What happens when someone speaks out against the drugs industry?

People who work in healthcare and speak out to protect others pay the cost. What happens when someone with integrity speaks out against the financial interests of the pharmaceutical industry:

‘One of the medical world’s most respected expert bodies is in turmoil as its annual meeting gets underway in Edinburgh, Scotland, after its governing board voted to expel a member. The Cochrane Collaboration, which reviews the scientific literature in areas of clinical research and produces widely cited analyses that help guide clinical practice, kicked out a member who has been an outspoken critic of certain vaccines and has blasted the profession of psychiatry for pushing unsafe drugs on unsuspecting patients…’

https://www.statnews.com/2018/09/16/expulsion-cochrane-peter-gotzsche-medicine/

In a letter circulated by Peter Gotzsche on 14^th September 2018 he wrote:

‘As most people know, much of my work is not very favourable to the financial interests of the pharmaceutical industry. Because of this Cochrane has faced pressure, criticism and complaints.

My expulsion is one of the results of these campaigns.

What is at stake is the ability of producing credible and trustworthy medical evidence that our

society values and needs.’

A moral governance crisis: the growing lack of democratic collaboration and scientific pluralism in

Cochrane. Peter C Gotzsche, Professor, Director, MD, DrMedSci, MSc, Nordic Cochrane Centre, Rigshospitalet, Dept 7811.

https://nordic.cochrane.org/sites/nordic.cochrane.org/files/public/uploads/moral_crisis_in_cochrane.pdf

See also BMJ blogs

https://blogs.bmj.com/bmj/2018/09/17/ray-moynihan-lets-stop-the-burning-and-the-bleeding-at-cochrane-theres-too-much-at-stake/

https://blogs.bmj.com/bmj/2018/09/17/trish-greenhalgh-the-cochrane-collaboration-what-crisis/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+bmj%2Fblogs+%28Latest+BMJ+blogs%29&g=w_bmj-com

and

https://www.bmj.com/content/362/bmj.k3927/rapid-responses

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The world is waking up to the lack of benefit and harms of screening.

Renaming low risk conditions labelled as cancer BMJ 2018;362:k3322

This Analysis article discusses our changing understanding of the prognosis of cancers:

‘…These small papillary thyroid cancers are increasingly being detected because of new technologies, increased access to health services, and thyroid cancer screening.4 Studies show that rates of metastases, progression to clinical disease, and tumour growth in patients with small papillary thyroid cancer who receive immediate surgery are comparable with those in patients who follow active surveillance…’

https://www.bmj.com/content/362/bmj.k3322

and

‘What can add five years to your life without lengthening it by a single day, improve the performance of the NHS while wasting its resources, and make people grateful for unnecessary suffering?’

– this superb article by Michael Blastland in Prospect magazine explains precisely what – and why:

‘The dark side of early diagnosis’. – surely a ‘must read’ for anyone with the slightest interest in health and screening.

https://www.prospectmagazine.co.uk/magazine/early-diagnosis-cancer-screening-women-risk

Want to know?

What your patient is thinking – this book spills the beans, plus it has discussion sections and research links to better/evidence-based practice: Nothing Personal, disturbing undercurrents in cancer care. Radcliffe Publishing (Taylor & Francis – Routledge); CPD certified. (Winner, Medical Journalists’ Association Open Book Award 2009; RCN’s essay prize 2009.

“Today’s patients continue to raise the same issues, but clinicians are now being encouraged to get in touch with their feelings, so perhaps my story could be useful to patients and professionals alike.”

Breast cancer: old news re reduced need for chemotherapy

‘Good News for Women with Breast Cancer: many don’t need chemotherapy’ writes Denise Grady in the New York Times, 3 June 2018 reporting on a major international study.

The gene test, called Oncotype DX Breast Cancer Assay, is the focus of the study.

‘The availability of the gene test in 2004 helped researchers sort out women with very high or very low risk.

“But we really didn’t know what to do with women in the middle,” Dr. Mayer said. “Some seemed to benefit and some didn’t. We were back to square zero, safe rather than sorry, giving chemo to a lot who didn’t need it.”

“We can spare thousands and thousands of women from getting toxic treatment that really wouldn’t benefit them,” said Dr. Ingrid A. Mayer, from Vanderbilt University Medical Center, an author of the study. https://www.nytimes.com/2018/06/03/health/breast-cancer-chemo.html

– However, media cancer hype is usually followed by scientific/commonsense explanations and this ‘good news’ is no exception – see responses to the bmj article ‘Seven in 10 women with early breast cancer do not need chemotherapy, study finds’:

BMJ 2018;361:k2473

https://www.bmj.com/content/361/bmj.k2473/rapid-responses

 

Breast screening, cervical screening: simple explanations should help citizens and doctors

Cancer screenings and overdiagnosis: pick the outcome that matters.

Excellent article for those who want to understand the real issues around breast screening.

The super clear graphic from the Harding Centre for Risk Literacy shows outcomes for numbers of women aged 50 or older screened or unscreened (worse outcomes for younger women are mentioned later on).  This is something that all women invited to breast screening should be offered if they are to give informed consent!

The principles of a good screening test are examined. Uncomfortable questions such as, “How many women who do not have cancer deserve to be harmed in order to diagnose or prevent one case of cancer in another woman?” are followed by simple explanations and there are many useful links, including ‘Why Cancer Screening Has Never Been Shown to Save Lives’ (BMJ).

“We have to consider all outcomes, not just the one we are interested in. This is why we no longer recommend PSA screening for prostate cancer, chest x-rays for lung cancer screening, urine screening for neuroblastoma, etc. We were doing more harm than good.”

The article also looks at cervical screening.

Cancer screenings and overdiagnosis: pick the outcome that matters. Howard Herrell MD. Published on 9 February 2016.

http://www.howardisms.com/obgyn/cancer-screenings/

Driving licence renewal delays

Does anyone have experience of driving licence withdrawal (following fall/spectacular head trauma) and delayed return please? Being wheel-less is like being in prison. No seizure, no stroke, no brain cancer – ‘Apply after 3 months’ advised consultant. No chance. Protocol calls for 6 months’ ban. Buy groceries online…but can’t trawl shops for birthday bargains. Become dab hand at hacking hair with nail scissors….Eight weeks before end date, as advised, obtain copies of all medical data & send with DVLA renewal forms. Haunt front door mat each day around postie times. Two jaw-grinding weeks past 6 month date I ring DVLA only to learn that licence return now depends on manager’s workload/quantity = unknown. Hmm…Prison inmates get timely release, don’t they?#donemytime, #kafka

Breast screening trial: information and consent

‘Misleading’ invitations left patients feeing manipulated’ (Ben Rumsby and Deborah Cohen, The Sunday Telegraph, p 10, 27 May 2018).

How many women who accepted an invitation to breast screening when aged over 70 or under 50 were personally affected by the article ‘Women ‘duped’ into needless trial breast screenings’ in The Sunday Telegraph last Sunday, 27 May 2018?

If the original information sheet clearly stated that acceptance meant taking part in a clinical trial, why were so many changes required of it – so many times?

How many women have been entered into a clinical trial without realising it? The Age-X breast screening Trial has no consent process, as is usual when human beings are used in ‘experimental healthcare’.

For more information follow Susan Bewley on Twitter and Facebook.

Take a look at the HealthWatch-UK website (‘an independent charity for science and integrity in healthcare’, not the later NHS organisation) https://www.healthwatch-uk.org/

(See also: https://www.healthwatch-uk.org/news/150-times-letter-sparks-media-frenzy-screening.html )