Thomas Paine:

“Reason obeys itself; and ignorance submits to whatever is dictated to it.”

Sunday, August 10, 2008

Trekking through Disease Capitalism Where, "Oh Well, Everyone Dies."

“A foolish faith in authority is the worst enemy of truth.” —Albert Einstein

      Losing body parts to breast cancer was pretty much the opposite of fun. Nevertheless, in 2001 I had a partial mastectomy on my left breast, and in 2007 a full mastectomy of my right breast—two different kinds of breast cancer.

      My current oncologist suggested awhile ago that I go on the drug Aromasin, now that I am done with chemo and radiation for the second time in my life.

      In 2001 my first oncologist wanted me to take Tamoxifin and became incensed when I told him I didn’t like the idea and would be getting a second opinion. The second opinion agreed I should go on Tamoxifin. I said, “But the drug is a carcinogen.” She answered, “Oh don’t worry about that. We’ll keep an eye on it.” I thought to myself, “What does that mean? You’re going to know the day before I get endometrial cancer?”

      The next oncologist wanted me to take Arimidex; yet another suggested the drug Femara.

      I cannot help wondering why each doctor has a different plan for me—could it be they just don’t have any idea what they’re doing? Naw-w-w...

      Tamoxifen has a black box warning label now and is listed as a carcinogen. The other drugs are “aromatase inhibitors,” and whether or not they are carcinogens has yet to be determined. My understanding is that these new drugs are supposed to limit the body’s production of tumor-feeding estrogen by “deactivating the aromatase enzyme,” an enzyme that converts androgens into estrogens, a perfectly normal aspect of my body’s functioning, one that protects me from osteoporosis.

      Aromasin does something the other drugs do not do, that is, the deactivation it performs of a cell’s aromatase enzyme is irreversible—what is morbidly referred to as “suicide inhibition.” Add to that a myriad of bad to worse side-effects, which my oncologist didn’t mention but which I found in reports on the internet, such as hot flashes, severe joint pain, painful feet, sleeplessness, increased aggressiveness, and on and on, meaning that a strong percentage of patients decide the fear of a recurrence of breast cancer is worth enduring, if only to have a return of the quality of life, and freedom from the miseries caused by this pill.

      What ever happened to “first do no harm?” I already have hot flashes, joint pain, sore feet, and occasional insomnia—how would taking a pill that causes more of such misery be harmless? Also, it turns out Aromasin is used by body-builders. It’s a steroidal drug! So, besides the sweat, pain, sleeplessness, and hostility, I should go Arnold too?

      Doctors sometimes get frustrated with me. I am supposed to ignore facts and trust them. I am supposed to have a flat learning curve and just go along with the program. I am not supposed to connect the dots, not supposed to think critically about their treatment plans.

      I used to trust my doctors. Then began my journey through menopause. I wasn’t particularly bothered by this natural transition of womanhood, but apparently my primary care doctor, an internist, was hugely disturbed by it. It was as if not to go on Hormone Replacement Therapy, specifically estrogen, was to wither away from true womanhood toward something unspeakably hideous and diseased. He had just the thing to fix me. He even called me at home to advocate on behalf of Premarin, going so far as to argue with me about it.

      Eventually, I gave in, and once I was “addicted” to the pill, every subsequent doctor over a ten-year span gladly filled my prescriptions, and I unknowingly became a guinea pig in what one author referred to as The Greatest Experiment Ever Performed on Women. No proper studies had been done on HRT at the time I first began taking it, no randomized trials, but, based on nothing more than anecdotal evidence, all the doctors went crazy for it. Only recently have we have had the proper studies, and the results were not good:

According to the Million Women’s Study, for one (The Lancet):
• Estrogen-progestin use increased breast cancer by 19 per 1,000 women.
• Estrogen-alone use increased breast cancer by 5 per 1,000 women.

      Regardless, in the year 2000, according to IMS Health, U.S. doctors wrote 23,454,000 prescriptions for Premarin.

      Okay, correct me if I'm wrong: 23,454,000 @ 5 per 1000 women = 117,270 extra cases, among the prescription holders who will get breast cancer, assuming the group stays on Premarin more than five years—this, from the use of Premarin alone.

      But physicians and gynecologists are still prescribing it, still advertising it in their offices, and still lamely defending its use, as if they don’t look like ethical morons to claim that stopping hot flashes is worth the risk of developing breast cancer. The FDA still has not banned this horrible drug, nor limited its use.

      So there I was: I had been using Premarin for ten years when I was diagnosed with breast cancer. It was a shock I still have not recovered from fully. Certainly, it was something I never anticipated: no woman in my family had ever had breast cancer; I have two older sisters who are breast cancer free (they never took HRT); I was not a drinker nor a smoker; I didn’t eat red meat—heck, I was a vegetarian. Did any of my doctors apologize for this medical atrocity, which left me missing body parts and bereft of confidence in my future? Nope. Not one word of remorse. In fact, one charming oncologist, upon hearing my complaint about being robbed of my golden years by HRT, said, “Well, everyone dies.”

      Let’s face it: we live in a culture where greed is good and the profit motive is sacrosanct. As patients we like to think the pharmaceutical industry that instructs and assists our hapless doctors in treating us are good people who would love to rid us of our diseases. But the reality is that breast cancer is an industry, a cash cow for the entire medical industrial complex; and, whether those who profit from our sickness admit it or not, they don’t want to find a cure for cancer— think of the profit losses, were a cure to be found!

      Paranoia? Conspiracy theory?

      Consider this example: DCA, dichloroacetate, is a drug that shows real promise as a cure for many kinds of cancers, including breast cancer. Dr. Evangelos Michelakis, a professor at the University of Alberta Department of Medicine in Canada, is currently researching this “inexpensive, relatively harmless,” drug. Has the pharmaceutical industry rushed to fund this research, or to do the research itself? Gosh O golly, NO! Don’t you know DCA is not patented—there’s no profit to be made off the drug? Did you think the industry would be interested in finding a cure anyway, for the sake of humanity, for the sake of you and me? Are you dreaming? As reality has it, Dr. Michelakis will just have to scrape up the funds for his research from independent donors. The big guys just don’t care.

      Consider another example, as a clue to the moral character and motives of the corporate owners and managers who bring our world of chemicals and pharmaceuticals to us:

• In 2000, Novartis —insecticides, the herbicide, atrazine— and AstraZeneca —agro-chemicals and pharmaceuticals— formed Syngenta through the merger of their agricultural divisions.
• Syngenta makes and sells both aromatase promoters and inhibitors, both atrazine and Arimidex, for example.
• Atrazine, a widely used weed killer, is an aromatase promoter, an endocrine disrupter. Atrazine was denied regulatory approval in the European Union—it’s banned in Europe. It CAUSES breast cancer.
• The United States uses about 80 million pounds of atrazine every year. It is in the water, folks.

      How tidy is that vicious cycle? With one hand, they cause breast cancer, by contaminating the environment with atrazine; with the other hand, they treat the breast cancer they caused in the first place, with aromatase inhibitors, to the tune of billions: “Worldwide sales of aromatase inhibitors have increased from approximately $340 million in 2001 to more than $1.2 billion in 2004, representing an annual growth rate of 52%.”

      Of course, Syngenta denies that its product causes breast cancer and has bribed researchers and quashed the findings of honest researchers, using the full force of its power to attack the truth about atrazine. You would think, if the CEO’s and managers at Syngesta cared about the health and safety of people and the environment, they would listen to bad news about the dangers posed by their product and remove it from the market. You would think...but that would be in a world where people come before profits. This, clearly, is not that world.

      You would also like to hope that Syngenta, and companies like it, would not want be responsible for contributing to an epidemic of breast cancer. But that would be a world where corporations were peopled by folks with consciences, where corporations are not peopled by sociopaths. This is not that world. Instead, this is a world where killing people for profit isn’t personal— it’s business, so that, if people die, well, “everyone dies”. Why not make a profit, while the gettin’s good?

      Just between you and me, it seems to me that if corporations insist on being legal “persons,” with all the rights afforded to persons in the Constitution, then they ought to be judged as persons in the criminal justice system—that is, if they kill people for profit, then try to suppress the evidence, they should be prosecuted for murder. The CEO’s, managers and boards of directors of these criminal entities need to go to prison. Enough of this lawsuit crap; they just count those losses as part of the cost of doing business. (Although verdicts can serve to validate the common sense finding of damage done.) No. They need pay a real price for first contaminating the environment, then, when we get sick, profiting again from our sickness.

      I discussed a few of these facts and issues with my oncologist the other day. I asked him how oncologists decide which aromatase inhibitor to recommend. Quite honestly, he said there was no logic to it, no evidence of one drug being any better than any other; sometimes the decision is based on whether or not a drug company has charity programs for patients. He laughed: “We just don’t know!”

      He also listened to my complaints about drug companies and agreed with me. He took notes on my information about DCA and web sites devoted to patient experiences with aromatase inhibitors. Best of all he didn’t push Aromasin on me. Then he kissed me on the cheek, when we said good-bye.

      I do think he is one of the good guys. Some do care, some are as frustrated as their patients with the industry, the system. I want to think I am in good hands, but I hesitate.

      Ralph Nader said, “The profit motive corrupts all things." Sadly, trust is among the casualties, as in, collateral damage.


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