ONE IN THREE by ADAM WISHART

Grierson Award

Pleasingly, we just won the Grierson Award for the Best Science Documentary.

Here is a link.

Hooray!

Improve Performance, Rather than Search for New cures

I’ve just finished reading Better by Atul Gawande. Like his previous book, Complications, this one is full of humane and insightful observations about the complexities of medicine.

There is one particularly fascinating chapter about performance, and how you improve performance in medicine. He tells the story of cystic fibrosis. Medicine has remarkably improved the life expectancy of patients over the last thirty years or so. In the sixties patients made it to just ten years old, now most live into theri mid thirties with some patients living much longer.

Too Much Health

There is a fascinating and timely report about Hormone Replacement Therapy in the Guardian today.

Survey after survey has linked hormone replacement therapy to cancer, strokes, blood clots and heart disease. Why, then, are so many women so relaxed about using it? And why do some doctors insist that the dangers are exaggerated? Sarah Boseley investigates

What it reveals is the continued attraction of HRT, more than a million women continue to take it in the UK, although for some of those women its pretty clear that taking HRT is not the optimum intervention.

What I find interesting about this is how compelling medical solutions can appear and how enduring they can be once the public first accepts them to be true. Once an idea like HRT has been promoted in the public realm, and once there is promotion of various sorts floating around, then its very difficult to get the idea our of the public imagination. None of us seem very attracted to the idea that actually medical intervention is bad for you.

I think many of us are afflicted by it. We go to doctors because we think they can help us. And they sometimes fob us off with placebos or what they think is more or less harmless sorts of drugs and interventions, such as HRT.

Its linked to my favourite piece of commentary of the year. Published on January 2nd, some of the best analysts in the business simply state,

For most Americans, the biggest health threat is not avian flu, West Nile or mad cow disease. It’s our health-care system. You might think this is because doctors make mistakes (we do make mistakes). But you can’t be a victim of medical error if you are not in the system. The larger threat posed by American medicine is that more and more of us are being drawn into the system not because of an epidemic of disease, but because of an epidemic of diagnoses.

LINK

Although this is a particularly American problem, UK patients are also afflicted. We demand and demand and demand in some situations where doing nothing might be the right thing to do.

Royal Society Book Prize

ONE IN THREE is on the shortlist of the Royal Society Book Prize.

Its great.

I especially like it because the Royal Society has such a heritage. Newton was its president, after all.

There is an article about it here.

And a comment piece here

THE TERRIBLE STORY OF HOO LOO

This is one of my favourite stories from the book. Its also one of the goriest, the rest of the book isn't quite as bloody. The picture is from the original article - unfortunately it was never included in the book. So now the story has been mentioned in the NY Times seems good to publish it here.

On Saturday 9 April 1831, a year before the passage of the Anatomy Act, but a few months after the opening of the world’s first purpose-built passenger railway, a crowd of men in top hats and coat-tails showed their ‘hospital tickets’ and entered the operating theatre of Guy’s Hospital in London. Hundreds of others jostled on the street outside. An attempt had already been made by the hospital authorities to prevent a scrum by moving the date forward by three days, but the tight, gossiping community of London’s doctors had defeated the ruse.

The patient in question was a 32-year-old Chinese labourer called Hoo Loo, who had disembarked at the Royal Docks from a sailing ship, a so-called East Indiaman, with some difficulty three weeks previously. He was carrying an enormous tumour four feet in circumference, which hung from his lower abdomen, enveloping his penis, to below his knees. It was ‘of a nature and extent hitherto unseen in this country’. Although the size of Hoo Loo’s growth made it exceptional, lumps, boils and malignancies were often seen to disfigure the human form in the age before routine surgery. Hoo Loo’s had been growing for ten years, but his doctors in Canton had refused him treatment. Because it had continued to grow, he had travelled for six months to London in the belief that there the art of surgery was somewhat more advanced and that the profession would have no such qualms in operating on him. On arriving at Guy’s Hospital he must have been aware of the excitement, for as he lay waiting for the operation his days were interrupted by ‘a great number of persons of all ranks’ keen to examine this oriental curiosity.

JANET MASLIN REVIEW - NEW YORK TIMES

"Mr. Wishart reports that during his years of writing and talking casually about cancer, he had a horrifying effect on others. Hearing him, listeners would shiver or quail or walk away. But his book does not prompt that kind of response: Mr. Wishart has done copious research and used it to shape a story more gripping than frightening ... [he] remains too erudite and civilized to succumb to fear."

How good is that?
LINK

Salon.com Review

The wonderful Andrew Leonard at Salon has written the first American review of the book.

"Wishart's genius is in combining the wrenching story of his father's cancer with the broader medical history of humanity's struggle to understand and treat the hydra-headed disease. ... To provide hope to others in the midst of his own sorrow is a marvelous achievement: "One in Three" is a fine piece of work."

LINK (its free, you just have to watch the ad)

CANCER DEATHS DECLINING

The number of cancer deaths in the United States has dropped for the second year in a row, the American Cancer Society reported yesterday. The finding suggests that the small drop reported last year — the first in more than 70 years — was real, possibly the start of a continuing decrease and not merely a statistical fluke, researchers said.

The American Cancer Society's annual study of cancer mortality came out yesterday. And for the second year its great news.

The New York Times, though, has a tinge of pessimism in its second paragraph.
"Although the drop is notable, it still pales in comparison with the number of cancer deaths, 553,888 in 2004.....But it has taken enormous efforts and ingenuity to produce relatively small gains." And there is a graph attached to the piece which makes out that cancer mortality has rising from about 400,000 deaths in the US to about 550,000 since 1980.

Well. Although its right to be cautious, these figures should be cause for enormous cheer particularly because cancer mortality is not an isolated statistic. Since the 1980s, the rates of heart disease have declined by about 25 per cent since the mid 1980s. As the leading cause of death in the US is clattering down, people are dying of other things. And although cancer has been slow to catch up with cardiovascular treatments, it is catching up.

And more than anything this kind of statistic rebutts the widely held belief that cancer rates are increasing.

Link: Second Drop in Cancer Deaths Could Point to a Trend, Researchers Say - New York Times.

ONE IN FOUR PEOPLE SAY CANCER IS DOWN TO FATE

Cancer Research UK did this amazing piece of research, and they discovered that one in four people think that cancer has nothing to do with risk factors and is only down to fate.

It is amazing, after half a century of campaigning about smoking, and twenty five years about the sun, and a least a few decades about five fruit and veg a dag, how little the message gets through. In poorer areas, that number reaches almost half of the population believes its fate.

I think one of the reasons is the complete mumbo jumbo that is so often spoken about the disease. Yesterday a faith healer (admittedly quite a comic one) was on BBC2 explaining that cancer is all about emotions, and Sense About Science recently wrote about the rubbish that celebrities speak about science.

And this really affects people's lives.

It really is time to change how we think about cancer.

"Monkeys, Rats and Me" is now online

My documentary about animal rights and experimentation that was broadcast on the BBC in November has been placed online, not sure by whom.

I'm told by my sources close to the animal liberation movement that the film is also being recut and portions of it are being passed around with their own particular slant. In the event that I can't police that, I figure that having the full thing downloadable at least allows people to see it in its full context.

I really hope more people get to see it. Although the images are a little dodgy, I think the content is as vibrant as provoking as ever.

I'm not sure what the copyright status of it is, I imagine many of the rights are part of the blanket BBC deal. But until the BBC gets its act together to put all this kind of stuff up immediately after its broadcast it seems like its fair game for it to be online.

The links are as follows.
On Google Video. Here.
And in the Internet Archive. Here
I guess its not on Youtube because it doesn't break into 10 minute chunks.

Links to the very fine reviews are here.