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Epilogue: Much Needed Research Strategies for Breast Cancer

by Dr Fleur Fisher(more info)

listed in cancer, originally published in issue 33 - October 1998

Breast cancer remains the most feared diagnosis for women in the developed world – yet, despite intense therapeutic effort, the results of treatment cannot be described as an overall success story.

Breast cancer may not be as prevalent in the developing world where the majority of women will not have access to early diagnosis or modern methods of treatment. Frequently presenting late, they will be dependent upon traditional herbal medicine, homeopathy, dietary or other approaches to healing, which as a first line of treatment, are considered unethical if not actually illegal in most developed countries.

In the UK complementary or alternative disciplines occasionally provide supportive care and treatment, often in a palliative or terminal care setting.

In the era of evidence-based medicine, only new treatments that can be evaluated will be offered to breast cancer sufferers. By limiting themselves to evaluating therapies in the Western medical canon, are clinicians and scientists cutting themselves off from possible new treatments? Yet, with the failure of modern medicine to improve the outcomes for women with breast cancer, new approaches are desperately needed.

There are thousands of published studies regarding the efficacy of nutrition in the prevention and treatment of cancer, including single nutrients such as vitamins A, C, E, beta-carotene, antioxidant minerals such as selenium, essential omega-3 and omega-6 fatty acids and other elements such as coenzyme Q10. What a needless waste that oncologists and general practitioners alike have little training in nutrition and virtually no knowledge of the vast research database underpinning nutrition in the treatment of cancer.

There are a myriad of diets purported to ameliorate cancer, including macrobiotics, Gerson, Dries, Nolfi and wheat grass – to name but a few. Each of these regimes has widespread supporters, with many individuals claiming great relief from or even 'cures' from their cancer. What a tragedy that the tremendous energy spent on disparaging and condemning all cancer diets as 'quackery' is not more usefully focussed upon researching and assessing the clinical outcomes of people following such regimes.

Among the huge array of medical herbs, both Chinese and Western, are many potent herbs with reputed anti-cancer activity. Many of our most potent drugs in the allopathic pharmacopoeia, including Taxol, have been derived from plant origin. Again, an utterly wasted opportunity not to conduct research to assess their therapeutic efficacy and discover the biochemical moiety and mode of their action.

Here is a wish-list of urgently required steps which need to be taken not to lose even more ground in the relentless deaths of tens of thousands of women each year in the UK:

1 - Introduce nutritional education and awareness of herbal medicine into Medical Schools.

2 - Set up expert cross-disciplinary research teams, including statisticians, clinicians and practitioners to plan and carry out clinical research to assess the efficacy of nutritional, dietary, herbal, homeopathic, aromatherapy and psychological regimes for breast cancer.

3 - Stop the campaigns against complementary approaches to cancer treatment.

4 - Gather research data on the therapeutic efficacy of traditional methods of treating cancer – herbal, Ayurvedic, Chinese herbal, homoeopathic – which will provide a yardstick with which to compare our own results with high-tech technology.

Where are the proposals for small collaborative studies with research scientists and statisticians sharing their technical expertise with physicians who, perforce, treat breast cancer with non-allopathic methods? Such bilateral transfer of clinical and technical expertise into tightly-focussed projects could be a small step for breast cancer treatment, but a giant step for both investigative and integrated medicine. Which of the cancer research funders will blaze this thorny trail, and commission a modest exploratory study?

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About Dr Fleur Fisher

Fleur Fisher is currently an independent consultant in Ethics and healthcare practice. She is also Co-Chairman of the Education and Training Working Group on the Prince of Wales Initiative on Integrated Healthcare; Chairman BMA Foundation for AIDS; Vice-Chairman of the International HIV/AIDS Alliance; Co-Chairman of POPAN (Prevention of Professional Abuse Network) and is the past president of the Medical Women's Federation. Between 1991-96 she was Head of Ethics, Science and Information for the British Medical Association and their media spokeswoman on those areas.

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