pump” of the body.
This decades-long study by Dr. Mesquita is a truly
remarkable contribution to our understanding of cardiology and the
etiology of heart disease. Because of this, I have included in this
issue a report by Carlos Monteiro on Dr. Mesquita’s studies (see
below).
If this Myogenic theory is correct, then the
billions of dollars spent on clearing out arterial blockages is
essentially an exercise in futility, which is pretty much what the
studies on longevity have shown. I am not saying that after an acute
MI it is not important to “flush out” the artery. After the event,
this flushing can be helpful, although probably not needed. What I
am saying is that this clearing of arterial blockages does nothing
to address the true cause of this illness.
The next step is to ask the question: Is there any
way to affect the heart cells so that they are able to extract
oxygen more efficiently and therefore be less susceptible to the
acidosis that is the underlying basis of the MI? One thing, of
course, is to avoid stress, but there is another perhaps more
straightforward possibility. It has been known for centuries that
there are a few plant medicines that clearly increase the efficiency
of the heart cells. The medicines in these plants are called cardiac
inotropes because they increase the ability of the heart to “pump”
blood by increasing the efficiency of the cells and improving the
overall contractibility and elasticity of the heart. The two main
plants that do this are Strophanthus, an African vine, and
Digitalis, common foxglove. I discuss these two in the next piece in
this edition.
(back
to top) |
|
Digitalis and Strophanthus
Digitalis Digitalis is probably the oldest heart medicine, in fact
one of the oldest medicines of any type, still in common use.
Commonly known as the beautiful plant Foxglove, one still finds
digitalis growing in most herbal and flower gardens in the western
hemisphere. It is a striking plant, growing very tall and straight
with amazing speckled bells coming off a central stalk. The mythos
surrounding digitalis is that it makes the heart glad and is an
especially good friend of the old man. Traditionally, it has been
used for the condition known as dropsy in which, appropriately
enough, the circulation slows down and can’t go uphill through the
veins anymore. Eventually gravity takes over and the blood and fluid
fall to the feet and into the lungs. The feet become swollen and
lifeless, and the choking fluid builds up in the lungs. In modern
times, we call this condition congestive heart failure.
Digitalis is a positive inotropic agent, which means
it makes the heart “pumping” action more effective. In terms of how
I see the heart, rather than increasing the pumping action of the
heart, I would say it increases the flow of the circulation and
improves the elasticity of the cardiac chambers. When the heart
chambers are more elastic, they can hold back the blood more
efficiently. Therefore when the gates open the forward flow is more
effective. Almost miraculously, when patients with dropsy are given
digitalis, within days they can breathe again, the fluid circulates,
the swelling goes out of the feet and in many cases even erections,
so dependent as they are on blood flow, will return. Truly the
friend of the old man.
On a cellular level, science has shown that
digitalis works its magic on the cell membrane, increasing the
activity of the sodium/potassium pump, thereby keeping the
electrical charge on the cells intact. This is important from the
myogenic theory point of view, as it is the activity of the
sodium/potassium pump that prevents acidosis from occuring. Acidosis
is the central pathological mechanism behind myocardial infarction.
Even better, digitalis has this effect not only for the heart cells
but for every cell of the body. Many famous alternative oncologists,
such as Max Gerson, MD, view this sodium/potassium imbalance and
subsequent acidosis as the central mechanism in the development of
cancer. (For more information on
digitalis use in the treatment of cancer, visit the Digitalis
page on our website.)
In a number of studies over the years, a surprising
finding keeps showing up which has only recently become explainable.
In autopsies and other studies of patients who died of or had an MI,
trace amounts of digitalis compounds (digoxin and digitoxin) have
been found in the blood, even in patients who had never taken the
drug. As with opium and endorphins, the two main ingredients in
digitalis are mimics of the endogenous (meaning normally within the
body) hormones that regulate the contractions and rhythms of the
heart. In other words, digitalis in some ways is an externalized
replica of the way the heart communicates with itself. It is the
plant form of the communication of the heart.
It should be no surprise then that studies of the
use of digitalis for angina and myocardial infarction show
digitalis’s remarkable ability to prevent or reverse the symptoms of
myocardial disease, even in acute situations.
Strophanthus I first encou ntered Strophanthus about 25
years ago from my primary teacher in medicine, a German physician by
the name of Otto Wolff, MD. He was passionate about Strophanthus,
even having gone so far as to make a few treks into the African
jungles to observe the habits of this tremendous creeping vine
firsthand. He observed the indigenous native tribesmen who dipped
their arrows into a slurry made of an extract of the seeds of
Strophanthus, which they used to temporarily paralyze their prey.
The Strophanthus seeds were found to contain an oily substance with
a chemical called oubain, which was found to be a potent cardiac
inotrope, even stronger that digitalis.
Initial enthusiasm for strophanthus as a medicine
was tempered when it was claimed that the oubain could not be
absorbed into the body through the oral route. As time went on, much
to Dr. Wolff’s disappointment, it was nearly abandoned as a
medicine. Then a few studies were done in association with the one
remaining manufacturer of oubain, the medicine now being called
Strodival. One study of patients with angina showed 81% of patients
had complete remission of their anginal (chest pain) symptoms, as
compared to 72% of the control group who did not take Strodival and
whose angina worsened (World Research Foundation report). A second
study showed that after MI, the use of Strodival decreased the
evidence of progression of the MI – often within minutes – in 85% of
the subjects, a remarkable result. It was found that, as with
digitalis, the heart uses oubain in its endogenous communication
system. It is as if digitalis and strophanthus contain exact copies
of the hormones that the heart uses to regulate its own beat and
elasticity.
Luckily for us, the fears of my dear teacher Otto
Wolff may not come to pass. A number of cardiac clinics and
hospitals in Europe have rediscovered the cardiac tonic effect of
strophanthus as well as its swift onset of action. It is said that a
sublingual dose of Strodival will often stop angina within minutes
and can also have a positive effect on developing MIs again within a
very brief period of time.
I would encourage all my patients with an interest
in digitalis and strophanthus in the treatment of angina/MI to read
carefully the following article, visit the website http://www.infarctcombat.org/,
and then get in touch with me to discuss this further.
(back
to top) |
|
Guest
Report: Two Heart Disease
Theories, Same Therapeutic Treatment by Carlos
Monteiro
“I
wish it was easy to write about Digitalis – I despair of pleasing
myself or instructing others in a subject so difficult. It is
much easier to write about a disease than a remedy. The former is
in the hands of nature and a faithful observer with an eye to
tolerable judgment can not fail to delineate a likeness; the
latter will ever be subject to the whims, the inaccuracies and
the blunders of mankind." William Withering, Letter, Sep 29,
1778
For centuries, drugs that increase the power of
contraction of the failing heart have been used to treat congestive
heart failure (sometimes called dropsy). The cardiac effect is due
to the content of cardiac glycosides. Squill or sea onion,
Urginea (Scilla) maritima, a seashore plant, was known by the
ancient Romans and Syrians and possibly also by the ancient
Egyptians. Squills were used erratically, but some prescriptions
indicate that they may have been used for the treatment of edematous
(sodium retention) states. The toxic effect of the strophanthus
species was known from poisoned arrows used by the natives in
Africa. Digitalis, derived from the foxglove plant, Digitalis
purpurea, is mentioned in writings as early as 1250: A Welsh
family, known as the Physicians of Myddvai, collected different
herbs, and digitalis was included in their prescriptions. However,
the drug was used erratically until the 18th century, when William
Withering, an English physician and botanist, published a monograph
describing the clinical effects of an extract of the foxglove plant.
In 1785, the indication and the toxicity of digitalis were reported
in his book, An Account of Foxglove and Some of its Medical Uses
with Practical Remarks on Dropsy and Other Diseases. In the 19th
century, digitalis was called “a God-given remedy” or the “opium of
the heart”.
Theory 1: Herrick’s Coronary Thrombosis
(Thrombogenic) Theory In his classic paper written in the
early 20th century, James Bryan Herrick (besides presenting his
proposition of a pathophysiological triggering mechanism) wrote of
his therapeutic experience using digitalis and strophanthin for
angina pectoris and coronary thrombosis:
“...If these cases are recognized,
the importance of absolute rest in bed for several days is clear. It
would seem to be far wiser to use Digitalis, Strophanthus or their
congeners than to follow the routine practice of giving
Nitroglycerin or allied drugs. The hope for the damaged Myocardium
lies in the direction of securing a supply of blood through friendly
neighboring vessels, so as to restore so far as possible its
functional integrity. Digitalis or Strophanthus, by increasing the
force of the heart’s beat, would tend to help in this direction more
than the Nitrites. The prejudice against Digitalis in cases in which
the Myocardium is weak is only partially grounded in fact. Clinical
experience shows this remedy to be of great value in Angina, and
especially in cases of angina with low blood pressure, and these
obstructive cases come under this head. The timely use of this
remedy may occasionally in such cases save life. Quick results
should also be sought by using it hypodermically or intravenously.
Other quickly acting heart remedies would also be of service."
Herrick’s priority in his treatment approach was to
preserve the myocardium in front of coronary thrombosis. This
clinical approach was largely ignored by his colleagues; perhaps it
didn’t sound plausible, possibly due to the absence of experimental
support. Or perhaps Withering was right in his despair of trying to
explain a remedy (see above
quote). Regardless, the fact is that Herrick’s
therapeutic approach isn’t largely discussed at medical schools or
in scientific papers. As a result, most physicians remain in total
medical ignorance about his clinical practice in the treatment of
angina and acute myocardial infarction (AMI), also known under the
general term “heart attack”. Herrick’s Thrombogenic Theory was
adopted, but his therapeutic conduct was forgotten.
“The
cardiac patient does not die from coronary disease, he dies from
myocardial disease!” George E. Burch, cardiologist and teacher,
1972
Drew Luten, professor at Washington University
School of Medicine, said in his book The Clinical Use of
Digitalis, published in 1936: “There is no evidence that the
mere occurrence of coronary thrombosis constitutes an indication for
digitalis.” He also said: “Without minimizing the possibility of
risk inherent in the theoretical objections above noted, it should
be kept in mind that the existence of any special danger from
digitalis in patients with coronary thrombosis has not been proved.”
Nonetheless, there was no citation in Drew Luten’s book about the
positive clinical experiences from Herrick and others regarding the
safe and effective use of digitalis in front of coronary thrombosis.
This repeated omission over time has certainly
contributed to the formation of the current dogma on how to deal
with heart disease.
Even so, different doctors in different times and
countries have used Digitalis and Strophanthin (Ouabain) in the
treatment of acute myocardial infarction and angina. Some doctors
also used it as prevention therapy. In Germany today, some 3,000
physicians still use the oral (sublingual) Strophanthin in angina
and acute myocardial infarction.
Theory 2: Mesquita’s Myogenic Theory of
Myocardial Infarction In 1972, Quintiliano H. de
Mesquita, a Brazilian cardiologist, professor and scientist,
developed a new pathophysiological explanation for the triggering of
heart attacks or acute myocardial infarction which he named
"Myogenic Theory".
In Myogenic Theory cardiac glycosides, such as
digitalis or strophanthin/ouabain, are compatible remedies for acute
myocardial infaction. According to Mesquita, the treatment with
these cardiotonics should be started as early as possible in order
to correct the regional myocardial collapse in progress.
Mesquita also stated that cardiotonic administration
protects the myocardial fibers in collapse, ischemia, and is useful
in preventing the necrosis which certainly could occur in without
the use of this remedy. Once past the acute period, the cardiotonic
should be used as a maintenance treatment, which blends with the
myocardial infarction prophylaxis, in order to defend the ischemic
myocardium in its functional side. (Cardiac ischemia is the name for
lack of blood flow and oxygen to the heart muscle.)
Professor Quintiliano de Mesquita and his team at
Matarazzo Hospital in São Paulo, Brazil, have applied cardiotonics
intravenously (digitalis or strophanthin/ouabain) in 1,183 patients
with acute myocardial infarction, recording a survival rate of
almost 90%. By using intravenous strophanthin in 126 cases of
unstable angina, he avoided the AMI with 0% hospitality mortality
rate. In 1975, he was awarded the Ernst Edens Traditionspreis, a
prize given by the International Society to Fight against Myocardial
Infarct, located in Stuttgart- Germany.
Treatment In 2002 Quintiliano de
Mesquita published a new paper that presented his clinical
experience using digitalis over a period of 28 years in the
prevention of congestive heart failure and acute coronary syndromes
(unstable angina, acute myocardial infarction and sudden death). The
study involved 1,150 cardiac patients. The global mortality rate for
the patients without previous myocardial infarction was 14.2%, while
the global mortality for the patients with previous myocardial
infarction was 41.0% (1.4% per year). Surprisingly, the cancer
mortality in the wake of this 28-year study was just 1.7% in total,
confirming studies that show digitalis useful as anti-cancer agent,
inhibiting proliferation and inducing apoptosis (cell death).
Quintiliano de Mesquita’s 2002 case study used the
following cardiac glycosides: Digitoxin, Digoxin, Acetildigoxin,
Lanatoside-C, Betametildigoxin or Proscillaridin-A (Scilla), at
therapeutic daily doses - nontoxic, preferably lower.
Some special remarks about digitalis:
Beyond its properties as inotropic positive
agent which stimulates cardiac contractility, low doses of oral
digitalis have potentially beneficial modulating effects by
decreasing excessive neurohumoral responses, improving symptoms, and
protecting against the progressive deterioration of cardiac
dysfunction. The noradrenaline/adrenaline blocking by low doses of
digitalis can also be helpful in preventing acute coronary syndromes
triggered by mental stress.
It is important to note that during the 19th
century the term congestive heart failure was also used to designate
other diseases of the heart and, until the beginning of the 20th
century, digitalis was prescribed for the treatment of organic heart
disease, including angina. At that time digitalis was extensively
indicated in hypertension cases to prevent heart failure.
The recent discovery of endogenous
cardiotonic hormones (digitalis-like substances) in mammals serves
as a new important argument for the Myogenic Theory. From our point
of view cardiac glycosides and other cardiotonics found in nature
are the “insulin for heart disease” because they can complement an
eventual and deficient production of endogenous cardiotonic hormones
produced by the human body and thus support cardiac metabolism and
protect the heart from the infarction, as proposed in Myogenic
Theory.
In parallel, an unusual but interesting new
hypothesis states that alterations in the metabolism of endogenous
digitalis-like compounds and in their interactions with the
Na/K-ATPase may be associated with the development of
cancer.
About Carlos Monteiro Carlos
Monteiro is an independent researcher and president of Infarct
Combat Project. He is a defender of the Myogenic Theory of
myocardial infarction since its development in 1972, helping Dr.
Mesquita and his team as assistant and collaborator. After Dr.
Mesquita’s death in 2000, he continued the fight, as an independent
researcher, for the Myogenic Theory point of view. Infarct Combat
Project is an international non-profit organization, Internet based,
providing information, research and education to fight heart
disease. ICP was created in 1998 at http://www.infarctcombat.org/.
Email: secretary@infarctcombat.org.
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Should I Be Tested for Cancer? by H. Gilbert Welch,
M.D., M.P.H.
Gilbert Welch, M.D. is a family practice physician,
epidemiologist, and professor of medicine at Dartmouth Medical
School, in my former home state of New Hampshire. He has written one
of the most important and controversial books on medicine since
Medical Nemesis was written by Ivan Illich in the late 1960s. Dr.
Welch’s book takes on perhaps the most sacred cow in all of
conventional medicine (which, by the way, Dr. Welch counts himself
as a practitioner of conventional medicine), getting screened for
early disease detection. Does catching illness at its early stage,
in particular cancer, improve the outcome? At first glance, this
question is so obvious as to be almost ludicrous. After all, if you
diagnose a serious illness like cancer early, then certainly the
patient stands a better chance of surviving. Dr. Welch decided to
take a look at all the studies done throughout the entire world that
were attempts to prove this theory, and he then wrote a book about
what he found.
Before I get into the book, let’s be clear about
some definitions. We are talking here about screening for cancer on
a person who is well, has no signs of illness, who goes in for a
test because it is the “designated” time. This study and my comments
do not include a person with a cough, difficulty passing urine, a
breast lump, or other signs and symptoms. These people are not being
screened; in this situation, we are looking for a reason for their
difficulty. This is a different (although somewhat unexplored)
situation altogether.
We are talking only about screening. As an
interesting historical note, in the 1940s more than 97% of visits to
medical practitioners were generated by the patient to address some
issue concerning that person. Now, more than half of all medical
visits are exclusively about screening, “prevention,” including
things such as annual physicals, well baby exams, vaccination, etc.,
or about following up or treating “illnesses” that were unnoticed by
the patient and found by the doctor. Until now there has been very
little data on whether this enormous industry of prevention actually
does anyone any good. We now have that information concerning the
subject of cancer, thanks in part to this book.
According to Dr. Welch only two studies have ever
shown a survival benefit from the disease that was being screened
for. The first is called the HIP mammography study, one of the
largest mammogram studies ever done. In this study the
deaths-per-1,000 rate for breast cancer fell from about 6.8 in the
unscreened to about 5 per 1,000 in the group that had yearly
mammograms. A modest, but significant drop. The second study was
called the Minnesota fecal occult blood test, in which people in
Minnesota were screened for blood in their stool every year for ten
years as a way of detecting cancer of the GI tract. Again, almost
identical numbers were found, a drop from a death rate of 6 per
1,000 from colon cancer in the unscreened group to about 4.8 per
thousand in the screened group. The amazing thing about both of
these studies, again the only two he claims showed a significant
drop in the death rate from any screening study, is that when you
chart not the death rate from breast or colon cancer but the
all-cause death rate meaning simply who was alive in 10 years, the
rates were an identical. EXACTLY identical. On that same note, I
sometimes tell my patients: If you care about what you die of, then
you could do a screening test. If you care whether you’ll die or
not, then don’t bother. (All my patients fall into the second
category!)
Dr. Welch also studies epidemiological data
concerning prostate cancer over the past 40 years. He states that in
the TURP era, when the diagnosis of prostate cancer was made by
sticking a long brush up the man’s penis and running it back and
forth a few times (not a lot of men signed up for that test), the
incidence of prostate cancer was about 100 per 100,000 men. In 1990
when the blood test for prostate cancer came into wide use, the PSA
test, the incidence skyrocketed to about 220 cases per 100,000 men.
The whole point of this endeavor was that finding it early would
result in fewer deaths from this disease. However, plotting out
those numbers instead shows only a SLIGHT increase in the prostate
cancer death rate since the introduction of the PSA test. Recently,
I had dinner with a retired doctor who spent his whole life
diagnosing prostate cancer on slides. I asked him, “What is the
incidence of prostate cancer in a 75 year old man who dies from a
car accident.” His reply surprised me: “Whatever you want it to be.”
He explained that if you give him 10 minutes to search, he will find
cancer cells in about 15% of these men. If you tell him to take the
whole week and find any prostate cancer cells if they are present,
he will find it in 100% of these men!
Dr. Welch reviews many studies like these I’ve
mentioned all with similar results. The conclusions he comes to are
that screening for cancer has never been shown to improve outcomes
for patients, and that it is an enormously expensive (we’re talking
trillions of dollars here), fear-producing, somewhat futile
undertaking. What are some the reasons for this futility? Among them
is that most cancer will never actually hurt a patient; screening
inherently finds mostly slow-growing cancer, whereas the more
aggressive tumors more likely to hurt an individual are found by the
person himself. Also the treatments we use may do more harm than
good. We as a society get scared literally to death by all this
cancer fear mongering. And by spending all this money on useless
tests we are bankrupting ourselves and therefore unable to spend the
money where it might do some good, for example on cleaning up the
rivers. There are probably many other reasons for the failure of
screening as a preventive measure. That it has and continues to fail
will not be disputed by anyone who reads Dr. Welch’s enlightening
book.
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A Recipe
from Jessica Prentice - Fresh Cranberry
Sauce
There is no reason to buy canned
cranberry sauce for this holiday season. It is very easy to make and
tastes much better.
Ingredients:
12 oz fresh
cranberries 2/3 cup maple syrup 1/3 cup water pinch of
cinnamon and cloves (optional) honey to taste
Procedure:
- Wash the cranberries and put in a pan.
Pour the maple syrup and water over them, add the optional spices,
and bring to a simmer.
- Cook until the cranberries pop open,
about 10 minutes. Remove from heat and allow to cool for about 15
minutes.
- Stir and taste. Add honey by
spoonfuls, stirring, until it is a little bit sweeter than you
want because it will lose some of its sweet taste when you chill
it.
- Allow to cool to room temperature,
then refrigerate until ready to eat.
Jessica Prentice is both
a professional chef and a passionate home cook. She currently
conducts cooking classes, writes a monthly New Moon Newsletter on
her Wise Food Ways website, and
offers monthly Full Moon Feasts in the Bay Area. She is a Bay Area
chapter head for the Weston A. Price Foundation for wise traditions
in food, farming, and the healing arts. She is at work on a book
about food and culture, due out in Spring 2006 from Chelsea Green
Publishing.
© 2005
Jessica Prentice
|
| Update - WAPF Conference
report |
The 6th Annual
Wise Traditions conference contributed by Larry
Wisch
The 6th annual Wise
Traditions Conference was held November 11-13 in Chantilly, VA.
What follows is a brief report from my experience there as the San
Francisco chapter leader and first time conference participant.
The Weston A. Price Foundation conference was
founded in 1999. In that first year there were 64 attendees at the
conference. This year nearly 900 people attended, of which about 150
of us were local chapter leaders. This international organization
now has a total of 7,500 members and 350 chapters worldwide.
With 40 exhibitors and 10 sponsors, the conference
center felt like a combination of a farmers’ market and green
festival. Attendees could meet and ask questions of many of the
suppliers that advertise in the WAP quarterly Wise Traditions. The
food hall had farmers’ stalls selling raw cheeses, grass-fed meats,
dense fresh breads, salmon jerky, ferments, raw butter, coconut
concoctions, natural root or ginger beers, and much more.
In the tradition of conscious nutrition, lunches and
dinners at the event were catered by Chefs John Umlauf and K.
Michael Sullivan. "Have a little fruit on your whip crème". What a
pleasure to attend a conference at a hotel and not fear the food!
Information on the program and schedule of speakers
can be found on the WAPF website at
www.westonaprice.org/conference/. This year, there were 35
interesting presenters, all of whose talks will be available through
Pfeffer Productions at (443) 528-3997.
In addition to the keynote speeches, there were
different tracks each day. I followed the lacto-ferment track on day
one and the cancer track on day two. Other tracks covered biological
dentistry, fertility issues, nutrition in schools and hospitals
(what a novel concept!), and heart disease. Of course, issues of raw
milk and of appropriate fats were also discussed.
High points for me were the talks by Sally Fallon,
Tom Cowan and Sandor Katz. Sally has a way of presenting radical
information in a digestible manner (pun intended). Dr. Cowan
received a standing ovation for his cancer presentation. Sandor
gives practical lessons and great samples about fermentation and
food activism. Three doctors spoke at length on Vitamins A, D and
B12. I'd rather ingest them than hear about them, but the audience
seemed attentive.
The event wasn’t all lectures and presentations. On
Friday evening there was a dance and on Saturday an awards banquet.
I must have been at the right conference because everyone I met was
interesting and fun to chat with.
On Monday there was a day long meeting of chapter
leaders. Eight presenters gave reports on the works proposed or in
progress. Topics ranged from web-based ordering systems to San
Francisco's Nourishing Our Children Campaign to a nutrition
curriculum to local WAPF franchise stores. Very inspiring
developments.
I recommend attending this conference, and will
continue to do so whenever I can. What a great opportunity for
education in an environment of like-minded, concerned
people.
Larry Wisch is a San Francisco WAPF
chapter head.
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|
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Fourfold Path to Healing
Newsletter © 2005 by Thomas S. Cowan, MD.
Not to be reproduced without permission. Material included in this
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