I always liked John W. Campbell's proposal for "licensed quacks." A licensed quack would be allowed to dispense any sort of medical care, regardless of the FDA. The only requirements would be informed consent from the patients, including informing them that you are a licensed quack; and good record-keeping and reporting.
Heck, if assisted suicide is OK, how can this not be?
I've never heard of the "licensed quack" suggestion, but I like it a lot. I wonder if someone could sell the stuff as a dietary supplement, next to the bottles of Horny Goat Weed and other weird concoctions in Walmart? The standards on supplements are much laxer than those on drugs. And, hey, this stuff might actually work!
The truth is that our current "peer review" system of funding for research (not peer review in general, peer review funding) is fundamentally broken and has been for some time. It is hopelessly mired in government incompetence, corporate greed, croneyism, and general ass-kissing. Along with good old fashioned stupidity, which gets no less stupid just because it comes from someone with a PhD attached to his name.
It is inexcusable that chemicals like this are not immediately on the front lines of research, while we sit around talking about pissing away 1.5 billion+ dollars on a "cancer genome project" to map every irregularity in the cancer genome in the hope that one day, many decades from now, it might provide some useful insight. After the tens of billions of dollars and decades of effort they've already pissed away drilling these dry wells.
Anyone who thinks scientists are immune to the same failings as the rest of us is guilty of turning them into a fucking priesthood.
And anyone who says that you as a taxpayer don't have every right to raise these questions because you're not smart enough to understand the issues deserves a swift kick in the shins.
Orthodox Oncology is the "Big House" on the hill where all the big money is. It doesn't have to work. It just has to be lucrative and support the current paradigm of clinical services.
It's the Noah's Ark that never had to float. That's good, because it can't. Neither does it hold water. Who leaves a trail of dead behind and calls it "cancer?" Who else could get away with it.
Anna Nicole supposedly died of an "overdose". But I understand all dosages were within normal ranges. So she dies of drug side-effects and they call it something else.
That's a metaphor for the Oncology practiced today.
If DCA supported new patent filings and a monopolistic market price three to four magnitudes higher, there would be clinical trials aplenty.
This claims the overall situation is even worse than that:
According to the NIA's report, over 784,000 people die annually due to medical mistakes. Comparatively, the 2001 annual death rate for heart disease was 699,697 and the annual death rate for cancer was 553,251.
There was a comment from an anonymous commenter posted in my livejournal (where I had a short earlier piece that touched on this topic) which might be of interest on this topic. I didn't even know those comments were popping up until I went looking for that post after reading this post here.
Yeah, I read awhile back that prescriptions medications, taken as prescribed, are the 4th-leading cause of death in the U.S.
The thing about pre-scriptions is that they are so very often prescribed before the patient has had any prior experience with the drug.
It seems like such a small consideration until you stop to think about the possible consequences of such preliminary ignorance of the individual patient.
But as for me, if I were seriously ill the last place I would go is a hospital. Those places are full of the dead and dying. It just doesn't seem like a good premise for success.
What's doubly sad is that such comments are invariably portrayed as "attacking doctors and nurses." Or "attacking scientists."
Nonsense.
Mostly, it's not their fault. It's a system that has had many successes and many failures. Any great enterprise will have those. What's annoying is the presumption that seeking reform and improvement equals "attacks."
I have specific proposals to remedy the situation. So do many others, in and outside of these fields. None involve demonization. All involve merely looking clearly at age-old problems like croneyism and conflict of interest and bureaucratic ineptitude, which these professions are as vulnerable to as any other.
I think a lot of people, such as Orac, have some pretty good responses to the claims about DCA being a new wonder drug that the system has unfairly kept down. Simply repeating the original claims without responding to the issues already answered doesn't seem to move this debate forward.
I've rarely found Orac to have anything remotely interesting to say on subjects like this one, as he always defends the establishment position on pretty much anything and goes straight to ad hominem on anyone who questions it.
What's next? Accusing us of saying there's a "conspiracy" here?
If there's something you want to bring forward to the debate, bring it. Facts would help. Got any?
"I've rarely found Orac to have anything remotely interesting to say on subjects like this one"
I've rarely found your answers to his and Tara's skepticism of your theories to be compelling or even always on point. And nearly always, just as you've done here, when you sum up their criticisms, you leave out almost everything of substance they say, and only report that you feel like they called you a conspiracy theorist.
And yet I still read and listen to what you say on these subjects.
As to the issues raised, we've already been over this, but apparently, every time this discussion starts, we have to go back to square one, as if none of the prior objections ever occurred or have to be countered. Some of the key points here:
The claim that drug industries can't reap profits on non-patentable drugs is a pretty weak one. There are lots and lots of non-patenable drugs on the market, some in brand form, some in generic form, and drug companies even spend millions in marketing them trying to get people to take one brand of the same generic chemical over another. The idea that they couldn't reap profit off of a miracle cancer cure is ridiculous. Companies make profit branding and selling sugar for goodness sakes, and there are a million ways to introduce patentable helper chemicals and other things into a drug line in order to make more rent-based profit on top of that.
Secondly, the fact that a drug cures cancer in a dish and in rats is nothing new or special when looking at the history of cancer research. We've been through this a million time before with other drugs and treatments: all have generally turned out to be disappointing when applied to actual human patients. Maybe this drug will turn out to be different, but at this point there's no particular to think so compared to others. What we have now is a lot hype, and now, requests for donations.
Thirdly, doctors just don't feed their patients everything plus the kitchen sink, even when they are going to die: it's not ethical to treat even the dying like glorified genie pigs (and what if the drug in question was a super expensive patented one that was claimed to have a new use in curing cancer: wouldn't people be screaming about how the horrible drug companies are conspiring to bilk cancer patients with false hope snake-oil, or using them as test subjects?). The medical treatment of patients is supposed to be evidence-based, and in that process, there are all sorts of steps taken to see if further research is warranted. If this process works too slow for some, fine, and I'm sure people will get DCA and take it just like they take all sorts of alternative medicine cures that also lack credible support, and if it turns out to work like magic, great: they lucked out. But the idea that it should be a general policy to prescribe things to patients based solely on hope and hype just doesn't work. DCA happens to have made it to the top of the hype chain at the moment: we'll see if it stays there. But even if it does turn out to be the one, that still won't justify the extreme claims made about it prior to a real evidential demonstration of its power.
He notes that there is a very real chance of liver toxicity at the level of the drug necessary to match that which was used in rats (which, as he notes, was tested against a single human tumor model so far only), so hardly the totally safe claim made by some.
"While DCA has been the subject of clinical trials for rare metabolic diseases, it has never been tested in cancer patients. We have no idea how DCA will affect the metabolism of other drugs, including chemotherapy, and I am concerned since high doses can have dramatic effects on systemic pH and kidney function."
In fact, he suggests that because it will prove so easy to get the drug, oncology doctors will likely be seeing patients with some of the known symptoms of toxicity (note that when used to treat metabolic disorders, actual doctors are following established guidelines that have been worked out for dosage and watching out for known side-effects and dangers, some of which need to be treated with additional drugs and therapies that self-proscribers are not going to know about or be able to handle on their own).
Vic: Thanks for linking yet another ad hominem attack on me by Orac. I see that in the piece you link, he's once again grossly distorting my position and going out of his way to be insulting. I frankly stopped reading at that point. If there's some compelling fact in there that directly answers any specific point you think I've made, feel free to quote it.
In any case, just to help you out, Vic: there is no miracle drug. There is also no conspiracy. And I have no theories, I take the position that there is pressing need for institutional reform in how my tax dollars are spent, and in the way the regulations on medical research work. Got it?
You've done nothing to advance the discussion here at all but point out that some creatures of the establishment feel there is no problem here, and that this particular drug may be too dangerous to give to dying people. Got it. Got anything else? Or are you going to keep peddling shit about "conspiracies" and "miracle drugs?"
"Thanks for linking yet another ad hominem attack on me by Orac."
I noticed that he did mention you at the end, which is too bad since it apparently gives you permission to completely ignore every substantive argument he and I made. Him taking potshots at you isn't exactly much different or more excited than you taking potshots at him.
He's never done anything with me but take cheap potshots, Vic. Excuse me for noticing that right away.
I read through most of his tedious, mostly-obvious essay. Neither he nor you has addressed a single one of my arguments in any direct way except to say that this isn't a miracle drug and that there is no conspiracy. Great. We're completely agreed that this is not a miracle drug and there is no conspiracy. Got anything else?
Not a single one of my actual points (or Dave's) has been addressed so far as I can see. But I'm glad you can sit there saying that I'm no better than Orac. Hey, it's a start.
If you want to forward the conversation, the first thing would be that you actually bring up what you want addressed, rather than slapping me in the face with 400 pages of bloviating and a statement about my shortcomings.
Which argument in the many, many, many pages of data you linked did you feel most compelling? What point did you see unaddressed? And how does it relate to anything I've said? I'm not going to sit around reading it all just to guess. So far most of it looks obvious, irrelevant, or silly.
4.1.2007 8:37pm
Commenting on Dean's World is a privilege, not a right. Dean is your host, you are his guest, and you should behave in that fashion. Dean is not your babysitter, nor is he your punching bag. Please remember this. In general, you are free to disagree with anyone on any subject you wish, but abusive behavior will not be tolerated.
Of course we all lose our tempers now and then. Dean freely admits to being imperfect in this regard, which is why regulars to this establishment will generally be cut more slack than people who we don't know very well.
Still: behave like an adult, or go find somewhere else to play. Thanks.
Heck, if assisted suicide is OK, how can this not be?
The truth is that our current "peer review" system of funding for research (not peer review in general, peer review funding) is fundamentally broken and has been for some time. It is hopelessly mired in government incompetence, corporate greed, croneyism, and general ass-kissing. Along with good old fashioned stupidity, which gets no less stupid just because it comes from someone with a PhD attached to his name.
It is inexcusable that chemicals like this are not immediately on the front lines of research, while we sit around talking about pissing away 1.5 billion+ dollars on a "cancer genome project" to map every irregularity in the cancer genome in the hope that one day, many decades from now, it might provide some useful insight. After the tens of billions of dollars and decades of effort they've already pissed away drilling these dry wells.
Anyone who thinks scientists are immune to the same failings as the rest of us is guilty of turning them into a fucking priesthood.
And anyone who says that you as a taxpayer don't have every right to raise these questions because you're not smart enough to understand the issues deserves a swift kick in the shins.
It's the Noah's Ark that never had to float. That's good, because it can't. Neither does it hold water. Who leaves a trail of dead behind and calls it "cancer?" Who else could get away with it.
Anna Nicole supposedly died of an "overdose". But I understand all dosages were within normal ranges. So she dies of drug side-effects and they call it something else.
That's a metaphor for the Oncology practiced today.
If DCA supported new patent filings and a monopolistic market price three to four magnitudes higher, there would be clinical trials aplenty.
But it doesn't. And there isn't.
According to the NIA's report, over 784,000 people die annually due to medical mistakes. Comparatively, the 2001 annual death rate for heart disease was 699,697 and the annual death rate for cancer was 553,251.
The thing about pre-scriptions is that they are so very often prescribed before the patient has had any prior experience with the drug.
It seems like such a small consideration until you stop to think about the possible consequences of such preliminary ignorance of the individual patient.
But as for me, if I were seriously ill the last place I would go is a hospital. Those places are full of the dead and dying. It just doesn't seem like a good premise for success.
Nonsense.
Mostly, it's not their fault. It's a system that has had many successes and many failures. Any great enterprise will have those. What's annoying is the presumption that seeking reform and improvement equals "attacks."
I have specific proposals to remedy the situation. So do many others, in and outside of these fields. None involve demonization. All involve merely looking clearly at age-old problems like croneyism and conflict of interest and bureaucratic ineptitude, which these professions are as vulnerable to as any other.
What's next? Accusing us of saying there's a "conspiracy" here?
If there's something you want to bring forward to the debate, bring it. Facts would help. Got any?
I've rarely found your answers to his and Tara's skepticism of your theories to be compelling or even always on point. And nearly always, just as you've done here, when you sum up their criticisms, you leave out almost everything of substance they say, and only report that you feel like they called you a conspiracy theorist.
And yet I still read and listen to what you say on these subjects.
As to the issues raised, we've already been over this, but apparently, every time this discussion starts, we have to go back to square one, as if none of the prior objections ever occurred or have to be countered. Some of the key points here:
The claim that drug industries can't reap profits on non-patentable drugs is a pretty weak one. There are lots and lots of non-patenable drugs on the market, some in brand form, some in generic form, and drug companies even spend millions in marketing them trying to get people to take one brand of the same generic chemical over another. The idea that they couldn't reap profit off of a miracle cancer cure is ridiculous. Companies make profit branding and selling sugar for goodness sakes, and there are a million ways to introduce patentable helper chemicals and other things into a drug line in order to make more rent-based profit on top of that.
Secondly, the fact that a drug cures cancer in a dish and in rats is nothing new or special when looking at the history of cancer research. We've been through this a million time before with other drugs and treatments: all have generally turned out to be disappointing when applied to actual human patients. Maybe this drug will turn out to be different, but at this point there's no particular to think so compared to others. What we have now is a lot hype, and now, requests for donations.
Thirdly, doctors just don't feed their patients everything plus the kitchen sink, even when they are going to die: it's not ethical to treat even the dying like glorified genie pigs (and what if the drug in question was a super expensive patented one that was claimed to have a new use in curing cancer: wouldn't people be screaming about how the horrible drug companies are conspiring to bilk cancer patients with false hope snake-oil, or using them as test subjects?). The medical treatment of patients is supposed to be evidence-based, and in that process, there are all sorts of steps taken to see if further research is warranted. If this process works too slow for some, fine, and I'm sure people will get DCA and take it just like they take all sorts of alternative medicine cures that also lack credible support, and if it turns out to work like magic, great: they lucked out. But the idea that it should be a general policy to prescribe things to patients based solely on hope and hype just doesn't work. DCA happens to have made it to the top of the hype chain at the moment: we'll see if it stays there. But even if it does turn out to be the one, that still won't justify the extreme claims made about it prior to a real evidential demonstration of its power.
He notes that there is a very real chance of liver toxicity at the level of the drug necessary to match that which was used in rats (which, as he notes, was tested against a single human tumor model so far only), so hardly the totally safe claim made by some.
And here he argues that self-medication with this stuff is a really bad idea that this point
"While DCA has been the subject of clinical trials for rare metabolic diseases, it has never been tested in cancer patients. We have no idea how DCA will affect the metabolism of other drugs, including chemotherapy, and I am concerned since high doses can have dramatic effects on systemic pH and kidney function."
In fact, he suggests that because it will prove so easy to get the drug, oncology doctors will likely be seeing patients with some of the known symptoms of toxicity (note that when used to treat metabolic disorders, actual doctors are following established guidelines that have been worked out for dosage and watching out for known side-effects and dangers, some of which need to be treated with additional drugs and therapies that self-proscribers are not going to know about or be able to handle on their own).
In any case, just to help you out, Vic: there is no miracle drug. There is also no conspiracy. And I have no theories, I take the position that there is pressing need for institutional reform in how my tax dollars are spent, and in the way the regulations on medical research work. Got it?
You've done nothing to advance the discussion here at all but point out that some creatures of the establishment feel there is no problem here, and that this particular drug may be too dangerous to give to dying people. Got it. Got anything else? Or are you going to keep peddling shit about "conspiracies" and "miracle drugs?"
I noticed that he did mention you at the end, which is too bad since it apparently gives you permission to completely ignore every substantive argument he and I made. Him taking potshots at you isn't exactly much different or more excited than you taking potshots at him.
I read through most of his tedious, mostly-obvious essay. Neither he nor you has addressed a single one of my arguments in any direct way except to say that this isn't a miracle drug and that there is no conspiracy. Great. We're completely agreed that this is not a miracle drug and there is no conspiracy. Got anything else?
Not a single one of my actual points (or Dave's) has been addressed so far as I can see. But I'm glad you can sit there saying that I'm no better than Orac. Hey, it's a start.
If you want to forward the conversation, the first thing would be that you actually bring up what you want addressed, rather than slapping me in the face with 400 pages of bloviating and a statement about my shortcomings.
Which argument in the many, many, many pages of data you linked did you feel most compelling? What point did you see unaddressed? And how does it relate to anything I've said? I'm not going to sit around reading it all just to guess. So far most of it looks obvious, irrelevant, or silly.
Of course we all lose our tempers now and then. Dean freely admits to being imperfect in this regard, which is why regulars to this establishment will generally be cut more slack than people who we don't know very well.
Still: behave like an adult, or go find somewhere else to play. Thanks.