1. This is a very interesting topic. Thank you for posting it.

http://beautytrendsblog.com/

Posted at 5:22PM on May 4th 2007 by BeautyTrends

2. Don't forget the mutagenic effects of the wrong chemo can start the chain of metastatic events. Particularly if you receive a "one-size-fits-all" agent(s). A chemo-induced gene mutation can happen when the original chemo received does not work. The cancer comes back. When it does this, the tumor comes back more aggressively. The mutagenic effects (changes in form) of chemotherapy on a genetically-unstable tumor, drives the tumor into a state of more aggressive behavior. You might kill off a whole lot of cancer, only to cause a mutation in the remaining cancer, such that the remaining cancer behaves in a more aggressive fashihon.

Shrinking tumors is a totally inadequate measure of the effectiveness of a drug. German investigators, using the CellSearch system (the technique that de Chaumont-Quitry has been commenting about), showed that Taxol produced the greatest degree of tumor shrinkage, but also the greatest release of circulating tumor cells, beginning the most life-threatening aspect of cancer, metastasis. With cells remaining in the circulation, this observation corresponds with results found in patients that tumor response does not mean increased survival.

Some researchers believe the reason for better survival for patients who could undergo complete resection without any tumor left behind is that these tumors are biologically less aggressive and would do better regardless of the type of treatment they receive, and that the removal of lymph nodes at the time of surgery may additionally contribute to a better outcome. Surgery is an integral part of the multimodality treatment of many cancers.

The line of reasoning frequently used to explain the value of surgery included five points: First, surgery is thought to remove resistant clones of tumor cells and thus decrease the likelihood of the early onset of drug resistance. Second, the removal of large masses likely to be associated with poorly vascularized areas of tumor improves the probability of delivering adequate drug doses to the remaining cancer cells. Third, the higher growth fraction in better vascularized small masses enhanced the effect of chemotherapy. Fourth, smaller masses required fewer cycles of chemotherapy and thus decreased the likelihood of drug resistance. Fifth, removal of bulky disease enhances the immune system.

Mayo Clinic
American Board of Surgeons
Society of Surgical Oncology
Oncol News Int'l, Vol 14, #5, May '05

Posted at 12:36PM on May 5th 2007 by Gregory D. Pawelski

3. Pawelski continues with his disnformation campaign, a campaign to frighten cancer patients who read this cancer blog.

I have addressed this disinformation here in past posts and he has yet to respond to my clarification.

Frightened cancer patients who believe their physician gives them taxol for monetary reward and not because he or she cares about their health should take the Pawelski challenge and ask their physician about this.

Pawelski states:

..."Taxol produced the greatest degree of tumor shrinkage, but also the greatest release of circulating tumor cells, beginning the most life-threatening aspect of cancer, metastasis."

The evidence that taxol causes brain metastasis is nonexistent. He believes that since one received taxol and then brain metastasis occurs that one caused the other. This is like saying the rooster causes the sun to rise. Here, Pawelski is that confident rooster.


This difference in the incidence of CNS relapse between patients with breast cancer and other solid tumors could be explained by the higher EFFICACY of the taxanes in breast cancer which is associated with increased survival in comparison with other solid tumors. It is well known that CNS involvement is more frequent in the late stages of the disease. A possible explanation could therefore be that the increase in survival and the prolonged period of advanced disease is correlated with the increased frequency of CNS relapse.

http://www.medscape.com/viewarticle/543766

Correlation does not equal causation. Any first year biology student should know this.

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Oh, and that taxol- circulating tumor cell thing. Well, just the opposite happens here:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8765198&dopt=Abstract

This google search indicates how Pawelski disinforms on hundreds of blogs based on one flawed and obscure Greek study:

http://www.google.com/search?hl=en&safe=off&client=firefox-a&rls=org.mozilla%3Aen-US%3Aofficial&hs=LMj&q=circulating+tumor+cells+pawelski+&btnG=Search

the scare campaign continues......

Posted at 2:25PM on May 5th 2007 by hchcec

4. It's very interesting, the organization behind Michelle (hchcec) is so protective of Taxol, they helped to give us a new form of it: Abraxane. Same old drug, but at a much higher price (cuts back on all the generic headaches).

Abraxane combines the drug paclitaxel with Albumin, a protein found in human blood. Taxol combines paclitaxel with Cremophor, a combination of castor oil and alcohol. The delivery mechanism is different but they are basically the same drug. It is possible for many patients to be resistant to it, and also to develop a tolerance, limiting the drug's ability to fight future occurrences of cancer.

Patients taking Taxol receive a steroid and an antihistamine to reduce the risk that Cremophor will cause harsh allergic reactions. Patients taking Abraxane do not need to take a steroid or antihistamine, and can be given at higher doses than Taxol. However, more of the women on Abraxane had numbness and tingling in their hands and feet. And more suffered nausea and vomiting, diarrhea, muscle and joint pain and anemia (but wait, there's plenty of new anemia drugs to take - at higher prices).

Some taxane-induced side effects are so common, and in some instances so severe, that patients and their physicians may delay treatment, reduce the dose or discontinue therapy altogether. While medications designed to prevent or treat nausea, vomiting and decreased white blood cell counts are available, there are currently no treatments for other serious taxane-induced side effects, particularly nerve damage.

Despite the broad antitumor activity of taxanes, their clinical usefulness has been limited by common side effects such as painful nerve damage, reduction of white blood cell counts, liver damage, allergic reactions, nausea and vomiting, and other toxicities.

According to clinical trials, although it does shrink tumors in more patients (shrinking tumors is a totally inadequate measure of the effectiveness of a drug), Abraxane does not help patients live longer than the older treatments.

Dr. Ramaswamy Govindan, a Washington University professor who was co-author of a December 2006 article in the Annals of Oncology about Abraxane and other, as-yet- unapproved Cremophor-free versions of Taxol, said that none of the new drugs had shown significant advantages over the older medicine. In general, the novel formulations so far have not stood out as distinctly superior.

Posted at 6:19AM on May 6th 2007 by Gregory D. Pawelski

5. "It's very interesting, the organization behind Michelle (hchcec) is so protective of Taxol,"

have no idea what he's talking about. His post is a red herring:

Partway through an argument, the arguer goes off on a tangent, raising a side issue that distracts the audience from what's really at stake. Often, the arguer never returns to the original issue.

From scaremongering about taxol causing metastasis (which he alone does on hundreds of blogs) to abruptly changing the subject to taxol constituents? What's there to respond to?

As far as the next "definitive" Pawelski statement:

"shrinking tumors is a totally inadequate measure of the effectiveness of a drug"

"MRI Measurements of Breast Tumor Volume Predict Response to Neoadjuvant Chemotherapy and Recurrence-Free Survival"
http://www.medscape.com/viewarticle/506094

MRI monitoring provided a sensitive evaluation of change in tumor size associated with treatment response and was more significantly predictive of disease recurrence than clinical or pathologic assessments. Although final change in MRI tumor volume was a stronger predictor of RFS in this study, the results of early MRI volume change after only one cycle of chemotherapy were encouraging. Early MRI volume change was significantly correlated with final volume change and may thus provide valuable response information at a time early enough to intervene. A multicenter trial is under way to further assess the predictive value of early changes in tumor volume and changes in tumor vascularity as measured by MRI.

Be careful when you see postings from individuals who use words like "always", "must", "totally".
They see the world in black and white, and then to convince themselves they are right, they must have you see the world the same way.

Posted at 11:43AM on May 6th 2007 by hchcec

6. You only have to look at your own postings Michelle. It is a common tactic for the Quackwatch people who unload a deluge of meaningless references when they cannot cobble together a cohesive and persuasive original argument based upon logic and the issues at hand. This is indeed fundamentalism with the guiding principle being NCCN, ASCO, US Oncology and JCO rather than the Koran.

Posted at 5:35PM on May 6th 2007 by Gregory D. Pawelski