“Publication bias” and “evidence-based” medicine…

Wow. It’s not easy to comment on this 13-minute TED talk given last year by Dr. Ben Goldacre, titled “What doctors don’t know about the drugs they prescribe.” (I’d add: “…and what patients don’t know about the drugs they are taking!”) I’m not totally surprised, but I didn’t realize it was THIS bad. To watch the video, just click on this link: http://goo.gl/mshuh

Check out (seven and a half minutes into the talk, more or less) what he says about antidepressants…a staggering difference, indeed. 

Then, ten minutes into the talk, don’t miss the reference to Tamiflu, a drug that is familiar to many of us (I’m now glad I’ve never touched the stuff). Whoa.

And then this: 50% of ALL trials are buried. This affects ALL fields of medicine, Dr. Goldacre says. And positive trial results are about twice as likely to be published as negative findings.  😯

Even though in the past eight years I’ve read a lot about problems and hidden data concerning clinical trials and studies, I must admit that I had no idea…I just had no idea…

And what about cancer drug trial results? Can we possibly believe they are exempt from what Dr. Goldacre calls “publication bias”? Or “research fraud”? Or fake fixes? Or…? No, of course we can’t.  

Well, we need to push to have all the “negative data” published. We need to push our doctors to find out. We need to KNOW. I think it’s bloody outrageous that we, and our doctors, are left stumbling in the dark when our lives hang in the balance. No, it’s utterly UNACCEPTABLE!!!

I want to watch this video again, to make sure I didn’t miss anything, but I have some more work to do today, so I must be off…Anyway, do have a look. And let me know what you think…Thanks!

And many thanks to Linda for posting this TED talk on FB. 🙂

Dr. Catherine Kerr: mindfulness starts with the body…

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Mindfulness meditation versus pain and depression. Here is the link to an incredibly interesting TED lecture that will take just 15 minutes of your time: http://goo.gl/0Zpk9 

And here’s a Huffington Post article on the same topic: http://goo.gl/b3Jod Notice what it says about the possibility of decreasing stress…Amazing what our brain can do…

As for me, I have my own form of meditation. I’ve never taken a meditation class so I don’t know if what I do is correct or not, but it relaxes me and makes me feel fabulous. But now I’m interested in learning more about this specific form of meditation. I want to do it properly, mainly because of what I read about its possible effect on stress.

Turn down the volume! 🙂 

My comments on the long term use of curcumin in two smoldering multiple myeloma patients. Part I.

Finally. Here goes. Are you ready? These are my first ramblings on the smoldering myeloma case report. 😉

At the end of the abstract, the authors state the following: These results suggest that patients with smoldering myeloma may benefit from daily ingestion of curcumin and long term use does not result in toxicity.”

Concerning possible long-term toxicity, let me say this: I’ve been on a higher daily dose than six grams for the past eight years (plus)…most of the time, an eight gram daily dose (note: I’ve been testing a lower dose lately, in the 7-gram range).

True, I don’t know what’s going on inside my cells, molecules, atoms and genes, but I can tell you this, for what it’s worth:

  1. I feel fine.
  2. I’m very active.
  3. I have no pain anywhere (the back pain I recently had, and wrote about on the blog, has totally disappeared…oh, and by the way, in case you remember that post and you’re still interested!, my urine is still clear! 😉 )…
  4. I haven’t taken an antibiotic in a year and a half. But I’ll have more to say about this in Part 2 of this post. 

Before we go on, I would like to say that this study gave me a lot of food for thought, which means I have lots to say, so I’m bound to rant and rave and repeat (sorry about that!)… 😉

In the full study, we can read these two sentences: “Given the uncertainty of disease progression with SMM, early intervention aimed at reducing the abnormal protein load, the abnormal serum-free light chain ratio and the % plasma cell load would be of benefit to the patient. It would be essential that this preventative approach does not itself increase the risk of progression or result in toxicity.”

Long term readers of my blog know how I feel about early intervention. Or rather, I should add, about early conventional intervention. Simply put, I’m against it.

Very.

Strongly.

So. 

Of course, this is MY OWN PERSONAL opinion, which is not based only on a gut feeling but on all the research I’ve done and all the scientific studies I’ve read in the past eight years (plus)…and also on the guidelines of the International Myeloma Working Group…

Anyway, that said, here’s what I believe: no CRAB symptoms = no intervention, no treatment

I’ve lived a mainly healthy life thus far (more than eight years since my SMM diagnosis and fourteen years since my MGUS diagnosis). Yet the percentage of evil plasma cells in my bone marrow is (probably still) quite high, to the point where, in 2007, my hematologist, based on what she knew (protocols protocols protocols), suggested that I take some Revlimid to bring down that number. I said no, to her surprise…but it was my decision, right or wrong (for the record: I think I made the right choice).  

But getting back to what Terry Golombick and his colleagues write…No, we certainly do NOT want to increase our risk of progression and/or make our lives miserable because of the toxic side effects of conventional treatments. I’m referring, of course, to MGUS and SMM situations, with no CRABs…

But that doesn’t mean that we should sit back and do nothing. I can still hear the words that a world-famous myeloma specialist told me over the phone in 2005: “No, there is nothing you can do to stop it from progressing.”

Nothing is unacceptable. Simply unacceptable.

And all those expressions that give absolutely no hope to the patient should be DELETED from the myeloma vocabulary. Words such as “watch and wait.” The only thing I “watch and wait” for are birds when Stefano and I go bird watching…

Sure, perhaps there isn’t anything I can do. Perhaps I’ll progress to active myeloma at some point, no matter what I do—even if I stand on my head every night at midnight singing an aria from “La Traviata”…even if I walk around with a pineapple precariously balanced on my head…even if I sleep all day like my cats do…even if…

But (seriously now!) here’s the thing: while it goes without saying that I want my hematologist to give me the truth, the straight and honest truth, I also don’t want her to give me what Dr. David Servan-Schreiber, the famous French neuroscientist and physician, called false hopelessness. Here’s an interesting 2008 article on this topic: http://goo.gl/oeJh5

Dr. Servan-Schreiber believed that feelings of helplessness can actually feed cancer. I’m convinced that’s true. But I’ve written about all this before and don’t want to repeat it, so just go have a look at my March 13 2011 post if you have no idea what I’m blabbing about: http://margaret.healthblogs.org/2011/03/13/hope/.

In spite of all the evidence that patients who are given hope do better than those who are given no hope, the current conventional approach in the MGUS and SMM world is to tell us that there is nothing we can do. Does that make any sense to you? And some doctors, like Vermorken and his team, go as far as to suggest that it might actually be DANGEROUS for us to do something like use turmeric in our cooking. I mean…you’ve got to be bloody KIDDING!!!! But that’s fodder for another post that I’m working on (grrrrrrimace!), so I’ll leave it at that for now.

Point is: watching and waiting and doing bloody nothing is no way to live. It takes power away from us. It makes us feel weak and afraid and anxious…It gives us a sense of despair and helplessness. All these negative feelings can only lead to the buildup of stress. And stress, as we should all know by now, feeds myeloma cells (look up “norepinephrine” on my blog or scroll down my Pages to the title “Myeloma and stress,” which, yes, needs some updating!).

Here’s what I firmly believe (and again, it’s MY OWN OPINION blablabla): we CAN be proactive in a way that doesn’t  risk waking up the monster inside of us. We have to be incredibly careful, of course, not to take anything toxic and without solid scientific backing…and not to go overboard. For example, I’m not a fan of drastic changes…”cold turkey” dietary changes, e.g. Do things gradually. Easy peasy. 

And for cryin’ out loud, if you really want that slice of chocolate cake or apple tart, go ahead and have it! 😉

As for being proactive, sure, I’ve had my doubts, too. Have I made the right choices or have I totally screwed up? Well, it’s pointless to dwell on all that. I don’t have a time machine, so I can’t go back to 2005-6 and do things differently. And, to be honest, even if I were offered that opportunity, I would ignore it. I doubt that I could have done any better…But, of course, only time (more time!) will tell. 🙂

A final rambling: even if you don’t believe in taking supplements or making any dietary changes, you can do other things. Laugh. Enjoy your life…even the little things…learn something new…travel…relax (meditate)…be with your loved ones and friends as much as possible…cuddle with your cats…do whatever makes you happy…and hey, don’t forget to eat some chocolate. 😉 

I’ll stop here for today. Note: the second part of my post is not as rambling as this one but instead focuses on a part of the study that should be of interest to all of us… Ciao for now! 🙂

Apologies, thyroid issues and more GOOD news on Vitamin D…

I have to apologize for not having published my comments on the smoldering myeloma case report yet. I’ve written sooooo much, in fact, that I’ve had to divide the post into two parts. But I still have some editing to do before it’s fit to be published. Soon, soon, I promise (tomorrow?)! 🙂

IMG_0902A big reason for the delay: Stefano and I have been terribly worried about our eldest cat, Puzzola. A couple of weeks ago I noticed that she was acting strangely. Then, the following day, she pulled down and peed all over my bathrobe. I knew exactly what was wrong (this has happened before) and took her immediately to the vet who confirmed it was a urinary tract infection. I’ll spare you the part about trying to give an antibiotic to a cat who can smell an antibiotic inside anchovy paste ten miles away… 😉

In checking her over, the vet also felt a small nodule on her thyroid gland. She ran a bunch of tests, which confirmed what she suspected: hyperthyroidism. This essentially means that her thyroid is working too much…It’s a condition that can eventually lead to a lot of problems involving the heart and the liver, just to mention a couple of things. And in fact her heartbeat is accelerated, and her liver numbers are already out of whack, even though this is only the beginning of hyperthyroidism. Still, she has lost quite a lot of weight and doesn’t really look like the cat in this photo, taken just a couple of months ago (uhm, Puzzola is the cat on the right… 😉 )…

She’s now on medication for the thyroid issue. Twice a day. Fingers crossed that it works!

Okay, now for something else…something that I think most of you will find incredibly interesting, that is, the results of a LARGE, long-term German cohort study on vitamin D, showing that you have a LOWER risk of dying from cardiovascular diseases, cancer, and respiratory diseases if you have HIGHER levels of vitamin D (= more than 30 nanomoles per liter, or 12 nanograms per milliliter. A nanogram, by the way, is the billionth part of a gram…amazing that it can even be measured, huh?). The difference between the sufficient and insufficient vitamin D groups was significant. See: http://goo.gl/kBFNI

I’d say this gives us another (!) incredibly good reason to keep our vitamin D levels up!

Okay, I need to get back to work now. Ciao! Oh wait…here’s a really cute Simon’s Cat video titled “The box”: http://goo.gl/x9og3 Okay, going…going…gone! 😉

UPDATE: Taking a break from work, I read an article titled “Do-it-yourself medicine” in “The Scientist” magazine. Fascinating…HEAPS of food for thought…worth reading: http://goo.gl/Om1wD

Trust is for suckers…

This morning I watched a video that made me LAUGH OUT LOUD…I mean, really burst out laughing (even the second time I watched it). Obviously, I DISAGREE with the remarks made at the end…Still, I found it simply hilarious…

Hope you enjoy this: http://goo.gl/57lFV 

***

And now for a more, a much more!, serious topic that has nothing to do with my less-than-serious blog title (which refers to the above video…). 

Why do we have people being treated like cattle herds? That’s waste! And the billions of dollars that’s being wasted each year for screening, and the wrong drugs, and the wrong everything. It’s astounding. And we just can’t go on like this,” says Dr. Eric Topol during a recent, fascinating NBC “Rock Center” interview: http://goo.gl/q9vKz  

Now, I have to admit that I’m more than a bit concerned about the use of all these “waves” and future “little grains of sand” sitting inside our bloodstream and sending out signals to our smart phones. Still, I really liked what he said about the wasteful nature of medicine today (towards the end of the interview) and “dumbing down” medicine and treating everyone the same…This doesn’t just apply to heart patients, as we well know…

P.S. I’m working on my smoldering post, so…stay tuned!!! 🙂