Iatrogenic Illness: The Downside of Modern Medicine Iatrogenic Illness: The Downside of Modern Medicine
Iatrogenic Illness: The Downside of ... 
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15 y
3,640
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Definition Iatrogenic:
induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedure
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| Iatrogenic Illness: The Downside of Modern Medicine |
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| by Gary Null, Ph.D. & Debora Rasio, M.D. |
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| During the past century, a medical establishment has evolved that has made itself the exclusive provider of so-called scientific, evidence-based therapies. The paradigm used by this establishment is what we call the orthodox medical approach, and for the first 70 years of this century, little effort was made to challenge it. In the past 30 years, however, there has been a growing awareness of the importance of an alternative approach to medical care, one that, either on its own, or as a complement to orthodox medicine, emphasizes nontoxic and noninvasive treatments, and prevention. Unfortunately, this new perspective has been fought vigorously. We've been told that it's only the treatments of orthodox medicine that have passed careful scientific scrutiny involving double-blind placebo-controlled studies. Concomitantly, we've been told that alternative or complementary health care has no science to back it up, only anecdotal evidence. These two ideas have led to the widely accepted "truths" that anyone offering an alternative or complementary approach is depriving patients of the proven benefits of safe and effective care, and that people not only don't get well with alternative care, but are actually endangered by it. By getting society to accept these precepts, orthodox medicine has maneuvered itself into being the sole provider of information about disease and its treatment, and has taken charge of curricula, accreditation, and insurance coverage in the health care arena. All 50 states have enacted strict proscriptions at the state medical board level against using so-called unscientific medicine, meaning anything that is not, according to the orthodox consensus, common-use medicine. Hundreds of physicians have been prosecuted and punished for not confining their treatments to the accepted paradigm, some to the point of having their licenses revoked, being imprisoned, or suffering bankruptcy. And it has been of only secondary importance whether or not their patients have claimed to benefit from their treatments. The prosecutors-the state attorneys general working hand-in-hand with state medical boards and "anti-quackery" groups supported by pharmaceutical interests-have influenced such federal enforcement agencies as the FDA, the USDA, and the Justice Department. They've also influenced such bodies as the National Institutes of Health as to which modalities receive funding and get incorporated into the standard medical model, thus perpetuating the status quo. It is the purpose of this review to question the status quo. Specifically, we'll be looking at a variety of areas-cancer, heart disease, mental illness, obstetrics and gynecology, psychiatry, etc.-and asking some basic questions:
It is vital to note that all the studies referred to here are from mainstream medicine's own respected journals, such as the Journal of the American Medical Association, the New England Journal of Medicine, and The Lancet. Thus this white paper's criticism of the various therapies comes not from the "alternative" world but from the very heart of orthodox medicine itself and from researchers using the gold standard of rigorously set-up controlled studies. So there is nothing subjective or political about the conclusions. Also, I should mention that this work was done over a period of eight years, during which time over 10,000 studies were analyzed. The studies contained herein are just samples; many more could have been included but were not because of space considerations. With more than 5000 physicians questioned, it is apparent to this author that the vast majority of medical procedures are done with the belief that they are safe and effective, rather than with proof that they are. Even after procedures and medications have been shown (a) not only not to work, but (b) to cause injury and death at a statistically significant level, they continue to gain in popularity and use. This is one of the reasons we have not had greater gains in combating the major diseases in recent decades. And it is also why there is an urgent need for physicians, legislators, journalists, funding agencies, curriculum developers, insurance companies, and peer review systems to take note of the substantial gaps in primary chronic care, and find better approaches. The facts here speak for themselves. We are a society that states that we live by the gold standard of scientific research, but this report shows that statement to be at odds with reality. It shows that we are routinely causing iatrogenic conditions and unnecessary suffering-not to mention wasting vast sums of money--through a systemic negligence of the facts. This situation must be challenged, and remedied. |
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http://www.garynull.com/GNthisArticle.php?article=50
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Re: Iatrogenic Illness: Gastric Canc... Will_I_Ever_Learn
15 y
3,469
RR
| Iatrogenic Illness: 2 - Cancer |
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| GASTRIC CANCER |
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The second British Stomach Cancer Group trial of adjuvant radiotherapy or chemotherapy in resectable gastric cancer: five-year follow-up. The results of this study show that adjuvant chemotherapy and adjuvant radiotherapy do not prolong survival in patients with cancer of the stomach. Four hundred thirty-six patients with gastric cancer were randomized to receive surgery alone, surgery followed by radiation, or surgery followed by chemotherapy. Five-year survival was 20% in patients who received surgery alone, 12% in those who received surgery with radiation, and 19% in those who received surgery plus chemotherapy. These data do not support the use of adjuvant therapies in the management of gastric cancer.
Pathological prognostic factors in the second British Stomach Cancer Group trial of adjuvant therapy in resectable gastric cancer. This study reports the results of a randomized controlled trial in which patients with gastric cancer were randomized to receive surgery alone, surgery followed by chemotherapy, or surgery followed by radiotherapy. No differences in survival were observed between the three groups, indicating that chemotherapy and radiotherapy are ineffective in the management of patients with gastric cancer.
Adjuvant therapy for gastric carcinoma: closing out the century. This article highlights that the results of 40 years of research in the West failed to document a survival advantage in patients with gastric cancer treated with chemotherapy or radiotherapy in addition to surgery, compared to those treated with surgery alone.
Treatment of gastric cancer. This article emphasizes that the effects of chemotherapy in the treatment of patients with early and late stage gastric cancer have been largely disappointing.
A phase II study of 5-fluorouracil, leucovorin, and interferon-alpha in the treatment of patients with metastatic or recurrent gastric carcinoma This study evaluated the effects of a combination chemotherapy regimen consisting of 5-fluorouracil, leucovorin and interferon-alpha in patients with advanced cancer of the stomach. Twenty-seven patients were enrolled. Severe diarrhea and inflammation of the lining of the mouth occurred in approximately one-third of patients. Severe reduction in number of white blood cells and fatigue occurred in 20% and 10% of patients, respectively. Fever and flu-like symptoms were commonly experienced. Partial tumor shrinkage was observed in 12% of patients, and overall median survival was 7.8 months. These data indicate that use of this chemotherapy regimen is associated with minimal activity and significant toxicity in patients with gastric cancer.
Treatment of advanced gastric cancer with oral etoposide, leucovorin and tegafur: experience with an oral modification of the etoposide, leucovorin and 5-fluorouracil (ELF) regimen. This study evaluated the effects of a modified version of the widely used oral combination chemotherapy regimen of etoposide, leucovorin and 5-fluorouracil in the management of patients with advanced pancreatic cancer. Thirty-two patients were enrolled. Tumor shrinkage was observed only in 16% of patients. Overall average survival was 6 months. Treatment was discontinued in 8 patients due to severe nausea and vomiting. Additionally, 12 patients experienced anorexia and progressive weight loss. The authors concluded that this regimen is not recommended for patients with advanced stomach cancer.
Efficacy of prolonged intermittent therapy with combined 5-FU and methyl-CCNU following resection for gastric carcinoma. The results of this study show that combination chemotherapy given after surgery does not improve relapse-free or overall survival in patients with gastric cancer, but substantially increases toxicity.
Morbidity and mortality of early postoperative intraperitoneal chemotherapy as adjuvant therapy for gastric cancer. This study evaluated the impact of chemotherapy delivered in the abdominal cavity early after surgery, on the morbidity and mortality of patients with cancer of the stomach. Two hundred and forty-eight patients were randomized to undergo either surgery alone, or surgery followed by intraperitoneal administration of mitomycin C and 5-fluorouracil in the 5 days after the operation. Overall morbidity and mortality were significantly higher in patients in the chemotherapy group compared to those in the surgery-only group. In particular, morbidity and post-operative mortality occurred in 29% and 5.6% of patients who received chemotherapy, respectively, compared to 20% and 0.8% of those who received surgery only. Minor complications occurred in over a third of patients in the chemotherapy group. These data do not support the use of this regimen in the management of patients with gastric cancer.
Adjuvant intraperitoneal chemotherapy with carbon-adsorbed mitomycin in patients with gastric cancer: This study evaluated the effects of a chemotherapy protocol consisting of intra-abdominal infusion of mitomycin in patients with gastric cancer. The trial was conducted after several studies reported a beneficial effect associated with use of this regimen. Ninety-one patients were randomized to receive surgery only (45 subjects) or surgery followed by chemotherapy (46 subjects). Morbidity and mortality were significantly higher in patients assigned to chemotherapy compared to those receiving surgery only. In particular, 35% of patients in the chemotherapy group experienced complications after surgery, compared to 16% of those in the surgery-only group. Furthermore, 11% of patients who received chemotherapy died in the 60 days after surgery, compared to 2% of those who received surgery only. These data do not support use of this protocol in the treatment of patients with gastric cancer.
Fotemustine in patients with advanced gastric cancer This study evaluated the activity of the anti-cancer drug fotemustine in the treatment of patients with advanced gastric cancer. Twenty-six patients were enrolled in the trial. Severe decrease in the number of white blood cells was observed in one-third of patients, while platelet depletion was observed in half of them. Two patients died of treatment-related hemorrhage. No partial or complete tumor responses were observed. Overall median survival was only 11 weeks.
A randomized trial comparing adjuvant fluorouracil, epirubicin, and mitomycin with no treatment in operable gastric cancer. This study evaluated the effects of combination chemotherapy on the outcome of patients with gastric cancer. Eighty-four patients were randomized to receive either surgery alone or surgery followed by chemotherapy with 5-fluorouracil, epirubicin, and mitomycin C. No significant differences in survival were observed between both groups. This treatment regimen cannot be recommended in the management of patients with gastric cancer.
Adjuvant chemotherapy with 5-FU, adriamycin, and mitomycin-C (FAM) versus surgery alone for patients with locally advanced gastric adenocarcinoma The results of this study show that combination chemotherapy is ineffective in the management of patients with gastric cancer. One hundred ninety-three patients with stage I, II, and III gastric cancer were randomized to receive either surgery followed by a chemotherapy regimen consisting of 5-fluorouracil, adriamycin, and mitomycin-C (93 patients), or surgery only (100 patients). No differences in disease-free and overall survival were observed between the two groups.
Adjuvant therapy for gastric carcinoma patients in the past 15 years: a review of western and oriental trials. This study reviewed all the randomized trials published in the world literature that investigated the effects of adjuvant treatments (chemotherapy, radiotherapy, and chemo-immunotherapy) in the management of patients with gastric cancer. All trials performed in the West failed to detect any benefit derived from use of post-operative adjuvant treatments. The conclusions derived from studies performed in the East are inconclusive. In spite of these results, adjuvant treatments are commonly administered to Asian patients diagnosed with gastric cancer.
Phase II trial of etoposide, doxorubicin, and cisplatin combination in advanced measurable gastric cancer. The results of this study show that combination chemotherapy consisting of etoposide, doxorubicin, and cisplatin for patients with advanced gastric cancer is associated with high toxicity and modest efficacy, and cannot be recommended for the management of this disease. In particular, of 31 patients undergoing treatment, 4 (13%) died of treatment-related complications and only 6 (23%) underwent partial tumor shrinkage. Average survival time was 9 months for the all group.
Cancer of the upper gastrointestinal tract. Palliative chemotherapy unproved in advanced gastric cancer. Letter. This letter is a response to an article written by Ellis and Cunningham advocating the use of palliative chemotherapy to relieve the symptoms and increase life expectancy in patients with gastric cancer. The author of the letter casts doubt on the validity of the results of the study presented by Ellis and Cunningham in support of the use of palliative chemotherapy. In that study, randomization was stopped early, after only 10 and 12 patients had been enrolled in the chemotherapy and supportive care group, respectively, due to an apparent prolonged survival in patients receiving chemotherapy. Stopping randomization prematurely, however, can introduce a bias in the selection of patients so that the two groups may not be properly compared any more (because they may differ, for example, as to the extension of disease or the general medical status). In addition, the study failed to assess quality of life in patients from both treatment arms. The author concludes that better data are required before chemotherapy can be recommended over supportive care in the management of patients with advanced gastric cancer.
No survival benefit from combined pancreaticosplenectomy and total gastrectomy for gastric cancer. The results of this study indicate that patients with gastric cancer who undergo more extensive surgery have similar survival rates but higher morbidity, compared to patients who receive more conservative surgery. The data of 190 patients with gastric cancer, who, between 1969 and 1996, underwent total stomach resection accompanied by removal of the spleen and the pancreas, were compared to those of 206 comparable patients who underwent removal of the stomach and the spleen only. No survival differences were observed between the two groups. However, morbidity was significantly increased in patients receiving more extensive surgery. Based on these data, the authors concluded that pancreas and spleen resection should not be routinely performed in patients with gastric cancer.
Role of radiotherapy in cancers of the stomach. This study reviewed all randomized trials investigating the effects of radiotherapy on survival, in patients with cancer of the stomach. No benefits could be demonstrated associated with use of radiation therapy.
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http://www.garynull.com/GNthisArticle.php?article=51
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