On 20-22 September 2016 Don Benjamin (Research Director – CISS) attended the Fifth Preventing Overdiagnosis Conference in Barcelona (Spain) where he made a brief presentation and displayed a poster inviting other researchers to join a special project to develop an alternative cancer paradigm.
Exploring Alternative Cancer Paradigms
A project to develop a new theory of what cancer is, consistent with treatments that work.
Overdiagnosis, by definition, includes diagnoses leading to interventions where patients are unlikely to benefit and may suffer physical and/or psychosocial harm.
One of the main reasons for preventing overdiagnosis is to avoid overtreatment. But overtreatment can occur with a correct diagnosis if standard treatments offered are ineffective and may cause harm.
The British Medical Journal’s Clinical Evidence Group has found that about 64% of common medical interventions have not been shown to be effective and may cause harm. For cancer I have estimated that the figure is closer to 80%. So if this wider definition is accepted, cancer treatments become one of the largest causes of overdiagnosis and overtreatment because most are likely to cause more harm than good. How did we get to this situation?
The current cancer paradigm was developed ad hoc in mid to late 19th century following refinement of microscopy that enabled the viewing of cancer cells in their early stages of growth, suggesting that cancer starts locally. (For the previous 2,000 years cancer was assumed to be a systemic disease, possibly with a psychological component.)
From this new paradigm developed the aim of “getting it all” and “getting it early”.
Since then screening trials have found no significant reduction in mortality with breast, bowel, lung, prostate or ovarian cancer. Chemotherapy increases 5-year survival by only about 2.3%.
So nearly 150 years later it is finally being accepted that this new paradigm needs to be reviewed. For example a few years ago the US National Cancer Institute recognised this lack of progress with treating cancer over the past 50 years and commissioned 12 research centres in the US to find out why.
Paul Davies, the head of one of these Centres concluded that cancer arises from a breakdown in cell communication that stops the cell responding to instructions about what it is supposed to do or be – i.e. differentiated as part of a community.
If you find it hard to hear someone giving you detailed instructions on a noisy telephone line, you’ll understand the cell’s problem. Let’s look at some of the evidence supporting this theory.
Candace Pert found that cancer was caused by too much stress causing circulating protein peptides that disrupt cell communication.
Elizabeth Blackburn and Elissa Epel found chronic stress shortened the cells’ telomeres and shortened life. Michael Marmot also found that too much stress shortened life.
Our research has confirmed that the cancer therapies that have produced the best results have been those that addressed this problem of a breakdown in cell communication, by increasing the signal to noise ratio – either by increasing the signal or reducing the background noise (eg caused by the stress) or both.
To find out more and possibly join our project, please view Exploring Alternative Cancer Paradigms – Poster (Barcelona 2016).
Barcelona – 20 September 2016