Showing posts with label drug use. Show all posts
Showing posts with label drug use. Show all posts

Monday, 16 May 2011

OK, lets get this out of the way


There's been a post circulating around on FaceBook, entitled "Scientists Cure Cancer, but No One Takes Notice". To be honest - it's unproven science at best, a load of rubbish at worst. Here's why:

1. The author of the article doesn't know what he/she is writing about, and scientific terms are thrown around in a nonsensical manner. For example, mitochondria are NOT cells - they are cell organelles (little organs in the cell). Sure, there is a theory that a million gazillion years ago when we all lived in a soup that they were infective bacteria, but that's a separate story. A more significant error is the fact that glycolysis does NOT produce lactic acid - it is an essential cellullar process that provides pyruvate, the substrate used for the cell to generate energy. Shut off glycolysis, and you kill ALL cells, period. Lactic acid is produced via a different mechanism (more on this later).

2. The original research paper proper (from the website) dates back to 2007, and is more a hypothesis than anything. What the original researchers are suggesting is this: cancer cells grow at very high rate, and and hence have high energy needs. Most of this energy has to be produced via anaerobic respiration (probably due to ineffective angiogenesis), hence producing lactic acid in the process. To maintain the high energy requirements, the rate of pyruvate production has to increase (so glycolysis needs to occur at a faster rate).

The researchers propose to use DCA to suppress glycolysis, thereby cutting down the rate of anaerobic respiration. This essentially cuts off the energy supply to the cancer cells and kills them. The theory is that other cells are not AS affected because they are much more energy efficient (aerobic respiration) than cancer cells, and thus do not require high rates of glycolysis.

Sounds like a good theory, and explains why cells such as lung cells are not damaged in early experiments. However, there are other cells that are pretty energy demanding - such as neurons - which may explain why DCAs side effects include neurotoxicity. Also, the researchers also seem to be proponents of the Warburg hypothesis - that lactic acid is the cause of cancer - an idea that has fallen out of favor due to genetic discoveries.

3. Some good results are seen in vitro, but the real test of a drug is in vivo. DCA has so far gone through Phase 1 and 2 testing - which means that it seems to be relatively safe, and that there seems to be the possibility of benefit from the drug. However, there are no Phase 3 study results available (which is where we get REAL information on whether the drug actually has a benefit, and how great a benefit/harm).

IE: The science behind this hypothesis ranges from reasonable to rubbish, and DCA as yet is unproven in cancer treatment and actually has significant known side effects. I wouldn't be asking any doctor to prescribe this for me, anytime soon.

Saturday, 25 October 2008

Public ethics - a messy business

I've just completed a 3 day course on HIV prevention amongst sex workers, IV drug users, and men who have sex with men - and it's given me a lot to think about - in particular on the issue of legislation.

Let's take, for example, IV drug use. No government would be "proud" of having IV drug users around, and it is universally regarded as an undesirable practice. However, evidence has demonstrated complete prohibition of IV drug use doesn't really work that well, and has the downstream effects of causing the social marginalization and isolation that leads to high -risk behavioral patterns in that population. Services that would actually help these drug users cannot function effectively, as their target population is essentially underground, scattered, and fragmented.

On the other hand, by legalizing drug use, as in Victoria, we give organisations the opportunities to gather and target this particular population, providing ready access to support programmes and services that not only minimise the harm of IV drug use, but also facilatate their entry into rehabilitation programmes.

This approach presupposes a particular interaction between LAW and MORALITY. It suggests that the legal acceptance of a particular behavior does not necessary correlate with a moral acceptance of that same behavior. The corollary of that is that our moral convictions does not necessarily need translate into a corresponding legal stance on the issue.

This, obviously, flies in the face of what so many of us assume about the nature of legislation, and the role of our Christian values in the interaction with greater society. It did for me, and has now led me to rethink and reflect on my own ethical system, and how a public health physician (an area I'm working towards) engages in policy formation that affects an entire non-Christian community. SHOULD the law reflect and ENFORCE morality by force? And on what basis can we actually enforce a SPECIFIC brand of morality - religious or not (eg: why don't we take pedophilia off the criminal code)?

These are difficult issues, issues that have been around since the Church started getting involved in Roman politics. But they are also crucial issues worth reflecting on. I'll post more as I sort out my thoughts ;)