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New Drug? No Thanks!

Dr. Scott — Thu, 23 Oct 2008 15:21:34 +0000

New Drug

New drugs are released all the time, usually to much fanfare and hype. The new drug often sound like a miracle: it works better than an old drug, it has less side effects, it will cure an incurable disease… While the hype surrounding a new drug almost always makes the drug sound great, the reality is that few drugs ever live up to their hype.

You may be tempted to try a new drug, especially if you are sick and in need of some relief, but this is a temptation you should avoid unless the condition you have is life threatening.

The reason why new drugs should be avoided is because they haven’t been thoroughly tested. While medical professionals would surely scoff at this idea – all drugs go through a rigorous testing before approval – the reality is that no drug can really be tested as well as it needs to be until it is released to the general public.

Real Life Drug Testing

A typical drug goes through three stages of testing, known as Phase 1, Phase 2 and Phase 3 testing.

Phase 1 testing is where the drug is testing in a laboratory setting. This is the so-called test-tube or in-vitro phase of testing. Scientists see if the drug can work in very controlled laboratory testing situation. In Phase 2 testing, drugs are then given to animals to see how they react to the drug. If Phase 1 and 2 look promising, then a drug moves on to a clinical phase where it is tested in humans.

During Phase 3 or human testing, the drug is given to a number of people (rarely numbering over 1000) and then, if the side effects are low enough and the drug actually proves to be effective, it will be approved. Some drugs have to go through a series of Phase 3 testing before being approved.

What you want to notice about this testing is that the drug has been tested, at most, in only 1000 people and usually the number of people who have tested the drug are much less.

The real life drug testing only begins when the drug is released and hundreds of thousands of people try it.

Who Does Drug Tests?

This is an interesting point and one to ponder. Who shows up to be a part of a drug test?

Usually the people who show up to try an experimental drug fall into two categories: The first are people who need money (college students or people down on their luck) and the second are people who have a condition who aren’t finding help through other means (a terminal cancer patient, or maybe someone who has a disease that no drug have been able to help).

The problem is that the people who usually use the drug are often not represented in the studies. This has lead to some strange situations where a drug meant for older patients has only been tested in younger patients, or a drug designed for women has only been tested in men.

How to Make a Decision about a New Drug

The only way to know if a new drug is safe is after it has been tested. But don’t be fooled, testing doesn’t happen in the laboratory; it happen in the real world after the drug is released. Only after a drug has been on the market for a number of years can you trust that most of the side-effects of the drug have been discovered.

Ask yourself these questions when considering a new drug:

Is the drug really necessary? Many new drugs offer only minor improvements over old drugs such as being longer lasting, or one pill instead of two. Is it really worth the risks for only a small improvement?
Has the drug been on the market long enough? I generally recommend that you don’t try a drug unless it has been on the market for at least two or three years, preferably five years.
What are your risks? If you have a terminal disease and the drug offers you hope, take it. The risks are moderated by your situation and it is always worth a try.

Ultimately, I think of drug therapy as a crutch, we all need some help every now and then, but we shouldn’t think of them as long-term solutions to problems. Drugs have side-effects because the change the way that your body works, unlike natural medicine that supports your body’s own healing mechanisms. New drugs can be harmful and should be avoided for everyone who is not in an emergency situation.

Our Faith in Medicine: Misplaced

Dr. Scott — Wed, 22 Oct 2008 11:32:35 +0000

Our Faith

Have you ever watched a television show or movie where someone from our time traveled to the future? Inevitably, sometime during the episode, the character from our time encounters the future medicine. The future doctor proclaims medicine’s triumph over some illness we think of as incurable. Cancer, leukemia, heart disease, autism, along with toenail fungus and bad breath have all been banished by the miracle of science and medicine. The future doctor can perform miracles with a mechanical magic-wand of sorts that he waves over wounds and even broken bones and they heal in seconds.

The reason television and movie writers can write that scene is because we never really question the underlying assumption that is the root for all these time-traveling episodes: that medicine will uncover a cure for everything… it only needs time.

This assumption, that science will discover all the answers to our health problems, crops up in all sorts of areas. Our faith in medicine is, for example, the reason why some dying people are willing to undergo experiments that might not help them, but might help someone in the future. They are willing to sacrifice themselves because they believe that a cure for their illness will eventually be found. It is also the reason why we get so excited about new drugs that hit the market (stay tuned because I have much more to say about new drugs in a future post).

Scientific Scoreboard

The reason why we have such faith in science is that it has appears to have a pretty good track record. The problem is that we have short memories. The faith we have in medicine probably began in the early to mid 1900s. The discovery of antibiotics, steroid anti-inflammatories, anesthesia and other chemically-based drugs truly was a miracle. But while many of these drugs were initially extremely helpful, they have failed to live up to their wonder-drug status due to overuse (as is the case with antibiotics) or side effects (as is the case with steroid anti-inflammatories).

While these wonder drugs worked well on acute illnesses (infection, pain, inflammation), medicine has had a much harder time wrestling with chronic diseases.

Imagine for a moment that today is the year 1971. You just watched Richard Nixon on the television tell you that he was declaring a War on Cancer. Finally, you think, we are going to spend money on finding a cure for cancer. You have faith in medicine and know they will find a cure if we only focus and spend money on research.

Spend money is exactly what they have done since the 1970s to the tune of nearly 1 billion dollars a year for research and drug development.

What have we gotten for our 40 billion dollars? Not much.

Cancer rates actually grew larger from 1971 to around 1995. Since that time, the percentage of cancer death rates has been dropping about 1 percent per year. That sounds like great news until you look closer at the statistics. What miracle drug do we say accounts for this drop? Actually, it isn’t drug, but the reduction in the number of smokers that accounts for a large percentage of this drop. Some of the drop in cancer death rates can be attributed to early detection of certain cancers such as breast, endometrial and prostate cancer.

So, after 40 years and 40 billion dollars worth of research, it is simple measures such as stopping smoking and regular medical checkups that accounts for the drop in cancer death rates.

What is even more astounding is that cancer incidence (the number of people getting cancer) has actually increased for many cancers over the last 40 years. That means that even though we have held the percentage of people who die from a certain cancer relatively steady, more and more people are getting cancer.

Other diseases follow similar tracks, with the main improvements in death rates not coming from science but from changes in our diets or improving lifestyle choices such as smoking or exposure to chemicals.

Where to Put Your Trust

I’m not saying that science is not helpful; in fact I feel the opposite, but our complete faith that science will find a cure for everything that ails us, I think, is misplaced. There are some things that science will just not be able to cure. There is no magic wand to wave over our skin to heal a cut or a broken bone or to remove all cancer from your body.

Your trust and faith shouldn’t lay in the scientist’s hands, but yours. You have the ability to affect your own health in ways no machine or drug ever could.

Health advice is not hard to find (especially since we all have access to the internet) and much of it is the same: eat better, exercise, reduce stress and sleep better. I would add that a major source of injury we do to ourselves has to do with our food choices and I generally recommend a diet that contains little to no grains or sugars (see my book Sugarettes).

My Television Show

I see a television show or movie where the time traveler meets the doctor of the future and the future doctor laughs at him when he asks the doctor if they can now cure cancer. “Cure cancer?” the future doctor says, “We haven’t learned how to cure it, but we now know how to prevent it be eating better, avoiding toxins, sleeping better and reducing stress. That is how we eradicated cancer.”