Well, I’m no longer too enthralled by clinical trials.  Nine years ago, when I was diagnosed with prostate cancer I chose x-ray radiation as the treatment.  The urologist said that I should undergo three months of shots to shut down my testosterone production.  That would shrink the prostate, et cetera, so they could focus the x-rays more carefully.  A few months after they stopped the shots, my body would be back to normal producing testosterone.  I ageed, then he mentioned that the Luperin shots should be given once or twice a week (I’m not sure which), but I could participate in a clinical trial using another material, Aberelix, that required a shot only every three or four weeks.  That sounded great, so I did that.  The cancer is gone, the prostate is a very small piece of well cooked scar tissue, and almost everything is back to normal.  It’s just that the et cetera never went back to the state they were before the shots.  Of course, at seventy-nine, it’s not that much of a problem.

I notice that Aberelix never made it to the market.  As an afterthought, current medical thinking is that the anti-testosterone procedure doesn’t buy one anything so they don’t do that now.

Occam

For example, if I take statins, all they are doing is to suppress the symptom, i.e., reduce my cholesterol. But it does not address the underlying causes, whatever they may be.

Well, I guess it depends on what you mean by “underlying cause.” If you take statins to reduce your risk of dying from a heart attack brought on by the clogging of your arteries with atherosclerotic plaques, they work because they do prevent the disease by blocking the underlying cause, the buildup of atherosclerotic plaques. Now, if you want to treat the genetic basis for a predisposition to make such plaques and the dietary and lifestyle factors that increase the risk of palque formation and of heart attacks, scientific medicine will encourage that too, to whatever extent current knowledge makes it possible.

Unfortunately, while we don’t have perfect knowledge to fix or prevent everything, I still think we need to consider the alternatives. On what basis do CAM methods claim to be treating “real underlying causes” rather than symptoms? Is the real underlying cause an imbalance of ch’i? A blockage of innate intelligence by a vertebral subluxation? I mean the CAM approaches that have strongly articulated theories of the primary cause of disease usually have theories that require rejecting everything else science has taught us about how reality works. And therapies like herbs and so on often don’t have any theory about causation at all, just the argument that somebody once said Herb X works for Disease Y and people have done it that way for a long time so it must work. Again, let’s be clear that while there are certainly weaknesses and limitations to scientific medicine, these don’t necessarily mean CAM is any better.

Occam - 04 October 2009 11:41 PM

Well, I’m no longer too enthralled by clinical trials.  Nine years ago, when I was diagnosed with prostate cancer I chose x-ray radiation as the treatment.  The urologist said that I should undergo three months of shots to shut down my testosterone production.  That would shrink the prostate, et cetera, so they could focus the x-rays more carefully.  A few months after they stopped the shots, my body would be back to normal producing testosterone.  I ageed, then he mentioned that the Luperin shots should be given once or twice a week (I’m not sure which), but I could participate in a clinical trial using another material, Aberelix, that required a shot only every three or four weeks.  That sounded great, so I did that.  The cancer is gone, the prostate is a very small piece of well cooked scar tissue, and almost everything is back to normal.  It’s just that the et cetera never went back to the state they were before the shots.  Of course, at seventy-nine, it’s not that much of a problem.

I notice that Aberelix never made it to the market.  As an afterthought, current medical thinking is that the anti-testosterone procedure doesn’t buy one anything so they don’t do that now.

Occam

When we are doing the clinical trials, I believe it is the last bit of testing before submission for approval (but I may be wrong). I have helped with trials we were very excited about, where the premise made perfect sense, just to have the trial fail for one reason or the other. But I have also helped with trials that were wildly successful, most were somewhere in the middle. The information we give to families mentions this as a possibility.

There are multiple levels of clinical trials depending on what is being tested. New drugs go through small scale trials in healthy volunteers first, then expand to larger scale trials with more complicated patients. Some drugs for fatal conditions with no good treatments go through “compassionate use” provisions, which allow them to be tested in sick pateints without all the usual preliminary steps. The there are trials for preventative interventions, new diagnostic tests, and lots of other things. HERE is a FAQ by the FDA on clinical trials.

They have, like everything people do, lots of flaws. But they are still the most reliable way to figure out the truth about diagnostic and therapeutic approaches.

mckenzievmd - 05 October 2009 01:36 PM

There are multiple levels of clinical trials depending on what is being tested. New drugs go through small scale trials in healthy volunteers first, then expand to larger scale trials with more complicated patients. Some drugs for fatal conditions with no good treatments go through “compassionate use” provisions, which allow them to be tested in sick pateints without all the usual preliminary steps. The there are trials for preventative interventions, new diagnostic tests, and lots of other things. HERE is a FAQ by the FDA on clinical trials.

They have, like everything people do, lots of flaws. But they are still the most reliable way to figure out the truth about diagnostic and therapeutic approaches.

I think that in the ICU where I worked, we were often part of the larger last trials. It would be very unusual that we would do a “compassionate use” trial for a child, although, my guess is that we probably have, on occasion. I know we do a lot of organ transplant research and we are one of the most successful transplant centers in CA.

This is a great video about causation vs correlation.

http://www.youtube.com/watch?v=VW1IEqKuf6s&feature=player_embedded

here is part two, that gets into the antivaxxer movement.

http://www.youtube.com/watch?v=8Tl3tUQng9Q&feature=player_embedded

Love the videos!!!