Lance Armstrong

Cancer is a pretty common talking point for various sorts of celebrities. But nobody has grasped the essence of the disease with such profound understanding as Lance Armstrong. Here he is last week on Capitol Hill.

What is interesting about Lance is that he is trying to do a number of things. First his LiveStrong foundation is trying to put out the message that cancer is a survivable disease. Then he is calling for the US Government to adopt some of the most boring, but ultimately the most sensible, strategies for cancer prevention. So he is suggesting that colon cancer screening for the low income population increases. Rather than demanding enormous increases in blue sky research for a cancer cure - although he'd like a bit of that too.

In a sense he is one of the first celebrities to really understand the modern meaning of the disease.

David Lodge

David Lodge, the author of Small World, Changing Places and Nice Work, says this about my book.

"One in Three shines like a good deed in a world full of unnecessary books. No disease exerts such universal dread as cancer, and yet few of us really understand its nature. By interweaving a moving, but unsentimental, account of his father’s last illness and death with a lucid history of cancer and the efforts of medical science to find a cure for it, Adam Wishart has produced a book that is informative, balanced, accessible, and absolutely riveting."

How good is that?

Clare Rayner

Claire Rayner, long time agony aunt, one-time cancer patients and President of the Patients Association has lovely things to say about my book.

“This book is a remarkable meld of medical history, scientific fact, and the human experience of cancer, once – and to an extent still – the most feared of diseases. Adam Wishart follows his father’s experience of cancer, as well as his own as a son, in the most enthralling manner possible. I couldn’t commend it more highly.”

How good is that?

Half of All Cancers are Preventable

This is interesting. The American Cancer Society says that so many cancers are preventable. Never mind the advances in treatments (or the scares about pesticides) - if only we followed a few simple things.

At least half of all cancer deaths could be avoided if we only did what we know works to prevent the disease. That's the conclusion of the 2006 edition of Cancer Prevention and Early Detection Facts & Figures, a yearly American Cancer Society report.

Cutting out tobacco, making use of cancer screening tests, reducing levels of obesity and overweight, and improving nutrition and physical activity could go a long way to lowering the number of cancer deaths in the United States, the report says.

Link.

Attack

So after I attacked Vyvyan Howard, he has responded.

He has written a letter in the Guardian.

Adam Wishart's attack on us (Response, March 30) over environmental influences in cancer is political rather than scientific, in that he does not address any specific scientific issue we raised. Wishart is a graduate in politics and philosophy, so maybe it is not surprising that he doesn't wish to engage on the latest science concerning cell signalling disruption by xenochemicals.

The part of the letter that I find most interesting is

We wrote our paper as a scientific article. It underwent peer review and was published in a respected academic journal. It is doubtful that Mr Wishart's book will undergo such rigorous scrutiny.

Its interesting, parts of my book have been reviewed by more than a dozen senior scientists. Karol Sikora one of the most senior cancer scientists in the UK, and an advisor to the WHO, read it and said that it was accurate.

And yet Howard's article was written in the Journal of Nutritional and Environmental Health. Its a journal that does not even win a place in Pubmed. According to this website it seems that the journal hasn't published for a year. Howard's article was published online - and not as part of the normal publishing process.

Moreover, the journal is doubtless respected but within a quite small group of scientists. The editorial board includes many members of the alternative health community. And its most senior editor is Damien Downing who runs a company promoting nutritional responses to health.

I'm not saying that my book should be given more credence. I'm only saying that Howard is making a political as well as a scientific point. He should at least acknoweldge that.

Parents, don't fall for this pesticide/cancer scare story

The Guardian have kindly published a piece by me in their repsonse page.

The myth that pesticide residues are causing a rise in cancers has once again surfaced (Scientists warn parents on pesticides and plastics, March 21). Professor Vyvyan Howard and John Newby of Liverpool University argue that "low levels of chemicals from pesticides and plastics could affect the development of babies before they are born and increase their likelihood of developing cancer later in life". In fact, although the claim is intuitively appealing, it is unlikely to be true. During the three and a half years researching my book on the history and science of cancer, I found no mainstream scientific organisation that subscribes to this theory and I repeatedly met scientists who complained that there is little evidence to justify it.

And it continues like this. Link

This was the original article.

Interestingly the Guardian ran a whole pile of letters about the subject.

Flu may trigger childhood leukemia

The study finds that just a few months after two especially severe flu outbreaks in the U.K. there were sharp peaks in cases of acute lymphoblastic leukemia (ALL), a form of childhood leukemia.

This is not proof that flu causes any kind of cancer in children, stresses study leader Michael Murphy, MD, director of Oxford University's Childhood Cancer Research Group. But the findings support theories that flu and other infectious diseases might play a role in the ongoing slow-but-steady increase in ALL.

Link

Fat or Fiction

H Gilbert Welch and his colleagues describe wonderfully the problems of assessing the effects of dietary fat in The Washington Post

"The best data to date suggesting the potential for diet -- or any lifestyle alterations -- to affect cancer risk is limited. The single notable exception is smoking: There is no doubt that not smoking dramatically lowers cancer risk.

The effect of diet on cancer is likely to be small for most people because diet is so heterogeneous and the effect of any given food may depend on its interaction with other foods. And the smaller the effect, the harder it is to demonstrate statistically. So it is really not surprising that results of research about diet and cancer flip-flop. Low-fat diets probably do lower the risk of breast cancer -- but the effect on risk is small -- particularly for women with no prior history of the disease. Changing diet to reduce breast cancer -- or any other cancer -- is a personal decision, not an imperative."

Its very counter-intuitive. All the five-a-day campaigning is partly premised on the idea that better diet will reduce cancer risk. Yet the evidence about dietary fat is not quite there.

The trouble is that there is a gulf between what we know for certain and what we might presume. That said, few doctors would advise their patients anything other than switching to healthier diets for the prevention of a range of other diseases as well as cancer.

Professor Karol Sikora Review

Karol Sikora, a Professor of Cancer has just sent me his comments on my book, ONE IN THREE.

He says,

"An amazing book - combining the personal story of one man's cancer journey seen through the eyes of his son with the history of cancer from the Ebers Papyrus of 1600BC to the molecular therapies of the 21st century. It's a mine of extremely well researched information, written with great clarity and style. It demystifies the cancer establishment on both sides of the Atlantic - the conventional and the less so. It explains the background to treatments - surgery, radiotherapy and drugs whilst dealing with society's ultimate goal - cancer prevention. It has something for everyone and is not biased toward any pet conspiracy theory. The shelves on cancer are filled with many wacky, self opionated and often simply inaccurate books. This is not one of such - it stands out as being an intelligent, balanced review of a complex and emotive subject. It's simply the best in its class today. Essential reading for anyone who has cancer or loves someone with the disease."

As he is one of the leading cancer specialists in Britain, the author of one of the post-graduate texts on the subject, and an advisor to the World Health Organisation, I'd say I'm thrilled.

The Cost of Drugs

The New York Times ran this story about the increasing cost of a drug.

"The medicine, also known as Mustargen, was developed more than 60 years ago and is among the oldest chemotherapy drugs. For decades, it has been blended into an ointment by pharmacists and used as a topical treatment for a cancer called cutaneous T-cell lymphoma, a form of cancer that mainly affects the skin.

Last August, Merck, which makes Mustargen, sold the rights to manufacture and market it and Cosmegen, another cancer drug, to Ovation Pharmaceuticals, a six-year-old company in Deerfield, Ill., that buys slow-selling medicines from big pharmaceutical companies.

The two drugs are used by fewer than 5,000 patients a year and had combined sales of about $1 million in 2004.

Now Ovation has raised the wholesale price of Mustargen roughly tenfold and that of Cosmegen even more, according to several pharmacists and patients."

What is invidious about this particular example is that many of the arguments that justify drug company costs aren't here. The drug is more than sixty years old, so there has been no cost to its development. There is no need to develop a manufacturing facility because one already exists.

This is not, of course, only a US thing. The increasing success of medicine and, in particular, the cost of drugs is pinching the limited resources of the NHS. As the Sunday Times said the other day We can control it, but can we afford it.

The problem of affording cancer care is only going to get worse.

About This Blog

This blog is really the spin off to my book, One in Three: a son's journey into the history and science of cancer.

Over the years of writing it, I've realised that I'll never be able to integrate the constant news about cancer into my book. At the same time many of the the themes of the book are reflected in the development of science. So this blog is an attempt to track the news and integrate it into the book.

It'll also be a repository of things that I might write about the book, or links to reviews and the like.

I'd hope also that this could be a place where a dialogue about the book happens, about the issues of cancer and our personal experiences.