Map of life expectancy at birth from Global Education Project.

Wednesday, December 21, 2005

Weird Science

It seems a doctor in has gotten into some trouble with the authorities for injecting cancer patients with insecticide, specifically dinitrophenol (it seems the AP story misspelled the name of the compound) which is toxic to the nervous system, liver and kidneys. (Not to mention, it's a high explosive!)

Unfortunately, the stuff the doctors legally inject cancer patients with isn't a whole lot better. You can check out the side effects of all the stuff here. Examples:

Cyclophosphamide (Cytoxan; CTX): may be administered orally or intravenously. Side effects include bone marrow suppression, hemorrhagic cystitis (severe inflammation of the bladder with blood in the urine), hair loss, electrolyte imbalances (especially sodium), gastrointestinal toxicity as manifested by nausea and vomiting and possible liver dysfunction. A rare lung toxicity manifested by lung inflammation and similar to "Busulfan lung" has been seen. Sexually, testicular atrophy, loss of periods (menses) and ovarian failure can occur.
Cis-platinum (Platinol): administered intravenously. The patient should be well hydrated prior to administration of the drug. It has been shown that administration in the face of poor hydration increases the likelihood of developing side effects. In patients with kidney dysfunction, impaired hearing, preexisting peripheral nerve damage (neuropathy) or past history of allergies to platinum this medication should be given (if at all) with extreme caution. Side effects include nausea and vomiting, anaphylactic reactions (consisting of fast heart rate, wheezing, lowered blood pressure and facial edema), kidney damage (nephrotoxicity), decreased hearing (ototoxicity), nerve damage (neurotoxicity; peripheral neuropathy) manifested by tingling and numbness of the hands and/or feet, bone marrow suppression with increased risk of bleeding and infection, electrolyte (sodium, potassium and magnesium) disturbances and possible heart toxicity (manifested by EKG changes) may be seen. It is important to discuss these issues with your physican so htat you may inform him/her of any symptoms, which may be attributable to the use of this drug.

And so on and so forth. They're all about equally appalling. Of course, the difference here is that all of these drugs have been FDA approved, meaning that in addition to being highly poisonous, they've been shown in some cases to result in shrinkage of tumors visible in X-rays, or to give people on average a few weeks or months of additional life, which as far as I know is not the case for dinitrophenol. On the other hand, an injection of dinitrophenol does not cost tens of thousands of dollars.

Cancer chemotherapeutic agents almost universally have very severe side effects, don't cure cancer, and buy at best only limited added survival. However, they are extremely expensive and they do buy yachts and cadillacs for drug company investors and oncologists. Not that some of these agents aren't worth trying in the right circumstances, but all the advances we have made in understanding the biological basis of cancer have yet to translate into major therapeutic benefits, contrary to anything you may have heard or read.

It's just the same old story -- we spend tens or hundreds of thousands of dollars to try to rescue seriously ill people, with limited benefit at best. We don't spend four bucks to save a poor kid from malaria, malnutrition, or fatal diarrhea.

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