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June 5, 2012 He Calls Himself a Nutrition Expert? • Investigating “Cancer Phobia” • New Breast Cancer Treatment Paradigm from FDA

By Lana Spivak

Big Apple Food Circus still in town

Yesterday we expressed our amazement that The New York Post would run an editorial supporting Mayor Bloomberg’s proposed ban on sugary beverages larger than 16 ounces. Today we were shocked again to see that The Post published a letter to the editor by renowned anti-food industry activist Dr. Michael Jacobson, executive director of the Center for Science in the Public Interest, replete with errors and plain nonsense posing as nutritional facts. For instance:

Sugary soft drinks are the single biggest source of calories in the American diet and are the only food or beverage shown to increase one’s risk of weight gain.

Needless to say, ACSH staffers were quite concerned to see that such blatant fallacies could even get published. “His assertions are completely outrageous and would not pass muster in an eighth grade science class,” notes ACSH’s Dr. Gilbert Ross, who is frustrated that “media outlets don’t bother to fact-check such statements, but instead simply publish everything Jacobson says as though it were etched in stone tablets.”

“You don’t have to have a Ph.D. in nutrition to realize that his comments are incorrect,” adds ACSH’s Dr. Ruth Kava. “In fact, the largest calorie contribution, according to the USDA, comes from flour and cereal products, followed by fats and oils — not caloric sweeteners.”

Cancer phobia: when fear overrides common sense

When folks here at ACSH hear the term “cancer phobia,” we instinctively assume it means the pervasive fear that exposure to certain chemicals or environmental factors will undoubtedly increase one’s risk of cancer. Yet in a recent op-ed for The New York Times, science journalist David Ropeik uses the label in quite a different way: He describes the sense of doom that many patients experience upon receiving a cancer diagnosis, or simply when they hear the word “cancer.”

As Ropeik observes, too often emotions override medical facts, thus making it difficult for many cancer patients to make rational treatment decisions. “The perception of risk is so often based more on emotion than just the facts,” he writes, “and the roots of the fear of cancer are so broad and deep, that understanding these anxieties might not help much.” And because cancer is so often associated with a great deal of pain and suffering, the very idea of it invokes that much more fear. In fact, according to a recent Harris Poll, cancer remains the most feared disease in the U.S., with 41 percent of respondents putting it at the top of their list.

ACSH’s Dr. Josh Bloom can understand such sentiments. He observes that, “despite substantial progress against a few cancers and a much better understanding of the disease on a molecular level, I think the ‘revolution’ of modern therapies is overstated. In fact, many regimens use chemotherapy drugs that are 50 years old. There is still plenty of progress to be made against cancer.”

And indeed, “cancer phobia” is more than just an individual experience. Such fear has had an effect on public policy as well: Large medical agencies such as the National Institutes of Health spend more than twice the amount on cancer research than on heart disease, even though the latter claims more lives annually. Furthermore, upon even the slightest prospect of a cancer diagnosis, it’s typical for a person to undergo a litany of unnecessary tests and treatments in order to achieve peace of mind. But are such extremes well-founded?

Ropeik considers this complex question as he watches his own friend, who was recently diagnosed with a slow-growing form of prostate cancer, grapple with “cancer phobia.” Read the entire story here.

A positive for those with triple-negative breast cancer Welcome news to women with so-called “triple-negative” breast cancer — a type of breast cancer more likely to resist commonly-used treatments: According to a new guidance issued this week by the FDA, pharmaceutical companies will now be allowed to test their cancer drugs on these patients before they undergo surgery. This is in contrast to current rules stipulating that drug makers must wait to treat early-stage cancer patients until the treatment has first been proven effective among those with late-stage, metastatic forms of the disease.

Drafted by Dr. Richard Pazdur, director of the FDA’s cancer drug office, and Dr. Tatiana Prowell, a medical officer for the FDA, the guidelines can be found in the current issue of the New England Journal of Medicine. “We’re looking at introducing drugs into a very early stage of breast cancer, where a patient has a primary tumor and the chemotherapy is given before surgery, “ explained Dr. Pazdur of the latest initiative. “The aim of this therapy would be to cure the woman of breast cancer.” If such tested drugs are indeed successful at eliminating any signs of the cancer in the breast or lymph nodes as determined at the time of surgery (termed “pathological complete remission”), the makers would be eligible to obtain accelerated approval.

Since women with triple-negative breast cancer have a less treatable form of the disease (unresponsive to most breast cancer drugs), the latest guidelines are directed only at these patients. Those who have the highest risk of relapse are the most likely to benefit from early treatment — if, that is, the treatment proves effective and not overly toxic.

Dr. Ross was pleased to read about the FDA’s latest initiative, and is “happy to note that the agency is thinking outside the box by initiating a new drug treatment paradigm geared toward women with this type of breast cancer, which is typically so difficult to treat.”

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