Saturday, January 29, 2011
Saturday Night's Alright for Musing
******
Don't let expectations limit the exploration of possibilities.
Thursday, January 27, 2011
FDA Medical Device Safety Communication: Reports of Anaplastic Large Cell Lymphoma (ALCL) in Women with Breast Implants
******
Date Issued: January 26, 2011
Audience:
Health care providers involved in the care of patients with breast implants
Hospital tumor boards
Breast implant patients and families of patients, including those that have received breast implants for aesthetic augmentation, revision, or reconstruction.
Patients considering breast implant surgery
Medical Specialties: Radiology, Pathology, Plastic Surgery, General Surgery, Internal Medicine, Obstetrics/Gynecology, Oncology, Nursing, General Practice
Purpose:
The FDA is issuing this communication to inform health care providers and the public about a possible association between breast implants and a type of anaplastic large cell lymphoma (ALCL). Although ALCL is extremely rare, the FDA believes that women with breast implants may have a very small but increased risk of developing this disease in the scar capsule adjacent to the implant. The FDA is also asking health care providers to report confirmed cases of ALCL in women with breast implants to the FDA.
Summary of Issue:
The FDA is exploring a possible link between breast implants and ALCL. ALCL is a rare cancer of the immune system, which can occur anywhere in the body. According to the Surveillance, Epidemiology, and End Results (SEER) Program1 of the National Cancer Institute, an estimated 1 in 500,000 women per year in the U.S. is diagnosed with ALCL. ALCL in the breast is even more rare; approximately 3 in 100 million women per year in the U.S. are diagnosed with ALCL in the breast.
As part of its analysis, the FDA conducted a thorough review of scientific literature published from January 1997 through May 2010. From this review, the FDA identified 34 unique cases of ALCL in women with breast implants throughout the world. In total, the FDA is aware of approximately 60 case reports of ALCL in women with breast implants worldwide. This number is difficult to verify because not all cases were published in the scientific literature. Some cases have been identified through the FDA’s contact with other regulatory authorities, scientific experts, and breast implant manufacturers, and it is not clear how many of these are duplicates of the ones found in the literature.
The number of identified cases is small compared to the estimated 5 to 10 million women who have received breast implants worldwide. But based on these data, the FDA believes that women with breast implants may have a very small but increased risk of ALCL. Because the risk of ALCL appears very small, FDA believes that the totality of evidence continues to support a reasonable assurance that FDA-approved breast implants are safe and effective when used as labeled.
The table below describes the characteristics of the 34 published cases of ALCL in women with breast implants:
Characteristics of 34 Published Cases of ALCL in Women with Breast Implants
Age (years) Median 51
Range 28-87
Type of Implant Silicone 24
Saline 7
Not specified 3
Time from Implant to
ALCL Diagnosis (years) Median 8
Range 1-23
Reason for Implant Reconstruction 11
Augmentation 19
Not specified 4
FDA’s overview, review of the literature and discussion of these cases can be found in the document Anaplastic Large Cell Lymphoma (ALCL) in Women with Breast Implants: Preliminary FDA Findings and Analyses2.
ALCL is Lymphoma – Not Cancer of the Breast Tissue. When breast implants are placed in the body, they are inserted behind the breast tissue or under the chest muscle. Over time, a fibrous scar called a capsule develops around the implant, separating it from the rest of the breast. In women with breast implants, the ALCL was generally found adjacent to the implant itself and contained within the fibrous capsule. ALCL is lymphoma, a type of cancer involving cells of the immune system. It is not cancer of the breast tissue.
Most patients were diagnosed when they sought medical treatment for implant-related symptoms such as pain, lumps, swelling, or asymmetry that developed after their initial surgical sites were fully healed. These symptoms were due to collection of fluid (persistent seroma), hardening of breast area around the implant (capsular contracture), or masses surrounding the breast implant. Examination of the fluid and capsule surrounding the breast implant led to the ALCL diagnosis.
The FDA believes that women with breast implants may have an increased risk of developing ALCL, but also believes any potential risk is extremely low. Due to the rarity of ALCL, the small number of reports, and the incomplete and limited data from these reports, more information is needed to fully understand the possible link between breast implants and ALCL.
Recommended Actions for Health Care Providers and Patients
Health Care Providers:
If you have patients with breast implants, you should continue to provide them routine care and support. ALCL is a very rare condition; when it occurs, it has been identified most frequently in patients undergoing implant revision operations for late onset, persistent seroma. Because it has generally only been identified in patients with late onset of symptoms such as pain, lumps, swelling, or asymmetry, prophylactic breast implant removal in patients without symptoms or other abnormality is not recommended.
Current recommendations include the steps below. As the FDA learns more about ALCL in patients with breast implants, these recommendations may change.
Consider the possibility of ALCL when you have a patient with late onset, persistent peri-implant seroma. In some cases, patients presented with capsular contracture or masses adjacent to the breast implant. If you have a patient with suspected ALCL, refer her to an appropriate specialist for evaluation. When testing for ALCL, collect fresh seroma fluid and representative portions of the capsule and send for pathology tests to rule out ALCL. Diagnostic evaluation should include cytological evaluation of seroma fluid with Wright Giemsa stained smears and cell block immunohistochemistry testing for cluster of differentiation (CD) and Anaplastic Lymphoma Kinase (ALK) markers.
Report all confirmed cases of ALCL in women with breast implants to the FDA. In some cases, the FDA may contact you for additional information. The FDA will keep the identities of the reporter and the patient confidential.
Develop an individualized treatment plan in coordination with the patient’s multi-disciplinary care team. Because of the small number of cases worldwide and variety of available treatment options, there is no single defined consensus treatment regimen.
Patients:
If you have breast implants, there is no need to change your routine medical care and follow-up. ALCL is very rare; it has occurred in only a very small number of the millions of women who have breast implants. Although not specific to ALCL, you should follow standard medical recommendations including:
Monitoring your breast implants. If you notice any changes, contact your health care provider promptly to schedule an appointment. For more information on self breast exams, visit Medline Plus: Breast Self Exam3.
Getting routine mammography screening.
If you have silicone gel-filled breast implants, getting periodic magnetic resonance imaging (MRI) to detect ruptures as recommended by your health care provider. The FDA-approved product labeling for silicone gel-filled breast implants states that the first MRI should occur three years after implant surgery and every two years thereafter.
If you do not currently have breast implants but are considering breast implant surgery, discuss the risks and benefits with your health care provider. You may also visit FDA’s Breast Implants website4 for additional information.
FDA Activities:
The FDA continues to evaluate all available information to understand the nature and possible factors contributing to ALCL in women with breast implants. In addition, the American Society of Plastic Surgeons (ASPS) and other experts in the clinical and scientific communities have agreed to pursue a collaboration with the FDA to develop a registry to gather additional information to better characterize ALCL in women with breast implants.
While the details of the collaboration are being developed, the FDA is advising health care professionals to test breast implant patients with suspected ALCL according to the recommendations above and to submit findings on confirmed ALCL cases to the FDA. The FDA is also asking breast implant manufacturers to report confirmed cases. The FDA will update the public as new information is obtained.
In an effort to ensure that patients receiving breast implants are informed of the possible link between ALCL and breast implants, the FDA will be working with breast implant manufacturers in the coming months to update their product labeling materials for patients and providers.
As part of its ongoing surveillance of all breast implants, the FDA plans to provide an update on the state of the science on silicone gel-filled breast implants in the spring of 2011. This update will include interim findings from ongoing post-approval studies for silicone gel-filled breast implants currently sold in the United States, adverse event reports submitted to the FDA, and a review of the scientific literature on these products.
How to Report Information to the FDA:
If you are a health care provider and you have identified ALCL in breast implant patients, please file a voluntary report through MedWatch, the FDA’s Safety Information and Adverse Event Reporting Program online5, or at 1-800-332-1088.
To help us learn as much as possible about ALCL in women with breast implants, please include the following information in your reports, if available:
The term “ALCL Case Report” in section B5 (Describe Event, Problem or Product Use Error) of the MedWatch form
Patient age, gender, race/ethnicity
ALCL diagnosis: date of diagnosis, anatomic site of ALCL, whether ALCL was primary in this site and pathologically confirmed
Clinical presentation
Detailed pathology findings
Breast implant exposure: date implanted, brand and type of implant (saline or silicone-filled), type of implant surface (smooth or textured), complications, length of time from implant insertion, and history of subsequent revision surgeries
Treatment(s) the patient received
Name, contact information and medical specialty of reporter
All reports to the FDA are strictly confidential and protect individual patient privacy.
Contact Information:
If you have questions about this communication, please contact the Division of Small Manufacturers, International and Consumer Assistance (DSMICA) at DSMICA@FDA.HHS.GOV, 800-638-2041 or 301-796-7100.
This document reflects the FDA’s current analysis of available information, in keeping with our commitment to inform the public about ongoing safety reviews of medical devices. The FDA will provide updates as more information becomes available.
Date Issued: January 26, 2011
Audience:
Health care providers involved in the care of patients with breast implants
Hospital tumor boards
Breast implant patients and families of patients, including those that have received breast implants for aesthetic augmentation, revision, or reconstruction.
Patients considering breast implant surgery
Medical Specialties: Radiology, Pathology, Plastic Surgery, General Surgery, Internal Medicine, Obstetrics/Gynecology, Oncology, Nursing, General Practice
Purpose:
The FDA is issuing this communication to inform health care providers and the public about a possible association between breast implants and a type of anaplastic large cell lymphoma (ALCL). Although ALCL is extremely rare, the FDA believes that women with breast implants may have a very small but increased risk of developing this disease in the scar capsule adjacent to the implant. The FDA is also asking health care providers to report confirmed cases of ALCL in women with breast implants to the FDA.
Summary of Issue:
The FDA is exploring a possible link between breast implants and ALCL. ALCL is a rare cancer of the immune system, which can occur anywhere in the body. According to the Surveillance, Epidemiology, and End Results (SEER) Program1 of the National Cancer Institute, an estimated 1 in 500,000 women per year in the U.S. is diagnosed with ALCL. ALCL in the breast is even more rare; approximately 3 in 100 million women per year in the U.S. are diagnosed with ALCL in the breast.
As part of its analysis, the FDA conducted a thorough review of scientific literature published from January 1997 through May 2010. From this review, the FDA identified 34 unique cases of ALCL in women with breast implants throughout the world. In total, the FDA is aware of approximately 60 case reports of ALCL in women with breast implants worldwide. This number is difficult to verify because not all cases were published in the scientific literature. Some cases have been identified through the FDA’s contact with other regulatory authorities, scientific experts, and breast implant manufacturers, and it is not clear how many of these are duplicates of the ones found in the literature.
The number of identified cases is small compared to the estimated 5 to 10 million women who have received breast implants worldwide. But based on these data, the FDA believes that women with breast implants may have a very small but increased risk of ALCL. Because the risk of ALCL appears very small, FDA believes that the totality of evidence continues to support a reasonable assurance that FDA-approved breast implants are safe and effective when used as labeled.
The table below describes the characteristics of the 34 published cases of ALCL in women with breast implants:
Characteristics of 34 Published Cases of ALCL in Women with Breast Implants
Age (years) Median 51
Range 28-87
Type of Implant Silicone 24
Saline 7
Not specified 3
Time from Implant to
ALCL Diagnosis (years) Median 8
Range 1-23
Reason for Implant Reconstruction 11
Augmentation 19
Not specified 4
FDA’s overview, review of the literature and discussion of these cases can be found in the document Anaplastic Large Cell Lymphoma (ALCL) in Women with Breast Implants: Preliminary FDA Findings and Analyses2.
ALCL is Lymphoma – Not Cancer of the Breast Tissue. When breast implants are placed in the body, they are inserted behind the breast tissue or under the chest muscle. Over time, a fibrous scar called a capsule develops around the implant, separating it from the rest of the breast. In women with breast implants, the ALCL was generally found adjacent to the implant itself and contained within the fibrous capsule. ALCL is lymphoma, a type of cancer involving cells of the immune system. It is not cancer of the breast tissue.
Most patients were diagnosed when they sought medical treatment for implant-related symptoms such as pain, lumps, swelling, or asymmetry that developed after their initial surgical sites were fully healed. These symptoms were due to collection of fluid (persistent seroma), hardening of breast area around the implant (capsular contracture), or masses surrounding the breast implant. Examination of the fluid and capsule surrounding the breast implant led to the ALCL diagnosis.
The FDA believes that women with breast implants may have an increased risk of developing ALCL, but also believes any potential risk is extremely low. Due to the rarity of ALCL, the small number of reports, and the incomplete and limited data from these reports, more information is needed to fully understand the possible link between breast implants and ALCL.
Recommended Actions for Health Care Providers and Patients
Health Care Providers:
If you have patients with breast implants, you should continue to provide them routine care and support. ALCL is a very rare condition; when it occurs, it has been identified most frequently in patients undergoing implant revision operations for late onset, persistent seroma. Because it has generally only been identified in patients with late onset of symptoms such as pain, lumps, swelling, or asymmetry, prophylactic breast implant removal in patients without symptoms or other abnormality is not recommended.
Current recommendations include the steps below. As the FDA learns more about ALCL in patients with breast implants, these recommendations may change.
Consider the possibility of ALCL when you have a patient with late onset, persistent peri-implant seroma. In some cases, patients presented with capsular contracture or masses adjacent to the breast implant. If you have a patient with suspected ALCL, refer her to an appropriate specialist for evaluation. When testing for ALCL, collect fresh seroma fluid and representative portions of the capsule and send for pathology tests to rule out ALCL. Diagnostic evaluation should include cytological evaluation of seroma fluid with Wright Giemsa stained smears and cell block immunohistochemistry testing for cluster of differentiation (CD) and Anaplastic Lymphoma Kinase (ALK) markers.
Report all confirmed cases of ALCL in women with breast implants to the FDA. In some cases, the FDA may contact you for additional information. The FDA will keep the identities of the reporter and the patient confidential.
Develop an individualized treatment plan in coordination with the patient’s multi-disciplinary care team. Because of the small number of cases worldwide and variety of available treatment options, there is no single defined consensus treatment regimen.
Patients:
If you have breast implants, there is no need to change your routine medical care and follow-up. ALCL is very rare; it has occurred in only a very small number of the millions of women who have breast implants. Although not specific to ALCL, you should follow standard medical recommendations including:
Monitoring your breast implants. If you notice any changes, contact your health care provider promptly to schedule an appointment. For more information on self breast exams, visit Medline Plus: Breast Self Exam3.
Getting routine mammography screening.
If you have silicone gel-filled breast implants, getting periodic magnetic resonance imaging (MRI) to detect ruptures as recommended by your health care provider. The FDA-approved product labeling for silicone gel-filled breast implants states that the first MRI should occur three years after implant surgery and every two years thereafter.
If you do not currently have breast implants but are considering breast implant surgery, discuss the risks and benefits with your health care provider. You may also visit FDA’s Breast Implants website4 for additional information.
FDA Activities:
The FDA continues to evaluate all available information to understand the nature and possible factors contributing to ALCL in women with breast implants. In addition, the American Society of Plastic Surgeons (ASPS) and other experts in the clinical and scientific communities have agreed to pursue a collaboration with the FDA to develop a registry to gather additional information to better characterize ALCL in women with breast implants.
While the details of the collaboration are being developed, the FDA is advising health care professionals to test breast implant patients with suspected ALCL according to the recommendations above and to submit findings on confirmed ALCL cases to the FDA. The FDA is also asking breast implant manufacturers to report confirmed cases. The FDA will update the public as new information is obtained.
In an effort to ensure that patients receiving breast implants are informed of the possible link between ALCL and breast implants, the FDA will be working with breast implant manufacturers in the coming months to update their product labeling materials for patients and providers.
As part of its ongoing surveillance of all breast implants, the FDA plans to provide an update on the state of the science on silicone gel-filled breast implants in the spring of 2011. This update will include interim findings from ongoing post-approval studies for silicone gel-filled breast implants currently sold in the United States, adverse event reports submitted to the FDA, and a review of the scientific literature on these products.
How to Report Information to the FDA:
If you are a health care provider and you have identified ALCL in breast implant patients, please file a voluntary report through MedWatch, the FDA’s Safety Information and Adverse Event Reporting Program online5, or at 1-800-332-1088.
To help us learn as much as possible about ALCL in women with breast implants, please include the following information in your reports, if available:
The term “ALCL Case Report” in section B5 (Describe Event, Problem or Product Use Error) of the MedWatch form
Patient age, gender, race/ethnicity
ALCL diagnosis: date of diagnosis, anatomic site of ALCL, whether ALCL was primary in this site and pathologically confirmed
Clinical presentation
Detailed pathology findings
Breast implant exposure: date implanted, brand and type of implant (saline or silicone-filled), type of implant surface (smooth or textured), complications, length of time from implant insertion, and history of subsequent revision surgeries
Treatment(s) the patient received
Name, contact information and medical specialty of reporter
All reports to the FDA are strictly confidential and protect individual patient privacy.
Contact Information:
If you have questions about this communication, please contact the Division of Small Manufacturers, International and Consumer Assistance (DSMICA) at DSMICA@FDA.HHS.GOV, 800-638-2041 or 301-796-7100.
This document reflects the FDA’s current analysis of available information, in keeping with our commitment to inform the public about ongoing safety reviews of medical devices. The FDA will provide updates as more information becomes available.
Tuesday, January 25, 2011
Book excerpt: "Pink Ribbon Blues" by Gayle Sulik
******
I sit and type away at my obscure little blog, created back in summer of 2009 for the sole purpose of giving me an outlet to express my personal myriad of emotions, psychological gymnastics and empirical experiences while adapting to a life with cancer. As my keystrokes hit the screen, I never dreamed of finding an empathetic cacophony where I could add my screams and drumbeats. I am not alone in my revolution against the breast cancer industry. Its a somber empowerment. (I have highlighted a couple of my favorite passages from the excerpt.) .... TC
Book excerpt: Pink Ribbon Blues by Gayle Sulik
Compiled by Caitlin Chappelle, BCA Communications Associate
The following two excerpts are from Gayle Sulik’s recently released book, Pink Ribbon Blues. Breast cancer is spoken about more than most other diseases. Yet increased dialogue has not come without a price of unfortunately superficial terms: “I <3 boobies,” “Save the ta-ta’s,” “Beat the hell out of breast cancer,” to name a few. Many readers will be familiar with the stories Sulik cites. Her book is provocative and we encourage anyone who is interested to take a look at it and consider the costs and benefits of increased “awareness” and the incredible amount of action still needed to end this epidemic.
From Pink Ribbon Blues (Oxford University Press, 2010):
“I was going to die, if not sooner then later, whether or not I had ever spoken myself. My silences had not protected me. Your silence will not protect you…while we wait in silence for that final luxury of fearlessness, the weight of that silence will choke us.”
For Lorde, it is the truthful telling of all kinds of stories that matters, not only those accepted in the broader culture. Her goal is not to construct a singular Truth, such as the story of the triumphant survivor, but to create opportunities for women to seek out and examine a diversity of stories and consider their relevance to their lives.”
“In the early 1990s… breast cancer activism was starting to gain momentum in extending public outreach, increasing research funding, and gaining a seat at the public policy table. In August 1993, The New York Times Magazine published a story about the achievements of the breast cancer movement with the title “You Can’t Look Away Anymore.” The caption referred both to the success of the movement in agitating for change and to the photograph on the cover.
“Beauty Out of Damage” is a graphic self-portrait in which the artist and activist, Matuschka, bared her mastectomy scar. Unlike typical images of breast cancer survivors, the explicit nature of the photograph sparked significant controversy about how breast cancer should be presented to the public.
I have always adhered to the philosophy that one should speak and show the truth, because knowledge leads to free will, to choice. If we keep quiet about what cancer does to women’s bodies, if we refuse to accept women’s bodies in whatever condition they are in, we are doing a disservice to womankind.
Since its cover debut, “Beauty Out of Damage” received 12 awards, including a Pulitzer Prize nomination. The silence that once surrounded breast cancer had been broken. Fifteen years after the Times Magazine confronted the “anguished politics” of breast cancer, representations of breast cancer are everywhere. Pink ribbons and talk of breast cancer awareness in everyday social spaces must mean that, unlike the dark and quiet past, we now have an exhaustive number of ways to show and speak the truth about breast cancer.
Reprinted with permission.
The Source—Winter 2011
1.19.11
© 2011, Breast Cancer Action
ISSN #1993-2408, published quarterly by BCA.
Articles on detection and treatment do not constitute endorsements or medical advice but are intended solely to inform.
Compiled by Caitlin Chappelle, BCA Communications Associate
The following two excerpts are from Gayle Sulik’s recently released book, Pink Ribbon Blues. Breast cancer is spoken about more than most other diseases. Yet increased dialogue has not come without a price of unfortunately superficial terms: “I <3 boobies,” “Save the ta-ta’s,” “Beat the hell out of breast cancer,” to name a few. Many readers will be familiar with the stories Sulik cites. Her book is provocative and we encourage anyone who is interested to take a look at it and consider the costs and benefits of increased “awareness” and the incredible amount of action still needed to end this epidemic.
From Pink Ribbon Blues (Oxford University Press, 2010):
In the first chapter of The Cancer Journals, “the transformation of silence into language and action,” Lorde emphasizes the importance of illness narratives. Putting what she feels into words enables the ill person to reflect on her experience, examine it, put it into a perspective, share it, and make use of it. Lorde argues forcefully that communicating our experiences not only benefits the speaker on a personal level, but also gives voice to realities that will cause harm if left unattended. She writes:
“I was going to die, if not sooner then later, whether or not I had ever spoken myself. My silences had not protected me. Your silence will not protect you…while we wait in silence for that final luxury of fearlessness, the weight of that silence will choke us.”
For Lorde, it is the truthful telling of all kinds of stories that matters, not only those accepted in the broader culture. Her goal is not to construct a singular Truth, such as the story of the triumphant survivor, but to create opportunities for women to seek out and examine a diversity of stories and consider their relevance to their lives.”
“In the early 1990s… breast cancer activism was starting to gain momentum in extending public outreach, increasing research funding, and gaining a seat at the public policy table. In August 1993, The New York Times Magazine published a story about the achievements of the breast cancer movement with the title “You Can’t Look Away Anymore.” The caption referred both to the success of the movement in agitating for change and to the photograph on the cover.
“Beauty Out of Damage” is a graphic self-portrait in which the artist and activist, Matuschka, bared her mastectomy scar. Unlike typical images of breast cancer survivors, the explicit nature of the photograph sparked significant controversy about how breast cancer should be presented to the public.
I have always adhered to the philosophy that one should speak and show the truth, because knowledge leads to free will, to choice. If we keep quiet about what cancer does to women’s bodies, if we refuse to accept women’s bodies in whatever condition they are in, we are doing a disservice to womankind.
Since its cover debut, “Beauty Out of Damage” received 12 awards, including a Pulitzer Prize nomination. The silence that once surrounded breast cancer had been broken. Fifteen years after the Times Magazine confronted the “anguished politics” of breast cancer, representations of breast cancer are everywhere. Pink ribbons and talk of breast cancer awareness in everyday social spaces must mean that, unlike the dark and quiet past, we now have an exhaustive number of ways to show and speak the truth about breast cancer.
Regrettably, women and their support networks are now hidden beneath a barrage of pink ribbons and silenced in a cacophony of pink talk. The accepted discourse of pink ribbon culture—solidly lodged in war metaphor, triumphant survivorship, pink consumption, and narratives of quest and transcendence—limits the words, plotlines, and imagery available to communicate women’s varied experiences of breast cancer and ways of coping.”
Reprinted with permission.
The Source—Winter 2011
1.19.11
© 2011, Breast Cancer Action
ISSN #1993-2408, published quarterly by BCA.
Articles on detection and treatment do not constitute endorsements or medical advice but are intended solely to inform.
Sunday, January 23, 2011
A Little Sunday Reflection
******
When you read Alice in Wonderland, you will find yourself trying to make sense of an illogical story. Alice, the key character, also experiences similar frustrations. But in the end, she emerges wiser with the learning involved in each situation. Everyone faces absurd choices in life. If you shrug off these choices as anomalies to your perfect life, you gain nothing. But if you try to learn from these absurdities, you will gain a lot of wisdom.
By Simran Khurana
Cancer, whether it be breast, prostrate, pancreatic, lung, brain, uterine, cervical, esophageal, skin, et. al., is a rude anomaly introduced into our individualistic lives. This rude awakening, however, gives us the opportunity to search out knowledge and make choices that reveal so much of who we really are - not just who we thought we were.
By Simran Khurana
Cancer, whether it be breast, prostrate, pancreatic, lung, brain, uterine, cervical, esophageal, skin, et. al., is a rude anomaly introduced into our individualistic lives. This rude awakening, however, gives us the opportunity to search out knowledge and make choices that reveal so much of who we really are - not just who we thought we were.
Wednesday, January 19, 2011
"At some point you have to accept defeat..."
******
A dear friend from life-times past made the comment : "At some point you have to accept defeat...." These words were said a couple of months ago; and certainly not in the context of my life with breast cancer. These words, however, have gnawed at me. I find that I bristle at the implications. I find, that I cannot help but think of the myriad of situations where someone might say them to me. And this thinking started me to wonder about the concept of "defeat" and "acceptance" in all facets of my life.
I just can't imagine accepting nullification, obsolescence, destruction or even loss.
To ACCEPT would require me to:
... to take or receive with approval or favor; or
... to agree or consent to; accede to; or
... to accommodate or reconcile oneself to; or
... to regard as true or sound; believe; or
... to regard as normal, suitable, or usual.
I cannot bend to the concept of combining accept with defeat. Not in any situation. It is not that I am unreasonably obstinate, intolerant, inflexible, or pig-headed (at least the majority of the time). (I acknowledge that I can be opinionated - but the Libra in me desperately tries find balance.) Rather, I attribute my disposition to the fact that in all arenas I have a tendency to bring my whole self with me. (Many times, to my detriment.) Whether the situation involves my children, my relationships, my profession, my avocations or my beliefs. My whole self is brought to bear even in my approach to living with a chronic disease. In all of these I am present. With such a self - investment and the high stakes that attach when you are personally vested, I admit that accepting defeat is not in my genetic make up.
That is not to say that I am incapable of graciously embracing contrary situations, and the concomitant lessons that unpleasant circumstances offer. I am also not generally naive. I consider myself cynically optimistic. An an optimistic cynic I embrace such adages as: "evil can only triumph if good people do nothing:" [Edmund Burke] And dare to expand that ideal to encompass my further belief that people can do as much harm, if not more, by their overt negligence and inaction. For me, this view finds its way into all aspects of my life. To passively accept defeat and be a bystander is, in my little universe, tantamount to overt negligence. And, personally abhorrent to me.
Anyone who truly knows me would most likely agree that I am not one to accept defeat. Analyze it, scrutinize it, dissect it, challenge it, do everything to rise above it -- yes. But to meet defeat with approval or favor, agreement or consent, or to accede a bad or destructive situation as true or sound. No, I don't think I am capable of that.
Definition of DEFEAT (n.)
1: frustration by nullification or by prevention of success
2: obsolete : destruction
3 a : an overthrow in battle / b : the loss of a contest
I just can't imagine accepting nullification, obsolescence, destruction or even loss.
To ACCEPT would require me to:
... to take or receive with approval or favor; or
... to agree or consent to; accede to; or
... to accommodate or reconcile oneself to; or
... to regard as true or sound; believe; or
... to regard as normal, suitable, or usual.
I cannot bend to the concept of combining accept with defeat. Not in any situation. It is not that I am unreasonably obstinate, intolerant, inflexible, or pig-headed (at least the majority of the time). (I acknowledge that I can be opinionated - but the Libra in me desperately tries find balance.) Rather, I attribute my disposition to the fact that in all arenas I have a tendency to bring my whole self with me. (Many times, to my detriment.) Whether the situation involves my children, my relationships, my profession, my avocations or my beliefs. My whole self is brought to bear even in my approach to living with a chronic disease. In all of these I am present. With such a self - investment and the high stakes that attach when you are personally vested, I admit that accepting defeat is not in my genetic make up.
That is not to say that I am incapable of graciously embracing contrary situations, and the concomitant lessons that unpleasant circumstances offer. I am also not generally naive. I consider myself cynically optimistic. An an optimistic cynic I embrace such adages as: "evil can only triumph if good people do nothing:" [Edmund Burke] And dare to expand that ideal to encompass my further belief that people can do as much harm, if not more, by their overt negligence and inaction. For me, this view finds its way into all aspects of my life. To passively accept defeat and be a bystander is, in my little universe, tantamount to overt negligence. And, personally abhorrent to me.
Anyone who truly knows me would most likely agree that I am not one to accept defeat. Analyze it, scrutinize it, dissect it, challenge it, do everything to rise above it -- yes. But to meet defeat with approval or favor, agreement or consent, or to accede a bad or destructive situation as true or sound. No, I don't think I am capable of that.
Friday, January 7, 2011
Coley's Controversial "Cancer / Fever" Connection
******
As a result of my month-long battle with flu, pneumonia, bacterial infections and high fevers (102.5+), my partner reminded me of an interesting theory regarding the benefits of high fevers in combatting cancer cells. I started to dig around to find a reader-friendly summary and history of the "cancer/fever theory" and found the following two articles. They are a good introduction to the controversial hypothesis. The url for the source website is listed at the end.
Fever and Cancer Healing
Fever, Cancer Incidence and Spontaneous Remissions
Kleef R, Jonas WB, Knogler W, Stenzinger W., Office of Complementary and Alternative Medicine, NIH, Bethesda, MD, USA.
Summary: [T]he occurrence of fever in childhood or adulthood may protect against the later onset of malignant disease; spontaneous remissions are often preceded by feverish infections.
OBJECTIVE: Accumulating evidence exists for (1) an inverse correlation between the incidence of infectious diseases and cancer risk and (2) an inverse correlation between febrile infections and remissions of malignancies. This review is part of an effort of the Office of Alternative Medicine at the National Institutes of Health to examine this evidence.
METHODS: A review of the literature to a key word search was undertaken, using the following key words: fever, infectious diseases, neoplasm, cancer incidence and spontaneous remission.
RESULTS: The data reviewed in this article support earlier observations on the topic, i.e. that the occurrence of fever in childhood or adulthood may protect against the later onset of malignant disease and that spontaneous remissions are often preceded by feverish infections.
CONCLUSION: Pyrogenic substances and the more recent use of whole-body hyperthermia to mimic the physiologic response to fever have successfully been administered in palliative and curative treatment protocols for metastatic cancer. Further research in this area is warranted.
Copyright 2001 S. Karger AG, Basel Dec 22 2003
Microbially Induced Fever and Spontaneous Cancer Remissions (“Coley's toxins”) -- excerpted from The Promise of William B. Coley
by Ralph W. Moss, Ph.D., September 2002
NOTE: Readers can find out more about this program by calling Gar Hildenbrand of the Issels Treatment Center at 858-759-2966.
Last week I spoke about the promise represented by the phenomenon of "spontaneous remissions." These are cures of cancer that occur without medical intervention. While rare, they are well documented. For centuries, doctors have dreamed of harnessing this phenomenon to create a natural cure for cancer.
In the 1890s, a young New York surgeon, fresh out of Yale University and Harvard Medical School, made a fascinating discovery. Desperate to find a cure for bone cancer, he searched the records of New York Hospital to see if anyone had ever been cured of the advanced form of that disease. He discovered that one man with advanced sarcoma had contracted an infectious skin disease called erysipelas in the hospital. He not only survived the infection but his cancer went into a "spontaneous" remission.
Most doctors would have shrugged their shoulders and moved on to the next case. But William B. Coley was no ordinary doctor. He was the Sherlock Holmes of cancer. He went to the address listed on the man's records, but the man had moved. And so he tracked him from tenement to tenement until finally in 1888 he found the man alive, well, and cancer-free seven years after the spontaneous cure.
This was an event that changed the course of Coley's life. In 1891, he began treating patients with the same organism that caused erysipelas, a germ called Streptococcus pyogenes. His first patient developed a raging fever, and then the "miracle" occurred: the tumors of his tonsils and neck completely disappeared, and only a scar remained. This man, who could only swallow liquids and whisper when Coley started the treatment, made a complete recovery. (Ten years later he was still free of cancer.) Coley inoculated nine more patients with live erysipelas microbes and discovered that physicians in Germany, such as Dr. Busch, were doing the same thing independently of his own discovery. In 1893, he tabulated the first results and published his first article on the method. Out of seventeen cases of advanced cancer, four were permanently cured, ten showed improvement, while three showed no improvement at all.
While some people saw their cancers regress with the use of live bacteria, others died. In addition to its risks for the patient being treated, using live bacteria was dangerous to other patients and to the staff. So Coley conceived the idea of using killed bacterial byproducts. He added a nonpathogenic organism called Serratia marcescens to the "soup" and started treating patients with this mixture.
The world quickly dubbed this combination "Coley's toxins," since they represented the toxic byproducts of the bacteria without the bacteria themselves. However, the word "toxins" was an unfortunate choice. (A more acceptable name for the treatment is "mixed bacterial vaccine.") The bacteria deliberately caused side effects, such as fever and malaise. But they were not toxic in the sense that radiation or chemotherapy is toxic. They did not destroy the immune system but put it through a rigorous drill that often resulted in the shrinkage or disappearance of the tumor.
Over the years Coley published dozens of articles in the best medical journals. These recorded his success (and sometimes his failure) in applying the mixed bacterial vaccine to people with advanced cancer. In sarcomas, he claimed 41 percent complete cures. In other kinds of cancer there were many astounding remissions.
There were drawbacks to the treatment, however. Having frequent fevers is trying on the patient. The preparations (mostly made for Coley by Parke-Davis) were variable in their potency. This led to much confusion and disappointment. Some doctors, initially enthusiastic about the treatment, became disillusioned when they used less effective preparations. Oftentimes, doctors did not use the toxins aggressively enough. It took a tremendous belief to persevere with this treatment. Nevertheless, despite the difficulties and drawbacks, there is no doubt in my mind that Coley's toxins represented one practical application of the idea of spontaneous remission to treatment.
The subsequent history of Coley's toxins is rather sad. Coley died in 1936. He never wrote a book about his amazing life experience, and his journal articles began to gather dust in medical libraries. His son, Bradley Coley, MD, continued to use the vaccine at Memorial Sloan-Kettering into the 1950s, but in an increasingly hostile environment. First radiation and then chemotherapy became directly competitive with this more natural approach. Coley's daughter, Helen Coley Nauts, founded the Cancer Research Institute of New York to save and promote his work. She was an amazing presence in the cancer field for many decades. But although she got her father removed from the American Cancer Society "quack list" in the mid-1970s, she was never able to get his treatment used widely.
I first heard of Coley from his Memorial colleague, Kanematsu Sugiura, DSc, who compared his own problems with laetrile to those experienced by Coley in the 1920s and 1930s. Through Lloyd Old, MD, then vice president of Sloan-Kettering Institute, I interviewed Mrs. Nauts at her home on Park Avenue in 1975. This was an eye-opener, to say the least. Mrs. Nauts remained a good friend for many years. She had a vast influence on cancer, befriending and supporting many young researchers. She died on January 2, 2001, at the age of 93.
At the present time, there are few clinics that use Coley's toxins as part of a comprehensive treatment protocol. One that interests me very much is an inpatient program in Tijuana, Mexico, that combines Coley's toxins with the Gerson diet [also compare Juicing & Juicers] and other forms of immunotherapy.
Copyright © Ralph W. Moss, Ph.D. CancerDecisions®
Dedicated to Joyful Healing
© 2004, 2005, 2006, 2007, 2008, 2009 & 2010 www.healingcancernaturally.com
All Rights Reserved
Copyright Notice
USE OF THIS SITE SIGNIFIES YOUR AGREEMENT TO THE DISCLAIMER.
Paradise Now
Ursula R. M. Schmid. P.O. Box 120244, 10592 Berlin, Germany,
Fax: +49 30 2639173 02053
http://www.healingcancernaturally.com/nature_heals2.html#Fever and Cancer healing
Fever can save lives and heal cancer. Here is a possibly life-saving article detailing the vital importance of non-interference with the body’s self-healing in the case of fevers healing the body, especially in virus (lung) infections, together with articles on the strong connection between fever or induced hyperthermia and cancer healing (including spontaneous remissions).
Fever and Cancer Healing
Fever, Cancer Incidence and Spontaneous Remissions
Kleef R, Jonas WB, Knogler W, Stenzinger W., Office of Complementary and Alternative Medicine, NIH, Bethesda, MD, USA.
Summary: [T]he occurrence of fever in childhood or adulthood may protect against the later onset of malignant disease; spontaneous remissions are often preceded by feverish infections.
OBJECTIVE: Accumulating evidence exists for (1) an inverse correlation between the incidence of infectious diseases and cancer risk and (2) an inverse correlation between febrile infections and remissions of malignancies. This review is part of an effort of the Office of Alternative Medicine at the National Institutes of Health to examine this evidence.
METHODS: A review of the literature to a key word search was undertaken, using the following key words: fever, infectious diseases, neoplasm, cancer incidence and spontaneous remission.
RESULTS: The data reviewed in this article support earlier observations on the topic, i.e. that the occurrence of fever in childhood or adulthood may protect against the later onset of malignant disease and that spontaneous remissions are often preceded by feverish infections.
CONCLUSION: Pyrogenic substances and the more recent use of whole-body hyperthermia to mimic the physiologic response to fever have successfully been administered in palliative and curative treatment protocols for metastatic cancer. Further research in this area is warranted.
Copyright 2001 S. Karger AG, Basel Dec 22 2003
Compare Terminal Colon Cancer Patient Healed Via Complete Budwig Protocol, Healthy Today. His healing journey involved multiple fever spells, both spontaneous and self-induced by epsom salt baths, each of which left him feeling better. Also see the powerful confirming observations reported in Homeopathy, Carcinosinum and Cancer: Cancer patients are regularly recorded as stating: "I cannot remember that I ever had fever." As their bodily defenses are rekindled (such as by homeopathic [= energetic] treatment), RESTORATION OF REACTIVITY, from the tumoral stage back to the infectious stage, takes place: "A process of cleaning out at all levels takes place, poisonous relationships are broken off or corrected, ... and a marked influenza or inflammation with high fever for the first time in twenty years cleans the poison from his body. All this means that the reactivity is increasing. ... Also the suppression of fever, a defense mechanism par excellence, the use of antibiotics and corticosteroids can lower the defense mechanisms.”
Microbially Induced Fever and Spontaneous Cancer Remissions (“Coley's toxins”) -- excerpted from The Promise of William B. Coley
by Ralph W. Moss, Ph.D., September 2002
NOTE: Readers can find out more about this program by calling Gar Hildenbrand of the Issels Treatment Center at 858-759-2966.
Last week I spoke about the promise represented by the phenomenon of "spontaneous remissions." These are cures of cancer that occur without medical intervention. While rare, they are well documented. For centuries, doctors have dreamed of harnessing this phenomenon to create a natural cure for cancer.
In the 1890s, a young New York surgeon, fresh out of Yale University and Harvard Medical School, made a fascinating discovery. Desperate to find a cure for bone cancer, he searched the records of New York Hospital to see if anyone had ever been cured of the advanced form of that disease. He discovered that one man with advanced sarcoma had contracted an infectious skin disease called erysipelas in the hospital. He not only survived the infection but his cancer went into a "spontaneous" remission.
Most doctors would have shrugged their shoulders and moved on to the next case. But William B. Coley was no ordinary doctor. He was the Sherlock Holmes of cancer. He went to the address listed on the man's records, but the man had moved. And so he tracked him from tenement to tenement until finally in 1888 he found the man alive, well, and cancer-free seven years after the spontaneous cure.
This was an event that changed the course of Coley's life. In 1891, he began treating patients with the same organism that caused erysipelas, a germ called Streptococcus pyogenes. His first patient developed a raging fever, and then the "miracle" occurred: the tumors of his tonsils and neck completely disappeared, and only a scar remained. This man, who could only swallow liquids and whisper when Coley started the treatment, made a complete recovery. (Ten years later he was still free of cancer.) Coley inoculated nine more patients with live erysipelas microbes and discovered that physicians in Germany, such as Dr. Busch, were doing the same thing independently of his own discovery. In 1893, he tabulated the first results and published his first article on the method. Out of seventeen cases of advanced cancer, four were permanently cured, ten showed improvement, while three showed no improvement at all.
While some people saw their cancers regress with the use of live bacteria, others died. In addition to its risks for the patient being treated, using live bacteria was dangerous to other patients and to the staff. So Coley conceived the idea of using killed bacterial byproducts. He added a nonpathogenic organism called Serratia marcescens to the "soup" and started treating patients with this mixture.
The world quickly dubbed this combination "Coley's toxins," since they represented the toxic byproducts of the bacteria without the bacteria themselves. However, the word "toxins" was an unfortunate choice. (A more acceptable name for the treatment is "mixed bacterial vaccine.") The bacteria deliberately caused side effects, such as fever and malaise. But they were not toxic in the sense that radiation or chemotherapy is toxic. They did not destroy the immune system but put it through a rigorous drill that often resulted in the shrinkage or disappearance of the tumor.
Over the years Coley published dozens of articles in the best medical journals. These recorded his success (and sometimes his failure) in applying the mixed bacterial vaccine to people with advanced cancer. In sarcomas, he claimed 41 percent complete cures. In other kinds of cancer there were many astounding remissions.
There were drawbacks to the treatment, however. Having frequent fevers is trying on the patient. The preparations (mostly made for Coley by Parke-Davis) were variable in their potency. This led to much confusion and disappointment. Some doctors, initially enthusiastic about the treatment, became disillusioned when they used less effective preparations. Oftentimes, doctors did not use the toxins aggressively enough. It took a tremendous belief to persevere with this treatment. Nevertheless, despite the difficulties and drawbacks, there is no doubt in my mind that Coley's toxins represented one practical application of the idea of spontaneous remission to treatment.
The subsequent history of Coley's toxins is rather sad. Coley died in 1936. He never wrote a book about his amazing life experience, and his journal articles began to gather dust in medical libraries. His son, Bradley Coley, MD, continued to use the vaccine at Memorial Sloan-Kettering into the 1950s, but in an increasingly hostile environment. First radiation and then chemotherapy became directly competitive with this more natural approach. Coley's daughter, Helen Coley Nauts, founded the Cancer Research Institute of New York to save and promote his work. She was an amazing presence in the cancer field for many decades. But although she got her father removed from the American Cancer Society "quack list" in the mid-1970s, she was never able to get his treatment used widely.
I first heard of Coley from his Memorial colleague, Kanematsu Sugiura, DSc, who compared his own problems with laetrile to those experienced by Coley in the 1920s and 1930s. Through Lloyd Old, MD, then vice president of Sloan-Kettering Institute, I interviewed Mrs. Nauts at her home on Park Avenue in 1975. This was an eye-opener, to say the least. Mrs. Nauts remained a good friend for many years. She had a vast influence on cancer, befriending and supporting many young researchers. She died on January 2, 2001, at the age of 93.
At the present time, there are few clinics that use Coley's toxins as part of a comprehensive treatment protocol. One that interests me very much is an inpatient program in Tijuana, Mexico, that combines Coley's toxins with the Gerson diet [also compare Juicing & Juicers] and other forms of immunotherapy.
Copyright © Ralph W. Moss, Ph.D. CancerDecisions®
Compare Terminal Colon Cancer Patient Healed Via Complete Budwig Protocol, Healthy Today. His healing journey involved multiple fever spells, both spontaneous and self-induced by epsom salt baths, each of which left him feeling better.
Also see the powerful confirming observations reported in Homeopathy, Carcinosinum and Cancer: Cancer patients are regularly recorded as stating: "I cannot remember that I ever had fever." As their bodily defenses are rekindled (such as by homeopathic treatment), RESTORATION OF REACTIVITY, from the tumoral stage back to the infectious stage, takes place: "A process of cleaning out at all levels takes place, poisonous relationships are broken off or corrected, ... and a marked influenza or inflammation with high fever for the first time in twenty years cleans the poison from his body. All this means that the reactivity is increasing.”
Dedicated to Joyful Healing
© 2004, 2005, 2006, 2007, 2008, 2009 & 2010 www.healingcancernaturally.com
All Rights Reserved
Copyright Notice
USE OF THIS SITE SIGNIFIES YOUR AGREEMENT TO THE DISCLAIMER.
Paradise Now
Ursula R. M. Schmid. P.O. Box 120244, 10592 Berlin, Germany,
Fax: +49 30 2639173 02053
http://www.healingcancernaturally.com/nature_heals2.html#Fever and Cancer healing
Tuesday, January 4, 2011
Auld Lang Syne 2010
******
"Auld Lang Syne" ... here here!
Blessing: a dear old friend (as in time we have known each other - definitely not our individual calendar) and her lovely Bond-boy came for an long-anticipated visit to celebrate her 1/2 century mark upon this planet.
Blessing: my eldest hermana visited with my niece and her boyfriend as they conducted a pre-relocation reconnaissance trip to the southwest.
Blessing: back to back visitors forced me to take some needed time away from the office to be a ... person.
Blessing: a 9 year old son.
Bane: a 9 year old germ-infested son.
Bane: a 9 year old who has germier schoolmates who shared a flu virus.
Blessing: being self-employed so that I can stay home and nurse sick 9 year old.
Bane: work-aholicism compromised my immune system and allowed the insidious flu virus to take root in my system.
Blessing: 9 year old recovers in 3 days.
Bane: flu virus within me turns into pneumonia, with a dose of double ear infections, an assault of sinusitis, and a smattering of conjunctivitis in both eyes.
Bane: 3 weeks of illness requiring two rounds of hi-octane antibiotics and a perpetual high fever.
Blessing: very cool delusions and hallucinations as a result of 102.5+ fevers.
Blessing: older children come home from college for the winter holidays.
Bane: doctors wanting to do yet another MRI and ultrasound to try and determine what the mass is that has taken root in the locale previously occupied by my right ovary.
Blessing: Well enough by New Years Eve to toast my 22nd wedding anniversary with an expensive and fab Zinfandel that my "old" friend brought from Toulouse.
Blessing: Being here to bitch, moan and celebrate the diverse banes and blessings life deigns to bestow.
Is well known Scottish folk song, sung in many English-speaking (and other) countries to celebrate the start of the New Year at the stroke of midnight. By extension, its use has also become common at funerals, graduations, and as a farewell or ending to other occasions.The last chapter of 2010 was defined by the banes and blessings that life gives us. Whether we want them or not. Below are my own 14 B & B s that defined my December 2010.
Blessing: a dear old friend (as in time we have known each other - definitely not our individual calendar) and her lovely Bond-boy came for an long-anticipated visit to celebrate her 1/2 century mark upon this planet.
Blessing: my eldest hermana visited with my niece and her boyfriend as they conducted a pre-relocation reconnaissance trip to the southwest.
Blessing: back to back visitors forced me to take some needed time away from the office to be a ... person.
Blessing: a 9 year old son.
Bane: a 9 year old germ-infested son.
Bane: a 9 year old who has germier schoolmates who shared a flu virus.
Blessing: being self-employed so that I can stay home and nurse sick 9 year old.
Bane: work-aholicism compromised my immune system and allowed the insidious flu virus to take root in my system.
Blessing: 9 year old recovers in 3 days.
Bane: flu virus within me turns into pneumonia, with a dose of double ear infections, an assault of sinusitis, and a smattering of conjunctivitis in both eyes.
Bane: 3 weeks of illness requiring two rounds of hi-octane antibiotics and a perpetual high fever.
Blessing: very cool delusions and hallucinations as a result of 102.5+ fevers.
Blessing: older children come home from college for the winter holidays.
Bane: doctors wanting to do yet another MRI and ultrasound to try and determine what the mass is that has taken root in the locale previously occupied by my right ovary.
Blessing: Well enough by New Years Eve to toast my 22nd wedding anniversary with an expensive and fab Zinfandel that my "old" friend brought from Toulouse.
Blessing: Being here to bitch, moan and celebrate the diverse banes and blessings life deigns to bestow.
. . . And surely ye'll be your pint-stowp!
And surely I'll be mine!
And we'll take a cup o' kindness yet,
for auld lang syne.
We twa hae run about the braes
And pou'd the gowans fine.
We've wandered mony a weary foot,
Sin' auld lang syne.
We twa hae sported i' the burn,
From morning sun till dine,
But seas between us braid hae roared
Sin' auld lang syne.
And ther's a hand, my trusty friend,
And gie's a hand o' thine;
We'll tak' a right good willie-waught,,
For auld lang syne.
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