Positive Health Online

Regulation Concerns

Information in the latest issue of Positive Health suggests that some of the Complementary professions may be looking favourably on the possibility of being regulated by the Health Professions Council (HPC), as though this will somehow give them formal recognition. That government body has been negotiating for some while with the Medical, Nursing, Psychology and other health-related professions, with the aim of having them all controlled and regulated by the HPC, whose membership will be selected primarily by the Government through its Department of Health.  There will be only a minority of professional members on the Council.  It is clearly desirable to prevent charlatans passing themselves off as registered Doctors, Nurses, Psychologists etceteras, but there are questions that we should be asking about the HPC.

1.    As it is clearly necessary to prevent unqualified people offering themselves as medical Doctors, Nurses, Psychologists etc., how strong is the existing protection against such malpractice? Anyone falsely claiming to practise as a Medical Doctor would be brought to Court and almost certainly imprisoned. Anyone applying for a job as a Nurse or Psychologist is asked to produce evidence of registration before being employed as such. People who set up in private practice to offer any of these services will soon be identified as phoney, and publicity about such malpractice will be given by the media and the professions themselves. Why then does the HPC want to take over the regulation of these professions?

2.    I am aware that both the Nursing and Psychology professional bodies are most unhappy about the proposed take-over. The Medical profession, after much protest, has reached an agreement with the government which still leaves a lot of significant control in the hands of the Doctors.  At this stage I am not sure whether that profession is aware of how much autonomy it nevertheless stands to lose.

3.    It is particularly concerning that the HPC is proposing that non-professionals will be in the majority on the Council and its subordinate organisations. This means that fundamental issues regarding the work and policies of these professions will, over time, be decided by a majority of lay people. This is particularly serious in regard to discipline, where one would expect to be judged by one’s peers and not by a committee, most of whose members will have little understanding of or experience within the profession concerned. The concept of being judged by one’s peers was always a fundamental principle in the governing of the professions. To have a minority of lay members involved in such judgements is a good principle, because it ensures that the decisions reached are also acceptable to ordinary people. Indeed, it may sometimes occur that the presence of lay people as part of a professional disciplinary panel leads to stronger measures than would otherwise have been taken.

4.    Most of the recognized Complementary professions have National Organisations responsible for setting standards and promoting training for those professions. Few of them, as far as I am aware, have requested legislative or regulatory recognition. of those organisations.  This is, I think, largely because it has always been difficult to get any of the Complementary professions accepted as legitimate forms of health care. Until a few decades ago, even Acupuncture was regarded as phoney and of no value. With all the research into its effectiveness, it is now being used increasingly by more forward looking Medical doctors. Aromatherapy and Homeopathy are much further away from formal recognition, and it will take a great deal more research to establish them as valid health-related professions. But what will happen if the HPC takes over and committees of doubting lay people sit in judgement on the recognition of Complementary practitioners? What conditions is the HPC likely to impose? Or will we end up with most of the existing Complementary professions being told that they can no longer practise in the way they are now doing, and restrictions imposed that give them little room for development?

5.    I do not know what the answers are, but perhaps we should all be aware that new laws, regulations and organisations are going to make life much more difficult for all the Complementary professions if they are taken over by the HPC. What are those professions doing to anticipate or prevent that development?

Chemotherapy Treatment May Fuel Cancer’s Spread

Chemotherapy is incapable of extending in any appreciable way the lives of patients afflicted with the most common cancers and even the palliative effect of these toxic drugs, which supposedly improve the quality of life, “rests on scientifically shaky ground”. That was the conclusion of West German cancer biostatistician Ulrich Abel PhD, in the most comprehensive study ever undertaken on cancer chemotherapy. In his 1990 book1 Dr Abel wrote, “There is no evidence for the vast majority of cancers that treatment with these drugs exerts any positive influence on survival or quality of life in patients with advanced disease.” The advanced cancers to which Dr Abel is referring are those malignancies responsible for over 80 per cent of the cancer deaths in the Western industrial countries. “Among others, they include nearly all malignant tumours of trachea, bronchus, lung, stomach, colon, rectum, oesophagus, breast, bladder, pancreas, ovary, cervix and corpus uteri, head and neck, and liver… Tumours are called advanced if they are recurrent, disseminated, or not radically resectable.”

Reference

1.    Ulrich Abel, Chemotherapy of Advanced Epithelial Cancer: A Critical Review (Stuttgart, Germany: Hippokrates Verlag GmbH, 1990), available from People Against Cancer, PO Box 10, Otho, IA 50569-0010. See also Chemo’s Berlin Wall Crumbles, The Cancer Chronicles, December 1990, pp. 4-5; and Chemotherapy: A Dull Weapon, Innovation, Spring-Summer 1991 (translation of Der Spiegel article), available from Foundation for the Advancement of Innovative Medicine, PO Box 338 Kinderhook, NY 12106-0338.

Treatment May Fuel Cancer’s Spread, Study Finds

By Maggie Fox, Health and Science Editor
Treating cancer with surgery, chemotherapy or radiation may sometimes cause tumours to spread, and US researchers said they may have nailed down one of the causes – a compound called TGF-beta.
Tests in mice show that using the chemotherapy drug doxorubicin or radiation both raised levels of TGF-beta, which in turn helped breast cancer tumours spread to the lung.

But using an antibody to block TGF-beta stopped the process, Dr Carlos Arteaga and colleagues at Vanderbilt University in Tennessee reported.

Developing drugs that block TGF-beta might help prevent cancer from recurring, Arteaga’s team reports in the May issue of the Journal of Clinical Investigation.

“The re-population and progression of tumours after anti-cancer therapy is a well-recognized phenomenon,” the researchers wrote. “It has been shown to occur following radiotherapy, chemotherapy, and surgery.”

Cancer experts have wondered if the so-called primary tumour – the first and biggest tumour – might somehow suppress the growth of other tumours, and that removing or destroying the first tumour might allow other, undetectable, tumours to then grow.

TGF-beta, which is involved in both the growth and suppression of tumours, may hold part of the answer, Arteaga’s team said.

When mice infected with human breast cancer cells were treated with radiation or doxorubicin, they had higher levels of TGF-beta in their blood. They also had more tiny tumour cells in their blood, and these cells metastasized to the lungs.

When the mice were treated with an antibody that suppresses TGF-beta, the spread stopped. And this spreading process did not occur at all in mice bred to lack the TGF-beta protein.

“We wondered then if TGF-beta induced by anti-cancer therapies can serve as a survival signal for tumour cells, thus allowing them to withstand therapy and later recur,” Arteaga said in a statement.

His team is now testing TGF-beta levels in the blood of breast cancer patients.

“We’ll be looking to see in what proportion of patients the serum and tumour TGF-beta goes up, and whether the increase correlates with the inability of the therapy to eliminate the cancer in the breast,” Arteaga said.

Higher levels of TGF-beta after treatment may be a way to predict which patients are likely to have their cancer come back after treatment, Arteaga said.

His team is also testing drugs that interfere with TGF-beta to see if they improve survival.

“It probably isn’t just TGF-beta that is having this effect,” Arteaga said. Many other compounds, including some immune system signalling chemicals, are also associated with tumour spread and growth.

“TGF-beta may be just the tip of the iceberg,” Arteaga said.

Comments to: Treatment May Fuel Cancer’s Spread

Cal Crilly
The TGF Beta question is often contradictory with cancer and sometimes it seems to suppress tumour growth. Raised levels of TGF Beta are indicative of an immune response in full action?

Or trying to suppress an overactive immune response?

“When the mice were treated with an antibody that suppresses TGF-beta, the spread stopped. And this spreading process did not occur at all in mice bred to lack the TGF-beta protein.”

There may be other reasons related to TGF Beta that caused this effect.

An example of the contradiction.

“Our data point to a potential benefit of combination therapy with 1,25-(OH)(2)D(3) and MEL(vitamin D and melatonin) in the treatment of breast cancer and suggest that the growth inhibition could be related, at least in part, to the enhanced TGF-beta(1) secretion.”

Melatonin and vitamin D3 increase TGF-beta1 release and induce growth inhibition in breast cancer cell cultures.

Survey of Doctors’ Experience of Patients Using the Internet

Henry WW Potts PhD, Jeremy C Wyatt DM FRCP
Background: There have been many studies showing the variable quality of Internet health information and it has often been assumed that patients will blindly follow this and frequently come to harm. There have also been reports of problems for doctors and health services following patient Internet use, but their frequency has not been quantified. However, there have been no large, rigorous surveys of the perceptions of Internet-aware doctors about the actual benefits and harms to their patients of using the Internet.

Objective: To describe Internet-literate doctors’ experiences of their patients’ use of the Internet and resulting benefits and problems.

Methods: Online survey to a group of 800 Web-using doctors (members of a UK medical Internet service provider, Medix) in September and October 2001.

Results: Responses were received from 748 (94%) doctors, including 375 general practitioners (50%). Respondents estimated that 1%-2% of their patients used the Internet for health information in the past month with no regional variation. Over two thirds of the doctors considered Internet health information to be usually (20%) or sometimes (48%) reliable; this was higher in those recently qualified. Twice as many reported patients experiencing benefits (85%; 95% confidence interval, 80%-90%) than problems (44%; 95% confidence interval, 37%-50%) from the Internet. Patients gaining actual physical benefits from Internet use were reported by 40% of respondents, while 8% reported physical harm. Patients’ overall experiences with the Internet were judged excellent 1%, good 29%, neutral 62%, poor 9%, or bad <1%. Turning to the impact of patient Internet use on the doctors themselves, 13% reported no problems, 38% 1 problem, and 49% 2 or more problems. Conversely, 20% reported no benefits for themselves, 49% 1 benefit, and 21% 2 or more benefits.

Conclusions: These doctors reported patient benefits from Internet use much more often than harms, but there were more problems than benefits for the doctors themselves. Reported estimates of patient Internet usage rates were low. Overall, this survey suggests that patients are deriving considerable benefits from using the Internet and that some of the claimed risks seem to have been exaggerated.

Cancer Fear Over Electric Blanket

Emma Bamford
WOMEN who use electric blankets to keep warm at night could be more at risk of cancer of the womb, according to scientists. They say those who have ever used one are 15 per cent more likely to become victims than those who have not. But for anyone who has regularly used them for 20 years or more, the risks increase to 36 per cent.

The scientists believe the reason may be that the blankets expose women to low levels of electro-magnetic radiation. The findings add to the controversy about whether electro-magnetic fields in the home are dangerous.

A recent study found black women who used electric blankets for 10 years had a five times greater risk of breast cancer. But other studies found no such link in white women. Scientists at Wayne State University in Michigan came up with the latest findings after analysing data on 90,000 women.

The results, published in the European Journal of Cancer Prevention, showed 1,500 of them developed a tumour of the womb. Once they had allowed for other risk factors, such as heavy drinking, being overweight and not having children, the experts found a significant link with the use of electric blankets. Womb cancer affects about 6,000 women every year in the UK, mostly over-50s.