Bally Ache

November 17, 2009

Lance Armstrong -- Survivor

I am not a doctor. I do, however, possess a body heir to the usual ills, so I take a keen interest in the medical sciences. One thing I have noticed is that genuine medical research is published in medical journals such as the Lancet or the New England Journal of Medicine and doesn’t make it into the mainstream media at all for the most part. If it does, it is often sensationalized by journalists who do not understand how the scientific method or the protocols of medical research work. The result is often something similar to what is reproduced, in all its ghastliness, here.

The treatment is worse than the disease!
Christine O’Brien
Contributor to Nutrition and Healing

The number of problems that survivors of testicular cancer are facing is much higher than previously thought. Simply because mainstream medicine just didn’t bother to take a look until now.

Clinicians only report treatment problems that are life-threatening or require medical intervention. And they only monitor most patients for five to ten years after treatment, meaning that many men suffering the after-effects of toxic cancer treatment have simply fallen through the cracks.

But researchers are finally getting a clue and took a look at data from the past 20 years.

Of course, what they’ve found is more or less all bad news. In a study that appeared in the Journal of the British Association of Urological Surgeons, researchers detailed an alarmingly long list of long-term effects.

Details like: Sensory nerve damage in 10-30% and hearing loss in 20% of patients on cisplatin-based (a platinum-based drug) chemotherapy. Pulmonary complications in men over 40 who are treated with bleomycin (an antibiotic) before surgery. Premature thickening of the arteries. Chronic fatigue in 17% of survivors (that’s nearly twice the normal population). And survivors are nearly TWICE as likely to develop secondary cancer.

This laundry list of threats to your health didn’t keep researchers from reaching for some good news. They reported that, “on a more positive note” up to 80% of men who try for fatherhood after treatment are successful.

I’m sorry, but with the possibility of permanent nerve damage, secondary cancer and hearing impairment, that doesn’t just seem to be enough of a silver lining.

Let’s hope that this serves as an example of why a close look at the long-term is so critical. I couldn’t help but think of the recent swine flu vaccine studies – they gave the drug the seal of approval after only a month of safety trials.

And now there are promises of protection from the pandemic – but who knows what long-term risks are waiting around the corner? And are we willing to sacrifice our lives for short-term benefits?

Let’s start with the title. Is a 20% chance of hearing loss or a 17% chance of developing chronic fatigue years or decades in the future really worse than dying of testicular cancer now? Perhaps Ms O’Brien’s cavalier attitude could be traced to the fact that she, presumably, does not possess testicles, cancerous or otherwise. Or perhaps the nonsensical headline is merely a means of grabbing eyeballs and the actual article might make some sense.

Alas, the first paragraph puts paid to that optimistic hope. The horrible ogre “mainstream medicine” couldn’t be bothered to “take a look until now”. Codswallop. If Ms O’Brien has a means of foretelling the side effects of a treatment given now which will manifest themselves decades in the future she should disclose it now; the medical fraternity will, I’m sure, be agog to hear it and the Nobel Committee will fall over themselves to honour her. Or perhaps she thinks clinical trials should last for a minimum of the average human lifespan before a drug is approved for use.

I think it was Benjamin Disraeli who first referred to “lies, damn lies and statistics”. The problem with statistics is that, whilst they are incredibly useful if properly used, they are extremely easy to misinterpret through ignorance or to misrepresent in an attempt to shore up a shoddy argument. Ms O’Brien has made extensive use of the latter technique here. Let’s have a look.

Firstly, the quoted statistics have little or no relevance to current treatments. Ms O’Brien neglected to tell us that “Some relevant observations, in particular those referring to long-term effects, are from survivors treated with ‘outdated’ therapies, although many of these survivors, treated after 1980 are still alive and with a life-expectancy of 20–30 years.” We are not told this because it makes the whole thesis of the article irrelevant.

17% chance of developing chronic fatigue? Well, unless we read the actual paper we would never know that this is in contrast to 9.5% of men who do not have testicular cancer and that “Compared to those not fatigued, the survivors with chronic fatigue were older, had less education, more unemployment and economic problems, hazardous alcohol use, somatic comorbidity, neurotoxic side-effects, mental distress after treatment, depression, anxiety, and cancerrelated distress, poor HRQL, high level of neuroticism, and a less satisfying sexual life.” Just reading that gives me chronic fatigue.

22% hearing loss? No, 22% ototoxicity, ranging from tinnitus to hearing loss, no other information provided. And so on.

A truly horrifying statistic that Ms O’Brien chose not to present is that 10% more testicular cancer survivors marry than their cancerless brethren. This is where I expect people to point out that correlation does not necessarily mean causation and that some other factor may be at play.

Ms O’Brien concludes her ridiculous rant with the question: “And are we willing to sacrifice our lives for short-term benefits?” But that is precisely what she are asking her readers to do. Sacrifice their lives for fear of long term consequences that may or may not arise in the face of the mortal peril they are facing now.

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Grumpy Old Man by Mark Widdicombe is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.5 License.