Archive for the ‘Medicine’ Category

As costs go up in flames, time to pull Obamacare off the market?

October 24, 2016

Obamacare costs are no longer affordable. So even Barack Obama is comparing his Affordable Care Act with Samsung’s Galaxy Note 7.

“When one of these companies comes out with a new smartphone… [and] it has a few bugs, what do they do, — they fix it, [they] upgrade it. Unless it catches fire – then they pull it off the market”.

And Obamacare is clearly on fire.




Obamacare’s Collapsing. That Was Always The Plan.

On Thursday, President Obama attempted to defend the skyrocketing costs of Obamacare by comparing them to the Samsung Galaxy Note 7, a smartphone that was banned on airplanes because it had a nasty habit of spontaneously combusting. …. Obama put the responsibility on the states for not expanding Medicaid, thereby avoiding picking up the costs of Obamacare. The vast majority of people who have enrolled in Obamacare have done so at point of government gun, and have done so as part of the Medicaid expansions Obamacare attempted to incentivize; as of October 2015, nearly all of the “newly insured” enrollees were Medicaid enrollees. Obama tried to claim that the federal government would pick up the tab for expanded Medicaid, but that neglects that over time, the states pick up more and more of the tab – and that the federal government is $20 trillion in debt.

Now, Obama’s pushing the public option, using George W. Bush’s egregiously awful Medicare Part D prescription drug benefit expansion. Part D has led to massive increases in healthcare costs, as well as to rejection of Medicare itself by health providers thanks to government restrictions on costs. As Mark Levin writes in Plunder and Deceit, “the impracticability of Medicare’s centralized management and archaic decision-making practices…significantly impairs the broader private sector.” …

….. I told Fox News back in August 2013 that Obamacare was designed to fail, thereby necessitating a government option. That option would bankrupt insurance companies – the government doesn’t have a necessity for profit margin, and therefore, for decent service – and lead to the complete government takeover of healthcare Obama has always sought. In other words, Obamacare was created with designed obsolescence – it’s as though Samsung had designed their phones to melt down so that they could then market the Samsung Galaxy Note 8, Government Edition.

Obamacare is not the shining example some people would like to pretend it is.


Zika fears lead to spike in DIY abortions in Latin America

June 23, 2016

Abortion is still illegal in most of Catholic Latin America and the governments have responded to the Zika virus by suggesting that women not get pregnant. They seem to have the support of the Pope for that approach. As The Guardian reports, “Pope Francis has indicated that women exposed to the Zika virus may be permitted to use contraception to avoid pregnancy, in a departure from Catholic teaching. However he reiterated the church’s staunch opposition to abortion, saying it was a crime and “absolute evil”.

But the reality is that DIY abortions are spiking and interestingly the countries advising women not to get pregnant are seeing the largest increases in abortion. Effectively The Pope’s dispensation on contraception is being taken, it would seem, as a dispensation also for abortion.

BBCFears over the Zika virus have contributed to a “huge” increase in the number of women in Latin America wanting abortions, researchers say. Estimates suggest there has been at least a doubling in requests in Brazil and an increase of a third in other countries. Many governments have advised women not to get pregnant due to the risk of babies being born with tiny brains.

The findings were published in the New England Journal of Medicine.

A termination remains illegal in many parts of Latin America, but women simply turn to unofficial providers. Women on Web, which advises women online and then delivers pills to end a pregnancy, is one of the largest. The researchers analysed the thousands of requests received by Women on Web in the five years before the Pan American Health Organization issued its warning on Zika on 17 November 2015. It used this to predict how many abortion requests would have been expected between 17 November 2015 and 1 March 2016.

The analysis of countries that advised against getting pregnant suggested Brazil and Ecuador had had more than twice the expected demand for abortions.

Country Expected Actual Increase
Brazil 582 1210 +108%
Colombia 102 141 +39%
Costa Rica 49 67 +36%
El Salvador 18 24 +36%
Ecuador 34 71 +108%
Honduras 21 36 +76%
Venezuela 45 86 +93%

Analysis from other countries, which did not advise against pregnancy, suggested smaller increases in abortion demand.


“Fantastic Voyage” comes to life – sort of

May 16, 2016
Raquel Welch fantastic voyage

Raquel Welch fantastic voyage

Old codgers like me will remember the 1965 science fiction film “Fantastic Voyage” where a medical team in the submarine “Proteus” are shrunk to microscopic size and are injected into the vessels of a brain-damaged scientist  to try and save him. The ship is reduced to one micron in size but the miniaturisation is temporary and they will revert to normal size after one hour. Naturally the team contains one bad guy. But the most memorable part of this film is that Raquel Welch is one of the team (an assistant).

But now comes news from MIT that “researchers at MIT, the University of Sheffield, and the Tokyo Institute of Technology have demonstrated a tiny origami robot that can unfold itself from a swallowed capsule and, steered by external magnetic fields, crawl across the stomach wall to remove a swallowed button battery or patch a wound.”

The new work, which the researchers are presenting this week at the International Conference on Robotics and Automation, builds on a long sequence of papers on origami robots from the research group of Daniela Rus, the Andrew and Erna Viterbi Professor in MIT’s Department of Electrical Engineering and Computer Science.

“It’s really exciting to see our small origami robots doing something with potential important applications to health care,” says Rus, who also directs MIT’s Computer Science and Artificial Intelligence Laboratory (CSAIL). “For applications inside the body, we need a small, controllable, untethered robot system. It’s really difficult to control and place a robot inside the body if the robot is attached to a tether.”

Protein injections could reverse Alzheimers

April 19, 2016

While life expectations have been increasing across the globe, the time spent suffering from Alzheimer’s and other forms of dementia have also been increasing. In the last decade this increase has not been checked by any breakthroughs in drugs to brake the onset of, or reverse the progression of, dementia. While life expectancies are approaching 90 years, the period at the end of life with serious disability is approaching 10 years. Among the elderly there is now a greater fear of the degradations at the end of life than of the end itself.

Now, the IL-33 protein is showing the potential of actually reversing some of the symptoms of Alzheimer’s. Injections of the protein succeeded in restoring the memory of mice which had been debilitated by an Alzheimer’s like affliction. The potential is that injections – if the protein acts in a similar way with humans – could restore the memory of Alzheimer’s patients within a week. It is hoped to start clinical trials by the end of the year and that could leave to approved drugs becoming available within 5 years.

The Scotsman:

A protein which can reverse symptoms of Alzheimer’s disease in mice could provide a key to potential treatments, Scottish scientists said.

Researchers from Glasgow University and Hong Kong University of Science and Technology (HKUST) discovered that injections of the protein IL-33 could improve cognitive function in mice with Alzheimer’s-like disease. …

….. Glasgow expert Professor Eddy Liew discovered the IL-33 protein could digest existing plaque deposits and prevent the build up of new ones, which led to an improvement in memory and brain function among mice within a week. Professor Liew said: “The relevance of this finding to human Alzheimer’s is at present unclear. But there are encouraging hints. For example, previous genetic studies have shown an association between IL-33 mutations and Alzheimer’s disease in European and Chinese populations. Exciting as it is, there is some distance between laboratory findings and clinical applications.”

The IL-33 protein is produced mostly in the nervous system but patients with Alzheimer’s had less IL-33 than people without the condition, he said. The study, published today in Proceedings of the National Academy of Sciences USA (PNAS), also found the IL-33 curbed the inflammation in the brain tissue, which has been shown previously to increase plaque and tangle formation.

alzheimer's brain scan

alzheimer’s brain scan (image BBC)

IL-33 is made in the body and the highest concentrations are found in the brain and the spinal cord. Those with Alzheimer’s have depressed levels. Alzheimer’s disease is widely believed to be driven by the production and deposition of the β-amyloid peptide (Aβ). The IL-33 protein is thought to activate the body’s immune system which in turn attacks the β-amyloid which causes the characteristic Alzheimer’s plaque.



The “design life” of humans

March 25, 2016

The “design life” of a component or system is generally a boundary condition before starting to design. It is an inherent part of the design. The human body can be taken to be a system based on the organs as major components and a myriad of other components. Our genes are the design for our bodies and they exhibit a “design life”. Whatever we may assign as the purpose of our DNA, our bodies exhibit a design life of between 50 and 60 years. 

In engineering, when an artefact or component or system is created, it is quite usual to have a “design life” as one of the key boundary conditions for designing the artefact. The artefact-lifetime to be designed for determines the choice of materials for strength and resistance to corrosion and erosion, and for their cycling properties and their resistance to fatigue and creep. The lifetime to be designed for leads to a choice for the level of redundancies to be included, the ease of maintenance to be allowed for and a choice of a maintenance strategy which includes a replacement “philosophy”. The “design life” is then usually defined as the time for which the artefact will be fully functional and can often be the lifetime guaranteed by the manufacturer. The designer makes his choices based on the probability of failures. For example the quoted design-life may be based on the time when the probability of failure or loss of functionality is – say – less than 10% or 1% or 0.1%.

The concept of “design-life” is different to the concept of “obsolescence” or the “mean time between failures” (MTBF). Obsolescence, whether introduced intentionally or not, is the time when when the defined functionality is no longer relevant. It could be intentionally “built-in” as a marketing strategy or it may result from the appearance of new technologies. The MTBF is a measure of the time between random – not due to wear – failures of a particular component. The MTBF of single components will generally be orders of magnitude longer than the design-life of that component.

Most components or systems can – with proper maintenance – be used with full functionality long beyond their quoted design life. A power plant may have a design life of 25 years, guarantees for only 2 years but may be used for 50 or 60 years. A digital camera may have a design life of 5 years but could be obsolete after just three. A Swatch may have a design-life of 5 years and materials to suit, whereas a Rolex may use materials and manufacturing quality to be able to come with a lifetime guarantee (with suitable caveats for the user’s negligence). When analysing reliability, the life of components and systems is often illustrated by the generic “bathtub curve”, where the total failure rate is given by the addition of random failures, failures due to “infancy problems” and failures due to wear. Infancy issues are those which are caused by quality of materials, manufacturing tolerances, manufacturing processes and the like.

Modes of failure

On the bathtub curve the design life used to create a design will always fall within the section where the total failure rate is at its lowest – that is after the initial period where “teething” and other infancy problems arise and before the sharp increase in failure due to wear. Generally, to change the design life the basic design itself must be changed.

Consider the human body as a system where the organs are the key components making up the system. The functionality of human organs and of different human functional abilities also exhibit a form very similar to a reversed “bathtub” curve. Failure of a human body occurs when one or more of the functionalities falls below some threshold minimum. In the diagram below, the shaded area represents the behaviour of most organs with age. The lines represent the variation of some of the complex human functional abilities with age.

Functionality of organs with age

Functionality of organs with age

The reverse bathtub curve suggests that the human body has a design life of between 50 and 60 years.

“Infancy problems” in this context include birth and genetic defects which can influence the development and failure rate of organs. “Wear” would be the physical and mental wear and tear but would now also include the effects of aging which curtail the replacement of cells. Average, global, life expectancy is now around 80 years and the longest verified age is about 122 years. Average life expectancy has increased over the last 200 years at the rate of about 3 months every year. Over the next 100 years this may level off to perhaps add another 20 years to life expectancy. Already in 2012 the UN estimated that there were more than 300,000 centenarians alive. By 2100 perhaps global life expectancy would have reached 100 years and the maximum age attained may then be around 140-150 years.

Using the engineering analogy, the main advances in life expectancy have so far come due to improving maintenance and replacement processes but have not improved on the “basic design”. The “improved quality” at birth and in infancy and medical advances have meant that “maintenance” processes have improved drastically. Modern health care is to a large extent the application of “preventive maintenance”.

But, the the basic design is unchanged. The materials used in making up the human body have not changed but “maintenance and repair” strategies have improved out of all recognition. The life of our various organs have not changed inherently, except as a result of the much improved maintenance regime. With no change in basic design, the design life has not changed either. The increasing lifetime of the system (the body) is now beginning to approach the lifetime of the components (the organs) it is made up of.

Currently the design life of a human body could be said to be about 50-60 years. Studies suggest that though we live longer we also have longer periods at the end of our lives when our functionality is severely impaired. The ” basic design” has not changed and the “design life” is not increasing. Life spans of 200 years will not be possible without some change in the “basic design”. For our design life to change it will need advances which allow our cells to keep replicating without the aging effects of the shortening of the telomeres. When that happens (not if), then we would effectively have altered the “basic design” of the human body and its design life.



Trend reversal and sharp increase of mortality of 45-54 year old, US white population

November 3, 2015

A new paper by Nobel winner Angus Deaton and his wife Anne Case points out a trend reversal and a sharp increase of mortality rates among 45-54 year old, non-Hispanic whites in the US between 1999 and 2013. This is highest among the less educated, less well-off population. It is the reversal of a previous trend and that is both perplexing and a little alarming. It suggests a deeper social malaise prevalent in this group.

A rather deadly – and morbid – case of “White Flight”.

Anne Case and Angus DeatonRising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century, PNAS, doi: 10.1073/pnas.1518393112

All-cause mortality, ages 45–54 for US White non-Hispanics (USW), US Hispanics (USH), and six comparison countries: France (FRA), Germany (GER), the United Kingdom (UK), Canada (CAN), Australia (AUS), and Sweden (SWE) Case & Deaton

All-cause mortality, ages 45–54 for US White non-Hispanics (USW), US Hispanics (USH), and six comparison countries: France (FRA), Germany (GER), the United Kingdom (UK), Canada (CAN), Australia (AUS), and Sweden (SWE)  – Case & Deaton


This paper documents a marked increase in the all-cause mortality of middle-aged white non-Hispanic men and women in the United States between 1999 and 2013. This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround. The midlife mortality reversal was confined to white non-Hispanics; black non-Hispanics and Hispanics at midlife, and those aged 65 and above in every racial and ethnic group, continued to see mortality rates fall. This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. Although all education groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, those with less education saw the most marked increases.

The sharpest increase has been in “poisonings” which is essentially the use of drugs (including pain related opiates) and alcohol.

Mortality by cause, white non-Hispanics ages 45–54.

Mortality by cause, white non-Hispanics ages 45–54.

American Prospect comments:

Case and Deaton’s data indicate that the white midlife mortality reversal was due almost entirely to increased deaths among those with a high school degree or less. Mortality rates in that group rose by 134 per 100,000 between 1999 and 2013, while there was little change among those with some college, and death rates fell by 57 per 100,000 for those with a college degree or more.

Death rates from suicide and poisonings such as drug overdoses increased among middle-aged whites at all socioeconomic levels (as measured by education). But the increases were largest among those with the least education and more than sufficient in that group to wipe out progress in reducing other causes of death. Deaths from diabetes rose slightly but did not account for a significant part of the white midlife mortality reversal.

  ……. Among blacks, midlife mortality has been higher than among whites. But over the period 1999-2013, according to Case and Deaton, midlife mortality declined by more than 200 per 100,000 for blacks while it was rising for whites. As a result, the ratio of black to white mortality rates dropped from 2.09 in 1999 to 1.40 in 2013. Contrary to what many Americans may still believe, drug overdoses are no longer concentrated among minorities; in fact, among the 45-54 age group, drug-related deaths are now higher among whites. …..

American Prospect goes on to suggest that this might be a loss of hope among the white, middle-aged, less educated population, which is part of the malaise which is showing up politically as support for Trump and Carson.

The declining health of middle-aged white Americans may also shed light on the intensity of the political reaction taking place on the right today. The role of suicide, drugs, and alcohol in the white midlife mortality reversal is a signal of heightened desperation among a population in measurable decline. ……  The phenomenon Case and Deaton have identified suggests a dire collapse of hope, and that same collapse may be propelling support for more radical political change. Much of that support is now going to Republican candidates, notably Donald Trump. Whether Democrats can compete effectively for that support on the basis of substantive economic and social policies will crucially affect the country’s political future.

Swedish study of one million children shows early exposure to dogs reduces asthma

November 2, 2015

We have probably gone a little too far and are just a little too protective of our children. The cleaner we try to keep everything around children, the less developed is their immunity and the more vulnerable they become later. I suspect it is the same thinking which has meant that we have also gone too far with so called Health and Safety provisions in schools which – for fear of accident and resulting liability – has reduced the fun – and the learning opportunities – of play, sports and excursions. The so-called precautionary principle (which is no principle but a political ideology) actually encourages actions to be subservient to fear. There is a difference between avoiding being foolhardy and being cowardly.

A Swedish cohort study on over one million children has found that early exposure to dogs clearly reduces the later risk of asthma.

Tove Fall, Cecilia Lundholm, Anne K Örtqvist, Katja Fall, Fang Fang, Åke Hedhammar, Olle Kämpe, Erik Ingelsson, and Catarina Almqvist. “Dog and farm animal exposure reduce risk of childhood asthma – a nationwide cohort study”.  JAMA Pediatrics. In press. DOI: 10.1001/jamapediatrics.2015.3219

Uppsala University press release (in Swedish) is here.


A team of Swedish scientists have used national register information in more than one million Swedish children to study the association of early life contact with dogs and subsequent development of asthma. This question has been studied extensively previously, but conclusive findings have been lacking. The new study showed that children who grew up with dogs had about 15 percent less asthma than children without dogs.  

A total of more than one million children were included in the researchers’ study linking together nine different national data sources, including two dog ownership registers not previously used for medical research. The results are being published for the first time in JAMA Pediatrics. The goal was to determine whether children exposed to animals early in life are at different risk of asthma.

“Earlier studies have shown that growing up on a farm reduces a child’s risk of asthma to about half. We wanted to see if this relationship also was true also for children growing up with dogs in their homes. Our results confirmed the farming effect, and we also saw that children who grew up with dogs had about 15 percent less asthma than children without dogs. Because we had access to such a large and detailed data set, we could account for confounding factors such as asthma in parents, area of residence and socioeconomic status” says Tove Fall, Assistant Professor in Epidemiology at the Department of Medical Sciences and the Science for Life Laboratory, Uppsala University, who coordinated the study together with researchers from the Karolinska Institutet in Stockholm, Sweden. ……. 

Birth and the 116 other things which increase cancer risk

October 29, 2015

The good old WHO.

I suppose they do do some good, but they also make some horrible blunders as with the UN introduced cholera epidemic in Haiti, or with the initial downplaying of the Ebola outbreak in some African countries, or when their panel members take money from vaccine manufacturers to recommend mass flu vaccination programs. As with all UN organisations the staff are a mixture of professionals, surrounded by bureaucrats with political agendas from their home countries, and with some members from partisan lobby groups who promote their own causes and self-interests. WHO panels which recommend certain drugs or mass vaccination programs always seem to contain members with commercial ties to the pharmaceutical industry. Many in the WHO justify their alarmist tactics as a means to stimulate or trigger actions and – inevitably – many of these actions are totally unnecessary (but they are often very lucrative for some members of the WHO and their sponsors).

Now the WHO are going after processed and even red meat as causing cancer. But they have had to torture their data to calculate the risk. They forget that living is risk. Not being born, however, carries no risk of dying of anything. Therefore, the risk of cancer due to being born is far, far greater than that introduced by any other parameter or substance.  I won’t be changing my meat eating habits just yet.

Their list of 116 other things – besides birth – that increase the risk of cancer are taken from the Daily Mail.

1. Tobacco smoking

2. Sunlamps and sunbeds

3. Aluminium production

4. Arsenic in drinking water

5. Auramine production

6. Boot and shoe manufacture and repair

7. Chimney sweeping

8. Coal gasification

9. Coal tar distillation

10. Coke (fuel) production

11. Furniture and cabinet making

12. Haematite mining (underground) with exposure to radon

13. Secondhand smoke

14. Iron and steel founding

15. Isopropanol manufacture (strong-acid process)

16. Magenta dye manufacturing

17. Occupational exposure as a painter

18. Paving and roofing with coal-tar pitch

19. Rubber industry

20. Occupational exposure of strong inorganic acid mists containing sulphuric acid

21. Naturally occurring mixtures of aflatoxins (produced by funghi)

22. Alcoholic beverages

23. Areca nut – often chewed with betel leaf

24. Betel quid without tobacco

25. Betel quid with tobacco

26. Coal tar pitches

27. Coal tars

28. Indoor emissions from household combustion of coal

29. Diesel exhaust

30. Mineral oils, untreated and mildly treated

31. Phenacetin, a pain and fever reducing drug

32. Plants containing aristolochic acid (used in Chinese herbal medicine)

33. Polychlorinated biphenyls (PCBs) – widely used in electrical equipment in the past, banned in many countries in the 1970s

34. Chinese-style salted fish

35. Shale oils

36. Soots

37. Smokeless tobacco products

38. Wood dust

39. Processed meat

40. Acetaldehyde

41. 4-Aminobiphenyl

42. Aristolochic acids and plants containing them

43. Asbestos

44. Arsenic and arsenic compounds

45. Azathioprine

46. Benzene

47. Benzidine

48. Benzo[a]pyrene

49. Beryllium and beryllium compounds

50. Chlornapazine (N,N-Bis(2-chloroethyl)-2-naphthylamine)

51. Bis(chloromethyl)ether

52. Chloromethyl methyl ether

53. 1,3-Butadiene

54. 1,4-Butanediol dimethanesulfonate (Busulphan, Myleran)

55. Cadmium and cadmium compounds

56. Chlorambucil

57. Methyl-CCNU (1-(2-Chloroethyl)-3-(4-methylcyclohexyl)-1-nitrosourea; Semustine)

58. Chromium(VI) compounds

 59. Ciclosporin

60. Contraceptives, hormonal, combined forms (those containing both oestrogen and a progestogen)

61. Contraceptives, oral, sequential forms of hormonal contraception (a period of oestrogen-only followed by a period of both oestrogen and a progestogen)

62. Cyclophosphamide

63. Diethylstilboestrol

64. Dyes metabolized to benzidine

65. Epstein-Barr virus

66. Oestrogens, nonsteroidal

67. Oestrogens, steroidal

68. Oestrogen therapy, postmenopausal

69. Ethanol in alcoholic beverages

70. Erionite

71. Ethylene oxide

72. Etoposide alone and in combination with cisplatin and bleomycin

73. Formaldehyde

74. Gallium arsenide

75. Helicobacter pylori (infection with)

76. Hepatitis B virus (chronic infection with)

77. Hepatitis C virus (chronic infection with)

78. Herbal remedies containing plant species of the genus Aristolochia

79. Human immunodeficiency virus type 1 (infection with)

80. Human papillomavirus type 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 66

81. Human T-cell lymphotropic virus type-I

82. Melphalan

83. Methoxsalen (8-Methoxypsoralen) plus ultraviolet A-radiation

84. 4,4′-methylene-bis(2-chloroaniline) (MOCA)

85. MOPP and other combined chemotherapy including alkylating agents

86. Mustard gas (sulphur mustard)

87. 2-Naphthylamine

88. Neutron radiation

89. Nickel compounds

90. 4-(N-Nitrosomethylamino)-1-(3-pyridyl)-1-butanone (NNK)

91. N-Nitrosonornicotine (NNN)

92. Opisthorchis viverrini (infection with)

93. Outdoor air pollution

94. Particulate matter in outdoor air pollution

95. Phosphorus-32, as phosphate

96. Plutonium-239 and its decay products (may contain plutonium-240 and other isotopes), as aerosols

97. Radioiodines, short-lived isotopes, including iodine-131, from atomic reactor accidents and nuclear weapons detonation (exposure during childhood)

98. Radionuclides, α-particle-emitting, internally deposited

99. Radionuclides, β-particle-emitting, internally deposited

100. Radium-224 and its decay products

101. Radium-226 and its decay products

102. Radium-228 and its decay products

103. Radon-222 and its decay products

104. Schistosoma haematobium (infection with)

105. Silica, crystalline (inhaled in the form of quartz or cristobalite from occupational sources)

106. Solar radiation

107. Talc containing asbestiform fibres

108. Tamoxifen

109. 2,3,7,8-tetrachlorodibenzo-para-dioxin

110. Thiotepa (1,1′,1′-phosphinothioylidynetrisaziridine)

111. Thorium-232 and its decay products, administered intravenously as a colloidal dispersion of thorium-232 dioxide

112. Treosulfan

113. Ortho-toluidine

114. Vinyl chloride

115. Ultraviolet radiation

116. X-radiation and gamma radiation

From the Daily Mail.


Swedish study says antioxidants also protect cancer cells

October 13, 2015

A new paper from Sahlgrenska Academy in Gothenburg shows that

Antioxidants can increase melanoma metastasis in mice, K Le Gal et al, Science Translational Medicine, 07 Oct 2015:
Vol. 7, Issue 308, DOI: 10.1126/scitranslmed.aad3740

First antioxidants were good for you, then they were of doubtful benefit and now it seems they are positively bad. Many foods containing antioxidants have been touted for their health benefits and have included chocolate, fresh fruits and vegetables, nuts, whole grains, maize, legumes and eggs. Red wine was on the list but the benefits of Resveratrol have already come under a cloud for alleged data tampering.

Of course, perceived antioxidant benefits have not much influenced my own consumption of dark chocolate and red wine. But what the study finds is that  “the overall conclusion from the various studies is that antioxidants protect healthy cells from free radicals that can turn them into malignancies but may also protect a tumor once it has developed”.

So antioxidants can help prevent a cancer developing, but once the cancer is there antioxidants can speed up the progression of the cancer. Dark chocolate and red wine therefore remain on the  “good foods list” for those who do not have any cancerous cells.

Sahlgrenska Press Release:

Fresh research at Sahlgrenska Academy has found that antioxidants can double the rate of melanoma metastasis in mice. The results reinforce previous findings that antioxidants hasten the progression of lung cancer. According to Professor Martin Bergö, people with cancer or an elevated risk of developing the disease should avoid nutritional supplements that contain antioxidants.

Researchers at Sahlgrenska Academy, University of Gothenburg, demonstrated in January 2014 that antioxidants hastened and aggravated the progression of lung cancer. Mice that were given antioxidants developed additional and more aggressive tumors. Experiments on human lung cancer cells confirmed the results.
Given well-established evidence that free radicals can cause cancer, the research community had simply assumed that antioxidants, which destroy them, provide protection against the disease. Found in many nutritional supplements, antioxidants are widely marketed as a means of preventing cancer. Because the lung cancer studies called the collective wisdom into question, they attracted a great deal of attention.

The follow-up studies at Sahlgrenska Academy have now found that antioxidants double the rate of metastasis in malignant melanoma, the most perilous type of skin cancer. Science Translational Medicine published the findings on October 7.
“As opposed to the lung cancer studies, the primary melanoma tumor was not affected,” Professor Bergö says. “But the antioxidant boosted the ability of the tumor cells to metastasize, an even more serious problem because metastasis is the cause of death in the case of melanoma. The primary tumor is not dangerous per se and is usually removed.”

Experiments on cell cultures from patients with malignant melanoma confirmed the new results. “We have demonstrated that antioxidants promote the progression of cancer in at least two different ways,” Professor Bergö says.
The overall conclusion from the various studies is that antioxidants protect healthy cells from free radicals that can turn them into malignancies but may also protect a tumor once it has developed. 

Taking nutritional supplements containing antioxidants may unintentionally hasten the progression of a small tumor or premalignant lesion, neither of which is possible to detect.
“Previous research at Sahlgrenska Academy has indicated that cancer patients are particularly prone to take supplements containing antioxidants,” Dr. Bergö says. “Our current research combined with information from large clinical trials with antioxidants suggests that people who have been recently diagnosed with cancer should avoid such supplements.”


A few extra copies of p53 and we could also suppress cancerous tumours

October 9, 2015

Elephants should get cancer 100 times more often than humans but instead they have a cancer mortality rate which is at 20-50% of the rate in humans. Cell for cell therefore, elephants are 200 to 500 times less likely to develop cancer than humans. Genetic studies may have revealed why that is so. They have 38 additional copies of a tumor suppressing gene (p53) while humans have only two.

Sounds fascinating. If we could only ingest some additional copies of a specific genes, of which humans have only two, we may be able to suppress cancerous tumours.

Wikipedia tells me that

Tumor protein p53, also known as p53, ……. is any isoform of a protein encoded by homologous genes in various organisms, such as TP53 (humans) and Trp53 (mice). …. p53 has been described as “the guardian of the genome” because of its role in conserving stability by preventing genome mutation. ….. The International Cancer Genome Consortium has established that the TP53 gene is the most frequently mutated gene (>50%) in human cancer, indicating that the TP53 gene plays a crucial role in preventing cancer formation. TP53 gene encodes proteins that bind to DNA and regulate gene expression to prevent mutations of the genome.

Now a new paper reports a study on why elephants rarely get cancers and finds that elephants have 38 copies of p53 whereas humans have only two.

Press Release Huntsman Cancer Institute:

Why Elephants rarely get cancer

…. elephants have 38 additional modified copies (alleles) of a gene that encodes p53, a well-defined tumor suppressor, as compared to humans, who have only two. Further, elephants may have a more robust mechanism for killing damaged cells that are at risk for becoming cancerous. In isolated elephant cells, this activity is doubled compared to healthy human cells, and five times that of cells from patients with Li-Fraumeni Syndrome, who have only one working copy of p53 and more than a 90 percent lifetime cancer risk in children and adults. The results suggest extra p53 could explain elephants’ enhanced resistance to cancer.

Joshua D. Schiffman, MD et al. Potential mechanisms for cancer resistance in elephants and comparative cellular response to DNA damage in humans. JAMA, October 2015 DOI:10.1001/jama.2015.13134

According to Schiffman, elephants have long been considered a walking conundrum. Because they have 100 times as many cells as people, they should be 100 times more likely to have a cell slip into a cancerous state and trigger the disease over their long life span of 50 to 70 years. And yet it’s believed that elephants get cancer less often, a theory confirmed in this study. Analysis of a large database of elephant deaths estimates a cancer mortality rate of less than 5 percent compared to 11 to 25 percent in people.

In search of an explanation, the scientists combed through the African elephant genome and found at least 40 copies of genes that code for p53, a protein well known for its cancer-inhibiting properties. DNA analysis provides clues as to why elephants have so many copies, a substantial increase over the two found in humans. A substantial majority, 38 of them, are so-called retrogenes, modified duplicates that have been churned out over evolutionary time.  

Schiffman’s team collaborated with Utah’s Hogle Zoo and Ringling Bros. Center for Elephant Conservation to test whether the extra gene copies may protect elephants from cancer. They extracted white blood cells from blood drawn from the animals during routine wellness checks and subjected the cells to treatments that damage DNA, a cancer trigger. In response, the cells reacted to damage with a characteristic p53-mediated response: they committed suicide.

“It’s as if the elephants said, ‘It’s so important that we don’t get cancer, we’re going to kill this cell and start over fresh,’” says Schiffman. “If you kill the damaged cell, it’s gone, and it can’t turn into cancer.  This may be more effective of an approach to cancer prevention than trying to stop a mutated cell from dividing and not being able to completely repair itself.”

I don’t understand any of this but can imagine that in a 100 years or so, children will routinely be given “genetic p53 shots”  — as routinely as they get vaccinations today. It’s not as if we don’t already have the gene. So just arranging a few extra copies of a gene we already have, doesn’t sound Frankensteinian and should not lead to developing elephantine features.

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